Shoulder Fractures

MedlinePlus

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Elbow Fractures

MedlinePlus

... Lawnmower Safety Snowblower safety Pumpkin Carving Gardening Safety Turkey Carving Removing a Ring Fireworks Safety Español Artritis ... Lawnmower Safety Snowblower safety Pumpkin Carving Gardening Safety Turkey Carving Removing a Ring Fireworks Safety Español Artritis ...

Application of EREP imagery to fracture-related mine safety hazards and environmental problems in mining. [Indiana

NASA Technical Reports Server (NTRS)

Wier, C. E.; Wobber, F. J.; Amato, R. V.; Russell, O. R. (Principal Investigator)

1974-01-01

The author has identified the following significant results. All Skylab 2 imagery received to date has been analyzed manually and data related to fracture analysis and mined land inventories has been summarized on map-overlays. A comparison of the relative utility of the Skylab image products for fracture detection, soil tone/vegetation contrast mapping, and mined land mapping has been completed. Numerous fracture traces were detected on both color and black and white transparencies. Unique fracture trace data which will contribute to the investigator's mining hazards analysis were noted on the EREP imagery; these data could not be detected on ERTS-1 imagery or high altitude aircraft color infrared photography. Stream segments controlled by fractures or joint systems could be identified in more detail than with ERTS-1 imagery of comparable scale. ERTS-1 mine hazards products will be modified to demonstrate the value of this additional data. Skylab images were used successfully to update a mined land map of Indiana made in 1972. Changes in mined area as small as two acres can be identified. As the Energy Crisis increases the demand for coal, such demonstrations of the application of Skylab data to coal resources will take on new importance.

Analysis of orthopedic injuries in an airplane landing disaster and a suggested mechanism of trauma.

PubMed

Mirzatolooei, Fardin; Bazzazi, Amirmohammad

2013-04-01

Survival after an airplane disaster is rare. We describe the injuries of survivors of an airplane accident and present a common mechanism of trauma for victims. Descriptive data were gathered by interviews with patients, physical examination. Review of charts and patients X-ray films. Informations regarding the flight characteristics were obtained from Iran air safety board. All dead patients were clinically examined by legal medicine department. The suggested mechanism of trauma was established according to present knowledge of mechanism of fractures. From 105 passengers, 27 survived. There was no mortality during hospital course. Between dead passengers, lower extremity fractures were the most common followed by chest wall fractures. Among the survivors, neurosurgical help was needed only in one case for shunt application. Brain concussions and effusions and one hematoma managed conservatively. Two laparotomies were performed for one splenectomy and two hepatoraphy. One pelvic fracture and two femur fractures were occurred. Tibia fractures were the most common (17) followed by spine (14) fractures. Ten tibial fractures were open, and 15 were in distal third. All tibia fractures were fixed with IM locking nails or locking plates. Eight posterior instrumentations were applied for seven burst and two fracture-dislocations. In this landing accident, a combination of vertical loading along with deceleration force produced burst fractures of spine and distal leg fractures.

Materials Examination of the Vertical Stabilizer from American Airlines Flight 587

NASA Technical Reports Server (NTRS)

Fox, Matthew R.; Schultheisz, Carl R.; Reeder, James R.; Jensen, Brian J.

2005-01-01

The first in-flight failure of a primary structural component made from composite material on a commercial airplane led to the crash of American Airlines Flight 587. As part of the National Transportation Safety Board investigation of the accident, the composite materials of the vertical stabilizer were tested, microstructure was analyzed, and fractured composite lugs that attached the vertical stabilizer to the aircraft tail were examined. In this paper the materials testing and analysis is presented, composite fractures are described, and the resulting clues to the failure events are discussed.

Lack of evidence for a harmful effect of sodium-glucose co-transporter 2 (SGLT2) inhibitors on fracture risk among type 2 diabetes patients: a network and cumulative meta-analysis of randomized controlled trials.

PubMed

Tang, H L; Li, D D; Zhang, J J; Hsu, Y H; Wang, T S; Zhai, S D; Song, Y Q

2016-12-01

To evaluate the comparative effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on risk of bone fracture in patients with type 2 diabetes mellitus (T2DM). PubMed, EMBASE, CENTRAL and ClinicalTrials.gov were systematically searched from inception to 27 January 2016 to identify randomized controlled trials (RCTs) reporting the outcome of fracture in patients with T2DM treated with SGLT2 inhibitors. Pairwise and network meta-analyses, as well as a cumulative meta-analysis, were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 38 eligible RCTs (10 canagliflozin, 15 dapagliflozin and 13 empagliflozin) involving 30 384 patients, with follow-ups ranging from 24 to 160 weeks, were included. The fracture event rates were 1.59% in the SGLT2 inhibitor groups and 1.56% in the control groups. The incidence of fracture events was similar among these three SGLT2 inhibitor groups. Compared with placebo, canagliflozin (OR 1.15; 95% CI 0.71-1.88), dapagliflozin (OR 0.68; 95% CI 0.37-1.25) and empagliflozin (OR 0.93; 95% CI 0.74-1.18) were not significantly associated with an increased risk of fracture. Our cumulative meta-analysis indicated the robustness of the null findings with regard to SGLT2 inhibitors. Our meta-analysis based on available RCT data does not support the harmful effect of SGLT2 inhibitors on fractures, although future safety monitoring from RCTs and real-world data with detailed information on bone health is warranted. © 2016 John Wiley & Sons Ltd.

Applications of a damage tolerance analysis methodology in aircraft design and production

NASA Technical Reports Server (NTRS)

Woodward, M. R.; Owens, S. D.; Law, G. E.; Mignery, L. A.

1992-01-01

Objectives of customer mandated aircraft structural integrity initiatives in design are to guide material selection, to incorporate fracture resistant concepts in the design, to utilize damage tolerance based allowables and planned inspection procedures necessary to enhance the safety and reliability of manned flight vehicles. However, validated fracture analysis tools for composite structures are needed to accomplish these objectives in a timely and economical manner. This paper briefly describes the development, validation, and application of a damage tolerance methodology for composite airframe structures. A closed-form analysis code, entitled SUBLAM was developed to predict the critical biaxial strain state necessary to cause sublaminate buckling-induced delamination extension in an impact damaged composite laminate. An embedded elliptical delamination separating a thin sublaminate from a thick parent laminate is modelled. Predicted failure strains were correlated against a variety of experimental data that included results from compression after impact coupon and element tests. An integrated analysis package was developed to predict damage tolerance based margin-of-safety (MS) using NASTRAN generated loads and element information. Damage tolerance aspects of new concepts are quickly and cost-effectively determined without the need for excessive testing.

The Depths of Hydraulic Fracturing and Accompanying Water Use Across the United States.

PubMed

Jackson, Robert B; Lowry, Ella R; Pickle, Amy; Kang, Mary; DiGiulio, Dominic; Zhao, Kaiguang

2015-08-04

Reports highlight the safety of hydraulic fracturing for drinking water if it occurs "many hundreds of meters to kilometers underground". To our knowledge, however, no comprehensive analysis of hydraulic fracturing depths exists. Based on fracturing depths and water use for ∼44,000 wells reported between 2010 and 2013, the average fracturing depth across the United States was 8300 ft (∼2500 m). Many wells (6900; 16%) were fractured less than a mile from the surface, and 2600 wells (6%) were fractured above 3000 ft (900 m), particularly in Texas (850 wells), California (720), Arkansas (310), and Wyoming (300). Average water use per well nationally was 2,400,000 gallons (9,200,000 L), led by Arkansas (5,200,000 gallons), Louisiana (5,100,000 gallons), West Virginia (5,000,000 gallons), and Pennsylvania (4,500,000 gallons). Two thousand wells (∼5%) shallower than one mile and 350 wells (∼1%) shallower than 3000 ft were hydraulically fractured with >1 million gallons of water, particularly in Arkansas, New Mexico, Texas, Pennsylvania, and California. Because hydraulic fractures can propagate 2000 ft upward, shallow wells may warrant special safeguards, including a mandatory registry of locations, full chemical disclosure, and, where horizontal drilling is used, predrilling water testing to a radius 1000 ft beyond the greatest lateral extent.

Fracture analysis of radial scientific instrument module registration fittings of the space telescope

NASA Technical Reports Server (NTRS)

Springfield, C. W., Jr.

1985-01-01

The space telescope contains various scientific instrument (SI) modules which are mounted to the Focal Plane Structure (FPS) in a statically determinate manner. This is accomplished by using three registration fittings per SI module, one resisting three translations, another resisting two and the third resisting only one. Due to thermal insulating requirements these fittings are complex devices composed of numerous pieces. The structural integrity of these fittings is of great importance to the safety of the orbiter transporting the telescope, so in addition to the stress analyses performed during the design of these components, fracture susceptibility also needs to be considered. The pieces of the registration fittings for the Radial SI Module containing the Wide Field Planetary Camera are examined to determine which would endanger the orbiter if they fractured and what is the likelihood of their fracture. The latter is stated in terms of maximum allowable initial flaw sizes in these pieces.

Incidence of trampoline related pediatric fractures in a large district general hospital in the United Kingdom: lessons to be learnt

PubMed Central

Bhangal, K K; Neen, D; Dodds, R

2006-01-01

Aim To test the observation that the incidence of trampoline related pediatric fractures is increasing—both nationally and in a large district general hospital. Method A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000–03. Theatre records of fractures treated operatively were used as the initial data source. Results A statistically significant increase in trampoline related injuries was discovered. This reflects the rising incidence of injuries from national data and furthermore corresponds to the growing popularity of domestic use trampolines in the UK. Conclusion The incidence of injuries is increasing. There are lessons to be learnt from existing work from countries where trampoline prevalence has been greater for longer. The authors recommend various safety measures that may reduce children's injuries. PMID:16595431

The Role of Unilateral Balloon Kyphoplasty for the Treatment of Patients with OVCFS: A Systematic Review and Meta-Analysis.

PubMed

Xiang, Guang-Heng; Tong, Min-Ji; Lou, Chao; Zhu, Si-Pin; Guo, Wei Jun; Ke, Chen Rong

2018-05-01

An increasing number of studies have been conducted to apply unilateral balloon kyphoplasty in the treatment of ostroporotic vertebral compression fractures (OVCFs). However, the efficacy and safety of unilateral kyphoplasty and whether a unilateral or a bilateral approach is superior is controversial. The purpose of this study was to evaluate the role of unilateral balloon kyphoplasty and use meta-analysis to compare the efficacy and safety of unilateral and bilateral kyphoplasty in patients with OVCFs. A systematic literature search was conducted from 1970 to April 2017 using Medline database and the Cochrane Central Register of Controlled Trials. Articles were limited to those published in English. Randomized controlled trials and nonrandomized comparative studies were also included. The following search terms were used: "osteoporotic vertebral compression fractures," or "OVCF," and "unilateral kyphoplasty," or "unipedicular approach," or "single balloon kyphoplasty," or "one balloon kyphoplasty." A comprehensive search of reference lists of retrieved articles and previous published reviews was also performed to ensure inclusion of all possible studies. All potential articles were independently reviewed by 2 investigators for inclusion into the final analysis. MINORS score was used for nonrandomized studies, and Detsky quality index was applied for prospective randomized controlled trials. Systematic review and meta-analysis was performed for the included studies. After unilateral balloon kyphoplasty the mean postoperative visual analog score (VAS) was from 1.74 to 4.77, mean postoperative kyphotic angle was from 5.9º to 11.22º, and complications involving cement leaks was from 6.8 to 21.9% or adjacent level fractures was from 0 to 5.6%). Unilateral kyphoplasty had significantly lower operative time, and less bone cement volume; however, the postoperative VAS, Oswestry Disability Index (ODI), vertebral height restoration rate, and cement leakage and adjacent vertebral fracture rate, were similar to bilateral kyphoplasty. Only 6 randomized controlled trials and 3 retrospective comparative studies were selected for analysis. Heterogeneity was detected among the studies when we pooled the outcomes. Based on the available evidence, the clinical and radiological results of unilateral balloon kyphoplasty were as good as those of bilateral balloon kyphoplasty for the treatment of OVCFs. And unilateral kyphoplasty had advantages in terms of operation time, radiation exposure, and cost. Unilateral balloon kyphoplasty, bilateral balloon kyphoplasty, osteoporotic vertebral compression fractures, complications of balloon kyphoplasty, meta-analysis.

Strontium ranelate reduces the risk of vertebral and nonvertebral fractures in women eighty years of age and older.

PubMed

Seeman, Ego; Vellas, Bruno; Benhamou, Claude; Aquino, Jean Pierre; Semler, Jutta; Kaufman, Jean Marc; Hoszowski, Krzysztof; Varela, Alfredo Roces; Fiore, Carmelo; Brixen, Kim; Reginster, Jean Yves; Boonen, Steven

2006-07-01

Strontium ranelate produces an early and sustained reduction of both vertebral and nonvertebral fractures in patients > or = 80 years of age. About 25-30% of the population burden of all fragility fractures in the community arise from women > or = 80 years of age, because this population is at high risk for all types of fracture, particularly nonvertebral fractures. Despite this, evidence that therapies reduce the risk of both vertebral and nonvertebral fractures in this group is lacking. The aim of this study was to determine whether strontium ranelate, an agent that reduces the risk of vertebral and nonvertebral fractures in postmenopausal women >50 years of age, also reduces fractures in the elderly. An analysis based on preplanned pooling of data from two international, phase III, randomized, placebo-controlled, double-blind studies (the Spinal Osteoporosis Therapeutic Intervention [SOTI] and TReatment Of Peripheral OSteoporosis [TROPOS]) included 1488 women between 80 and 100 years of age followed for 3 years. Yearly spinal X-rays were performed in 895 patients. Only radiographically confirmed nonvertebral fractures were included. Baseline characteristics did not differ in placebo and treatment arms. In the intent-to-treat analysis, the risk of vertebral, nonvertebral, and clinical (symptomatic vertebral and nonvertebral) fractures was reduced within 1 year by 59% (p = 0.002), 41% (p = 0.027), and 37% (p = 0.012), respectively. At the end of 3 years, vertebral, nonvertebral, and clinical fracture risks were reduced by 32% (p = 0.013), 31% (p = 0.011), and 22% (p = 0.040), respectively. The medication was well tolerated, and the safety profile was similar to that in younger patients. Treatment with strontium ranelate safely reduces the risk of vertebral and nonvertebral fractures in women with osteoporosis > or = 80 years of age. Even in the oldest old, it is not too late to reduce fracture risk.

Fracture of Structural Materials under Dynamic Loading

DTIC Science & Technology

1981-03-25

in character- izing the dynamic fracture resistance of materials, and in designing equipment and procedures for measuring dynamic fracture toughness...useful in assessing the safety of structures under dynamic loads, in characterizing the dyraamic fracture resistance of materials, and in designing ...I INTRODUCTION Structures used by the United States Air Force must be designed to resist catastrophic fracture when subjected ti dynamic loads. For

The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals

PubMed Central

Shaw, Charles D.; Groene, Oliver; Botje, Daan; Sunol, Rosa; Kutryba, Basia; Klazinga, Niek; Bruneau, Charles; Hammer, Antje; Wang, Aolin; Arah, Onyebuchi A.; Wagner, Cordula; Klazinga, N; Kringos, DS; Lombarts, K; Plochg, T; Lopez, MA; Secanell, M; Sunol, R; Vallejo, P; Bartels, P; Kristensen, S; Michel, P; Saillour-Glenisson, F; Vlcek, F; Car, M; Jones, S; Klaus, E; Garel, P; Hanslik, K; Saluvan, M; Bruneau, C; Depaigne-Loth, A; Shaw, C; Hammer, A; Ommen, O; Pfaff, H; Groene, O; Botje, D; Wagner, C; Kutaj-Wasikowska, H; Kutryba, B; Escoval, A; Franca, M; Almeman, F; Kus, H; Ozturk, K; Mannion, R; Arah, OA; Chow, A; DerSarkissian, M; Thompson, C; Wang, A; Thompson, A

2014-01-01

Objective To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. Setting and Participants Seventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Main Outcome Measure Four composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways. Results Accreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke). Conclusions Accreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes. PMID:24615598

The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals.

PubMed

Shaw, Charles D; Groene, Oliver; Botje, Daan; Sunol, Rosa; Kutryba, Basia; Klazinga, Niek; Bruneau, Charles; Hammer, Antje; Wang, Aolin; Arah, Onyebuchi A; Wagner, Cordula

2014-04-01

To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. Seventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Four composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways. Accreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke). Accreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes.

A Multi-Parameter Approach for Calculating Crack Instability

NASA Technical Reports Server (NTRS)

Zanganeh, M.; Forman, R. G.

2014-01-01

An accurate fracture control analysis of spacecraft pressure systems, boosters, rocket hardware and other critical low-cycle fatigue cases where the fracture toughness highly impacts cycles to failure requires accurate knowledge of the material fracture toughness. However, applicability of the measured fracture toughness values using standard specimens and transferability of the values to crack instability analysis of the realistically complex structures is refutable. The commonly used single parameter Linear Elastic Fracture Mechanics (LEFM) approach which relies on the key assumption that the fracture toughness is a material property would result in inaccurate crack instability predictions. In the past years extensive studies have been conducted to improve the single parameter (K-controlled) LEFM by introducing parameters accounting for the geometry or in-plane constraint effects]. Despite the importance of the thickness (out-of-plane constraint) effects in fracture control problems, the literature is mainly limited to some empirical equations for scaling the fracture toughness data] and only few theoretically based developments can be found. In aerospace hardware where the structure might have only one life cycle and weight reduction is crucial, reducing the design margin of safety by decreasing the uncertainty involved in fracture toughness evaluations would result in lighter hardware. In such conditions LEFM would not suffice and an elastic-plastic analysis would be vital. Multi-parameter elastic plastic crack tip field quantifying developments combined with statistical methods] have been shown to have the potential to be used as a powerful tool for tackling such problems. However, these approaches have not been comprehensively scrutinized using experimental tests. Therefore, in this paper a multi-parameter elastic-plastic approach has been used to study the crack instability problem and the transferability issue by considering the effects of geometrical constraints as well as the thickness. The feasibility of the approach has been examined using a wide range of specimen geometries and thicknesses manufactured from 7075-T7351 aluminum alloy.

The Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) study: 2-year nonvertebral fragility fracture results.

PubMed

Silverman, S; Miller, P; Sebba, A; Weitz, M; Wan, X; Alam, J; Masica, D; Taylor, K A; Ruff, V A; Krohn, K

2013-08-01

This observational study evaluated the occurrence of nonvertebral fragility fractures (NVFX) in over 4,000 men and women with osteoporosis treated with teriparatide (TPTD). The incidence of new NVFX decreased for patients receiving TPTD treatment for greater than 6 months. No new significant safety findings were observed in this large trial. The Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) study evaluated the occurrence of NVFX in patients receiving TPTD for osteoporosis in a real-world setting. DANCE is a multicenter, prospective, observational trial that examined the long-term effectiveness of TPTD in men and women with osteoporosis whom study physicians judged to be suitable for TPTD therapy. Patients received 20 μg TPTD per day by subcutaneous injection for up to 24 months and were followed for 24 months after treatment cessation. The incidence of patients experiencing a new NVFX, defined as a fracture associated with low trauma, was evaluated during four 6-month periods in both the treatment and cessation phases with >0 to ≤6 months serving as the reference. We also observed the spectrum and occurrence of serious adverse events. Of the 4,167 patients enrolled, 4,085 took one or more doses of TPTD (safety population); 3,720 were included in the efficacy analysis. The incidence of patients experiencing a NVFX was 1.42, 0.91, 0.70, and 0.81 % for the four treatment periods, respectively, and 0.80, 0.68, 0.33, and 0.33 % for the four periods after treatment cessation. Differences for each period were statistically significant compared with the reference period (first 6-month interval, each p < 0.05). No new significant safety findings were observed. In this study, the incidence of NVFX decreased for patients receiving TPTD for all three treatment periods >6 months compared to 0 to ≤6 months, and this trend persisted throughout the cessation phase. TPTD was generally well tolerated.

Hydraulic fracturing near domestic groundwater wells.

PubMed

Jasechko, Scott; Perrone, Debra

2017-12-12

Hydraulic fracturing operations are generating considerable discussion about their potential to contaminate aquifers tapped by domestic groundwater wells. Groundwater wells located closer to hydraulically fractured wells are more likely to be exposed to contaminants derived from on-site spills and well-bore failures, should they occur. Nevertheless, the proximity of hydraulic fracturing operations to domestic groundwater wells is unknown. Here, we analyze the distance between domestic groundwater wells (public and self-supply) constructed between 2000 and 2014 and hydraulically fractured wells stimulated in 2014 in 14 states. We show that 37% of all recorded hydraulically fractured wells stimulated during 2014 exist within 2 km of at least one recently constructed (2000-2014) domestic groundwater well. Furthermore, we identify 11 counties where most ([Formula: see text]50%) recorded domestic groundwater wells exist within 2 km of one or more hydraulically fractured wells stimulated during 2014. Our findings suggest that understanding how frequently hydraulic fracturing operations impact groundwater quality is of widespread importance to drinking water safety in many areas where hydraulic fracturing is common. We also identify 236 counties where most recorded domestic groundwater wells exist within 2 km of one or more recorded oil and gas wells producing during 2014. Our analysis identifies hotspots where both conventional and unconventional oil and gas wells frequently exist near recorded domestic groundwater wells that may be targeted for further water-quality monitoring.

Hydraulic fracturing near domestic groundwater wells

PubMed Central

Jasechko, Scott; Perrone, Debra

2017-01-01

Hydraulic fracturing operations are generating considerable discussion about their potential to contaminate aquifers tapped by domestic groundwater wells. Groundwater wells located closer to hydraulically fractured wells are more likely to be exposed to contaminants derived from on-site spills and well-bore failures, should they occur. Nevertheless, the proximity of hydraulic fracturing operations to domestic groundwater wells is unknown. Here, we analyze the distance between domestic groundwater wells (public and self-supply) constructed between 2000 and 2014 and hydraulically fractured wells stimulated in 2014 in 14 states. We show that 37% of all recorded hydraulically fractured wells stimulated during 2014 exist within 2 km of at least one recently constructed (2000–2014) domestic groundwater well. Furthermore, we identify 11 counties where most (>50%) recorded domestic groundwater wells exist within 2 km of one or more hydraulically fractured wells stimulated during 2014. Our findings suggest that understanding how frequently hydraulic fracturing operations impact groundwater quality is of widespread importance to drinking water safety in many areas where hydraulic fracturing is common. We also identify 236 counties where most recorded domestic groundwater wells exist within 2 km of one or more recorded oil and gas wells producing during 2014. Our analysis identifies hotspots where both conventional and unconventional oil and gas wells frequently exist near recorded domestic groundwater wells that may be targeted for further water-quality monitoring. PMID:29180405

Patterns and perspectives in applied fracture mechanics

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

Merkle, J.G.

1994-12-31

This lecture begins with a overview of applied fracture mechanics pertinent to safety of pressure vessels. It then progresses to a chronological panorama of experimental and analytical results. To be useful and dependable in safety analysis of real structures, new analysis developments must be physically realistic, which means that they must accurately describe physical cause and effect. Consequently, before mathematical modeling can begin, cause and effect must be established from experimental data. This can be difficult and time consuming, but worth the effort. Accordingly, the theme of this paper is that the search for patterns is constant and vital. Thismore » theme is illustrated by the development of small, single-specimen, fracture toughness testing techniques. It is also illustrated by the development, based on two different published large-strain, elastic-plastic, three-dimensional finite-element analyses, of a hypothesis concerning three-dimensional loss of constraint. When a generalization of Irwin`s thickness-normalized plastic-zone parameter, reaches a value close to 2{pi}, the through-thickness contraction strain at the apex of the near-tip logarithmic-spiral slip-line region becomes the dominant negative strain accommodating crack opening. Because slip lines passing from the midplane to the stress-free side surfaces do not have to curve, once these slip lines are established, stresses near the crack tip are only elevated by strain hardening and constraint becomes significantly relaxed. This hypothesis, based on published three-dimensional elastic-plastic analyses, provides a potentially valuable means for gaining additional insight into constraint effects on fracture toughness by considering the roles played by the plastic strains as well as the stresses that develop near a crack tip.« less

Safety of silastic sheet for orbital wall reconstruction.

PubMed

Moon, Seong June; Suh, Hyun Suk; Park, Bo Young; Kang, So Ra

2014-07-01

Many implants are being used for the reconstruction of orbital wall fractures. The effect of the choice of implant for the reconstruction of an orbital wall fracture on the surgical outcome is under debate. The purpose of this article is to compare the outcomes of orbital wall reconstruction of small orbital wall fractures on the basis of the implants used. The authors conducted a retrospective study using electronic databases. Between March 2001 and December 2012, 461 patients with orbital wall fractures were included in this study. Among them, 431 patients in whom the fracture size was less than 300 mm(2) were analyzed. The fracture size was calculated using computed tomography scans of the orbit in the sagittal and coronal images. Cases in which the fracture size was less than 300 mm(2) were included in this study. One hundred and twenty-nine patients were treated with silastic sheets; 238 patients were treated with titanium meshes; and absorbable meshes were used in the case of 64 patients. Overall, 13 patients required revision, and the revision rate was 3.0%. The revision rate of the silastic sheet group was 5.4%. In the multivariable analysis, the revision rate of the group reconstructed with silastic sheets was highly statistically significant (P=0.043, odds ratio=3.65). However, other factors such as age, sex, fracture type, and fracture size were not significant. Reconstruction of orbital wall fractures with silastic sheets may cause more complications than that with other materials such as titanium meshes and absorbable meshes.

DFN Modeling for the Safety Case of the Final Disposal of Spent Nuclear Fuel in Olkiluoto, Finland

NASA Astrophysics Data System (ADS)

Vanhanarkaus, O.

2017-12-01

Olkiluoto Island is a site in SW Finland chosen to host a deep geological repository for high-level nuclear waste generated by nuclear power plants of power companies TVO and Fortum. Posiva, a nuclear waste management organization, submitted a construction license application for the Olkiluoto repository to the Finnish government in 2012. A key component of the license application was an integrated geological, hydrological and biological description of the Olkiluoto site. After the safety case was reviewed in 2015 by the Radiation and Nuclear Safety Authority in Finland, Posiva was granted a construction license. Posiva is now preparing an updated safety case for the operating license application to be submitted in 2022, and an update of the discrete fracture network (DFN) model used for site characterization is part of that. The first step describing and modelling the network of fractures in the Olkiluoto bedrock was DFN model version 1 (2009), which presented an initial understanding of the relationships between rock fracturing and geology at the site and identified the important primary controls on fracturing. DFN model version 2 (2012) utilized new subsurface data from additional drillholes, tunnels and excavated underground facilities in ONKALO to better understand spatial variability of the geological controls on geological and hydrogeological fracture properties. DFN version 2 connected fracture geometric and hydraulic properties to distinct tectonic domains and to larger-scale hydraulically conductive fault zones. In the version 2 DFN model, geological and hydrogeological models were developed along separate parallel tracks. The version 3 (2017) DFN model for the Olkiluoto site integrates geological and hydrogeological elements into a single consistent model used for geological, rock mechanical, hydrogeological and hydrogeochemical studies. New elements in the version 3 DFN model include a stochastic description of fractures within Brittle Fault Zones (BFZ), integration of geological and hydrostructural interpretations of BFZ, greater use of 3D geological models to better constrain the spatial variability of fracturing and fractures using hydromechanical principles to account for material behavior and in-situ stresses.

Safety of saxagliptin: events of special interest in 9156 patients with type 2 diabetes mellitus.

PubMed

Hirshberg, Boaz; Parker, Artist; Edelberg, Helen; Donovan, Mark; Iqbal, Nayyar

2014-10-01

A post hoc pooled analysis was undertaken to evaluate the safety of saxagliptin in patients with type 2 diabetes mellitus, with attention to events of special interest for dipeptidyl peptidase-4 inhibitors. Pooled analyses were performed for 20 randomized controlled studies (N = 9156) of saxagliptin as monotherapy or add-on therapy, and a subset of 11 saxagliptin + metformin studies. Adverse events and events of special interest (gastrointestinal adverse events, infections, hypersensitivity, pancreatitis, skin lesions, lymphopenia, thrombocytopenia, hypoglycaemia, bone fracture, severe cutaneous adverse reactions, opportunistic infection, angioedema, malignancy, worsening renal function, and specific laboratory events) were assessed; incidence rates (events/100 person-years) and incidence rates ratios (saxagliptin/control) were calculated (Mantel-Haenszel method). In both pooled datasets, the incidence rates for deaths, serious adverse events, discontinuations due to adverse events, pancreatitis, malignancy, and most other events of special interest, excepting bone fractures and hypersensitivity, were similar between treatments, with 95% confidence intervals (CIs) for incidence rates ratios including 1. In the 20-study pool, the incidence rates per 100 person-years was higher with saxagliptin versus control for bone fractures [1.1 vs 0.6; incidence rates ratio (95% CI), 1.81 (1.04-3.28)] and hypersensitivity adverse events [1.3 vs 0.8; 1.67 (1.01-2.87)]. Pooled data from 20 studies confirm that saxagliptin has a favourable safety and benefit-risk profile. Copyright © 2013 John Wiley & Sons, Ltd.

Damage Tolerance Assessment Branch

NASA Technical Reports Server (NTRS)

Walker, James L.

2013-01-01

The Damage Tolerance Assessment Branch evaluates the ability of a structure to perform reliably throughout its service life in the presence of a defect, crack, or other form of damage. Such assessment is fundamental to the use of structural materials and requires an integral blend of materials engineering, fracture testing and analysis, and nondestructive evaluation. The vision of the Branch is to increase the safety of manned space flight by improving the fracture control and the associated nondestructive evaluation processes through development and application of standards, guidelines, advanced test and analytical methods. The Branch also strives to assist and solve non-aerospace related NDE and damage tolerance problems, providing consultation, prototyping and inspection services.

Clinical efficacy and safety of denosumab in postmenopausal women with low bone mineral density and osteoporosis: a meta-analysis.

PubMed

von Keyserlingk, Camilla; Hopkins, Robert; Anastasilakis, Athanasios; Toulis, Konstantinos; Goeree, Ron; Tarride, Jean-Eric; Xie, Feng

2011-10-01

Clinical trials indicate that denosumab could be a potential treatment for postmenopausal osteoporosis. The objective of this meta-analysis was to assess the clinical efficacy and safety of offering denosumab to postmenopausal women with low bone mass. Data sources included MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to February 3, 2010 and bibliographies of reviews. Randomized controlled trials comparing the efficacy and safety of denosumab to placebo for treatment of low bone mass (low bone mineral density or osteoporosis) in postmenopausal women were selected. Two reviewers independently abstracted data on study general characteristics and outcomes. Review Manager 5.0 software was used for data syntheses and meta-analysis. The database search revealed 4 studies (comprising 8864 patients randomized) that met the inclusion criteria and contributed to some or all of the meta-analysis outcomes. Relative risk (95% CI) of fractures for the denosumab compared with placebo group was 0.58 (0.52 to 0.66); relative risk (95% CI) of serious adverse events was 1.33 (0.83 to 2.14); relative risk (95% CI) of serious adverse events related to infection was 2.10 (0.64 to 6.90); relative risk (95% CI) of neoplasm was 1.11 (0.91 to 1.36); relative risk (95% CI) of study discontinuation due to adverse events was 1.10 (0.83 to 1.47); and relative risk (95% CI) of death was 0.78 (0.57 to 1.06). Findings remained robust to sensitivity analyses. Our analysis found a significant reduction in relative fracture risk in the denosumab compared with the placebo group. Copyright © 2011 Elsevier Inc. All rights reserved.

Vitamin D supplementation and fracture risk

USDA-ARS?s Scientific Manuscript database

This letter is written in response to an editorial by Gray and Bolland stating incorrectly that vitamin D does not reduce fracture risk and that safety of vitamin D has not been demonstrated. We and others have demonstrated that vitamin D is effective in lowering risk of fractures when given in adeq...

Fractures in New Zealand Elementary School Settings

ERIC Educational Resources Information Center

Rubie-Davies, Christine M.; Townsend, Michael A. R.

2007-01-01

Background: There is a need for greater international understanding of student safety in schools. This New Zealand study investigated the causes and school location of fractures sustained by students attending elementary school, with special emphasis on the types of fractures sustained following falls from playground equipment of various heights.…

Finite element analysis on a medical implant.

PubMed

Semenescu, Augustin; Radu-Ioniță, Florentina; Mateș, Ileana Mariana; Bădică, Petre; Batalu, Nicolae Dan; Negoita, Olivia Doina; Purcarea, Victor Lorin

2016-01-01

Several studies have shown a tight connection between several ocular pathologies and an increased risk of hip fractures due to falling, especially among elderly patients. The total replacement of the hip joint is a major surgical intervention that aims to restore the function of the affected hip by various factors, such as arthritis, injures, and others. A corkscrew-like femoral stem was designed in order to preserve the bone stock and to prevent the occurrence of iatrogenic fractures during the hammering of the implant. In this paper, the finite element analysis for the proposed design was applied, considering different loads and three types of materials. A finite element analysis is a powerful tool to simulate, optimize, design, and select suitable materials for new medical implants. The results showed that the best scenario was for Ti6Al4V alloy, although Ti and 316L stainless steel had a reasonable high safety factor.

Origin of Permeability and Structure of Flows in Fractured Media

NASA Astrophysics Data System (ADS)

De Dreuzy, J.; Darcel, C.; Davy, P.; Erhel, J.; Le Goc, R.; Maillot, J.; Meheust, Y.; Pichot, G.; Poirriez, B.

2013-12-01

After more than three decades of research, flows in fractured media have been shown to result from multi-scale geological structures. Flows result non-exclusively from the damage zone of the large faults, from the percolation within denser networks of smaller fractures, from the aperture heterogeneity within the fracture planes and from some remaining permeability within the matrix. While the effect of each of these causes has been studied independently, global assessments of the main determinisms is still needed. We propose a general approach to determine the geological structures responsible for flows, their permeability and their organization based on field data and numerical modeling [de Dreuzy et al., 2012b]. Multi-scale synthetic networks are reconstructed from field data and simplified mechanical modeling [Davy et al., 2010]. High-performance numerical methods are developed to comply with the specificities of the geometry and physical properties of the fractured media [Pichot et al., 2010; Pichot et al., 2012]. And, based on a large Monte-Carlo sampling, we determine the key determinisms of fractured permeability and flows (Figure). We illustrate our approach on the respective influence of fracture apertures and fracture correlation patterns at large scale. We show the potential role of fracture intersections, so far overlooked between the fracture and the network scales. We also demonstrate how fracture correlations reduce the bulk fracture permeability. Using this analysis, we highlight the need for more specific in-situ characterization of fracture flow structures. Fracture modeling and characterization are necessary to meet the new requirements of a growing number of applications where fractures appear both as potential advantages to enhance permeability and drawbacks for safety, e.g. in energy storage, stimulated geothermal energy and non-conventional gas productions. References Davy, P., et al. (2010), A likely universal model of fracture scaling and its consequence for crustal hydromechanics, Journal of Geophysical Research-Solid Earth, 115, 13. de Dreuzy, J.-R., et al. (2012a), Influence of fracture scale heterogeneity on the flow properties of three-dimensional Discrete Fracture Networks (DFN), J. Geophys. Res.-Earth Surf., 117(B11207), 21 PP. de Dreuzy, J.-R., et al. (2012b), Synthetic benchmark for modeling flow in 3D fractured media, Computers and Geosciences(0). Pichot, G., et al. (2010), A Mixed Hybrid Mortar Method for solving flow in Discrete Fracture Networks, Applicable Analysis, 89(10), 1729-1643. Pichot, G., et al. (2012), Flow simulation in 3D multi-scale fractured networks using non-matching meshes, SIAM Journal on Scientific Computing (SISC), 34(1). Figure: (a) Fracture network with a broad-range of fracture lengths. (b) Flows (log-scale) with homogeneous fractures. (c) Flows (log-scale) with heterogeneous fractures [de Dreuzy et al., 2012a]. The impact of the fracture apertures (c) is illustrated on the organization of flows.

Study of application of ERTS-1 imagery to fracture-related mine safety hazards in the coal mining industry

NASA Technical Reports Server (NTRS)

Wier, C. E. (Principal Investigator); Wobber, F. J. (Principal Investigator); Russell, O. R.; Amato, R. V.

1972-01-01

The author has identified the following significant results. Numerous fractures are identifiable on the 1:120,000 color infrared photography. Some of these fractures are in the proximity of operating open pit mines and should provide opportunities for field checking and confirmation.

Composite Structures Damage Tolerance Analysis Methodologies

NASA Technical Reports Server (NTRS)

Chang, James B.; Goyal, Vinay K.; Klug, John C.; Rome, Jacob I.

2012-01-01

This report presents the results of a literature review as part of the development of composite hardware fracture control guidelines funded by NASA Engineering and Safety Center (NESC) under contract NNL04AA09B. The objectives of the overall development tasks are to provide a broad information and database to the designers, analysts, and testing personnel who are engaged in space flight hardware production.

Economic Analysis of Kiva VCF Treatment System Compared to Balloon Kyphoplasty Using Randomized Kiva Safety and Effectiveness Trial (KAST) Data.

PubMed

Beall, Douglas P; Olan, Wayne J; Kakad, Priyanka; Li, Qianyi; Hornberger, John

2015-01-01

Vertebral compression fractures (VCFs) are the most common osteoporotic fractures and cause persistent pain, kyphotic deformity, weight loss, depression, reduced quality of life, and even death. Current surgical approaches for the treatment of VCF include vertebroplasty (VP) and balloon kyphoplasty (BK). The Kiva® VCF Treatment System (Kiva System) is a next-generation alternative surgical intervention in which a percutaneously introduced nitinol Osteo Coil guidewire is advanced through a deployment cannula and subsequently a PEEK Implant is implanted incrementally and fully coiled in the vertebral body. The Kiva System's effectiveness for the treatment of VCF has been evaluated in a large randomized controlled trial, the Kiva Safety and Effectiveness Trial (KAST). The Kiva System was non-inferior to BK with respect to pain reduction (70.8% vs. 71.8% in Visual Analogue Scale) and physical function restoration (38.1 % vs. 42.2% reduction in Oswestry Disability Index) while using less bone cement. The economic impact of the Kiva system has yet to be analyzed. To analyze hospital resource use and costs of the Kiva System over 2 years for the treatment of VCF compared to BK. A representative US hospital. Economic analysis of the KAST randomized trial, focusing on hospital resource use and costs. The analysis was conducted from a hospital perspective and utilized clinical data from KAST as well as unit-cost data from the published literature. The cost of initial VCF surgery, reoperation cost, device market cost, and other medical costs were compared between the Kiva System and BK. The relative risk reduction rate in adjacent-level fracture with Kiva [31.6% (95% CI: -22.5%, 61.9%)] demonstrated in KAST was used in this analysis. With 304 vertebral augmentation procedures performed in a representative U.S. hospital over 2 years, the Kiva System will produce a direct medical cost savings of $1,118 per patient and $280,876 per hospital. This cost saving with the Kiva System was attributable to 19 reduced adjacent-level fractures with the Kiva System. This study does not compare the Kiva System with VP or any other non-surgical procedures for the treatment of VCF. This first-ever economic analysis of the KAST data showed that the Kiva System for vertebral augmentation is hospital resource and cost saving over BK in a hospital setting over 2 years. These savings are attributable to reduced risk of developing adjacent-level fractures with the Kiva System compared to BK.

KAST Study: The Kiva System As a Vertebral Augmentation Treatment-A Safety and Effectiveness Trial: A Randomized, Noninferiority Trial Comparing the Kiva System With Balloon Kyphoplasty in Treatment of Osteoporotic Vertebral Compression Fractures.

PubMed

Tutton, Sean M; Pflugmacher, Robert; Davidian, Mark; Beall, Douglas P; Facchini, Francis R; Garfin, Steven R

2015-06-15

The KAST (Kiva Safety and Effectiveness Trial) study was a pivotal, multicenter, randomized control trial for evaluation of safety and effectiveness in the treatment of patients with painful, osteoporotic vertebral compression fractures (VCFs). The objective was to demonstrate noninferiority of the Kiva system to balloon kyphoplasty (BK) with respect to the composite primary endpoint. Annual incidence of osteoporotic VCFs is prevalent. Optimal treatment of VCFs should address pain, function, and deformity. Kiva is a novel implant for vertebral augmentation in the treatment of VCFs. A total of 300 subjects with 1 or 2 painful osteoporotic VCFs were randomized to blindly receive Kiva (n = 153) or BK (n = 147). Subjects were followed through 12 months. The primary endpoint was a composite at 12 months defined as a reduction in fracture pain by at least 15 mm on the visual analogue scale, maintenance or improvement in function on the Oswestry Disability Index, and absence of device-related serious adverse events. Secondary endpoints included cement usage, extravasation, and adjacent level fracture. A mean improvement of 70.8 and 71.8 points in the visual analogue scale score and 38.1 and 42.2 points in the Oswestry Disability Index was noted in Kiva and BK, respectively. No device-related serious adverse events occurred. Despite significant differences in risk factors favoring the control group at baseline, the primary endpoint demonstrated noninferiority of Kiva to BK. Analysis of secondary endpoints revealed superiority with respect to cement use and site-reported extravasation and a positive trend in adjacent level fracture warranting further study. The KAST study successfully established that the Kiva system is noninferior to BK based on a composite primary endpoint assessment incorporating pain-, function-, and device-related serious adverse events for the treatment of VCFs due to osteoporosis. Kiva was shown to be noninferior to BK and revealed a positive trend in several secondary endpoints. 1.

Brittleness of twig bases in the genus Salix: fracture mechanics and ecological relevance.

PubMed

Beismann, H; Wilhelmi, H; Baillères, H; Spatz, H C; Bogenrieder, A; Speck, T

2000-03-01

The twig bases within the genus Salix were investigated. Brittleness of twig bases as defined in the literature neither correlates with Young's modulus nor with growth strains, which were measured for S. alba, S. fragilis and S. x rubens. For the species S. alba, S. appendiculata, S. eleagnos, S. fragilis, S. purpurea, S. triandra, S. viminalis, and S. x rubens, fracture surfaces of broken twigs were investigated and semiquantitatively described in terms of 'relative roughness' (ratio of rough area of fracture surface over whole area of fracture surface). The relative roughness clearly corresponds with the classification into brittle and nonbrittle species given in the literature. An attempt was made to quantify brittleness with mechanical tests. The absolute values of stress and strain do not correlate with the brittleness of the twig bases as defined by the relative roughness. However, the 'index stress' (ratio of stress at yield over stress at fracture) or the 'index strain' (ratio of strain at yield over strain at fracture), correlate well with the relative roughness. The graphic analysis of index stress against index strain reveals a straight line on which the eight species are ordered according to their brittleness. Depending on growth form and habitat, brittle twig bases of willows may function ecologically as mechanical safety mechanisms and, additionally, as a propagation mechanism.

Zoledronic Acid in Reducing Clinical Fracture and Mortality after Hip Fracture

PubMed Central

Lyles, Kenneth W.; Colón-Emeric, Cathleen S.; Magaziner, Jay S.; Adachi, Jonathan D.; Pieper, Carl F.; Mautalen, Carlos; Hyldstrup, Lars; Recknor, Chris; Nordsletten, Lars; Moore, Kathy A.; Lavecchia, Catherine; Zhang, Jie; Mesenbrink, Peter; Hodgson, Patricia K.; Abrams, Ken; Orloff, John J.; Horowitz, Zebulun; Eriksen, Erik Fink; Boonen, Steven

2008-01-01

BACKGROUND Mortality is increased after a hip fracture, and strategies that improve outcomes are needed. METHODS In this randomized, double-blind, placebo-controlled trial, 1065 patients were assigned to receive yearly intravenous zoledronic acid (at a dose of 5 mg), and 1062 patients were assigned to receive placebo. The infusions were first administered within 90 days after surgical repair of a hip fracture. All patients received supplemental vitamin D and calcium. The median follow-up was 1.9 years. The primary end point was a new clinical fracture. RESULTS The rates of any new clinical fracture were 8.6% in the zoledronic acid group and 13.9% in the placebo group, a 35% risk reduction (P = 0.001); the respective rates of a new clinical vertebral fracture were 1.7% and 3.8% (P = 0.02), and the respective rates of new nonvertebral fractures were 7.6% and 10.7% (P = 0.03). In the safety analysis, 101 of 1054 patients in the zoledronic acid group (9.6%) and 141 of 1057 patients in the placebo group (13.3%) died, a reduction of 28% in deaths from any cause in the zoledronic-acid group (P = 0.01). The most frequent adverse events in patients receiving zoledronic acid were pyrexia, myalgia, and bone and musculoskeletal pain. No cases of osteonecrosis of the jaw were reported, and no adverse effects on the healing of fractures were noted. The rates of renal and cardiovascular adverse events, including atrial fibrillation and stroke, were similar in the two groups. CONCLUSIONS An annual infusion of zoledronic acid within 90 days after repair of a low-trauma hip fracture was associated with a reduction in the rate of new clinical fractures and improved survival. (ClinicalTrials.gov number, NCT00046254.) PMID:17878149

Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial

PubMed Central

Inzucchi, Silvio E.; Young, Lawrence H.; Insogna, Karl L.; Conwit, Robin; Furie, Karen L.; Gorman, Mark; Kelly, Michael A.; Lovejoy, Anne M.; Kernan, Walter N.

2017-01-01

Context: Pioglitazone reduces cardiovascular risk in nondiabetic patients after an ischemic stroke or transient ischemic attack (TIA) but is associated with increased risk for bone fracture. Objective: To characterize fractures associated with pioglitazone by location, mechanism, severity, timing, and sex. Design, Setting, and Patients: Patients were 3876 nondiabetic participants in the Insulin Resistance Intervention after Stroke trial randomized to pioglitazone or placebo and followed for a median of 4.8 years. Fractures were identified through quarterly interviews. Results: At 5 years, the increment in fracture risk between pioglitazone and placebo groups was 4.9% [13.6% vs 8.8%; hazard ratio (HR), 1.53; 95% confidence interval (CI), 1.24 to 1.89). In each group, ∼80% of fractures were low energy (i.e., resulted from fall) and 45% were serious (i.e., required surgery or hospitalization). For serious fractures most likely to be related to pioglitazone (low energy, nonpathological), the risk increment was 1.6% (4.7% vs 3.1%; HR, 1.47; 95% CI, 1.03 to 2.09). Increased risk for any fracture was observed in men (9.4% vs 5.2%; HR, 1.83; 95% CI, 1.36 to 2.48) and women (14.9% vs 11.6%; HR, 1.32; 95% CI, 0.98 to 1.78; interaction P = 0.13). Conclusions: Fractures affected 8.8% of placebo-treated patients within 5 years after an ischemic stroke or TIA. Pioglitazone increased the absolute fracture risk by 1.6% to 4.9% and the relative risk by 47% to 60%, depending on fracture classification. Our analysis suggests that treatments to improve bone health and prevent falls may help optimize the risk/benefit ratio for pioglitazone. PMID:27935736

Chemical Effect on Wellbore Instability of Nahr Umr Shale

PubMed Central

Nie, Zhen

2013-01-01

Wellbore instability is one of the major problems that hamper the drilling speed in Halfaya Oilfield. Comprehensive analysis of geological and engineering data indicates that Halfaya Oilfield features fractured shale in the Nahr Umr Formation. Complex accidents such as wellbore collapse and sticking emerged frequently in this formation. Tests and theoretical analysis revealed that wellbore instability in the Halfaya Oilfield was influenced by chemical effect of fractured shale and the formation water with high ionic concentration. The influence of three types of drilling fluids on the rock mechanical properties of Nahr Umr Shale is tested, and time-dependent collapse pressure is calculated. Finally, we put forward engineering countermeasures for safety drilling in Halfaya Oilfield and point out that increasing the ionic concentration and improving the sealing capacity of the drilling fluid are the way to keep the wellbore stable. PMID:24282391

Chemical effect on wellbore instability of Nahr Umr Shale.

PubMed

Yu, Baohua; Yan, Chuanliang; Nie, Zhen

2013-01-01

Wellbore instability is one of the major problems that hamper the drilling speed in Halfaya Oilfield. Comprehensive analysis of geological and engineering data indicates that Halfaya Oilfield features fractured shale in the Nahr Umr Formation. Complex accidents such as wellbore collapse and sticking emerged frequently in this formation. Tests and theoretical analysis revealed that wellbore instability in the Halfaya Oilfield was influenced by chemical effect of fractured shale and the formation water with high ionic concentration. The influence of three types of drilling fluids on the rock mechanical properties of Nahr Umr Shale is tested, and time-dependent collapse pressure is calculated. Finally, we put forward engineering countermeasures for safety drilling in Halfaya Oilfield and point out that increasing the ionic concentration and improving the sealing capacity of the drilling fluid are the way to keep the wellbore stable.

Structural design/margin assessment

NASA Technical Reports Server (NTRS)

Ryan, R. S.

1993-01-01

Determining structural design inputs and the structural margins following design completion is one of the major activities in space exploration. The end result is a statement of these margins as stability, safety factors on ultimate and yield stresses, fracture limits (fracture control), fatigue lifetime, reuse criteria, operational criteria and procedures, stability factors, deflections, clearance, handling criteria, etc. The process is normally called a load cycle and is time consuming, very complex, and involves much more than structures. The key to successful structural design is the proper implementation of the process. It depends on many factors: leadership and management of the process, adequate analysis and testing tools, data basing, communications, people skills, and training. This process and the various factors involved are discussed.

Application of EREP imagery to fracture-related mine safety hazards in coal mining and mining-environmental problems in Indiana. [Indiana and Illinois

NASA Technical Reports Server (NTRS)

Wier, C. E. (Principal Investigator); Powell, R. L.; Amato, R. V.; Russell, O. R.; Martin, K. R.

1975-01-01

The author has identified the following significant results. This investigation evaluated the applicability of a variety of sensor types, formats, and resolution capabilities to the study of both fuel and nonfuel mined lands. The image reinforcement provided by stereo viewing of the EREP images proved useful for identifying lineaments and for mined lands mapping. Skylab S190B color and color infrared transparencies were the most useful EREP imagery. New information on lineament and fracture patterns in the bedrock of Indiana and Illinois extracted from analysis of the Skylab imagery has contributed to furthering the geological understanding of this portion of the Illinois basin.

Pelvic ring fractures: implications of vehicle design, crash type, and occupant characteristics.

PubMed

Rowe, Stephen A; Sochor, Mark S; Staples, Kurtis S; Wahl, Wendy L; Wang, Stewart C

2004-10-01

Pelvic ring fractures (PRFs) are a major cause of morbidity and mortality in motor vehicle collisions (MVCs). Understanding the factors leading to PRFs may help improve vehicle design and safety. This study sought to determine the vehicular, crash, and occupant characteristics that contribute to PRFs. From 1997 to 2003, 240 adult patients involved in lateral or frontal crashes were prospectively studied. Comprehensive crash reconstructions, vehicle analysis, and occupant data were compiled and analyzed as part of the national Crash Injury Research Engineering Network project. Of 240 study patients, 38 had PRFs. The incidence of PRFs was significantly associated with female gender, lateral impact crashes, vehicle incompatibility, and severity of crash. Seat belts and airbags were not protective against PRFs in either lateral or frontal crashes. All vehicles in the current study were less than 6 years old at the time of the MVC and thus reflect newer safety designs. Compared with studies of PRFs in MVCs before the widespread adoption of modern safety standards, our series suggests there has been a modest decrease in the incidence of PRFs in newer vehicles. Current safety standards do not adequately protect against PRFs, especially in lateral MVCs involving incompatibility and female occupants. New technology needs to be developed and implemented. Our data suggest that side impact airbags, alteration of vehicle geometry, and increased reinforcement of side panels and doors may result in fewer PRFs.

Clinical efficacy and safety of limited internal fixation combined with external fixation for Pilon fracture: A systematic review and meta-analysis.

PubMed

Zhang, Shao-Bo; Zhang, Yi-Bao; Wang, Sheng-Hong; Zhang, Hua; Liu, Peng; Zhang, Wei; Ma, Jing-Lin; Wang, Jing

2017-04-01

To compare the clinical efficacy and complications of limited internal fixation combined with external fixation (LIFEF) and open reduction and internal fixation (ORIF) in the treatment of Pilon fracture. We searched databases including Pubmed, Embase, Web of science, Cochrane Library and China Biology Medicine disc for the studies comparing clinical efficacy and complications of LIFEF and ORIF in the treatment of Pilon fracture. The clinical efficacy was evaluated by the rate of nonunion, malunion/delayed union and the excellent/good rate assessed by Mazur ankle score. The complications including infections and arthritis symptoms after surgery were also investigated. Nine trials including 498 pilon fractures of 494 patients were identified. The meta-analysis found no significant differences in nonunion rate (RR = 1.60, 95% CI: 0.66 to 3.86, p = 0.30), and the excellent/good rate (RR = 0.95, 95% CI: 0.86 to 1.04, p = 0.28) between LIFEF group and ORIF group. For assessment of infections, there were significant differences in the rate of deep infection (RR = 2.18, 95% CI: 1.34 to 3.55, p = 0.002), and the rate of arthritis (RR = 1.26, 95% CI: 1.03 to 1.53, p = 0.02) between LIFEF group and ORIF group. LIFEF has similar effect as ORIF in the treatment of pilon fractures, however, LIFEF group has significantly higher risk of complications than ORIF group does. So LIFEF is not recommended in the treatment of pilon fracture. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Near real-time adverse drug reaction surveillance within population-based health networks: methodology considerations for data accrual.

PubMed

Avery, Taliser R; Kulldorff, Martin; Vilk, Yury; Li, Lingling; Cheetham, T Craig; Dublin, Sascha; Davis, Robert L; Liu, Liyan; Herrinton, Lisa; Brown, Jeffrey S

2013-05-01

This study describes practical considerations for implementation of near real-time medical product safety surveillance in a distributed health data network. We conducted pilot active safety surveillance comparing generic divalproex sodium to historical branded product at four health plans from April to October 2009. Outcomes reported are all-cause emergency room visits and fractures. One retrospective data extract was completed (January 2002-June 2008), followed by seven prospective monthly extracts (January 2008-November 2009). To evaluate delays in claims processing, we used three analytic approaches: near real-time sequential analysis, sequential analysis with 1.5 month delay, and nonsequential (using final retrospective data). Sequential analyses used the maximized sequential probability ratio test. Procedural and logistical barriers to active surveillance were documented. We identified 6586 new users of generic divalproex sodium and 43,960 new users of the branded product. Quality control methods identified 16 extract errors, which were corrected. Near real-time extracts captured 87.5% of emergency room visits and 50.0% of fractures, which improved to 98.3% and 68.7% respectively with 1.5 month delay. We did not identify signals for either outcome regardless of extract timeframe, and slight differences in the test statistic and relative risk estimates were found. Near real-time sequential safety surveillance is feasible, but several barriers warrant attention. Data quality review of each data extract was necessary. Although signal detection was not affected by delay in analysis, when using a historical control group differential accrual between exposure and outcomes may theoretically bias near real-time risk estimates towards the null, causing failure to detect a signal. Copyright © 2013 John Wiley & Sons, Ltd.

Hydrogen Embrittlement Susceptibility and Safety Control of Reheated CGHAZ in X80 Welded Pipeline

NASA Astrophysics Data System (ADS)

Deng, Qiushi; Zhao, Weimin; Jiang, Wei; Zhang, Timing; Li, Tingting; Zhao, Yujiao

2018-03-01

Coarse-grained heat-affected zone (CGHAZ) exhibits the highest hydrogen embrittlement (HE) susceptibility, which changes under the influence of thermal cycle. In this study, slow strain rate tension (SSRT) tests were conducted to investigate the HE susceptibility of reheated CGHAZs and the critical hydrogen pressure for fracture failure. Results show that intercritically reheated CGHAZ (ICCGHAZ) possesses the lowest HE resistance. Analyses of HE index and fracture indicate that the critical hydrogen pressure is 3.5 MPa. Microstructure analysis reveals that HE susceptibility is associated with multiple factors, such as phase composition, grain coarsening, HAB density, and MA constituent. Blocky necklace-like MA constituent along prior austenite boundaries plays a predominant role in intensifying the HE susceptibility of ICCGHAZ.

Lateral drill holes decrease strength of the femur: an observational study using finite element and experimental analyses.

PubMed

Fox, Melanie J; Scarvell, Jennie M; Smith, Paul N; Kalyanasundaram, Shankar; Stachurski, Zbigniew H

2013-08-30

Internal fixation of femoral fractures requires drilling holes through the cortical bone of the shaft of the femur. Intramedullary suction reduces the fat emboli produced by reaming and nailing femoral fractures but requires four suction portals to be drilled into the femoral shaft. This work investigated the effect of these additional holes on the strength of the femur. Finite element analysis (FEA) was used to calculate compression, tension and load limits which were then compared to the results from mechanical testing. Models of intact femora and fractured femora internally fixed with intramedullary nailing were generated. In addition, four suction portals, lateral, anterior and posterior, were modelled. Stresses were used to calculate safety factors and predict fatigue. Physical testing on synthetic femora was carried out on a universal mechanical testing machine. The FEA model for stresses generated during walking showed tensile stresses in the lateral femur and compression stresses in the medial femur with a maximum sheer stress through the neck of the femur. The lateral suction portals produced tensile stresses up to over 300% greater than in the femur without suction portals. The anterior and posterior portals did not significantly increase stresses. The lateral suction portals had a safety factor of 0.7, while the anterior and posterior posts had safety factors of 2.4 times walking loads. Synthetic bone subjected to cyclical loading and load to failure showed similar results. On mechanical testing, all constructs failed at the neck of the femur. The anterior suction portals produced minimal increases in stress to loading so are the preferred site should a femur require such drill holes for suction or internal fixation.

[Injury patterns and typical stress situations in paragliding].

PubMed

Bohnsack, M; Schröter, E

2005-05-01

Paragliding is known as a high risk sport with a substantial rate of severe and fatal injuries. Analysis of typical injury mechanisms and statistics showed that the total rate of paragliding injuries has decreased in recent years for an increasing number of pilots. In 2003, the rate of severe and fatal injuries in paragliding was less than that of other air sports and motorcycling. Through the introduction of a spine protector system in Germany and Austria, the number of vertebral fractures decreased significantly between 2000 and 2003. Most other injuries, especially of the lower extremities, could be avoided by adequate and farsighted flight behavior. Qualified instruction with regular training, standardized development of safety equipment and consequent analysis of paragliding injuries will help to improve the safety status in paragliding.

Rib and sternum fractures in the elderly and extreme elderly following motor vehicle crashes.

PubMed

Bansal, Vishal; Conroy, Carol; Chang, David; Tominaga, Gail T; Coimbra, Raul

2011-05-01

As the population ages, the need to protect the elderly during motor vehicle crashes becomes increasingly critical. This study focuses on causation of elderly rib and sternum fractures in seriously injured elderly occupants involved in motor vehicle crashes. We used data from the Crash Injury Research and Engineering Network (CIREN) database (1997-2009). Study case criteria included occupant (≥ 65 years old) drivers (sitting in the left outboard position of the first row) or passengers (sitting in the first row right outboard position) who were in frontal or side impacts. To avoid selection bias, only occupants with a Maximum Abbreviated Injury Scale (MAIS) 3 (serious) or greater severity injury were included in this study. Odds ratios were used as a descriptive measure of the strength of association between variables and Chi square tests were used to determine if there was a statistically significant relationship between categorical variables. Of the 211 elderly (65-79 years old) occupants with thoracic injury, 92.0% had rib fractures and 19.6% had sternum fractures. For the 76 extreme elderly (80 years or older) with thoracic injury, 90.4% had rib fractures and 27.7% had sternum fractures. Except for greater mortality and more rib fractures caused by safety belts, there were no differences between the extreme elderly and the elderly occupants. Current safety systems may need to be redesigned to prevent rib and sternum fractures in occupants 80 years and older. Copyright © 2010 Elsevier Ltd. All rights reserved.

Numerical analysis of multi-level versus short instrumentation for the treatment of thoracolumbar fractures.

PubMed

Hübner, André Rafael; Gasparin, Daniel; de Meira Junior, Agenor Dias; Israel, Charles Leonardo; Dambrós, Jean Marcel; Ribeiro, Marcelo; de Freitas Spinelli, Leandro

2015-07-01

The research analyses the strength of metallic implants in posterior spinal instrumentation for the treatment of thoracolumbar fractures, considering extended and short fixation techniques on the immediate post-surgical load. Considering that short fixation may bring the advantage of a less invasive surgical procedure to the patient and may also result in lower costs, this evaluation becomes necessary. Three-dimensional modelling of the thoracolumbar spine was initially performed. CT images were captured and converted for analysis with the ANSYS program. Both treatment techniques were analysed for stresses, and strains generated in the immediate postoperative period, when the fracture is still not healed. The maximum stress obtained for long fixation by the theory of Von Mises was 230 MPa, and it was located in the rod area next to the L2 vertebra. The maximum stress obtained for short fixation was 274.24 MPa, and it was located in the pedicle screw on the T12 vertebra. There were no significant differences between the two techniques, since the observed stresses are well below the flow stress of the material, ensuring good safety factor (ranging from 3.5 to 4.1).

46 CFR 116.1010 - Safety glazing materials.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ARRANGEMENT Window Construction and Visibility § 116.1010 Safety glazing materials. Glass and other glazing material used in windows must be of material that will not break into dangerous fragments if fractured. ...

The changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists.

PubMed

Winkler, Dennis; Goudie, Stuart T; Court-Brown, Charles M

2018-02-01

To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures. The severity of the open fractures was analysed using the Gustilo classification. The 23-year study period was divided into four shorter periods and the results were compared. There were 696 patients treated in 23 years. Analysis showed that the incidence of RTA open fractures initially fell in both males and females and continued to fall in females during the 23 years. In males it levelled off about 2000. The age of the female patients also fell during the study period but it did not change in males. The only patient group to show an increased incidence of open fractures were cyclists. In vehicle occupants the incidence fell throughout the study period but it levelled off in pedestrians and motorcyclists. There was no difference in the severity of injury in any group during the study period. The most severe open fractures were those of the distal femur and femoral diaphysis although open tibial diaphyseal fractures were the most common fracture in all patient groups. Improved car design and road safety legislation has resulted in a reduction in the incidence of open fractures in vehicle occupants, pedestrians and motorcyclists. The most obvious group to have benefitted from this are older female pedestrians. The only group to show an increase in age during the study period were male motorcyclists. Copyright © 2017 Elsevier Ltd. All rights reserved.

Surveillance for work-related skull fractures in Michigan.

PubMed

Kica, Joanna; Rosenman, Kenneth D

2014-12-01

The objective was to develop a multisource surveillance system for work-related skull fractures. Records on work-related skull fractures were obtained from Michigan's 134 hospitals, Michigan's Workers' Compensation Agency and death certificates. Cases from the three sources were matched to eliminate duplicates from more than one source. Workplaces where the most severe injuries occurred were referred to OSHA for an enforcement inspection. There were 318 work related skull fractures, not including facial fractures, between 2010 and 2012. In 2012, after the inclusion of facial fractures, 316 fractures were identified of which 218 (69%) were facial fractures. The Bureau of Labor Statistic's (BLS) 2012 estimate of skull fractures in Michigan, which includes facial fractures, was 170, which was 53.8% of those identified from our review of medical records. The inclusion of facial fractures in the surveillance system increased the percentage of women identified from 15.4% to 31.2%, decreased severity (hospitalization went from 48.7% to 10.6% and loss of consciousness went from 56.5% to 17.8%), decreased falls from 48.2% to 27.6%, and increased assaults from 5.0% to 20.2%, shifted the most common industry from construction (13.3%) to health care and social assistance (15.0%) and the highest incidence rate from males 65+ (6.8 per 100,000) to young men, 20-24 years (9.6 per 100,000). Workplace inspections resulted in 45 violations and $62,750 in penalties. The Michigan multisource surveillance system of workplace injuries had two major advantages over the existing national system: (a) workplace investigations were initiated hazards identified and safety changes implemented at the facilities where the injuries occurred; and (b) a more accurate count was derived, with 86% more work-related skull fractures identified than BLS's employer based estimate. A more comprehensive system to identify and target interventions for workplace injuries was implemented using hospital and emergency department medical records. Copyright © 2014 National Safety Council and Elsevier Ltd. All rights reserved.

An analysis of chemicals and other constituents found in produced water from hydraulically fractured wells in California and the challenges for wastewater management.

PubMed

Chittick, Emily A; Srebotnjak, Tanja

2017-12-15

As high-volume hydraulic fracturing (HF) has grown substantially in the United States over the past decade, so has the volume of produced water (PW), i.e., briny water brought to the surface as a byproduct of oil and gas production. According to a recent study (Groundwater Protection Council, 2015), more than 21 billion barrels of PW were generated in 2012. In addition to being high in TDS, PW may contain hydrocarbons, PAH, alkylphenols, naturally occurring radioactive material (NORM), metals, and other organic and inorganic substances. PW from hydraulically fractured wells includes flowback water, i.e., injection fluids containing chemicals and additives used in the fracturing process such as friction reducers, scale inhibitors, and biocides - many of which are known to cause serious health effects. It is hence important to gain a better understanding of the chemical composition of PW and how it is managed. This case study of PW from hydraulically fractured wells in California provides a first aggregate chemical analysis since data collection began in accordance with California's 2013 oil and gas well stimulation law (SB4, Pavley). The results of analyzing one-time wastewater analyses of 630 wells hydraulically stimulated between April 1, 2014 and June 30, 2015 show that 95% of wells contained measurable and in some cases elevated concentrations of BTEX and PAH compounds. PW from nearly 500 wells contained lead, uranium, and/or other metals. The majority of hazardous chemicals known to be used in HF operations, including formaldehyde and acetone, are not reported in the published reports. The prevalent methods for dealing with PW in California - underground injection and open evaporation ponds - are inadequate for this waste stream due to risks from induced seismicity, well integrity failure, well upsets, accidents and spills. Beneficial reuse of PW, such as for crop irrigation, is as of yet insufficiently safety tested for consumers and agricultural workers as well as plant health. Technological advances in onsite direct PW reuse and recycling look promising but need to control energy requirements, productivity and costs. The case study concludes that (i) reporting of PW chemical composition should be expanded in frequency and cover a wider range of chemicals used in hydraulic fracturing fluids, and (ii) PW management practices should be oriented towards safer and more sustainable options such as reuse and recycling, but with adequate controls in place to ensure their safety and reliability. Copyright © 2017 Elsevier Ltd. All rights reserved.

Could martial arts fall training be safe for persons with osteoporosis?: a feasibility study

PubMed Central

2010-01-01

Background Osteoporosis is a well-established risk factor for fall-related hip fractures. Training fall arrest strategies, such as martial arts (MA) fall techniques, might be useful to prevent hip fractures in persons with osteoporosis, provided that the training itself is safe. This study was conducted to determine whether MA fall training would be safe for persons with osteoporosis extrapolated from the data of young adults and using stringent safety criteria. Methods Young adults performed sideways and forward MA falls from a kneeling position on both a judo mat and a mattress as well as from a standing position on a mattress. Hip impact forces and kinematic data were collected. For each condition, the highest hip impact force was compared with two safety criteria based on the femoral fracture load and the use of a hip protector. Results The highest hip impact force during the various fall conditions ranged between 1426 N and 3132 N. Sideways falls from a kneeling and standing position met the safety criteria if performed on the mattress (max 1426 N and 2012 N, respectively) but not if the falls from a kneeling position were performed on the judo mat (max 2219 N). Forward falls only met the safety criteria if performed from a kneeling position on the mattress (max 2006 N). Hence, forward falls from kneeling position on a judo mat (max 2474 N) and forward falls from standing position on the mattress (max 3132 N) did not meet both safety criteria. Conclusions Based on the data of young adults and safety criteria, the MA fall training was expected to be safe for persons with osteoporosis if appropriate safety measures are taken: during the training persons with osteoporosis should wear hip protectors that could attenuate the maximum hip impact force by at least 65%, perform the fall exercises on a thick mattress, and avoid forward fall exercises from a standing position. Hence, a modified MA fall training might be useful to reduce hip fracture risk in persons with osteoporosis. PMID:20412560

Efficacy and Safety of a Once-Yearly Intravenous Zoledronic Acid 5 mg for Fracture Prevention in Elderly Postmenopausal Women with Osteoporosis Aged 75 and Older

PubMed Central

Boonen, Steven; Black, Dennis M.; Colón-Emeric, Cathleen S.; Eastell, Richard; Magaziner, Jay S.; Eriksen, Erik Fink; Mesenbrink, Peter; Haentjens, Patrick; Lyles, Kenneth W.

2013-01-01

OBJECTIVES To determine the efficacy of once-yearly intravenous zoledronic acid (ZOL) 5 mg in reducing risk of clinical vertebral, nonvertebral, and any clinical fractures in elderly osteoporotic postmenopausal women. DESIGN A post hoc subgroup analysis of pooled data from the Health Outcome and Reduced Incidence with Zoledronic Acid One Yearly (HORIZON) Pivotal Fracture Trial and the HORIZON Recurrent Fracture Trial. SETTING Multicenter, randomized, double-blind, placebo-controlled trials. PARTICIPANTS Postmenopausal women (aged ≥75) with documented osteoporosis (T-score ≤ −2.5 at femoral neck or ≥1 prevalent vertebral or hip fracture) or a recent hip fracture. INTERVENTION Patients were randomized to receive an intravenous infusion of ZOL 5 mg (n =1,961) or placebo (n =1,926) at baseline and 12 and 24 months. MEASUREMENTS Primary endpoints were incidence of clinical vertebral and nonvertebral and any clinical fracture after treatment. RESULTS At 3 years, incidence of any clinical, clinical vertebral, and nonvertebral fracture were significantly lower in the ZOL group than in the placebo group (10.8% vs 16.6%, 1.1% vs 3.7%, and 9.9% vs 13.7%, respectively) (hazard ratio (HR) =0.65, 95% confidence interval (CI) =0.54–0.78, P<.001; HR =0.34, 95% CI =0.21–0.55, P<.001; and HR =0.73, 95% CI =0.60–0.90, P =.002, respectively). The incidence of hip fracture was lower with ZOL but did not reach statistical significance. The incidence rate of postdose adverse events were higher with ZOL, although the rate of serious adverse events and deaths was comparable between the two groups. CONCLUSION Once-yearly intravenous ZOL 5 mg was associated with a significant reduction in the risk of new clinical fractures (vertebral and nonvertebral) in elderly postmenopausal women with osteroporosis. PMID:20070415

Efficacy and safety of rivaroxaban versus low-molecular-weight heparin therapy in patients with lower limb fractures.

PubMed

Long, Anhua; Zhang, Lihai; Zhang, Yingze; Jiang, Baoguo; Mao, Zhi; Li, Hongda; Zhang, Shanbao; Xie, Zongyan; Tang, Peifu

2014-10-01

Thromboprophylaxis with rivaroxaban has proved effective and safe in patients undergoing hip and knee replacement surgery. As it is unclear whether it is also effective and safe in fracture patients, the aim of the present study was to evaluate the efficacy and safety of rivaroxaban in patients with lower limb fractures. We performed a retrospective cohort study of 2,050 consecutive patients treated for lower limb fractures at our trauma center, comparing rates of venous thromboembolism (VTE), bleeding and surgical complications, and the length of hospital stay for 608 patients who received rivaroxaban and 717 who received a low-molecular-weight heparin (LMWH). Rates of symptomatic VTE were 4.9 and 8.6% in the rivaroxaban and LMWH groups, respectively (p = 0.008), and distal VTE rates were 1.8 and 5.7%, respectively (p = 0.036). The incidence of major bleeding events in the rivaroxaban group was also lower than in the LMWH group (0.2 vs 0.6%), but the difference between the groups was not statistically significant. The mean length of hospital stay was significantly shorter in the rivaroxaban group (12.2 vs 13.1 days, respectively; p = 0.016). This retrospective cohort study is the first report documenting the efficacy and safety of rivaroxaban in patients with lower extremity fractures. In comparison with LMWH, rivaroxaban reduced the incidence of VTE by 45% without increasing the risk of bleeding. However, prospective, randomized controlled trials comparing rivaroxaban and LMWH are needed to confirm our findings.

Sustained efficacy and safety of bazedoxifene in preventing fractures in postmenopausal women with osteoporosis: results of a 5-year, randomized, placebo-controlled study.

PubMed

Silverman, S L; Chines, A A; Kendler, D L; Kung, A W C; Teglbjærg, C S; Felsenberg, D; Mairon, N; Constantine, G D; Adachi, J D

2012-01-01

In this 2-year extension of a 3-year study, bazedoxifene showed sustained efficacy in preventing new vertebral fractures in postmenopausal women with osteoporosis and in preventing non-vertebral fractures in higher-risk women. Bazedoxifene significantly increased bone mineral density and reduced bone turnover versus placebo and was generally safe and well tolerated. This study evaluated the efficacy and safety of bazedoxifene for the treatment of postmenopausal osteoporosis over 5 years. A total of 4,216 postmenopausal women with osteoporosis were enrolled in this 2-year extension of a 3-year, randomized, double-blind, placebo-controlled, phase 3 trial. In the core study (N = 7,492), subjects received bazedoxifene 20 or 40 mg/day, raloxifene 60 mg/day, or placebo. The raloxifene arm was discontinued after 3 years; subjects receiving bazedoxifene 40 mg were transitioned to bazedoxifene 20 mg after 4 years. Five-year findings are reported for bazedoxifene 20 and 40/20 mg and placebo. Endpoints included incidence of new vertebral fractures (primary) and non-vertebral fractures, and changes in bone mineral density (BMD) and bone turnover markers. At 5 years, the incidence of new vertebral fractures in the intent-to-treat population was significantly lower with bazedoxifene 20 mg (4.5%) and 40/20 mg (3.9%) versus placebo (6.8%; P < 0.05), with relative risk reductions of 35% and 40%, respectively. Non-vertebral fracture incidence was similar among groups. In a subgroup of higher-risk women (n = 1,324; femoral neck T-score ≤-3.0 and/or ≥ 1 moderate or severe or ≥ 2 mild vertebral fracture[s]), bazedoxifene 20 mg reduced non-vertebral fracture risk versus placebo (37%; P = 0.06); combined data for bazedoxifene 20 and 40/20 mg reached statistical significance (34% reduction; P < 0.05). Bazedoxifene significantly increased BMD and reduced bone turnover versus placebo (P < 0.05) and was generally safe and well tolerated. The findings support a sustained anti-fracture effect of bazedoxifene on new vertebral fractures in postmenopausal osteoporotic women and on non-vertebral fractures in the higher-risk subgroup of women.

Finite element analysis of the tetragonal to monoclinic phase transformation during oxidation of zirconium alloys

NASA Astrophysics Data System (ADS)

Platt, P.; Frankel, P.; Gass, M.; Howells, R.; Preuss, M.

2014-11-01

Corrosion is a key limiting factor in the degradation of zirconium alloys in light water reactors. Developing a mechanistic understanding of the corrosion process offers a route towards improving safety and efficiency as demand increases for higher burn-up of fuel. Oxides formed on zirconium alloys are composed of both monoclinic and meta-stable tetragonal phases, and are subject to a number of potential mechanical degradation mechanisms. The work presented investigates the link between the tetragonal to monoclinic oxide phase transformation and degradation of the protective character of the oxide layer. To achieve this, Abaqus finite element analysis of the oxide phase transformation has been carried out. Study of the change in transformation strain energy shows how relaxation of oxidation induced stress and fast fracture at the metal-oxide interface could destabilise the tetragonal phase. Central to this is the identification of the transformation variant most likely to form, and understanding why twinning of the transformed grain is likely to occur. Development of transformation strain tensors and analysis of the strain components allows some separation of dilatation and shear effects. Maximum principal stress is used as an indication of fracture in the surrounding oxide layer. Study of the stress distributions shows the way oxide fracture is likely to occur and the differing effects of dilatation and shape change. Comparison with literature provides qualitative validation of the finite element simulations.

Fractographic Examination of the Vertical Stabilizer and Rudder from American Airlines Flight 587

NASA Technical Reports Server (NTRS)

Fox, Matthew R.; Schultheisz, Carl R.; Reeder, James R.

2005-01-01

The first major structural component failure of a composite part on a commercial airplane occurred during the crash of American Airlines Flight 587. The fractured composite lugs that attached the vertical stabilizer to the aircraft tail and the fractured composite honeycomb rudder were examined as part of the National Transportation Safety Board investigation of the accident. In this paper the composite fractures are described and the resulting clues to the failure events are discussed.

[Increasing the safety of ceramic femoral heads for hip prostheses].

PubMed

Willmann, G; Pfaff, H G; Richter, H G

1995-12-01

Since 1974 Biolox ceramic femoral ball heads have been used successfully for artificial modular hip joints. The revision rate due to ball head fracture is lower than 0.02%. This is an extremely low value. In this article it is shown how the safety of a ceramic ball head can be improved using the procedures of HIPing, engraving by laser technique, and 100% proof testing. By applying these means the materials properties density, grain size, grain size distribution, and the strength of the ball head, i.e. the fracture load can be improved significantly.

Lean business model and implementation of a geriatric fracture center.

PubMed

Kates, Stephen L

2014-05-01

Geriatric hip fracture is a common event associated with high costs of care and often with suboptimal outcomes for the patients. Ideally, a new care model to manage geriatric hip fractures would address both quality and safety of patient care as well as the need for reduced costs of care. The geriatric fracture center model of care is one such model reported to improve both outcomes and quality of care. It is a lean business model applied to medicine. This article describes basic lean business concepts applied to geriatric fracture care and information needed to successfully implement a geriatric fracture center. It is written to assist physicians and surgeons in their efforts to implement an improved care model for their patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessing edge cracking resistance in AHSS automotive parts by the Essential Work of Fracture methodology

NASA Astrophysics Data System (ADS)

Frómeta, D.; Tedesco, M.; Calvo, J.; Lara, A.; Molas, S.; Casellas, D.

2017-09-01

Lightweight designs and demanding safety requirements in automotive industry are increasingly promoting the use of Advanced High Strength Steel (AHSS) sheets. Such steels present higher strength (above 800 MPa) but lower ductility than conventional steels. Their great properties allow the reduction of the thickness of automobile structural components without compromising the safety, but also introduce new challenges to parts manufacturers. The fabrication of most cold formed components starts from shear cut blanks and, due to the lower ductility of AHSS, edge cracking problems can appear during forming operations, forcing the stop of the production and slowing down the industrial process. Forming Limit Diagrams (FLD) and FEM simulations are very useful tools to predict fracture problems in zones with high localized strain, but they are not able to predict edge cracking. It has been observed that the fracture toughness, measured through the Essential Work of Fracture (EWF) methodology, is a good indicator of the stretch flangeability in AHSS and can help to foresee this type of fractures. In this work, a serial production automotive component has been studied. The component showed cracks in some flanged edges when using a dual phase steel. It is shown that the conventional approach to explain formability, based on tensile tests and FLD, fails in the prediction of edge cracking. A new approach, based on fracture mechanics, help to solve the problem by selecting steel grades with higher fracture toughness, measured by means of EWF. Results confirmed that fracture toughness, in terms of EWF, can be readily used as a material parameter to rationalize cracking related problems and select AHSS with improved edge cracking resistance.

Safety of definitive in-theater repair of facial fractures.

PubMed

Lopez, Manuel A; Arnholt, Jonathan L

2007-01-01

To determine the safety of definitive in-theater facial fracture repair on American military personnel wounded during Operation Iraqi Freedom. A retrospective review of all patients with head and neck trauma treated at the 322nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, from May 7, 2005, through September 18, 2005, was performed. This study focused on the outcomes of wounded American military personnel whose facial fractures were definitively repaired in theater. The criteria used to determine candidacy for definitive in-theater facial fracture repair on American military personnel were (1) the fracture site was exposed through either a soft tissue wound or because of an adjacent surgical approach, (2) treatment would not delay evacuation from theater, and (3) treatment would allow the military member to remain in theater. From May 2005 to September 2005, 207 patients were taken to the operating room and required 388 procedures. A total of 175 patients (85%) were operated on for traumatic injuries, and 52 of these patients required open reduction and internal fixation (ORIF) of a facial fracture. Of the 52 patients who underwent an ORIF, 17 were American military personnel. Of the 17 American patients who were definitively treated for their facial fractures in theater, 16 were contacted and/or followed up on the global military medical database. None of these patients developed an Acinetobacter baumannii infection or had a complication caused by the definitive in-theater ORIF. The range of follow-up was 2 months to 11 months, with a mean of 8.3 months. Definitive repair of facial fractures with ORIF on American military personnel in theater is advised when the aforementioned criteria are observed. An otolaryngologist is a crucial member of the head and neck trauma team.

Application of EREP imagery to fracture-related mine safety hazards and environmental problems in mining

NASA Technical Reports Server (NTRS)

Wier, C. E.; Wobber, F. J.; Amato, R. V.; Russell, O. R. (Principal Investigator)

1973-01-01

The author has identified the following significant results. Numerous fracture traces were detected on both the color transparencies and black and white spectral bands. Fracture traces of value to mining hazards analysis were noted on the EREP imagery which could not be detected on either the ERTS-1 or high altitude aircraft color infrared photography. Several areas of mine subsidence occurring in the Busseron Creek area near Sullivan, Indiana were successfully identified using color photography. Skylab photography affords an increase over comparable scale ERTS-1 imagery in level of information obtained in mined lands inventory and reclamation analysis. A review of EREP color photography permitted the identification of a substantial number of non-fuel mines within the Southern Indiana test area. A new mine was detected on the EREP photography without prior data. EREP has definite value for estimating areal changes in active mines and for detecting new non-fuel mines. Gob piles and slurry ponds of several acres could be detected on the S-190B color photography when observed in association with large scale mining operations. Apparent degradation of water quality resulting from acid mine drainage and/or siltation was noted in several ponds or small lakes and appear to be related to intensive mining activity near Sullivan, Indiana.

Surgical treatment of mandibular condyle fractures using the retromandibular anterior transparotid approach and a triangular-positioned double miniplate osteosynthesis technique: A clinical and radiological evaluation of 124 fractures.

PubMed

Dalla Torre, Daniel; Burtscher, Doris; Widmann, Gerlig; Pichler, Albina; Rasse, Michael; Puelacher, Wolfgang

2015-07-01

Different modalities have been described regarding the treatment of mandibular condyle fractures. The most advantageous and safest one is still a topic of discussion. The present analysis describes the combination of a retromandibular, transparotideal approach combined to a triangular-positioned double-miniplate osteosynthesis, with a special regard for the patients' long term outcomes. Clinical data of 102 patients with 124 condyle fractures treated with the mentioned surgical procedure were evaluated. Functional parameters such as the maximal interincisal distance, deviations/deflections, facial nerve function, occlusion as well as complications regarding the parotid gland, osteosynthesis, and esthetics were evaluated 1 week, 2 weeks, 3 months, and 6 months postoperatively. The mean maximal interincisal distance ranged from 38 mm after 1 week to 45 mm after 6 months. Deviations/deflections were seen in 22.5% of the cases 1 week postoperatively and decreased to 2% at 6 months postoperatively. A temporary facial palsy was diagnosed in 3.9% during the first follow-up, whereas no impairment was recorded after 3 or 6 months. At the same time, no patient had occlusional disturbances or complications regarding the parotid gland or the osteosynthesis 6 months postoperatively. Direct fracture visualization and a stable three-dimensional fracture stabilization are the main advantages of the presented combination of a surgical approach and osteosynthesis technique. Additionally, the absence of long-term complications confirms the safety of the procedure. Therefore, it may be considered as a successful treatment option for mandibular condyle fractures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The Impact of Child Safety Restraint Status and Age in Motor Vehicle Collisions in Predicting Type and Severity of Bone Fractures and Traumatic Injuries.

PubMed

Loftis, Christopher M; Sawyer, Jeffrey R; Eubanks, James W; Kelly, Derek M

2017-12-01

Although morbidity and mortality in children increases in motor vehicle collisions (MVC) if child restraints are not used, no data exist correlating specific injuries with proper or improper use of safety restraints or age. The purpose of this study was to evaluate correlations between childhood MVC injuries, age, and restraint status. A medical record search for pediatric patients involved in a MVC was conducted at a pediatric hospital (level 1 trauma). Charts were reviewed for demographics and injury-specific information. Patients were grouped by age, restraint use, and injuries. Nine hundred sixty-seven patients ≤12 years (average age 6.39 y) were identified. Being properly restrained was most common in all age groups except the 4- to 8-year age group in which being improperly restrained was most common. Unrestrained patients were most commonly found in the 9- to 12-year age group. A statistically significant difference was not observed for orthopaedic injuries among the restraint groups, but internal thoracic injuries, open head wound, and open upper extremity wounds were significantly more common in improperly or unrestrained patients. Improperly restrained infants had a significantly higher rate of intracranial bleeds and abrasions than those properly restrained. Unrestrained and improperly restrained 9- to 12-year olds had significantly more open head, open upper extremity, and vascular injuries. When comparing injury types with age groups, upper extremity fractures, femoral fractures, dislocations, and spinal fractures were found to be significantly higher in older children. Preventing orthopaedic injuries in older children may be accomplished by changes in regulations or automotive safety equipment. Rear-facing child safety seats could possibly be improved to prevent head trauma in the youngest patients. There is a continued need to reinforce the importance of proper use of child safety devices to parents. Knowledge of the patient's age, along with restraint status, might aid in diagnosis of less obvious MCV injuries. Level III.

Safety and effectiveness of daily teriparatide in a prospective observational study in patients with osteoporosis at high risk of fracture in Japan: final report

PubMed Central

Nishikawa, Atsushi; Ishida, Takehiro; Taketsuna, Masanori; Yoshiki, Fumito; Enomoto, Hiroyuki

2016-01-01

This postmarketing surveillance study assessed the safety and effectiveness of teriparatide in patients with osteoporosis at high risk of fracture in Japan. The patients received teriparatide 20 μg daily by subcutaneous injection, for a maximum of 24 months. Safety and effectiveness analyses were based on data from 1,847 patients who were predominantly female (92.6%) with a mean age of 75.4 years. A total of 157 adverse drug reactions (ADRs) were reported in 140 (7.58%) patients; the most common ADRs were hyperuricemia, nausea, and dizziness. Only six (0.32%) patients reported serious ADRs, the most common being nausea (two patients; 0.1%). Persistence with teriparatide treatment was 60.8% and 39.1% at 18 and 24 months, respectively. There were significant increases in biomarkers for bone formation (procollagen type I N-terminal propeptide and bone-specific alkaline phosphatase) and bone resorption (collagen type I cross-linked C telopeptide and tartrate-resistant acid phosphatase 5b) throughout the study. These were accompanied by significant increases in bone mineral density and low incidences of new vertebral and nonvertebral fractures. Patient-reported measurements for health-related quality of life revealed significant improvements from baseline in back pain and overall health-related quality of life (Short Form-8™ health survey). The results of this 24-month postmarketing surveillance study imply that teriparatide has a favorable safety profile and is effective in the treatment of patients with osteoporosis at high risk of fracture in Japan. Teriparatide may also be a useful treatment for osteoporosis in other societies with aging populations. PMID:27462147

Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study.

PubMed

Kawasaki, Yoshiteru; Hirano, Tetsuya; Miyatake, Katsutoshi; Fujii, Koji; Takeda, Yoshitsugu

2014-07-01

Coracoid base fracture accompanied by acromioclavicular joint dislocation with intact coracoclavicular ligaments is a rare injury. Generally, an open reduction with screw fixation is the first treatment choice, as it protects the important structures around the coracoid process. This report presents a new technique of screw fixation for coracoid base fracture and provides anatomic information on cross-sectional size of the coracoid base obtained by computed tomography (CT). An axial image of the coracoid base was visualized over the neck of the scapula, and a guidewire was inserted into this circle under fluoroscopic guidance. The wire was inserted easily into the neck of scapula across the coracoid base fracture with imaging in only 1 plane. In addition, 25 measurements of the coracoid base were made in 25 subjects on axial CT images. Average length of the long and short axes at the thinnest part of the coracoid base was 13.9 ± 2.0 mm (range 10.6-17.0) and 10.5 ± 2.2 mm (6.6-15.1), respectively. This new screw fixation technique and measurement data on the coracoid base may be beneficial for safety screw fixation of coracoid base fracture.

Impact of the U.S. Food and Drug Administration's Safety-Related Announcements on the Use of Bisphosphonates After Hip Fracture.

PubMed

Kim, Seoyoung C; Kim, Dae Hyun; Mogun, Helen; Eddings, Wesley; Polinski, Jennifer M; Franklin, Jessica M; Solomon, Daniel H

2016-08-01

The U.S. Food and Drug Administration (FDA) issued several announcements related to potential risk of bisphosphonates including osteonecrosis of the jaw (2005), atrial fibrillation (2007), and atypical femur fracture (2010). We aimed to evaluate the impact of three FDA drug safety announcements on the use of bisphosphonates in patients with hip fracture using claims data from a U.S. commercial health plan (2004-2013). We calculated the proportion of patients in each quarter who received a bisphosphonate or other osteoporosis medication in the 6 months following hospitalization for hip fracture. Segmented logistic regression models examined the time trends. Among 22,598 patients with hip fracture, use of bisphosphonate decreased from 15% in 2004 to 3% in the last quarter of 2013. Prior to the 2007 announcement, there was a 4% increase in the odds of bisphosphonate use every quarter (OR 1.04; 95% CI, 1.02 to 1.07). After the 2007 announcement, there was a 4% decrease in the odds of bisphosphonate use (OR 0.96; 95% CI, 0.93 to 0.99) every quarter. The announcement in 2007 was associated with a significant decline in the rate of change of bisphosphonate uses over time (p < 0.001), but no impact on other osteoporosis medication use (p = 0.2). After the 2010 announcement, the odds of bisphosphonate use continued to decrease by 4% (OR 0.96; 95% CI, 0.94 to 0.98) each quarter and the odds of other osteoporosis medication use remained stable over time (OR 0.99; 95% CI, 0.96 to 1.02). The FDA safety announcement related to atrial fibrillation in 2007 was significantly associated with a decrease in bisphosphonate use among patients with hip fracture. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

[Evidences of safety and tolerability of the zoledronic acid 5 mg yearly in the post-menopausal osteoporosis: the HORIZON project].

PubMed

Dalle Carbonare, L; Bertoldo, F; Lo Cascio, V

2009-01-01

Bisphosphonates are the most commonly prescribed medications for the treatment of osteoporosis. Despite evidence supporting the anti-fracture efficacy of aminobisphosphonates approximately 50% of patients do not follow their prescribed treatment regimen and/or discontinue treatment within the first year. Poor compliance is associated with negative outcomes, including increased fracture risk. Tolerability and safety are among the causes of poor compliance. Intravenous bisphosphonates avoids the gastrointestial intolerance and the complex dosing instruction of the oral route ensuring full compliance which may provide improved efficacy. However, there are some concerns regarding potent intravenous bisphosphonates as zoledronic acid with respect to tolerability, mainly the acute phase response and to safety, mainly a theoretical risk of over suppression of bone turnover, renal toxicity and osteonecrosis of the jaw. In the HORIZON study, 152 patients on active treatment (82) or placebo (70) underwent to a bone biopsy after double tetracycline labeling. Bone biopsies (iliac crest) were obtained at the final visit at month 36, 1 year after the last infusion. The biopsies were analyzed by histomorphometry on bone sections and by micro-CT (microCT) analysis. One hundred forthy-three biopsies (76 zoledronic acid, 67 placebo) had at least one microCT parameter measured and 111 were available for quantitative histomorphometry (59 zoledronic acid, 52 placebo). Micro-CT analysis of bone structure revealed higher trabecular bone volume (BV/TV), decreased trabecular separation (Tb.Sp), and a strong trend towards improvement in connectivity density in biopsies obtained from patients treated with zoledronic acid, indicating preservation of trabecular bone structure with respect to placebo. Histomorphometric analysis obtained from patients treated with zoledronic acid exhibited reduction of bone turnover, as suggested by decreased activation frequency (Ac.F) by 63%, mineralizing surface (MS/BS), bone formation rate (BFR/BV). In addition, mineral appositional rate (MAR), reflecting the bone-forming capacity of osteoblastic teams at the bone multicellular unit (BMU) level, was significantly higher in patients on active treatment. No sign of excessive suppression of bone turnover or mineralization impairment was detected, confirming the safety of the treatment with intravenous zoledronic acid once a year. These interesting findings are discussed in the article, particularly in terms of new histomorphometric results and clinical findings supporting the tolerability and safety of zoledronic acid.

Polymethylmethacrylate (PMMA) Material Test Results for the Capillary Flow Experiments (CFE)

NASA Technical Reports Server (NTRS)

Lerch, Bradley A.; Thesken, John C.; Bunnell, Charles T.

2007-01-01

In support of the Capillary Flow Experiments (CFE) program, several polymethylmethacrylate (PMMA) flight vessels were constructed. Some vessels used a multipiece design, which was chemically welded together. Due to questions regarding the effects of the experiment fluid (silicone oil) on the weld integrity, a series of tests were conducted to provide evidence of the adequacy of the current vessel design. Tensile tests were conducted on PMMA samples that were both in the as-received condition, and also aged in air or oil for up to 8 weeks. Both welded and unwelded samples were examined. Fracture of the joints was studied using notched tensile specimens and Brazilian disk tests. Results showed that aging had no effect on tensile properties. While the welded samples were weaker than the base parent material, the weld strength was found to be further degraded by bubbles in the weld zone. Finally a fracture analysis using the worst-case fracture conditions of the vessel was performed, and the vessel design was found to have a factor of three safety margin.

Self-healing polymer cement composites for geothermal wellbore applications

NASA Astrophysics Data System (ADS)

Rod, K. A.; Fernandez, C.; Childers, I.; Koech, P.; Um, W.; Roosendaal, T.; Nguyen, M.; Huerta, N. J.; Chun, J.; Glezakou, V. A.

2017-12-01

Cement is vital for controlling leaks from wellbores employed in oil, gas, and geothermal operations by sealing the annulus between the wellbore casing and geologic formation. Wellbore cement failure due to physical and chemical stresses is common and can result in significant environmental consequences and ultimately significant financial costs due to remediation efforts. To date numerous alternative cement blends have been proposed for the oil and gas industry. Most of these possess poor mechanical properties, or are not designed to work in high temperature environments. This research investigates novel polymer-cement composites which could function at most geothermal temperatures. Thermal stability and mechanical strength of the polymer is attributed to the formation of a number of chemical interactions between the polymer and cement matrix including covalent bonds, hydrogen bonding, and van der Waals interactions. It has been demonstrated that the bonding between cement and casing is more predictable when polymer is added to cement and can even improve healing of adhesion break when subjected to stresses such as thermal shock. Fractures have also been healed, effectively reducing permeability with fractures up to 0.3-0.5mm apertures, which is two orders of magnitude larger than typical wellbore fractures. Additionally, tomography analysis was used to determine internal structure of the cement polymer composite and imaging reveals that polymers fill fractures in the cement and between the cement and casing. By plugging fractures that occur in wellbore cement, reducing permeability of fractures, both environmental safety and economics of subsurface operations will be improved for geothermal energy and oil and gas production.

Fat embolism syndrome after nailing an isolated open tibial fracture in a stable patient: a case report.

PubMed

Aparicio, Gustavo; Soler, Isabel; López-Durán, Luis

2014-04-14

Fat embolism syndrome is a potentially fatal complication of long bone fractures. It is usually seen in the context of polytrauma or a femoral fracture. There are few reports of fat embolism syndrome occurring after isolated long bone fractures other than those of the femur. We describe a case of fat embolism syndrome in a 33-year-old Caucasian man. He was being seen for an isolated Gustilo's grade II open tibial fracture. He was deemed clinically stable, so we proceeded to treat the fracture with intramedullary reamed nailing. He developed fat embolism syndrome intraoperatively and was treated successfully. This case caused us to question the use of injury severity scoring for isolated long bone fractures. It suggests that parameters that have been described in the literature other than that the patient is apparently clinically stable should be used to establish the best time for nailing a long bone fracture, thereby improving patient safety.

Fat embolism syndrome after nailing an isolated open tibial fracture in a stable patient: a case report

PubMed Central

2014-01-01

Background Fat embolism syndrome is a potentially fatal complication of long bone fractures. It is usually seen in the context of polytrauma or a femoral fracture. There are few reports of fat embolism syndrome occurring after isolated long bone fractures other than those of the femur. Case presentation We describe a case of fat embolism syndrome in a 33-year-old Caucasian man. He was being seen for an isolated Gustilo’s grade II open tibial fracture. He was deemed clinically stable, so we proceeded to treat the fracture with intramedullary reamed nailing. He developed fat embolism syndrome intraoperatively and was treated successfully. Conclusion This case caused us to question the use of injury severity scoring for isolated long bone fractures. It suggests that parameters that have been described in the literature other than that the patient is apparently clinically stable should be used to establish the best time for nailing a long bone fracture, thereby improving patient safety. PMID:24731759

Efficacy and safety of bisphosphonates in management of low bone density in inflammatory bowel disease: A meta-analysis.

PubMed

Yao, Liwei; Wang, Haiqing; Dong, Wenwei; Liu, Zhenxin; Mao, Haijiao

2017-01-01

This study aims to determine whether bisphosphonates are safe, as well as effective against bone mineral loss in inflammatory bowel disease (IBD). A computerized search of electronic databases from 1966 to 2016 was performed. Randomized controlled trials (RCTs) were included in this review to evaluate the role of bisphosphonates in the management of osteoporosis in IBD patients. A revised 7-point Jadad scale was used to evaluate the quality of each study. Overall, 13 RCTs and 923 patients met the inclusion criteria of this meta-analysis. The result showed that bisphosphonates decreased bone mass density (BMD) loss at the lumbar spine (P = 0.0002), reduced the risk of new fractures (P = 0.01), and retained the similar adverse events (P = 0.86). Bisphosphonates may provide protection and safety against bone mineral loss in IBD patients.

Integration of fracturing dynamics and pressure transient analysis for hydraulic fracture evaluation

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

Arihara, N.; Abbaszadeh, M.; Wright, C.A.

This paper presents pre- and post-fracture pressure transient analysis, combined with net fracture pressure interpretation, for a well in a naturally fractured geothermal reservoir. Integrated analysis was performed to achieve a consistent interpretation of the created fracture geometry, propagation, conductivity, shrinkage, reservoir flow behavior, and formation permeability characteristics. The interpreted data includes two-rate pre-frac injection tests, step-rate injection tests, a series of pressure falloff tests, and the net fracturing pressure from a massive fracture treatment. Pressure transient analyses were performed utilizing advanced well test interpretation techniques and a thermal reservoir simulator with fracture propagation option. Hydraulic fracture propagation analysis wasmore » also performed Milt a generalized 3-D dynamic fracture growth model simulator. Three major conclusions resulted from the combined analysis: (1) that an increasing number of hydraulic fractures were being simultaneously propagated during the fracture treatment. (2) that the reservoir behaved as a composite reservoir Keith the outer region permeability being greater than the permeability of the region immediately surrounding the wellbore, and (3) that the created fractures extended into the outer region during the fracture treatment but retreated to the inner region several days after stimulation had ceased. These conclusions were apparent from independent pressure transient analysis and from independent hydraulic fracture propagation analysis. Integrated interpretation, however, increased the confidence in these conclusions and greatly aided the quantification of the created hydraulic fracture geometry and characterization of the reservoir permeability.« less

Effects of teriparatide versus alendronate for treatment of postmenopausal osteoporosis: A meta-analysis of randomized controlled trials.

PubMed

Wang, Ya-Kang; Qin, Si-Qing; Ma, Tao; Song, Wei; Jiang, Ren-Qi; Guo, Jian-Bin; Li, Kun; Zhang, Yu-Min

2017-05-01

Osteoporosis remains a clinical challenge. Teriparatide is an anabolic drug and alendronate is an antiresorptive agent; both are used in the treatment of osteoporosis. Comprehensive reviews investigating the comparative safety and efficacy of teriparatide versus alendronate are scarce. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the safety and efficacy of teriparatide versus alendronate for the treatment of postmenopausal osteoporosis. We conducted a comprehensive literature review of the PubMed, EMBASE, Cochrane Controlled Trials Registry, and the China Academic Journal Network Publishing databases for relevant RCTs of teriparatide versus alendronate in postmenopausal osteoporosis patients. Outcome measures were percentage change in lumbar spine and femoral neck bone mineral density (BMD) and incidence of vertebral and nonvertebral fractures. Effect size was reported as weighted mean differences (WMDs) for continuous outcomes and odds ratios (OR) for dichotomous outcomes, with associated 95% confidence intervals (CIs). Six trials involving 618 patients were included. The meta-analysis demonstrated a significant increase in lumbar spine BMD (WMD: 3.46, 95% CI: 2.15-4.77, P < .00001), but not femoral neck BMD (WMD = 1.50, 95% CI: 0.04-2.95, P = .04), in postmenopausal osteoporosis patients treated with teriparatide compared with alendronate for 6 to 18 months. These beneficial effects were apparent in the lumbar spine at 12 months of treatment (WMD: 4.49, 95% CI: 2.57-6.40, P < .01). Teriparatide was not superior to alendronate in reducing fracture risk (OR: -0.03, 95% CI: -0.12 to 0.07; P = .52). Teriparatide may be superior to alendronate for increasing lumbar spine BMD in postmenopausal osteoporosis. The efficacy and safety of long-term teriparatide and alendronate treatment in postmenopausal osteoporosis should be further investigated in clinical trials.

Application of ERTS-1 imagery to fracture related mine safety hazards in the coal mining industry. [Indiana

NASA Technical Reports Server (NTRS)

Wier, C. E.; Wobber, F. J. (Principal Investigator); Russell, O. R.; Amato, R. V.; Leshendok, T. V.

1974-01-01

The author has identified the following significant results. New fracture detail of Indiana has been observed and mapped from ERTS-1 imagery. Studies so far indicate a close relationship between the directions of fracture traces mapped from the imagery, fractures measured on bedrock outcrops, and fractures measured in the underground mines. First hand observations and discussions with underground mine operators indicate good correlation of mine hazard maps prepared from ERTS-1/aircraft imagery and actual roof falls. The inventory of refuse piles/slurry ponds of the coal field of Indiana has identified over 225 such sites from past mining operations. These data will serve the State Legislature in making tax decisions on coal mining which take on increased importance because of the energy crisis.

A revisit to high-rate mode-II fracture characterization of composites with Kolsky bar techniques.

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

Lu, Wei-Yang; Song, Bo; Jin, Huiqing

2010-03-01

Nowadays composite materials have been extensively utilized in many military and industrial applications. For example, the newest Boeing 787 uses 50% composite (mostly carbon fiber reinforced plastic) in production. However, the weak delamination strength of fiber reinforced composites, when subjected to external impact such as ballistic impact, has been always potential serious threats to the safety of passengers. Dynamic fracture toughness is a critical indicator of the performance from delamination in such impact events. Quasi-static experimental techniques for fracture toughness have been well developed. For example, end notched flexure (ENF) technique, which is illustrated in Fig. 1, has become amore » typical method to determined mode-II fracture toughness for composites under quasi-static loading conditions. However, dynamic fracture characterization of composites has been challenging. This has resulted in conflictive and confusing conclusions in regard to strain rate effects on fracture toughness of composites.« less

Beneficial effects of intravenous pamidronate treatment in children with osteogenesis imperfecta under 24 months of age.

PubMed

Kusumi, Kirsten; Ayoob, Rose; Bowden, Sasigarn A; Ingraham, Susan; Mahan, John D

2015-09-01

Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and low bone mass. Low bone density and fracture is a cause of morbidity. Limited data exists on bisphosphonate treatment in patients under 24 months of age. The objective of the study was to examine the safety and efficacy of pamidronate in children under 24 months with OI. To do so, we carried out a retrospective chart review and analysis of OI patients started on intravenous pamidronate under 24 months of age. Pamidronate was administered in three-day cycles. Growth, the number of fractures, and lumbar bone mineral densities were recorded both prior to and after treatment initiation. A total of 18 patients were reviewed. Five were classified as OI type I, seven were type III, and six were type IV. The mean age at treatment initiation was 12 months (range 11 days to 23 months). The mean lumbar z score at baseline was -3.63, which improved to -1.53 at one year (P < 0.01) and 0.79 (P < 0.01) at the end of the study. The fracture rate improved from 68 fractures in 209 months (0.32 fractures/patient-month) before treatment to 41 fractures in 1,248 months (0.03 fractures/patient-month) post-treatment (P < 0.05). Height standard deviation score (SDS) was conserved from baseline to end of study (-2.12 ± 2.45 vs. -2.45 ± 2.73) (P = 0.05) with an average follow-up of 73 months. The only adverse effect recorded in six infants was fever during the initial pamidronate infusion. Treatment with intravenous pamidronate is safe, significantly improves lumbar bone mineral density (L-BMD), and reduces fracture rates in young infants with OI while preserving linear growth.

Delayed pneumothorax complicating minor rib fracture after chest trauma.

PubMed

Lu, Ming-Shian; Huang, Yao-Kuang; Liu, Yun-Hen; Liu, Hui-Ping; Kao, Chiung-Lun

2008-06-01

Pneumothorax (PTX) after trauma is a preventable cause of death. Drainage procedures such as chest tube insertion have been traditionally advocated to prevent fatal tension PTX. We evaluated the safety of close observation in patients with delayed PTX complicating rib fracture after minor chest trauma. Adult patients (>18 years) with a diagnosis of chest trauma and 3 or fewer fractured ribs were reviewed. Case patients were divided according to age, location and number of fractured ribs, mechanism of trauma, and initial pulmonary complication after thoracic trauma for comparative analysis. There were 207 male (70.2%) and 88 female (29.8%) patients whose ages ranged from 18 to 93 years (median, 55 years). The mechanisms of trauma were a motor vehicle accident in 207 patients, falls in 66, pedestrian injury in 10, and assaults in 14. Ninety-five patients sustained 1 rib fracture, 95 had 2 rib fractures, and 105 suffered 3 rib fractures. Right-sided injury occurred in 164 cases, left-sided injury did in 127, and bilateral injury did in 4. The most frequent location of rib fractures was from the fourth rib to the ninth rib. The initial pulmonary complications after trauma were PTX in 16 patients, hemothorax in 43, pneumohemothorax in 14, lung contusion in 75, and isolated subcutaneous emphysema (SubcEmph) in 33. Thirty percent of the patients (n = 5/16) who presented with traumatic PTX were observed safely without drainage. Delayed PTX was recorded in 16 patients, occurring mostly during the first 2 days of their admission. Associated extrathoracic injury was recorded in 189 patients. The mean hospital stay of the patients was 7.66 days. Longer hospital stay was related to increasing number of fractured ribs, need for thoracic drainage, and the presence of associated extrathoracic injury. The mortality rate for the entire group was 2%. The presence of SubcEmph was the only risk factor associated with the development of delayed PTX. Patients sustaining blunt chest trauma and minor rib fractures should be admitted for close observation when presenting with SubcEmph because of possible delayed presentation of PTX.

Sternal fractures occur most often in old cars to seat-belted drivers without any airbag often with concomitant spinal injuries: clinical findings and technical collision variables among 42,055 crash victims.

PubMed

Knobloch, Karsten; Wagner, Sebastian; Haasper, Carl; Probst, Christian; Krettek, Christian; Otte, Dietmar; Richter, Martinus

2006-08-01

The incidence and treatment of sternal fractures caused by traffic accidents is of increasing importance to ensure best possible outcomes. Analysis of technical indicators of the collision, preclinical, and clinical data of patients with sternal fractures from 1985 to 2004 among 42,055 injured patients was assessed by an Accident Research Unit. Two time groups were categorized: 1985 to 1994 (group A) versus 1995 to 2004 (group B). Of 42,055 patients, 267 (0.64%) suffered a sternal fracture. Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251 of 31,183 patients), followed by 0.19% (5 of 2,633 patients) driving motorbike, and 0.11% (4 of 3,258 patients) driving a truck. Ninety-one percent wore a safety belt. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33 of 255 car/trucks), with an airbag malfunction in 18%. The steering column was deformed in 39%, the steering wheel in 36%. Cars in the recent years were significantly older (group B, 7.67 +/- 5 years, versus group A, 5.88 +/- 5 years; p = 0.003). Cervical spine injuries are frequent (23% versus 22%), followed by multiple rib fractures (14% versus 12%) and lung contusions (12% versus 11%). We found 9 of 146 (6%) and 3 of 121 patients (3%) with heart contusion among the 267 sternal fractures. Maximal abbreviated injury scale score was 2.56 +/- 1.3 versus 2.62 +/- 1.3 (group A versus B, p = 0.349). Eighteen percent of patients were polytraumatized, with 11.2% dying at the scene, 2.3% in the hospital. Sternal fractures occur most often in old cars to seat-belted drivers often without any airbag. Severe multiple rib fractures and lung contusion are concomitant injuries in more than 10% each, indicating the severity of the crash. Over a 20-year period, the injury severity encountered was not different, with 18% polytrauma patients suffering sternal fractures.

Impact of automobile restraint device utilization on facial fractures and fiscal implications for plastic surgeons.

PubMed

Adkinson, Joshua M; Murphy, Robert X

2011-05-01

In 2009, the National Highway Traffic Safety Administration projected that 33,963 people would die and millions would be injured in motor vehicle collisions (MVC). Multiple studies have evaluated the impact of restraint devices in MVCs. This study examines longitudinal changes in facial fractures after MVC as result of utilization of restraint devices. The Pennsylvania Trauma Systems Foundation-Pennsylvania Trauma Outcomes Study database was queried for MVCs from 1989 to 2009. Restraint device use was noted, and facial fractures were identified by International Classification of Diseases-ninth revision codes. Surgeon cost data were extrapolated. More than 15,000 patients sustained ≥1 facial fracture. Only orbital blowout fractures increased over 20 years. Patients were 2.1% less likely every year to have ≥1 facial fracture, which translated into decreased estimated surgeon charges. Increased use of protective devices by patients involved in MVCs resulted in a change in incidence of different facial fractures with reduced need for reconstructive surgery.

Federal Aviation Administration Plan for Research, Engineering & Development, 1998.

DTIC Science & Technology

1998-02-01

release rate. • Improved fracture toughness of non-combustible geopolymer composite fire barriers to enable use as interior and secondary composites ...Fire Resistant, Non-Toxic Interior Panels for Evaluation of Heat Release Rate ♦ Improved Fracture Toughness of Non-Combustible Geopolymer Composite ... composites , atmospheric hazards, crash worthiness, fire safety, and forensics capabilities to support accident investigations. Aviation Security R,E&D

Visit from JAXA to NASA MSFC: The Engines Element & Ideas for Collaboration

NASA Technical Reports Server (NTRS)

Greene, William D.

2013-01-01

System Design, Development, and Fabrication: Design, develop, and fabricate or procure MB-60 component hardware compliant with the imposed technical requirements and in sufficient quantities to fulfill the overall MB-60 development effort. System Development, Assembly, and Test: Manage the scope of the development, assembly, and test-related activities for MB-60 development. This scope includes engine-level development planning, engine assembly and disassembly, test planning, engine testing, inspection, anomaly resolution, and development of necessary ground support equipment and special test equipment. System Integration: Provide coordinated integration in the realms of engineering, safety, quality, and manufacturing disciplines across the scope of the MB-60 design and associated products development Safety and Mission Assurance, structural design, fracture control, materials and processes, thermal analysis. Systems Engineering and Analysis: Manage and perform Systems Engineering and Analysis to provide rigor and structure to the overall design and development effort for the MB-60. Milestone reviews, requirements management, system analysis, program management support Program Management: Manage, plan, and coordinate the activities across all portions of the MB-60 work scope by providing direction for program administration, business management, and supplier management.

Spine and Spinal Cord Injuries After Falls From Tree Stands During the Wisconsin Deer Hunting Season.

PubMed

Hamilton, Kimberly; Rocque, Brandon; Brooks, Nathaniel

2017-11-01

Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. We reviewed the University of Wisconsin Hospital and Clinics' trauma database for tree stand-related injuries from 1999 to 2013. We collected and analyzed data pertaining to hunters' demographics, comorbidities, type and mechanism of injury, injury severity, and management. We identified 117 patients evaluated after a tree stand fall. Sixty-five (ages 16-76) suffered spine fractures that occurred at all levels, from occipital condyle to sacrum, with thoracolumbar compression and burst fractures being most common. Fractures occurred in the following locations: cranio-cervical junction (8.7%), cervical spine (7.6%), cervical-thoracic junction (6.5%), thoracic spine (32.6%), thoracolumbar junction (33.7%), and lumbar spine (10.9%). Twenty-one patients (32%) experienced a single spinal fracture; 44 patients (68%) suffered multiple spinal fractures. Twenty-five patients (38%) required surgical fixation; 19 patients experienced loss of neurologic function: 5 complete spinal cord injuries (SCI), 5 incomplete SCI, 2 central cord syndromes, and 8 radiculopathies. Two mortalities, both of cardiopulmonary etiology, were noted-one in a patient without a spine fracture and the other in a patient with a complete spinal cord injury at T4. The majority of spine fractures are treated nonoperatively. However, enough patients require surgical intervention that consultation with a neurosurgical or orthopedic spine surgeon is prudent. It is more common to have multiple spine fractures from a tree stand fall, therefore, it is recommended that if 1 fracture is identified the entire spine be evaluated for additional fractures. For safety, it is recommended that hunters wear and use safety harnesses appropriately. Additionally, keeping the height of the tree stand at 10 feet or less is associated with a lower likelihood of spinal cord injury. Further study is needed to determine additional interventions such as education that might reduce the injury frequency in this population.

Settlement mechanism of piled-raft foundation due to cyclic train loads and its countermeasure

NASA Astrophysics Data System (ADS)

Gu, Linlin; Ye, Guanlin; Wang, Zhen; Ling, Xianzhang; Zhang, Feng

2017-07-01

In this paper, numerical simulation with soil-water coupling finite element-finite difference (FE-FD) analysis is conducted to investigate the settlement and the excess pore water pressure (EPWP) of a piled-raft foundation due to cyclic high-speed (speed: 300km/h) train loading. To demonstrate the performance of this numerical simulation, the settlement and EPWP in the ground under the train loading within one month was calculated and confirmed by monitoring data, which shows that the change of the settlement and EPWP can be simulated well on the whole. In order to ensure the safety of train operation, countermeasure by the fracturing grouting is proposed. Two cases are analyzed, namely, grouting in No-4 softest layer and No-9 pile bearing layer respectively. It is found that fracturing grouting in the pile bearing layer (No-9 layer) has better effect on reducing the settlement.

Unconventional oil and gas extraction and animal health.

PubMed

Bamberger, M; Oswald, R E

2014-08-01

The extraction of hydrocarbons from shale formations using horizontal drilling with high volume hydraulic fracturing (unconventional shale gas and tight oil extraction), while derived from methods that have been used for decades, is a relatively new innovation that was introduced first in the United States and has more recently spread worldwide. Although this has led to the availability of new sources of fossil fuels for domestic consumption and export, important issues have been raised concerning the safety of the process relative to public health, animal health, and our food supply. Because of the multiple toxicants used and generated, and because of the complexity of the drilling, hydraulic fracturing, and completion processes including associated infrastructure such as pipelines, compressor stations and processing plants, impacts on the health of humans and animals are difficult to assess definitively. We discuss here findings concerning the safety of unconventional oil and gas extraction from the perspectives of public health, veterinary medicine, and food safety.

Design-Optimization and Material Selection for a Proximal Radius Fracture-Fixation Implant

NASA Astrophysics Data System (ADS)

Grujicic, M.; Xie, X.; Arakere, G.; Grujicic, A.; Wagner, D. W.; Vallejo, A.

2010-11-01

The problem of optimal size, shape, and placement of a proximal radius-fracture fixation-plate is addressed computationally using a combined finite-element/design-optimization procedure. To expand the set of physiological loading conditions experienced by the implant during normal everyday activities of the patient, beyond those typically covered by the pre-clinical implant-evaluation testing procedures, the case of a wheel-chair push exertion is considered. Toward that end, a musculoskeletal multi-body inverse-dynamics analysis is carried out of a human propelling a wheelchair. The results obtained are used as input to a finite-element structural analysis for evaluation of the maximum stress and fatigue life of the parametrically defined implant design. While optimizing the design of the radius-fracture fixation-plate, realistic functional requirements pertaining to the attainment of the required level of the devise safety factor and longevity/lifecycle were considered. It is argued that the type of analyses employed in the present work should be: (a) used to complement the standard experimental pre-clinical implant-evaluation tests (the tests which normally include a limited number of daily-living physiological loading conditions and which rely on single pass/fail outcomes/decisions with respect to a set of lower-bound implant-performance criteria) and (b) integrated early in the implant design and material/manufacturing-route selection process.

Approach to the Child with Fractures

PubMed Central

Boyce, Alison M.

2011-01-01

Evaluation of the child with fractures is challenging, as no clear guidelines exist to distinguish traumatic from pathological fractures. Although most fractures in childhood are benign, recurrent fractures may be associated with a wide variety of primary skeletal diseases as well as secondary causes, necessitating a careful history and physical exam to guide the evaluation. There is no “gold standard” for the evaluation and treatment of children with fractures and low bone mineral density (BMD); therefore, the diagnosis of osteoporosis in a pediatric patient should be made using a combination of clinical and radiographic features. Interpretation of bone densitometry in growing patients presents a unique set of challenges because areal BMD measured by dual-energy x-ray absorptiometry depends on multiple dynamic variables. Interpretation of pediatric dual-energy x-ray absorptiometry should be based on Z-scores (sd scores compared to age, sex, and ethnicity-matched controls), using normative databases specific to the brand of densitometer and the patient population. Given the skeleton's ability to recover from low BMD through modeling and remodeling, optimizing management of underlying conditions leading to bone fragility is the initial step. Conservative measures including calcium and vitamin D supplementation and weight-bearing physical activity are important interventions that should not be overlooked. The use of bisphosphonates in children and adolescents is controversial due to lack of long-term efficacy and safety data and should be limited to clinical trials and compassionate therapy in children with significantly compromised quality of life. Close monitoring is required, and further study is necessary to assess their long-term safety and efficacy in children. PMID:21734001

Estimation of Ultimate Tensile Strength of dentin Using Finite Element Analysis from Endodontically Treated Tooth

NASA Astrophysics Data System (ADS)

Sinthaworn, S.; Puengpaiboon, U.; Warasetrattana, N.; Wanapaisarn, S.

2018-01-01

Endodontically treated teeth were simulated by finite element analysis in order to estimate ultimate tensile strength of dentin. Structures of the endodontically treated tooth cases are flared root canal, restored with different number of fiber posts {i.e. resin composite core without fiber post (group 1), fiber post No.3 with resin composite core (group 2) and fiber post No.3 accessory 2 fiber posts No.0 with resin composite core (group 3)}. Elastic modulus and Poisson’s ratio of materials were selected from literatures. The models were loaded by the average fracture resistances load of each groups (group 1: 361.80 N, group 2: 559.46 N, group 3: 468.48 N) at 135 degree angulation in respect to the longitudinal axis of the teeth. The stress analysis and experimental confirm that fracture zone is at dentin area. To estimate ultimate tensile strength of dentin, trial and error of ultimate tensile strength were tested to obtain factor of safety (FOS) equal to 1.00. The result reveals that ultimate tensile strength of dentin of group 1, 2, 3 are 38.89, 30.96, 37.19 MPa, respectively.

Efficacy and safety of once-yearly zoledronic acid in Japanese patients with primary osteoporosis: two-year results from a randomized placebo-controlled double-blind study (ZOledroNate treatment in Efficacy to osteoporosis; ZONE study).

PubMed

Nakamura, T; Fukunaga, M; Nakano, T; Kishimoto, H; Ito, M; Hagino, H; Sone, T; Taguchi, A; Tanaka, S; Ohashi, M; Ota, Y; Shiraki, M

2017-01-01

In a 2-year randomized, placebo-controlled study of 665 Japanese patients with primary osteoporosis, once-yearly administration of zoledronic acid (5 mg) reduced the risk of new morphometric vertebral fractures. The purpose of this study was to determine the efficacy and safety of once-yearly intravenous infusion of ZOL in Japanese patients with primary osteoporosis. This was a two-year multicenter, randomized, placebo-controlled, double-blind, parallel-group comparative study (ZONE Study). Subjects were 665 Japanese patients between the ages of 65 and 89 years who had prevalent vertebral fracture. Subjects were randomly assigned to receive once-yearly intravenous infusion of 5 mg of ZOL or placebo at baseline and 12 months. The 2-year incidence of new morphometric vertebral fracture was 3.0 % (10/330 subjects) in the ZOL group and 8.9 % (29/327) in the placebo group (p = 0.0016). The 24-month cumulative incidence of new morphometric vertebral fracture was 3.3 % in the ZOL group versus 9.7 % in the placebo group (log-rank test: p = 0.0029; hazard ratio: 0.35; 95 % confidence interval: 0.17-0.72). The cumulative incidence of any clinical fracture, clinical vertebral fracture, and non-vertebral fracture was significantly reduced in the ZOL group by 54, 70, and 45 %, respectively, compared to the placebo group. At 24 months, ZOL administration increased bone mineral density in the lumbar spine, femoral neck, and total hip (t test: p < 0.0001). No new adverse events or osteonecrosis of the jaw were observed in this study. Once-yearly administration of ZOL 5 mg to Japanese patients with primary osteoporosis reduced the risk of new morphometric vertebral fractures and was found to be safe.

Stress analysis and design considerations for Shuttle pointed autonomous research tool for astronomy /SPARTAN/

NASA Technical Reports Server (NTRS)

Ferragut, N. J.

1982-01-01

The Shuttle Pointed Autonomous Research Tool for Astronomy (SPARTAN) family of spacecraft are intended to operate with minimum interfaces with the U.S. Space Shuttle in order to increase flight opportunities. The SPARTAN I Spacecraft was designed to enhance structural capabilities and increase reliability. The approach followed results from work experience which evolved from sounding rocket projects. Structural models were developed to do the analyses necessary to satisfy safety requirements for Shuttle hardware. A loads analysis must also be performed. Stress analysis calculations will be performed on the main structural elements and subcomponents. Attention is given to design considerations and program definition, the schematic representation of a finite element model used for SPARTAN I spacecraft, details of loads analysis, the stress analysis, and fracture mechanics plan implications.

The continued burden of spine fractures after motor vehicle crashes.

PubMed

Wang, Marjorie C; Pintar, Frank; Yoganandan, Narayan; Maiman, Dennis J

2009-02-01

Spine fractures are a significant cause of morbidity and mortality after motor vehicle crashes (MVCs). Public health interventions, such as the National Highway Traffic Safety Administration's Federal Motor Vehicle Safety Standards, have led to an increase in automobiles with air bags and the increased use of seat belts to lessen injuries sustained from MVCs. The purpose of this study was to evaluate secular trends in the occurrence of spine fractures associated with MVCs and evaluate the association between air bag and seat belt use with spine fractures. Using the Crash Outcome Data Evaluation System, a database of the police reports of all MVCs in Wisconsin linked to hospital records, the authors studied the occurrence of spine fractures and seat belt and air bag use from 1994 to 2002. Demographic information and crash characteristics were obtained from the police reports. Injury characteristics were determined using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) hospital discharge codes. From 1994 to 2002, there were 29,860 hospital admissions associated with automobile or truck crashes. There were 20,276 drivers or front-seat passengers 16 years of age and older who were not missing ICD-9-CM discharge codes, seat belt or air bag data, and who had not been ejected from the vehicle. Of these, 2530 (12.5%) sustained a spine fracture. The occurrence of spine fractures increased over the study period, and the use of a seat belt plus air bag, and of air bags alone also increased during this period. However, the occurrence of severe spine fractures (Abbreviated Injury Scale Score > or =3) did not significantly increase over the study period. The use of both seat belt and air bag was associated with decreased odds of a spine fracture. Use of an air bag alone was associated with increased odds of a severe thoracic, but not cervical spine fracture. Among drivers and front-seat passengers admitted to the hospital after MVCs, the occurrence of spine fractures increased from 1994 to 2002 despite concomitant increases in seat belt and air bag use. However, the occurrence of severe spine fractures did not increase over the study period. The use of both seat belt and air bag is protective against spine fractures. Although the overall increased occurrence of spine fractures may appear contrary to the increased use of seat belts and air bags in general, it is possible that improved imaging technology may be associated with an increase in the diagnosis of relatively minor fractures. However, given the significant protective effects of both seat belt and air bag use against spine fractures, resources should continue to be dedicated toward increasing their use to mitigate the effects of MVCs.

Heavy-section steel irradiation program. Semiannual progress report, October 1996--March 1997

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

Rosseel, T.M.

1998-02-01

Maintaining the integrity of the reactor pressure vessel (RPV) in a light-water-cooled nuclear power plant is crucial in preventing and controlling severe accidents that have the potential for major contamination release. Because the RPV is the only key safety-related component of the plant for which a redundant backup system does not exist, it is imperative to fully understand the degree of irradiation-induced degradation of the RPV`s fracture resistance that occurs during service. For this reason, the Heavy-Section Steel Irradiation (HSSI) Program has been established. Its primary goal is to provide a thorough, quantitative assessment of the effects of neutron irradiationmore » on the material behavior and, in particular, the fracture toughness properties of typical pressure-vessel steels as they relate to light-water RPV integrity. Effects of specimen size; material chemistry; product form and microstructure; irradiation fluence, flux, temperature, and spectrum; and postirradiation annealing are being examined on a wide range of fracture properties. The HSSI Program is arranged into eight tasks: (1) program management, (2) irradiation effects in engineering materials, (3) annealing, (4) microstructural analysis of radiation effects, (5) in-service irradiated and aged material evaluations, (6) fracture toughness curve shift method, (7) special technical assistance, and (8) foreign research interactions. The work is performed by the Oak Ridge National Laboratory.« less

Finite element modelling of primary hip stem stability: the effect of interference fit.

PubMed

Abdul-Kadir, Mohammed Rafiq; Hansen, Ulrich; Klabunde, Ralf; Lucas, Duncan; Amis, Andrew

2008-01-01

The most commonly reported complications related to cementless hip stems are loosening and thigh pain; both of these have been attributed to high levels of relative micromotion at the bone-implant interface due to insufficient primary fixation. Primary fixation is believed by many to rely on achieving a sufficient interference fit between the implant and the bone. However, attempting to achieve a high interference fit not infrequently leads to femoral canal fracture either intra-operatively or soon after. The appropriate range of diametrical interference fit that ensures primary stability without risking femoral fracture is not well understood. In this study, a finite element model was constructed to predict micromotion and, therefore, instability of femoral stems. The model was correlated with an in vitro micromotion experiment carried out on four cadaver femurs. It was confirmed that interference fit has a very significant effect on micromotion and ignoring this parameter in an analysis of primary stability is likely to underestimate the stability of the stem. Furthermore, it was predicted that the optimal level of interference fit is around 50 microm as this is sufficient to achieve good primary fixation while having a safety factor of 2 against femoral canal fracture. This result is of clinical relevance as it indicates a recommendation for the surgeon to err on the side of a low interference fit rather than risking femoral fracture.

Application and Testing of Transparent Plastics Used in Airplane Construction

NASA Technical Reports Server (NTRS)

Riechers, K; Olms, J

1938-01-01

This report concerns the efforts being made to remove the source of danger to passengers arising from the fracturing of silicate glass. Some of the alternatives presented include: single-layer safety glass, multi-layer safety glass, transparent plastic resins. Some of the resins considered are celluloid, cellulose acetates, and mixtures of polymers.

Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral and Proximal Popliteal Arteries: Twelve-Month Results of the SUPERB Trial.

PubMed

Garcia, Lawrence; Jaff, Michael R; Metzger, Christopher; Sedillo, Gino; Pershad, Ashish; Zidar, Frank; Patlola, Raghotham; Wilkins, Robert G; Espinoza, Andrey; Iskander, Ayman; Khammar, George S; Khatib, Yazan; Beasley, Robert; Makam, Satyaprakash; Kovach, Richard; Kamat, Suraj; Leon, Luis R; Eaves, William Britton; Popma, Jeffrey J; Mauri, Laura; Donohoe, Dennis; Base, Carol C; Rosenfield, Kenneth

2015-05-01

Stent-based therapy in the superficial femoral and popliteal arteries in patients with peripheral artery disease is compromised by restenosis and risk of stent fracture or distortion. A novel self-expanding nitinol stent was developed that incorporates an interwoven-wire design (Supera stent, IDEV Technologies, Inc, Webster, TX) to confer greater radial strength, flexibility, and fracture resistance. This prospective, multicenter, investigational device exemption, single-arm trial enrolled 264 patients with symptomatic peripheral artery disease undergoing percutaneous treatment of de novo or restenotic lesions of the superficial femoral or proximal popliteal (femoropopliteal) artery. Freedom from death, target lesion revascularization, or any amputation of the index limb at 30 days (+ 7 days) postprocedure was achieved in 99.2% (258/260) of patients (P < 0.001). Primary patency at 12 months (360 ± 30 days) was achieved in 78.9% (180/228) of the population (P < 0.001). Primary patency by Kaplan-Meier analysis at 12 months (360 days) was 86.3%. No stent fracture was observed by independent core laboratory analysis in the 243 stents (228 patients) evaluated at 12 months. Clinical assessment at 12 months demonstrated improvement by at least 1 Rutherford-Becker category in 88.7% of patients. The SUPERB Trial, an investigational device exemption study using an interwoven nitinol wire stent in the femoropopliteal artery, achieved the efficacy and safety performance goals predesignated by the Food and Drug Administration. On the basis of the high primary patency rate, absence of stent fracture, and significant improvements in functional and quality-of-life measures, the Supera stent provides safe and effective treatment of femoropopliteal lesions in symptomatic patients with peripheral artery disease. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00933270. © 2015 American Heart Association, Inc.

Mountain biking-related injuries treated in emergency departments in the United States, 1994-2007.

PubMed

Nelson, Nicolas G; McKenzie, Lara B

2011-02-01

Injury research on mountain biking has been mostly limited to examining professional riders and off-road biking. Mountain bikes represent the largest segment of bike sales in the United States. Recreational mountain bike use is popular and understudied. To describe the scope, distribution, and trends of mountain bike-related injuries treated in US emergency departments. Descriptive epidemiologic study. A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients aged ≥ 8 years from 1994 through 2007. Sample weights provided by the system were used to calculate national estimates of mountain bike-related injuries based on 4624 cases. Bivariate comparisons between categorical variables were assessed with injury proportion ratios and 95% confidence intervals. Nationwide, an estimated 217 433 patients were treated for mountain bike-related injuries in US emergency departments from 1994 to 2007, an average of 15 531 injuries per year. The annual number of injuries decreased 56%, from a high of 23 177 in 1995 to 10 267 in 2007 (P < .001). The most common injuries were upper extremity fractures (10.6%) and shoulder fractures (8.3%). Patients aged 14 to 19 years sustained a greater proportion of traumatic brain injuries (8.4%) than did patients aged 8 to 13 years and ≥ 20 years combined (4.3%). A greater proportion of female riders (6.1%) than male riders (4.5%) were hospitalized. Mountain bike-related injuries decreased from 1994 to 2007. Upper extremity fractures were the most common injury. Girls and women may be more likely than boys and men to sustain more severe injuries requiring hospitalization. Despite the decline over the past decade, more can be done to improve safety and reduce injuries in this popular recreational activity.

Strontium ranelate: short- and long-term benefits for post-menopausal women with osteoporosis

PubMed Central

2008-01-01

Strontium ranelate is a bone-seeking element that has been assessed in post-menopausal osteoporosis in two large double-blind, placebo-controlled studies. This treatment is able to decrease the risk of vertebral fractures, by 41% over 3 yrs, and by 49% within the first year of treatment. This risk of non-vertebral fractures is decreased by 16% and, in patients at high risk for such a fracture, the risk of hip fracture is decreased by 36% over 3 yrs. Recent 5-yr data from these double-blind, placebo-controlled studies show that the anti-fracture efficacy is maintained over time. Treatment efficacy with strontium ranelate has been documented across a wide range of patient profiles: age, number of prevalent vertebral fractures, BMI, as well as family history of osteoporosis and addiction to smoking are not determinants of anti-fracture efficacy. During these clinical trials, safety was good. Its large spectrum of efficacy allows the use of strontium ranelate in the different subgroups of patients with post-menopausal osteoporosis. PMID:18556647

Solute transport in a single fracture involving an arbitrary length decay chain with rock matrix comprising different geological layers.

PubMed

Mahmoudzadeh, Batoul; Liu, Longcheng; Moreno, Luis; Neretnieks, Ivars

2014-08-01

A model is developed to describe solute transport and retention in fractured rocks. It accounts for advection along the fracture, molecular diffusion from the fracture to the rock matrix composed of several geological layers, adsorption on the fracture surface, adsorption in the rock matrix layers and radioactive decay-chains. The analytical solution, obtained for the Laplace-transformed concentration at the outlet of the flowing channel, can conveniently be transformed back to the time domain by the use of the de Hoog algorithm. This allows one to readily include it into a fracture network model or a channel network model to predict nuclide transport through channels in heterogeneous fractured media consisting of an arbitrary number of rock units with piecewise constant properties. More importantly, the simulations made in this study recommend that it is necessary to account for decay-chains and also rock matrix comprising at least two different geological layers, if justified, in safety and performance assessment of the repositories for spent nuclear fuel. Copyright © 2014 Elsevier B.V. All rights reserved.

The research on delayed fracture behavior of high-strength bolts in steel structure

NASA Astrophysics Data System (ADS)

Li, Guo dong; Li, Nan

2017-07-01

High-strength bolts have been widely used in power plants. However, the high-strength bolts which being employed in pumping station, steel structure and pipeline anti-whip structure have been found delayed fracture for many times in a power plant, this will affect the reliability of steel fracture and bring blow risk caused by falling objects. The high-strength bolt with delayed fracture was carried out fracture analysis, metallurgical analysis, chemical analysis, mechanical analysis, as well as bolts installation analysis, it can be comprehensively confirmed that the direct cause of high-strength bolts delayed fracture is the stress corrosion, and the root cause of high-strength bolts delayed fracture should be the improper installation at the initial and the imperfect routine anti-corrosion maintenance.

Exercise prescription after fragility fracture in older adults: a scoping review

PubMed Central

Feehan, Lynne M.; Beck, Charlotte A.; Harris, Susan R.; MacIntyre, Donna L.; Li, Linda C.

2017-01-01

Purpose To identify and chart research literature on safety, efficacy or effectiveness of exercise prescription following fracture in older adults. Methods We conducted a systematic, research-user-informed, scoping review. The population of interest was adults aged ≥ 45 years with any fracture. ‘Exercise prescription’ included post-fracture therapeutic exercise, physical activity or rehabilitation interventions. Eligible designs included knowledge synthesis studies, primary interventional studies and observational studies. Trained reviewers independently evaluated citations for inclusion. Results A total of 9415 citations were reviewed with 134 citations (119 unique studies) identified: 13 knowledge syntheses, 95 randomized or controlled clinical trials, and 11 ‘other’ designs, representing 74 articles on lower extremity fractures, 34 on upper extremity, eight on vertebral, and three on mixed body region fractures. Exercise prescription characteristics were often missing or poorly described. Six general categories emerged describing exercise prescription characteristics: timing post-fracture, person prescribing, program design, functional focus, exercise script parameters and co-interventions. Upper extremity and ankle fracture studies focused on fracture healing or structural impairment outcomes, whereas hip fracture studies focused more on activity limitation outcomes. The variety of different outcome measures used made pooling or comparison of outcomes difficult. Conclusions There was insufficient information to identify evidence-informed parameters for safe and effective exercise prescription for older adults following fracture. Key gaps in the literature include limited numbers of studies on exercise prescription following vertebral fracture, poor delineation of effectiveness of different strategies for early post-fracture mobilization following upper extremity fracture, and inconsistent details of exercise prescription characteristics after lower extremity fracture. PMID:20967425

Fracture resistance behaviour of gamma-irradiation sterilized cortical bone protected with a ribose pre-treatment

NASA Astrophysics Data System (ADS)

Woodside, Carman Mitchell

Structural bone allograft reconstructions are often implemented to repair large skeletal defects. To ensure the biological safety of the patient, allograft material is routinely sterilized with gamma-irradiation prior to implantation. The sterilization process damages the tissue, specifically the collagen protein network, leading to severe losses in the mechanical properties of the bone. Our lab has begun developing a ribose pre-treatment that can protect bone from these harmful effects. The goals of the present study were to develop a method to measure the fracture toughness of bone, an important clinical failure mode, and implement it to determine the effectiveness of the ribose pre-treatment on fracture toughness. We have shown that the ribose pre-treatment is successful at protecting some of the original fracture toughness of sterilized bone, and that the connectivity of the collagen network is an important contributor to the fracture resistance of bone.

Analysis of Workplace Accidents in Automotive Repair Workshops in Spain.

PubMed

López-Arquillos, Antonio; Rubio-Romero, Juan Carlos

2016-09-01

To analyze the effects of the factors associated with different types of injury (superficial wounds, dislocations and sprains, bone fractures, concussion and internal injuries, burns scalding and freezing) caused by occupational accidents in automotive repair workshops. Study of a sample consisting of 89,954 industry accidents reported from 2003 to 2008. Odds ratios were calculated with a 95% confidence interval. Belonging to a small company is a risk factor for suffering three of the five types of injury studied. Women are less likely to suffer burns and superficial wounds, and more likely to suffer dislocations or sprains. Foreign workers are more likely to suffer concussion and internal injuries. Health and safety strategies and accident prevention measures should be individualized and adapted to the type of worker most likely to be injured in each type of accident. Occupational health and safety training courses designed according to worker profile, and improving the participation of the workers in small firms creating regional or roving safety representatives would improve working conditions.

Fundamentals of Aeronautical and Aerospace Medical Science,

DTIC Science & Technology

1981-07-17

internal air bubbles and gas embol - isms can appear; over 18 kilometers it is necessary to use a pressure suit to maintain life safety. 10. Airtight...examinations have expanded this to fractures , muscle and skin injuries, blood spots, muscle tension and weakness, heart and intracranial hemorrhaging...vertebra inclines forward and when the front edge of the vertebra is subjected to a concentration of negative overweightness, fractures occur. If the

Multi-scale groundwater flow modeling during temperate climate conditions for the safety assessment of the proposed high-level nuclear waste repository site at Forsmark, Sweden

NASA Astrophysics Data System (ADS)

Joyce, Steven; Hartley, Lee; Applegate, David; Hoek, Jaap; Jackson, Peter

2014-09-01

Forsmark in Sweden has been proposed as the site of a geological repository for spent high-level nuclear fuel, to be located at a depth of approximately 470 m in fractured crystalline rock. The safety assessment for the repository has required a multi-disciplinary approach to evaluate the impact of hydrogeological and hydrogeochemical conditions close to the repository and in a wider regional context. Assessing the consequences of potential radionuclide releases requires quantitative site-specific information concerning the details of groundwater flow on the scale of individual waste canister locations (1-10 m) as well as details of groundwater flow and composition on the scale of groundwater pathways between the facility and the surface (500 m to 5 km). The purpose of this article is to provide an illustration of multi-scale modeling techniques and the results obtained when combining aspects of local-scale flows in fractures around a potential contaminant source with regional-scale groundwater flow and transport subject to natural evolution of the system. The approach set out is novel, as it incorporates both different scales of model and different levels of detail, combining discrete fracture network and equivalent continuous porous medium representations of fractured bedrock.

Heavy-section steel technology and irradiation programs-retrospective and prospective views

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

Nanstad, Randy K; Bass, Bennett Richard; Rosseel, Thomas M

In 1965, the Atomic Energy Commission (AEC), at the advice of the Advisory Committee on Reactor Safeguards (ACRS), initiated the process that resulted in the establishment of the Heavy Section Steel Technology (HSST) Program at Oak Ridge National Laboratory (ORNL). Dr. Spencer H. Bush of Battelle Northwest Laboratory, the man being honored by this symposium, representing the ACRS, was one of the Staff Advisors for the program and helped to guide its technical direction. In 1989, the Heavy-Section Steel Irradiation (HSSI) Program, formerly the HSST task on irradiation effects, was formed as a separate program, and this year the HSST/HSSImore » Programs, sponsored by the U.S. Nuclear Regulatory Commission (USNRC), celebrate 40 years of continuous research oriented toward the safety of light-water nuclear reactor pressure vessels. This paper presents a summary of results from those programs with a view to future activities. The HSST Program was established in 1967 and initially included extensive investigations of heavy-section low-alloy steel plates, forgings, and welds, including metallurgical studies, mechanical properties, fracture toughness (quasi-static and dynamic), fatigue crack-growth, and crack arrest toughness. Also included were irradiation effects studies, thermal shock analyses, testing of thick-section tensile and fracture specimens, and non-destructive testing. In the subsequent decades, the HSST Program conducted extensive large-scale experiments with intermediate-size vessels (with varying size flaws) pressurized to failure, similar experiments under conditions of thermal shock and even pressurized thermal shock (PTS), wide-plate crack arrest tests, and biaxial tests with cruciform-shaped specimens. Extensive analytical and numerical studies accompanied these experiments, including the development of computer codes such as the recent Fracture Analysis of Vessels Oak Ridge (FAVOR) code currently being used for PTS evaluations. In the absence of radiation damage to the RPV, fracture of the vessel is improbable. However, exposure to high energy neutrons can result in embrittlement of radiation-sensitive RPV materials. The HSSI Program has conducted a series of experiments to assess the effects of neutron irradiation on RPV material behavior, especially fracture toughness. These studies have included RPV plates and welds, varying chemical compositions, and fracture toughness specimens up to 4 in. thickness. The results of these investigations, in conjunction with results from commercial reactor surveillance programs, are used to develop a methodology for the prediction of radiation effects on RPV materials. Results from the HSST and HSSI Program are used by the USNRC in the evaluation of RPV integrity and regulation of overall nuclear plant safety.« less

Second hip fractures at Chiang Mai University Hospital.

PubMed

Wongtriratanachai, Prasit; Chiewchantanakit, Siripong; Vaseenon, Tanawat; Rojanasthien, Sattaya; Leerapun, Taninnit

2015-02-01

Hip fractures are a major public health problem. Patients who have suffered a hip fracture have an increased risk of a subsequent hip fracture. This study examines the incidence ofsecondhip fractures and attempts to identify underlying risk factors. To examine the incidence ofsecond hip fractures in osteoporotic patients at Chiang Mai University Hospital and to identify risk factors related to second hip fractures. A retrospective review was conducted of all low-energy mechanism hip fracture patients admitted during 2008 and 2009. Analysis of second hip fractures was conducted using survival analysis and logistic regression analysis. A total of 191 patients were observed for 391.68 person-years (mean 2.05 person-years per patient). Among that group, nine second hip fractures were identified, an overall incidence rate of 0.023 second fractures per person-year. Second hip fractures tended to occur within the first year following an initial hip fracture. There were no significant differences related to either gender or comorbid medical conditions. Logistic regression analysis revealed that increased risk of a second hip fracture was associated with age (highest between 80 to 89 years) and patients who were not treated for osteoporosis following their initial fracture. The incidence of second hip fractures at Chiang Mai University Hospital was 0.023 per person-year Careful follow-up of older patients, especially those over 80, and treatment ofosteoporosis with bisphosphonate plus vitamin D and calcium supplements was correlated with a reduction in the incidence of second hip fractures.

NASGRO(registered trademark): Fracture Mechanics and Fatigue Crack Growth Analysis Software

NASA Technical Reports Server (NTRS)

Forman, Royce; Shivakumar, V.; Mettu, Sambi; Beek, Joachim; Williams, Leonard; Yeh, Feng; McClung, Craig; Cardinal, Joe

2004-01-01

This viewgraph presentation describes NASGRO, which is a fracture mechanics and fatigue crack growth analysis software package that is used to reduce risk of fracture in Space Shuttles. The contents include: 1) Consequences of Fracture; 2) NASA Fracture Control Requirements; 3) NASGRO Reduces Risk; 4) NASGRO Use Inside NASA; 5) NASGRO Components: Crack Growth Module; 6) NASGRO Components:Material Property Module; 7) Typical NASGRO analysis: Crack growth or component life calculation; and 8) NASGRO Sample Application: Orbiter feedline flowliner crack analysis.

Three Cases of Spine Fractures after an Airplane Crash.

PubMed

Lee, Han Joo; Moon, Bong Ju; Pennant, William A; Shin, Dong Ah; Kim, Keung Nyun; Yoon, Do Heum; Ha, Yoon

2015-10-01

While injuries to the spine after an airplane crash are not rare, most crashes result in fatal injuries. As such, few studies exist that reported on spine fractures sustained during airplane accidents. In this report, we demonstrate three cases of spine fractures due to crash landing of a commercial airplane. Three passengers perished from injuries after the crash landing, yet most of the passengers and crew on board survived, with injuries ranging from minor to severe. Through evaluating our three spine fracture patients, it was determined that compression fracture of the spine was the primary injury related to the airplane accident. The first patient was a 20-year-old female who sustained a T6-8 compression fracture without neurologic deterioration. The second patient was a 33-year-old female with an L2 compression fracture, and the last patient was a 49-year-old male patient with a T8 compression fracture. All three patients were managed conservatively and required spinal orthotics. During the crash, each of these patients were subjected to direct, downward high gravity z-axis (Gz) force, which gave rise to load on the spine vertically, thereby causing compression fracture. Therefore, new safety methods should be developed to prevent excessive Gz force during airplane crash landings.

Three Cases of Spine Fractures after an Airplane Crash

PubMed Central

Lee, Han Joo; Moon, Bong Ju; Pennant, William A.; Shin, Dong Ah; Kim, Keung Nyun; Yoon, Do Heum

2015-01-01

While injuries to the spine after an airplane crash are not rare, most crashes result in fatal injuries. As such, few studies exist that reported on spine fractures sustained during airplane accidents. In this report, we demonstrate three cases of spine fractures due to crash landing of a commercial airplane. Three passengers perished from injuries after the crash landing, yet most of the passengers and crew on board survived, with injuries ranging from minor to severe. Through evaluating our three spine fracture patients, it was determined that compression fracture of the spine was the primary injury related to the airplane accident. The first patient was a 20-year-old female who sustained a T6-8 compression fracture without neurologic deterioration. The second patient was a 33-year-old female with an L2 compression fracture, and the last patient was a 49-year-old male patient with a T8 compression fracture. All three patients were managed conservatively and required spinal orthotics. During the crash, each of these patients were subjected to direct, downward high gravity z-axis (Gz) force, which gave rise to load on the spine vertically, thereby causing compression fracture. Therefore, new safety methods should be developed to prevent excessive Gz force during airplane crash landings. PMID:27169094

A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures.

PubMed

Davis, Sarah; Martyn-St James, Marrissa; Sanderson, Jean; Stevens, John; Goka, Edward; Rawdin, Andrew; Sadler, Susi; Wong, Ruth; Campbell, Fiona; Stevenson, Matt; Strong, Mark; Selby, Peter; Gittoes, Neil

2016-10-01

Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. To evaluate the clinical effectiveness and safety of bisphosphonates [alendronic acid (Fosamax ® and Fosamax ® Once Weekly, Merck Sharp & Dohme Ltd), risedronic acid (Actonel ® and Actonel Once a Week ® , Warner Chilcott UK Ltd), ibandronic acid (Bonviva ® , Roche Products Ltd) and zoledronic acid (Aclasta ® , Novartis Pharmaceuticals UK Ltd)] for the prevention of fragility fracture and to assess their cost-effectiveness at varying levels of fracture risk. For the clinical effectiveness review, six electronic databases and two trial registries were searched: MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Web of Science and BIOSIS Previews, Clinicaltrials.gov and World Health Organization International Clinical Trials Registry Platform. Searches were limited by date from 2008 until September 2014. A systematic review and network meta-analysis (NMA) of effectiveness studies were conducted. A review of published economic analyses was undertaken and a de novo health economic model was constructed. Discrete event simulation was used to estimate lifetime costs and quality-adjusted life-years (QALYs) for each bisphosphonate treatment strategy and a strategy of no treatment for a simulated cohort of patients with heterogeneous characteristics. The model was populated with effectiveness evidence from the systematic review and NMA. All other parameters were estimated from published sources. A NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Fracture risk was estimated from patient characteristics using the QFracture ® (QFracture-2012 open source revision 38, Clinrisk Ltd, Leeds, UK) and FRAX ® (web version 3.9, University of Sheffield, Sheffield, UK) tools. The relationship between fracture risk and incremental net benefit (INB) was estimated using non-parametric regression. Probabilistic sensitivity analysis (PSA) and scenario analyses were used to assess uncertainty. Forty-six randomised controlled trials (RCTs) were included in the clinical effectiveness systematic review, with 27 RCTs providing data for the fracture NMA and 35 RCTs providing data for the femoral neck bone mineral density (BMD) NMA. All treatments had beneficial effects on fractures versus placebo, with hazard ratios varying from 0.41 to 0.92 depending on treatment and fracture type. The effects on vertebral fractures and percentage change in BMD were statistically significant for all treatments. There was no evidence of a difference in effect on fractures between bisphosphonates. A statistically significant difference in the incidence of influenza-like symptoms was identified from the RCTs for zoledronic acid compared with placebo. Reviews of observational studies suggest that upper gastrointestinal symptoms are frequently reported in the first month of oral bisphosphonate treatment, but pooled analyses of placebo-controlled trials found no statistically significant difference. A strategy of no treatment was estimated to have the maximum INB for patients with a 10-year QFracture risk under 1.5%, whereas oral bisphosphonates provided maximum INB at higher levels of risk. However, the PSA suggested that there is considerable uncertainty regarding whether or not no treatment is the optimal strategy until the QFracture score is around 5.5%. In the model using FRAX, the mean INBs were positive for all oral bisphosphonate treatments across all risk categories. Intravenous bisphosphonates were estimated to have lower INBs than oral bisphosphonates across all levels of fracture risk when estimated using either QFracture or FRAX. We assumed that all treatment strategies are viable alternatives across the whole population. Bisphosphonates are effective in preventing fragility fractures. However, the benefit-to-risk ratio in the lowest-risk patients may be debatable given the low absolute QALY gains and the potential for adverse events. We plan to extend the analysis to include non-bisphosphonate therapies. This study is registered as PROSPERO CRD42013006883. The National Institute for Health Research Health Technology Assessment programme.

Occupational exposures to respirable crystalline silica during hydraulic fracturing.

PubMed

Esswein, Eric J; Breitenstein, Michael; Snawder, John; Kiefer, Max; Sieber, W Karl

2013-01-01

This report describes a previously uncharacterized occupational health hazard: work crew exposures to respirable crystalline silica during hydraulic fracturing. Hydraulic fracturing involves high pressure injection of large volumes of water and sand, and smaller quantities of well treatment chemicals, into a gas or oil well to fracture shale or other rock formations, allowing more efficient recovery of hydrocarbons from a petroleum-bearing reservoir. Crystalline silica ("frac sand") is commonly used as a proppant to hold open cracks and fissures created by hydraulic pressure. Each stage of the process requires hundreds of thousands of pounds of quartz-containing sand; millions of pounds may be needed for all zones of a well. Mechanical handling of frac sand creates respirable crystalline silica dust, a potential exposure hazard for workers. Researchers at the National Institute for Occupational Safety and Health collected 111 personal breathing zone samples at 11 sites in five states to evaluate worker exposures to respirable crystalline silica during hydraulic fracturing. At each of the 11 sites, full-shift samples exceeded occupational health criteria (e.g., the Occupational Safety and Health Administration calculated permissible exposure limit, the NIOSH recommended exposure limit, or the ACGIH threshold limit value), in some cases, by 10 or more times the occupational health criteria. Based on these evaluations, an occupational health hazard was determined to exist for workplace exposures to crystalline silica. Seven points of dust generation were identified, including sand handling machinery and dust generated from the work site itself. Recommendations to control exposures include product substitution (when feasible), engineering controls or modifications to sand handling machinery, administrative controls, and use of personal protective equipment. To our knowledge, this represents the first systematic study of work crew exposures to crystalline silica during hydraulic fracturing. Companies that conduct hydraulic fracturing using silica sand should evaluate their operations to determine the potential for worker exposure to respirable crystalline silica and implement controls as necessary to protect workers.

The Effect of Three or Six Years of Denosumab Exposure in Women With Postmenopausal Osteoporosis: Results From the FREEDOM Extension

PubMed Central

Chapurlat, Roland; Brandi, Maria-Luisa; Brown, Jacques P.; Czerwiński, Edward; Krieg, Marc-Antoine; Mellström, Dan; Radominski, Sebastião C.; Reginster, Jean-Yves; Resch, Heinrich; Ivorra, Jose A. Román; Roux, Christian; Vittinghoff, Eric; Daizadeh, Nadia S.; Wang, Andrea; Bradley, Michelle N.; Franchimont, Nathalie; Geller, Michelle L.; Wagman, Rachel B.; Cummings, Steven R.; Papapoulos, Socrates

2013-01-01

Context: The Fracture Reduction Evaluation of Denosumab in Osteoporosis Every 6 Months (FREEDOM) extension is evaluating the long-term efficacy and safety of denosumab for up to 10 years. Objective: The objective of the study was to report results from the first 3 years of the extension, representing up to 6 years of denosumab exposure. Design, Setting, and Participants: This was a multicenter, international, open-label study of 4550 women. Intervention: Women from the FREEDOM denosumab group received 3 more years of denosumab for a total of 6 years (long-term) and women from the FREEDOM placebo group received 3 years of denosumab (crossover). Main Outcome Measures: Bone turnover markers (BTMs), bone mineral density (BMD), fracture, and safety data are reported. Results: Reductions in BTMs were maintained (long-term) or achieved rapidly (crossover) after denosumab administration. In the long-term group, BMD further increased for cumulative 6-year gains of 15.2% (lumbar spine) and 7.5% (total hip). During the first 3 years of denosumab treatment, the crossover group had significant gains in lumbar spine (9.4%) and total hip (4.8%) BMD, similar to the long-term group during the 3-year FREEDOM trial. In the long-term group, fracture incidences remained low and below the rates projected for a virtual placebo cohort. In the crossover group, 3-year incidences of new vertebral and nonvertebral fractures were similar to those of the FREEDOM denosumab group. Incidence rates of adverse events did not increase over time. Six participants had events of osteonecrosis of the jaw confirmed by adjudication. One participant had a fracture adjudicated as consistent with atypical femoral fracture. Conclusion: Denosumab treatment for 6 years remained well tolerated, maintained reduced bone turnover, and continued to increase BMD. Fracture incidence remained low. PMID:23979955

Intralesional Injection of Collagenase Clostridium histolyticum May Increase the Risk of Late-Onset Penile Fracture.

PubMed

Beilan, Jonathan A; Wallen, Jared J; Baumgarten, Adam S; Morgan, Kevin N; Parker, Justin L; Carrion, Rafael E

2018-04-01

The use of intralesional injection of collagenase Clostridium histolyticum (CCH) has become a valid treatment option in the management of Peyronie's disease (PD). Multiple studies have shown the drug's safety and efficacy. However, sparse literature exists on the utility of the injection protocol's 14-day "observation period," in which patients are instructed to abstain from all sexual activity. To summarize the contemporary literature and report on our series of patients treated with CCH in an effort to explore the effectiveness of the postinjection observation period. We retrospectively reviewed the clinical course of men treated with at least one CCH injection at our institution from April 2014 through February 2017. The main outcome measure for our cohort was complication rate (hematoma, fracture). Secondary outcomes included progression to corrective surgery. Of the 102 patients treated, 5 (4.9%) developed a corporal fracture. Four of these occurred outside the 14-day observation period. One fracture was managed conservatively and the rest underwent surgical exploration and repair. Twelve penile hematomas were reported; one of these patients was surgically explored because of suspicious magnetic resonance imaging findings. Seven patients (6.9%) progressed to corrective surgery. Penile hematoma and corporal fracture are serious complications that must be discussed with patients before initiation of intralesional CCH treatment. Little evidence exists to direct physicians on the proper management of post-CCH penile fractures; many caregivers and patients elect to treat these injuries conservatively and avoid surgical exploration. Further studies are warranted to generate discussion and reassessment regarding the safety and effectiveness of this 14-day observation period. Beilan JA, Wallen JJ, Baumgarten AS, Morgan KN, Parker JL, Carrion RE. Intralesional Injection of Collagenase Clostridium histolyticum May Increase the Risk of Late-Onset Penile Fracture. Sex Med Rev 2018;6:272-278. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Real frequency of ordinary and atypical sub-trochanteric and diaphyseal fractures in France based on X-rays and medical file analysis.

PubMed

Beaudouin-Bazire, Constance; Dalmas, Noémie; Bourgeois, Julie; Babinet, Antoine; Anract, Philippe; Chantelot, Christophe; Farizon, Frédéric; Chopin, Florence; Briot, Karine; Roux, Christian; Cortet, Bernard; Thomas, Thierry

2013-03-01

Atypical sub-trochanteric and femoral shaft fractures have been reported in patients treated with bisphosphonates. Their incidence has been determined from registered data analysis using international codes. Therefore, the aim of our study was to estimate the real frequency of typical and atypical sub-trochanteric or diaphyseal fractures, based on radiological and clinical data compared to registered data. In the registers of three large French University Hospitals, patients identified with International Classification of Diseases, 10th Revision diagnosis codes for sub-trochanteric or diaphyseal fracture were selected. Frequencies of ordinary and atypical fractures were calculated after both registered data, radiological and clinical files analysis. Among the 4592 patients hospitalized for a femoral fracture over 5 years, 574 were identified to have had a sub-trochanteric or femoral shaft fracture. 47.7% of the sub-trochanteric and femoral shaft fractures were misclassified, predominantly in the sub-trochanteric fractures subset. 12 patients had an atypical fracture (4% of the sub-trochanteric and femoral shaft fractures) and 11 fractures presented radiological features of atypical fractures, whereas clinical files analysis revealed they were pathological or traumatic fractures. Atypical fractures frequency is very low. Because of their low frequency and the unreliability of registered databases, the risk of atypical fractures is very difficult to estimate retrospectively. A prospective study is needed to clarify the risk factors associated with these fractures. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Safety assessment characteristics of pedestrian legform impactors in vehicle-front impact tests.

PubMed

Matsui, Yasuhiro

2014-12-01

This study investigated the characteristics of safety assessment results of front-area vehicle impact tests carried out using the Transport Research Laboratory (TRL) legform impactor and a flexible legform impactor (FLEX legform impactor). Different types of vehicles (sedan, sport utility vehicle, high-roof K-car, and light cargo van) were examined. The impact locations in the study were the center of the bumper and an extremely stiff structure of the bumper (i.e., in front of the side member) of each tested vehicle. The measured injury criteria were normalized by injury assessment reference values of each legform impactor. The test results for center and side-member impacts indicated that there were no significant differences in ligament injury assessments derived from the normalized knee ligament injury measures between the TRL legform impactor and the FLEX legform impactor. Evaluations made using the TRL legform impactor and the FLEX legform impactor are thus similar in the vehicle safety investigation for knee ligament injury. Vehicle-center impact test results revealed that the tibia fracture assessments derived from the normalized tibia fracture measures did not significantly differ between the TRL legform impactor and the FLEX legform impactor. However, for an impact against an extremely stiff structure, there was a difference in the tibia fracture assessment between the FLEX legform impactor and the TRL legform impactor owing to their different sensor types. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rock fracture skeleton tracing by image processing and quantitative analysis by geometry features

NASA Astrophysics Data System (ADS)

Liang, Yanjie

2016-06-01

In rock engineering, fracture measurement is important for many applications. This paper proposes a novel method for rock fracture skeleton tracing and analyzing. As for skeleton localizing, the curvilinear fractures are multiscale enhanced based on a Hessian matrix, after image binarization, and clutters are post-processed by image analysis; subsequently, the fracture skeleton is extracted via ridge detection combined with a distance transform and thinning algorithm, after which gap sewing and burrs removal repair the skeleton. In regard to skeleton analyzing, the roughness and distribution of a fracture network are respectively described by the fractal dimensions D s and D b; the intersection and fragmentation of a fracture network are respectively characterized by the average number of ends and junctions per fracture N average and the average length per fracture L average. Three rock fracture surfaces are analyzed for experiments and the results verify that both the fracture tracing accuracy and the analysis feasibility are satisfactory using the new method.

Design and real-time control of a robotic system for fracture manipulation.

PubMed

Dagnino, G; Georgilas, I; Tarassoli, P; Atkins, R; Dogramadzi, S

2015-08-01

This paper presents the design, development and control of a new robotic system for fracture manipulation. The objective is to improve the precision, ergonomics and safety of the traditional surgical procedure to treat joint fractures. The achievements toward this direction are here reported and include the design, the real-time control architecture and the evaluation of a new robotic manipulator system. The robotic manipulator is a 6-DOF parallel robot with the struts developed as linear actuators. The control architecture is also described here. The high-level controller implements a host-target structure composed by a host computer (PC), a real-time controller, and an FPGA. A graphical user interface was designed allowing the surgeon to comfortably automate and monitor the robotic system. The real-time controller guarantees the determinism of the control algorithms adding an extra level of safety for the robotic automation. The system's positioning accuracy and repeatability have been demonstrated showing a maximum positioning RMSE of 1.18 ± 1.14mm (translations) and 1.85 ± 1.54° (rotations).

Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008.

PubMed

Kim, Sunny H; Szabo, Robert M; Marder, Richard A

2012-03-01

To evaluate the occurrence of emergency department (ED) visits due to humerus fractures in the US. We analyzed the 2008 Nationwide Emergency Department Sample, which contained approximately 28 million ED records. We identified the cases of interest using diagnostic codes for proximal, shaft, and distal humerus fractures. In 2008, approximately 370,000 ED visits in the US resulted from humerus fractures. Proximal humerus fractures were the most common, accounting for 50% of humerus fractures. The incidence rate of proximal humerus fractures followed the shape of an exponential function in the age groups 40-84 years for women (R(2) = 97.9%) and 60-89 years for men (R(2) = 98.2%). After the exponential increase in these age intervals, the growth rate of proximal humerus fracture slowed and eventually decreased. The peak occurrence of distal humerus fractures was in children ages 5-9 years; however, elderly women had an increased risk. As the baby boomer generation ages, unless fracture prevention programs improve, more than 490,000 ED visits due to humerus fractures are expected in 2030 when the youngest of the baby boomers turn age 65 years. Compared to epidemiologic studies in Japan and European countries, the incidence rates of humerus fractures are substantially higher in the US. The high incidence rate of humerus fractures in the expanding elderly population may contribute to the recent trend of rapid increase in shoulder arthroplasty in the US. Rigorous safety measures to reduce falls and improved preventive treatments of osteoporosis are needed. Copyright © 2012 by the American College of Rheumatology.

Influence of fracture network physical properties on stability criteria of density-driven flow in a dual-porosity system

NASA Astrophysics Data System (ADS)

Hassanzadeh, H.; Jafari Raad, S. M.

2017-12-01

Linear stability analysis is conducted to study the onset of buoyancy-driven convection involved in solubility trapping of CO2 into deep fractured aquifers. In this study, the effect of fracture network physical properties on the stability criteria in a brine-rich fractured porous layer is investigated using dual porosity concept for both single and variable matrix block size distributions. Linear stability analysis results show that both fracture interporosity flow and fracture storativity factors play an important role in the stability behavior of the system. It is shown that a diffusive boundary layer under the gravity field in a fractured rock with lower fracture storativity and/or higher fracture interporosity flow coefficient is more stable. We present scaling relations that relate the onset of convective instability in fractured aquifers. These findings improve our understanding of buoyancy driven flow in fractured aquifers and are particularly important in estimation of potential storage capacity, risk assessment, and storage sites characterization and screening.Keywords: CO2 sequestration; fractured rock; buoyancy-driven convection; stability analysis

Scaling Laws of Discrete-Fracture-Network Models

NASA Astrophysics Data System (ADS)

Philippe, D.; Olivier, B.; Caroline, D.; Jean-Raynald, D.

2006-12-01

The statistical description of fracture networks through scale still remains a concern for geologists, considering the complexity of fracture networks. A challenging task of the last 20-years studies has been to find a solid and rectifiable rationale to the trivial observation that fractures exist everywhere and at all sizes. The emergence of fractal models and power-law distributions quantifies this fact, and postulates in some ways that small-scale fractures are genetically linked to their larger-scale relatives. But the validation of these scaling concepts still remains an issue considering the unreachable amount of information that would be necessary with regards to the complexity of natural fracture networks. Beyond the theoretical interest, a scaling law is a basic and necessary ingredient of Discrete-Fracture-Network models (DFN) that are used for many environmental and industrial applications (groundwater resources, mining industry, assessment of the safety of deep waste disposal sites, ..). Indeed, such a function is necessary to assemble scattered data, taken at different scales, into a unified scaling model, and to interpolate fracture densities between observations. In this study, we discuss some important issues related to scaling laws of DFN: - We first describe a complete theoretical and mathematical framework that takes account of both the fracture- size distribution and the fracture clustering through scales (fractal dimension). - We review the scaling laws that have been obtained, and we discuss the ability of fracture datasets to really constrain the parameters of the DFN model. - And finally we discuss the limits of scaling models.

Head Injuries

MedlinePlus

... contusion: This is a bruise of your brain. Minor bleeding in your brain causes swelling. Skull fracture: ... Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control ...

Fracture modes in notched angleplied composite laminates

NASA Technical Reports Server (NTRS)

Irvine, T. B.; Ginty, C. A.

1984-01-01

The Composite Durability Structural Analysis (CODSTRAN) computer code is used to determine composite fracture. Fracture modes in solid and notched, unidirectional and angleplied graphite/epoxy composites were determined by using CODSTRAN. Experimental verification included both nondestructive (ultrasonic C-Scanning) and destructive (scanning electron microscopy) techniques. The fracture modes were found to be a function of ply orientations and whether the composite is notched or unnotched. Delaminations caused by stress concentrations around notch tips were also determined. Results indicate that the composite mechanics, structural analysis, laminate analysis, and fracture criteria modules embedded in CODSTRAN are valid for determining composite fracture modes.

76 FR 40735 - Joint Meeting of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-11

... bisphosphonate use for the treatment and prevention of osteoporosis (thinning and weakening of bones that increases the chance of having a broken bone) in light of the emergence of the safety concerns of osteonecrosis of the jaw (jawbone death) and atypical femur fractures (unusual broken thigh bone) that may be...

Structural integrity of engineering composite materials: a cracking good yarn.

PubMed

Beaumont, Peter W R; Soutis, Costas

2016-07-13

Predicting precisely where a crack will develop in a material under stress and exactly when in time catastrophic fracture of the component will occur is one the oldest unsolved mysteries in the design and building of large-scale engineering structures. Where human life depends upon engineering ingenuity, the burden of testing to prove a 'fracture safe design' is immense. Fitness considerations for long-life implementation of large composite structures include understanding phenomena such as impact, fatigue, creep and stress corrosion cracking that affect reliability, life expectancy and durability of structure. Structural integrity analysis treats the design, the materials used, and figures out how best components and parts can be joined, and takes service duty into account. However, there are conflicting aims in the complete design process of designing simultaneously for high efficiency and safety assurance throughout an economically viable lifetime with an acceptable level of risk. This article is part of the themed issue 'Multiscale modelling of the structural integrity of composite materials'. © 2016 The Author(s).

Effect of Casting Defect on Mechanical Properties of 17-4PH Stainless Steel

NASA Astrophysics Data System (ADS)

Kim, Jong-Yup; Lee, Joon-Hyun; Nahm, Seung-Hoon

Damage and integrity evaluation techniques should be developed steadily in order to ensure the reliability and the economic efficiency of gas turbine engines. Casting defects may exist in most casting components of gas turbine engines, and the defects could give serious effect on mechanical properties and fracture toughness. Therefore, it is very important to understand the effect of casting defects on the above properties in order to predict the safety and life of components. In this study, specimens with internal casting defects, made from 17-4PH stainless steel, were prepared and evaluated and characterized based on the volume fraction of defects. The relation between mechanical properties such as tensile, low cycle fatigue and fracture toughness and volume fraction of defect has been investigated. As a result of the analysis, the mechanical properties of 17-4PH decreased as the defect volume fraction increased with very good linearity. The mechanical properties also showed an inversely proportional relationship to electrical resistivity.

Internal fixators: a safe option for managing distal femur fractures?

PubMed Central

Batista, Bruno Bellaguarda; Salim, Rodrigo; Paccola, Cleber Antonio Jansen; Kfuri, Mauricio

2014-01-01

OBJECTIVE: Evaluate safety and reliability of internal fixator for the treatment of intra-articular and periarticular distal femur fractures. METHODS: Retrospective data evaluation of 28 patients with 29 fractures fixed with internal fixator was performed. There was a predominance of male patients (53.5%), with 52% of open wound fractures, 76% of AO33C type fractures, and a mean follow up of 21.3 months. Time of fracture healing, mechanical axis deviation, rate of infection and postoperative complications were registered. RESULTS: Healing rate was 93% in this sample, with an average time of 5.5 months. Twenty-seven percent of patients ended up with mechanical axis deviation, mostly resulting from poor primary intra-operative reduction. There were two cases of implant loosening; two implant breakage, and three patients presented stiff knee. No case of infection was observed. Healing rate in this study was comparable with current literature; there was a high degree of angular deviation, especially in the coronal plane. CONCLUSION: Internal fixators are a breakthrough in the treatment of knee fractures, but its use does not preclude application of principles of anatomical articular reduction and mechanical axis restoration. Level of Evidence II, Retrospective Study. PMID:25061424

Biodegradable fixation of mandibular fractures in children: stability and early results.

PubMed

Yerit, Kaan C; Hainich, Sibylle; Enislidis, Georg; Turhani, Dritan; Klug, Clemens; Wittwer, Gert; Ockher, Michael; Undt, Gerhard; Kermer, Christian; Watzinger, Franz; Ewers, Rolf

2005-07-01

The aim of this study was to assess the safety and efficiency of biodegradable self-reinforced (SR-PLDLA) bone plates and screws in open reduction and internal fixation of mandible fractures in children. Thirteen patients (5 female, 8 male; mean age 12 years, range 5-16 years) were operated on various fractures of the mandible (2 symphyseal, 6 parasymphyseal, 4 body, 3 angle, 1 ramus, 2 condylar fractures). The mean follow-up time was 26.4 months (range 10.9-43.4 months). Intermaxillary fixation was applied in cases with concomitant condylar fractures up to 3 weeks. Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operations was not endangered. Adverse tissue reactions to the implants, malocclusion, and growth restrictions did not occur during the observation period. Pediatric patients benefit from the advantages of resorbable materials, especially from faster mobilization and the avoidance of secondary removal operations. Based on these preliminary results, self-reinforced fixation devices are safe and efficient in the treatment of pediatric mandible fractures. However, further clinical investigations are necessary to evaluate the long-term reliability.

Patterns of Maxillofacial Fractures in Uttar Pradesh, India

PubMed Central

Agarwal, Padmanidhi; Mehrotra, Divya; Agarwal, Rajul; Kumar, Sumit; Pandey, Rahul

2016-01-01

This study aimed to obtain dependable epidemiologic data of the variation in cause and characteristics of maxillofacial fractures by identifying, describing, and quantifying trauma. This retrospective study was conducted in the state of Uttar Pradesh, India, over 1 year, based on a systematic computer-assisted database search from March 2015 to March 2016 for maxillofacial fractures. The demographics, etiology, geographic distribution, date of injury, site and number of fractures, and type of intervention were recorded for each. The study population consisted of 1,000 patients with 1,543 fractures. The male:female ratio was 8:1. A peak incidence of fractures was seen in the third decade (mean age: 30.3) with maximum patients younger than 40 years (80.8%). The incidence of fractures was highest in spring (42.9%). Road traffic accidents were the most common cause of trauma (64.4%) and mainly involved two wheelers (60.2%). Single-site fractures were most common. Mostly zygomatic (45.1%) and mandibular fractures (44.4%) were encountered, accounting for approximately 90% of all fractures. The main site of mandibular fractures was the body (34.4%); 46.2% of fractures underwent open reduction and internal fixation (ORIF) while 53.8% were treated by closed methods. The study provides important data to contrive future plans for injury prevention. The trend of most traffic-related injuries continues with the increasing traffic on roads. Zygomatic complex and mandibular fractures remain the most frequent. The major populations at risk are young men and those driving two wheelers. The use of helmets could achieve a large reduction in maxillofacial fractures. Awareness for preventive measures and safety guidelines should be propagated and legislation on traffic rules strictly reinforced. PMID:28210408

Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment?

PubMed

de Kruijf, Marjolein; Vroemen, J P A M; de Leur, K; van der Voort, E A M; Vos, D I; Van der Laan, L

2014-06-01

Over 75 % of patients presenting with a proximal humerus fracture are 70 years or older. Very little is known about the outcome after operative treatment of these fractures in very old patients. This study was performed to gain more insight in safety and functional outcome of surgical treatment of proximal humerus fractures in the elderly. In this observational study, we analyzed all operatively treated patients, aged 75 or older, with a proximal humerus fracture between January 2003 and December 2008 in our center. Patient selection was on clinical grounds, based on physical, mental, and social criteria. Complications were evaluated. We used the DASH Questionnaire to investigate functional outcome, pain, and ADL limitations. Sixty-four patients were treated surgically for a displaced proximal fracture of the humerus: 15 two-part, 32 three-part, and 17 four-part fractures. Mean DASH scores were 37.5, 36.9, and 48.6, respectively. Regarding the operative methods, overall good results were obtained with the modern locked plate osteosynthesis (mean DASH 34.4). Prosthetic treatment, mostly used in highly comminuted fractures, often resulted in poor function (mean DASH 72.9). Persistent pain and ADL limitations were more present in more comminuted fractures (64 and 50 % in patients with 4-part fractures vs. 14 % in 2-part fractures). There were no postoperative deaths within 3 months of surgery, and fracture-related and non-fracture-related complication rates were low (non-union 3 %; 1 myocardial infarction). This study shows that it is safe and justifiable to consider surgical treatment of a severely dislocated proximal humerus fracture in selected patients aged 75 and older. According to OCEBM Working Group,Level IV.

Individual risk factors for deep infection and compromised fracture healing after intramedullary nailing of tibial shaft fractures: a single centre experience of 480 patients.

PubMed

Metsemakers, W-J; Handojo, K; Reynders, P; Sermon, A; Vanderschot, P; Nijs, S

2015-04-01

Despite modern advances in the treatment of tibial shaft fractures, complications including nonunion, malunion, and infection remain relatively frequent. A better understanding of these injuries and its complications could lead to prevention rather than treatment strategies. A retrospective study was performed to identify risk factors for deep infection and compromised fracture healing after intramedullary nailing (IMN) of tibial shaft fractures. Between January 2000 and January 2012, 480 consecutive patients with 486 tibial shaft fractures were enrolled in the study. Statistical analysis was performed to determine predictors of deep infection and compromised fracture healing. Compromised fracture healing was subdivided in delayed union and nonunion. The following independent variables were selected for analysis: age, sex, smoking, obesity, diabetes, American Society of Anaesthesiologists (ASA) classification, polytrauma, fracture type, open fractures, Gustilo type, primary external fixation (EF), time to nailing (TTN) and reaming. As primary statistical evaluation we performed a univariate analysis, followed by a multiple logistic regression model. Univariate regression analysis revealed similar risk factors for delayed union and nonunion, including fracture type, open fractures and Gustilo type. Factors affecting the occurrence of deep infection in this model were primary EF, a prolonged TTN, open fractures and Gustilo type. Multiple logistic regression analysis revealed polytrauma as the single risk factor for nonunion. With respect to delayed union, no risk factors could be identified. In the same statistical model, deep infection was correlated with primary EF. The purpose of this study was to evaluate risk factors of poor outcome after IMN of tibial shaft fractures. The univariate regression analysis showed that the nature of complications after tibial shaft nailing could be multifactorial. This was not confirmed in a multiple logistic regression model, which only revealed polytrauma and primary EF as risk factors for nonunion and deep infection, respectively. Future strategies should focus on prevention in high-risk populations such as polytrauma patients treated with EF. Copyright © 2014 Elsevier Ltd. All rights reserved.

Guidelines for Proof Test Analysis

NASA Technical Reports Server (NTRS)

Chell, G. G.; McClung, R. C.; Kuhlman, C. J.; Russell, D. A.; Garr, K.; Donnelly, B.

1999-01-01

These guidelines integrate state-of-the-art elastic-plastic fracture mechanics (EPFM) and proof test implementation issues into a comprehensive proof test analysis procedure in the form of a road map which identifies the types of data, fracture mechanics based parameters, and calculations needed to perform flaw screening and minimum proof load analyses of fracture critical components. Worked examples are presented to illustrate the application of the road map to proof test analysis. The state-of-the art fracture technology employed in these guidelines is based on the EPFM parameter, J, and a pictorial representation of a J fracture analysis, called the failure assessment diagram (FAD) approach. The recommended fracture technology is validated using finite element J results, and laboratory and hardware fracture test results on the nickel-based superalloy Inconel 718, the aluminum alloy 2024-T3511, and ferritic pressure vessel steels. In all cases the laboratory specimens and hardware failed by ductile mechanisms. Advanced proof test analyses involving probability analysis and multiple-cycle proof testing (MCPT) are addressed. Finally, recommendations are provided on how to account for the effects of the proof test overload on subsequent service fatigue and fracture behaviors.

Water Pressure Effects on Strength and Deformability of Fractured Rocks Under Low Confining Pressures

NASA Astrophysics Data System (ADS)

Noorian Bidgoli, Majid; Jing, Lanru

2015-05-01

The effect of groundwater on strength and deformation behavior of fractured crystalline rocks is one of the important issues for design, performance and safety assessments of surface and subsurface rock engineering problems. However, practical difficulties make the direct in situ and laboratory measurements of these properties of fractured rocks impossible at present, since effects of complex fracture system hidden inside the rock masses cannot be accurately estimated. Therefore, numerical modeling needs to be applied. The overall objective of this paper is to deepen our understanding on the validity of the effective stress concept, and to evaluate the effects of water pressure on strength and deformation parameters. The approach adopted uses discrete element methods to simulate the coupled stress-deformation-flow processes in a fractured rock mass with model dimensions at a representative elementary volume (REV) size and realistic representation of fracture system geometry. The obtained numerical results demonstrate that water pressure has significant influence on the strength, but with minor effects on elastic deformation parameters, compared with significant influence by the lateral confining pressure. Also, the classical effective stress concept to fractured rock can be quite different with that applied in soil mechanics. Therefore, one should be cautious when applying the classical effective stress concept to fractured rock media.

Dynamic Fracture Behavior of Plastic-Bonded Explosives

NASA Astrophysics Data System (ADS)

Fu, Hua; Li, Jun-Ling; Tan, Duo-Wang; Ifp, Caep Team

2011-06-01

Plastic-Bonded Explosives (PBX) are used as important energetic materials in nuclear or conventional weapons. Arms Warhead in the service process and the ballistic phase, may experience complex process such as long pulse and higher loading, compresson, tension and reciprocating compression - tension, friction with the projectile shell, which would lead to explosive deformation and fracture.And the dynamic deformation and fracture behavior of PBX subsequently affect reaction characteristics and initiation mechanism in explosives, then having influence on explosives safety. The dynamic fracure behavior of PBX are generally complex and not well studied or understood. In this paper, the dynamic fracture of explosives are conducted using a Kolsky bar. The Brazilian test, also known as a indirect tensile test or splitting test, is chosen as the test method. Tensile strength under different strain rates are obtained using quartz crystal embedded in rod end. The dynamic deformation and fracture process are captured in real-time by high-speed digital camera, and the displacement and strain fields distribution before specimen fracture are obtained by digital correlation method. Considering the non-uniform microstructure of explosives,the dynamic fracture behavior of explosive are simulated by discrete element method, the simulation results can reproduce the deformation and fracture process in Brazilian test using a maximum tensile strain criterion.

Proton-pump inhibitors and risk of fractures: an update meta-analysis.

PubMed

Zhou, B; Huang, Y; Li, H; Sun, W; Liu, J

2016-01-01

To identify the relationship between proton-pump inhibitors (PPIs) and the risk of fracture, we conducted an update meta-analysis of observational studies. Results showed that PPI use was associated with a modestly increased risk of hip, spine, and any-site fracture. Many studies have investigated the association of proton-pump inhibitors (PPIs) with fracture risk, but the results have been inconsistent. To evaluate this question, we performed a meta-analysis of relevant observational studies. A systematic literature search up to February 2015 was performed in PubMed. We combined relative risks (RRs) for fractures using random-effects models and conducted subgroup and stratified analyses. Eighteen studies involving a total of 244,109 fracture cases were included in this meta-analysis. Pooled analysis showed that PPI use could moderately increase the risk of hip fracture [RR = 1.26, 95 % confidence intervals (CIs) 1.16–1.36]. There was statistically significant heterogeneity among studies (p < 0.001; I 2 = 71.9 %). After limiting to cohort studies, there was also a moderate increase in hip fracture risk without evidence of study heterogeneity. Pooling revealed that short-term use (<1 year) and longer use (>1 year) were similarly associated with increased risk of hip fracture. Furthermore, a moderately increased risk of spine (RR = 1.58, 95 % CI 1.38–1.82) and any-site fracture (RR = 1.33, 95 % CI 1.15–1.54) was also found among PPI users. In this update meta-analysis of observational studies, PPI use modestly increased the risk of hip, spine, and any-site fracture, but no evidence of duration effect in subgroup analysis.

Insights into the Behavior of Potential Structural Failures Originating from Localized High Stress Regions in Configurations Relevant to Solid Rocket Motor Nozzles

NASA Technical Reports Server (NTRS)

McCutcheon, David Matthew

2017-01-01

During the structural certification effort for the Space Launch System solid rocket booster nozzle, it was identified that no consistent method for addressing local negative margins of safety in non-metallic materials had been developed. Relevant areas included bond-line terminations and geometric features in the composite nozzle liners. In order to gain understanding, analog test specimens were designed that very closely mimic the conditions in the actual full scale hardware. Different locations in the nozzle were represented by different analog specimen designs. This paper describes those tests and corresponding results. Finite element analysis results for the tests are presented. Strain gage correlation of the analysis to the test results is addressed. Furthermore, finite fracture mechanics (a coupled stress and energy failure criterion) is utilized to predict the observed crack pop-in loads for the different configurations. The finite fracture mechanics predictions are found to be within a 10% error relative to the average measured pop-in load for each of four configurations. Initiation locations, arrest behaviors, and resistances to further post-arrest crack propagation are also discussed.

Impact of Micro-to Meso-scale Fractures on Sealing Behavior of Argillaceous Cap Rocks For CO 2 Sequestration

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

Evans, James

This multi-disciplinary project evaluated seal lithologies for the safety and security of long-term geosequestration of CO 2. We used integrated studies to provide qualitative risk for potential seal failure; we integrated data sets from outcrop, core, geochemical analysis, rock failure properties from mechanical testing, geophysical wireline log analysis, and geomechanical modeling to understand the effects of lithologic heterogeneity and changing mechanical properties have on the mechanical properties of the seal. The objectives of this study were to characterize cap rock seals using natural field analogs, available drillhole logging data and whole-rock core, geochemical and isotopic analyses. Rock deformation experiments weremore » carried out on collected samples to develop better models of risk estimation for potential cap rock seal failure. We also sampled variably faulted and fractured cap rocks to examine the impacts of mineralization and/or alteration on the mechanical properties. We compared CO 2 reacted systems to non-CO 2 reacted seal rock types to determine response of each to increased pore fluid pressures and potential for the creation of unintentional hydrofractures at depth.« less

Natural fracture systems studies

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

Lorenz, J.C.; Warpinski, N.R.

The objectives of this program are (1) to develop a basinal-analysis methodology for natural fracture exploration and exploitation, and (2) to determine the important characteristics of natural fracture systems for use in completion, stimulation, and production operations. Natural-fracture basinal analysis begins with studies of fractures in outcrop, core and logs in order to determine the type of fracturing and the relationship of the fractures to the lithologic environment. Of particular interest are the regional fracture systems that are pervasive in western US tight sand basins. A Methodology for applying this analysis is being developed, with the goal of providing amore » structure for rationally characterizing natural fracture systems basin-wide. Such basin-wide characterizations can then be expanded and supplemented locally, at sites where production may be favorable. Initial application of this analysis is to the Piceance basin where there is a wealth of data from the Multiwell Experiment (MWX), DOE cooperative wells, and other basin studies conducted by Sandia, CER Corporation, and the USGS (Lorenz and Finley, 1989, Lorenz et aI., 1989, and Spencer and Keighin, 1984). Such a basinal approach has been capable of explaining the fracture characteristics found throughout the southern part of the Piceance basin and along the Grand Hogback.« less

A Novel Low-Molecular-Weight Compound Enhances Ectopic Bone Formation and Fracture Repair

PubMed Central

Wong, Eugene; Sangadala, Sreedhara; Boden, Scott D.; Yoshioka, Katsuhito; Hutton, William C.; Oliver, Colleen; Titus, Louisa

2013-01-01

Background: Use of recombinant human bone morphogenetic protein-2 (rhBMP-2) is expensive and may cause local side effects. A small synthetic molecule, SVAK-12, has recently been shown in vitro to potentiate rhBMP-2-induced transdifferentiation of myoblasts into the osteoblastic phenotype. The aims of this study were to test the ability of SVAK-12 to enhance bone formation in a rodent ectopic model and to test whether a single percutaneous injection of SVAK-12 can accelerate callus formation in a rodent femoral fracture model. Methods: Collagen disks with rhBMP-2 alone or with rhBMP-2 and SVAK-12 were implanted in a standard athymic rat chest ectopic model, and radiographic analysis was performed at four weeks. In a second set of rats (Sprague-Dawley), SVAK-12 was percutaneously injected into the site of a closed femoral fracture. The fractures were analyzed radiographically and biomechanically (with torsional testing) five weeks after surgery. Results: In the ectopic model, there was dose-dependent enhancement of rhBMP-2 activity with use of SVAK-12 at doses of 100 to 500 μg. In the fracture model, the SVAK-12-treated group had significantly higher radiographic healing scores than the untreated group (p = 0.028). Biomechanical testing revealed that the fractured femora in the 200 to 250-μg SVAK-12 group were 43% stronger (p = 0.008) and 93% stiffer (p = 0.014) than those in the control group. In summary, at five weeks the femoral fracture group injected with SVAK-12 showed significantly improved radiographic and biomechanical evidence of healing compared with the controls. Conclusions: A single local dose of a low-molecular-weight compound, SVAK-12, enhanced bone-healing in the presence of low-dose exogenous rhBMP-2 (in the ectopic model) and endogenous rhBMPs (in the femoral fracture model). Clinical Relevance: This study demonstrates that rhBMP-2 responsiveness can be enhanced by a novel small molecule, SVAK-12. Local application of anabolic small molecules has the potential for potentiating and accelerating fracture-healing. Use of this small molecule to lower required doses of rhBMPs might both decrease their cost and improve their safety profile. PMID:23467869

Analysis of Vertebral Bone Strength, Fracture Pattern, and Fracture Location: A Validation Study Using a Computed Tomography-Based Nonlinear Finite Element Analysis

PubMed Central

Imai, Kazuhiro

2015-01-01

Finite element analysis (FEA) is an advanced computer technique of structural stress analysis developed in engineering mechanics. Because the compressive behavior of vertebral bone shows nonlinear behavior, a nonlinear FEA should be utilized to analyze the clinical vertebral fracture. In this article, a computed tomography-based nonlinear FEA (CT/FEA) to analyze the vertebral bone strength, fracture pattern, and fracture location is introduced. The accuracy of the CT/FEA was validated by performing experimental mechanical testing with human cadaveric specimens. Vertebral bone strength and the minimum principal strain at the vertebral surface were accurately analyzed using the CT/FEA. The experimental fracture pattern and fracture location were also accurately simulated. Optimization of the element size was performed by assessing the accuracy of the CT/FEA, and the optimum element size was assumed to be 2 mm. It is expected that the CT/FEA will be valuable in analyzing vertebral fracture risk and assessing therapeutic effects on osteoporosis. PMID:26029476

Immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures: is it safe enough?

PubMed

Acker, A; Perry, Z H; Blum, S; Shaked, G; Korngreen, A

2018-04-01

The purpose of this study was to compare the results of immediate and delayed percutaneous sacroiliac screws surgery for unstable pelvic fractures, regarding technical results and complication rate. Retrospective study. The study was conducted at the Soroka University Medical center, Beer Sheva, Israel, which is a level 1 trauma Center. 108 patients with unstable pelvic injuries were operated by the orthopedic department at the Soroka University Medical Center between the years 1999-2010. A retrospective analysis found 50 patients with immediate surgery and 58 patients with delayed surgery. Preoperative and postoperative imaging were analyzed and data was collected regarding complications. All patients were operated on by using the same technique-percutaneous fixation of sacroiliac joint with cannulated screws. The study's primary outcome measure was the safety and quality of the early operation in comparison with the late operation. A total of 156 sacroiliac screws were inserted. No differences were found between the immediate and delayed treatment groups regarding technical outcome measures (P value = 0.44) and complication rate (P value = 0.42). The current study demonstrated that immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures produced equally good technical results, in comparison with the conventional delayed operation, without additional complications.

Roof instability characteristics and pre-grouting of the roof caving zone in residual coal mining

NASA Astrophysics Data System (ADS)

Zhao, Tong; Liu, Changyou

2017-12-01

Abandoned roadways and roof caving zones are commonly found in residual coal, and can destroy the integrity of the coal seam and roof. Resulting from mining-induced stress, continuous collapse and fracture instability in roof caving zones (RCZs) jeopardize the safety and efficiency of residual coal mining. Based on the engineering geology conditions of remining face 3101 in Shenghua Mine, the roof fracture and instability features of the RCZ were analyzed through physical simulation, theoretical analysis, and field measurements. In this case, influenced by the RCZ, the main roof across the RCZ fractured and rotated towards the goaf, greatly increasing the working resistance, and crushing the supports. The sudden instability of the coal pillars weakened its support of the main roof, thus resulting in long-key blocks across the RCZ and hinged roof structures, which significantly decreased the stability of the underlying immediate roof. This study establishes a mechanical model for the interactions between the surrounding rock and the supports in the RCZ, determines the reasonable working resistance, and examines the use of pre-grouting solidification restoration technology (PSRT) to solidify the RCZ and reinforce the coal pillars—thus increasing their bearing capacity. Field measurements revealed no roof flaking, inhomogeneous loading or support crushing, indicating that the PSRT effectively controlled the surrounding rock of the RCZ.

Bone Parameters and Risk of Hip and Femur Fractures in Patients on Hemodialysis

PubMed Central

Hazzan, Azzour D.; Jhaveri, Kenar D.; Ma, Lin; Lacson, Eduardo

2016-01-01

Background and objectives Patients on hemodialysis have a high rate of hip fractures. In this study, we performed a contemporary analysis of mineral and bone parameters and their relationship to hip and femur fracture risk. Design, setting, participants, & measurements Patients on hemodialysis treated between 2000 and 2013 in Fresenius Medical Care North America facilities were included. Predictors were on the basis of data as of December 31 of each baseline year and time-averaged values of selected laboratory parameters and medication doses throughout the year. Four period cohorts were constructed from baseline years: 2000, 2003, 2006, and 2009. Follow-up for each cohort was ≤3 years. Results The incidence of hip and femur fractures remained generally unchanged (P=0.40), except among patients who were white and >65 years of age, in whom the rate decreased significantly over the 14-year period (P<0.01). Results from combined multivariable models indicated that the lowest quartiles of time–averaged intact parathyroid hormone were independently associated with higher hip fracture risk (intact parathyroid hormone =181–272 pg/ml: hazard ratio, 1.20; 95% confidence interval [95% CI], 1.03 to 1.41 and intact parathyroid hormone <181 pg/ml: hazard ratio, 1.20; 95% CI, 1.01 to 1.44; referent third quartile, 273 to <433 pg/ml). The lowest quartile of time–averaged serum calcium was also associated with higher risk (calcium <8.7 mg/dl; hazard ratio, 1.17; 95% CI, 1.00 to 1.37) compared with the referent third quartile of 9.1 to <9.5 mg/dl. Conclusions We found an association between lower levels of intact parathyroid hormone and serum calcium and greater risk for hip and femur fractures among patients on hemodialysis. These findings support additional research toward elucidating long-term safety of treatment approaches for hyperparathyroidism in patients with ESRD. PMID:27026521

The Predictive Capability of Conditioned Simulation of Discrete Fracture Networks using Structural and Hydraulic Data from the ONKALO Underground Research Facility, Finland

NASA Astrophysics Data System (ADS)

Williams, T. R. N.; Baxter, S.; Hartley, L.; Appleyard, P.; Koskinen, L.; Vanhanarkaus, O.; Selroos, J. O.; Munier, R.

2017-12-01

Discrete fracture network (DFN) models provide a natural analysis framework for rock conditions where flow is predominately through a series of connected discrete features. Mechanistic models to predict the structural patterns of networks are generally intractable due to inherent uncertainties (e.g. deformation history) and as such fracture characterisation typically involves empirical descriptions of fracture statistics for location, intensity, orientation, size, aperture etc. from analyses of field data. These DFN models are used to make probabilistic predictions of likely flow or solute transport conditions for a range of applications in underground resource and construction projects. However, there are many instances when the volumes in which predictions are most valuable are close to data sources. For example, in the disposal of hazardous materials such as radioactive waste, accurate predictions of flow-rates and network connectivity around disposal areas are required for long-term safety evaluation. The problem at hand is thus: how can probabilistic predictions be conditioned on local-scale measurements? This presentation demonstrates conditioning of a DFN model based on the current structural and hydraulic characterisation of the Demonstration Area at the ONKALO underground research facility. The conditioned realisations honour (to a required level of similarity) the locations, orientations and trace lengths of fractures mapped on the surfaces of the nearby ONKALO tunnels and pilot drillholes. Other data used as constraints include measurements from hydraulic injection tests performed in pilot drillholes and inflows to the subsequently reamed experimental deposition holes. Numerical simulations using this suite of conditioned DFN models provides a series of prediction-outcome exercises detailing the reliability of the DFN model to make local-scale predictions of measured geometric and hydraulic properties of the fracture system; and provides an understanding of the reduction in uncertainty in model predictions for conditioned DFN models honouring different aspects of this data.

Use of Groundwater Lifetime Expectancy for the Performance Assessment of Deep Geologic Radioactive Waste Repositories.

NASA Astrophysics Data System (ADS)

Cornaton, F.; Park, Y.; Normani, S.; Sudicky, E.; Sykes, J.

2005-12-01

Long-term solutions for the disposal of toxic wastes usually involve isolation of the wastes in a deep subsurface geologic environment. In the case of spent nuclear fuel, the safety of the host repository depends on two main barriers: the engineered barrier and the natural geological barrier. If radionuclide leakage occurs from the engineered barrier, the geological medium represents the ultimate barrier that is relied upon to ensure safety. Consequently, an evaluation of radionuclide travel times from the repository to the biosphere is critically important in a performance assessment analysis. In this study, we develop a travel time framework based on the concept of groundwater lifetime expectancy as a safety indicator. Lifetime expectancy characterizes the time radionuclides will spend in the subsurface after their release from the repository and prior to discharging into the biosphere. The probability density function of lifetime expectancy is computed throughout the host rock by solving the backward-in-time solute transport equation subject to a properly posed set of boundary conditions. It can then be used to define optimal repository locations. In a second step, the risk associated with selected sites can be evaluated by simulating an appropriate contaminant release history. The proposed methodology is applied in the context of a typical Canadian Shield environment. Based on a statistically-generated three-dimension network of fracture zones embedded in the granitic host rock, the sensitivity and the uncertainty of lifetime expectancy to the hydraulic and dispersive properties of the fracture network, including the impact of conditioning via their surface expressions, is computed in order to demonstrate the utility of the methodology.

Effect of high-temperature water and hydrogen on the fracture behavior of a low-alloy reactor pressure vessel steel

NASA Astrophysics Data System (ADS)

Roychowdhury, S.; Seifert, H.-P.; Spätig, P.; Que, Z.

2016-09-01

Structural integrity of reactor pressure vessels (RPV) is critical for safety and lifetime. Possible degradation of fracture resistance of RPV steel due to exposure to coolant and hydrogen is a concern. In this study tensile and elastic-plastic fracture mechanics (EPFM) tests in air (hydrogen pre-charged) and EFPM tests in hydrogenated/oxygenated high-temperature water (HTW) was done, using a low-alloy RPV steel. 2-5 wppm hydrogen caused embrittlement in air tensile tests at room temperature (25 °C) and at 288 °C, effects being more significant at 25 °C and in simulated weld coarse grain heat affected zone material. Embrittlement at 288 °C is strain rate dependent and is due to localized plastic deformation. Hydrogen pre-charging/HTW exposure did not deteriorate the fracture resistance at 288 °C in base metal, for investigated loading rate range. Clear change in fracture morphology and deformation structures was observed, similar to that after air tests with hydrogen.

Applications and benefits of technology in naturally fractured, low permeability reservoirs with special emphasis on results from GRI`s devonian shale and berea sand research in the appalachian basin

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

Jochen, J.E.; Hopkins, C.W.

1993-12-31

;Contents: Naturally fractured reservoir description; Geologic considerations; Shale-specific log model; Stress profiles; Berea reasearch; Benefits analysis; Summary of technologies; Novel well test methods; Natural fracture identification; Reverse drilling; Production data analysis; Fracture treatment quality control; Novel core analysis methods; and Shale well cleanouts.

A study of sports-related orbital fractures in Singapore.

PubMed

Lock, Jing Zhan; Hegde, Raghuraj; Young, Stephanie; Lim, Thiam Chye; Amrith, Shantha; Sundar, Gangadhara

2017-10-01

With an increased popularity of sport and active living worldwide, our study aims to explore the incidence and features of sports-related orbital fractures in Singapore. 1421 computer tomography (CT) imaging scans of the face and orbits done at the National University Hospital over a 24-month period from January 2013 and December 2014 were reviewed retrospectively for orbital fractures. We identified 483 orbital fractures of which sports injury was the fourth most common etiology (n = 65; 13.5%) after road traffic accident (n = 131; 27.1%), geriatric fall (n = 81; 16.8%) and workplace injury (n = 67; 13.9%). The three most common sport in orbital fractures were soccer (n = 20; 30.8%), bicycling (n = 11; 16.9%) and jogging (n = 8; 12.3%). The three most common fracture patterns were zygomatico-maxillary complex fractures (n = 24; 36.9%), isolated one wall blowout fractures (n = 19; 29.2%) and naso-orbito-ethmoid fractures (n = 7; 10.8%). Sports-related orbital fractures were associated with a low mean age of patients (45.9 years, range, 14-79 years), a higher proportion of males (n = 58; 89.2%) than that from geriatric falls (n = 37, 45.6%) (P < 0.01), a higher likelihood of unilaterality (n = 62; 95.4%) than that from traffic accidents (n = 99; 75.6%) (P < 0.01) and a lower likelihood of pan-facial involvement (n = 4; 6.15%) than that from traffic accident (n = 60; 45.8%) (P < 0.01). Sports-related orbital fractures are the fourth most common cause of orbital fractures. Though commonly seen in young male adults, in view of the aging population and people exercising more regularly, education of safety measures among sports users is paramount to preventing sports-related orbital fractures.

Osteoporosis in paediatric patients with spina bifida.

PubMed

Marreiros, Humberto; Marreiros, Humberto Filipe; Loff, Clara; Calado, Eulalia

2012-01-01

The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB.

Extending Topological Approaches to Microseismic-Derived 3D Fracture Networks

NASA Astrophysics Data System (ADS)

Urbancic, T.; Bosman, K.; Baig, A.; Ardakani, E. P.

2017-12-01

Fracture topology is important for determining the fluid-flow characteristics of a fracture network. In most unconventional petroleum applications, flow through subsurface fracture networks is the primary source of production, as matrix permeability is often in the nanodarcy range. Typical models of reservoir discrete fracture networks (DFNs) are constructed using fracture orientation and average spacing, without consideration of how the connectivity of the fracture network aids the percolation of hydrocarbons back to the wellbore. Topological approaches to DFN characterization have been developed and extensively used in analysis of outcrop data and aerial photography. Such study of the surface expression of fracture networks is straight-forward, and the physical form of the observed fractures is directly reflected in the parameters used to describe the topology. However, this analysis largely ignores the three-dimensional nature of natural fracture networks, which is difficult to define accurately in geological studies. SMTI analysis of microseismic event distributions can produce DFNs, where each event is represented by a penny-shaped crack with radius and orientation determined from the frequency content of the waveforms and assessment of the slip instability of the potential fracture planes, respectively. Analysis of the geometric relationships between a set of fractures can provide details of intersections between fractures, and thus the topological characteristics of the fracture network. Extension of existing 2D topology approaches to 3D fracture networks is non-trivial. In the 2D case, a fracture intersection is a single point (node), and branches connect adjacent nodes along fractures. For the 3D case, intersection "nodes" become lines, and connecting nodes to find branches becomes more complicated. There are several parameters defined in 2D topology to quantify the connectivity of the fracture network. Equivalent quantities must be defined and calibrated for the 3D case to provide a meaningful measurement of fracture network connectivity. We have developed an approach to analyze the topology of 3D fracture networks derived from microseismic moment tensors. We illustrate the utility of the approach with applications to example datasets from hydraulic fracturing completions.

Hip Fractures among Older Adults

MedlinePlus

... to Prevent Falls brochure Check for Safety brochure Postural Hypotension brochure Chair Rise Exercise Related Pages Important ... September 20, 2016 Content source: Centers for Disease Control and Prevention , National Center for Injury Prevention and ...

Efficacy and safety of bisphosphonates in management of low bone density in inflammatory bowel disease

PubMed Central

Yao, Liwei; Wang, Haiqing; Dong, Wenwei; Liu, Zhenxin; Mao, Haijiao

2017-01-01

Abstract This study aims to determine whether bisphosphonates are safe, as well as effective against bone mineral loss in inflammatory bowel disease (IBD). A computerized search of electronic databases from 1966 to 2016 was performed. Randomized controlled trials (RCTs) were included in this review to evaluate the role of bisphosphonates in the management of osteoporosis in IBD patients. A revised 7-point Jadad scale was used to evaluate the quality of each study. Overall, 13 RCTs and 923 patients met the inclusion criteria of this meta-analysis. The result showed that bisphosphonates decreased bone mass density (BMD) loss at the lumbar spine (P = 0.0002), reduced the risk of new fractures (P = 0.01), and retained the similar adverse events (P = 0.86). Bisphosphonates may provide protection and safety against bone mineral loss in IBD patients. PMID:28099343

A Statistics-Based Cracking Criterion of Resin-Bonded Silica Sand for Casting Process Simulation

NASA Astrophysics Data System (ADS)

Wang, Huimin; Lu, Yan; Ripplinger, Keith; Detwiler, Duane; Luo, Alan A.

2017-02-01

Cracking of sand molds/cores can result in many casting defects such as veining. A robust cracking criterion is needed in casting process simulation for predicting/controlling such defects. A cracking probability map, relating to fracture stress and effective volume, was proposed for resin-bonded silica sand based on Weibull statistics. Three-point bending test results of sand samples were used to generate the cracking map and set up a safety line for cracking criterion. Tensile test results confirmed the accuracy of the safety line for cracking prediction. A laboratory casting experiment was designed and carried out to predict cracking of a cup mold during aluminum casting. The stress-strain behavior and the effective volume of the cup molds were calculated using a finite element analysis code ProCAST®. Furthermore, an energy dispersive spectroscopy fractographic examination of the sand samples confirmed the binder cracking in resin-bonded silica sand.

An analysis of fracture trace patterns in areas of flat-lying sedimentary rocks for the detection of buried geologic structure. [Kansas and Texas

NASA Technical Reports Server (NTRS)

Podwysocki, M. H.

1974-01-01

Two study areas in a cratonic platform underlain by flat-lying sedimentary rocks were analyzed to determine if a quantitative relationship exists between fracture trace patterns and their frequency distributions and subsurface structural closures which might contain petroleum. Fracture trace lengths and frequency (number of fracture traces per unit area) were analyzed by trend surface analysis and length frequency distributions also were compared to a standard Gaussian distribution. Composite rose diagrams of fracture traces were analyzed using a multivariate analysis method which grouped or clustered the rose diagrams and their respective areas on the basis of the behavior of the rays of the rose diagram. Analysis indicates that the lengths of fracture traces are log-normally distributed according to the mapping technique used. Fracture trace frequency appeared higher on the flanks of active structures and lower around passive reef structures. Fracture trace log-mean lengths were shorter over several types of structures, perhaps due to increased fracturing and subsequent erosion. Analysis of rose diagrams using a multivariate technique indicated lithology as the primary control for the lower grouping levels. Groupings at higher levels indicated that areas overlying active structures may be isolated from their neighbors by this technique while passive structures showed no differences which could be isolated.

Bioprosthetic Valve Fracture to Facilitate Transcatheter Valve-in-Valve Implantation.

PubMed

Allen, Keith B; Chhatriwalla, Adnan K; Cohen, David J; Saxon, John T; Aggarwal, Sanjeev; Hart, Anthony; Baron, Suzanne; Davis, J Russell; Pak, Alex F; Dvir, Danny; Borkon, A Michael

2017-11-01

Valve-in-valve transcatheter aortic valve replacement is less effective in small surgical bioprostheses. We evaluated the feasibility of bioprosthetic valve fracture with a high-pressure balloon to facilitate valve-in-valve transcatheter aortic valve replacement. In vitro bench testing on aortic tissue valves was performed on 19-mm and 21-mm Mitroflow (Sorin, Milan, Italy), Magna and Magna Ease (Edwards Lifesciences, Irvine, CA), Trifecta and Biocor Epic (St. Jude Medical, Minneapolis, MN), and Hancock II and Mosaic (Medtronic, Minneapolis, MN). High-pressure balloons Tru Dilation, Atlas Gold, and Dorado (C.R. Bard, Murray Hill, NJ) were used to determine which valves could be fractured and at what pressure fracture occurred. Mitroflow, Magna, Magna Ease, Mosaic, and Biocor Epic surgical valves were successfully fractured using high-pressures balloon 1 mm larger than the labeled valve size whereas Trifecta and Hancock II surgical valves could not be fractured. Only the internal valve frame was fractured, and the sewing cuff was never disrupted. Manufacturer's rated burst pressures for balloons were exceeded, with fracture pressures ranging from 8 to 24 atmospheres depending on the surgical valve. Testing further demonstrated that fracture facilitated the expansion of previously constrained, underexpanded transcatheter valves (both balloon and self-expanding) to the manufacturer's recommended size. Bench testing demonstrates that the frame of most, but not all, bioprosthetic surgical aortic valves can be fractured using high-pressure balloons. The safety of bioprosthetic valve fracture to optimize valve-in-valve transcatheter aortic valve replacement in small surgical valves requires further clinical investigation. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

NASA Contractor Report: Guidelines for Proof Test Analysis

NASA Technical Reports Server (NTRS)

Chell, G. G.; McClung, R. C.; Kuhlman, C. J.; Russell, D. A.; Garr, K.; Donnelly, B.

1997-01-01

These Guidelines integrate state-of-the-art Elastic-Plastic Fracture Mechanics (EPFM) and proof test implementation issues into a comprehensive proof test analysis procedure in the form of a Road Map which identifies the types of data, fracture mechanics based parameters, and calculations needed to perform flaw screening and minimum proof load analyses of fracture critical components. Worked examples are presented to illustrate the application of the Road Map to proof test analysis. The state-of-the-art fracture technology employed in these Guidelines is based on the EPFM parameter, J, and a pictorial representation of a J fracture analysis, called the Failure Assessment Diagram (FAD) approach. The recommended fracture technology is validated using finite element J results, and laboratory and hardware fracture test results on the nickel-based superalloy IN-718, the aluminum alloy 2024-T351 1, and ferritic pressure vessel steels. In all cases the laboratory specimens and hardware failed by ductile mechanisms. Advanced proof test analyses involving probability analysis and Multiple Cycle Proof Testing (MCPT) are addressed. Finally, recommendations are provided on to how to account for the effects of the proof test overload on subsequent service fatigue and fracture behaviors.

Fracture overprinting history using Markov chain analysis: Windsor-Kennetcook subbasin, Maritimes Basin, Canada

NASA Astrophysics Data System (ADS)

Snyder, Morgan E.; Waldron, John W. F.

2018-03-01

The deformation history of the Upper Paleozoic Maritimes Basin, Atlantic Canada, can be partially unraveled by examining fractures (joints, veins, and faults) that are well exposed on the shorelines of the macrotidal Bay of Fundy, in subsurface core, and on image logs. Data were collected from coastal outcrops and well core across the Windsor-Kennetcook subbasin, a subbasin in the Maritimes Basin, using the circular scan-line and vertical scan-line methods in outcrop, and FMI Image log analysis of core. We use cross-cutting and abutting relationships between fractures to understand relative timing of fracturing, followed by a statistical test (Markov chain analysis) to separate groups of fractures. This analysis, previously used in sedimentology, was modified to statistically test the randomness of fracture timing relationships. The results of the Markov chain analysis suggest that fracture initiation can be attributed to movement along the Minas Fault Zone, an E-W fault system that bounds the Windsor-Kennetcook subbasin to the north. Four sets of fractures are related to dextral strike slip along the Minas Fault Zone in the late Paleozoic, and four sets are related to sinistral reactivation of the same boundary in the Mesozoic.

Dog Bites

MedlinePlus

... Safety Older Adult Falls Important Facts about Falls Costs of Falls Hip Fractures Among Older Adults Older Adult Falls Programs Compendium of Effective Fall Interventions, 3rd Edition Preventing Falls: Implementation Guide Publications and Resources STEADI Initiative for Health ...

Strontium ranelate for preventing and treating postmenopausal osteoporosis.

PubMed

O'Donnell, S; Cranney, A; Wells, G A; Adachi, J D; Reginster, J Y

2006-10-18

Strontium ranelate is a new treatment for osteoporosis therefore, its benefits and harms need to be known. To determine the efficacy and safety of strontium ranelate for the treatment and prevention of postmenopausal osteoporosis. We searched MEDLINE (1996 to March 2005), EMBASE (1996 to week 9 2005), the Cochrane Library (1996 to Issue 1 2005), reference lists of relevant articles and conference proceedings from the last two years. Additional data was sought from authors. We included randomized controlled trials (RCTs) of at least one year duration comparing strontium ranelate versus placebo reporting fracture incidence, bone mineral density (BMD), health related quality of life or safety in postmenopausal women. Treatment (versus prevention) population was defined as women with prevalent vertebral fractures and/or lumbar spine BMD T score < -2.5 SD. Two reviewers independently determined study eligibility, assessed trial quality and extracted the relevant data. Disagreements were resolved by consensus. RCTs were grouped by dose of strontium ranelate and treatment duration. Where possible, meta-analysis was conducted using the random effects model. Four trials met the inclusion criteria. Three included a treatment population (0.5 to 2 g of strontium ranelate daily) and one a prevention population (0.125 g, 0.5 g and 1 g daily). A 37% reduction in vertebral fractures (RR 0.63, 95% CI 0.56, 0.71) and a 14% reduction in non-vertebral fractures (RR 0.86, 95% CI 0.75, 0.98) were demonstrated over three years with 2 g of strontium ranelate daily in a treatment population. An increase in BMD was shown at all BMD sites after two to three years in both populations. Lower doses of strontium ranelate were superior to placebo and the highest dose demonstrated the greatest reduction in vertebral fractures and increase in BMD. An increased risk of diarrhea with 2 g of strontium ranelate was found; however, adverse events did not affect the risk of discontinuing treatment nor did it increase the risk of serious side effects, gastritis or death. Additional data suggests that the risk of vascular and nervous system side-effects is slightly increased with taking 2 g of strontium ranelate daily over three to four years. There is silver level evidence (www.cochranemsk.org) to support the efficacy of strontium ranelate for the reduction of fractures (vertebral and to a lesser extent non-vertebral) in postmenopausal osteoporotic women and an increase in BMD in postmenopausal women with/without osteoporosis. Diarrhea may occur however, adverse events leading to study withdrawal were not significantly increased with taking 2 g of strontium ranelate daily. Potential vascular and neurological side-effects need to be further explored.

Onset of density-driven instabilities in fractured aquifers

NASA Astrophysics Data System (ADS)

Jafari Raad, Seyed Mostafa; Hassanzadeh, Hassan

2018-04-01

Linear stability analysis is conducted to study the onset of density-driven convection involved in solubility trapping of C O2 in fractured aquifers. The effect of physical properties of a fracture network on the stability of a diffusive boundary layer in a saturated fractured porous media is investigated using the dual porosity concept. Linear stability analysis results show that both fracture interporosity flow and fracture storativity play an important role in the stability behavior of the system. It is shown that a diffusive boundary layer under the gravity field in fractured porous media with lower fracture storativity and/or higher fracture interporosity flow coefficient is more stable. We present scaling relations for the onset of convective instability in fractured aquifers with single and variable matrix block size distribution. These findings improve our understanding of density-driven flow in fractured aquifers and are important in the estimation of potential storage capacity, risk assessment, and storage site characterization and screening.

Development of a new semi-analytical model for cross-borehole flow experiments in fractured media

USGS Publications Warehouse

Roubinet, Delphine; Irving, James; Day-Lewis, Frederick D.

2015-01-01

Analysis of borehole flow logs is a valuable technique for identifying the presence of fractures in the subsurface and estimating properties such as fracture connectivity, transmissivity and storativity. However, such estimation requires the development of analytical and/or numerical modeling tools that are well adapted to the complexity of the problem. In this paper, we present a new semi-analytical formulation for cross-borehole flow in fractured media that links transient vertical-flow velocities measured in one or a series of observation wells during hydraulic forcing to the transmissivity and storativity of the fractures intersected by these wells. In comparison with existing models, our approach presents major improvements in terms of computational expense and potential adaptation to a variety of fracture and experimental configurations. After derivation of the formulation, we demonstrate its application in the context of sensitivity analysis for a relatively simple two-fracture synthetic problem, as well as for field-data analysis to investigate fracture connectivity and estimate fracture hydraulic properties. These applications provide important insights regarding (i) the strong sensitivity of fracture property estimates to the overall connectivity of the system; and (ii) the non-uniqueness of the corresponding inverse problem for realistic fracture configurations.

Using decision analysis to assess comparative clinical efficacy of surgical treatment of unstable ankle fractures.

PubMed

Michelson, James D

2013-11-01

The development of a robust treatment algorithm for ankle fractures based on well-established stability criteria has been shown to be prognostic with respect to treatment and outcomes. In parallel with the development of improved understanding of the biomechanical rationale of ankle fracture treatment has been an increased emphasis on assessing the effectiveness of medical and surgical interventions. The purpose of this study was to investigate the use of using decision analysis in the assessment of the cost effectiveness of operative treatment of ankle fractures based on the existing clinical data in the literature. Using the data obtained from a previous structured review of the ankle fracture literature, decision analysis trees were constructed using standard software. The decision nodes for the trees were based on ankle fracture stability criteria previously published. The outcomes were assessed by calculated Quality-Adjusted Life Years (QALYs) assigned to achieving normal ankle function, developing posttraumatic arthritis, or sustaining a postoperative infection. Sensitivity analysis was undertaken by varying the patient's age, incidence of arthritis, and incidence or infection. Decision analysis trees captured the essential aspects of clinical decision making in ankle fracture treatment in a clinically useful manner. In general, stable fractures yielded better outcomes with nonoperative treatment, whereas unstable fractures had better outcomes with surgery. These were consistent results over a wide range of postoperative infection rates. Varying the age of the patient did not qualitatively change the results. Between the ages of 30 and 80 years, surgery yielded higher expected QALYs than nonoperative care for unstable fractures, and generated lower QALYs than nonoperative care for stable fractures. Using local cost estimates for operative and nonoperative treatment, the incremental cost of surgery for unstable fractures was less than $40,000 per QALY (the usual cutoff for the determination of cost effectiveness) for patients aged up to 90 years. Decision analysis is a useful methodology in developing treatment guidelines. Numerous previous studies have indicated superior clinical outcomes when unstable ankle fractures underwent operative reduction and stabilization. What has been lacking was an examination of the cost effectiveness of such an approach, particularly in older patients who have fewer expected years of life. In light of the evidence for satisfactory outcomes for surgery of severe ankle fractures in older people, the justification for operative intervention is an obvious question that can be asked in the current increasingly cost-conscious environment. Using a decision-tree decision analysis structured around the stability-based ankle fracture classification system, in conjunction with a relatively simple cost effectiveness analysis, this study was able to demonstrate that surgical treatment of unstable ankle fractures in elderly patients is in fact cost effective. The clinical implication of the present analysis is that these existing treatment protocols for ankle fracture treatment are also cost effective when quality of life outcome measures are taken into account. Economic Level II. See Instructions for Authors for a complete description of levels of evidence.

Clinical strategies to address patients' concerns in osteoporosis management with bisphosphonates.

PubMed

Cole, Raymond E

2011-03-01

Approximately 44 million Americans either have, or are at risk of developing, osteoporosis, a disease associated with an increased risk of fracture and, consequently, morbidity and mortality. Osteoporosis affects 20% to 30% of postmenopausal women, and resulting fractures pose a major economic burden, with estimated annual direct costs ranging from $17 billion to $19 billion. Hip fractures account for the majority of costs (~60%) because they often require costly long-term follow-up care in addition to the direct costs of initial treatment. Screening, diagnosis, and disease management are of paramount importance when treating patients at risk for osteoporosis. The National Osteoporosis Foundation recommends that all postmenopausal women be evaluated for osteoporosis risk factors and that all women aged ≥ 65 years undergo bone mineral density testing. Once the primary care physician has identified a patient at risk for osteoporosis-related fracture, the physician must decide whether and how to treat the patient (ie, nonpharmacologic or pharmacologic options). Bisphosphonates are the first-line pharmacologic treatment for women aged ≥ 50 years with postmenopausal osteoporosis. Bisphosphonates-which have a favorable safety and tolerability profile in clinical trials-have shown efficacy in reducing fractures. However, achieved real world effectiveness is very much dependent on good treatment adherence by the patient. Media attention to rare adverse events has motivated some patients to deliberate nonadherence. Physicians should screen patients for contraindications and adverse event risk factors, educate them on the risks of fracture and benefits and risks of treatment, and monitor them during therapy. To assist primary care physicians in clinical decision making for women at risk for or with confirmed osteoporosis, this article presents a review of the guidelines for the diagnosis and treatment of postmenopausal osteoporosis, recent long-term efficacy data for extended-interval bisphosphonates, recent safety concerns with bisphosphonates, and lastly, suggests strategies for improving bisphosphonate adherence and patient outcomes.

Bier block regional anesthesia and casting for forearm fractures: safety in the pediatric emergency department setting.

PubMed

Aarons, Chad E; Fernandez, Meagan D; Willsey, Matt; Peterson, Bret; Key, Charles; Fabregas, Jorge

2014-01-01

Bier block regional anesthesia was first described in 1908; however, it is uncommonly used for fears of cardiac and neurological complications. Although recent studies have documented safe usage in an adult population, no study to date has investigated its use in a pediatric setting. In addition, most emergency departments feel that splint placement is safer than casting after acute forearm fracture reduction in the pediatric population. However, to our knowledge there is no such study that documents the complication rates associated with immediate casting. The goal of this study was to assess the safety and efficacy of Bier block regional anesthesia and immediate cast application after closed reduction of pediatric forearm fractures. A retrospective review was conducted of patients treated for forearm fractures in a 2-year period at a major metropolitan pediatric hospital. Rates of complications and length and costs of the 2 procedures were analyzed. A total of 600 patients were treated with Bier block regional anesthesia and 645 were treated with conscious sedation for displaced fractures of the forearm in the 2-year study period. No complications requiring admission were seen in either group. No patient experienced compartment syndrome or a need for readmission secondary to cast application. 2.2% and 4.3% (P=0.0382) of patients in the Bier block and sedation groups, respectively, needed their cast bivalved secondary to swelling. The average time from initiation of procedural sedation to discharge was 1 hour and 42 minutes, whereas the time to discharge from initiation of Bier block regional anesthesia was 47 minutes (P<0.0001). The average cost for a patient treated with procedural sedation was $6313, whereas the average cost for the Bier block regional anesthesia group was $4956. Bier block regional anesthesia is a safe, efficient, and cost-effective method of reducing pediatric forearm fractures. Immediate cast application can be used without fear of major complications. Level III--retrospective review.

Bioinformatics and Microarray Analysis of miRNAs in Aged Female Mice Model Implied New Molecular Mechanisms for Impaired Fracture Healing

PubMed Central

He, Bing; Zhang, Zong-Kang; Liu, Jin; He, Yi-Xin; Tang, Tao; Li, Jie; Guo, Bao-Sheng; Lu, Ai-Ping; Zhang, Bao-Ting; Zhang, Ge

2016-01-01

Impaired fracture healing in aged females is still a challenge in clinics. MicroRNAs (miRNAs) play important roles in fracture healing. This study aims to identify the miRNAs that potentially contribute to the impaired fracture healing in aged females. Transverse femoral shaft fractures were created in adult and aged female mice. At post-fracture 0-, 2- and 4-week, the fracture sites were scanned by micro computed tomography to confirm that the fracture healing was impaired in aged female mice and the fracture calluses were collected for miRNA microarray analysis. A total of 53 significantly differentially expressed miRNAs and 5438 miRNA-target gene interactions involved in bone fracture healing were identified. A novel scoring system was designed to analyze the miRNA contribution to impaired fracture healing (RCIFH). Using this method, 11 novel miRNAs were identified to impair fracture healing at 2- or 4-week post-fracture. Thereafter, function analysis of target genes was performed for miRNAs with high RCIFH values. The results showed that high RCIFH miRNAs in aged female mice might impair fracture healing not only by down-regulating angiogenesis-, chondrogenesis-, and osteogenesis-related pathways, but also by up-regulating osteoclastogenesis-related pathway, which implied the essential roles of these high RCIFH miRNAs in impaired fracture healing in aged females, and might promote the discovery of novel therapeutic strategies. PMID:27527150

Development of a Finite Element Model of the Human Shoulder to Investigate the Mechanical Responses and Injuries in Side Impact

NASA Astrophysics Data System (ADS)

Iwamoto, Masami; Miki, Kazuo; Yang, King H.

Previous studies in both fields of automotive safety and orthopedic surgery have hypothesized that immobilization of the shoulder caused by the shoulder injury could be related to multiple rib fractures, which are frequently life threatening. Therefore, for more effective occupant protection, it is important to understand the relationship between shoulder injury and multiple rib fractures in side impact. The purpose of this study is to develop a finite element model of the human shoulder in order to understand this relationship. The shoulder model included three bones (the humerus, scapula and clavicle) and major ligaments and muscles around the shoulder. The model also included approaches to represent bone fractures and joint dislocations. The relationships between shoulder injury and immobilization of the shoulder are discussed using model responses for lateral shoulder impact. It is also discussed how the injury can be related to multiple rib fractures.

Liquid metal embrittlement of T91 and 316L steels by heavy liquid metals: A fracture mechanics assessment

NASA Astrophysics Data System (ADS)

Auger, T.; Hamouche, Z.; Medina-Almazàn, L.; Gorse, D.

2008-06-01

LME of the martensitic T91 and the austenitic 316L steels have been investigated in the CCT geometry in the plane-stress condition. Using such a geometry, premature cracking induced by a liquid metal (PbBi and Hg) can be studied using a fracture mechanics approach based on CTOD, J-Δ a and fracture assessment diagram. One is able to measure a reduction of the crack tip blunting and a reduction of the energy required for crack propagation induced by the liquid metal. In spite of some limitations, this qualitative evaluation shows that liquid metals do not induce strong embrittlement on steels in plane-stress condition. Rather, the effect of the liquid metal seems to promote a fracture mode by plastic collapse linked with strain localization. It indicates that the materials, in spite of a potential embrittlement, should still be acceptable in terms of safety criteria.

Snowboarding injuries in Australia: investigating risk factors in wrist fractures to enhance injury prevention strategies.

PubMed

Dickson, Tracey J; Terwiel, F Anne

2011-09-01

To investigate risk factors associated with wrist fractures in snowboarders to inform future snowsport safety strategies. A prospective case-control study using a nonprobability convenience sample was conducted with data collected via a respondent-completed questionnaire. Subjects consisted of snowboarders with a snowboard-related injury who presented to one of 10 medical centers and physiotherapy clinics in resort medical centers and gateway communities across the Australian snowsport season in 2007. Those presenting with injuries other than wrist fractures acted as the control. The 611 respondents reported 802 injuries (61.3% were males and 51.5% were aged 16-25 years). Protective equipment was worn by 57.0% of respondents. The main reason for not wearing a wrist guard was that they did not see the need; of these, 12.9% experienced a wrist fracture. Most injuries occurred on-piste, in a terrain park, or in a lesson. The main mechanism of injury was falling. The major risk factors for wrist fractures were being less than 16 years of age (OR 3.97, CI 2.54-6.22), being in the alpine area for a holiday (OR 2.77, CI 1.47-5.21), and being a first-day snowboard participant (OR 2.02, CI 1.15-3.64). A direct logistic regression indicated that 3 variables had a statistically significant contribution to the model (being less than 16 years old, being on holidays in the region, and not wearing a wrist guard). The key risk factors in this Australian study reflect other international studies, providing a clear market segment for targeted snowsport safety messages: those less than 16 years old, visitors to the alpine regions, and those not wearing wrist guards. Copyright © 2011. Published by Elsevier Inc.

Nintendo Wii Fit as an adjunct to physiotherapy following lower limb fractures: preliminary feasibility, safety and sample size considerations.

PubMed

McPhail, S M; O'Hara, M; Gane, E; Tonks, P; Bullock-Saxton, J; Kuys, S S

2016-06-01

The Nintendo Wii Fit integrates virtual gaming with body movement, and may be suitable as an adjunct to conventional physiotherapy following lower limb fractures. This study examined the feasibility and safety of using the Wii Fit as an adjunct to outpatient physiotherapy following lower limb fractures, and reports sample size considerations for an appropriately powered randomised trial. Ambulatory patients receiving physiotherapy following a lower limb fracture participated in this study (n=18). All participants received usual care (individual physiotherapy). The first nine participants also used the Wii Fit under the supervision of their treating clinician as an adjunct to usual care. Adverse events, fracture malunion or exacerbation of symptoms were recorded. Pain, balance and patient-reported function were assessed at baseline and discharge from physiotherapy. No adverse events were attributed to either the usual care physiotherapy or Wii Fit intervention for any patient. Overall, 15 (83%) participants completed both assessments and interventions as scheduled. For 80% power in a clinical trial, the number of complete datasets required in each group to detect a small, medium or large effect of the Wii Fit at a post-intervention assessment was calculated at 175, 63 and 25, respectively. The Nintendo Wii Fit was safe and feasible as an adjunct to ambulatory physiotherapy in this sample. When considering a likely small effect size and the 17% dropout rate observed in this study, 211 participants would be required in each clinical trial group. A larger effect size or multiple repeated measures design would require fewer participants. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Automotive Airbag Safety Enhancement Final Report CRADA No. TSB-1165-95

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

Cutting, Jack; Durrell, Robert

The Vehicle Safety systems (VSS) Division of Quantic Industries, Inc. (QII) manufactured automotive airbag components. When both the driver and the passenger side airbags inflated in a tightly sealed passenger compartment, the compression of the surrounding air could and, in some instances, would cause damage to the eardrums of the occupants. The Aerospace and Division (ADD) of QII had partially developed the technology to fracture the canopy of a jet aircraft at the time of pilot ejection. The technical problem was how to adapt the canopy fracturing technology to the rear window of a motor vehicle in a safe andmore » cost effective manner. The existing approach was to replace the embedded rear window defroster with a series-parallel network of exploding bridge wires (EBWs). This would still provide the defrost function at low voltage/ current, but would cause fracturing of the window when a high current/voltage pulse was applied without pyrotechnics or explosives. The elements of this system were the embedded EBW network and a trunk-mounted fireset. The fireset would store the required energy to fire the network upon the receipt of a trigger signal from the existing air bag crash sensor.« less

Surgical Technical Evidence Review of Hip Fracture Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

PubMed

Siletz, Anaar; Childers, Christopher P; Faltermeier, Claire; Singer, Emily S; Hu, Q Lina; Ko, Clifford Y; Kates, Stephen L; Maggard-Gibbons, Melinda; Wick, Elizabeth

2018-01-01

Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Perioperative care was divided into components or "bins." For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials. Observational studies were included when higher levels of evidence were not available. Existing guidelines for perioperative care were also incorporated. For convenience, the components of care that are under the auspices of anesthesia providers will be reported separately. Recommendations for an evidence-based protocol were synthesized based on review of this evidence. Eleven bins were identified. Preoperative risk factor bins included nutrition, diabetes mellitus, tobacco use, and anemia. Perioperative management bins included thromboprophylaxis, timing of surgery, fluid management, drain placement, early mobilization, early alimentation, and discharge criteria/planning. This review provides the evidence basis for an ERP for perioperative care of patients with hip fracture.

The Applications of Finite Element Analysis in Proximal Humeral Fractures.

PubMed

Ye, Yongyu; You, Wei; Zhu, Weimin; Cui, Jiaming; Chen, Kang; Wang, Daping

2017-01-01

Proximal humeral fractures are common and most challenging, due to the complexity of the glenohumeral joint, especially in the geriatric population with impacted fractures, that the development of implants continues because currently the problems with their fixation are not solved. Pre-, intra-, and postoperative assessments are crucial in management of those patients. Finite element analysis, as one of the valuable tools, has been implemented as an effective and noninvasive method to analyze proximal humeral fractures, providing solid evidence for management of troublesome patients. However, no review article about the applications and effects of finite element analysis in assessing proximal humeral fractures has been reported yet. This review article summarized the applications, contribution, and clinical significance of finite element analysis in assessing proximal humeral fractures. Furthermore, the limitations of finite element analysis, the difficulties of more realistic simulation, and the validation and also the creation of validated FE models were discussed. We concluded that although some advancements in proximal humeral fractures researches have been made by using finite element analysis, utility of this powerful tool for routine clinical management and adequate simulation requires more state-of-the-art studies to provide evidence and bases.

[Characteristic of the fractures of the cervical, thoracic and lumbar vertebrae in the victims of a traffic accident found in the passenger compartment of a modern motor vehicle].

PubMed

Pigolkin, Iu I; Dubrovin, I A; Sedykh, E P; Mosoian, A S

2016-01-01

The objective of the present work was to study peculiar features of the injuries to three spinal regions in the victims of a head-on car collision found in the passenger compartments of modern motor vehicles equipped with seat belts and other safety means. It was shown that most frequent fatal injuries to the driver include the fractures of the cervical, thoracic, and lumbar vertebrae. These injuries are much less frequent in the passengers occupying the front and the right back seats. The multilayer and multiple character of the fractures in different parts of the spinal column in the car drivers is attributable to more pronounced spine flexion and extension associated with injuries of this kind. The fractures of the lower cervical vertebrae in the front seat passengers occur more frequently than injuries of a different type whereas the passengers of the back seats most frequently experience fractures of the upper cervical vertebrae. The passengers of the left back seat less frequently suffer from injuries to the thoracic spine than from the fractures of the cervical and lumbar vertebrae. The passengers of the central back seat most frequently experience fractures of the thoracic part of the vertebral column and the passengers occupying the right back seat fractures of the lumbar vertebrae.

Factors associated with fall-related fractures in Parkinson's disease.

PubMed

Cheng, Kuei-Yueh; Lin, Wei-Che; Chang, Wen-Neng; Lin, Tzu-Kong; Tsai, Nai-Wen; Huang, Chih-Cheng; Wang, Hung-Chen; Huang, Yung-Cheng; Chang, Hsueh-Wen; Lin, Yu-Jun; Lee, Lian-Hui; Cheng, Ben-Chung; Kung, Chia-Te; Chang, Ya-Ting; Su, Chih-Min; Chiang, Yi-Fang; Su, Yu-Jih; Lu, Cheng-Hsien

2014-01-01

Fall-related fracture is one of the most disabling features of idiopathic Parkinson's disease (PD). A better understanding of the associated factors is needed to predict PD patients who will require treatment. This prospective study enrolled 100 adult idiopathic PD patients. Stepwise logistic regressions were used to evaluate the relationships between clinical factors and fall-related fracture. Falls occurred in 56 PD patients, including 32 with fall-related fractures. The rate of falls in the study period was 2.2 ± 1.4 per 18 months. The percentage of osteoporosis was 34% (19/56) and 11% in PD patients with and without falls, respectively. Risk factors associated with fall-related fracture were sex, underlying knee osteoarthritis, mean Unified Parkinson's Disease Rating Scale score, mean Morse fall scale, mean Hoehn and Yahr stage, and exercise habit. By stepwise logistic regression, sex and mean Morse fall scale were independently associated with fall-related fracture. Females had an odds ratio of 3.8 compared to males and the cut-off value of the Morse fall scale for predicting fall-related fracture was 72.5 (sensitivity 72% and specificity 70%). Higher mean Morse fall scales (>72.5) and female sex are associated with higher risk of fall-related fractures. Preventing falls in the high-risk PD group is an important safety issue and highly relevant for their quality of life. Copyright © 2013 Elsevier Ltd. All rights reserved.

Craniomaxillofacial fractures during recreational baseball and softball.

PubMed

Bak, Matthew J; Doerr, Timothy D

2004-10-01

Baseball and softball are leading causes of sports-related facial trauma in the United States. We review our institutional experience (Strong Memorial Hospital, Rochester, NY) with these injuries and discuss measures to reduce their incidence. We review our institutions experience with facial fractures sustained during the course of a softball or baseball game over a 12-year period. A total of 38 patients were identified and medical records analyzed for patient demographics, type of impact, and fracture location. The male-to-female ratio was 3.2:1; mean age was 24.2 years, with 17 (45%) of the injuries occurring in the pediatric population. The majority of the injuries were caused by direct impact with the ball (68%), while player-player collisions (18%) and impact from a swung bat (13%) were responsible for the remaining injuries. There were a total of 39 fractures; 18 fractures (46%) involved the midface (level 2), skull (level 1) fractures accounted for 12 (31%), while 9 (23%) were mandibular (level 3) fractures. With 68% of the injuries resulting from a ball impact, we endorse the recommendations of the Consumer Product Safety Commission for the use of low-impact National Operating Committee on Standards for Athletic Equipment-approved baseballs and softballs for youth and recreational leagues.

Incorporating bazedoxifene into the treatment paradigm for postmenopausal osteoporosis in Japan.

PubMed

Ohta, H; Solanki, J

2015-03-01

The incidence of osteoporosis-related fractures in Asian countries is steadily increasing. Optimizing osteoporosis treatment is especially important in Japan, where the rate of aging is increasing rapidlyelderly population is increasing rapidly and life expectancy is among the longest in the world. There are several therapies currently available in Japan for the treatment of postmenopausal osteoporosis, each with a unique risk/benefit profile. A novel selective estrogen receptor modulator, bazedoxifene (BZA), was recently approved for the treatment of postmenopausal osteoporosis in Japan. Results from a 2-year, phase 2 trial in postmenopausal Japanese women showed that BZA significantly improved lumbar spine and total hip bone mineral density compared with placebo, while maintaining endometrial and breast safety, consistent with results from 2 global, phase 3 trials including a 2-year osteoporosis prevention study and a 3-year osteoporosis treatment study. In the pivotal 3-year treatment study, BZA significantly reduced the incidence of new vertebral fractures compared with placebo; in a post hoc analysis of a subgroup of women at higher risk of fractures, BZA significantly reduced the risk of nonvertebral fractures compared with placebo and raloxifene. A 2-year extension of the 3-year treatment study demonstrated the sustained efficacy of BZA over 5 years of treatment. BZA was generally safe and well tolerated in these studies. In a "super-aging" society such as Japan, long-term treatment for postmenopausal osteoporosis is a considerable need. BZA may be considered as a first choice for younger women anticipating long-term treatment, and also an appropriate option for older women who are unable or unwilling to take bisphosphonates.

Intravenous zoledronic acid for the treatment of osteoporosis: The evidence of its therapeutic effect

PubMed Central

Lewiecki, E Michael

2010-01-01

Introduction: Osteoporosis is a disease characterized by low bone mineral density and poor bone quality resulting in reduced bone strength and increased risk of fracture. Oral bisphosphonates, first-line therapy for most patients with osteoporosis, are associated with suboptimal adherence to therapy due to factors that include a complex dosing regimen and gastrointestinal intolerance in some patients. Intravenous bisphosphonates address these limitations through infrequent injectable dosing that assures 100% bioavailability. Intravenous zoledronic acid is the newest bisphosphonate to be approved for the treatment of osteoporosis. Aims: This review assesses the evidence for the therapeutic effects of intravenous zoledronic acid for the treatment of osteoporosis. Evidence review: Zoledronic acid 5 mg administered as an annual 15-min intravenous infusion has been shown to reduce the risk of vertebral fractures, hip fractures, and other fractures in a three-year randomized, double-blind, placebo-controlled trial in women with postmenopausal osteoporosis. In a randomized, double-blind, placebo-controlled trial in women and men with a recent surgical repair of low-trauma hip fracture, it reduced the risk of new clinical fractures and improved survival. In both studies, zoledronic acid was associated with a good safety profile and was generally well tolerated. Zoledronic acid has the potential to improve clinical outcomes by reducing the risk of fracture in patients with osteoporosis. Clinical value: Intravenous zoledronic acid 5 mg every 12 months reduces fracture risk in women with postmenopausal osteoporosis and in women and men with recent low-trauma hip fracture. PMID:20694061

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

PubMed

Malik, Mudasir; Halwai, Manzoor Ahmad

2014-10-01

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

Framing moving and handling as a complex healthcare intervention within the acute care of older people with osteoporosis: a qualitative study.

PubMed

Smith, Margaret Coulter; O'May, Fiona; Tropea, Savina; Berg, Jackie

2016-10-01

To investigate healthcare staff's views and experiences of caring for older hospitalised adults (aged 60+) with osteoporosis focusing on moving and handling. Specific objectives were to explore the composition of manual handling risk assessments and interventions in osteoporosis. Osteoporosis is a skeletal disease that reduces bone density and causes increased fracture risk. Incidence rises with age and osteoporotic fractures cause increased morbidity and mortality. It is a major global health problem. In the UK older hospitalised adults are normally screened for falls risk but not necessarily for osteoporosis. As presentation of osteoporosis is normally silent until fractures are evident, it is frequently undiagnosed. Healthcare staff's knowledge of osteoporosis is often suboptimal and specific manual handling implications are under-researched. An exploratory qualitative content analysis research design informed by critical realism. The purposive sample comprised 26 nursing and allied health professionals. Semi-structured interviews addressed topics including knowledge of osteoporosis, implications for acute care, moving and handling and clinical guidelines. Qualitative content data analysis was used. Awareness of osteoporosis prevalence in older populations varies and implications for nursing are indistinct to nonspecialists. In-hospital fractures potentially linked to suboptimal moving and handling seemed rare, but prospective studies are needed. Categories of 'Understanding moving and handling as routine care or as a healthcare intervention', with further categories 'healthcare practitioners' capacities and capabilities for dealing with people with osteoporosis' and 'the structural and organisational context for moving and handling' are reported alongside safety, frailty and dependency dimensions. This study informs moving and handling in higher risk groups such as osteoporosis. Clinical knowledge/expertise is required when adapting generic manual handling guidelines to specific patients/contexts. Patients' experiences of moving and handling have received limited attention. Increased focus on musculoskeletal conditions and moving and handling implications is required. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Water Inrush Analysis of the Longmen Mountain Tunnel Based on a 3D Simulation of the Discrete Fracture Network

NASA Astrophysics Data System (ADS)

Xiong, Ziming; Wang, Mingyang; Shi, ShaoShuai; Xia, YuanPu; Lu, Hao; Bu, Lin

2017-12-01

The construction of tunnels and underground engineering in China has developed rapidly in recent years in both the number and the length of tunnels. However, with the development of tunnel construction technology, risk assessment of the tunnels has become increasingly important. Water inrush is one of the most important causes of engineering accidents worldwide, resulting in considerable economic and environmental losses. Accordingly, water inrush prediction is important for ensuring the safety of tunnel construction. Therefore, in this study, we constructed a three-dimensional discrete network fracture model using the Monte Carlo method first with the basic data from the engineering geological map of the Longmen Mountain area, the location of the Longmen Mountain tunnel. Subsequently, we transformed the discrete fracture networks into a pipe network model. Next, the DEM of the study area was analysed and a submerged analysis was conducted to determine the water storage area. Finally, we attempted to predict the water inrush along the Longmen Mountain tunnel based on the Darcy flow equation. Based on the contrast of water inrush between the proposed approach, groundwater dynamics and precipitation infiltration method, we conclude the following: the water inflow determined using the groundwater dynamics simulation results are basically consistent with those in the D2K91+020 to D2K110+150 mileage. Specifically, in the D2K91+020 to D2K94+060, D2K96+440 to D2K98+100 and other sections of the tunnel, the simulated and measured results are in close agreement and show that this method is effective. In general, we can predict the water inflow in the area of the Longmen Mountain tunnel based on the existing fracture joint parameters and the hydrogeological data of the Longmen Mountain area, providing a water inrush simulation and guiding the tunnel excavation and construction stages.

Public priorities for osteoporosis and fracture research: results from a general population survey.

PubMed

Paskins, Zoe; Jinks, Clare; Mahmood, Waheed; Jayakumar, Prakash; Sangan, Caroline B; Belcher, John; Gwilym, Stephen

2017-12-01

This is the first national study of public and patient research priorities in osteoporosis and fracture. We have identified new research areas of importance to members of the public, particularly 'access to information from health professionals'. The findings are being incorporated into the research strategy of the National Osteoporosis Society. This study aimed to prioritise, with patients and public members, research topics for the osteoporosis research agenda. An e-survey to identify topics for research was co-designed with patient representatives. A link to the e-survey was disseminated to supporters of the UK National Osteoporosis Society (NOS) in a monthly e-newsletter. Responders were asked to indicate their top priority for research across four topics (understanding and preventing osteoporosis, living with osteoporosis, treating osteoporosis and treating fractures) and their top three items within each topic. Descriptive statistics were used to describe demographics and item ranking. A latent class analysis was applied to identify a substantive number of clusters with different combinations of binary responses. One thousand one hundred eighty-eight (7.4%) respondents completed the e-survey. The top three items overall were 'Having easy access to advice and information from health professionals' (63.8%), 'Understanding further the safety and benefit of osteoporosis drug treatments' (49.9%) and 'Identifying the condition early by screening' (49.2%). Latent class analysis revealed distinct clusters of responses within each topic including primary care management and self-management. Those without a history of prior fracture or aged under 70 were more likely to rate items within the cluster of self-management as important (21.0 vs 12.9 and 19.8 vs 13.3%, respectively). This is the first study of public research priorities in osteoporosis and has identified new research areas of importance to members of the public including access to information. The findings are being incorporated into the research strategy of the National Osteoporosis Society.

Reaction-Infiltration Instabilities in Fractured and Porous Rocks

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

Ladd, Anthony

In this project we are developing a multiscale analysis of the evolution of fracture permeability, using numerical simulations and linear stability analysis. Our simulations include fully three-dimensional simulations of the fracture topography, fluid flow, and reactant transport, two-dimensional simulations based on aperture models, and linear stability analysis.

New software for 3D fracture network analysis and visualization

NASA Astrophysics Data System (ADS)

Song, J.; Noh, Y.; Choi, Y.; Um, J.; Hwang, S.

2013-12-01

This study presents new software to perform analysis and visualization of the fracture network system in 3D. The developed software modules for the analysis and visualization, such as BOUNDARY, DISK3D, FNTWK3D, CSECT and BDM, have been developed using Microsoft Visual Basic.NET and Visualization TookKit (VTK) open-source library. Two case studies revealed that each module plays a role in construction of analysis domain, visualization of fracture geometry in 3D, calculation of equivalent pipes, production of cross-section map and management of borehole data, respectively. The developed software for analysis and visualization of the 3D fractured rock mass can be used to tackle the geomechanical problems related to strength, deformability and hydraulic behaviors of the fractured rock masses.

History of internal fixation (part 1): early developments with wires and plates before World War II.

PubMed

Hernigou, Philippe; Pariat, Jacques

2017-06-01

Though the date at which an orthopaedic implant was first used cannot be ascertained with any certainty, the fixation of bone fracture using an iron wire was reported for the first time in a French manuscript in 1775. The first techniques of operative fracture treatment were developed at the end of the 18th and in the beginning of the 19th centuries. The use of cerclage wires to fix fractures was the most frequent fixation at this time. The French Berenger-Feraud (1832-1900) had written the first book on internal fixation. However internal fixation of fractures could not become a practical method before Lister had ensured the safety of open reduction and internal fixation in the treatment of fractures. Lister is not only the father of asepsis; he also used metal wires to fix even closed fractures. The first internal fixation by means of a plate and screws was described by Carl Hansmann in 1858 in Hamburg. Nevertheless, Arbuthnot Lane (1892) and Albin Lambotte (1905) are considered to be the founders of this method, which was further developed by Sherman in the first part of the 20th century.

Management of Symphysis and Parasymphysis Mandibular Fractures in Children Treated with MacLennan Splint: Stability and Early Results

PubMed Central

Bhat, Manohar; Sharma, Anupama; Sharma, Rajesh

2015-01-01

ABSTRACT Objective: The aim of this study was to assess the safety and efficiency of MacLennan splint in symphysis and parasymphysis mandibular fractures in children. Study design: Six patients (four boys and two girls, mean age 3 years, range between 2 and 5 years) were operated on parasymphysis fractures of children. The mean follow-up time was 12 months. MacLennan splint was applied in these case upto 3 weeks. Results: Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operation was not endangered. Adverse tissue reaction like infection, malocclusion, swelling and growth restrictions did not occur during observation period. Conclusion: MacLennan splint is having various advantages like faster mobilization and the avoidance of secondary removal operations. Based on this preliminary results MacLennan splints are safe and efficient in the treatment of pediatric mandible fracture. How to cite this article: Khairwa A, Bhat M, Sharma A, Sharma R. Management of Symphysis and Parasymphysis Mandibular Fractures in Children Treated with MacLennan Splint: Stability and Early Results. Int J Clin Pediatr Dent 2015;8(2):127-132. PMID:26379381

Diabetes mellitus and risk of hip fractures: a meta-analysis.

PubMed

Fan, Y; Wei, F; Lang, Y; Liu, Y

2016-01-01

This meta-analysis revealed that diabetic adults had a twofold greater risk of hip fractures compared with non-diabetic populations, and this association was more pronounced in type 1 diabetes. The relationship between diabetes mellitus and risk of hip fracture yielded conflicting results. We conducted a meta-analysis to investigate the association between diabetes mellitus and the risk of hip fractures based on observational studies. We conducted a systematic literature search of PubMed and Embase databases through May 2015. We selected cohort and case-control studies providing at least age-adjusted risk ratio (RR) and corresponding 95 % confidence intervals (CI) of hip fractures among diabetic and non-diabetic subjects. Moreover, we pooled the female-to-male RR of hip fractures from studies that reported gender-specific risk estimate in a single study. Twenty-one studies involving 82,293 hip fracture events among 6,995,272 participants were identified. Diabetes mellitus was associated with an increased risk of hip fractures (RR 2.07; 95 % CI 1.83-2.33) in a random effects model. Subgroup analysis indicated that excess risk of hip fracture was more pronounced in type 1 diabetes (RR 5.76; 95 % CI 3.66-9.07) than that in type 2 diabetes (RR 1.34; 95 % CI 1.19-1.51). The pooled female-to-male RR of hip fractures was 1.09 (95 % CI 0.93-1.28). Individuals with diabetes mellitus have an excessive risk of hip fractures, and this relationship is more pronounced in type 1 diabetes. The association between diabetes and hip fracture risk is similar in men and women.

Visualization and Hierarchical Analysis of Flow in Discrete Fracture Network Models

NASA Astrophysics Data System (ADS)

Aldrich, G. A.; Gable, C. W.; Painter, S. L.; Makedonska, N.; Hamann, B.; Woodring, J.

2013-12-01

Flow and transport in low permeability fractured rock is primary in interconnected fracture networks. Prediction and characterization of flow and transport in fractured rock has important implications in underground repositories for hazardous materials (eg. nuclear and chemical waste), contaminant migration and remediation, groundwater resource management, and hydrocarbon extraction. We have developed methods to explicitly model flow in discrete fracture networks and track flow paths using passive particle tracking algorithms. Visualization and analysis of particle trajectory through the fracture network is important to understanding fracture connectivity, flow patterns, potential contaminant pathways and fast paths through the network. However, occlusion due to the large number of highly tessellated and intersecting fracture polygons preclude the effective use of traditional visualization methods. We would also like quantitative analysis methods to characterize the trajectory of a large number of particle paths. We have solved these problems by defining a hierarchal flow network representing the topology of particle flow through the fracture network. This approach allows us to analyses the flow and the dynamics of the system as a whole. We are able to easily query the flow network, and use paint-and-link style framework to filter the fracture geometry and particle traces based on the flow analytics. This allows us to greatly reduce occlusion while emphasizing salient features such as the principal transport pathways. Examples are shown that demonstrate the methodology and highlight how use of this new method allows quantitative analysis and characterization of flow and transport in a number of representative fracture networks.

Influence of core design, production technique, and material selection on fracture behavior of yttria-stabilized tetragonal zirconia polycrystal fixed dental prostheses produced using different multilayer techniques: split-file, over-pressing, and manually built-up veneers.

PubMed

Mahmood, Deyar Jallal Hadi; Linderoth, Ewa H; Wennerberg, Ann; Vult Von Steyern, Per

2016-01-01

To investigate and compare the fracture strength and fracture mode in eleven groups of currently, the most commonly used multilayer three-unit all-ceramic yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) fixed dental prostheses (FDPs) with respect to the choice of core material, veneering material area, manufacturing technique, design of connectors, and radii of curvature of FDP cores. A total of 110 three-unit Y-TZP FDP cores with one intermediate pontic were made. The FDP cores in groups 1-7 were made with a split-file design, veneered with manually built-up porcelain, computer-aided design-on veneers, and over-pressed veneers. Groups 8-11 consisted of FDPs with a state-of-the-art design, veneered with manually built-up porcelain. All the FDP cores were subjected to simulated aging and finally loaded to fracture. There was a significant difference (P<0.05) between the core designs, but not between the different types of Y-TZP materials. The split-file designs with VITABLOCS(®) (1,806±165 N) and e.max(®) ZirPress (1,854±115 N) and the state-of-the-art design with VITA VM(®) 9 (1,849±150 N) demonstrated the highest mean fracture values. The shape of a split-file designed all-ceramic reconstruction calls for a different dimension protocol, compared to traditionally shaped ones, as the split-file design leads to sharp approximal indentations acting as fractural impressions, thus decreasing the overall strength. The design of a framework is a crucial factor for the load bearing capacity of an all-ceramic FDP. The state-of-the-art design is preferable since the split-file designed cores call for a cross-sectional connector area at least 42% larger, to have the same load bearing capacity as the state-of-the-art designed cores. All veneering materials and techniques tested in the study, split-file, over-press, built-up porcelains, and glass-ceramics are, with a great safety margin, sufficient for clinical use both anteriorly and posteriorly. Analysis of the fracture pattern shows differences between the milled veneers and over-pressed or built-up veneers, where the milled ones show numerically more veneer cracks and the other groups only show complete connector fractures.

Fractographic Analysis of a Split Tooth Presenting Radiographically as a Horizontal Root Fracture in an Unrestored Mandibular Second Molar.

PubMed

Krishnan, Unni; Moule, Alex; Michael, Shaji; Swain, Michael

2018-02-01

Spontaneously catastrophic fracture of intact unrestored molar teeth is not common. Nevertheless, cracks do occur that progress apically, resulting in the complete splitting of the tooth and root. This report describes a catastrophic fracture that occurred in an unrestored mandibular second molar resulting in a previously unreported combination of a longitudinal and horizontal root fracture, appearing radiographically as a single horizontal root fracture. Tooth fragments were examined clinically, stereoscopically, and by scanning electron microscopy. Fractographic analysis was used to investigate the dynamics involved in fracture initiation, structural resistances encountered during progression of the fracture, and reasons for direction changes culminating in the unusual radiographic appearance. The uniqueness of this report is that it describes fractographic evidence of factors contributing to the initiation and progression of an in vivo crack. It shows fracture markings that are evidence of the energy dissipation mechanisms. The topographic location of these markings confirmed that cracks occur in vivo in stages with different rates of progression. This analysis helps to explain why split teeth are uncommon and highlights some of the multitude of factors that have to coincide for a tooth to catastrophically fracture. The report describes the mechanism of fracture and should stimulate clinicians and researchers to investigate cracking of teeth by undertaking fractographic analysis of extracted cracked teeth. Copyright © 2017 American Association of Endodontists. All rights reserved.

A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by Computed Tomography

PubMed Central

2009-01-01

Background Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded. Methods The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions) by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan. Results The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult. Conclusion The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis. PMID:19835570

Progressive Fracture of Composite Structures

NASA Technical Reports Server (NTRS)

Chamis, Christos C.; Minnetyan, Levon

2008-01-01

A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells and the built-up composite structure global fracture are enhanced when internal pressure is combined with shear loads.

Failure Analysis on Tail Rotor Teeter Pivot Bolt on a Helicopter

NASA Astrophysics Data System (ADS)

Qiang, WANG; Zi-long, DONG

2018-03-01

Tail rotor teeter pivot bolt of a helicopter fractured when in one flight. Failure analysis on the bolt was finished in laboratory. Macroscopic observation of the tailor rotor teeter pivot bolt, macro and microscopic inspection on the fracture surface of the bolt was carried out. Chemical components and metallurgical structure was also carried out. Experiment results showed that fracture mode of the tail rotor teeter pivot bolt is fatigue fracture. Fatigue area is over 80% of the total fracture surface, obvious fatigue band characteristics can be found at the fracture face. According to the results were analyzed from the macroscopic and microcosmic aspects, fracture reasons of the tail rotor teeter pivot bolt were analyzed in detail

Kuhn-Tucker optimization based reliability analysis for probabilistic finite elements

NASA Technical Reports Server (NTRS)

Liu, W. K.; Besterfield, G.; Lawrence, M.; Belytschko, T.

1988-01-01

The fusion of probability finite element method (PFEM) and reliability analysis for fracture mechanics is considered. Reliability analysis with specific application to fracture mechanics is presented, and computational procedures are discussed. Explicit expressions for the optimization procedure with regard to fracture mechanics are given. The results show the PFEM is a very powerful tool in determining the second-moment statistics. The method can determine the probability of failure or fracture subject to randomness in load, material properties and crack length, orientation, and location.

Application of Fracture Mechanics to Specify the Proof Load Factor for Clamp Band Systems of Launch Vehicles

NASA Astrophysics Data System (ADS)

Singaravelu, J.; Sundaresan, S.; Nageswara Rao, B.

2013-04-01

This article presents a methodology for evaluation of the proof load factor (PLF) for clamp band system (CBS) made of M250 Maraging steel following fracture mechanics principles.CBS is most widely used as a structural element and as a separation system. Using Taguchi's design of experiments and the response surface method (RSM) the compact tension specimens were tested to establish an empirical relation for the failure load ( P max) in terms of the ultimate strength, width, thickness, and initial crack length. The test results of P max closely matched with the developed RSM empirical relation. Crack growth rates of the maraging steel in different environments were examined. Fracture strength (σf) of center surface cracks and through-crack tension specimens are evaluated utilizing the fracture toughness ( K IC). Stress induced in merman band at flight loading conditions is evaluated to estimate the higher load factor and PLF. Statistical safety factor and reliability assessments were made for the specified flaw sizes useful in the development of fracture control plan for CBS of launch vehicles.

The utility of FRAX® in predicting bone fractures in patients with chronic kidney disease on hemodialysis: a two-year prospective multicenter cohort study.

PubMed

Przedlacki, J; Buczyńska-Chyl, J; Koźmiński, P; Niemczyk, E; Wojtaszek, E; Gieglis, E; Żebrowski, P; Podgórzak, A; Wściślak, J; Wieliczko, M; Matuszkiewicz-Rowińska, J

2018-05-01

We assessed the FRAX® method in 718 hemodialyzed patients in estimating increased risk of bone major and hip fractures. Over two prospective years, statistical analysis showed that FRAX® enables a better assessment of bone major fracture risk in these patients than any of its components and other risk factors considered in the analysis. Despite the generally increased risk of bone fractures among patients with end-stage renal disease, no prediction models for identifying individuals at particular risk have been developed to date. The goal of this prospective, multicenter observational study was to assess the usefulness of the FRAX® method in comparison to all its elements considered separately, selected factors associated with renal disease and the history of falls, in estimating increased risk of low-energy major bone and hip fractures in patients undergoing chronic hemodialysis. The study included a total of 1068 hemodialysis patients, who were followed for 2 years, and finally, 718 of them were analyzed. The risk analysis included the Polish version of the FRAX® calculator (without bone mineral density), dialysis vintage, mineral metabolism disorders (serum calcium, phosphate, and parathyroid hormone), and the number of falls during the last year before the study. Over 2 years, low-energy 30 major bone fractures were diagnosed and 13 of hip fractures among them. Area under the curve for FRAX® was 0.76 (95% CI 0.69-0.84) for major fractures and 0.70 (95% CI 0.563-0.832) for hip fractures. The AUC for major bone fractures was significantly higher than for all elements of the FRAX® calculator. In logistic regression analysis FRAX® was the strongest independent risk factor of assessment of the major bone fracture risk. FRAX® enables a better assessment of major bone fracture risk in ESRD patients undergoing hemodialysis than any of its components and other risk factors considered in the analysis.

Semi-analytical model of cross-borehole flow experiments for fractured medium characterization

NASA Astrophysics Data System (ADS)

Roubinet, D.; Irving, J.; Day-Lewis, F. D.

2014-12-01

The study of fractured rocks is extremely important in a wide variety of research fields where the fractures and faults can represent either rapid access to some resource of interest or potential pathways for the migration of contaminants in the subsurface. Identification of their presence and determination of their properties are critical and challenging tasks that have led to numerous fracture characterization methods. Among these methods, cross-borehole flowmeter analysis aims to evaluate fracture connections and hydraulic properties from vertical-flow-velocity measurements conducted in one or more observation boreholes under forced hydraulic conditions. Previous studies have demonstrated that analysis of these data can provide important information on fracture connectivity, transmissivity, and storativity. Estimating these properties requires the development of analytical and/or numerical modeling tools that are well adapted to the complexity of the problem. Quantitative analysis of cross-borehole flowmeter experiments, in particular, requires modeling formulations that: (i) can be adapted to a variety of fracture and experimental configurations; (ii) can take into account interactions between the boreholes because their radii of influence may overlap; and (iii) can be readily cast into an inversion framework that allows for not only the estimation of fracture hydraulic properties, but also an assessment of estimation error. To this end, we present a new semi-analytical formulation for cross-borehole flow in fractured media that links transient vertical-flow velocities measured in one or a series of observation wells during hydraulic forcing to the transmissivity and storativity of the fractures intersected by these wells. Our model addresses the above needs and provides a flexible and computationally efficient semi-analytical framework having strong potential for future adaptation to more complex configurations. The proposed modeling approach is demonstrated in the context of sensitivity analysis for a relatively simple two-fracture synthetic problem, as well as in the context of field-data analysis for fracture connectivity and estimation of corresponding hydraulic properties.

Use of antipsychotics increases the risk of fracture: a systematic review and meta-analysis.

PubMed

Lee, S-H; Hsu, W-T; Lai, C-C; Esmaily-Fard, A; Tsai, Y-W; Chiu, C-C; Wang, J; Chang, S-S; Lee, C C

2017-04-01

Our systematic review and meta-analysis of observational studies indicated that the use of antipsychotics was associated with a nearly 1.5-fold increase in the risk of fracture. First-generation antipsychotics (FGAs) appeared to carry a higher risk of fracture than second-generation antipsychotics (SGAs). The risk of fractures associated with the use of antipsychotic medications has inconsistent evidence between different drug classes. A systematic review and meta-analysis was conducted to evaluate whether there is an association between the use of antipsychotic drugs and fractures. Searches were conducted through the PubMed and EMBASE databases to identify observational studies that had reported a quantitative estimate of the association between use of antipsychotics and fractures. The summary risk was derived from random effects meta-analysis. The search yielded 19 observational studies (n = 544,811 participants) with 80,835 fracture cases. Compared with nonuse, use of FGAs was associated with a significantly higher risk for hip fractures (OR 1.67, 95% CI, 1.45-1.93), and use of second generation antipsychotics (SGAs) was associated with an attenuated but still significant risk for hip fractures (OR 1.33, 95% CI, 1.11-1.58). The risk of fractures associated with individual classes of antipsychotic users was heterogeneous, and odds ratios ranged from 1.24 to 2.01. Chlorpromazine was associated with the highest risk (OR 2.01, 95% CI 1.43-2.83), while Risperidone was associated with the lowest risk of fracture (OR 1.24, 95% CI 0.95-1.83). FGA users were at a higher risk of hip fracture than SGA users. Both FGAs and SGAs were associated with an increased risk of fractures, especially among the older population. Therefore, the benefit of the off-label use of antipsychotics in elderly patients should be weighed against any risks for fracture.

Analysis of delamination related fracture processes in composites

NASA Technical Reports Server (NTRS)

Armanios, Erian A.

1988-01-01

Delamination related fracture processes in composite materials are discussed. Thermal and moisture influences on the free-edge delamination of laminated composites, fracture analysis of local delaminations in laminated composites, and strain energy release rates in belts are among the topics covered.

Applications of Automation Methods for Nonlinear Fracture Test Analysis

NASA Technical Reports Server (NTRS)

Allen, Phillip A.; Wells, Douglas N.

2013-01-01

As fracture mechanics material testing evolves, the governing test standards continue to be refined to better reflect the latest understanding of the physics of the fracture processes involved. The traditional format of ASTM fracture testing standards, utilizing equations expressed directly in the text of the standard to assess the experimental result, is self-limiting in the complexity that can be reasonably captured. The use of automated analysis techniques to draw upon a rich, detailed solution database for assessing fracture mechanics tests provides a foundation for a new approach to testing standards that enables routine users to obtain highly reliable assessments of tests involving complex, non-linear fracture behavior. Herein, the case for automating the analysis of tests of surface cracks in tension in the elastic-plastic regime is utilized as an example of how such a database can be generated and implemented for use in the ASTM standards framework. The presented approach forms a bridge between the equation-based fracture testing standards of today and the next generation of standards solving complex problems through analysis automation.

Multiscale Multifunctional Progressive Fracture of Composite Structures

NASA Technical Reports Server (NTRS)

Chamis, C. C.; Minnetyan, L.

2012-01-01

A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells. Global fracture is enhanced when internal pressure is combined with shear loads. The old reference denotes that nothing has been added to this comprehensive report since then.

Hydraulic Fracturing Fluid Analysis for Regulatory Parameters - A Progress Report

EPA Pesticide Factsheets

This presentation is a progress report on the analysis of Hydraulic Fracturing Fluids for regulatory compounds outlined in the various US EPA methodologies. Fracturing fluids vary significantly in consistency and viscosity prior to fracturing. Due to the nature of the fluids the analytical challenges will have to be addressed. This presentation also outlines the sampling issues associated with the collection of dissolved gas samples.

Design and methods of a postmarketing pharmacoepidemiology study assessing long-term safety of Prolia® (denosumab) for the treatment of postmenopausal osteoporosis.

PubMed

Xue, Fei; Ma, Haijun; Stehman-Breen, Catherine; Haller, Christine; Katz, Leonid; Wagman, Rachel B; Critchlow, Cathy W

2013-10-01

To describe the rationale and methods for a prospective, open-cohort study assessing the long-term safety of Prolia(®) for treatment of postmenopausal osteoporosis (PMO) in postmarketing settings. Data will be derived from United States Medicare, United Healthcare, and Nordic (Denmark, Sweden, Norway) national registries. Observation will begin on the date of first Prolia(®) regulatory approval (May 26, 2010) and continue for 10 years. Women with PMO will be identified by postmenopausal age, osteoporosis diagnosis, osteoporotic fracture, or osteoporosis treatment. Exposure to Prolia(®) and bisphosphonates will be updated during follow-up; exposure cohorts will be defined based on patient-years during which patients are on- or post-treatment. Nine adverse events (AEs) will be assessed based on diagnosis codes: osteonecrosis of the jaw (ONJ), atypical femoral fracture (AFF), fracture healing complications, hypocalcemia, infection, dermatologic AEs, acute pancreatitis, hypersensitivity, and new primary malignancy. Medical review will confirm selected potential cases of ONJ and AFF. Incidence rates (IRs) of AEs will be described overall and for exposure cohorts; multivariate Cox proportional hazard regression models will compare IRs of AEs across exposure cohorts. Utilization patterns of Prolia(®) for approved, and unapproved indications will be described. This study is based on comprehensive preliminary research and considers methodological challenges specific to the study population. The integrated data systems used in this regulatory committed program can serve as a powerful data resource to assess diverse and rare AEs over time. © 2013 Amgen Inc. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

Theoretical Analysis of the Mechanism of Fracture Network Propagation with Stimulated Reservoir Volume (SRV) Fracturing in Tight Oil Reservoirs.

PubMed

Su, Yuliang; Ren, Long; Meng, Fankun; Xu, Chen; Wang, Wendong

2015-01-01

Stimulated reservoir volume (SRV) fracturing in tight oil reservoirs often induces complex fracture-network growth, which has a fundamentally different formation mechanism from traditional planar bi-winged fracturing. To reveal the mechanism of fracture network propagation, this paper employs a modified displacement discontinuity method (DDM), mechanical mechanism analysis and initiation and propagation criteria for the theoretical model of fracture network propagation and its derivation. A reasonable solution of the theoretical model for a tight oil reservoir is obtained and verified by a numerical discrete method. Through theoretical calculation and computer programming, the variation rules of formation stress fields, hydraulic fracture propagation patterns (FPP) and branch fracture propagation angles and pressures are analyzed. The results show that during the process of fracture propagation, the initial orientation of the principal stress deflects, and the stress fields at the fracture tips change dramatically in the region surrounding the fracture. Whether the ideal fracture network can be produced depends on the geological conditions and on the engineering treatments. This study has both theoretical significance and practical application value by contributing to a better understanding of fracture network propagation mechanisms in unconventional oil/gas reservoirs and to the improvement of the science and design efficiency of reservoir fracturing.

Theoretical Analysis of the Mechanism of Fracture Network Propagation with Stimulated Reservoir Volume (SRV) Fracturing in Tight Oil Reservoirs

PubMed Central

Su, Yuliang; Ren, Long; Meng, Fankun; Xu, Chen; Wang, Wendong

2015-01-01

Stimulated reservoir volume (SRV) fracturing in tight oil reservoirs often induces complex fracture-network growth, which has a fundamentally different formation mechanism from traditional planar bi-winged fracturing. To reveal the mechanism of fracture network propagation, this paper employs a modified displacement discontinuity method (DDM), mechanical mechanism analysis and initiation and propagation criteria for the theoretical model of fracture network propagation and its derivation. A reasonable solution of the theoretical model for a tight oil reservoir is obtained and verified by a numerical discrete method. Through theoretical calculation and computer programming, the variation rules of formation stress fields, hydraulic fracture propagation patterns (FPP) and branch fracture propagation angles and pressures are analyzed. The results show that during the process of fracture propagation, the initial orientation of the principal stress deflects, and the stress fields at the fracture tips change dramatically in the region surrounding the fracture. Whether the ideal fracture network can be produced depends on the geological conditions and on the engineering treatments. This study has both theoretical significance and practical application value by contributing to a better understanding of fracture network propagation mechanisms in unconventional oil/gas reservoirs and to the improvement of the science and design efficiency of reservoir fracturing. PMID:25966285

Real-World Rib Fracture Patterns in Frontal Crashes in Different Restraint Conditions.

PubMed

Lee, Ellen L; Craig, Matthew; Scarboro, Mark

2015-01-01

The purpose of this study was to use the detailed medical injury information in the Crash Injury Research and Engineering Network (CIREN) to evaluate patterns of rib fractures in real-world crash occupants in both belted and unbelted restraint conditions. Fracture patterns binned into rib regional levels were examined to determine normative trends associated with belt use and other possible contributing factors. Front row adult occupants with Abbreviated Injury Scale (AIS) 3+ rib fractures, in frontal crashes with a deployed frontal airbag, were selected from the CIREN database. The circumferential location of each rib fracture (with respect to the sternum) was documented using a previously published method (Ritchie et al. 2006) and digital computed tomography scans. Fracture patterns for different crash and occupant parameters (restraint use, involved physical component, occupant kinematics, crash principal direction of force, and occupant age) were compared qualitatively and quantitatively. There were 158 belted and 44 unbelted occupants included in this study. For belted occupants, fractures were mainly located near the path of the shoulder belt, with the majority of fractures occurring on the inboard (with respect to the vehicle) side of the thorax. For unbelted occupants, fractures were approximately symmetric and distributed across both sides of the thorax. There were negligible differences in fracture patterns between occupants with frontal (0°) and near side (330° to 350° for drivers; 10° to 30° for passengers) crash principal directions of force but substantial differences between groups when occupant kinematics (and contacts within the vehicle) were considered. Age also affected fracture pattern, with fractures tending to occur more anteriorly in older occupants and more laterally in younger occupants (both belted and unbelted). Results of this study confirmed with real-world data that rib fracture patterns in unbelted occupants were more distributed and symmetric across the thorax compared to belted occupants in crashes with a deployed frontal airbag. Other factors, such as occupant kinematics and occupant age, also produced differing patterns of fractures. Normative data on rib fracture patterns in real-world occupants can contribute to understanding injury mechanisms and the role of different causation factors, which can ultimately help prevent fractures and improve vehicle safety.

Study on fracture identification of shale reservoir based on electrical imaging logging

NASA Astrophysics Data System (ADS)

Yu, Zhou; Lai, Fuqiang; Xu, Lei; Liu, Lin; Yu, Tong; Chen, Junyu; Zhu, Yuantong

2017-05-01

In recent years, shale gas exploration has made important development, access to a major breakthrough, in which the study of mud shale fractures is extremely important. The development of fractures has an important role in the development of gas reservoirs. Based on the core observation and the analysis of laboratory flakes and laboratory materials, this paper divides the lithology of the shale reservoirs of the XX well in Zhanhua Depression. Based on the response of the mudstone fractures in the logging curve, the fracture development and logging Response to the relationship between the conventional logging and electrical imaging logging to identify the fractures in the work, the final completion of the type of fractures in the area to determine and quantify the calculation of fractures. It is concluded that the fracture type of the study area is high and the microstructures are developed from the analysis of the XX wells in Zhanhua Depression. The shape of the fractures can be clearly seen by imaging logging technology to determine its type.

Space Transportation System (STS)-133/External Tank (ET)-137 Intertank (IT) Stringer Cracking Issue and Repair Assessment: Proximate Cause Determination and Material Characterization Study

NASA Technical Reports Server (NTRS)

Piascik, Robert S.

2011-01-01

Several cracks were detected in stringers located beneath the foam on the External Tank (ET) following the launch scrub of Space Transportation System (STS)-133 on November 5, 2010. The stringer material was aluminum-lithium (AL-Li) 2090-T83 fabricated from sheets that were nominally 0.064 inches thick. The mechanical properties of the stringer material were known to vary between different material lots, with the stringers from ET-137 (predominately lots 620853 and 620854) having the highest yield and ultimate stresses. Subsequent testing determined that these same lots also had the lowest fracture toughness properties. The NASA Engineering and Safety Center (NESC) supported the Space Shuttle Program (SSP)-led investigation. The objective of this investigation was to develop a database of test results to provide validation for structural analysis models, independently confirm test results obtained from other investigators, and determine the proximate cause of the anomalous low fracture toughness observed in stringer lots 620853 and 620854. This document contains the outcome of the investigation.

Analysis of impact energy to fracture un-notched charpy specimens made from railroad tank car steel

DOT National Transportation Integrated Search

2007-09-11

This paper describes a nonlinear finite element analysis : (FEA) framework that examines the impact energy to fracture : unnotched Charpy specimens by an oversized, nonstandard : pendulum impactor called the Bulk Fracture Charpy Machine : (BFCM). The...

Fractography and estimates of fracture origin size from fracture mechanics

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

Quinn, G.D.; Swab, J.J.

1996-12-31

Fracture mechanics should be used routinely in fractographic analyses in order to verify that the correct feature has been identified as the fracture origin. This was highlighted in a recent Versailles Advanced Materials and Standards (VAMAS) fractographic analysis round robin. The practice of using fracture mechanics as an aid to fractographic interpretation is codified in a new ASTM Standard Practice. Conversely, very good estimates for fracture toughness often come from fractographic analysis of strength tested specimens. In many instances however, the calculated flaw size is different from the empirically-measured flaw size. This paper reviews the factors which may cause themore » discrepancies.« less

Scanning electron microscope fractography in failure analysis of steels

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

Wouters, R.; Froyen, L.

1996-04-01

For many failure cases, macroscopic examination of the fracture surface permits discrimination of fatigue fractures from overload fractures. For clarifying fatigue fractures, the practical significance of microfractography is limited to an investigation of the crack initiation areas. Scanning electron microscopy is successfully used in tracing local material abnormalities that act as fatigue crack initiators. The task for the scanning electron microscope, however, is much more substantial in failure analysis of overload fractures, especially for steels. By revealing specific fractographic characteristics, complemented by information about the material and the loading conditions, scanning electron microscopy provides a strong indication of the probablemore » cause of failure. A complete dimple fracture is indicative of acceptable bulk material properties; overloading, by subdimensioning or excessive external loading, has to be verified. The presence of cleavage fracture makes the material properties questionable if external conditions causing embrittlement are absent. Intergranular brittle fracture requires verification of grain-boundary weakening conditions--a sensitized structure, whether or not combined with a local stress state or a specific environment. The role of scanning electron microscopy in failure analysis is illustrated by case histories of the aforementioned fracture types.« less

Analysis of macroscopic fractures in granite in the HDR geothermal well EPS-1, Soultz-sous-Foreêts, France

NASA Astrophysics Data System (ADS)

Genter, Albert; Traineau, Hervé

1996-07-01

An exhaustive analysis of 3000 macroscopic fractures encountered in the geothermal Hot Dry Rock borehole, EPS-1, located inside the Rhine graben (Soultz-sous-Foreˆts, France), was done on a continuous core section over a depth interval from 1420 to 2230 m: 97% of the macroscopic structures were successfully reorientated with a good degree of confidence by comparison between core and acoustic borehole imagery. Detailed structural analysis of the fracture population indicates that fractures are grouped in two principal fractures sets striking N005 and N170 °, and dipping 70 °W and 70 °E, respectively. This average attitude is closely related to the past tectonic rifting activity of the graben during the Tertiary, and is consistent with data obtained from nearby boreholes and from neighbouring crystalline outcrops. Fractures are distributed in clusters of hydrothermally altered and fractured zones. They constitute a complex network of fault strands dominated by N-S trends, except within some of the most fractured depth intervals (1650 m, 2170 m), where an E-W-striking fracture set occurs. The geometry of the pre-existing fracture system strikes in a direction nearly parallel to the maximum horizontal stress. In this favorable situation, hydraulic injections will tend both to reactivate natural fractures at low pressures, and to create a geothermal reservoir.

Method for detecting moment connection fracture using high-frequency transients in recorded accelerations

USGS Publications Warehouse

Rodgers, J.E.; Elebi, M.

2011-01-01

The 1994 Northridge earthquake caused brittle fractures in steel moment frame building connections, despite causing little visible building damage in most cases. Future strong earthquakes are likely to cause similar damage to the many un-retrofitted pre-Northridge buildings in the western US and elsewhere. Without obvious permanent building deformation, costly intrusive inspections are currently the only way to determine if major fracture damage that compromises building safety has occurred. Building instrumentation has the potential to provide engineers and owners with timely information on fracture occurrence. Structural dynamics theory predicts and scale model experiments have demonstrated that sudden, large changes in structure properties caused by moment connection fractures will cause transient dynamic response. A method is proposed for detecting the building-wide level of connection fracture damage, based on observing high-frequency, fracture-induced transient dynamic responses in strong motion accelerograms. High-frequency transients are short (<1 s), sudden-onset waveforms with frequency content above 25 Hz that are visually apparent in recorded accelerations. Strong motion data and damage information from intrusive inspections collected from 24 sparsely instrumented buildings following the 1994 Northridge earthquake are used to evaluate the proposed method. The method's overall success rate for this data set is 67%, but this rate varies significantly with damage level. The method performs reasonably well in detecting significant fracture damage and in identifying cases with no damage, but fails in cases with few fractures. Combining the method with other damage indicators and removing records with excessive noise improves the ability to detect the level of damage. ?? 2010 Elsevier B.V. All rights reserved.

The evolution of selective estrogen receptor modulators in osteoporosis therapy

PubMed Central

2012-01-01

Selective estrogen receptor modulators (SERMs), which exhibit estrogen receptor agonist or antagonist activity based on the target tissue, have evolved through multiple generations for the prevention and/or treatment of postmenopausal osteoporosis. An ideal SERM would protect bone without stimulating the breast or endometrium. Raloxifene, lasofoxifene, and bazedoxifene have demonstrated unique preclinical profiles. Raloxifene, lasofoxifene, and bazedoxifene have shown significant reduction in the risk of vertebral fracture and improvement in bone mineral density versus placebo in postmenopausal women with osteoporosis. Raloxifene has been shown to reduce the risk of non-vertebral fractures in women with severe prevalent fractures at baseline. Lasofoxifene 0.5 mg, but not lasofoxifene 0.25 mg, has shown reduction in the incidence of non-vertebral fractures. Bazedoxifene 20 mg has been associated with a significant reduction in the risk of non-vertebral fracture versus placebo and raloxifene 60 mg in women at higher baseline fracture risk. Neither raloxifene, lasofoxifene, nor bazedoxifene has shown an increase in the incidence of endometrial hyperplasia or carcinoma. All SERMs have been associated with increased venous thromboembolic events and hot flushes. SERMs are effective alternatives for women who cannot tolerate or are unwilling to take bisphosphonates and may be appropriate for women at higher risk of fracture, particularly younger women who expect to remain on therapy for many years and are concerned about the long-term safety of bisphosphonates. PMID:22853318

Fracture Analysis of Cast Steel Sling

NASA Astrophysics Data System (ADS)

Li, Xinghui

2018-02-01

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

Tritium and 36Cl as constraints on fast fracture flow and percolation flux in the unsaturated zone at Yucca Mountain

NASA Astrophysics Data System (ADS)

Guerin, Marianne

2001-10-01

An analysis of tritium and 36Cl data collected at Yucca Mountain, Nevada suggests that fracture flow may occur at high velocities through the thick unsaturated zone. The mechanisms and extent of this "fast flow" in fractures at Yucca Mountain are investigated with data analysis, mixing models and several one-dimensional modeling scenarios. The model results and data analysis provide evidence substantiating the weeps model [Gauthier, J.H., Wilson, M.L., Lauffer, F.C., 1992. Proceedings of the Third Annual International High-level Radioactive Waste Management Conference, vol. 1, Las Vegas, NV. American Nuclear Society, La Grange Park, IL, pp. 891-989] and suggest that fast flow in fractures with minimal fracture-matrix interaction may comprise a substantial proportion of the total infiltration through Yucca Mountain. Mixing calculations suggest that bomb-pulse tritium measurements, in general, represent the tail end of travel times for thermonuclear-test-era (bomb-pulse) infiltration. The data analysis shows that bomb-pulse tritium and 36Cl measurements are correlated with discrete features such as horizontal fractures and areas where lateral flow may occur. The results presented here imply that fast flow in fractures may be ubiquitous at Yucca Mountain, occurring when transient infiltration (storms) generates flow in the connected fracture network.

Tritium and 36Cl as constraints on fast fracture flow and percolation flux in the unsaturated zone at Yucca Mountain.

PubMed

Guerin, M

2001-10-01

An analysis of tritium and 36Cl data collected at Yucca Mountain, Nevada suggests that fracture flow may occur at high velocities through the thick unsaturated zone. The mechanisms and extent of this "fast flow" in fractures at Yucca Mountain are investigated with data analysis, mixing models and several one-dimensional modeling scenarios. The model results and data analysis provide evidence substantiating the weeps model [Gauthier, J.H., Wilson, M.L., Lauffer, F.C., 1992. Proceedings of the Third Annual International High-level Radioactive Waste Management Conference, vol. 1, Las Vegas, NV. American Nuclear Society, La Grange Park, IL, pp. 891-989] and suggest that fast flow in fractures with minimal fracture-matrix interaction may comprise a substantial proportion of the total infiltration through Yucca Mountain. Mixing calculations suggest that bomb-pulse tritium measurements, in general, represent the tail end of travel times for thermonuclear-test-era (bomb-pulse) infiltration. The data analysis shows that bomb-pulse tritium and 36Cl measurements are correlated with discrete features such as horizontal fractures and areas where lateral flow may occur. The results presented here imply that fast flow in fractures may be ubiquitous at Yucca Mountain, occurring when transient infiltration (storms) generates flow in the connected fracture network.

Failure analysis of eleven Gates Glidden drills that fractured intraorally during post space preparation. A retrieval analysis study.

PubMed

Al Jabbari, Youssef S; Fournelle, Raymond; Al Taweel, Sara M; Zinelis, Spiros

2017-07-19

The purpose of this study was to determine the failure mechanism of clinically failed Gates Glidden (GG) drills. Eleven retrieved GG drills (sizes #1 to #3) which fractured during root canal preparation were collected and the fracture location was recorded based on macroscopic observation. All fracture surfaces were investigated by a SEM. Then the fractured parts were embedded in acrylic resin and after metallographic preparation, the microstructure and elemental composition was evaluated by SEM and EDS. The Vickers hardness (HV) of all specimens was also determined. Macroscopic examination and SEM analysis showed that the drills failed near the hand piece end by torsional fatigue with fatigue cracks initiating at several locations around the circumference and propagating toward the center. Final fracture followed by a tensile overloading at the central region of cross section. Microstructural analysis, hardness measurements and EDS show that the drills are made of a martensitic stainless steel like AISI 440C. Based on the findings of this study, clinicians should expect fatigue fracture of GG drills that have small size during root canal preparation. Selection of a more fatigue resistant stainless steel alloy and enhancing the instrument design might reduce the incidence of quasi-cleavage fracture on GG drills.

Mechanical behavior and failure analysis of prosthetic retaining screws after long-term use in vivo. Part 4: Failure analysis of 10 fractured retaining screws retrieved from three patients.

PubMed

Al Jabbari, Youssef S; Fournelle, Raymond; Ziebert, Gerald; Toth, Jeffrey; Iacopino, Anthony M

2008-04-01

The aim of this study was to perform a failure analysis on fractured prosthetic retaining screws after long-term use in vivo. Additionally, the study addresses the commonly asked question regarding whether complex repeated functional occlusal forces initiate fatigue-type cracks in prosthetic retaining screws. Ten fractured prosthetic retaining screws retrieved from three patients treated with fixed detachable hybrid prostheses were subjected to a failure analysis. In patients 1 and 2, the middle three retaining screws of the prostheses were found fractured at retrieval time after they had been in service for 20 and 19 months, respectively. In patient 3, the middle three and one of the posterior retaining screws were found to be fractured at retrieval after they had been in service for 18 months. Low power stereomicroscopy and high-power scanning electron microscopy (SEM) were performed to analyze the fractured surfaces of the retaining screws examining fatigue cracks in greater detail. Typical fatigue failure characterized by ratchet mark formation was revealed by light microscopy and SEM for all examined screws. Using low magnification light microscopy, ratchet marks were visible on the fracture surfaces of only two screws. SEM examination revealed all three classical stages of fatigue failure, and it was possible to see the ratchet marks on the fracture surfaces of all specimens, indicating a fatigue zone. The final catastrophic overload fracture appeared fibrous, indicating ductile fracture. The final overload ductile fracture surfaces showed equiaxed dimples, suggesting tensile overload in all examined screws except in two specimens that showed an elongated dimple pattern indicating shear/tearing overload forces. Fracture of prosthetic retaining screws in hybrid prostheses occurs mainly through a typical fatigue mode involving mostly the middle anterior three screws. Fatigue cracks can grow in more than one prosthetic retaining screw, leading to fracture before the patient or clinician determines that any problem exists.

[Clinical application of atlas translaminar screws fixation in treatment of atlatoaxial instability].

PubMed

Wang, Guoyou; Fu, Shijie; Shen, Huarui; Guan, Taiyuan; Xu, Ping

2013-10-01

To explore the effectiveness of fixation of atlas translaminar screws in the treatment of atlatoaxial instability. A retrospective analysis was made on the clinical data of 32 patients with atlatoaxial instability treated with atlantoaxial trans-pedicle screws between March 2007 and August 2009. Of them, 7 patients underwent atlas translaminar screws combined with axis transpedicle screws fixation because of fracture types, anatomic variation, and intraoperative reason, including 5 males and 2 females with an average age of 48.2 years (range, 35-69 years). A total of 9 translaminar screws were inserted. Injury was caused by traffic accident in 4 cases, falling from height in 2 cases, and crushing in 1 case. Two cases had simple odontoid fracture (Anderson type II), and 5 cases had odontoid fracture combined with other injuries (massa lateralis atlantis fracture in 2, atlantoaxial dislocation in 1, and Hangman fracture in 2). The interval between injury and operation was 4-9 days (mean, 6 days). The preoperative Japanese Orthopaedic Association (JOA) score was 8.29 +/- 1.60. The X-ray films showed good position of the screws. Healing of incision by first intention was obtained, and no patient had injuries of the spinal cord injury, nerve root, and vertebral artery. Seven cases were followed up 9-26 months (mean, 14 months). Good bone fusion was observed at 8 months on average (range, 6-11 months). No loosening, displacement, and breakage of internal fixation, re-dislocation and instability of atlantoaxial joint, or penetrating of pedicle screw into the spinal canal and the spinal cord occurred. The JOA score was significantly improved to 15.29 +/- 1.38 at 6 months after operation (t = 32.078, P = 0.000). Atlas translaminar screws fixation has the advantages of firm fixation, simple operating techniques, and relative safety, so it may be a remedial measure of atlatoaxial instability.

Safety and effectiveness of percutaneous sacroplasty: a single-centre experience in 58 consecutive patients with tumours or osteoporotic insufficient fractures treated under fluoroscopic guidance.

PubMed

Pereira, Licia Pacheco; Clarençon, Frédéric; Cormier, Evelyne; Rose, Michèle; Jean, Beatrix; Le Jean, Lise; Chiras, Jacques

2013-10-01

To report our experience in percutaneous sacroplasty (PSP) for tumours and insufficiency fractures of the sacrum. Single-centre retrospective analysis of 58 consecutive patients who underwent 67 PSPs for intractable pain from sacral tumours (84.5 %) or from osteoporotic fractures (15.5 %). The following data were assessed: visual analogue scale (VAS) before and after the procedure for global pain; short-term (1-month) clinical follow-up using a four-grade patient satisfaction scale (worse, unchanged, mild improvement and significant improvement); modification in analgesics consumption; referred short-term walking mobility. Minor and major complications were systematically assessed. The mean VAS score was 5.3 ± 2.0 in pre-procedure and 1.7 ± 1.8 in post-procedure. At 1-month follow-up, 34/58 (58.5 %) patients experienced a mild improvement; 15/58 (26 %) presented a significant improvement while 4/58 (7 %) and 5/58 (8.5 %) patients had unchanged or worse pain, respectively. Decreased analgesic consumption was observed in 34 % (20/58) of the patients. Eighty percent of patients with walking limitation experienced improvement, 16 % remained unchanged and 4 % were worse. We noted minor complications in 2/58 patients (3.4 %) and major complications in 2/58 patients (3.4 %). Percutaneous sacroplasty for metastatic and osteoporotic fractures is a safe and effective technique in terms of pain relief and functional outcome. • Percutaneous sacroplasty provides pain relief and functional improvement for insufficiency sacral fractures. • Percutaneous sacroplasty provides pain relief and function improvement for sacral tumours. • The major complication rate is acceptable (3.4 %), and is higher in sacral tumours. • Posterior wall/cortical sacral bone disruption is not statistically associated with more complications. • However, osteolytic tumours seem to be associated with higher risk of complications.

A comprehensive analysis of craniofacial trauma.

PubMed

Hussain, K; Wijetunge, D B; Grubnic, S; Jackson, I T

1994-01-01

A review of the literature identified a need for a prospective study of the complete range of craniofacial trauma. The aims of this study were to determine the incidence, etiology, and mechanisms of craniofacial and associated injuries, enabling a greater understanding of their range and magnitude. Nine hundred fifty consecutive patients seen at an urban university hospital with any degree of craniofacial trauma were prospectively investigated. Craniofacial trauma was found to be very common at all ages. The causes were directly related to age, sex, and alcohol consumption, and determine the type and severity of injury. The commonest cause of soft-tissue injury was falls, whereas that of fractures was interpersonal violence. Falls accounted for most of the injuries in children and the elderly, whereas interpersonal violence was mainly responsible for those occurring in patients aged 15 to 50 years. Interpersonal violence mostly involved young male adults: fights occurring mainly between strangers who had consumed excessive amounts of alcohol. Women were usually assaulted by assailants known to them, their partners. Pedestrians showed a propensity to sustain cranial fractures, whereas motor vehicle occupants tended to sustain midfacial fractures and bicyclists mandibular fractures. Pedestrians incurred the severest injuries of all road users, and a significant proportion of road user collisions involved bicyclists. Sports were responsible for a significant proportion of craniofacial injuries in youths and young adults. Craniofacial soft-tissue injuries overall occurred most frequently on the forehead, nose, lips, and chin, and a method for their classification is proposed. The commonest craniofacial fracture was that of the nasal bones (45%), followed by cranial bones (24%), mandible (13%), zygoma (13%), orbital blow-out (3%), and maxilla (2%). The incidence of craniofacial trauma can be greatly reduced by improvements in interior home design, school education in alcohol abuse and handling potentially hostile situations (especially for men), improvement in automotive safety devices and compliance by motor vehicle occupants, and utilization of full-face helmets by bicyclists and motorcyclists.

Development and validation of a generic finite element vehicle buck model for the analysis of driver rib fractures in real life nearside oblique frontal crashes.

PubMed

Iraeus, Johan; Lindquist, Mats

2016-10-01

Frontal crashes still account for approximately half of all fatalities in passenger cars, despite several decades of crash-related research. For serious injuries in this crash mode, several authors have listed the thorax as the most important. Computer simulation provides an effective tool to study crashes and evaluate injury mechanisms, and using stochastic input data, whole populations of crashes can be studied. The aim of this study was to develop a generic buck model and to validate this model on a population of real-life frontal crashes in terms of the risk of rib fracture. The study was conducted in four phases. In the first phase, real-life validation data were derived by analyzing NASS/CDS data to find the relationship between injury risk and crash parameters. In addition, available statistical distributions for the parameters were collected. In the second phase, a generic parameterized finite element (FE) model of a vehicle interior was developed based on laser scans from the A2MAC1 database. In the third phase, model parameters that could not be found in the literature were estimated using reverse engineering based on NCAP tests. Finally, in the fourth phase, the stochastic FE model was used to simulate a population of real-life crashes, and the result was compared to the validation data from phase one. The stochastic FE simulation model overestimates the risk of rib fracture, more for young occupants and less for senior occupants. However, if the effect of underestimation of rib fractures in the NASS/CDS material is accounted for using statistical simulations, the risk of rib fracture based on the stochastic FE model matches the risk based on the NASS/CDS data for senior occupants. The current version of the stochastic model can be used to evaluate new safety measures using a population of frontal crashes for senior occupants. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patient factors associated with increased acute care costs of hip fractures: a detailed analysis of 402 patients.

PubMed

Aigner, R; Meier Fedeler, T; Eschbach, D; Hack, J; Bliemel, C; Ruchholtz, S; Bücking, B

2016-12-01

The aim of the present study was to identify patient factors associated with higher costs in hip fracture patients. The mean costs of a prospectively observed sample of 402 patients were 8853 €. The ASA score, Charlson comorbidity index, and fracture location were associated with increased costs. Fractures of the proximal end of the femur (hip fractures) are of increasing incidence due to demographic changes. Relevant co-morbidities often present in these patients cause high complication rates and prolonged hospital stays, thus leading to high costs of acute care. The aim of this study was to perform a precise cost analysis of the actual hospital costs of hip fractures and to identify patient factors associated with increased costs. The basis of this analysis was a prospectively observed single-center trial, which included 402 patients with fractures of the proximal end of the femur. All potential cost factors were recorded as accurately as possible for each of the 402 patients individually, and statistical analysis was performed to identify associations between pre-existing patient factors and acute care costs. The mean total acute care costs per patient were 8853 ± 5676 € with ward costs (5828 ± 4294 €) and costs for surgical treatment (1972 ± 956 €) representing the major cost factors. The ASA score, Charlson comorbidity index, and fracture location were identified as influencing the costs of acute care for hip fracture treatment. Hip fractures are associated with high acute care costs. This study underlines the necessity of sophisticated risk-adjusted payment models based on specific patient factors. Economic aspects should be an integral part of future hip fracture research due to limited health care resources.

Surgical Technical Evidence Review of Hip Fracture Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

PubMed Central

Siletz, Anaar; Faltermeier, Claire; Singer, Emily S.; Hu, Q. Lina; Ko, Clifford Y.; Kates, Stephen L.; Maggard-Gibbons, Melinda; Wick, Elizabeth

2018-01-01

Background: Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Study Design: Perioperative care was divided into components or “bins.” For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials. Observational studies were included when higher levels of evidence were not available. Existing guidelines for perioperative care were also incorporated. For convenience, the components of care that are under the auspices of anesthesia providers will be reported separately. Recommendations for an evidence-based protocol were synthesized based on review of this evidence. Results: Eleven bins were identified. Preoperative risk factor bins included nutrition, diabetes mellitus, tobacco use, and anemia. Perioperative management bins included thromboprophylaxis, timing of surgery, fluid management, drain placement, early mobilization, early alimentation, and discharge criteria/planning. Conclusions: This review provides the evidence basis for an ERP for perioperative care of patients with hip fracture. PMID:29844947

Shale gas and non-aqueous fracturing fluids: Opportunities and challenges for supercritical CO₂

DOE PAGES

Middleton, Richard S.; Carey, James William; Currier, Robert P.; ...

2015-06-01

Hydraulic fracturing of shale formations in the United States has led to a domestic energy boom. Currently, water is the only fracturing fluid regularly used in commercial shale oil and gas production. Industry and researchers are interested in non-aqueous working fluids due to their potential to increase production, reduce water requirements, and to minimize environmental impacts. Using a combination of new experimental and modeling data at multiple scales, we analyze the benefits and drawbacks of using CO₂ as a working fluid for shale gas production. We theorize and outline potential advantages of CO₂ including enhanced fracturing and fracture propagation, reductionmore » of flow-blocking mechanisms, increased desorption of methane adsorbed in organic-rich parts of the shale, and a reduction or elimination of the deep re-injection of flow-back water that has been linked to induced seismicity and other environmental concerns. We also examine likely disadvantages including costs and safety issues associated with handling large volumes of supercritical CO₂. The advantages could have a significant impact over time leading to substantially increased gas production. In addition, if CO₂ proves to be an effective fracturing fluid, then shale gas formations could become a major utilization option for carbon sequestration.« less

Recurrent Penile Fracture-Case Report and Alternative Surgical Approach.

PubMed

Nascimento, Bruno; Guglielmetti, Giuliano B; Miranda, Eduardo P; Ivanovic, Renato F; Batagello, Carlos A; Nahas, William C; Srougi, Miguel; Cury, José

2018-05-03

Penile refracture is an exceedingly rare event, with very few published studies. To the best of our knowledge, this is the first documented case in the literature of penile fracture with 3 same-site recurrences. To describe the case of a 25-year-old Caucasian man with recurrent penile fracture ultimately treated with resuture and patch reinforcement. Patient history (clinical and surgical) and literature review. After the 3rd same-site recurrence, patch reinforcement over the sutured area was performed. The patient had an uneventful recovery and no recurrences to date. There is no evidence indicating the superiority of non-absorbable sutures. Bovine pericardium reinforcement over the sutured area was used to minimize the chance of another recurrence. More studies are necessary to investigate its safety and efficacy in this scenario. Nascimento B, Guglielmetti GB, Miranda EP, et al. Recurrent Penile Fracture-Case Report and Alternative Surgical Approach. Sex Med 2018;X:XX-XX. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

[Vertebroplasty: state of the art].

PubMed

Chiras, J; Barragán-Campos, H M; Cormier, E; Jean, B; Rose, M; LeJean, L

2007-09-01

Over the last 10 years, there has been much development in the management of metastatic and osteoporotic vertebral compression fractures using vertebroplasty. This percutaneous image-guided interventional radiology procedure allows stabilization of a vertebral body by injection of an acrylic cement and frequently results in significant symptomatic relief. During cement polymerisation, an exothermic reaction may destroy adjacent tumor cells. Advances have been made to reduce complications from extravasation of cement in veins or surrounding soft tissues. Safety relates to experience but also to technical parameters: optimal cement radio-density, adequate digital fluoroscopy unit (single or bi-plane digital angiography unit), development of cements other than PMMA to avoid the risk of adjacent vertebral compression fractures. The rate of symptomatic relief from vertebroplasty performed for its principal indications (vertebral hemangioma, metastases, osteoporotic fractures) reaches 90-95%. The rate of complications is about 2% for metastases and less than 0.5% for osteoporotic fractures. Vertebroplasty plays a major role in the management of specific bone weakening vertebral lesions causing, obviating the need for kyphoplasty.

Challenges and Solutions for the Integration of Structural and Hydrogeological Understanding of Fracture Systems - Insights from the Olkiluoto Site, Finland

NASA Astrophysics Data System (ADS)

Hartley, L. J.; Aaltonen, I.; Baxter, S. J.; Cottrell, M.; Fox, A. L.; Hoek, J.; Koskinen, L.; Mattila, J.; Mosley, K.; Selroos, J. O.; Suikkanen, J.; Vanhanarkaus, O.; Williams, T. R. N.

2017-12-01

A field site at Olkiluoto in SW Finland has undergone extensive investigations as a location for a deep geological repository for spent nuclear fuel, which is expected to become operational in the early 2020s. Characterisation data comes from 58 deep cored drillholes, a wide variety of geophysical investigations, many outcrops, kilometres of underground mapping and testing in the ONKALO research facility, and groundwater pressure monitoring and sampling in both deep and shallow holes. A primary focus is on the properties of natural fractures and brittle fault zones in the low permeability crystalline rocks at Olkiluoto; an understanding of the flow and transport processes in these features are an essential part of assessing long-term safety of the repository. This presentation will illustrate how different types of source data and cross-disciplinary interpretations are integrated to develop conceptual and numerical models of the fracture system. A model of the brittle fault zones developed from geological and geophysical data provides the hydrostructural backbone controlling the most intense fracturing and dynamic conduits for fluids. Models of ductile deformation and lithology form a tectonic framework for the description of fracture heterogeneity in the background rock, revealing correlations between the intensity and orientation of fractures with geological and spatial properties. The sizes of brittle features are found to be best defined on two scales relating to individual fractures and zones. Inferred fracture-specific from flow logging are correlated with fracture geometric and mechanical properties along with in situ stress measurements to create a hydromechanical description of fracture hydraulic properties. The insights and understandings gained from these efforts help define a discrete fracture network (DFN) model for the Olkiluoto site, with hydrogeological characteristics consistent with monitoring data of hydraulic heads and their disturbances to pumping and underground construction. This work offers ideas and proposed solutions on how some of the challenges in describing fractured rock hydrogeology can be tackled.

Dynamic characterisation of the specific surface area for fracture networks

NASA Astrophysics Data System (ADS)

Cvetkovic, V.

2017-12-01

One important application of chemical transport is geological disposal of high-level nuclear waste for which crystalline rock is a prime candidate for instance in Scandinavia. Interconnected heterogeneous fractures of sparsely fractured rock such as granite, act as conduits for transport of dissolved tracers. Fluid flow is known to be highly channelized in such rocks. Channels imply narrow flow paths, adjacent to essentially stagnant water in the fracture and/or the rock matrix. Tracers are transported along channelised flow paths and retained by minerals and/or stagnant water, depending on their sorption properties; this mechanism is critical for rocks to act as a barrier and ultimately provide safety for a geological repository. The sorbing tracers are retained by diffusion and sorption on mineral surfaces, whereas non-sorbing tracers can be retained only by diffusion into stagnant water of fractures. The retention and transport properties of a sparsely fractured rock will primarily depend on the specific surface area (SSA) of the fracture network which is determined by the heterogeneous structure and flow. The main challenge when characterising SSA on the field-scale is its dependence on the flow dynamics. We first define SSA as a physical quantity and clarify its importance for chemical transport. A methodology for dynamic characterisation of SSA in fracture networks is proposed that relies on three sets of data: i) Flow rate data as obtained by a flow logging procedure; ii) transmissivity data as obtained by pumping tests; iii) fracture network data as obtained from outcrop and geophysical observations. The proposed methodology utilises these data directly as well as indirectly through flow and particle tracking simulations in three-dimensional discrete fracture networks. The methodology is exemplified using specific data from the Swedish site Laxemar. The potential impact of uncertainties is of particular significance and is illustrated for radionuclide attenuation. Effects of internal fracture heterogeneity vs fracture network heterogeneity, and of rock deformation, on the statistical properties of SSA are briefly discussed.

Exposed versus buried wires for fixation of lateral humeral condyle fractures in children: a comparison of safety and efficacy.

PubMed

Chan, Lester Wai Mon; Siow, Hua Ming

2011-10-01

Displaced fractures of the lateral condyle of the humerus are usually treated with open reduction and fixation with smooth Kirschner wires. These may be passed through the skin and left exposed or buried subcutaneously. Exposed wires may be removed in the outpatient clinic, whereas buried wires require a formal procedure under anaesthesia. This advantage may be offset if there is a higher rate of complications with exposed wires. The aim of this study was to compare the safety and efficacy of exposed and buried wires. Retrospective cohort. Children with lateral condyle fractures of the humerus who had undergone surgery were identified from our departmental database. Case records and X-rays of 75 patients were reviewed. Forty-two patients had buried wires and 33 had exposed wires. There were no serious complications in either group. In the exposed wires group, 1 patient had a superficial wound infection that was treated effectively with 1 week of oral antibiotics, while 2 patients had hypergranulation of pin tracts treated with topical silver nitrate. None of the patients showed loss of reduction, deep infection, or any other complications requiring additional procedures. There was no statistically significant difference in the rate of complications between the buried and exposed groups. We conclude that open reduction and exposed wiring is a safe and effective option for lateral condyle fractures, and recommend a period of 4 weeks of K-wire fixation followed by 2 weeks of backslab immobilisation as adequate for union with minimal risk of infection.

The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)--quality of life during the first 4 months after fracture.

PubMed

Borgström, F; Lekander, I; Ivergård, M; Ström, O; Svedbom, A; Alekna, V; Bianchi, M L; Clark, P; Curiel, M D; Dimai, H P; Jürisson, M; Kallikorm, R; Lesnyak, O; McCloskey, E; Nassonov, E; Sanders, K M; Silverman, S; Tamulaitiene, M; Thomas, T; Tosteson, A N A; Jönsson, B; Kanis, J A

2013-03-01

The quality of life during the first 4 months after fracture was estimated in 2,808 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss. The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS. ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire. The total sample for the analysis was 2,808 patients (1,273 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not. The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries.

Analysis of 213 currently used rehabilitation protocols in foot and ankle fractures.

PubMed

Pfeifer, Christian G; Grechenig, Stephan; Frankewycz, Borys; Ernstberger, Antonio; Nerlich, Michael; Krutsch, Werner

2015-10-01

Fractures of the ankle, hind- and midfoot are amongst the five most common fractures. Besides initial operative or non-operative treatment, rehabilitation of the patients plays a crucial role for fracture union and long term functional outcome. Limited evidence is available with regard to what a rehabilitation regimen should include and what guidelines should be in place for the initial clinical course of these patients. This study therefore investigated the current rehabilitation concepts after fractures of the ankle, hind- and midfoot. Written rehabilitation protocols provided by orthopedic and trauma surgery institutions in terms of recommendations for weight bearing, range of motion (ROM), physiotherapy and choice of orthosis were screened and analysed. All protocols for lateral ankle fractures type AO 44A1, AO 44B1 and AO 44C1, for calcaneal fractures and fractures of the metatarsal as well as other not specific were included. Descriptive analysis was carried out and statistical analysis applied where appropriate. 209 rehabilitation protocols for ankle fractures type AO 44B1 and AO 44C1, 98 for AO 44A1, 193 for metatarsal fractures, 142 for calcaneal fractures, 107 for 5(th) metatarsal base fractures and 70 for 5(th) metatarsal Jones fractures were evaluated. The mean time recommended for orthosis treatment was 6.04 (SD 0.04) weeks. While the majority of protocols showed a trend towards increased weight bearing and increased ROM over time, the best consensus was noted for weight bearing recommendations. Our study shows that there exists a huge variability in rehabilitation of fractures of the ankle-, hind- and midfoot. This may be contributed to a lack of consensus (e.g. missing publication of guidelines), individualized patient care (e.g. in fragility fractures) or lack of specialization. This study might serve as basis for prospective randomized controlled trials in order to optimize rehabilitation for these common fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Characteristics on fractures of tibia and fibula in car impacts to pedestrians and bicyclists - influences of car bumper height and shape.

PubMed

Otte, D; Haasper, C

2007-01-01

This study deals with the analysis of lower leg fractures in pedestrians and bicyclists after collisions with passenger cars and examines to what extent the shape and location of the fractures in the lower leg changed, following alterations in the shape of bumpers. It can be assumed that that the bumpers changed in shape and effective impact height, not least due to the realization of the developments of vehicle safety tests as in the context of the European Union Directive 2003/102/EC on pedestrian protection. In addition, consumer protection tests, EuroNCAP, accomplished a change of the injury situation. All of these are mainly focused on pedestrian protection measurements but adopt the bicyclists also in their goal. For the study, traffic accidents from GIDAS (German in-Depth-Accident Study) were selected, which had been documented in the years 1995 to 2004 by scientific teams in Hannover and Dresden (Germany) and for which there is detailed information regarding injury patterns and collision speeds. The accident documentations can be regarded as representative and constitute a random sample with statistic weighing of the data. Altogether 143 cases of lower leg fractures (Tibia/ Fibula) with x-rays of pedestrians and 79 cases of bicyclists were differentiated according to new and old vehicles (year of manufacture before/after 1995). The bumper shapes were divided into classical types (protruding pronouncedly/ protruding integrated /integrated rounded). Besides the injuries to the lower leg, those to thighs and feet were also regarded, and the injury conditions involving the head and trunk were included in the kinematic analytics.

Systematic review of raloxifene in postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia)

PubMed Central

Fujiwara, Saeko; Hamaya, Etsuro; Sato, Masayo; Graham-Clarke, Peita; Flynn, Jennifer A; Burge, Russel

2014-01-01

Purpose To systematically review the literature describing the efficacy, effectiveness, and safety of raloxifene for postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia). Materials and methods Medline via PubMed and Embase was systematically searched using prespecified terms. Retrieved publications were screened and included if they described randomized controlled trials or observational studies of postmenopausal Japanese women with osteoporosis or osteopenia treated with raloxifene and reported one or more outcome measures (change in bone mineral density [BMD]; fracture incidence; change in bone-turnover markers, hip structural geometry, or blood–lipid profile; occurrence of adverse events; and change in quality of life or pain). Excluded publications were case studies, editorials, letters to the editor, narrative reviews, or publications from non-peer-reviewed journals; multidrug, multicountry, or multidisease studies with no drug-, country-, or disease-level analysis; or studies of participants on dialysis. Results Of the 292 publications retrieved, 15 publications (seven randomized controlled trials, eight observational studies) were included for review. Overall findings were statistically significant increases in BMD of the lumbar spine (nine publications), but not the hip region (eight publications), a low incidence of vertebral fracture (three publications), decreases in markers of bone turnover (eleven publications), improved hip structural geometry (two publications), improved blood–lipid profiles (five publications), a low incidence of hot flushes, leg cramps, venous thromboembolism, and stroke (12 publications), and improved quality of life and pain relief (one publication). Conclusion Findings support raloxifene for reducing vertebral fracture risk by improving BMD and reducing bone turnover in postmenopausal Japanese women with osteoporosis or osteopenia. Careful consideration of fracture risk and the risk–benefit profile of antiosteoporosis medications is required when managing patients with osteoporosis. PMID:25395843

Systematic review of raloxifene in postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia).

PubMed

Fujiwara, Saeko; Hamaya, Etsuro; Sato, Masayo; Graham-Clarke, Peita; Flynn, Jennifer A; Burge, Russel

2014-01-01

To systematically review the literature describing the efficacy, effectiveness, and safety of raloxifene for postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia). Medline via PubMed and Embase was systematically searched using prespecified terms. Retrieved publications were screened and included if they described randomized controlled trials or observational studies of postmenopausal Japanese women with osteoporosis or osteopenia treated with raloxifene and reported one or more outcome measures (change in bone mineral density [BMD]; fracture incidence; change in bone-turnover markers, hip structural geometry, or blood-lipid profile; occurrence of adverse events; and change in quality of life or pain). Excluded publications were case studies, editorials, letters to the editor, narrative reviews, or publications from non-peer-reviewed journals; multidrug, multicountry, or multidisease studies with no drug-, country-, or disease-level analysis; or studies of participants on dialysis. Of the 292 publications retrieved, 15 publications (seven randomized controlled trials, eight observational studies) were included for review. Overall findings were statistically significant increases in BMD of the lumbar spine (nine publications), but not the hip region (eight publications), a low incidence of vertebral fracture (three publications), decreases in markers of bone turnover (eleven publications), improved hip structural geometry (two publications), improved blood-lipid profiles (five publications), a low incidence of hot flushes, leg cramps, venous thromboembolism, and stroke (12 publications), and improved quality of life and pain relief (one publication). Findings support raloxifene for reducing vertebral fracture risk by improving BMD and reducing bone turnover in postmenopausal Japanese women with osteoporosis or osteopenia. Careful consideration of fracture risk and the risk-benefit profile of antiosteoporosis medications is required when managing patients with osteoporosis.

GENOA-PFA: Progressive Fracture in Composites Simulated Computationally

NASA Technical Reports Server (NTRS)

Murthy, Pappu L. N.

2000-01-01

GENOA-PFA is a commercial version of the Composite Durability Structural Analysis (CODSTRAN) computer program that simulates the progression of damage ultimately leading to fracture in polymer-matrix-composite (PMC) material structures under various loading and environmental conditions. GENOA-PFA offers several capabilities not available in other programs developed for this purpose, making it preferable for use in analyzing the durability and damage tolerance of complex PMC structures in which the fiber reinforcements occur in two- and three-dimensional weaves and braids. GENOA-PFA implements a progressive-fracture methodology based on the idea that a structure fails when flaws that may initially be small (even microscopic) grow and/or coalesce to a critical dimension where the structure no longer has an adequate safety margin to avoid catastrophic global fracture. Damage is considered to progress through five stages: (1) initiation, (2) growth, (3) accumulation (coalescence of propagating flaws), (4) stable propagation (up to the critical dimension), and (5) unstable or very rapid propagation (beyond the critical dimension) to catastrophic failure. The computational simulation of progressive failure involves formal procedures for identifying the five different stages of damage and for relating the amount of damage at each stage to the overall behavior of the deteriorating structure. In GENOA-PFA, mathematical modeling of the composite physical behavior involves an integration of simulations at multiple, hierarchical scales ranging from the macroscopic (lamina, laminate, and structure) to the microscopic (fiber, matrix, and fiber/matrix interface), as shown in the figure. The code includes algorithms to simulate the progression of damage from various source defects, including (1) through-the-thickness cracks and (2) voids with edge, pocket, internal, or mixed-mode delaminations.

Numerical analysis of fracture propagation during hydraulic fracturing operations in shale gas systems

EPA Pesticide Factsheets

Researchers used the TOUGH+ geomechanics computational software and simulation system to examine the likelihood of hydraulic fracture propagation (the spread of fractures) traveling long distances to connect with drinking water aquifers.

Use of satellite pictures for determining major shield fractures relevant for ore prospecting, northern Finland

NASA Technical Reports Server (NTRS)

Tuominen, H. V.; Aarnisalo, J. (Principal Investigator)

1976-01-01

The author has identified the following significant results. A combined analysis of LANDSAT 1 imagery, aeromagnetic and other maps, and aerial photos has revealed a dense network of bedrock fractures in northern Finland. They form several fracturing zones, which obviously represent surficial manifestations of major fractures. The fractures follow, in general, the eight main trends of crustal shear characteristics of the Baltic Shield, but show distinct deviations from them in detail. The major fracture zones divide the bedrock into a mosaic of polygonal blocks, which in many cases coincide with the main rock units of the area and are characterized by different patterns of internal fracturing. Known mineralizations show a tendency to concentrate along the fracture zones. Optical filtering of original LANDSAT images might provide a rapid tool for the analysis of major structural trends in extensive areas such as shields or entire continents.

Scanning electron microscopy fractography analysis of fractured hollow implants.

PubMed

Sbordone, Ludovico; Traini, Tonino; Caputi, Sergio; Scarano, Antonio; Bortolaia, Claudia; Piattelli, Adriano

2010-01-01

Fracture of the implant is one of the possible complications affecting dental implants; it is a rare event but of great clinical relevance. The aim of the present study was to perform a scanning electron microscopy (SEM) fractography evaluation of 7 International Team for oral Implantology (ITI) hollow implants removed because of fracture. The most common clinical risk factors, such as malocclusion, bruxism, and cantilevers on the prosthesis, were absent. Seven fractured ITI hollow implants were retrieved from 5 patients and were analyzed with the use of SEM. SEM analysis showed typical signs of a cleavage-type fracture. Fractures could be due to an association of multiple factors such as fatigue, inner defects, material electrochemical problems, and tensocorrosion.

Computational simulation of progressive fracture in fiber composites

NASA Technical Reports Server (NTRS)

Chamis, C. C.

1986-01-01

Computational methods for simulating and predicting progressive fracture in fiber composite structures are presented. These methods are integrated into a computer code of modular form. The modules include composite mechanics, finite element analysis, and fracture criteria. The code is used to computationally simulate progressive fracture in composite laminates with and without defects. The simulation tracks the fracture progression in terms of modes initiating fracture, damage growth, and imminent global (catastrophic) laminate fracture.

Fracture control procedures for aircraft structural integrity

NASA Technical Reports Server (NTRS)

Wood, H. A.

1972-01-01

The application of applied fracture mechanics in the design, analysis, and qualification of aircraft structural systems are reviewed. Recent service experiences are cited. Current trends in high-strength materials application are reviewed with particular emphasis on the manner in which fracture toughness and structural efficiency may affect the material selection process. General fracture control procedures are reviewed in depth with specific reference to the impact of inspectability, structural arrangement, and material on proposed analysis requirements for safe crack growth. The relative impact on allowable design stress is indicated by example. Design criteria, material, and analysis requirements for implementation of fracture control procedures are reviewed together with limitations in current available data techniques. A summary of items which require further study and attention is presented.

Immediate versus delayed intramedullary nailing for open fractures of the tibial shaft: a multivariate analysis of factors affecting deep infection and fracture healing.

PubMed

Yokoyama, Kazuhiko; Itoman, Moritoshi; Uchino, Masataka; Fukushima, Kensuke; Nitta, Hiroshi; Kojima, Yoshiaki

2008-10-01

The purpose of this study was to evaluate contributing factors affecting deep infection and fracture healing of open tibia fractures treated with locked intramedullary nailing (IMN) by multivariate analysis. We examined 99 open tibial fractures (98 patients) treated with immediate or delayed locked IMN in static fashion from 1991 to 2002. Multivariate analyses following univariate analyses were derived to determine predictors of deep infection, nonunion, and healing time to union. The following predictive variables of deep infection were selected for analysis: age, sex, Gustilo type, fracture grade by AO type, fracture location, timing or method of IMN, reamed or unreamed nailing, debridement time (< or =6 h or >6 h), method of soft-tissue management, skin closure time (< or =1 week or >1 week), existence of polytrauma (ISS< 18 or ISS> or =18), existence of floating knee injury, and existence of superficial/pin site infection. The predictive variables of nonunion selected for analysis was the same as those for deep infection, with the addition of deep infection for exchange of pin site infection. The predictive variables of union time selected for analysis was the same as those for nonunion, excluding of location, debridement time, and existence of floating knee and superficial infection. Six (6.1%; type II Gustilo n=1, type IIIB Gustilo n=5) of the 99 open tibial fractures developed deep infections. Multivariate analysis revealed that timing or method of IMN, debridement time, method of soft-tissue management, and existence of superficial or pin site infection significantly correlated with the occurrence of deep infection (P< 0.0001). In the immediate nailing group alone, the deep infection rate in type IIIB + IIIC was significantly higher than those in type I + II and IIIA (P = 0.016). Nonunion occurred in 17 fractures (20.3%, 17/84). Multivariate analysis revealed that Gustilo type, skin closure time, and existence of deep infection significantly correlated with occurrence of nonunion (P < 0.05). Gustilo type and existence of deep infection were significantly correlated with healing time to union on multivariate analysis (r(2) = 0.263, P = 0.0001). Multivariate analyses for open tibial fractures treated with IMN showed that IMN after EF (especially in existence of pin site infection) was at high risk of deep infection, and that debridement within 6 h and appropriate soft-tissue managements were also important factor in preventing deep infections. These analyses postulated that both the Gustilo type and the existence of deep infection is related with fracture healing in open fractures treated with IMN. In addition, immediate IMN for type IIIB and IIIC is potentially risky, and canal reaming did not increase the risk of complication for open tibial fractures treated with IMN.

The emerging trend of non-operative treatment in paediatric type I open forearm fractures.

PubMed

Zhang, H; Fanelli, M; Adams, C; Graham, J; Seeley, M

2017-08-01

Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures. An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention. A fixed-effect meta-analysis, weighting each study based on the number of patients, and a pooled estimate of infection risk (with 95% confidence interval (CI)) was performed. The search results yielded five studies that were eligible for inclusion. No included patients had operative debridement and all were treated with antibiotics. The number of patients in each study ranged from 3 to 45, with a total of 127 paediatric patients in the meta-analysis. The infection rate was 0% for all patients included. The meta-analysis estimated a pooled infection risk of 0% (95% CI 0 to 2.9). The five included studies had a total of 127 patients with no cases of infection after non-operative management of Type I open paediatric forearm fractures. The infection rate of Type I fractures among operatively managed patients is 1.9%. The trend in literature towards non-operative treatment of paediatric Type I open fractures holds true in this meta-analysis.

Stress-Induced Fracturing of Reservoir Rocks: Acoustic Monitoring and μCT Image Analysis

NASA Astrophysics Data System (ADS)

Pradhan, Srutarshi; Stroisz, Anna M.; Fjær, Erling; Stenebråten, Jørn F.; Lund, Hans K.; Sønstebø, Eyvind F.

2015-11-01

Stress-induced fracturing in reservoir rocks is an important issue for the petroleum industry. While productivity can be enhanced by a controlled fracturing operation, it can trigger borehole instability problems by reactivating existing fractures/faults in a reservoir. However, safe fracturing can improve the quality of operations during CO2 storage, geothermal installation and gas production at and from the reservoir rocks. Therefore, understanding the fracturing behavior of different types of reservoir rocks is a basic need for planning field operations toward these activities. In our study, stress-induced fracturing of rock samples has been monitored by acoustic emission (AE) and post-experiment computer tomography (CT) scans. We have used hollow cylinder cores of sandstones and chalks, which are representatives of reservoir rocks. The fracture-triggering stress has been measured for different rocks and compared with theoretical estimates. The population of AE events shows the location of main fracture arms which is in a good agreement with post-test CT image analysis, and the fracture patterns inside the samples are visualized through 3D image reconstructions. The amplitudes and energies of acoustic events clearly indicate initiation and propagation of the main fractures. Time evolution of the radial strain measured in the fracturing tests will later be compared to model predictions of fracture size.

Calcium plus vitamin D supplementation and risk of fractures: an updated meta analysis from the National Osteoporosis Foundation

USDA-ARS?s Scientific Manuscript database

Introduction: Calcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized contr...

Early and late fracture following extensive limb lengthening in patients with achondroplasia and hypochondroplasia.

PubMed

Kitoh, H; Mishima, K; Matsushita, M; Nishida, Y; Ishiguro, N

2014-09-01

Two types of fracture, early and late, have been reported following limb lengthening in patients with achondroplasia (ACH) and hypochondroplasia (HCH). We reviewed 25 patients with these conditions who underwent 72 segmental limb lengthening procedures involving the femur and/or tibia, between 2003 and 2011. Gender, age at surgery, lengthened segment, body mass index, the shape of the callus, the amount and percentage of lengthening and the healing index were evaluated to determine predictive factors for the occurrence of early (within three weeks after removal of the fixation pins) and late fracture (> three weeks after removal of the pins). The Mann‑Whitney U test and Pearson's chi-squared test for univariate analysis and stepwise regression model for multivariate analysis were used to identify the predictive factor for each fracture. Only one patient (two tibiae) was excluded from the analysis due to excessively slow formation of the regenerate, which required supplementary measures. A total of 24 patients with 70 limbs were included in the study. There were 11 early fractures in eight patients. The shape of the callus (lateral or central callus) was the only statistical variable related to the occurrence of early fracture in univariate and multivariate analyses. Late fracture was observed in six limbs and the mean time between removal of the fixation pins and fracture was 18.3 weeks (3.3 to 38.4). Lengthening of the tibia, larger healing index, and lateral or central callus were related to the occurrence of a late fracture in univariate analysis. A multivariate analysis demonstrated that the shape of the callus was the strongest predictor for late fracture (odds ratio: 19.3, 95% confidence interval: 2.91 to 128). Lateral or central callus had a significantly larger risk of fracture than fusiform, cylindrical, or concave callus. Radiological monitoring of the shape of the callus during distraction is important to prevent early and late fracture of lengthened limbs in patients with ACH or HCH. In patients with thin callus formation, some measures to stimulate bone formation should be considered as early as possible. ©2014 The British Editorial Society of Bone & Joint Surgery.

Structural and Geophysical Characterization of Oklahoma Basement

NASA Astrophysics Data System (ADS)

Morgan, C.; Johnston, C. S.; Carpenter, B. M.; Reches, Z.

2017-12-01

Oklahoma has experienced a large increase in seismicity since 2009 that has been attributed to wastewater injection. Most earthquakes, including four M5+ earthquakes, nucleated at depths > 4 km, well within the pre-Cambrian crystalline basement, even though wastewater injection occurred almost exclusively in the sedimentary sequence above. To better understand the structural characteristics of the rhyolite and granite that makeup the midcontinent basement, we analyzed a 150 m long core recovered from a basement borehole (Shads 4) in Rogers County, NE Oklahoma. The analysis of the fracture network in the rhyolite core included measurements of fracture inclination, aperture, and density, the examination fracture surface features and fill minerology, as well as x-ray diffraction analysis of secondary mineralization. We also analyzed the highly fractured and faulted segments of the core with a portable gamma-ray detector, magnetometer, and rebound hammer. The preliminary analysis of the fractures within the rhyolite core showed: (1) Fracture density increasing with depth by a factor of 10, from 4 fractures/10m in the upper core segment to 40 fracture/10m at 150 m deeper. (2) The fractures are primarily sub-vertical, inclined 10-20° from the axis of the vertical core. (3) The secondary mineralization is dominated by calcite and epidote. (4) Fracture aperture ranges from 0.35 to 2.35mm based on the thickness of secondary filling. (5) About 8% of the examined fractures display slickenside striations. (6) Increases of elasticity (by rebound hammer) and gamma-ray emissions are systematically correlated with a decrease in magnetic susceptibility in core segments of high fracture density and/or faulting; this observation suggests diagenetic fracture re-mineralization.

Fractography: determining the sites of fracture initiation.

PubMed

Mecholsky, J J

1995-03-01

Fractography is the analysis of fracture surfaces. Here, it refers to quantitative fracture surface analysis (FSA) in the context of applying the principles of fracture mechanics to the topography observed on the fracture surface of brittle materials. The application of FSA is based on the principle that encoded on the fracture surface of brittle materials is the entire history of the fracture process. It is our task to develop the skills and knowledge to decode this information. There are several motivating factors for applying our knowledge of FSA. The first and foremost is that there is specific, quantitative information to be obtained from the fracture surface. This information includes the identification of the size and location of the fracture initiating crack or defect, the stress state at failure, the existence, or not, of local or global residual stress, the existence, or not, of stress corrosion and a knowledge of local processing anomalies which affect the fracture process. The second motivating factor is that the information is free. Once a material is tested to failure, the encoded information becomes available. If we decide to observe the features produced during fracture then we are rewarded with much information. If we decide to ignore the fracture surface, then we are left to guess and/or reason as to the cause of the failure without the benefit of all of the possible information available. This paper addresses the application of quantitative fracture surface analysis to basic research, material and product development, and "trouble-shooting" of in-service failures. First, the basic principles involved will be presented. Next, the methodology necessary to apply the principles will be presented. Finally, a summary of the presentation will be made showing the applicability to design and reliability.

Effect of Measured Welding Residual Stresses on Crack Growth

NASA Technical Reports Server (NTRS)

Hampton, Roy W.; Nelson, Drew; Doty, Laura W. (Technical Monitor)

1998-01-01

Welding residual stresses in thin plate A516-70 steel and 2219-T87 aluminum butt weldments were measured by the strain-gage hole drilling and X-ray diffraction methods. The residual stress data were used to construct 3D strain fields which were modeled as thermally induced strains. These 3D strain fields were then analyzed with the WARP31) FEM fracture analysis code in order to predict their effect on fatigue and on fracture. For analyses of fatigue crack advance and subsequent verification testing, fatigue crack growth increments were simulated by successive saw-cuts and incremental loading to generate, as a function of crack length, effects on crack growth of the interaction between residual stresses and load induced stresses. The specimen experimental response was characterized and compared to the WARM linear elastic and elastic-plastic fracture mechanics analysis predictions. To perform the fracture analysis, the plate material's crack tearing resistance was determined by tests of thin plate M(T) specimens. Fracture analyses of these specimen were performed using WARP31D to determine the critical Crack Tip Opening Angle [CTOA] of each material. These critical CTOA values were used to predict crack tearing and fracture in the weldments. To verify the fracture predictions, weldment M(T) specimen were tested in monotonic loading to fracture while characterizing the fracture process.

Non-Destructive X-ray Computed Tomography (XCT) of Gas Hydrate Bearing Fractures in Marine Sediment

NASA Astrophysics Data System (ADS)

Oti, E.; Buchwalter, E.; Cook, A.; Crandall, D.

2017-12-01

Hydrate-filled fractures are found in many environments, both related to methane vents and constrained to lithologic layers; how hydrate filled fractures form in layered environments is not well understood. We focus on understanding hydrate origins and fracture formation by examining hydrate-bearing fractures in conventional cores taken from Gulf of Mexico sites from JIP Leg 1 and UT-GOM, Keathley Canyon 151. There are two main methane sources available for hydrate formation. The first is the hydrocarbon reservoir underlying the Gulf sediments. This reservoir formed when deeply buried organic matter of high molecular weight was exposed to high temperature and pressures and degraded. A second source is the biogenesis of organic material, which occurs when microbial activity breaks down organic materials. Biogenic methane is more enriched in lighter carbon isotopes as the reduction or fermentation reactions preferentially consume lighter carbon isotopes. As a result, we hypothesize that sediment surrounding biogenically derived methane will have heavier carbon isotopes when compared to non-host sediment, due to the consumption of the lighter carbon isotopes during methanogenesis. We use non-destructive X-ray Computed Tomography (XCT) scanning to visualize and identify hydrate-bearing fractures. The presence of hydrate fractures is further confirmed with a salinity analysis, as hydrate dissociation freshens the pore water and lowers the salinity. After hydrate fracture location is inferred, carbon isotope analysis is used to identify hydrocarbon source. XCT scans of Keathley Canyon core JIP-1 17H-4 revealed 10 total fractures, five of which XCT and salinity analysis indicated as formerly containing hydrate. All ten fractures, in addition to background sediment, underwent a carbon isotope analysis in which organic isotopes were measured. In the background sediment and the non hydrate-bearing fractures, DOC values were relatively light, with dC13 percentages ranging from -27.8% to -30.8%. In the five hydrate fracture regions, DOC was comparatively heavy, with DOC dC13 values ranging from -23.2% to -30.3%. These values suggest that biogenic methane was formed adjacent to the fracture and likely migrated into the hydrate filled fracture.

Integrated approach for quantification of fractured tight reservoir rocks: Porosity, permeability analyses and 3D fracture network characterisation on fractured dolomite samples

NASA Astrophysics Data System (ADS)

Voorn, Maarten; Barnhoorn, Auke; Exner, Ulrike; Baud, Patrick; Reuschlé, Thierry

2015-04-01

Fractured reservoir rocks make up an important part of the hydrocarbon reservoirs worldwide. A detailed analysis of fractures and fracture networks in reservoir rock samples is thus essential to determine the potential of these fractured reservoirs. However, common analyses on drill core and plug samples taken from such reservoirs (including hand specimen analysis, thin section analysis and laboratory porosity and permeability determination) suffer from various problems, such as having a limited resolution, providing only 2D and no internal structure information, being destructive on the samples and/or not being representative for full fracture networks. In this study, we therefore explore the use of an additional method - non-destructive 3D X-ray micro-Computed Tomography (μCT) - to obtain more information on such fractured samples. Seven plug-sized samples were selected from narrowly fractured rocks of the Hauptdolomit formation, taken from wellbores in the Vienna Basin, Austria. These samples span a range of different fault rocks in a fault zone interpretation, from damage zone to fault core. 3D μCT data is used to extract porosity, fracture aperture, fracture density and fracture orientations - in bulk as well as locally. The 3D analyses are complemented with thin sections made to provide some 2D information with a much higher detail than the μCT data. Finally, gas- and water permeability measurements under confining pressure provide an important link (at least in order of magnitude) of the µCT results towards more realistic reservoir conditions. Our results show that 3D μCT can be applied efficiently on plug-sized samples of naturally fractured rocks, and that several important parameters can be extracted. μCT can therefore be a useful addition to studies on such reservoir rocks, and provide valuable input for modelling and simulations. Also permeability experiments under confining pressure provide important additional insights. Combining these and other methods can therefore be a powerful approach in microstructural analysis of reservoir rocks, especially when applying the concepts that we present (on a small set of samples) in a larger study, in an automated and standardised manner.

[The forensic medical evaluation of the injuries inflicted inside the passenger compartment of a moving car equipped with the modern personal safety systems].

PubMed

Pigolkin, Yu I; Dubrovin, I A; Mosoyan, A S; Bychkov, A A

The objective of the present study was to elucidate the characteristic features of the injuries inflicted to the victims of a road traffic accident inside the passenger compartment of a moving car equipped with the modern personal safety systems. The materials available for the present work included the lesions documented in 210 drivers and 150 occupants of the car passenger compartments. Both comparative, morphometric and statistical methods were used to analyze the data obtained. The morphometric analysis included identification of the form of the injury, such as extravasation, wounds, fractures, and lesions of the internal organs (e.g. hemorrhages, ruptures, etc.), their number and localization. Special attention was given to the specific features of the injuries to the occupants of the cars equipped with the modern personal safety systems. The study has demonstrated that the form, frequency, and localization of the injuries inflicted to the victims of a road traffic accident inside the passenger car compartment (including the drivers and other occupants) can be used for determining the positions of the victims at the moment of the accident.

60th Anniversary of electricity production from light water reactors: Historical review of the contribution of materials science to the safety of the pressure vessel

NASA Astrophysics Data System (ADS)

van Duysen, J. C.; Meric de Bellefon, G.

2017-02-01

The first light water nuclear reactor dedicated to electricity production was commissioned in Shippingport, Pennsylvania in the United States in 1957. Sixty years after the event, it is clear that this type of reactor will be a major source of electricity and one of the key solutions to limit climate change in the 21st century. This article pays homage to the teams that contributed to this achievement by their involvement in research and development and their determination to push back the frontiers of knowledge. Via a few examples of scientific or technological milestones, it describes the evolution of ideas, models, and techniques during the last 60 years, and gives the current state-of-the-art in areas related to the safety of the reactor pressure vessel. Among other topics, it focuses on vessel manufacturing, steel fracture mechanics analysis, and understanding of irradiation-induced damage.

Cooperative well report: Maxus exploration Company Carl Ellis E-3 well, Ochiltree County, Texas. Topical report, January 1992-March 1993

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

Holditch, S.A.; Whitehead, W.S.; Davidson, B.M.

Maxus Exploration drilled the Carl Ellis E-3 well in the Ellis Ranch Field, Ochiltree County, Texas in December 1991. The GRI cooperative research program on this well included coring, logging, stress testing, pre-fracture well testing, a mini-frac, post-fracture production data analysis, a fracture treatment, and a post-fracture well test. The well was completed in the Cleveland formation at 6,929-7,008 feet. After a ballout treatment, the well flowed 32 Mscf/day. Results of the pre-fracture pressure buildup test indicate a permeability-thickness product of 1.45 md-ft, a skin factor of -0.05, and a reservoir pressure of 1900 psi. The well was fracture treatedmore » with 70,000 gallons of a 40 lb/1000 gallon linear gel and 185,000 pounds of 20/40 sand. The initial post-fracture flow rate was approximately 500 Mscf/day. Post-fracture analysis with TRIFRAC indicated that the propped fracture height at the wellbore was 330 feet and the propped fracture length was 93 feet.« less

Fractography of modern engineering materials: composites and metals

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

Masters, J.E.; Au, J.J.

1987-01-01

The fractographic analysis of fracture surfaces in composites and metals is discussed in reviews and reports of recent theoretical and experimental investigations. Topics addressed include fracture-surface micromorphology in engineering solids, SEM fractography of pure and mixed-mode interlaminar fractures in graphite/epoxy composites, determination of crack propagation directions in graphite/epoxy structures, and the fracture surfaces of irradiated composites. Consideration is given to fractographic feature identification and characterization by digital imaging analysis, fractography of pressure-vessel steel weldments, the micromechanisms of major/minor cycle fatigue crack growth in Inconel 718, and fractographic analysis of hydrogen-assisted cracking in alpha-beta Ti alloys.

Effects of Cinacalcet on Fracture Events in Patients Receiving Hemodialysis: The EVOLVE Trial.

PubMed

Moe, Sharon M; Abdalla, Safa; Chertow, Glenn M; Parfrey, Patrick S; Block, Geoffrey A; Correa-Rotter, Ricardo; Floege, Jürgen; Herzog, Charles A; London, Gerard M; Mahaffey, Kenneth W; Wheeler, David C; Dehmel, Bastian; Goodman, William G; Drüeke, Tilman B

2015-06-01

Fractures are frequent in patients receiving hemodialysis. We tested the hypothesis that cinacalcet would reduce the rate of clinical fractures in patients receiving hemodialysis using data from the Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events trial, a placebo-controlled trial that randomized 3883 hemodialysis patients with secondary hyperparathyroidism to receive cinacalcet or placebo for ≤64 months. This study was a prespecified secondary analysis of the trial whose primary end point was all-cause mortality and non-fatal cardiovascular events, and one of the secondary end points was first clinical fracture event. Clinical fractures were observed in 255 of 1935 (13.2%) patients randomized to placebo and 238 of 1948 (12.2%) patients randomized to cinacalcet. In an unadjusted intention-to-treat analysis, the relative hazard for fracture (cinacalcet versus placebo) was 0.89 (95% confidence interval [95% CI], 0.75 to 1.07). After adjustment for baseline characteristics and multiple fractures, the relative hazard was 0.83 (95% CI, 0.72 to 0.98). Using a prespecified lag-censoring analysis (a measure of actual drug exposure), the relative hazard for fracture was 0.72 (95% CI, 0.58 to 0.90). When participants were censored at the time of cointerventions (parathyroidectomy, transplant, or provision of commercial cinacalcet), the relative hazard was 0.71 (95% CI, 0.58 to 0.87). Fracture rates were higher in older compared with younger patients and the effect of cinacalcet appeared more pronounced in older patients. In conclusion, using an unadjusted intention-to-treat analysis, cinacalcet did not reduce the rate of clinical fracture. However, when accounting for differences in baseline characteristics, multiple fractures, and/or events prompting discontinuation of study drug, cinacalcet reduced the rate of clinical fracture by 16%-29%. Copyright © 2015 by the American Society of Nephrology.

Complex ruptures during hydraulic fracturing of the Marcellus Shale

NASA Astrophysics Data System (ADS)

Viegas, G. F.; Urbancic, T.; Bosman, K.; Baig, A. M.

2016-12-01

Complex rupture patterns were observed on several M0+ events recorded during a hydraulic stimulation of the Marcellus shale. Although M>0 events associated with hydraulic fracturing have now been commonly recorded and may cause concern in terms of public and infrastructure safety, the vast majority of these events are smaller than M3 and are not felt at the surface. We investigate the rupture characteristics of one such multi-rupture event with 3 sub-events, by examining the failure dynamics of the overall fracture itself and of each individual sub-event, and the growth of the overall fracture from rupture initiation to arrest. This analysis is only possible due to the wide frequency range of the seismic monitoring system put in place which spanned from 0.1 Hz to 1000 Hz. The monitoring system consists of: high-frequency sensor-arrays of geophones deployed downhole close to the reservoir and thus to the rupture initiation point; and low to intermediate frequency accelerometers and geophones deployed at intermediate and shallow depths, allowing for the investigation of overall rupture characteristics. We aim to gain an understanding of the role of asperities, fracture roughness, and fluids on the different aspects of the rupture processes and of the failure mechanisms (shearing versus tensile dominance of behavior) associated with these complex events. Our results show that the overall event is characterized by the failure of multiple asperities and the distance between the 3 sub-events is less than 20 m. We observe decreasing stress drop and increasing Mw over time for the successive sub-events which suggest decreasing frictional resistance due to the presence of fluids over an increasingly large rupture surface akin to increased slip over a larger and less resistant contact area such as an asperity. The overall failure shows a dominant shearing mode mechanism whereas the sub-events failures show strong tensile components. The ruptures of the 1st and 2nd sub-events are indicative of shear-compaction of an asperity and the one of the 3rd sub-event is suggestive of a rupture riding over several surface patches. Additional analysis of other complex events will improve the characterization of the rupture processes of these larger-magnitude events and allow for the assessment of conditions under which the failures occur.

Using a Remotely Piloted Aircraft System (RPAS) to analyze the stability of a natural rock slope

NASA Astrophysics Data System (ADS)

Salvini, Riccardo; Esposito, Giuseppe; Mastrorocco, Giovanni; Seddaiu, Marcello

2016-04-01

This paper describes the application of a rotary wing RPAS for monitoring the stability of a natural rock slope in the municipality of Vecchiano (Pisa, Italy). The slope under investigation is approximately oriented NNW-SSE and has a length of about 320 m; elevation ranges from about 7 to 80 m a.s.l.. The hill consists of stratified limestone, somewhere densely fractured, with dip direction predominantly oriented in a normal way respect to the slope. Fracture traces are present in variable lengths, from decimetre to metre, and penetrate inward the rock versant with thickness difficult to estimate, often exceeding one meter in depth. The intersection between different fracture systems and the slope surface generates rocky blocks and wedges of variable size that may be subject to phenomena of gravitational instability (with reference to the variation of hydraulic and dynamic conditions). Geometrical and structural info about the rock mass, necessary to perform the analysis of the slope stability, were obtained in this work from geo-referenced 3D point clouds acquired using photogrammetric and laser scanning techniques. In particular, a terrestrial laser scanning was carried out from two different point of view using a Leica Scanstation2. The laser survey created many shadows in the data due to the presence of vegetation in the lower parts of the slope and limiting the feasibility of geo-structural survey. To overcome such a limitation, we utilized a rotary wing Aibotix Aibot X6 RPAS geared with a Nikon D3200 camera. The drone flights were executed in manual modality and the images were acquired, according to the characteristics of the outcrops, under different acquisition angles. Furthermore, photos were captured very close to the versant (a few meters), allowing to produce a dense 3D point cloud (about 80 Ma points) by the image processing. A topographic survey was carried out in order to guarantee the necessary spatial accuracy to the process of images exterior orientation. The coordinates of GCPs were calculated through the post-processing of data collected by using two GPS receivers, operating in static modality, and a Total Station. The photogrammetric processing of image blocks allowed us to create the 3D point cloud, DTM, orthophoto, and 3D textured model with high level of cartographic detail. Discontinuities were deterministically characterized in terms of attitude, persistence, and spacing. Moreover, the main discontinuity sets were identified through a density analysis of attitudes in stereographic projection. In addition, the size and shape of potentially unstable blocks identified along the rock slope were measured. Finally, using additional data from traditional engineering-geological surveys executed in accessible outcrops, the kinematic and dynamic stability analysis of the rocky slope was performed. Results from this step have indicated the deterministic safety factors of rock blocks and wedges, and will be used by local Authorities to plan the protection works for safety guarantee. Results from this application show the great advantage of modern RPAS that can be successfully applied for the analysis of sub-vertical rocky slopes, especially in areas either difficult to access with traditional techniques or masked by the presence of vegetation. KEY WORDS: 3D point cloud, RPAS photogrammetry, Terrestrial laser scanning, Rock slope, Fracture mapping, Stability analysis

Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older.

PubMed

Finsterwald, M; Sidelnikov, E; Orav, E J; Dawson-Hughes, B; Theiler, R; Egli, A; Platz, A; Simmen, H P; Meier, C; Grob, D; Beck, S; Stähelin, H B; Bischoff-Ferrari, H A

2014-01-01

In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

RSRM TP-H1148 Main Grain Propellant Crack Initiation Evaluation

NASA Technical Reports Server (NTRS)

Earnest, Todd E.

2005-01-01

Pressurized TP-HI 148 propellant fracture toughness testing was performed to assess the potential for initiation of visually undetectable cracks in the RSRM forward segment transition region during motor ignition. Two separate test specimens were used in this evaluation. Testing was performed in cold-gas and hot-fire environments, and under both static and dynamic pressurization conditions. Analysis of test results demonstrates safety factors against initiation of visually undetectable cracks in excess of 8.0. The Reusable Solid Rocket Motor (RSRM) forward segment is cast with PBAN propellant (TP-HI 148) to form T an 1 1-point star configuration that transitions to a tapered center perforated bore (see Figure 1). The geometry of the transition region between the fin valleys and the bore causes a localized area of high strain during horizontal storage. Updated analyses using worst-case mechanical properties at 40 F and improved modeling techniques indicated a slight reduction in safety margins over previous predictions. Although there is no history of strain induced cracks or flaws in the transition region propellant, a proactive test effort was initiated to better understand the implications of the new analysis, primarily the resistance of TP-H1148 propellant to crack initiation' during RSRM ignition.

Lessons regarding the safety of orthopaedic patient care: an analysis of four hundred and sixty-four closed malpractice claims.

PubMed

Matsen, Frederick A; Stephens, Linda; Jette, Jocelyn L; Warme, Winston J; Posner, Karen L

2013-02-20

An orthopaedic malpractice claim alleges that the patient sustained a preventable iatrogenic injury. The analysis of a representative series of malpractice claims provides a unique view of alleged orthopaedic adverse events, revealing what can potentially go wrong across a spectrum of practice settings and anatomic locations. The goal of this study was to identify high-impact targets in order to institute measures to reduce claims through efforts focused on patient safety. The authors investigated 464 consecutive closed malpractice claims from the nation's largest insurer of medical liability. We analyzed the claims by anatomical site, type of care rendered, type of allegation, and payment. We calculated an "impact factor" for each claim type by dividing the percentage of total payments for each type by the percentage of total claims for that type. Our analysis revealed major concerns regarding patient safety within this series of malpractice claims. One-third of the claims alleged permanent disabling injuries, including amputations, brain damage, and major nerve damage. The highest impact allegations were failure to protect structures in the surgical field (41% of total payments to plaintiffs, 15% of all claims, impact factor of 2.7) and failure to prevent, diagnose, and/or treat complications of treatment (16% of total payments, 7% of all claims, impact factor of 2.3). Spine procedures had high impact (1.9), representing 28% of dollars paid and 15% of claims, with 45% of spine claims involving death or severe permanent injury. Failure of implant positioning was commonly alleged in hip and knee arthroplasty. In claims related to fracture care, the most common allegations were related to malunions, nonunions, dislocations, failure to protect structures in the surgical field, infection, and treatment complications. Total payment for the eighty-eight claims paid was $17,917,614 (U.S. dollars adjusted to 2009). Regarding clinical relevance, this analysis suggests risk areas for targeted efforts to improve patient safety and reduce malpractice claims.

Acoustic emission characterization of microcracking in laboratory-scale hydraulic fracturing tests

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

Hampton, Jesse; Gutierrez, Marte; Matzar, Luis

Understanding microcracking near coalesced fracture generation is critically important for hydrocarbon and geothermal reservoir characterization as well as damage evaluation in civil engineering structures. Dense and sometimes random microcracking near coalesced fracture formation alters the mechanical properties of the nearby virgin material. Individual microcrack characterization is also significant in quantifying the material changes near the fracture faces (i.e. damage). Acoustic emission (AE) monitoring and analysis provide unique information regarding the microcracking process temporally, and information concerning the source characterization of individual microcracks can be extracted. In this context, laboratory hydraulic fracture tests were carried out while monitoring the AEs frommore » several piezoelectric transducers. In-depth post-processing of the AE event data was performed for the purpose of understanding the individual source mechanisms. Several source characterization techniques including moment tensor inversion, event parametric analysis, and volumetric deformation analysis were adopted. Post-test fracture characterization through coring, slicing and micro-computed tomographic imaging was performed to determine the coalesced fracture location and structure. Distinct differences in fracture characteristics were found spatially in relation to the openhole injection interval. Individual microcrack AE analysis showed substantial energy reduction emanating spatially from the injection interval. Lastly, it was quantitatively observed that the recorded AE signals provided sufficient information to generalize the damage radiating spatially away from the injection wellbore.« less

Acoustic emission characterization of microcracking in laboratory-scale hydraulic fracturing tests

DOE PAGES

Hampton, Jesse; Gutierrez, Marte; Matzar, Luis; ...

2018-06-11

Understanding microcracking near coalesced fracture generation is critically important for hydrocarbon and geothermal reservoir characterization as well as damage evaluation in civil engineering structures. Dense and sometimes random microcracking near coalesced fracture formation alters the mechanical properties of the nearby virgin material. Individual microcrack characterization is also significant in quantifying the material changes near the fracture faces (i.e. damage). Acoustic emission (AE) monitoring and analysis provide unique information regarding the microcracking process temporally, and information concerning the source characterization of individual microcracks can be extracted. In this context, laboratory hydraulic fracture tests were carried out while monitoring the AEs frommore » several piezoelectric transducers. In-depth post-processing of the AE event data was performed for the purpose of understanding the individual source mechanisms. Several source characterization techniques including moment tensor inversion, event parametric analysis, and volumetric deformation analysis were adopted. Post-test fracture characterization through coring, slicing and micro-computed tomographic imaging was performed to determine the coalesced fracture location and structure. Distinct differences in fracture characteristics were found spatially in relation to the openhole injection interval. Individual microcrack AE analysis showed substantial energy reduction emanating spatially from the injection interval. Lastly, it was quantitatively observed that the recorded AE signals provided sufficient information to generalize the damage radiating spatially away from the injection wellbore.« less

Posterior to Anteriorly Directed Screws for Management of Talar Neck Fractures.

PubMed

Beltran, Michael J; Mitchell, Phillip M; Collinge, Cory A

2016-10-01

Screws placed from posterior to anterior have been shown to be biomechanically and anatomically superior in the fixation of talar neck and neck-body fractures, yet most surgeons continue to place screws from an anterior start point. The safety and efficacy of percutaneously applied posterior screws has not been clinically defined, and functional outcomes after their use is lacking. After institutional review board approval, we performed a retrospective review of 24 consecutive talar neck fractures treated by a single surgeon that utilized posterior-to-anterior screw fixation. Clinical, radiographic, and functional outcomes were assessed at a minimum follow-up of 12 months. Functional outcomes including the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, Olerud-Molander Scores, and the Short Form 36 (SF-36) measurement were collected and reviewed. Average patient follow-up was 44 months. According to the classification system of Canale and Kelly, there were 4 type I fractures, 15 type II fractures, 4 type III fractures, and 1 type IV fracture. Four patients had open fractures. One superficial wound infection occurred, 1 patient reported FHL stiffness, and 6 complained of numbness or paresthesias in the distribution of the sural nerve (5 transient, 1 permanent). One reoperation was required to exchange a screw impinging on the talonavicular joint. Radiographically, 44% developed a positive Hawkins sign, and the specificity of this finding was 100% for talar dome viability. Avascular necrosis developed in 43% of patients, with 33% revascularizing and none going on to collapse. Subtalar arthrosis developed in 62% of patients. Screws placed from posterior to anterior are a useful technique in the treatment of talar neck fractures. Functional outcomes following their use appear favorable compared with recent reports with minimal risk to local structures. Level IV, retrospective case series. © The Author(s) 2016.

Sonic logging for detecting the excavation disturbed and fracture zones

NASA Astrophysics Data System (ADS)

Lin, Y. C.; Chang, Y. F.; Liu, J. W.; Tseng, C. W.

2017-12-01

This study presents a new sonic logging method to detect the excavation disturbed zone (EDZ) and fracture zones in a tunnel. The EDZ is a weak rock zone where its properties and conditions have been changed by excavation, which results such as fracturing, stress redistribution and desaturation in this zone. Thus, the EDZ is considered as a physically less stable and could form a continuous and high-permeable pathway for groundwater flow. Since EDZ and fracture zone have the potential of affecting the safety of the underground openings and repository performance, many studies were conducted to characterize the EDZ and fracture zone by different methods, such as the rock mass displacements and strain measurements, seismic refraction survey, seismic tomography and hydraulic test, etc. In this study, we designed a new sonic logging method to explore the EDZ and fracture zone in a tunnel at eastern Taiwan. A high power and high frequency sonic system was set up which includes a two hydrophones pitch-catch technique with a common-offset immersed in water-filled uncased wells and producing a 20 KHz sound to scan the well rock. Four dominant sonic events were observed in the measurements, they are refracted P- and S-wave along the well rock, direct water wave and the reverberation in the well water. Thus the measured P- and S-wave velocities, the signal-to-noise ratio of the refraction and the amplitudes of reverberation along the well rock were used as indexes to determine the EDZ and fracture zone. Comparing these indexes with core samples shows that significant changes in the indexes are consistent with the EDZ and fracture zone. Thus, the EDZ and fracture zone can be detected by this new sonic method conclusively.

Transcaruncular Approach for Treatment of Medial Wall and Large Orbital Blowout Fractures.

PubMed

Nguyen, Dennis C; Shahzad, Farooq; Snyder-Warwick, Alison; Patel, Kamlesh B; Woo, Albert S

2016-03-01

We evaluate the safety and efficacy of the transcaruncular approach for reconstruction of medial orbital wall fractures and the combined transcaruncular-transconjunctival approach for reconstruction of large orbital defects involving the medial wall and floor. A retrospective review of the clinical and radiographic data of patients who underwent either a transcaruncular or a combined transcaruncular-transconjunctival approach by a single surgeon for orbital fractures between June 2007 and June 2013 was undertaken. Seven patients with isolated medial wall fractures underwent a transcaruncular approach, and nine patients with combined medial wall and floor fractures underwent a transcaruncular-transconjunctival approach with a lateral canthotomy. Reconstruction was performed using a porous polyethylene implant. All patients with isolated medial wall fractures presented with enophthalmos. In the combined medial wall and floor group, five out of eight patients had enophthalmos with two also demonstrating hypoglobus. The size of the medial wall defect on preoperative computed tomography (CT) scan ranged from 2.6 to 4.6 cm(2); the defect size of combined medial wall and floor fractures was 4.5 to 12.7 cm(2). Of the 11 patients in whom postoperative CT scans were obtained, all were noted to have acceptable placement of the implant. All patients had correction of enophthalmos and hypoglobus. One complication was noted, with a retrobulbar hematoma having developed 2 days postoperatively. The transcaruncular approach is a safe and effective method for reconstruction of medial orbital floor fractures. Even large fractures involving the orbital medial wall and floor can be adequately exposed and reconstructed with a combined transcaruncular-transconjunctival-lateral canthotomy approach. The level of evidence of this study is IV (case series with pre/posttest).

Internal Fixation of Transverse Patella Fractures Using Cannulated Cancellous Screws with Anterior Tension Band Wiring.

PubMed

Khan, I; Dar, M Y; Rashid, S; Butt, M F

2016-07-01

Aims : To evaluate the effectiveness and safety of anterior tension band wiring technique using two cannulated cancellous screws in patients with transverse (AO34-C1) or transverse with mildly comminuted (AO34-C2) patellar fractures. Materials and Methods: This is a prospective study of 25 patients with transverse fracture or transverse fracture with mildly comminuted patella fractures. All the patients were treated with open reduction and internal fixation using two parallel cannulated screws and 18G stainless steel wire as per the tension band principle. Results : There were eighteen males (72%) and seven females (28%). The age group ranged from 24 to 58 years, with mean age of 38 years. The most common mode of injury was fall (72%) followed by road traffic accident (20%) and violent quadriceps contraction (8%). Transverse fracture was present in 60% and transverse fracture with mild comminution in 40% of patients. Mean time to achieve union was 10.7 weeks (range 8-12 weeks). Mean ROM at three months was 113.8 degree (90-130) and at final follow up this improved to 125.4 degrees (range 100-140). There was one case of knee stiffness and no case of implant failure was observed. Patients were evaluated using Bostman scoring, the mean score at three months being 26.04 which improved to 27.36 at the end of final follow up at one year. Conclusion : Cannulated cancellous screws with anterior tension band wiring is a safe, reliable and reproducible method in management of transverse patellar fractures, with less chances of implant failure and soft tissue irritation.

[The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation].

PubMed

Bi, Hong-zheng; Yang, Mao-qing; Tan, Yuan-chao; Fu, Song

2008-07-01

To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture. All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups. After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (P<0.05). Rotatory manual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.

A Survey of Serious Aircraft Accidents Involving Fatigue Fracture. Volume 1. Fixed-Wing Aircraft (Etude sur des Accidents Importants d’Avions du aux Effets des Fractures de Fatigue. Volume 1. Effets sur des Avions).

DTIC Science & Technology

1983-04-01

Bureau of Standards. NTS3 National Transportation Safety Board (USA). NTSB AAR NTSB Aircraft Accident Report. NZ AAR New Zealand Aircraft Accident Report...NZ AI New Zealand Accident Investigation Bureau. 0 -5- RAN Royal Australian Navy RAAI Royal Australian Air Force RAF Royal Air Force, UK S Substantial...Ice land Iraq Ireland Jamaica (1966 -1981) Japan (1973 - Feb. 81) Kenya Lethoso Malaysia Ma law i Mal ta Mexico Netherlands New Zealand Norway

Effect of Restraining Devices on Facial Fractures in Motor Vehicle Collisions.

PubMed

Hwang, Kun; Kim, Joo Ho

2015-09-01

The aim of this systematic review is to summarize and critically evaluate the evidence for or against the effectiveness of restraining devices on facial fractures in motor vehicle collisions (MVCs).In a PubMed search, the search terms "facial bone fracture and seat belt," "facial bone fracture and air bag," and "facial bone fracture and restraining" were used. The authors abstracted the odds ratio (OR) and 95% confidence intervals (CIs) from each study. Weighted mean differences and 95% CIs were also calculated. The statistical analysis was performed with Review Manager (The Nordic Cochrane Centre).The authors found 30 potentially relevant articles, of which 6 articles met our inclusion criteria. Five studies were subgrouped, and a meta-analysis of these data suggested beneficial effects of seat belts on decreasing facial fractures in MVCs (n = 15,768,960, OR, 0.46, 95% CI = 0.35-0.60). Three studies were subgrouped, and a meta-analysis of these data suggested that there were beneficial effects of seat belts and air bags on decreasing facial fractures in MVCs (n = 15,768,021, OR, 0.59, 95% CI = 0.47-0.74). Four studies were subgrouped, and a meta-analysis of these data suggested there were no significant effects of an air bag on decreasing facial fracture in MVCs (n = 15,932,259, OR, 1.00, 95% CI = 0.72-1.39).A seat belt alone (OR, 0.46) or a seat belt and an air bag (OR, 0.59) were effective to decrease facial fractures in MVCs. However, air bags alone had no significant effect (OR, 1.00). In using air bags, seat belt should be applied together to prevent facial fractures in motor vehicle injuries.

Carotenoids and risk of fracture: a meta-analysis of observational studies

PubMed Central

Song, Xiaochao; Zhang, Xi; Li, Xinli

2017-01-01

To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture. PMID:27911854

Carotenoids and risk of fracture: a meta-analysis of observational studies.

PubMed

Xu, Jiuhong; Song, Chunli; Song, Xiaochao; Zhang, Xi; Li, Xinli

2017-01-10

To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture.

[Minimally invasive percutaneous plate osteosynthesis versus open reduction and internal fixation for distal tibial fractures in adults: a meta-analysis].

PubMed

Zhang, Qing-xi; Gao, Fu-qiang; Sun, Wei; Wang, Yun-ting; Yang, Yu-run; Li, Zirong

2015-08-01

To perform a meta-analysis on clinical outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) or open reduction and internal fixation (ORIF) for distal tibial fractures in adults. Pubmed database (from 1968 to March 2014), Cochrane library and CNKI database (from 1998 to March 2014) were searched. Case-control study on minimally invasive percutaneous plate osteosynthesis (MIPPO) or open reduction and internal fixation (ORIF) for distal tibial fractures in adults were chosen,and postoperative infection, operative time, blood loss, fracture nonunion rate, delayed union,fracture malunion rate were seen as evaluation index for meta analysis. The system review was performed using the method recommended by the Cochrane Collaboration. Totally 5 studies (366 patients) were enrolled. Meta-analysis showed that there were significant meaning in postoperative infection between MIPPO and ORIF [OR = 0.23,95% CI (0.06,0.92), P = 0.04]; fracture nonunion rate in MIPPO was lower than in ORIF group [OR = 0.16, 95% CI (0.03,0.76), P = 0.02]; operative time in MIPPO was shorter than in ORIF group, and had significant difference [MD = -14.42, 95% CI (-27.79, -1.05), P < 0.05]; blood loss in MIPPO was less than in ORIF group [MD= -87.17,95%CI (-99.20, -75.15), P < 0.05]; there was no obviously meaning in delayed union between two groups. For distal tibial fractures in adults, MIPPO has, advantages of short operative time, less blood loss, lower incidence of infection and fracture non-uniom, but with high fracture malunion rate. MIPPO for distal tibial fractures in adults is better than ORIF, and the best treatment should choose according to patient's condition.

Association between metabolic syndrome and bone fracture risk: A community-based study using a fracture risk assessment tool.

PubMed

Yu, Chia-Ying; Chen, Fang-Ping; Chen, Li-Wei; Kuo, Sheng-Fong; Chien, Rong-Nan

2017-12-01

Osteoporosis and metabolic syndrome (MS) share similar risk factors. Previous studies of association between bone marrow density (BMD) and MS are controversial. Moreover, some studies revealed that MS is associated with BMD but not with bone fracture. In clinical practice, patients pay more attention to bone fracture risk than BMD values. Hence, this study aimed to evaluate the association between MS and the 10-year bone fracture risk probability using a fracture risk assessment tool (FRAX) from community-based data. From March 2014 to August 2015, 2689 participants (897 men and 1792 women) were enrolled in this study. Inflammatory cytokines, such as tumor necrosis factor alpha and C-reactive protein, and adipokines were included for analysis.The mean age was 60.2 ± 10.7 years in men and 58.9 ± 9.6 years in women. The percentage of MS was 27.6% in men and 27.9% in women. Participants were divided into 2 groups, those with or without MS. Compared with women without MS, women with MS had a higher rate of fracture risk (22.8% vs 16.3%, P = .001). In contrast, men with MS had a lower rate of fracture risk then men without MS (5.6% vs 12.3%, P = .004). However, MS loss the association with a high bone fracture risk in men based on multivariate logistical regression analysis, after adjusting for confounding factor of body mass index (BMI). Conclusively, the result of regression analysis between MS and the bone fracture risk may be different in men and women, and BMI was an important confounding factor to interfere with the regression analysis. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Recurrent Proximal Femur Fractures in a Teenager With Osteogenesis Imperfecta on Continuous Bisphosphonate Therapy: Are We Overtreating?

PubMed

Vasanwala, Rashida F; Sanghrajka, Anish; Bishop, Nicholas J; Högler, Wolfgang

2016-07-01

Long-term bisphosphonate (BP) therapy in adults with osteoporosis is associated with atypical femoral fractures, caused by increased material bone density and prolonged suppression of bone remodeling which may reduce fracture toughness. In children with osteogenesis imperfecta (OI), long-term intravenous BP therapy improves bone structure and mass without further increasing the already hypermineralized bone matrix, and is generally regarded as safe. Here we report a teenage girl with OI type IV, who was started on cyclical intravenous pamidronate therapy at age 6 years because of recurrent fractures. Transiliac bone biopsy revealed classical structural features of OI but unusually low bone resorption surfaces. She made substantial improvements in functional ability, bone mass, and fracture rate. However, after 5 years of pamidronate therapy she started to develop recurrent, bilateral, nontraumatic, and proximal femur fractures, which satisfied the case definition for atypical femur fractures. Some fractures were preceded by periosteal reactions and prodromal pain. Pamidronate was discontinued after 7 years of therapy, following which she sustained two further nontraumatic femur fractures, and continued to show delayed tibial osteotomy healing. Despite rodding surgery, and very much in contrast to her affected, untreated, and normally mobile mother, she remains wheelchair-dependent. The case of this girl raises questions about the long-term safety of BP therapy in some children, in particular about the risk of oversuppressed bone remodeling with the potential for microcrack accumulation, delayed healing, and increased stiffness. The principal concern is whether there is point at which benefit from BP therapy could turn into harm, where fracture risk increases again. This case should stimulate debate whether current adult atypical femoral fracture guidance should apply to children, and whether low-frequency, low-dose cyclical, intermittent, or oral treatment maintenance regimens should be considered on a case-by-case basis. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

Morbidity and Mortality Associated with Geriatric Ankle Fractures: A Medicare Part A Claims Database Analysis.

PubMed

Hsu, Raymond Y; Lee, Yoojin; Hayda, Roman; DiGiovanni, Christopher W; Mor, Vincent; Bariteau, Jason T

2015-11-04

The purpose of this study was to examine the incidence of adverse events in elderly patients who required inpatient admission after sustaining an ankle fracture and to consider these data in relation to geriatric hip fracture and other geriatric patient admissions. A retrospective cohort study of patients admitted with an ankle fracture, a hip fracture, or any other diagnosis was performed with the Medicare Part A database for 2008. The primary outcome measure was the one-year mortality rate, examined with multivariate analysis factoring for both patient age and preexisting comorbidity. Secondary outcome measures analyzed additional morbidity as reflected by length of stay, discharge disposition, readmissions, and medical complications. There were 19,648 patients with ankle fractures, 193,980 patients with hip fractures, and 5,801,831 patients with other admitting diagnoses. Significant differences (p < 0.001) were noted in both age and comorbidity status between the group with ankle fractures and the group with hip fractures. The one-year mortality after admission was 11.9% for patients with ankle fracture, 28.2% for patients with hip fracture, and 21.5% for patients with any other admission. Upon using multivariate analysis to account for both age and comorbidity, the hazard ratio for one-year mortality associated with fracture was 1.088 for patients with hip fracture and 0.557 for patients with ankle fracture. Even after selecting for admitted patients and accounting for both age and comorbidity, geriatric patients with ankle fractures were found to have a lower one-year morbidity compared with geriatric patients who had sustained a hip fracture or alternative admitting diagnoses. Geriatric patients with ankle fractures are likely healthier and more active in ways that are not captured by simply accounting for age and comorbidity. These findings may support more aggressive definitive management of such injuries in this population. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Five Years of Cenosumab Exposure in Women With Postmenopausal Osteoporosis: Results From the First Two Years of the FREEDOM Extension

PubMed Central

Papapoulos, Socrates; Chapurlat, Roland; Libanati, Cesar; Brandi, Maria Luisa; Brown, Jacques P; Czerwiński, Edward; Krieg, Marc-Antoine; Man, Zulema; Mellström, Dan; Radominski, Sebastião C; Reginster, Jean-Yves; Resch, Heinrich; Ivorra, José A Román; Roux, Christian; Vittinghoff, Eric; Austin, Matthew; Daizadeh, Nadia; Bradley, Michelle N; Grauer, Andreas; Cummings, Steven R; Bone, Henry G

2012-01-01

The 3-year FREEDOM trial assessed the efficacy and safety of 60 mg denosumab every 6 months for the treatment of postmenopausal women with osteoporosis. Participants who completed the FREEDOM trial were eligible to enter an extension to continue the evaluation of denosumab efficacy and safety for up to 10 years. For the extension results presented here, women from the FREEDOM denosumab group had 2 more years of denosumab treatment (long-term group) and those from the FREEDOM placebo group had 2 years of denosumab exposure (cross-over group). We report results for bone turnover markers (BTMs), bone mineral density (BMD), fracture rates, and safety. A total of 4550 women enrolled in the extension (2343 long-term; 2207 cross-over). Reductions in BTMs were maintained (long-term group) or occurred rapidly (cross-over group) following denosumab administration. In the long-term group, lumbar spine and total hip BMD increased further, resulting in 5-year gains of 13.7% and 7.0%, respectively. In the cross-over group, BMD increased at the lumbar spine (7.7%) and total hip (4.0%) during the 2-year denosumab treatment. Yearly fracture incidences for both groups were below rates observed in the FREEDOM placebo group and below rates projected for a “virtual untreated twin” cohort. Adverse events did not increase with long-term denosumab administration. Two adverse events in the cross-over group were adjudicated as consistent with osteonecrosis of the jaw. Five-year denosumab treatment of women with postmenopausal osteoporosis maintained BTM reduction and increased BMD, and was associated with low fracture rates and a favorable risk/benefit profile. © 2012 American Society for Bone and Mineral Research PMID:22113951

Use of borehole radar reflection logging to monitor steam-enhanced remediation in fractured limestone-results of numerical modelling and a field experiment

USGS Publications Warehouse

Gregoire, C.; Joesten, P.K.; Lane, J.W.

2006-01-01

Ground penetrating radar is an efficient geophysical method for the detection and location of fractures and fracture zones in electrically resistive rocks. In this study, the use of down-hole (borehole) radar reflection logs to monitor the injection of steam in fractured rocks was tested as part of a field-scale, steam-enhanced remediation pilot study conducted at a fractured limestone quarry contaminated with chlorinated hydrocarbons at the former Loring Air Force Base, Limestone, Maine, USA. In support of the pilot study, borehole radar reflection logs were collected three times (before, during, and near the end of steam injection) using broadband 100 MHz electric dipole antennas. Numerical modelling was performed to predict the effect of heating on radar-frequency electromagnetic (EM) wave velocity, attenuation, and fracture reflectivity. The modelling results indicate that EM wave velocity and attenuation change substantially if heating increases the electrical conductivity of the limestone matrix. Furthermore, the net effect of heat-induced variations in fracture-fluid dielectric properties on average medium velocity is insignificant because the expected total fracture porosity is low. In contrast, changes in fracture fluid electrical conductivity can have a significant effect on EM wave attenuation and fracture reflectivity. Total replacement of water by steam in a fracture decreases fracture reflectivity of a factor of 10 and induces a change in reflected wave polarity. Based on the numerical modelling results, a reflection amplitude analysis method was developed to delineate fractures where steam has displaced water. Radar reflection logs collected during the three acquisition periods were analysed in the frequency domain to determine if steam had replaced water in the fractures (after normalizing the logs to compensate for differences in antenna performance between logging runs). Analysis of the radar reflection logs from a borehole where the temperature increased substantially during the steam injection experiment shows an increase in attenuation and a decrease in reflectivity in the vicinity of the borehole. Results of applying the reflection amplitude analysis method developed for this study indicate that steam did not totally replace the water in most of the fractures. The observed decreases in reflectivity were consistent with an increase in fracture-water temperature, rather than the presence of steam. A limiting assumption of the reflection amplitude analysis method is the requirement for complete displacement of water in a fracture by steam. ?? 2006 Elsevier B.V. All rights reserved.

Spatial arrangement of faults and opening-mode fractures

NASA Astrophysics Data System (ADS)

Laubach, S. E.; Lamarche, J.; Gauthier, B. D. M.; Dunne, W. M.; Sanderson, David J.

2018-03-01

Spatial arrangement is a fundamental characteristic of fracture arrays. The pattern of fault and opening-mode fracture positions in space defines structural heterogeneity and anisotropy in a rock volume, governs how faults and fractures affect fluid flow, and impacts our understanding of the initiation, propagation and interactions during the formation of fracture patterns. This special issue highlights recent progress with respect to characterizing and understanding the spatial arrangements of fault and fracture patterns, providing examples over a wide range of scales and structural settings. Five papers describe new methods and improvements of existing techniques to quantify spatial arrangement. One study unravels the time evolution of opening-mode fracture spatial arrangement, which are data needed to compare natural patterns with progressive fracture growth in kinematic and mechanical models. Three papers investigate the role of evolving diagenesis in localizing fractures by mechanical stratigraphy and nine discuss opening-mode fracture spatial arrangement. Two papers show the relevance of complex cluster patterns to unconventional reservoirs through examples of fractures in tight gas sandstone horizontal wells, and a study of fracture arrangement in shale. Four papers demonstrate the roles of folds in fracture localization and the development spatial patterns. One paper models along-fault friction and fluid pressure and their effects on fault-related fracture arrangement. Contributions address deformation band patterns in carbonate rocks and fault size and arrangement above a detachment fault. Three papers describe fault and fracture arrangements in basement terrains, and three document fracture patterns in shale. This collection of papers points toward improvement in field methods, continuing improvements in computer-based data analysis and creation of synthetic fracture patterns, and opportunities for further understanding fault and fracture attributes in the subsurface through coupled spatial, size, and pattern analysis.

Fracture heuristics: surgical decision for approaches to distal radius fractures. A surgeon's perspective.

PubMed

Wichlas, Florian; Tsitsilonis, Serafim; Kopf, Sebastian; Krapohl, Björn Dirk; Manegold, Sebastian

2017-01-01

Introduction: The aim of the present study is to develop a heuristic that could replace the surgeon's analysis for the decision on the operative approach of distal radius fractures based on simple fracture characteristics. Patients and methods: Five hundred distal radius fractures operated between 2011 and 2014 were analyzed for the surgeon's decision on the approach used. The 500 distal radius fractures were treated with open reduction and internal fixation through palmar, dorsal, and dorsopalmar approaches with 2.4 mm locking plates or underwent percutaneous fixation. The parameters that should replace the surgeon's analysis were the fractured palmar cortex, and the frontal and the sagittal split of the articular surface of the distal radius. Results: The palmar approach was used for 422 (84.4%) fractures, the dorsal approach for 39 (7.8%), and the combined dorsopalmar approach for 30 (6.0%). Nine (1.8%) fractures were treated percutaneously. The correlation between the fractured palmar cortex and the used palmar approach was moderate (r=0.464; p<0.0001). The correlation between the frontal split and the dorsal approach, including the dorsopalmar approach, was strong (r=0.715; p<0.0001). The sagittal split had only a weak correlation for the dorsal and dorsopalmar approach (r=0.300; p<0.0001). Discussion: The study shows that the surgical decision on the preferred approach is dictated through two simple factors, even in the case of complex fractures. Conclusion: When the palmar cortex is displaced in distal radius fractures, a palmar approach should be used. When there is a displaced frontal split of the articular surface, a dorsal approach should be used. When both are present, a dorsopalmar approach should be used. These two simple parameters could replace the surgeon's analysis for the surgical approach.

Progressive fracture of fiber composites

NASA Technical Reports Server (NTRS)

Irvin, T. B.; Ginty, C. A.

1983-01-01

Refined models and procedures are described for determining progressive composite fracture in graphite/epoxy angleplied laminates. Lewis Research Center capabilities are utilized including the Real Time Ultrasonic C Scan (RUSCAN) experimental facility and the Composite Durability Structural Analysis (CODSTRAN) computer code. The CODSTRAN computer code is used to predict the fracture progression based on composite mechanics, finite element stress analysis, and fracture criteria modules. The RUSCAN facility, CODSTRAN computer code, and scanning electron microscope are used to determine durability and identify failure mechanisms in graphite/epoxy composites.

Evaluation of rock/fracture interactions during steam injection through vertical hydraulic fractures

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

Kovscek, A.R.; Johnston, R.M.; Patzek, T.W.

1997-05-01

The design, results, and analysis of a steamdrive pilot in the South Belridge diatomite, Kern County, California, are reviewed. Pilot results demonstrate that steam can be injected across a 1,000-ft-tall diatomite column using hydraulically fractured wells and that significant oil is produced in response to steaming. A computationally simple numerical model is proposed and used to analyze reservoir heating and volumetric sweep by steam. Results from the analysis show that hydraulic fractures undergoing steam injection can be dynamic and asymmetrical.

Performance and safety of holmium: YAG laser optical fibers.

PubMed

Knudsen, Bodo E; Glickman, Randolph D; Stallman, Kenneth J; Maswadi, Saher; Chew, Ben H; Beiko, Darren T; Denstedt, John D; Teichman, Joel M H

2005-11-01

Lower-pole ureteronephroscopy requires transmission of holmium:YAG energy along a deflected fiber. Current ureteroscopes are capable of high degrees of deflection, which may stress laser fibers beyond safe limits during lower-pole use. We hypothesized that optical fiber and safety measures differ among manufacturers. Small (200-273-microm) and medium-diameter (300-400-microm) Ho:YAG fibers were tested in a straight and 180 degrees bent configuration. Energy transmission was measured by an energy detector. Fiber durability was assessed by firing the laser in sequentially tighter bending diameters. The fibers were bent to 180 degrees with a diameter of 6 cm and run at 200- to 4000-mJ pulse energy to determine the minimum energy required to fracture the fiber. The bending diameter was decreased by 1-cm increments and testing repeated until a bending diameter of 1 cm was reached. The maximum deflection of the ACMI DUR-8E ureteroscope with each fiber in the working channel was recorded. The flow rate through the working channel of the DUR-8E was measured for each fiber. The mean energy transmission differed among fibers (P < 0.001). The Lumenis SL 200 and the InnovaQuartz 400 were the best small and medium-diameter fibers, respectively, in resisting thermal breakdown (P < 0.01). The Dornier Lightguide Super 200 fractured repeatedly at a bend diameter of 2 cm and with the lowest energy (200 mJ). The other small fibers fractured only at a bend diameter of 1 cm. The Sharplan 200 and InnovaQuartz Sureflex 273T were the most flexible fibers, the Lumenis SL 365 the least. The flow rate was inversely proportional to four times the power of the diameter of the fiber. Optical performance and safety differ among fibers. Fibers transmit various amounts of energy to their cladding when bent. During lower-pole nephroscopy with the fiber deflected, there is a risk of fiber fracture from thermal breakdown and laser-energy transmission to the endoscope. Some available laser fibers carry a risk of ureteroscope damage.

Predicting bulk permeability using outcrop fracture attributes: The benefits of a Maximum Likelihood Estimator

NASA Astrophysics Data System (ADS)

Rizzo, R. E.; Healy, D.; De Siena, L.

2015-12-01

The success of any model prediction is largely dependent on the accuracy with which its parameters are known. In characterising fracture networks in naturally fractured rocks, the main issues are related with the difficulties in accurately up- and down-scaling the parameters governing the distribution of fracture attributes. Optimal characterisation and analysis of fracture attributes (fracture lengths, apertures, orientations and densities) represents a fundamental step which can aid the estimation of permeability and fluid flow, which are of primary importance in a number of contexts ranging from hydrocarbon production in fractured reservoirs and reservoir stimulation by hydrofracturing, to geothermal energy extraction and deeper Earth systems, such as earthquakes and ocean floor hydrothermal venting. This work focuses on linking fracture data collected directly from outcrops to permeability estimation and fracture network modelling. Outcrop studies can supplement the limited data inherent to natural fractured systems in the subsurface. The study area is a highly fractured upper Miocene biosiliceous mudstone formation cropping out along the coastline north of Santa Cruz (California, USA). These unique outcrops exposes a recently active bitumen-bearing formation representing a geological analogue of a fractured top seal. In order to validate field observations as useful analogues of subsurface reservoirs, we describe a methodology of statistical analysis for more accurate probability distribution of fracture attributes, using Maximum Likelihood Estimators. These procedures aim to understand whether the average permeability of a fracture network can be predicted reducing its uncertainties, and if outcrop measurements of fracture attributes can be used directly to generate statistically identical fracture network models.

Non-destructive evaluation of laboratory scale hydraulic fracturing using acoustic emission

NASA Astrophysics Data System (ADS)

Hampton, Jesse Clay

The primary objective of this research is to develop techniques to characterize hydraulic fractures and fracturing processes using acoustic emission monitoring based on laboratory scale hydraulic fracturing experiments. Individual microcrack AE source characterization is performed to understand the failure mechanisms associated with small failures along pre-existing discontinuities and grain boundaries. Individual microcrack analysis methods include moment tensor inversion techniques to elucidate the mode of failure, crack slip and crack normal direction vectors, and relative volumetric deformation of an individual microcrack. Differentiation between individual microcrack analysis and AE cloud based techniques is studied in efforts to refine discrete fracture network (DFN) creation and regional damage quantification of densely fractured media. Regional damage estimations from combinations of individual microcrack analyses and AE cloud density plotting are used to investigate the usefulness of weighting cloud based AE analysis techniques with microcrack source data. Two granite types were used in several sample configurations including multi-block systems. Laboratory hydraulic fracturing was performed with sample sizes ranging from 15 x 15 x 25 cm3 to 30 x 30 x 25 cm 3 in both unconfined and true-triaxially confined stress states using different types of materials. Hydraulic fracture testing in rock block systems containing a large natural fracture was investigated in terms of AE response throughout fracture interactions. Investigations of differing scale analyses showed the usefulness of individual microcrack characterization as well as DFN and cloud based techniques. Individual microcrack characterization weighting cloud based techniques correlated well with post-test damage evaluations.

Fracture risk in patients with type 2 diabetes mellitus and possible risk factors: a systematic review and meta-analysis

PubMed Central

Moayeri, Ardeshir; Mohamadpour, Mahmoud; Mousavi, Seyedeh Fatemeh; Shirzadpour, Ehsan; Mohamadpour, Safoura; Amraei, Mansour

2017-01-01

Aim Patients with type 2 diabetes mellitus (T2DM) have an increased risk of bone fractures. A variable increase in fracture risk has been reported depending on skeletal site, diabetes duration, study design, insulin use, and so on. The present meta-analysis aimed to investigate the association between T2DM with fracture risk and possible risk factors. Methods Different databases including PubMed, Institute for Scientific Information, and Scopus were searched up to May 2016. All epidemiologic studies on the association between T2DM and fracture risk were included. The relevant data obtained from these papers were analyzed by a random effects model and publication bias was assessed by funnel plot. All analyses were done by R software (version 3.2.1) and STATA (version 11.1). Results Thirty eligible studies were selected for the meta-analysis. We found a statistically significant positive association between T2DM and hip, vertebral, or foot fractures and no association between T2DM and wrist, proximal humerus, or ankle fractures. Overall, T2DM was associated with an increased risk of any fracture (summary relative risk =1.05, 95% confidence interval: 1.04, 1.06) and increased with age, duration of diabetes, and insulin therapy. Conclusion Our findings strongly support an association between T2DM and increased risk of overall fracture. These findings emphasize the need for fracture prevention strategies in patients with diabetes. PMID:28442913

Spacing of bending-induced fractures at saturation: Numerical models and approximate analytical solution

NASA Astrophysics Data System (ADS)

Schöpfer, Martin; Lehner, Florian; Grasemann, Bernhard; Kaserer, Klemens; Hinsch, Ralph

2017-04-01

John G. Ramsay's sketch of structures developed in a layer progressively folded and deformed by tangential longitudinal strain (Figure 7-65 in Folding and Fracturing of Rocks) and the associated strain pattern analysis have been reproduced in many monographs on Structural Geology and are referred to in numerous publications. Although the origin of outer-arc extension fractures is well-understood and documented in many natural examples, geomechanical factors controlling their (finite or saturation) spacing are hitherto unexplored. This study investigates the formation of bending-induced fractures during constant-curvature forced folding using Distinct Element Method (DEM) numerical modelling. The DEM model comprises a central brittle layer embedded within weaker (low modulus) elastic layers; the layer interfaces are frictionless (free slip). Folding of this three-layer system is enforced by a velocity boundary condition at the model base, while a constant overburden pressure is maintained at the model top. The models illustrate several key stages of fracture array development: (i) Prior to the onset of fracture, the neutral surface is located midway between the layer boundaries; (ii) A first set of regularly spaced fractures develops once the tensile stress in the outer-arc equals the tensile strength of the layer. Since the layer boundaries are frictionless, these bending-induced fractures propagate through the entire layer; (iii) After the appearance of the first fracture set, the rate of fracture formation decreases rapidly and so-called infill fractures develop approximately midway between two existing fractures (sequential infilling); (iv) Eventually no new fractures form, irrespective of any further increase in fold curvature (fracture saturation). Analysis of the interfacial normal stress distributions suggests that at saturation the fracture-bound blocks are subjected to a loading condition similar to three-point bending. Using classical beam theory an analytical solution is derived for the critical fracture spacing, i.e. the spacing below which the maximum tensile stress cannot reach the layer strength. The model results are consistent with an approximate analytical solution, and illustrate that the spacing of bending-induced fractures is proportional to layer thickness and a square root function of the ratio of layer tensile strength to confining pressure. Although highly idealised, models and analysis presented in this study offer an explanation for fracture saturation during folding and point towards certain key factors that may control fracture spacing in natural systems.

49 CFR 178.705 - Standards for metal IBCs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... metal lattice-work casing. (c) Construction requirements for metal IBCs are as follows: (1) Body. The... minimum elongation (as a percentage) of the reference steel to be used on fracture under tensile stress...

49 CFR 178.705 - Standards for metal IBCs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... metal lattice-work casing. (c) Construction requirements for metal IBCs are as follows: (1) Body. The... minimum elongation (as a percentage) of the reference steel to be used on fracture under tensile stress...

Modelling radionuclide transport in fractured media with a dynamic update of K d values

DOE PAGES

Trinchero, Paolo; Painter, Scott L.; Ebrahimi, Hedieh; ...

2015-10-13

Radionuclide transport in fractured crystalline rocks is a process of interest in evaluating long term safety of potential disposal systems for radioactive wastes. Given their numerical efficiency and the absence of numerical dispersion, Lagrangian methods (e.g. particle tracking algorithms) are appealing approaches that are often used in safety assessment (SA) analyses. In these approaches, many complex geochemical retention processes are typically lumped into a single parameter: the distribution coefficient (Kd). Usually, the distribution coefficient is assumed to be constant over the time frame of interest. However, this assumption could be critical under long-term geochemical changes as it is demonstrated thatmore » the distribution coefficient depends on the background chemical conditions (e.g. pH, Eh, and major chemistry). In this study, we provide a computational framework that combines the efficiency of Lagrangian methods with a sound and explicit description of the geochemical changes of the site and their influence on the radionuclide retention properties.« less

Fractography of glasses and ceramics II

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

Frechette, V.D.; Varner, J.R.

1991-01-01

Topics addressed include finite element stress analysis and crack path prediction of imploding CRT; fractography and fracture mechanics of combustion growth diamond thin films; the fracture behavior of machineable hydroxyapatite; a fractal approach to crack branching (bifurcation) in glass; the fracture of glass-ionomer cements; the effect of quartz particle size on the strength and toughness of whitewares; and a proposed standard practice for fractographic analysis of monolithic advanced ceramics. Also treated are thermal exposure effects on ceramic matrix composites, fractography applied to rock core analysis, fractography of flexurally fractured glass rods, the fractographic determination of K(IC) and effects of microstructuralmore » effects in ceramics.« less

Fracture network evaluation program (FraNEP): A software for analyzing 2D fracture trace-line maps

NASA Astrophysics Data System (ADS)

Zeeb, Conny; Gomez-Rivas, Enrique; Bons, Paul D.; Virgo, Simon; Blum, Philipp

2013-10-01

Fractures, such as joints, faults and veins, strongly influence the transport of fluids through rocks by either enhancing or inhibiting flow. Techniques used for the automatic detection of lineaments from satellite images and aerial photographs, LIDAR technologies and borehole televiewers significantly enhanced data acquisition. The analysis of such data is often performed manually or with different analysis software. Here we present a novel program for the analysis of 2D fracture networks called FraNEP (Fracture Network Evaluation Program). The program was developed using Visual Basic for Applications in Microsoft Excel™ and combines features from different existing software and characterization techniques. The main novelty of FraNEP is the possibility to analyse trace-line maps of fracture networks applying the (1) scanline sampling, (2) window sampling or (3) circular scanline and window method, without the need of switching programs. Additionally, binning problems are avoided by using cumulative distributions, rather than probability density functions. FraNEP is a time-efficient tool for the characterisation of fracture network parameters, such as density, intensity and mean length. Furthermore, fracture strikes can be visualized using rose diagrams and a fitting routine evaluates the distribution of fracture lengths. As an example of its application, we use FraNEP to analyse a case study of lineament data from a satellite image of the Oman Mountains.

Classification of fracture and non-fracture groups by analysis of coherent X-ray scatter

PubMed Central

Dicken, A. J.; Evans, J. P. O.; Rogers, K. D.; Stone, N.; Greenwood, C.; Godber, S. X.; Clement, J. G.; Lyburn, I. D.; Martin, R. M.; Zioupos, P.

2016-01-01

Osteoporotic fractures present a significant social and economic burden, which is set to rise commensurately with the aging population. Greater understanding of the physicochemical differences between osteoporotic and normal conditions will facilitate the development of diagnostic technologies with increased performance and treatments with increased efficacy. Using coherent X-ray scattering we have evaluated a population of 108 ex vivo human bone samples comprised of non-fracture and fracture groups. Principal component fed linear discriminant analysis was used to develop a classification model to discern each condition resulting in a sensitivity and specificity of 93% and 91%, respectively. Evaluating the coherent X-ray scatter differences from each condition supports the hypothesis that a causal physicochemical change has occurred in the fracture group. This work is a critical step along the path towards developing an in vivo diagnostic tool for fracture risk prediction. PMID:27363947

Surface Fractal Analysis for Estimating the Fracture Energy Absorption of Nanoparticle Reinforced Composites

PubMed Central

Pramanik, Brahmananda; Tadepalli, Tezeswi; Mantena, P. Raju

2012-01-01

In this study, the fractal dimensions of failure surfaces of vinyl ester based nanocomposites are estimated using two classical methods, Vertical Section Method (VSM) and Slit Island Method (SIM), based on the processing of 3D digital microscopic images. Self-affine fractal geometry has been observed in the experimentally obtained failure surfaces of graphite platelet reinforced nanocomposites subjected to quasi-static uniaxial tensile and low velocity punch-shear loading. Fracture energy and fracture toughness are estimated analytically from the surface fractal dimensionality. Sensitivity studies show an exponential dependency of fracture energy and fracture toughness on the fractal dimensionality. Contribution of fracture energy to the total energy absorption of these nanoparticle reinforced composites is demonstrated. For the graphite platelet reinforced nanocomposites investigated, surface fractal analysis has depicted the probable ductile or brittle fracture propagation mechanism, depending upon the rate of loading. PMID:28817017

Sliding contact fracture of dental ceramics: Principles and validation

PubMed Central

Ren, Linlin; Zhang, Yu

2014-01-01

Ceramic prostheses are subject to sliding contact under normal and tangential loads. Accurate prediction of the onset of fracture at two contacting surfaces holds the key to greater long-term performance of these prostheses. In this study, building on stress analysis of Hertzian contact and considering fracture criteria for linear elastic materials, a constitutive fracture mechanics relation was developed to incorporate the critical fracture load with the contact geometry, coefficient of friction and material fracture toughness. Critical loads necessary to cause fracture under a sliding indenter were calculated from the constitutive equation, and compared with the loads predicted from elastic stress analysis in conjunction with measured critical load for frictionless normal contact—a semi-empirical approach. The major predictions of the models were calibrated with experimentally determined critical loads of current and future dental ceramics after contact with a rigid spherical slider. Experimental results conform with the trends predicted by the models. PMID:24632538

Fracture control methods for space vehicles. Volume 1: Fracture control design methods. [for space shuttle configuration planning

NASA Technical Reports Server (NTRS)

Liu, A. F.

1974-01-01

A systematic approach for applying methods for fracture control in the structural components of space vehicles consists of four major steps. The first step is to define the primary load-carrying structural elements and the type of load, environment, and design stress levels acting upon them. The second step is to identify the potential fracture-critical parts by means of a selection logic flow diagram. The third step is to evaluate the safe-life and fail-safe capabilities of the specified part. The last step in the sequence is to apply the control procedures that will prevent damage to the fracture-critical parts. The fracture control methods discussed include fatigue design and analysis methods, methods for preventing crack-like defects, fracture mechanics analysis methods, and nondestructive evaluation methods. An example problem is presented for evaluation of the safe-crack-growth capability of the space shuttle crew compartment skin structure.

The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

PubMed

Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

2015-08-01

Percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) are minimally invasive and effective vertebral augmentation techniques for managing osteoporotic vertebral compression fractures (OVCFs). Recent meta-analyses have compared the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques or conservative treatment; however, the inclusions were not thorough and rigorous enough, and the effects of each technique on the incidence of secondary vertebral fractures remain unclear. To perform an updated systematic review and meta-analysis of the studies with more rigorous inclusion criteria on the effects of vertebral augmentation techniques and conservative treatment for OVCF on the incidence of secondary vertebral fractures. PubMed, MEDLINE, EMBASE, SpringerLink, Web of Science, and the Cochrane Library database were searched for relevant original articles comparing the incidence of secondary vertebral fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (NRCTs) were identified. The methodological qualities of the studies were evaluated, relevant data were extracted and recorded, and an appropriate meta-analysis was conducted. A total of 13 articles were included. The pooled results from included studies showed no statistically significant differences in the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques and conservative treatment. Subgroup analysis comparing different study designs, durations of symptoms, follow-up times, races of patients, and techniques were conducted, and no significant differences in the incidence of secondary fractures were identified (P > 0.05). No obvious publication bias was detected by either Begg's test (P = 0.360 > 0.05) or Egger's test (P = 0.373 > 0.05). Despite current thinking in the field that vertebral augmentation procedures may increase the incidence of secondary fractures, we found no differences in the incidence of secondary fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. © The Foundation Acta Radiologica 2014.

Extreme value statistics analysis of fracture strengths of a sintered silicon nitride failing from pores

NASA Technical Reports Server (NTRS)

Chao, Luen-Yuan; Shetty, Dinesh K.

1992-01-01

Statistical analysis and correlation between pore-size distribution and fracture strength distribution using the theory of extreme-value statistics is presented for a sintered silicon nitride. The pore-size distribution on a polished surface of this material was characterized, using an automatic optical image analyzer. The distribution measured on the two-dimensional plane surface was transformed to a population (volume) distribution, using the Schwartz-Saltykov diameter method. The population pore-size distribution and the distribution of the pore size at the fracture origin were correllated by extreme-value statistics. Fracture strength distribution was then predicted from the extreme-value pore-size distribution, usin a linear elastic fracture mechanics model of annular crack around pore and the fracture toughness of the ceramic. The predicted strength distribution was in good agreement with strength measurements in bending. In particular, the extreme-value statistics analysis explained the nonlinear trend in the linearized Weibull plot of measured strengths without postulating a lower-bound strength.

Biomechanical analysis on fracture risk associated with bone deformity

NASA Astrophysics Data System (ADS)

Kamal, Nur Amalina Nadiah Mustafa; Som, Mohd Hanafi Mat; Basaruddin, Khairul Salleh; Daud, Ruslizam

2017-09-01

Osteogenesis Imperfecta (OI) is a disease related to bone deformity and is also known as `brittle bone' disease. Currently, medical personnel predict the bone fracture solely based on their experience. In this study, the prediction for risk of fracture was carried out by using finite element analysis on the simulated OI bone of femur. The main objective of this research was to analyze the fracture risk of OI-affected bone with respect to various loadings. A total of 12 models of OI bone were developed by applying four load cases and the angle of deformation for each of the models was calculated. The models were differentiated into four groups, namely standard, light, mild and severe. The results show that only a small amount of load is required to increase the fracture risk of the bone when the model is tested with hopping conditions. The analysis also shows that the torsional load gives a small effect to the increase of the fracture risk of the bone.

Trajectory of social isolation following hip fracture: an analysis of the English Longitudinal Study of Ageing (ELSA) cohort.

PubMed

Smith, Toby O; Dainty, Jack R; MacGregor, Alex

2018-01-01

social isolation is defined as a lack of meaningful and sustained communication or interactions with social networks. There is limited understanding on the prevalence of social isolation and loneliness in people following hip fracture and no previous understanding of how this changes over time. to determine the prevalence and trajectory of social isolation and loneliness before a hip fracture, during the recovery phase and a minimum of 2 years post-hip fracture in an English population. data were from the English Longitudinal Study of Ageing (ELSA) cohort (2004/5-2014/15). The sample comprised of 215 participants who had sustained a hip fracture. Measures of social isolation and loneliness were analysed through multilevel modelling to determine their trajectories during three-time intervals (pre-fracture; interval at hip fracture and recovery; minimum 2 years post-fracture). The prevalence of social isolation and loneliness were determined pre- and post-fracture. prevalence of social isolation was 19% post-hip fracture and loneliness 13% post-hip fracture. There was no statistically significant change in social isolation pre-fracture compared to a minimum of 2 years post-fracture (P = 0.78). Similarly, there was no statistically significant change in loneliness pre-fracture compared to a minimum of 2 years post-fracture (P = 0.12). this analysis has determined that whilst social isolation and loneliness do not change over time following hip fracture, these remain a significant problem for this population. Interventions are required to address these physical and psychological health needs. This is important as they may have short and longer term health benefits for people post-hip fracture. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

The evolution of fracture surface roughness and its dependence on slip

NASA Astrophysics Data System (ADS)

Wells, Olivia L.

Under effective compression, impingement of opposing rough surfaces of a fracture can force the walls of the fracture apart during slip. Therefore, a fracture's surface roughness exerts a primary control on the amount of dilation that can be sustained on a fracture since the opposing surfaces need to remain in contact. Previous work has attempted to characterize fracture surface roughness through topographic profiles and power spectral density analysis, but these metrics describing the geometry of a fracture's surface are often non-unique when used independently. However, when combined these metrics are affective at characterizing fracture surface roughness, as well as the mechanisms affecting changes in roughness with increasing slip, and therefore changes in dilation. These mechanisms include the influence of primary grains and pores on initial fracture roughness, the effect of linkage on locally increasing roughness, and asperity destruction that limits the heights of asperities and forms gouge. This analysis reveals four essential stages of dilation during the lifecycle of a natural fracture, whereas previous slip-dilation models do not adequately address the evolution of fracture surface roughness: (1) initial slip companied by small dilation is mediated by roughness controlled by the primary grain and pore dimensions; (2) rapid dilation during and immediately following fracture growth by linkage of formerly isolated fractures; (3) wear of the fracture surface and gouge formation that minimizes dilation; and (4) between slip events cementation that modifies the mineral constituents in the fracture. By identifying these fundamental mechanisms that influence fracture surface roughness, this new conceptual model relating dilation to slip has specific applications to Enhanced Geothermal Systems (EGS), which attempt to produce long-lived dilation in natural fractures by inducing slip.

Evidence for tectonic, lithologic, and thermal controls on fracture system geometries in an andesitic high-temperature geothermal field

NASA Astrophysics Data System (ADS)

Massiot, Cécile; Nicol, Andrew; McNamara, David D.; Townend, John

2017-08-01

Analysis of fracture orientation, spacing, and thickness from acoustic borehole televiewer (BHTV) logs and cores in the andesite-hosted Rotokawa geothermal reservoir (New Zealand) highlights potential controls on the geometry of the fracture system. Cluster analysis of fracture orientations indicates four fracture sets. Probability distributions of fracture spacing and thickness measured on BHTV logs are estimated for each fracture set, using maximum likelihood estimations applied to truncated size distributions to account for sampling bias. Fracture spacing is dominantly lognormal, though two subordinate fracture sets have a power law spacing. This difference in spacing distributions may reflect the influence of the andesitic sequence stratification (lognormal) and tectonic faults (power law). Fracture thicknesses of 9-30 mm observed in BHTV logs, and 1-3 mm in cores, are interpreted to follow a power law. Fractures in thin sections (˜5 μm thick) do not fit this power law distribution, which, together with their orientation, reflect a change of controls on fracture thickness from uniform (such as thermal) controls at thin section scale to anisotropic (tectonic) at core and BHTV scales of observation. However, the ˜5% volumetric percentage of fractures within the rock at all three scales suggests a self-similar behavior in 3-D. Power law thickness distributions potentially associated with power law fluid flow rates, and increased connectivity where fracture sets intersect, may cause the large permeability variations that occur at hundred meter scales in the reservoir. The described fracture geometries can be incorporated into fracture and flow models to explore the roles of fracture connectivity, stress, and mineral precipitation/dissolution on permeability in such andesite-hosted geothermal systems.

Simulation of Grouting Process in Rock Masses Under a Dam Foundation Characterized by a 3D Fracture Network

NASA Astrophysics Data System (ADS)

Deng, Shaohui; Wang, Xiaoling; Yu, Jia; Zhang, Yichi; Liu, Zhen; Zhu, Yushan

2018-06-01

Grouting plays a crucial role in dam safety. Due to the concealment of grouting activities, complexity of fracture distribution in rock masses and rheological properties of cement grout, it is difficult to analyze the effects of grouting. In this paper, a computational fluid dynamics (CFD) simulation approach of dam foundation grouting based on a 3D fracture network model is proposed. In this approach, the 3D fracture network model, which is based on an improved bootstrap sampling method and established by VisualGeo software, can provide a reliable and accurate geometric model for CFD simulation of dam foundation grouting. Based on the model, a CFD simulation is performed, in which the Papanastasiou regularized model is used to express the grout rheological properties, and the volume of fluid technique is utilized to capture the grout fronts. Two sets of tests are performed to verify the effectiveness of the Papanastasiou regularized model. When applying the CFD simulation approach for dam foundation grouting, three technical issues can be solved: (1) collapsing potential of the fracture samples, (2) inconsistencies in the geometric model in actual fractures under complex geological conditions, and (3) inappropriate method of characterizing the rheological properties of cement grout. The applicability of the proposed approach is demonstrated by an illustrative case study—a hydropower station dam foundation in southwestern China.

Neonatal clavicle fracture in cesarean delivery: incidence and risk factors.

PubMed

Choi, Hyun Ah; Lee, Yeon Kyung; Ko, Sun Young; Shin, Son Moon

2017-07-01

Neonatal clavicle fracture in cesarean delivery is rare and has not been extensively studied. We performed a retrospective review of cesarean deliveries with neonatal clavicle fracture during a 12-year period. Maternal and neonatal factors as well as surgical factors related to cesarean delivery for the fracture were determined and compared to the control group to analyze their significance. Among a total 89 367 deliveries during the study period, 36 286 babies were born via cesarean section. Nineteen cases of clavicle fractures in cesarean section were identified (0.05% of total live births via cesarean section). In the analysis of maternal and neonatal risk factors, birthweight, birthweight ≥ 4000  g and maternal age were significantly associated with clavicle fracture in cesarean section. However, clavicle fractures were not correlated with the selected surgical factors such as indication for cesarean section, skin incision to delivery time and incision type of skin and uterus. Logistic regression analysis showed that birthweight was the major risk factor for clavicle fracture. Clavicle fractures complicated 0.05% of cesarean deliveries. The main risk factor related to a clavicle fracture in cesarean section was the birthweight of an infant. As reported in previous studies associated with vaginal delivery, clavicle fracture is considered to be an unavoidable event and may not be eliminated, even in cesarean delivery.

Determination of the effect of formation water on fracture-fluid cleanup

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

NONE

1998-03-01

Understanding hydraulic-fracture cleanup is essential for improving well stimulation. Residual gel damages fracture conductivity, shortens effective fracture half-length, and limits well productivity. The drive to develop fluids, additives, and procedures that minimize this damage continues to be a dominant theme in fracture-fluid-development programs. Fracture cleanup is a complex problem, and many parameters (e.g., fluid system, job design, flowback procedure, and reservoir conditions) can influence polymer and fluid recovery efficiencies. Often, specific products and methods that work well in one reservoir have little effect in another. Systematic analysis of fluid and polymer returns after a treatment is completed is the onlymore » way to quantify fracture cleanup. This is referred to as flowback analysis. This paper discusses a flowback-analysis field study on large hydraulic-fracturing treatments in the Taylor zone of the Cotton Valley formation in east Texas. This is a low-permeability (approximately 0.01 md) tight gas formation. It is a heterogeneous zone with layers of productive sandstone interspersed with relatively impermeable layers of shale. A typical well in this field initially produces approximately 0.75 to 1.3 MMcf/D gas and 35 to 40 bbl of water/MMcf of gas. The returns from 10 wells in this field were analyzed thoroughly.« less

EFFECTS OF LONG-TERM ALENDRONATE TREATMENT ON A LARGE SAMPLE OF PEDIATRIC PATIENTS WITH OSTEOGENESIS IMPERFECTA.

PubMed

Lv, Fang; Liu, Yi; Xu, Xiaojie; Wang, Jianyi; Ma, Doudou; Jiang, Yan; Wang, Ou; Xia, Weibo; Xing, Xiaoping; Yu, Wei; Li, Mei

2016-12-01

Osteogenesis imperfecta (OI) is a group of inherited diseases characterized by reduced bone mass, recurrent bone fractures, and progressive bone deformities. Here, we evaluate the efficacy and safety of long-term treatment with alendronate in a large sample of Chinese children and adolescents with OI. In this prospective study, a total of 91 children and adolescents with OI were included. The patients received 3 years' treatment with 70 mg alendronate weekly and 500 mg calcium daily. During the treatment, fracture incidence, bone mineral density (BMD), and serum levels of the bone turnover biomarkers (alkaline phosphatase [ALP] and cross-linked C-telopeptide of type I collagen [β-CTX]) were evaluated. Linear growth speed and parameters of safety were also measured. After 3 years of treatment, the mean annual fracture incidence decreased from 1.2 ± 0.8 to 0.2 ± 0.3 (P<.01). BMD at the lumbar spine and femoral neck significantly increased by 74.6% and 39.5%, with their BMD Z-score increasing from -3.0 to 0.1 and from -4.2 to -1.3, respectively (both P<.01 vs. baseline). In addition, serum ALP and β-CTX levels decreased by 35.6% and 44.3%, respectively (both P<.05 vs. baseline). Height significantly increased, but without an obvious increase in its Z-score. Patient tolerance of alendronate was good. Three years' treatment with alendronate was demonstrated for the first time to significantly reduce fracture incidence, increase lumbar spine and femoral neck BMD, and decrease bone turnover biomarkers in Chinese children and adolescents with OI. ALP = alkaline phosphatase β-CTX = cross-linked C-telopeptide of type I collagen BMD = bone mineral density BP = bisphosphonate DXA = dual-energy X-ray absorptiometry 25OHD = 25-hydroxyvitamin D OI = osteogenesis imperfecta PTH = parathyroid hormone.

Correlation analysis of fracture arrangement in space

NASA Astrophysics Data System (ADS)

Marrett, Randall; Gale, Julia F. W.; Gómez, Leonel A.; Laubach, Stephen E.

2018-03-01

We present new techniques that overcome limitations of standard approaches to documenting spatial arrangement. The new techniques directly quantify spatial arrangement by normalizing to expected values for randomly arranged fractures. The techniques differ in terms of computational intensity, robustness of results, ability to detect anti-correlation, and use of fracture size data. Variation of spatial arrangement across a broad range of length scales facilitates distinguishing clustered and periodic arrangements-opposite forms of organization-from random arrangements. Moreover, self-organized arrangements can be distinguished from arrangements due to extrinsic organization. Traditional techniques for analysis of fracture spacing are hamstrung because they account neither for the sequence of fracture spacings nor for possible coordination between fracture size and position, attributes accounted for by our methods. All of the new techniques reveal fractal clustering in a test case of veins, or cement-filled opening-mode fractures, in Pennsylvanian Marble Falls Limestone. The observed arrangement is readily distinguishable from random and periodic arrangements. Comparison of results that account for fracture size with results that ignore fracture size demonstrates that spatial arrangement is dominated by the sequence of fracture spacings, rather than coordination of fracture size with position. Fracture size and position are not completely independent in this example, however, because large fractures are more clustered than small fractures. Both spatial and size organization of veins here probably emerged from fracture interaction during growth. The new approaches described here, along with freely available software to implement the techniques, can be applied with effect to a wide range of structures, or indeed many other phenomena such as drilling response, where spatial heterogeneity is an issue.

Depression and risk of fracture and bone loss: an updated meta-analysis of prospective studies.

PubMed

Wu, Q; Liu, B; Tonmoy, S

2018-03-12

This meta-analysis pooled results from 23 qualifying individual cohort studies and found that depression was significantly associated with an increased risk of fractures and bone loss. The association between depression and risk of fracture remains controversial. We conducted a comprehensive meta-analysis to examine the effect of depression on the risk of osteoporotic fractures and bone loss. We searched databases and reviewed citations in relevant articles for eligible cohort studies. Two investigators independently conducted study selection, appraisal, and data abstraction through the use of a standardized protocol. Random effect models were used for meta-analysis. Cochrane Q and I 2 statistics were used to assess heterogeneity. Funnel plots and rank correlation tests were used to evaluate publication bias. Twenty-three studies were included for meta-analysis. In studies that reported hazard ratio (HR) as the outcome (nine studies [n = 309,862]), depression was associated with 26% increase in fracture risk (HR = 1.26, 95% CI, 1.10-1.43, p < 0.001). Studies that reported risk ratio (RR) as the outcome (seven studies [n = 64,975]) suggested that depression was associated with 39% increase in fracture risk (RR = 1.39, 95% CI, 1.19-1.62, p < 0.001). Among studies that reported hip bone mineral density (BMD) as an outcome (eight studies [n = 15,442]), depression was associated with a reduced mean annual bone loss rate of 0.35% (0.18-0.53%, p < 0.001). The increased risk of fracture and bone loss associated with depression was consistent in all meta-analysis having modified inclusion criteria and in different subgroup analyses as well. Significant heterogeneity was observed in the meta-analysis; however, no significant publication bias was detected. Depression is associated with a significant increased risk in fracture and bone loss. Effective prevention may decrease such risk.

Coffee consumption and risk of fractures: a meta-analysis

PubMed Central

Liu, Huifang; Yao, Ke; Zhang, Wenjie; Zhou, Jun; Wu, Taixiang

2012-01-01

Introduction Recent studies have indicated higher risk of fractures among coffee drinkers. To quantitatively assess the association between coffee consumption and the risk of fractures, we conducted this meta-analysis. Material and methods We searched MEDLINE and EMBASE for prospective studies reporting the risk of fractures with coffee consumption. Quality of included studies was assessed with the Newcastle Ottawa scale. We conducted a meta-analysis and a cumulative meta-analysis of relative risk (RR) for an increment of one cup of coffee per day, and explored the potential dose-response relationship. Sensitivity analysis was performed where statistical heterogeneity existed. Results We included 10 prospective studies covering 214,059 participants and 9,597 cases. There was overall 3.5% higher fracture risk for an increment of one cup of coffee per day (RR = 1.035, 95% CI: 1.019-1.052). Pooled RRs were 1.049 (95% CI: 1.022-1.077) for women and 0.910 (95% CI: 0.873-0.949) for men. Among women, RR was 1.055 (95% CI: 0.999-1.114) for younger participants, and 1.047 (95% CI: 1.016-1.080) for older ones. Cumulative meta-analysis indicated that risk estimates reached a stabilization level (RR = 1.035, 95% CI: 1.019-1.052), and it revealed a positive dose-response relationship between coffee consumption and risk of fractures either for men and women combined or women specifically. Conclusions This meta-analysis suggests an overall harm of coffee intake in increasing the risk of fractures, especially for women. But current data are insufficient to reach a convincing conclusion and further research needs to be conducted. PMID:23185185

Stability and failure analysis of steering tie-rod

NASA Astrophysics Data System (ADS)

Jiang, GongFeng; Zhang, YiLiang; Xu, XueDong; Ding, DaWei

2008-11-01

A new car in operation of only 8,000 km, because of malfunction, resulting in lost control and rammed into the edge of the road, and then the basic vehicle scrapped. According to the investigation of the site, it was found that the tie-rod of the car had been broken. For the subjective analysis of the accident and identifying the true causes of rupture of the tierod, a series of studies, from the angle of theory to experiment on the bended broken tie-rod, were conducted. The mechanical model was established; the stability of the defective tie-rod was simulated based on ANSYS software. Meanwhile, the process of the accident was simulated considering the effect of destabilization of different vehicle speed and direction of the impact. Simultaneously, macro graphic test, chemical composition analysis, microstructure analysis and SEM analysis of the fracture were implemented. The results showed that: 1) the toughness of the tie-rod is at a normal level, but there is some previous flaws. One quarter of the fracture surface has been cracked before the accident. However, there is no relationship between the flaw and this incident. The direct cause is the dynamic instability leading to the large deformation of impact loading. 2) The declining safety factor of the tie-rod greatly due to the previous flaws; the result of numerical simulation shows that previous flaw is the vital factor of structure instability, on the basis of the comparison of critical loads of the accident tie-rod and normal. The critical load can decrease by 51.3% when the initial defect increases 19.54% on the cross-sectional area, which meets the Theory of Koiter.

Association between metabolic syndrome and bone fractures: a meta-analysis of observational studies.

PubMed

Sun, Kan; Liu, Jianmin; Lu, Nan; Sun, Hanxiao; Ning, Guang

2014-02-09

Emerging epidemiological evidence suggest an association between metabolic syndrome and fractures. However, whether metabolic syndrome is an independent risk or protective factor of fractures remains controversial. Our goal is to provide a quantitative assessment of the association between metabolic syndrome and bone fractures by conducting a meta-analysis of observational studies. The PubMed and Embase database were searched through to March 2013 to identify studies that met pre-established inclusion criteria. Reference lists of retrieved articles were also reviewed. Summary effect estimates with 95% confidence intervals (CI) were derived using a fixed or random effects model, depending on the heterogeneity of the included studies. Eight epidemiologic studies involving 39,938 participants were included in the meta-analysis. In overall analysis, metabolic syndrome was not associated with prevalent fractures [pooled odds ratio (OR) 0.93, 95% CI 0.84 - 1.03] in cross-sectional studies or incident fractures [pooled relative risk (RR) 0.88, 95% CI 0.37 - 2.12] in prospective cohort studies. No evidence of heterogeneity was found in cross-sectional studies (p = 0.786, I2 = 0.0%). A substantial heterogeneity was detected in cohort studies (p = 0.001, I2 = 85.7%). No indication of significant publication bias was found either from Begg's test or Egger's test. Estimates of total effects were substantially consistent in the sensitivity and stratification analyses. The present meta-analysis of observational studies suggests that the metabolic syndrome has no explicit effect on bone fractures.

49 CFR 178.705 - Standards for metal IBCs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...-work casing. (c) Construction requirements for metal IBCs are as follows: (1) Body. The body must be... minimum elongation (as a percentage) of the reference steel to be used on fracture under tensile stress...

49 CFR 178.705 - Standards for metal IBCs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...-work casing. (c) Construction requirements for metal IBCs are as follows: (1) Body. The body must be... minimum elongation (as a percentage) of the reference steel to be used on fracture under tensile stress...

78 FR 29279 - Safety Standard for Carriages and Strollers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... incorporate automatic or assisted folding and unfolding mechanisms. B. Market Description The majority of... resulted in a bone fracture and head concussion. Parking brake problems related to parking brake failure or assembly resulted in 132 incidents, including eight injuries. Incidents typically occurred when the parking...

Identification of modes of fracture in a 2618-T6 aluminum alloy using stereophotogrammetry

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

Salas Zamarripa, A., E-mail: a.salaszamarripa@gmail.com; Pinna, C.; Brown, M.W.

2011-12-15

The identification and the development of a quantification technique of the modes of fracture in fatigue fracture surfaces of a 2618-T6 aluminum alloy were developed during this research. Fatigue tests at room and high temperature (230 Degree-Sign C) were carried out to be able to compare the microscopic fractographic features developed by this material under these testing conditions. The overall observations by scanning electron microscopy (SEM) of the fracture surfaces showed a mixture of transgranular and ductile intergranular fracture. The ductile intergranular fracture contribution appears to be more significant at room temperature than at 230 Degree-Sign C. A quantitative methodologymore » was developed to identify and to measure the contribution of these microscopic fractographic features. The technique consisted of a combination of stereophotogrammetry and image analysis. Stereo-pairs were randomly taken along the crack paths and were then analyzed using the profile module of MeX software. The analysis involved the 3-D surface reconstruction, the trace of primary profile lines in both vertical and horizontal directions within the stereo-pair area, the measurements of the contribution of the modes of fracture in each profile, and finally, the calculation of the average contribution in each stereo-pair. The technique results confirmed a higher contribution of ductile intergranular fracture at room temperature than at 230 Degree-Sign C. Moreover, there was no indication of a direct relationship between this contribution and the strain amplitudes range applied during the fatigue testing. - Highlights: Black-Right-Pointing-Pointer Stereophotogrammetry and image analysis as a measuring tool of modes of fracture in fatigue fracture surfaces. Black-Right-Pointing-Pointer A mixture of ductile intergranular and transgranular fracture was identified at room temperature and 230 Degree-Sign C testing. Black-Right-Pointing-Pointer Development of a quantitative methodology to obtain the percentage of modes of fracture within the fracture surface.« less

Prediction of Fracture Behavior in Rock and Rock-like Materials Using Discrete Element Models

NASA Astrophysics Data System (ADS)

Katsaga, T.; Young, P.

2009-05-01

The study of fracture initiation and propagation in heterogeneous materials such as rock and rock-like materials are of principal interest in the field of rock mechanics and rock engineering. It is crucial to study and investigate failure prediction and safety measures in civil and mining structures. Our work offers a practical approach to predict fracture behaviour using discrete element models. In this approach, the microstructures of materials are presented through the combination of clusters of bonded particles with different inter-cluster particle and bond properties, and intra-cluster bond properties. The geometry of clusters is transferred from information available from thin sections, computed tomography (CT) images and other visual presentation of the modeled material using customized AutoCAD built-in dialog- based Visual Basic Application. Exact microstructures of the tested sample, including fractures, faults, inclusions and void spaces can be duplicated in the discrete element models. Although the microstructural fabrics of rocks and rock-like structures may have different scale, fracture formation and propagation through these materials are alike and will follow similar mechanics. Synthetic material provides an excellent condition for validating the modelling approaches, as fracture behaviours are known with the well-defined composite's properties. Calibration of the macro-properties of matrix material and inclusions (aggregates), were followed with the overall mechanical material responses calibration by adjusting the interfacial properties. The discrete element model predicted similar fracture propagation features and path as that of the real sample material. The path of the fractures and matrix-inclusion interaction was compared using computed tomography images. Initiation and fracture formation in the model and real material were compared using Acoustic Emission data. Analysing the temporal and spatial evolution of AE events, collected during the sample testing, in relation to the CT images allows the precise reconstruction of the failure sequence. Our proposed modelling approach illustrates realistic fracture formation and growth predictions at different loading conditions.

Survival times of patients with a first hip fracture with and without subsequent major long-bone fractures.

PubMed

Angthong, Chayanin; Angthong, Wirana; Harnroongroj, Thos; Naito, Masatoshi; Harnroongroj, Thossart

2013-01-01

Survival rates are poorer after a second hip fracture than after a first hip fracture. Previous survival studies have included in-hospital mortality. Excluding in-hospital deaths from the analysis allows survival times to be evaluated in community-based patients. There is still a lack of data regarding the effects of subsequent fractures on survival times after hospital discharge following an initial hip fracture. This study compared the survival times of community-dwelling patients with hip fracture who had or did not have a subsequent major long-bone fracture. Hazard ratios and risk factors for subsequent fractures and mortality rates with and without subsequent fractures were calculated. Of 844 patients with hip fracture from 2000 through 2008, 71 had a subsequent major long-bone fracture and 773 did not. Patients who died of other causes, such as perioperative complications, during hospitalization were excluded. Such exclusion allowed us to determine the effect of subsequent fracture on the survival of community-dwelling individuals after hospital discharge or after the time of the fracture if they did not need hospitalization. Demographic data, causes of death, and mortality rates were recorded. Differences in mortality rates between the patient groups and hazard ratios were calculated. Mortality rates during the first year and from 1 to 5 years after the most recent fracture were 5.6% and 1.4%, respectively, in patients with subsequent fractures, and 4.7% and 1.4%, respectively, in patients without subsequent fractures. These rates did not differ significantly between the groups. Cox regression analysis and calculation of hazard ratios did not show significant differences between patients with subsequent fractures and those without. On univariate and multivariate analyses, age <75 years and male sex were risk factors for subsequent fracture. This study found that survival times did not differ significantly between patients with and without subsequent major long-bone fractures after hip fracture. Therefore, all patients with hip fracture, with or without subsequent fractures, need the same robust holistic care. The risks of subsequent fractures should be addressed in patients with hip fracture and should be reduced where possible by education regarding fracture prevention and regular rehabilitation programs. Efforts should be made to decrease the rates of major long-bone fractures and their burdens, even though such fractures have only a minor effect on survival in community-dwelling individuals.

Effects of fracture surface roughness and shear displacement on geometrical and hydraulic properties of three-dimensional crossed rock fracture models

NASA Astrophysics Data System (ADS)

Huang, Na; Liu, Richeng; Jiang, Yujing; Li, Bo; Yu, Liyuan

2018-03-01

While shear-flow behavior through fractured media has been so far studied at single fracture scale, a numerical analysis of the shear effect on the hydraulic response of 3D crossed fracture model is presented. The analysis was based on a series of crossed fracture models, in which the effects of fracture surface roughness and shear displacement were considered. The rough fracture surfaces were generated using the modified successive random additions (SRA) algorithm. The shear displacement was applied on one fracture, and at the same time another fracture shifted along with the upper and lower surfaces of the sheared fracture. The simulation results reveal the development and variation of preferential flow paths through the model during the shear, accompanied by the change of the flow rate ratios between two flow planes at the outlet boundary. The average contact area accounts for approximately 5-27% of the fracture planes during shear, but the actual calculated flow area is about 38-55% of the fracture planes, which is much smaller than the noncontact area. The equivalent permeability will either increase or decrease as shear displacement increases from 0 to 4 mm, depending on the aperture distribution of intersection part between two fractures. When the shear displacement continuously increases by up to 20 mm, the equivalent permeability increases sharply first, and then keeps increasing with a lower gradient. The equivalent permeability of rough fractured model is about 26-80% of that calculated from the parallel plate model, and the equivalent permeability in the direction perpendicular to shear direction is approximately 1.31-3.67 times larger than that in the direction parallel to shear direction. These results can provide a fundamental understanding of fluid flow through crossed fracture model under shear.

Porosity, permeability and 3D fracture network characterisation of dolomite reservoir rock samples

PubMed Central

Voorn, Maarten; Exner, Ulrike; Barnhoorn, Auke; Baud, Patrick; Reuschlé, Thierry

2015-01-01

With fractured rocks making up an important part of hydrocarbon reservoirs worldwide, detailed analysis of fractures and fracture networks is essential. However, common analyses on drill core and plug samples taken from such reservoirs (including hand specimen analysis, thin section analysis and laboratory porosity and permeability determination) however suffer from various problems, such as having a limited resolution, providing only 2D and no internal structure information, being destructive on the samples and/or not being representative for full fracture networks. In this paper, we therefore explore the use of an additional method – non-destructive 3D X-ray micro-Computed Tomography (μCT) – to obtain more information on such fractured samples. Seven plug-sized samples were selected from narrowly fractured rocks of the Hauptdolomit formation, taken from wellbores in the Vienna basin, Austria. These samples span a range of different fault rocks in a fault zone interpretation, from damage zone to fault core. We process the 3D μCT data in this study by a Hessian-based fracture filtering routine and can successfully extract porosity, fracture aperture, fracture density and fracture orientations – in bulk as well as locally. Additionally, thin sections made from selected plug samples provide 2D information with a much higher detail than the μCT data. Finally, gas- and water permeability measurements under confining pressure provide an important link (at least in order of magnitude) towards more realistic reservoir conditions. This study shows that 3D μCT can be applied efficiently on plug-sized samples of naturally fractured rocks, and that although there are limitations, several important parameters can be extracted. μCT can therefore be a useful addition to studies on such reservoir rocks, and provide valuable input for modelling and simulations. Also permeability experiments under confining pressure provide important additional insights. Combining these and other methods can therefore be a powerful approach in microstructural analysis of reservoir rocks, especially when applying the concepts that we present (on a small set of samples) in a larger study, in an automated and standardised manner. PMID:26549935

Porosity, permeability and 3D fracture network characterisation of dolomite reservoir rock samples.

PubMed

Voorn, Maarten; Exner, Ulrike; Barnhoorn, Auke; Baud, Patrick; Reuschlé, Thierry

2015-03-01

With fractured rocks making up an important part of hydrocarbon reservoirs worldwide, detailed analysis of fractures and fracture networks is essential. However, common analyses on drill core and plug samples taken from such reservoirs (including hand specimen analysis, thin section analysis and laboratory porosity and permeability determination) however suffer from various problems, such as having a limited resolution, providing only 2D and no internal structure information, being destructive on the samples and/or not being representative for full fracture networks. In this paper, we therefore explore the use of an additional method - non-destructive 3D X-ray micro-Computed Tomography (μCT) - to obtain more information on such fractured samples. Seven plug-sized samples were selected from narrowly fractured rocks of the Hauptdolomit formation, taken from wellbores in the Vienna basin, Austria. These samples span a range of different fault rocks in a fault zone interpretation, from damage zone to fault core. We process the 3D μCT data in this study by a Hessian-based fracture filtering routine and can successfully extract porosity, fracture aperture, fracture density and fracture orientations - in bulk as well as locally. Additionally, thin sections made from selected plug samples provide 2D information with a much higher detail than the μCT data. Finally, gas- and water permeability measurements under confining pressure provide an important link (at least in order of magnitude) towards more realistic reservoir conditions. This study shows that 3D μCT can be applied efficiently on plug-sized samples of naturally fractured rocks, and that although there are limitations, several important parameters can be extracted. μCT can therefore be a useful addition to studies on such reservoir rocks, and provide valuable input for modelling and simulations. Also permeability experiments under confining pressure provide important additional insights. Combining these and other methods can therefore be a powerful approach in microstructural analysis of reservoir rocks, especially when applying the concepts that we present (on a small set of samples) in a larger study, in an automated and standardised manner.

Characterizing Fractures Across the Astronaut Corps: Preliminary Findings from Population-Level Analysis

NASA Technical Reports Server (NTRS)

Rossi, Meredith M.; Charvat, Jacqueline M.; Sibonga, Jean D.; Sieker, Jeremy

2017-01-01

Despite evidence of bone loss during spaceflight and the implementation of countermeasures to mitigate this loss, the subsequent risk of fracture among astronauts is not known. Multiple factors such as age, sex, fracture history, and others may combine to increase fracture risk. The purpose of this study was to describe fractures among the astronaut population and generate questions for future occupational surveillance studies.

Analysis of the flow property of aluminum alloy AA6016 based on the fracture morphology using the hydroforming technology

NASA Astrophysics Data System (ADS)

Lang, Lihui; Zhang, Quanda; Sun, Zhiying; Wang, Yao

2017-09-01

In this paper, the hydraulic bulging experiments were respectively carried out using AA6016-T4 aluminum alloy and AA6016-O aluminum alloy, and the deformation properties and fracture mechanism of aluminum alloy under the conditions of thermal and hydraulic were analyzed. Firstly, the aluminum alloy AA6016 was dealt with two kinds of heat treatment systems such as solid solution heat treatment adding natural ageing and full annealing, then the aluminum alloy such as AA6016-T4 and AA6016-O were obtained. In the same working environment, the two kinds of materials were used in the process of hydraulic bulging experiments, according to the observation and measurement of the deformation sizes of grid circles and material thicknesses near the fracture region, the flow properties and development trend of fracture defect of the materials were analyzed comprehensively from the perspective of qualitative analysis and quantitative analysis; Secondly, the two kinds of materials were sampled in different regions of the fracture area and the microstructure morphology of the fracture was observed by the scanning electron microscope (SEM). The influence laws of the heat treatment systems on the fracture defect of the aluminum alloy under the condition of the liquid pressure were studied preliminarily by observing the distribution characteristics of the fracture microstructure morphology of dimple. At the same time, the experimental research on the ordinary stamping forming process of AA6016-O was carried out and the influence law of different forming process on the fracture defect of the aluminum alloy material was studied by observing the distribution of the fracture microstructure morphology; Finally, the development process of the fracture defect of aluminum alloy sheet was described theoretically from the view of the stress state.

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

PubMed

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

2014-08-01

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

Investigation of Weibull statistics in fracture analysis of cast aluminum

NASA Technical Reports Server (NTRS)

Holland, Frederic A., Jr.; Zaretsky, Erwin V.

1989-01-01

The fracture strengths of two large batches of A357-T6 cast aluminum coupon specimens were compared by using two-parameter Weibull analysis. The minimum number of these specimens necessary to find the fracture strength of the material was determined. The applicability of three-parameter Weibull analysis was also investigated. A design methodology based on the combination of elementary stress analysis and Weibull statistical analysis is advanced and applied to the design of a spherical pressure vessel shell. The results from this design methodology are compared with results from the applicable ASME pressure vessel code.

Fractured reservoir characterization through injection, falloff, and flowback tests

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

Peng, C.P.; Singh, P.K.; Halvorsen, H.

1992-09-01

This paper presents the development of a multiphase pressure-transient-analysis technique for naturally fractured reservoirs and the analysis of a series of field tests performed to evaluate the water injection potential and the reservoir characteristics of a naturally fractured reservoir. These included step-rate, water-injectivity, pressure-falloff, and flowback tests. Through these tests, a description of the reservoir was obtained.

Hydraulic Fracture Extending into Network in Shale: Reviewing Influence Factors and Their Mechanism

PubMed Central

Ren, Lan; Zhao, Jinzhou; Hu, Yongquan

2014-01-01

Hydraulic fracture in shale reservoir presents complex network propagation, which has essential difference with traditional plane biwing fracture at forming mechanism. Based on the research results of experiments, field fracturing practice, theory analysis, and numerical simulation, the influence factors and their mechanism of hydraulic fracture extending into network in shale have been systematically analyzed and discussed. Research results show that the fracture propagation in shale reservoir is influenced by the geological and the engineering factors, which includes rock mineral composition, rock mechanical properties, horizontal stress field, natural fractures, treating net pressure, fracturing fluid viscosity, and fracturing scale. This study has important theoretical value and practical significance to understand fracture network propagation mechanism in shale reservoir and contributes to improving the science and efficiency of shale reservoir fracturing design. PMID:25032240

The Effect of Vitamin A on Fracture Risk: A Meta-Analysis of Cohort Studies

PubMed Central

Zhang, Xinge; Zhang, Rui; Wang, Yueqiao; Yan, Hanyi; Wu, Yingru; Tan, Anran; Fu, Jialin; Shen, Ziqiong; Qin, Guiyu; Li, Rui; Chen, Guoxun

2017-01-01

This meta-analysis evaluated the influence of dietary intake and blood level of vitamin A (total vitamin A, retinol or β-carotene) on total and hip fracture risk. Cohort studies published before July 2017 were selected through English-language literature searches in several databases. Relative risk (RR) with corresponding 95% confidence interval (CI) was used to evaluate the risk. Heterogeneity was checked by Chi-square and I2 test. Sensitivity analysis and publication bias were also performed. For the association between retinol intake and total fracture risk, we performed subgroup analysis by sex, region, case ascertainment, education level, age at menopause and vitamin D intake. R software was used to complete all statistical analyses. A total of 319,077 participants over the age of 20 years were included. Higher dietary intake of retinol and total vitamin A may slightly decrease total fracture risk (RR with 95% CI: 0.95 (0.91, 1.00) and 0.94 (0.88, 0.99), respectively), and increase hip fracture risk (RR with 95% CI: 1.40 (1.02, 1.91) and 1.29 (1.06, 1.57), respectively). Lower blood level of retinol may slightly increase total fracture risk (RR with 95% CI: 1.11 (0.94, 1.30)) and hip fracture risk (RR with 95% CI: 1.27 (1.05, 1.53)). In addition, higher β-carotene intake was weakly associated with the increased risk of total fracture (RR with 95% CI: 1.07 (0.97, 1.17)). Our data suggest that vitamin A intake and level may differentially influence the risks of total and hip fractures. Clinical trials are warranted to confirm these results and assess the clinical applicability. PMID:28891953

Analysis of severely fractured glenoid components: clinical consequences of biomechanics, design, and materials selection on implant performance.

PubMed

Ansari, Farzana; Lee, Taylor; Malito, Louis; Martin, Audrey; Gunther, Stephen B; Harmsen, Samuel; Norris, Tom R; Ries, Mike; Van Citters, Douglas; Pruitt, Lisa

2016-07-01

The longevity of total shoulder replacement is primarily limited by the performance of the ultrahigh-molecular-weight polyethylene (UHMWPE) glenoid component in vivo. Variations in glenoid design (conformity, thickness), biomechanics (joint kinematics), and UHMWPE material selection (sterilization, cross-linking) distinguish total shoulder replacements from hip and knee arthroplasty devices. These variables can lead to severe mechanical failures, including gross fracture. Sixteen retrieved glenoids with severe fracture were analyzed. The explant cohort included 3 material groups (gamma-sterilized Hylamer; gamma-sterilized UHMWPE; and gas plasma-sterilized, remelted, highly cross-linked UHMWPE [HXL]) and a range of conformities (0- to 10-mm radial mismatch). Analysis included fractography (optical and scanning electron microscopy) and Fourier transform infrared spectroscopy for oxidative analysis. Fracture primarily occurred along the exterior rim for all 16 explants. Fourier transform infrared analysis and fractography revealed significant oxidative embrittlement for all gamma-sterilized glenoids. Fatigue striations and internal flaws were evident on the fracture surface of the HXL glenoid, with little oxidation detected. Fracture initiated at the external rim of all devices. Elevated oxidation levels and visible material distortion for representative gamma-sterilized conventional and Hylamer devices suggest oxidative embrittlement as a driving force for crack inception and subsequent fracture. Brittle fracture of theHXL glenoid resulted from a combination of elevated contact stress due to a nonconforming surface, an internal flaw, and reduced resistance to fatigue crack growth. This demonstrates that glenoid fracture associated with oxidation has not been eliminated with the advent of modern materials (HXL) in the shoulder domain. Basic Science Study; Implant Retrieval Study. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2017 GTO Project review Laboratory Evaluation of EGS Shear Stimulation.

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

Bauer, Stephen J.

The objectives and purpose of this research has been to produce laboratory-based experimental and numerical analyses to provide a physics-based understanding of shear stimulation phenomena (hydroshearing) and its evolution during stimulation. Water was flowed along fractures in hot and stressed fractured rock, to promote slip. The controlled laboratory experiments provide a high resolution/high quality data resource for evaluation of analysis methods developed by DOE to assess EGS “behavior” during this stimulation process. Segments of the experimental program will provide data sets for model input parameters, i.e., material properties, and other segments of the experimental program will represent small scale physicalmore » models of an EGS system, which may be modeled. The coupled lab/analysis project has been a study of the response of a fracture in hot, water-saturated fractured rock to shear stress experiencing fluid flow. Under this condition, the fracture experiences a combination of potential pore pressure changes and fracture surface cooling, resulting in slip along the fracture. The laboratory work provides a means to assess the role of “hydroshearing” on permeability enhancement in reservoir stimulation. Using the laboratory experiments and results to define boundary and input/output conditions of pore pressure, thermal stress, fracture shear deformation and fluid flow, and models were developed and simulations completed by the University of Oklahoma team. The analysis methods are ones used on field scale problems. The sophisticated numerical models developed contain parameters present in the field. The analysis results provide insight into the role of fracture slip on permeability enhancement-“hydroshear” is to be obtained. The work will provide valuable input data to evaluate stimulation models, thus helping design effective EGS.« less

Fracture mapping and strip mine inventory in the Midwest by using ERTS-1 imagery

NASA Technical Reports Server (NTRS)

Wier, C. W.; Wobber, F. J.; Russell, O. R.; Amato, R. V.

1973-01-01

Analysis of the ERTS-1 imagery and high-altitude infrared photography indicates that useful fracture data can be obtained in Indiana and Illinois despite a glacial till cover. ERTS MSS bands 5 and 7 have proven most useful for fracture mapping in coal-bearing rocks in this region. Preliminary results suggest a reasonable correlation between image-detected fractures and mine roof-fall accidents. Information related to surface mined land, such as disturbed area, water bodies, and kind of reclamation, has been derived from the analysis of ERTS imagery.

External validation of the Garvan nomograms for predicting absolute fracture risk: the Tromsø study.

PubMed

Ahmed, Luai A; Nguyen, Nguyen D; Bjørnerem, Åshild; Joakimsen, Ragnar M; Jørgensen, Lone; Størmer, Jan; Bliuc, Dana; Center, Jacqueline R; Eisman, John A; Nguyen, Tuan V; Emaus, Nina

2014-01-01

Absolute risk estimation is a preferred approach for assessing fracture risk and treatment decision making. This study aimed to evaluate and validate the predictive performance of the Garvan Fracture Risk Calculator in a Norwegian cohort. The analysis included 1637 women and 1355 aged 60+ years from the Tromsø study. All incident fragility fractures between 2001 and 2009 were registered. The predicted probabilities of non-vertebral osteoporotic and hip fractures were determined using models with and without BMD. The discrimination and calibration of the models were assessed. Reclassification analysis was used to compare the models performance. The incidence of osteoporotic and hip fracture was 31.5 and 8.6 per 1000 population in women, respectively; in men the corresponding incidence was 12.2 and 5.1. The predicted 5-year and 10-year probability of fractures was consistently higher in the fracture group than the non-fracture group for all models. The 10-year predicted probabilities of hip fracture in those with fracture was 2.8 (women) to 3.1 times (men) higher than those without fracture. There was a close agreement between predicted and observed risk in both sexes and up to the fifth quintile. Among those in the highest quintile of risk, the models over-estimated the risk of fracture. Models with BMD performed better than models with body weight in correct classification of risk in individuals with and without fracture. The overall net decrease in reclassification of the model with weight compared to the model with BMD was 10.6% (p = 0.008) in women and 17.2% (p = 0.001) in men for osteoporotic fractures, and 13.3% (p = 0.07) in women and 17.5% (p = 0.09) in men for hip fracture. The Garvan Fracture Risk Calculator is valid and clinically useful in identifying individuals at high risk of fracture. The models with BMD performed better than those with body weight in fracture risk prediction.

Linear Elastic and Cohesive Fracture Analysis to Model Hydraulic Fracture in Brittle and Ductile Rocks

NASA Astrophysics Data System (ADS)

Yao, Yao

2012-05-01

Hydraulic fracturing technology is being widely used within the oil and gas industry for both waste injection and unconventional gas production wells. It is essential to predict the behavior of hydraulic fractures accurately based on understanding the fundamental mechanism(s). The prevailing approach for hydraulic fracture modeling continues to rely on computational methods based on Linear Elastic Fracture Mechanics (LEFM). Generally, these methods give reasonable predictions for hard rock hydraulic fracture processes, but still have inherent limitations, especially when fluid injection is performed in soft rock/sand or other non-conventional formations. These methods typically give very conservative predictions on fracture geometry and inaccurate estimation of required fracture pressure. One of the reasons the LEFM-based methods fail to give accurate predictions for these materials is that the fracture process zone ahead of the crack tip and softening effect should not be neglected in ductile rock fracture analysis. A 3D pore pressure cohesive zone model has been developed and applied to predict hydraulic fracturing under fluid injection. The cohesive zone method is a numerical tool developed to model crack initiation and growth in quasi-brittle materials considering the material softening effect. The pore pressure cohesive zone model has been applied to investigate the hydraulic fracture with different rock properties. The hydraulic fracture predictions of a three-layer water injection case have been compared using the pore pressure cohesive zone model with revised parameters, LEFM-based pseudo 3D model, a Perkins-Kern-Nordgren (PKN) model, and an analytical solution. Based on the size of the fracture process zone and its effect on crack extension in ductile rock, the fundamental mechanical difference of LEFM and cohesive fracture mechanics-based methods is discussed. An effective fracture toughness method has been proposed to consider the fracture process zone effect on the ductile rock fracture.

Orbital fracture and eyeball rupture caused by golf-club injury.

PubMed

Hwang, Kun; Kim, Joo Ho

2014-05-01

We report a case of an orbital fracture and an eyeball rupture caused by a golf-club injury. A 75-year-old man was struck in his right eye by a golf club while watching behind his son swinging a hybrid-type golf club at his home. A 70-mm muscle-depth laceration was present in the infraorbital area with active bleeding. Computed tomographic imaging of the face revealed a rupture of the right eyeball; fractures in the superior, medial, lateral, and inferior wall of the right orbit; a fracture in the right zygomaticofrontal junction; and a small amount of pneumocephalus in the parafalx region. Under general anesthesia, evisceration of the right eyeball was performed. Not only golfers but also people just watching or passing by can be injured by an errantly struck golf ball or swung golf club. Elderly people as well as children should be instructed in technique and safety and also be supervised when playing golf. Also, the public should be educated about the risk of eye injuries and the benefits of wearing a protective eyewear.

Research and application of absorbable screw in orthopedics: a clinical review comparing PDLLA screw with metal screw in patients with simple medial malleolus fracture.

PubMed

Tang, Jin; Hu, Jin-feng; Guo, Wei-chun; Yu, Ling; Zhao, Sheng-hao

2013-01-01

To observe the therapeutic effect of absorbable screw in medial malleolus fracture and discuss its clinical application in orthopedics. A total of 129 patients with simple medial malleolus fracture were studied. Among them, 64 patients were treated with poly-D, L-lactic acid (PDLLA) absorbable screws, while the others were treated with metal screws. All the patients were followed up for 12-20 months (averaged 18.4 months) and the therapeutic effect was evaluated according to the American Orthopaedic Foot and Ankle Society clinical rating systems. In absorbable screw group, we obtained excellent and good results in 62 cases (96.88%); in steel screw group, 61 cases (93.85%) achieved excellent and good results. There was no significant difference between the two groups. In the treatment of malleolus fracture, absorbable screw can achieve the same result compared with metal screw fixation. Absorbable screw is preferred due to its advantages of safety, cleanliness and avoiding the removal procedure associated with metallic implants.

Osteogenesis imperfecta: diagnosis and treatment.

PubMed

Palomo, Telma; Vilaça, Tatiane; Lazaretti-Castro, Marise

2017-12-01

Here we summarize the diagnosis of osteogenesis imperfecta, discuss newly discovered genes involved in osteogenesis imperfecta, and review the management of this disease in children and adults. Mutations in the two genes coding for collagen type I, COL1A1 and COL1A2, are the most common cause of osteogenesis imperfecta. In the past 10 years, defects in at least 17 other genes have been identified as responsible for osteogenesis imperfecta phenotypes, with either dominant or recessive transmission. Intravenous bisphosphonate infusions are the most widely used medical treatment. This has a marked effect on vertebra in growing children and can lead to vertebral reshaping after compression fractures. However, bisphosphonates are less effective for preventing long-bone fractures. At the moment, new therapies are under investigation. Despite advances in the diagnosis and treatment of osteogenesis imperfecta, more research is needed. Bisphosphonate treatment decreases long-bone fracture rates, but such fractures are still frequent. New antiresorptive and anabolic agents are being investigated but efficacy and safety of these drugs, especially in children, need to be better established before they can be used in clinical practice.

Analysis of stress fractures in athletes based on our clinical experience

PubMed Central

Iwamoto, Jun; Sato, Yoshihiro; Takeda, Tsuyoshi; Matsumoto, Hideo

2011-01-01

AIM: To analyze stress fractures in athletes based on experience from our sports medicine clinic. METHODS: We investigated the association between stress fractures and age, sex, sports level, sports activity, and skeletal site in athletes seen at our sports medicine clinic between September 1991 and April 2009. Stress fractures of the pars interarticularis were excluded from this analysis. RESULTS: During this period (18 years and 8 mo), 14276 patients (9215 males and 5061 females) consulted our clinic because of sports-related injuries, and 263 patients (1.8%) [171 males (1.9%) and 92 females (1.8%)] sustained stress fractures. The average age of the patients with stress fractures was 20.2 years (range 10-46 years); 112 patients (42.6%) were 15-19 years of age and 90 (34.2%) were 20-24 years of age. Altogether, 90 patients (34.2%) were active at a high recreational level and 173 (65.8%) at a competitive level. The highest proportion of stress fractures was seen in basketball athletes (21.3%), followed by baseball (13.7%), track and field (11.4%), rowing (9.5%), soccer (8.4%), aerobics (5.3%), and classical ballet (4.9%). The most common sites of stress fractures in these patients were the tibia (44.1%), followed by the rib (14.1%), metatarsal bone (12.9%), ulnar olecranon (8.7%) and pelvis (8.4%). The sites of the stress fractures varied from sport to sport. The ulnar olecranon was the most common stress fracture site in baseball players, and the rib was the most common in rowers. Basketball and classical ballet athletes predominantly sustained stress fractures of the tibia and metatarsal bone. Track and field and soccer athletes predominantly sustained stress fractures of the tibia and pubic bone. Aerobics athletes predominantly sustained stress fractures of the tibia. Middle and long distance female runners who sustained multiple stress fractures had the female athlete triad. CONCLUSION: The results of this analysis showed that stress fractures were seen in high-level young athletes, with similar proportions for males and females, and that particular sports were associated with specific sites for stress fractures. Middle and long distance female runners who suffered from multiple stress fractures had the female athlete triad. PMID:22474626

Multi-scale fracture damage associated with underground chemical explosions

NASA Astrophysics Data System (ADS)

Swanson, E. M.; Sussman, A. J.; Wilson, J. E.; Townsend, M. J.; Prothro, L. B.; Gang, H. E.

2018-05-01

Understanding rock damage induced by explosions is critical for a number of applications including the monitoring and verification of underground nuclear explosions, mine safety issues, and modeling fluid flow through fractured rock. We use core observations, televiewer logs, and thin section observations to investigate fracture damage associated with two successive underground chemical explosions (SPE2 and SPE3) in granitic rock at both the mesoscale and microscale. We compare the frequency and orientations of core-scale fractures, and the frequency of microfractures, between a pre-experiment core and three post-experiment cores. Natural fault zones and explosion-induced fractures in the vicinity of the explosive source are readily apparent in recovered core and in thin sections. Damage from faults and explosions is not always apparent in fracture frequency plots from televiewer logs, although orientation data from these logs suggests explosion-induced fracturing may not align with the pre-existing fracture sets. Core-scale observations indicate the extent of explosion-induced damage is 10.0 m after SPE2 and 6.8 m after SPE3, despite both a similar size and location for both explosions. At the microscale, damage is observed to a range distance of 10.2 ± 0.9 m after SPE2, and 16.6 ± 0.9 and 11.2 ± 0.6 in two different cores collected after SPE3. Additional explosion-induced damage, interpreted to be the result of spalling, is readily apparent near the surface, but only in the microfracture data. This depth extent and intensity of damage in the near-surface region also increased after an additional explosion. This study highlights the importance of evaluating structural damage at multiple scales for a more complete characterization of the damage, and particularly shows the importance of microscale observations for identifying spallation-induced damage.

Aromatase inhibitors associated musculoskeletal disorders and bone fractures in postmenopausal breast cancer patients: a result from Chinese population.

PubMed

Xu, Lu; Wang, Jue; Xue, Dan-Dan; He, Wei

2014-09-01

As the prognosis of early breast cancer patients improves, the long-term safety of aromatase inhibitors (AIs) is increasingly important. In the present study, we retrospectively investigated the incidences of musculoskeletal disorders (MSDs) and bone fractures in a cohort of Chinese postmenopausal patients with breast cancer. Data of postmenopausal patients with breast cancer were collected. Among which, 70 patients received AIs therapy (median follow-up of 32.5 months), 52 patients received tamoxifen (TAM), and 89 patients received no endocrine therapy (NE). Baseline characteristics, incidence of MSDs and bone fractures were analyzed and compared. When compared with NE group (40.4 %, 36/89), more patients in AIs group developed MSDs (72.9 %, 51/70, adjusted odds ratio (AOR) = 3.30, 95 % confidence interval (CI) = 1.59-6.88, P = 0.001). But no difference was found between TAM group (36.5 %, 19/52, AOR = 0.70, 95 % CI = 0.32-1.52, P = 0.372) and NE group. About 39.7 months after initial AIs therapy, nine patients in AI group developed bone fractures in different sites, and the bone fracture rate was significantly increased (12.9 %, 9/70, adjusted hazard ratio (AHR) = 20.08, 95 % CI = 1.72-234.08, P = 0.017) in comparison with NE group (1.1 %, 1/89). Moreover, the bone fracture rate of TAM group was not different from NE group (1.9 %, 1/52, AHR = 2.64, 95 % CI = 0.14-48.73, P = 0.513). AIs therapy may induce increased rates of MSDs and bone fractures in Chinese population of postmenopausal breast cancer patients, whereas TAM therapy did not help reduce the incidences of MSDs and bone fractures.

Economic viability of geriatric hip fracture centers.

PubMed

Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

2013-12-01

Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers.

On the Problems of Cracking and the Question of Structural Integrity of Engineering Composite Materials

NASA Astrophysics Data System (ADS)

Beaumont, Peter W. R.

2014-02-01

Predicting precisely where a crack will develop in a material under stress and exactly when in time catastrophic fracture of the component will occur is one the oldest unsolved mysteries in the design and building of large engineering structures. Where human life depends upon engineering ingenuity, the burden of testing to prove a "fracture safe design" is immense. For example, when human life depends upon structural integrity as an essential design requirement, it takes ten thousand material test coupons per composite laminate configuration to evaluate an airframe plus loading to ultimate failure tails, wing boxes, and fuselages to achieve a commercial aircraft airworthiness certification. Fitness considerations for long-life implementation of aerospace composites include understanding phenomena such as impact, fatigue, creep, and stress corrosion cracking that affect reliability, life expectancy, and durability of structure. Structural integrity analysis treats the design, the materials used, and figures out how best components and parts can be joined. Furthermore, SI takes into account service duty. However, there are conflicting aims in the complete design process of designing simultaneously for high efficiency and safety assurance throughout an economically viable lifetime with an acceptable level of risk.

A simplified technique for polymethyl methacrylate cranioplasty: combined cotton stacking and finger fracture method.

PubMed

Kung, Woon-Man; Lin, Muh-Shi

2012-01-01

Polymethyl methacrylate (PMMA) is one of the most frequently used cranioplasty materials. However, limitations exist with PMMA cranioplasty including longer operative time, greater blood loss and a higher infection rate. To reduce these disadvantages, it is proposed to introduce a new surgical method for PMMA cranioplasty. Retrospective review of nine patients who received nine PMMA implants using combined cotton stacking and finger fracture method from January 2008 to July 2011. The definitive height of skull defect was quantified by computer-based image analysis of computed tomography (CT) scans. Aesthetic outcomes as measured by post-reduction radiographs and cranial index of symmetry (CIS), cranial nerve V and VII function and complications (wound infection, hardware extrusions, meningitis, osteomyelitis and brain abscess) were evaluated. The mean operation time for implant moulding was 24.56 ± 4.6 minutes and 178.0 ± 53 minutes for skin-to-skin. Average blood loss was 169 mL. All post-operative radiographs revealed excellent reduction. The mean CIS score was 95.86 ± 1.36%, indicating excellent symmetry. These results indicate the safety, practicability, excellent cosmesis, craniofacial symmetry and stability of this new surgical technique.

Ibandronate treatment for osteoporosis: rationale, preclinical, and clinical development of extended dosing regimens.

PubMed

Epstein, Solomon

2006-03-01

Ibandronate is a potent nitrogen-containing bisphosphonate available as a once-monthly oral formulation for the treatment and prevention of osteoporosis. Preclinical experiments with estrogen-depleted rats, dogs, and monkeys demonstrated the efficacy of daily and intermittent ibandronate dosing. Initial clinical trials explored the optimal dosing regimens for oral administration in humans. The Oral Ibandronate Osteoporosis Vertebral Fracture Trial in North America and Europe (BONE) and Monthly Oral Ibandronate in Ladies (MOBILE) trials demonstrated that long-term daily and intermittent administration of ibandronate was efficacious for increasing bone mineral density, reducing markers of bone turnover, and preventing fractures, while maintaining bone quality. These preclinical and clinical ibandronate trials provided progressive evidence that a simple, long interval dosing regimen could offer efficacy and safety comparable with currently available bisphosphonates. It is anticipated that once-monthly ibandronate may have a positive impact on patient adherence, and ultimately, on fracture protection in osteoporotic women.

The safety and effectiveness profile of eldecalcitol in a prospective, post-marketing observational study in Japanese male patients with osteoporosis.

PubMed

Kondo, Satoshi; Kakihata, Hiroyuki; Nishida, Yosuke; Furuno, Yuko; Kobayashi, Yumiko; Tabata, Hidehiro; Nomura, Makoto

2018-03-12

We conducted a post-marketing observational study to investigate the safety and effectiveness of eldecalcitol for the treatment of osteoporosis in a Japanese clinical setting. The observation period was 12 months for women and 36 months for men. The final results for the female patients have already been published. In this article, the final results for the male patients are reported. A total of 470 male osteoporosis patients were enrolled. The safety analysis set included 431 patients (mean age, 76.8 years; mean ± SD follow-up period, 631.0 ± 450.3 days), and 175 patients continued treatment throughout the 3-year observational period. Adverse drug reactions (ADRs) were reported in 28 patients (6.49%); the most common ADRs were hypercalcemia (1.16%) and renal impairment (1.16%). Serious ADRs were reported in 5 patients (1.16%). Mean serum calcium was within the normal range throughout the observation period. The cumulative incidence of new vertebral and nonvertebral fractures at 36 months, estimated by Kaplan-Meier analysis, was 10.23 and 4.06%, respectively. At the last observation, mean lumbar spine bone mineral density was 3.49% higher (P < 0.0001) than at baseline, and levels of the bone turnover markers BAP and TRACP-5b were reduced (-14.64%; P = 0.0009, and - 29.51%; P < 0.0001, respectively). In conclusion, the safety and effectiveness of eldecalcitol for the treatment of Japanese male osteoporosis patients was confirmed in clinical practice. Careful monitoring of serum calcium and estimated glomerular filtration rate, both before and during treatment, is necessary to minimize the risk of hypercalcemia and renal impairment while maximizing the effectiveness of eldecalcitol.

Rigid fixation of facial fractures in children.

PubMed

Koltai, P J; Rabkin, D; Hoehn, J

1995-01-01

This article presents a retrospective analysis of a selective use of rigid fixation among 62 children with facial fractures, treated at a Level I trauma center over a 5-year period (1986-1991). There were 21 mandible fractures, 11 orbital fractures, 11 zygomaticomalar complex fractures, 7 nasal fractures, 5 maxillary fractures, 3 pan-facial fractures, 2 nasal-orbital-ethmoidal complex fractures, and 2 frontal sinus fractures. Only 18 children had rigid fixation of their injuries. Complications of Le Fort upper facial fractures repaired with rigid fixation involved perioperative sinusitis; one case required oral antibiotics, the other ethmoidectomy and maxillary antrostomy. One child with a Le Fort fracture had delayed exposure of a zygomaticomalar buttress plate, which required surgical removal. Permanent enophthalmos occurred in two children with Le Fort fractures. The authors conclude that traditional conservative management is appropriate in most cases. However, in children aged 13 and older with mandible fractures and children with complex mid- and upper facial fractures, a judicious use of rigid fixation has advantages over the traditional techniques.

Adherence to a Mediterranean-style diet and incident fractures: pooled analysis of observational evidence.

PubMed

Kunutsor, Setor K; Laukkanen, Jari A; Whitehouse, Michael R; Blom, Ashley W

2018-06-01

The Mediterranean diet is associated with decreased morbidity and mortality from various chronic diseases. Adherence to a Mediterranean-style diet has been suggested to have protective effects on bone health and decreases the incidence of bone fractures, but the evidence is not clear. We conducted a systematic review and meta-analysis of available observational studies to quantify the association between adherence to a Mediterranean-style diet, as assessed by the Mediterranean Diet Score (MDS), and the risk of fractures in the general population. Relevant studies were identified in a literature search of MEDLINE, EMBASE, Web of Science, and reference lists of relevant studies to October 2016. Relative risks (RRS) with 95% confidence intervals (CIs) were aggregated using random-effects models. Five observational studies with data on 353,076 non-overlapping participants and 33,576 total fractures (including 6,881 hip fractures) were included. The pooled fully adjusted RR (95% CI) for hip fractures per 2-point increment in adherence to the MDS was 0.82 (0.71-0.96). Adherence to the MDS was not associated with the risk of any or total fractures based on pooled analysis of only two studies. Limited observational evidence supports a beneficial effect of adherence to a Mediterranean-style diet on the incidence of hip fractures. Well-designed intervention studies are needed to elucidate the relationship between adherence to a Mediterranean-style diet and the risk of adverse bone health outcomes such as fractures.

Prior ankle fractures in postmenopausal women are associated with low areal bone mineral density and bone microstructure alterations.

PubMed

Biver, E; Durosier, C; Chevalley, T; Herrmann, F R; Ferrari, S; Rizzoli, R

2015-08-01

In a cross-sectional analysis in postmenopausal women, prior ankle fractures were associated with lower areal bone mineral density (BMD) and trabecular bone alterations compared to no fracture history. Compared to women with forearm fractures, microstructure alterations were of lower magnitude. These data suggest that ankle fractures are another manifestation of bone fragility. Whether ankle fractures represent fragility fractures associated with low areal bone mineral density (aBMD) and volumetric bone mineral density (vBMD) and/or bone microstructure alterations remains unclear, in contrast to the well-recognised association between forearm fractures and osteoporosis. The objective of this study was to investigate aBMD, vBMD and bone microstructure in postmenopausal women with prior ankle fracture in adulthood, compared with women without prior fracture or with women with prior forearm fractures, considered as typically of osteoporotic origin. In a cross-sectional analysis in the Geneva Retirees Cohort study, 63 women with ankle fracture and 59 with forearm fracture were compared to 433 women without fracture (mean age, 65 ± 1 years). aBMD was measured by dual-energy X-ray absorptiometry; distal radius and tibia vBMD and bone microstructure were measured by high-resolution peripheral quantitative computed tomography. Compared with women without fracture, those with ankle fractures had lower aBMD, radius vBMD (-7.9%), trabecular density (-10.7%), number (-7.3%) and thickness (-4.6%) and higher trabecular spacing (+14.5%) (P < 0.05 for all). Tibia trabecular variables were also altered. For 1 standard deviation decrease in total hip aBMD or radius trabecular density, odds ratios for ankle fractures were 2.2 and 1.6, respectively, vs 2.2 and 2.7 for forearm fracture, respectively (P ≤ 0.001 for all). Compared to women with forearm fractures, those with ankle fractures had similar spine and hip aBMD, but microstructure alterations of lower magnitude. Women with ankle fractures have lower aBMD and vBMD and trabecular bone alterations, suggesting that ankle fractures are another manifestation of bone fragility.

Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial.

PubMed

Katzman, W B; Vittinghoff, E; Kado, D M; Lane, N E; Ensrud, K E; Shipp, K

2016-03-01

Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. We used data from the Fracture Intervention Trial among 3038 women 55-81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Mean baseline kyphosis was 48° (SD = 12) (range 7-83). At baseline, 962 (32%) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95% CI 2.8-4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22% increase (95% CI 8-38%, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8% per 10° kyphosis (95% CI -4 to 22%, p = 0.18). While greater kyphosis increased the rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture.

Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial

PubMed Central

Vittinghoff, E.; Kado, D. M.; Lane, N. E.; Ensrud, K. E.; Shipp, K.

2016-01-01

Summary Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Introduction Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. Methods We used data from the Fracture Intervention Trial among 3038 women 55–81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Results Mean baseline kyphosis was 48° (SD = 12) (range 7–83). At baseline, 962 (32 %) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95 % CI 2.8–4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22 % increase (95 % CI 8–38 %, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8 % per 10° kyphosis (95 % CI −4 to 22 %, p = 0.18). Conclusions While greater kyphosis increased the rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. PMID:26782685

Do Concomitant Cranium and Axis Injuries Predict Worse Outcome? A Trauma Database Quantitative Analysis

PubMed Central

Chittiboina, Prashant; Banerjee, Anirban Deep; Nanda, Anil

2011-01-01

We performed a trauma database analysis to identify the effect of concomitant cranial injuries on outcome in patients with fractures of the axis. We identified patients with axis fractures over a 14-year period. A binary outcome measure was used. Univariate and multiple logistic regression analysis were performed. There were 259 cases with axis fractures. Closed head injury was noted in 57% and skull base trauma in 14%. Death occurred in 17 cases (6%). Seventy-two percent had good outcome. Presence of abnormal computed tomography head findings, skull base fractures, and visceral injury was significantly associated with poor outcome. Skull base injury in association with fractures of the axis is a significant independent predictor of worse outcomes, irrespective of the severity of the head injury. We propose that presence of concomitant cranial and upper vertebral injuries require careful evaluation in view of the associated poor prognosis. PMID:22470268

Stress analysis of implant-bone fixation at different fracture angle

NASA Astrophysics Data System (ADS)

Izzawati, B.; Daud, R.; Afendi, M.; Majid, MS Abdul; Zain, N. A. M.; Bajuri, Y.

2017-10-01

Internal fixation is a mechanism purposed to maintain and protect the reduction of a fracture. Understanding of the fixation stability is necessary to determine parameters influence the mechanical stability and the risk of implant failure. A static structural analysis on a bone fracture fixation was developed to simulate and analyse the biomechanics of a diaphysis shaft fracture with a compression plate and conventional screws. This study aims to determine a critical area of the implant to be fractured based on different implant material and angle of fracture (i.e. 0°, 30° and 45°). Several factors were shown to influence stability to implant after surgical. The stainless steel, (S. S) and Titanium, (Ti) screws experienced the highest stress at 30° fracture angle. The fracture angle had a most significant effect on the conventional screw as compared to the compression plate. The stress was significantly higher in S.S material as compared to Ti material, with concentrated on the 4th screw for all range of fracture angle. It was also noted that the screws closest to the intense concentration stress areas on the compression plate experienced increasing amounts of stress. The highest was observed at the screw thread-head junction.

Fractures in Kidney Transplant Recipients: A Comparative Study Between England and New York State.

PubMed

Arnold, Julia; Mytton, Jemma; Evison, Felicity; Gill, Paramjit S; Cockwell, Paul; Sharif, Adnan; Ferro, Charles J

2017-11-15

Fractures are associated with high morbidity and are a major concern for kidney transplant recipients. No comparative analysis has yet been conducted between countries in the contemporary era to inform future international prevention trials. Data were obtained from the Hospital Episode Statistics and the Statewide Planning and Research Cooperative databases on all adult kidney transplants performed in England and New York State from 2003 to 2013, respectively, and on posttransplant fracture-related hospitalization from 2003 to 2014. Our analysis included 18 493 English and 11 602 New York State kidney transplant recipients. Overall, 637 English recipients (3.4%) and 398 New York State recipients (3.4%) sustained a fracture, giving an unadjusted event rate of 7.0 and 5.9 per 1000 years, respectively (P = .948). Of these, 147 English (0.8%) and 101 New York State recipients (0.9%) sustained a hip fracture, giving an unadjusted event rate of 1.6 and 1.5 per 1000 years, respectively (P = .480). There were no differences in the cumulative incidence of all fractures or hip fractures. One-year mortality rates after any fracture (9% and 11%) or after a hip fracture (15% and 17%) were not different between cohorts. Contemporaneous English and New York State kidney transplant recipients have similar fracture rates and mortality rates postfracture.

Cost-effectiveness analysis of fixation options for intertrochanteric hip fractures.

PubMed

Swart, Eric; Makhni, Eric C; Macaulay, William; Rosenwasser, Melvin P; Bozic, Kevin J

2014-10-01

Intertrochanteric hip fractures are a major source of morbidity and financial burden, accounting for 7% of osteoporotic fractures and costing nearly $6 billion annually in the United States. Traditionally, "stable" fracture patterns have been treated with an extramedullary sliding hip screw whereas "unstable" patterns have been treated with the more expensive intramedullary nail. The purpose of this study was to identify parameters to guide cost-effective implant choices with use of decision-analysis techniques to model these common clinical scenarios. An expected-value decision-analysis model was constructed to estimate the total costs and health utility based on the choice of a sliding hip screw or an intramedullary nail for fixation of an intertrochanteric hip fracture. Values for critical parameters, such as fixation failure rate, were derived from the literature. Three scenarios were evaluated: (1) a clearly stable fracture (AO type 31-A1), (2) a clearly unstable fracture (A3), or (3) a fracture with questionable stability (A2). Sensitivity analysis was performed to test the validity of the model. The fixation failure rate and implant cost were the most important factors in determining implant choice. When the incremental cost for the intramedullary nail was set at the median value ($1200), intramedullary nailing had an incremental cost-effectiveness ratio of $50,000/quality-adjusted life year when the incremental failure rate of sliding hip screws was 1.9%. When the incremental failure rate of sliding hip screws was >5.0%, intramedullary nails dominated with lower cost and better health outcomes. The sliding hip screw was always more cost-effective for A1 fractures, and the intramedullary nail always dominated for A3 fractures. As for A2 fractures, the sliding hip screw was cost-effective in 70% of the cases, although this was highly sensitive to the failure rate. Sliding hip screw fixation is likely more cost-effective for stable intertrochanteric fractures (A1) or those with questionable stability (A2), whereas intramedullary nail fixation is more cost-effective for reverse obliquity fractures (A3). These conclusions are highly sensitive to the fixation failure rate, which was the major influence on the model results. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Fracture control methods for space vehicles. Volume 2: Assessment of fracture mechanics technology for space shuttle applications

NASA Technical Reports Server (NTRS)

Ehret, R. M.

1974-01-01

The concepts explored in a state of the art review of those engineering fracture mechanics considered most applicable to the space shuttle vehicle include fracture toughness, precritical flaw growth, failure mechanisms, inspection methods (including proof test logic), and crack growth predictive analysis techniques.

Failure analysis of fractured dental zirconia implants.

PubMed

Gahlert, M; Burtscher, D; Grunert, I; Kniha, H; Steinhauser, E

2012-03-01

The purpose of the present study was the macroscopic and microscopic failure analysis of fractured zirconia dental implants. Thirteen fractured one-piece zirconia implants (Z-Look3) out of 170 inserted implants with an average in situ period of 36.75±5.34 months (range from 20 to 56 months, median 38 months) were prepared for macroscopic and microscopic (scanning electron microscopy [SEM]) failure analysis. These 170 implants were inserted in 79 patients. The patient histories were compared with fracture incidences to identify the reasons for the failure of the implants. Twelve of these fractured implants had a diameter of 3.25 mm and one implant had a diameter of 4 mm. All fractured implants were located in the anterior side of the maxilla and mandibula. The patient with the fracture of the 4 mm diameter implant was adversely affected by strong bruxism. By failure analysis (SEM), it could be demonstrated that in all cases, mechanical overloading caused the fracture of the implants. Inhomogeneities and internal defects of the ceramic material could be excluded, but notches and scratches due to sandblasting of the surface led to local stress concentrations that led to the mentioned mechanical overloading by bending loads. The present study identified a fracture rate of nearly 10% within a follow-up period of 36.75 months after prosthetic loading. Ninety-two per cent of the fractured implants were so-called diameter reduced implants (diameter 3.25 mm). These diameter reduced implants cannot be recommended for further clinical use. Improvement of the ceramic material and modification of the implant geometry has to be carried out to reduce the failure rate of small-sized ceramic implants. Nevertheless, due to the lack of appropriate laboratory testing, only clinical studies will demonstrate clearly whether and how far the failure rate can be reduced. © 2011 John Wiley & Sons A/S.

Patients with prior vertebral or hip fractures treated with teriparatide in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study.

PubMed

Beall, D P; Feldman, R G; Gordon, M L; Gruber, B L; Lane, J M; Valenzuela, G; Yim, D; Alam, J; Krege, J H; Krohn, K

2016-03-01

In patients in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study with and without a prior vertebral or hip fracture, the incidence of nonvertebral fractures was lower with >6 months of teriparatide treatment than during the first 6 months. Clinical evidence on the effect of teriparatide in patients with prior fracture is limited. In the DANCE observational study, the incidence of nonvertebral fragility fractures (NVFX) decreased significantly in patients receiving teriparatide for >6 months (6-24 months) versus >0 to ≤6 months (reference period). We performed a post hoc analysis to assess the effect of teriparatide 20 μg/day in patients who entered DANCE with prior vertebral or hip fractures. The incidence of patients experiencing a NVFX for four 6-month intervals during and after treatment was compared with the reference period. Overall, 4085 patients received ≥1 dose of teriparatide. Of 3720 with sufficient data for efficacy analysis, 692 had prior vertebral fracture, including 179 with previous kyphoplasty/vertebroplasty; 290 had prior hip fracture. These patients were older, and those with prior vertebral fractures had more comorbid conditions at baseline than those without prior vertebral fractures. The incidence of patients experiencing NVFX declined over time in all patient groups. The fracture incidence rate declined 49 and 46%, respectively, in patients with and without prior vertebral fracture and was 63 and 46% lower in patients with previous kyphoplasty/vertebroplasty and without prior vertebral fracture. NVFX declined 43 and 48% in patients with and without prior hip fracture. The reduced incidence over time was consistent in the subgroups (all interaction p values >0.05). Patients with prior fracture were more likely to experience serious adverse events. The incidence of NVFX decreased over time in patients receiving teriparatide in DANCE regardless of prior fracture status.

49 CFR 178.705 - Standards for metal IBCs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... a frame with a metal lattice-work casing. (c) Construction requirements for metal IBCs are as... used on fracture under tensile stress (Rm × Ao = 10,000 × 145; if tensile strength is in U.S. Standard...

77 FR 21594 - Duke Energy Carolinas, LLC; Environmental Assessment and Finding of No Significant Impact, Oconee...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... of light-water nuclear power reactors provide adequate margins of safety during any condition of... toughness requirements for protection against pressurized thermal shock (PTS) events. The proposed action... for Protection Against Pressurized Thermal Shock Events,'' and 10 CFR part 50 Appendix G, ``Fracture...

Directed Research in Bone Discipline: Refining Previous Research Observations for Space Medicine

NASA Technical Reports Server (NTRS)

Sibonga, Jean D.

2015-01-01

Dual-energy X-ray absorptiometry bone mass density, as a sole index, is an insufficient surrogate for fracture; Clinical Practice Guidelines using bone mass density (both World Health Organization and FRAX) are not specific for complicated subjects such as young, healthy persons following prolonged exposure to skeletal unloading (i.e. an attribute of spaceflight); Research data suggest that spaceflight induces changes to astronaut bones that could be profound, possibly irreversible and unlike age-related bone loss on Earth.; There is a need to objectively assess factors across human physiology that are also influenced by spaceflight (e.g., muscle) that contribute to fracture risk. Some of these objective assessments may require innovative technologies, analyses and modeling.; Astronauts are also exposed to novel situations that may overload their bones highlighting a need integrate biomechanics of physical activities into risk assessments.; As we accumulate data, which reflects the biomechanical competence of bone under specific mechanically-loaded scenarios (even activities of daily living), BONE expects Bone Fracture Module to be more sensitive and/or have less uncertainty in its assessments of fracture probability.; Fracture probability drives the requirement for countermeasures. Level of evidence will unlikely be obtained; hence, the Bone Research and Clinical Advisory Panel (like a Data Safety Monitoring Board) will provide the recommendations.

Thermo-hydro-mechanical-chemical processes in fractured-porous media: Benchmarks and examples

NASA Astrophysics Data System (ADS)

Kolditz, O.; Shao, H.; Görke, U.; Kalbacher, T.; Bauer, S.; McDermott, C. I.; Wang, W.

2012-12-01

The book comprises an assembly of benchmarks and examples for porous media mechanics collected over the last twenty years. Analysis of thermo-hydro-mechanical-chemical (THMC) processes is essential to many applications in environmental engineering, such as geological waste deposition, geothermal energy utilisation, carbon capture and storage, water resources management, hydrology, even climate change. In order to assess the feasibility as well as the safety of geotechnical applications, process-based modelling is the only tool to put numbers, i.e. to quantify future scenarios. This charges a huge responsibility concerning the reliability of computational tools. Benchmarking is an appropriate methodology to verify the quality of modelling tools based on best practices. Moreover, benchmarking and code comparison foster community efforts. The benchmark book is part of the OpenGeoSys initiative - an open source project to share knowledge and experience in environmental analysis and scientific computation.

Advanced stimulation technology deployment program, Chevron USA Production Company, Wolfcamp A2 Sand, Pakenham Field, Val Verde Basin. Topical report, July 1995-March 1996

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

Wright, C.A.; Weijers, L.; Minner, W.A.

1996-07-01

This report describes the results from Chevron`s Pakenham Field effort at fracture stimulation engineering which incorporated, to the greatest extent possible, the results of actual measured field data. Measurement of the sand-shale closure stress contrast around the Wolfcamp A2 sand and the relatively high net fracturing pressures (compared to the closure stress contrast) that were observed during real-data (net pressure) fracture treatment analysis revealed that fractures obtained in most of the treatments were much shorter and less confined than originally expected: the fracture half-length was about 200 to 300 ft (instead of about 600 ft), which is consistent with estimatesmore » from post-fracture pressure build-up tests. Based on these measurements, Chevron`s fracturing practices in the Pakenham Field could be carefully reviewed to enhance fracture economics. Supported by the real-data fracture treatment analysis, several changes in completion, fracture treatment design and data-collection procedures were made, such as: (1) using cheaper 20/40 Ottawa sand instead of pre-cured 20/40 resin coated sand; (2) reducing the pad fluid size, as fluid leakoff from the fracture into the formation was relatively low; and, (3) utilizing stepdown tests and proppant slugs to minimize near-wellbore screen-out potential (in the Wolfcamp D sand).« less

Risk Factors for Open Malleolar Fractures: An Analysis of the National Trauma Data Bank (2007 to 2011).

PubMed

Shibuya, Naohiro; Liu, George T; Davis, Matthew L; Grossman, Jordan P; Jupiter, Daniel C

2016-01-01

A limited number of studies have described the epidemiology of open fractures, and the epidemiology of open ankle fractures is not an exception. Therefore, the risk factors associated with open ankle fractures have not been extensively evaluated. The frequencies and proportions of open ankle fractures among all the recorded malleolar fractures in the US National Trauma Data Bank data set from January 2007 to December 2011 were analyzed. Clinically relevant variables captured in the data set were also used to evaluate the risk factors associated with open ankle fractures, adjusting for other covariates. The entire cohort was further subdivided into "lower" and "higher" energy trauma groups and the same analysis performed for each group separately. We found that a body mass index of >40 kg/m(2) and farm location were risk factors for open ankle fractures and impaired sensorium was protective against open ankle fractures. In the "lower energy" group, male gender, alcohol use, peripheral vascular disease, other injuries, and injury occurring at a farm location were risk factors for open fractures. In the "higher energy" group, female gender, work-related injury, and injury at a farm or industry location demonstrated statistically significantly associations with open fractures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Applications in bridge structure health monitoring using distributed fiber sensing

NASA Astrophysics Data System (ADS)

Feng, Yafei; Zheng, Huan; Ge, Huiliang

2017-10-01

In this paper, Brillouin Optical Time Domain Analysis (BOTDA) is proposed to solve the problem that the traditional point sensor is difficult to realize the comprehensive safety monitoring of bridges and so on. This technology not only breaks through the bottleneck of traditional monitoring point sensor, realize the distributed measurement of temperature and strain on a transmission path; can also be used for bridge and other structures of the damage identification, fracture positioning, settlement monitoring. The effectiveness and frontier of the technology are proved by comparing the test of the indoor model beam and the external field bridge, and the significance of the distributed optical fiber sensing technology to the monitoring of the important structure of the bridge is fully explained.

Effects of Crimped Fiber Paths on Mixed Mode Delamination Behaviors in Woven Fabric Composites

DTIC Science & Technology

2016-09-01

continuum finite - element models. Three variations of a plain-woven fabric architecture—each of which had different crimped fiber paths—were considered... Finite - Element Analysis Fracture Mechanics Fracture Toughness Mixed Modes Strain Energy Release Rate 16. SECURITY...polymer FB Fully balanced laminate FEA Finite - element analysis FTCM Fracture toughness conversion mechanism G Shear modulus GI, GII, GIII Mode

The Shock and Vibration Digest. Volume 18, Number 12

DTIC Science & Technology

1986-12-01

practical msthods for fracture mechanics analysis. Linear elastic methods can yield useful results. Elas- dc-plasdc methods are becoming useful with...geometry factors. Fracture mechanics analysis based on linear elastic concepts developed in the 1960s has become established during the last decade as...2) is slightly conservative [2,3]. Materials that ran be treated with linear elastic fracture mechanics usually belong in this category. No

Structural analysis characterization of permeability pathways across reservoir-seal interface - South-Eastern Utah; Results from integrated sedimentological, structural, and geochemical studies.

NASA Astrophysics Data System (ADS)

Petrie, E. S.; Evans, J. P.; Richey, D.; Flores, S.; Barton, C.; Mozley, P.

2015-12-01

Sedimentary rocks in the San Rafael Swell, Utah, were deformed by Laramide compression and subsequent Neogene extension. We evaluate the effect of fault damage zone morphology as a function of structural position, and changes in mechanical stratigraphy on the distribution of secondary minerals across the reservoir-seal pair of the Navajo Sandstone and overlying Carmel Formation. We decipher paleo-fluid migration and examine the effect faults and fractures have on reservoir permeability and efficacy of top seal for a range of geo-engineering applications. Map-scale faults have an increased probability of allowing upward migration of fluids along the fault plane and within the damage zone, potentially bypassing the top seal. Field mapping, mesoscopic structural analyses, petrography, and geochemical observations demonstrate that fault zone thickness increases at structural intersections, fault relay zones, fault-related folds, and fault tips. Higher densities of faults with meters of slip and dense fracture populations are present in relay zones relative to single, discrete faults. Curvature analysis of the San Rafael monocline and fracture density data show that fracture density is highest where curvature is highest in the syncline hinge and near faults. Fractures cross the reservoir-seal interface where fracture density is highest and structural diagensis includes mineralization events and bleaching and calcite and gypsum mineralization. The link between fracture distributions and structural setting implys that transmissive fractures have predictable orientations and density distributions. At the m- to cm- scale, deformation-band faults and joints in the Navajo Sandstone penetrate the reservoir-seal interface and transition into open-mode fractures in the caprock seal. Scanline analysis and petrography of veins provide evidence for subsurface mineralization and fracture reactivation, suggesting that the fractures act as loci for fluid flow through time. Heterolithic caprock seals with variable fracture distributions and morphology highlight the strong link between the variation in material properties and the response to changing stress conditions. The variable connectivity of fractures and the changes in fracture density plays a critical role in subsurface fluid flow.

Numerical Borehole Breakdown Investigations using XFEM

NASA Astrophysics Data System (ADS)

Beckhuis, Sven; Leonhart, Dirk; Meschke, Günther

2016-04-01

During pressurization of a wellbore a typical downhole pressure record shows the following regimes: first the applied wellbore pressure balances the reservoir pressure, then after the compressive circumferential hole stresses are overcome, tensile stresses are induced on the inside surface of the hole. When the magnitude of these stresses reach the tensile failure stress of the surrounding rock medium, a fracture is initiated and propagates into the reservoir. [1] In standard theories this pressure, the so called breakdown pressure, is the peak pressure in the down-hole pressure record. However experimental investigations [2] show that the breakdown did not occur even if a fracture was initiated at the borehole wall. Drilling muds had the tendency to seal and stabilize fractures and prevent fracture propagation. Also fracture mechanics analysis of breakdown process in mini-frac or leak off tests [3] show that the breakdown pressure could be either equal or larger than the fracture initiation pressure. In order to gain a deeper understanding of the breakdown process in reservoir rock, numerical investigations using the extended finite element method (XFEM) for hydraulic fracturing of porous materials [4] are discussed. The reservoir rock is assumed to be pre-fractured. During pressurization of the borehole, the injection pressure, the pressure distribution and the position of the highest flux along the fracture for different fracturing fluid viscosities are recorded and the influence of the aforementioned values on the stability of fracture propagation is discussed. [1] YEW, C. H. (1997), "Mechanics of Hydraulic Fracturing", Gulf Publishing Company [2] MORITA, N.; BLACK, A. D.; FUH, G.-F. (1996), "Borehole Breakdown Pressure with Drilling Fluids". International Journal of Rock Mechanics and Mining Sciences 33, pp. 39-51 [3] DETOURNAY, E.; CARBONELL, R. (1996), "Fracture Mechanics Analysis of the Breakdown Process in Minifrac or Leakoff Test", Society of Petroleum Engineers, Inc. [4] MESCHKE, G.; Leonhart, D. (2015), "A generalized finite element method for hydro-mechanically coupled analysis of hydraulic fracturing problems using space-time variant enrichment functions." Computer Methods in Applied Mechanics and Engineering, 290:438 - 465

Handling glacially induced faults in the assessment of the long term safety of a repository for spent nuclear fuel at Forsmark, Sweden

NASA Astrophysics Data System (ADS)

Munier, R.

2011-12-01

Located deep into the Baltic shield, far from active plate boundaries and volcanism, Swedish bedrock is characterised by a low frequency of earthquakes of small magnitudes. Yet, faults, predominantly in the Lapland region, offsetting the quarternary regolith ten meters or more, reveal that Swedish bedrock suffered from substantial earthquake activity in connection to the retreat of the latest continental glacier, Weichsel. Storage of nuclear wastes, hazardous for hundreds of thousand years, requires, firstly, isolation of radionuclides and, secondly, retardation of the nuclides should the barriers fail. Swedish regulations require that safety is demonstrated for a period of a million years. Consequently, the repository must be designed to resist the impact of several continental glaciers. Large, glacially induced, earthquakes near the repository have the potential of triggering slip along fractures across the canisters containing the nuclear wastes, thereby simultaneously jeopardising isolation, retardation and, hence, long term safety. It has therefore been crucial to assess the impact of such intraplate earthquake upon the primary functions of the repository. We conclude that, by appropriate design of the repository, the negative impact of earthquakes on long term safety can be considerably lessened. We were, additionally, able to demonstrate compliance with Swedish regulations in our safety assessment, SR-Site, submitted to the authorities earlier this year. However, the assessment required a number of critical assumptions, e.g. concerning the strain rate and the fracture properties of the rock, many of which are subject of current research in the geoscientific community. By a conservative approach, though, we judge to have adequately propagated critical uncertainties through the assessment and bound the uncertainty space.

Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial.

PubMed

Bartl, Christoph; Stengel, Dirk; Bruckner, Thomas; Rossion, Inga; Luntz, Steffen; Seiler, Christoph; Gebhard, Florian

2011-03-22

Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF) with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation.Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius) is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool.The primary objective is to determine differences in the Short Form 36 (SF-36) Physical Component Score (PCS) between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH) instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery), as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture involves a central statistical unit, an independent monitoring institute, and a data safety monitoring board. Following approval by the institutional review boards of all participating centers, conduct and reporting will strictly adhere to national and international rules, regulations, and recommendations (e.g., Good Clinical Practice, data safety laws, and EQUATOR/CONSORT proposals). To our knowledge, ORCHID is the first multicenter RCT designed to assess quality of life and functional outcomes following operative treatment compared to conservative treatment of complex, intra-articular fractures of the distal radius in elderly patients. The results are expected to influence future treatment recommendations and policies on an international level. ISRCTN: ISRCTN76120052 Registration date: 31.07.2008; Randomization of first patient: 15.09.2008.

Risk of bone fractures associated with glucagon-like peptide-1 receptor agonists' treatment: a meta-analysis of randomized controlled trials.

PubMed

Su, Bin; Sheng, Hui; Zhang, Manna; Bu, Le; Yang, Peng; Li, Liang; Li, Fei; Sheng, Chunjun; Han, Yuqi; Qu, Shen; Wang, Jiying

2015-02-01

Traditional anti-diabetic drugs may have negative or positive effects on risk of bone fractures. Yet the relationship between the new class glucagon-like peptide-1 receptor agonists (GLP-1 RA) and risk of bone fractures has not been established. We performed a meta-analysis including randomized controlled trials (RCT) to study the risk of bone fractures associated with liraglutide or exenatide, compared to placebo or other active drugs. We searched MEDLINE, EMBASE, and clinical trial registration websites for published or unpublished RCTs comparing the effects of liraglutide or exenatide with comparators. Only studies with disclosed bone fracture data were included. Separate pooled analysis was performed for liraglutide or exenatide, respectively, by calculating Mantel-Haenszel odds ratio (MH-OR). 16 RCTs were identified including a total of 11,206 patients. Liraglutide treatment was associated with a significant reduced risk of incident bone fractures (MH-OR=0.38, 95% CI 0.17-0.87); however, exenatide treatment was associated with an elevated risk of incident bone fractures (MH-OR=2.09, 95% CI 1.03-4.21). Publication bias and heterogeneity between studies were not observed. Our study demonstrated a divergent risk of bone fractures associated with different GLP-1 RA treatments. The current findings need to be confirmed by future well-designed prospective or RCT studies.

Fractographic study of the behavior of different ceramic veneers on full coverage crowns in relation to supporting core materials

PubMed Central

Agustín-Panadero, Rubén; Román-Rodriguez, Juan L.; Solá-Ruíz, María F.; Granell-Ruíz, María; Fons-Font, Antonio

2013-01-01

Objectives: To observe porcelain veneer behavior of zirconia and metal-ceramic full coverage crowns when subjected to compression testing, comparing zirconia cores to metal cores. Study Design: The porcelain fracture surfaces of 120 full coverage crowns (60 with a metal core and 60 with a zirconia core) subjected to static load (compression) testing were analyzed. Image analysis was performed using macroscopic processing with 8x and 12x enlargement. Five samples from each group were prepared and underwent scanning electron microscope (SEM) analysis in order to make a fractographic study of fracture propagation in the contact area and composition analysis in the most significant areas of the specimen. Results: Statistically significant differences in fracture type (cohesive or adhesive) were found between the metal-ceramic and zirconia groups: the incidence of adhesive fracture was seen to be greater in metal-ceramic groups (92%) and cohesive fracture was more frequent in zirconium oxide groups (72%). The fracture propagation pattern was on the periphery of the contact area in the full coverage crown restorations selected for fractographic study. Conclusions: The greater frequency of cohesive fracture in restorations with zirconia cores indicates that their behavior is inadequate compared to metal-ceramic restorations and that further research is needed to improve their clinical performance. Key words:Zirconia, zirconium oxide, fractography, composition, porcelain veneers, fracture, cohesive, adhesive. PMID:24455092

Size-dependent fracture mode transition in copper nanowires.

PubMed

Peng, Cheng; Zhan, Yongjie; Lou, Jun

2012-06-25

In situ uni-axial tensile tests of single-crystalline copper nanowires are performed using a micromechanical device inside a scanning electron microscope chamber. The single-crystalline copper nanowires are synthesized by solvothermal processes, and the growth direction along the wire axis is the <110> orientation as confirmed by transmission electron microscopy (TEM) selected area diffraction (SAD) analysis. The fracture strengths of copper nanowires are found to be much higher than that of bulk copper. More interestingly, both ductile and brittle-like fracture modes are found in the same batch of fabricated nanowires, and the fracture modes appear to be dependent on the diameters of tested nanowires. From the analysis of fracture surfaces, sample morphologies and corresponding stress-strain curves, the competition between deformation and fracture mechanisms controlled by initial defects density and by the probability of dislocation interactions is attributed to this intriguing size-dependent fracture mode transition. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Bisphosphonates for the prevention of fractures in osteogenesis imperfecta: meta-analysis of placebo-controlled trials.

PubMed

Hald, Jannie D; Evangelou, Evangelos; Langdahl, Bente L; Ralston, Stuart H

2015-05-01

Bisphosphonates are widely used off-label in the treatment of patients with osteogenesis imperfecta (OI) with the intention of reducing the risk of fracture. Although there is strong evidence that bisphosphonates increase bone mineral density in osteogenesis imperfecta, the effects on fracture occurrence have been inconsistent. The aim of this study was to gain a better insight into the effects of bisphosphonate therapy on fracture risk in patients with osteogenesis imperfecta by conducting a meta-analysis of randomized controlled trials in which fractures were a reported endpoint. We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials in which the effects of bisphosphonates on fracture risk in osteogenesis imperfecta were compared with placebo and conducted a meta-analysis of these studies using standard methods. Heterogeneity was assessed using the I2 statistic. Six eligible studies were identified involving 424 subjects with 751 patient-years of follow-up. The proportion of patients who experienced a fracture was not significantly reduced by bisphosphonate therapy (Relative Risk [RR] = 0.83 [95% confidence interval 0.69-1.01], p = 0.06) with no heterogeneity between studies (I2  = 0). The fracture rate was reduced by bisphosphonate treatment when all studies were considered (RR = 0.71 [0.52-0.96], p = 0.02), but with considerable heterogeneity (I2  = 36%) explained by one study where a small number of patients in the placebo group experienced a large number of fractures. When this study was excluded, the effects of bisphosphonates on fracture rate was not significant (RR = 0.79 [0.61-1.02], p = 0.07, I2  = 0%). We conclude that the effects of bisphosphonates on fracture prevention in osteogenesis imperfecta are inconclusive. Adequately powered trials with a fracture endpoint are needed to further investigate the risks and benefits of bisphosphonates in this condition. © 2014 American Society for Bone and Mineral Research.

Trends in the volume of operative treatment of midshaft clavicle fractures in children and adolescents: a retrospective, 12-year, single-institution analysis.

PubMed

Suppan, Catherine A; Bae, Donald S; Donohue, Kyna S; Miller, Patricia E; Kocher, Mininder S; Heyworth, Benton E

2016-07-01

The purpose of this study was to examine institutional trends in the volume of clavicle fractures in children and adolescents. Medical records were retrospectively reviewed to identify patients aged 10-18 years treated for a clavicle fracture between 1999 and 2011 at a single tertiary-care pediatric hospital. There were significant increases in the number of clavicle fractures seen annually, of midshaft clavicle fractures, and of midshaft clavicle fractures treated operatively. The percentage of midshaft clavicle fractures treated with fixation also increased significantly. The volumes of clavicle fractures and midshaft clavicle fractures treated operatively appear to be increasing. Despite a lack of evidence-based support, the frequency of fixation of midshaft clavicle fractures appear to be increasing in the pediatric population.

Facial Fractures.

PubMed

Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy

2018-06-01

The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.

High weight or body mass index increase the risk of vertebral fractures in postmenopausal osteoporotic women.

PubMed

Pirro, Matteo; Fabbriciani, Gianluigi; Leli, Christian; Callarelli, Laura; Manfredelli, Maria Rosaria; Fioroni, Claudio; Mannarino, Massimo Raffaele; Scarponi, Anna Maria; Mannarino, Elmo

2010-01-01

In the general population, low body weight and body mass index (BMI) are significant risk factors for any fracture, but the specific association between body weight, BMI, and prevalence of vertebral fractures in osteoporotic women is not fully recognized. Hence, the association between body weight, BMI, and prevalent vertebral fractures was investigated in 362 women with never-treated postmenopausal osteoporosis. All participants underwent measurement of BMI, bone mineral density (BMD), and semiquantitative assessment of vertebral fractures. Thirty percent of participants had > or =1 vertebral fracture. Body weight and BMI were associated with L1-L4 BMD (R = 0.29, P < 0.001 and R = 0.17, P = 0.009, respectively). In logistic regression analysis, BMI was positively associated with the presence of vertebral fractures independent of age and other traditional risk factors for fractures. Including weight and height instead of BMI in the multivariate model, showed weight as a positive and significant covariate of the presence of vertebral fractures (OR = 1.045; P = 0.016; 95% CI 1.008-1.084). BMI was associated with the number of vertebral fractures (rho = 0.18; P = 0.001), this association being confirmed also in the multivariate analysis (beta = 0.14; P = 0.03) after correction for smoking, early menopause, family history of fragility fractures and BMD. In conclusion, among postmenopausal women with osteoporosis, body weight and BMI are associated with a higher likelihood of having a vertebral fracture, irrespective of the positive association between weight and BMD.

Continuum mechanics analysis of fracture progression in the vitrified cryoprotective agent DP6

PubMed Central

Steif, Paul S.; Palastro, Matthew C.; Rabin, Yoed

2008-01-01

As part of an ongoing effort to study the continuum mechanics effects associated with cryopreservation, the current report focuses on the prediction of fracture formation in cryoprotective agents. Fractures had been previously observed in 1 mℓ samples of the cryoprotective agent cocktail DP6, contained in a standard 15 mℓ glass vial, and subjected to various cooling rates. These experimental observations were obtained by means of a cryomacroscope, which has been recently presented by the current research team. High and low cooling rates were found to produce very distinct patterns of cracking. The current study seeks to explain the observed patterns on the basis of stresses predicted from finite element analysis, which relies on a simple viscoelastic constitutive model and on estimates of the critical stress for cracking. The current study demonstrates that the stress which results in instantaneous fracture at low cooling rates is consistent with the stress to initiate fracture at high cooling rate. This consistency supports the credibility of the proposed constitutive model and analysis, and the unified criterion for fracturing, that is, a critical stress threshold. PMID:18412493

Effect of Speed (Centrifugal Load) on Gear Crack Propagation Direction

NASA Technical Reports Server (NTRS)

Lewicki, David G.

2001-01-01

The effect of rotational speed (centrifugal force) on gear crack propagation direction was explored. Gears were analyzed using finite element analysis and linear elastic fracture mechanics. The analysis was validated with crack propagation experiments performed in a spur gear fatigue rig. The effects of speed, rim thickness, and initial crack location on gear crack propagation direction were investigated. Crack paths from the finite element method correlated well with those deduced from gear experiments. For the test gear with a backup ratio (rim thickness divided by tooth height) of nib = 0.5, cracks initiating in the tooth fillet propagated to rim fractures when run at a speed of 10,000 rpm and became tooth fractures for speeds slower than 10,000 rpm for both the experiments and anal sis. From additional analysis, speed had little effect on crack propagation direction except when initial crack locations were near the tooth/rim fracture transition point for a given backup ratio. When at that point, higher speeds tended to promote rim fracture while lower speeds (or neglecting centrifugal force) produced tooth fractures.

Effect of hydro mechanical coupling on natural fracture network formation in sedimentary basins

NASA Astrophysics Data System (ADS)

Ouraga, Zady; Guy, Nicolas; Pouya, Amade

2018-05-01

In sedimentary basin context, numerous phenomena, depending on the geological time span, can result in natural fracture network formation. In this paper, fracture network and dynamic fracture spacing triggered by significant sedimentation rate are studied considering mode I fracture propagation using a coupled hydro-mechanical numerical methods. The focus is put on synthetic geological structure under a constant sedimentation rate on its top. This model contains vertical fracture network initially closed and homogeneously distributed. The fractures are modelled with cohesive zone model undergoing damage and the flow is described by Poiseuille's law. The effect of the behaviour of the rock is studied and the analysis leads to a pattern of fracture network and fracture spacing in the geological layer.

Delay in weight bearing in surgically treated tibial shaft fractures is associated with impaired healing: a cohort analysis of 166 tibial fractures.

PubMed

Houben, I B; Raaben, M; Van Basten Batenburg, M; Blokhuis, T J

2018-04-09

The relation between timing of weight bearing after a fracture and the healing outcome is yet to be established, thereby limiting the implementation of a possibly beneficial effect for our patients. The current study was undertaken to determine the effect of timing of weight bearing after a surgically treated tibial shaft fracture. Surgically treated diaphyseal tibial fractures were retrospectively studied between 2007 and 2015. The timing of initial weight bearing (IWB) was analysed as a predictor for impaired healing in a multivariate regression. Totally, 166 diaphyseal tibial fractures were included, 86 cases with impaired healing and 80 with normal healing. The mean age was 38.7 years (range 16-89). The mean time until IWB was significantly shorter in the normal fracture healing group (2.6 vs 7.4 weeks, p < 0.001). Correlation analysis yielded four possible confounders: infection requiring surgical intervention, fracture type, fasciotomy and open fractures. Logistic regression identified IWB as an independent predictor for impaired healing with an odds ratio of 1.13 per week delay (95% CI 1.03-1.25). Delay in initial weight bearing is independently associated with impaired fracture healing in surgically treated tibial shaft fractures. Unlike other factors such as fracture type or soft tissue condition, early resumption of weight bearing can be influenced by the treating physician and this factor therefore has a direct clinical relevance. This study indicates that early resumption of weight bearing should be the treatment goal in fracture fixation. 3b.

An integrated approach to characterization of fractured reservoirs

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

Datta-Gupta, A.; Majer, E.; Vasco, D.

1995-12-31

This paper summarizes an integrated hydrologic and seismic characterization of a fractured limestone formation at the Conoco Borehole Test Facility (CBTF) in Kay County, Oklahoma. Transient response from pressure interference tests were first inverted in order to identify location and orientation of dominant fractures at the CBTF. Subsequently, high resolution (1000 to 10000 Hz) cross-well and single-well seismic surveys were conducted to verify the preferential slow paths indicated by hydrologic analysis. Seismic surveys were conducted before and after an air injection in order to increase the visibility of the fracture zone to seismic imaging. Both Seismic and hydrologic analysis weremore » found to yield consistent results in detecting the location of a major fracture zone.« less

Fracture surface analysis of a quenched (α+β)-metastable titanium alloy

NASA Astrophysics Data System (ADS)

Illarionov, A. G.; Stepanov, S. I.; Demakov, S. L.

2017-12-01

Fracture surface analysis is conducted by means of SEM for VT16 titanium alloy specimens solution-treated at temperatures ranging from 700 to 875 °C, water-quenched and subjected to tensile testing. A cup and cone shape failure and dimple microstructure of the fracture surface indicates the ductile behavior of the alloy. Dimple dimensions correlated with the β-grain size of the alloy in quenched condition. The fracture area (namely, the size; the cup and cone shape) depends on the volume fraction of the primary α-phase in the quenched sample. However, the fracture surface changes considerably when the strain-induced β-αʺ-transformation takes place during tensile testing, resulting in the increase of alloy ductility.

Effects of exercise on fracture reduction in older adults: a systematic review and meta-analysis.

PubMed

Kemmler, W; Häberle, L; von Stengel, S

2013-07-01

In this meta-analysis, we evaluated the effect of exercise on fracture reduction in the elderly. Our results determined a significantly positive effect on overall fractures, whereas the possibility of a publication bias indicates the need for well-designed (multi-center) trials that generate enough power to focus on osteoporotic fractures. The preventive effect of exercise on fracture incidence has not been clearly determined yet. Thus, the purpose of this study is to evaluate the effectiveness of exercise in preventing overall and vertebral fractures in older adults by meta-analyses technique. This study followed the PRISMA recommendations for systematic reviews and meta-analyses. A systematic review of English articles between 1980 and March 2012 was performed. Terms used were: "exercise", "fractures", "bone", "falls", "osteoporosis", "BMD", "BMC", "bone turnover", while the search was limited to "clinical trial" and "humans". Controlled exercise trials that reported fracture number as endpoint or observation in subjects 45 years and older were included. Ten controlled exercise trials that reported overall fractures and three exercise trials that reported vertebral fractures met our inclusion criteria. Overall fracture number in the exercise group was 36 (n = 754) compared with 73 fractures in the CG (n = 670) (relative risk [RR] = 0.49; 95 % confidence interval [CI], 0.31-0.76). No significant heterogeneity of trial results (p = 0.28; I (2) = 17) was determined; however, there was some evidence to suggest a publication bias. The overall RR for vertebral fracture number (0.56; 95 % CI, 0.30-1.04) (EG: 19 fractures/103 subjects vs. CG: 31 fractures/102 subjects) was borderline non-significant while the heterogeneity of trial results also cannot be ruled out. Although there is evidence that exercise reduces overall and, to a lesser degree, vertebral fractures in the elderly, the possibility of publication bias weakens our result and demonstrates the imperative for large exercise studies with dedicated exercise protocols that focus on fractures as a primary endpoint.

Anterior-Inferior Plating Results in Fewer Secondary Interventions Compared to Superior Plating for Acute Displaced Midshaft Clavicle Fractures.

PubMed

Serrano, Rafael; Borade, Amrut; Mir, Hassan; Shah, Anjan; Watson, David; Infante, Anthony; Frankle, Mark A; Mighell, Mark A; Sagi, H Claude; Horwitz, Daniel S; Sanders, Roy W

2017-09-01

To determine whether a difference in plate position for fixation of acute, displaced, midshaft clavicle fractures would affect the rate of secondary intervention. Retrospective Comparative Study. Two academic Level 1 Regional Trauma Centers. Five hundred ten patients treated surgically for an acutely displaced midshaft clavicle fracture between 2000 and 2013 were identified and reviewed retrospectively at a minimum of 24 months follow-up (F/U). Fractures were divided into 2 cohorts, according to plate position: Anterior-Inferior (AI) or Superior (S). Exclusion criteria included age <16 years, incomplete data records, and loss to F/U. Group analysis included demographics (age, sex, body mass index), fracture characteristics (mechanism of injury, open or closed), hand dominance, ipsilateral injuries, time between injury to surgery, time to radiographic union, length of F/U, and frequency of secondary procedures. Patients were treated either with AI or S clavicle plating at the treating surgeon's discretion. Rate and reason for secondary intervention. Fisher exact test, t test. and odds ratio were used for statistical analysis. Final analysis included 252 fractures/251 patients. One hundred eighteen (47%) were in group AI; 134 (53%) were in group S. No differences in demographics, fracture characteristics, time to surgery, time to union, or length of F/U existed between groups. Seven patients/7 fractures (5.9%) in Group AI underwent a secondary surgery whereas 30 patients/30 fractures (22.3%) in group S required a secondary surgery. An additional intervention secondary to superior plate placement was highly statistically significant (P < 0.001). Furthermore, because 80% of these subsequent interventions were a result of plate irritation with patient discomfort, the odds ratio for a second procedure was 5 times greater in those fractures treated with a superior plate. This comparative analysis indicates that AI plating of midshaft clavicle fractures seems to lessen clinical irritation and results in significantly fewer secondary interventions. Considering patient satisfaction and a reduced financial burden to the health care system, we recommend routine AI plate application when open reduction internal fixation of the clavicle is indicated. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Structural Safety of a Hubble Space Telescope Science Instrument

NASA Technical Reports Server (NTRS)

Lou, M. C.; Brent, D. N.

1993-01-01

This paper gives an overview of safety requirements related to structural design and verificationof payloads to be launched and/or retrieved by the Space Shuttle. To demonstrate the generalapproach used to implement these requirements in the development of a typical Shuttle payload, theWide Field/Planetary Camera II, a second generation science instrument currently being developed bythe Jet Propulsion Laboratory (JPL) for the Hubble Space Telescope is used as an example. Inaddition to verification of strength and dynamic characteristics, special emphasis is placed upon thefracture control implementation process, including parts classification and fracture controlacceptability.

Surface flaw reliability analysis of ceramic components with the SCARE finite element postprocessor program

NASA Technical Reports Server (NTRS)

Gyekenyesi, John P.; Nemeth, Noel N.

1987-01-01

The SCARE (Structural Ceramics Analysis and Reliability Evaluation) computer program on statistical fast fracture reliability analysis with quadratic elements for volume distributed imperfections is enhanced to include the use of linear finite elements and the capability of designing against concurrent surface flaw induced ceramic component failure. The SCARE code is presently coupled as a postprocessor to the MSC/NASTRAN general purpose, finite element analysis program. The improved version now includes the Weibull and Batdorf statistical failure theories for both surface and volume flaw based reliability analysis. The program uses the two-parameter Weibull fracture strength cumulative failure probability distribution model with the principle of independent action for poly-axial stress states, and Batdorf's shear-sensitive as well as shear-insensitive statistical theories. The shear-sensitive surface crack configurations include the Griffith crack and Griffith notch geometries, using the total critical coplanar strain energy release rate criterion to predict mixed-mode fracture. Weibull material parameters based on both surface and volume flaw induced fracture can also be calculated from modulus of rupture bar tests, using the least squares method with known specimen geometry and grouped fracture data. The statistical fast fracture theories for surface flaw induced failure, along with selected input and output formats and options, are summarized. An example problem to demonstrate various features of the program is included.

Finite element analysis of unnotched charpy impact tests

DOT National Transportation Integrated Search

2008-10-01

This paper describes nonlinear finite element analysis (FEA) to examine the energy to : fracture unnotched Charpy specimens under pendulum impact loading. An oversized, : nonstandard pendulum impactor, called the Bulk Fracture Charpy Machine (BFCM), ...

Fracture risk assessment: improved evaluation of vertebral integrity among metastatic cancer patients to aid in surgical decision-making

NASA Astrophysics Data System (ADS)

Augustine, Kurt E.; Camp, Jon J.; Holmes, David R.; Huddleston, Paul M.; Lu, Lichun; Yaszemski, Michael J.; Robb, Richard A.

2012-03-01

Failure of the spine's structural integrity from metastatic disease can lead to both pain and neurologic deficit. Fractures that require treatment occur in over 30% of bony metastases. Our objective is to use computed tomography (CT) in conjunction with analytic techniques that have been previously developed to predict fracture risk in cancer patients with metastatic disease to the spine. Current clinical practice for cancer patients with spine metastasis often requires an empirical decision regarding spinal reconstructive surgery. Early image-based software systems used for CT analysis are time consuming and poorly suited for clinical application. The Biomedical Image Resource (BIR) at Mayo Clinic, Rochester has developed an image analysis computer program that calculates from CT scans, the residual load-bearing capacity in a vertebra with metastatic cancer. The Spine Cancer Assessment (SCA) program is built on a platform designed for clinical practice, with a workflow format that allows for rapid selection of patient CT exams, followed by guided image analysis tasks, resulting in a fracture risk report. The analysis features allow the surgeon to quickly isolate a single vertebra and obtain an immediate pre-surgical multiple parallel section composite beam fracture risk analysis based on algorithms developed at Mayo Clinic. The analysis software is undergoing clinical validation studies. We expect this approach will facilitate patient management and utilization of reliable guidelines for selecting among various treatment option based on fracture risk.

Characterization of fractures and flow zones in a contaminated shale at the Watervliet Arsenal, Albany County, New York

USGS Publications Warehouse

Williams, John H.; Paillet, Frederick L.

2002-01-01

Flow zones in a fractured shale in and near a plume of volatile organic compounds at the Watervliet Arsenal in Albany County, N. Y. were characterized through the integrated analysis of geophysical logs and single- and cross-hole flow tests. Information on the fracture-flow network at the site was needed to design an effective groundwater monitoring system, estimate offsite contaminant migration, and evaluate potential containment and remedial actions.Four newly drilled coreholes and four older monitoring wells were logged and tested to define the distribution and orientation of fractures that intersected a combined total of 500 feet of open hole. Analysis of borehole-wall image logs obtained with acoustic and optical televiewers indicated 79 subhorizontal to steeply dipping fractures with a wide range of dip directions. Analysis of fluid resistivity, temperature, and heat-pulse and electromagnetic flowmeter logs obtained under ambient and short-term stressed conditions identified 14 flow zones, which consist of one to several fractures and whose estimated transmissivity values range from 0.1 to more than 250 feet squared per day.Cross-hole flow tests, which were used to characterize the hydraulic connection between fracture-flow zones intersected by the boreholes, entailed (1) injection into or extraction from boreholes that penetrated a single fracture-flow zone or whose zones were isolated by an inflatable packer, and (2) measurement of the transient response of water levels and flow in surrounding boreholes. Results indicate a wellconnected fracture network with an estimated transmissivity of 80 to 250 feet squared per day that extends for at least 200 feet across the site. This interconnected fracture-flow network greatly affects the hydrology of the site and has important implications for contaminant monitoring and remedial actions.

Use of acid-suppressive drugs and risk of fracture: a meta-analysis of observational studies.

PubMed

Eom, Chun-Sick; Park, Sang Min; Myung, Seung-Kwon; Yun, Jae Moon; Ahn, Jeong-Soo

2011-01-01

Previous studies have reported inconsistent findings regarding the association between the use of acid-suppressive drugs such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H(2)RAs) and fracture risk. We investigated this association using meta-analysis. We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library from inception through December 2010 using common key words. We included case-control, nested case-control, and cohort studies. Two evaluators independently reviewed and selected articles. We determined pooled effect estimates by using random-effects meta-analysis, because of heterogeneity. Of 1,809 articles meeting our initial inclusion criteria, 5 case-control studies, 3 nested case-control studies, and 3 cohort studies were included in the final analyses. The pooled odds ratio (OR) for fracture was 1.29 (95% confidence interval [CI], 1.18-1.41) with use of PPIs and 1.10 (95% CI, 0.99-1.23) with use of H(2)RAs when compared with nonuse of the respective medications. Long-term use of PPIs increased the risk of any fracture (adjusted OR = 1.30; 95% CI, 1.15-1.48) and hip fracture risk (adjusted OR = 1.34; 95% CI, 1.09-1.66), whereas long-term H(2)RA use was not significantly associated with fracture risk. We found possible evidence linking PPI use to an increased risk of fracture, but no association between H(2)RA use and fracture risk. Widespread use of PPIs with the potential risk of fracture is of great importance to public health. Clinicians should carefully consider their decision to prescribe PPIs for patients already having an elevated risk of fracture because of age or other factors.

A cost-benefit analysis of produced water management opportunities in selected unconventional oil and gas plays

NASA Astrophysics Data System (ADS)

Marsters, P.; Macknick, J.; Bazilian, M.; Newmark, R. L.

2013-12-01

Unconventional oil and gas production in North America has grown enormously over the past decade. The combination of horizontal drilling and hydraulic fracturing has made production from shale and other unconventional resources economically attractive for oil and gas operators, but has also resulted in concerns over potential water use and pollution issues. Hydraulic fracturing operations must manage large volumes of water on both the front end as well as the back end of operations, as significant amounts of water are coproduced with hydrocarbons. This water--often called flowback or produced water--can contain chemicals from the hydraulic fracturing fluid, salts dissolved from the source rock, various minerals, volatile organic chemicals, and radioactive constituents, all of which pose potential management, safety, and public health issues. While the long-term effects of hydraulic fracturing on aquifers, drinking water supplies, and surface water resources are still being assessed, the immediate impacts of produced water on local infrastructure and water supplies are readily evident. Produced water management options are often limited to underground injection, disposal at centralized treatment facilities, or recycling for future hydraulic fracturing operations. The costs of treatment, transport, and recycling are heavily dependent on local regulations, existing infrastructure, and technologies utilized. Produced water treatment costs also change over time during energy production as the quality of the produced water often changes. To date there is no publicly available model that evaluates the cost tradeoffs associated with different produced water management techniques in different regions. This study addresses that gap by characterizing the volume, qualities, and temporal dynamics of produced water in several unconventional oil and gas plays; evaluating potential produced water management options, including reuse and recycling; and assessing how hydraulic fracturing and produced water issues relate to the larger water-energy nexus. Specifically, this study develops a play-specific model to compare the decision factors and costs involved in managing produced water. For example, when transport distances to a wastewater disposal site are far enough, options for recycling water become more favorable, depending on the characteristics of each play. This model can provide policymakers and other interested parties with cost estimates of different water management options, including a better understanding of the costs and opportunities associated with recycling produced water. This work provides a cross-play assessment of produced water management options and costs and could serve as the foundation for more detailed analyses of opportunities to minimize hydraulic fracturing's impacts on freshwater resources.

Fracture related-fold patterns analysis and hydrogeological implications: Insight from fault-propagation fold in Northwestern of Tunisia

NASA Astrophysics Data System (ADS)

Sanai, L.; Chenini, I.; Ben Mammou, A.; Mercier, E.

2015-01-01

The spatial distribution of fracturing in hard rocks is extremely related to the structural profile and traduces the kinematic evolution. The quantitative and qualitative analysis of fracturing combined to GIS techniques seem to be primordial and efficient in geometric characterization of lineament's network and to reconstruct the relative timing and interaction of the folding and fracturing histories. Also a detailed study of the area geology, lithology, tectonics, is primordial for any hydrogeological study. For that purpose we used a structural approach that consist in comparison between fracture sets before and after unfolding completed by aerospace data and DEM generated from topographic map. The above methodology applied in this study carried out in J. Rebia located in Northwestern of Tunisia demonstrated the heterogeneity of fracturing network and his relation with the fold growth throught time and his importance on groundwater flow.

[Surgical approach of internal fixation of maxillofacial fracture].

PubMed

Liu, Dashun; Zhang, Ruizhen; Dong, Xiao

2013-11-01

By summary and analysis of rigid internal fixation for the treatment of maxillofacial fractures incision and exposure, investigate the plate reasonable surgical approach of fracture reduction and fixation titanium. Summary of the 76 surgical cases, Counting the statistics of the number that the surgery ways choose by facial incision and fractures location, analysis of the indications for surgery and the advantages and disadvantages of various surgical approaches. Followed up for more than six months, in order to observe the recovery of occlusal function and the facial cosmetic results. The upper jaw or cheek bone has the more possibility in facial fracture, which used of a small incision hidden under the lip gingival sulcus and lower eyelid. After six months, the facial wound healing recover in good occlusal with no obvious scarring. Reasonable choice of surgical incision can make the fracture site exposure and the facial aesthetic effect into account.

Comparative biomechanical evaluation of mono-cortical osteosynthesis systems for condylar fractures using photoelastic stress analysis.

PubMed

Christopoulos, Panos; Stathopoulos, Panagiotis; Alexandridis, Constantinos; Shetty, Vivek; Caputo, Angelo

2012-10-01

Fractures of the condyle account for 20-30% of all mandibular fractures, and are therefore one of the most common facial injuries. Precise evaluation of the mechanical stresses that develop in a fractured mandible is essential, particularly for the testing of systems currently used for stabilisation of the condylar fragment. Photoelastic stress analysis can be used to visualise alterations in the strain that is induced in the mandible by a fracture, and in the osteosynthesis materials used to stabilise it. This method, used on currently used osteosynthesis materials, showed that stabilisation of a subcondylar fracture with a single miniplate does not provide enough stability, whereas the use of two miniplates - properly positioned - offers sufficient stability in all loading conditions. A microplate may be used as a tension-resisting plate with equally good results. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Fracture mode during cyclic loading of implant-supported single-tooth restorations.

PubMed

Hosseini, Mandana; Kleven, Erik; Gotfredsen, Klaus

2012-08-01

Fracture of veneering ceramics in zirconia-based restorations has frequently been reported. Investigation of the fracture mode of implant-supported ceramic restorations by using clinically relevant laboratory protocols is needed. This study compared the mode of fracture and number of cyclic loads until veneering fracture when ceramic and metal ceramic restorations with different veneering ceramics were supported by implants. Thirty-two implant-supported single-tooth restorations were fabricated. The test group was composed of 16 ceramic restorations of zirconia abutment-retained crowns with zirconia copings veneered with glass-ceramics (n=8) and feldspathic ceramics (n=8). The control group was composed of 16 metal ceramic restorations of titanium abutment-retained crowns with gold alloy copings veneered with glass (n=8) and feldspathic ceramics (n=8). The palatal surfaces of the crowns were exposed to cyclic loading of 800 N with a frequency of 2 Hz, which continued to 4.2 million cycles or until fracture of the copings, abutments, or implants. The number of cycles and the fracture modes were recorded. The fracture modes were analyzed by descriptive analysis and the Mann-Whitney test (α=.05). The differences in loading cycles until veneering fracture were estimated with the Cox proportional hazards analysis. Veneering fracture was the most frequently observed fracture mode. The severity of fractures was significantly more in ceramic restorations than in metal ceramic restorations. Significantly more loading cycles until veneering fracture were estimated with metal ceramic restorations veneered with glass-ceramics than with other restorations. The metal ceramic restorations demonstrated fewer and less severe fractures and resisted more cyclic loads than the ceramic restorations, particularly when the metal ceramic crowns were veneered with glass-ceramics. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Observation of ground deformation associated with hydraulic fracturing and seismicity in the Western Canadian Sedimentary Basin

NASA Astrophysics Data System (ADS)

Kubanek, J.; Liu, Y.; Harrington, R. M.; Samsonov, S.

2017-12-01

In North America, the number of induced earthquakes related to fluid injection due to the unconventional recovery of oil and gas resources has increased significantly within the last five years. Recent studies demonstrate that InSAR is an effective tool to study surface deformation due to large-scale wastewater injection, and highlight the value of surface deformation monitoring with respect to understanding evolution of pore pressure and stress at depth - vital parameters to forecast fault reactivation, and thus, induced earthquakes. In contrast to earthquakes related to the injection of large amounts of wastewater, seismic activity related to the hydraulic fracturing procedure itself was, until recently, considered to play a minor role without significant hazard. In the Western Canadian Sedimentary Basin (WCSB), however, Mw>4 earthquakes have recently led to temporary shutdown of industrial injection activity, causing multi-million dollar losses to operators and raising safety concerns with the local population. Recent studies successfully utilize seismic data and modeling to link seismic activity with hydraulic fracturing in the WCSB. Although the study of surface deformation is likely the most promising tool for monitoring integrity of a well and to derive potential signatures prior to moderate or large induced events, InSAR has, to date, not been utilized to detect surface deformation related to hydraulic fracturing and seismicity. We therefore plan to analyze time-series of SAR data acquired between 1991 to present over two target sites in the WCSB that will enable the study of long- and short-term deformation. Since the conditions for InSAR are expected to be challenging due to spatial and temporal decorrelation, we have designed corner reflectors that will be installed at one target site to improve interferometric performance. The corner reflectors will be collocated with broadband seismometers and Trimble SeismoGeodetic Systems that simultaneously measure GNSS positioning and acceleration. We expect the joint data analysis of dense seismic and geodetic observations to give new insights about the correlation between surface deformation, fluid injection, and induced seismicity that can be used to assess the hazard potential of hydraulic fracturing in the WCSB.

"Beaned": A 5-Year Analysis of Baseball-Related Injuries of the Face.

PubMed

Carniol, Eric T; Shaigany, Kevin; Svider, Peter F; Folbe, Adam J; Zuliani, Giancarlo F; Baredes, Soly; Eloy, Jean Anderson

2015-12-01

Baseball remains one of the most popular and safest games played by children and adults in America and worldwide. Rules and equipment changes have continued to make the game safer. For youth leagues, pitching restrictions, safety balls, helmets, and face mask equipment continue to make the game safer. With increased utilization of safety equipment, the objective was to analyze recent trends in baseball-related facial injuries. Cross-sectional analysis of a national database. The National Electronic Injury Surveillance System was searched for baseball-related facial injuries with analysis of incidence, age, and sex and specific injury diagnoses, mechanisms, and facial locations. From 2009 to 2013, there were 5270 cases entries, or 187,533 estimated emergency department (ED) visits, due to baseball-related facial injuries. During this time, there was a significant decline in the incidence of ED visits (P = .014). Inclusion criteria were met by 3208 visits. The majority of injuries occurred in patients ≤18 years old (81.5%). The most common injury was laceration (33.2%), followed by contusion (29.7%) and fracture (26.9%), while the most common injury site on the face was the nose (24.9%). The injuries were most commonly due to impact from a baseball (70%) or a bat (12.5%). The overall incidence of ED visits due to baseball-related facial injuries has decreased over the past 5 years, concurrent with increased societal use of protective equipment. Nonetheless, these injuries remain a common source for ED visits, and a continued effort to utilize safety measures should be made, particularly in youth leagues. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Studying physical properties of deformed intact and fractured rocks by micro-scale hydro-mechanical-seismicity model

NASA Astrophysics Data System (ADS)

Raziperchikolaee, Samin

The pore pressure variation in an underground formation during hydraulic stimulation of low permeability formations or CO2 sequestration into saline aquifers can induce microseismicity due to fracture generation or pre-existing fracture activation. While the analysis of microseismic data mainly focuses on mapping the location of fractures, the seismic waves generated by the microseismic events also contain information for understanding of fracture mechanisms based on microseismic source analysis. We developed a micro-scale geomechanics, fluid-flow and seismic model that can predict transport and seismic source behavior during rock failure. This model features the incorporation of microseismic source analysis in fractured and intact rock transport properties during possible rock damage and failure. The modeling method considers comprehensive grains and cements interaction through a bonded-particle-model. As a result of grain deformation and microcrack development in the rock sample, forces and displacements in the grains involved in the bond breakage are measured to determine seismic moment tensor. In addition, geometric description of the complex pore structure is regenerated to predict fluid flow behavior of fractured samples. Numerical experiments are conducted for different intact and fractured digital rock samples, representing various mechanical behaviors of rocks and fracture surface properties, to consider their roles on seismic and transport properties of rocks during deformation. Studying rock deformation in detail provides an opportunity to understand the relationship between source mechanism of microseismic events and transport properties of damaged rocks to have a better characterizing of fluid flow behavior in subsurface formations.

Statistical methods of fracture characterization using acoustic borehole televiewer log interpretation

NASA Astrophysics Data System (ADS)

Massiot, Cécile; Townend, John; Nicol, Andrew; McNamara, David D.

2017-08-01

Acoustic borehole televiewer (BHTV) logs provide measurements of fracture attributes (orientations, thickness, and spacing) at depth. Orientation, censoring, and truncation sampling biases similar to those described for one-dimensional outcrop scanlines, and other logging or drilling artifacts specific to BHTV logs, can affect the interpretation of fracture attributes from BHTV logs. K-means, fuzzy K-means, and agglomerative clustering methods provide transparent means of separating fracture groups on the basis of their orientation. Fracture spacing is calculated for each of these fracture sets. Maximum likelihood estimation using truncated distributions permits the fitting of several probability distributions to the fracture attribute data sets within truncation limits, which can then be extrapolated over the entire range where they naturally occur. Akaike Information Criterion (AIC) and Schwartz Bayesian Criterion (SBC) statistical information criteria rank the distributions by how well they fit the data. We demonstrate these attribute analysis methods with a data set derived from three BHTV logs acquired from the high-temperature Rotokawa geothermal field, New Zealand. Varying BHTV log quality reduces the number of input data points, but careful selection of the quality levels where fractures are deemed fully sampled increases the reliability of the analysis. Spacing data analysis comprising up to 300 data points and spanning three orders of magnitude can be approximated similarly well (similar AIC rankings) with several distributions. Several clustering configurations and probability distributions can often characterize the data at similar levels of statistical criteria. Thus, several scenarios should be considered when using BHTV log data to constrain numerical fracture models.

Development and application of computer assisted optimal method for treatment of femoral neck fracture.

PubMed

Wang, Monan; Zhang, Kai; Yang, Ning

2018-04-09

To help doctors decide their treatment from the aspect of mechanical analysis, the work built a computer assisted optimal system for treatment of femoral neck fracture oriented to clinical application. The whole system encompassed the following three parts: Preprocessing module, finite element mechanical analysis module, post processing module. Preprocessing module included parametric modeling of bone, parametric modeling of fracture face, parametric modeling of fixed screw and fixed position and input and transmission of model parameters. Finite element mechanical analysis module included grid division, element type setting, material property setting, contact setting, constraint and load setting, analysis method setting and batch processing operation. Post processing module included extraction and display of batch processing operation results, image generation of batch processing operation, optimal program operation and optimal result display. The system implemented the whole operations from input of fracture parameters to output of the optimal fixed plan according to specific patient real fracture parameter and optimal rules, which demonstrated the effectiveness of the system. Meanwhile, the system had a friendly interface, simple operation and could improve the system function quickly through modifying single module.

Numerical simulation based on core analysis of a single fracture in an Enhanced Geothermal System

NASA Astrophysics Data System (ADS)

Jarrahi, Miad; Holländer, Hartmut

2017-04-01

The permeability of reservoirs is widely affected by the presence of fractures dispersed within them, as they form superior paths for fluid flow. Core analysis studies the fractures characteristics and explains the fluid-rock interactions to provide the information of permeability and saturation of a hydraulic fracturing reservoir or an enhanced geothermal system (EGS). This study conducted numerical simulations of a single fracture in a Granite core obtained from a depth of 1890 m in borehole EPS1 from Soultz-sous-Forêts, France. Blaisonneau et al. (2016) designed the apparatus to investigate the complex physical phenomena on this cylindrical sample. The method of the tests was to percolate a fluid through a natural fracture contained in a rock sample, under controlled thermo-hydro-mechanical conditions. A divergent radial flow within the fracture occurred due to the injection of fluid into the center of the fracture. The tests were performed within a containment cell with a normal stress of 2.6, 4.9, 7.2 and 9.4 MPa loading on the sample perpendicular to the fracture plane. This experiment was numerically performed to provide an efficient numerical method by modeling single phase flow in between the fracture walls. Detailed morphological features of the fracture such as tortuosity and roughness, were obtained by image processing. The results included injection pressure plots with respect to injection flow rate. Consequently, by utilizing Hagen-Poiseuille's cubic law, the equivalent hydraulic aperture size, of the fracture was derived. Then, as the sample is cylindrical, to modify the Hagen-Poiseuille's cubic law for circular parallel plates, the geometric relation was applied to obtain modified hydraulic aperture size. Finally, intrinsic permeability of the fracture under each mechanical normal stress was evaluated based on modified hydraulic aperture size. The results were presented in two different scenarios, before and after reactive percolation test, to demonstrate the effect of chemical reactive flow. The fracture after percolation test showed larger equivalent aperture size and higher permeability. Additionally, the higher the normal stress, the lower permeability was investigated. This confirmed the permeability evolution due to chemical percolation and mechanical loading. All results showed good agreements with corresponding experimental results provided by Blaisonneau et al. (2016). Keyword: Core analysis, Hydraulic fracturing, Enhanced geothermal system, Permeability, Fluid-rock interactions.

Clinical and Radiologic Predictive Factors of Rib Fractures in Outpatients With Chest Pain.

PubMed

Zhang, Liang; McMahon, Colm J; Shah, Samir; Wu, Jim S; Eisenberg, Ronald L; Kung, Justin W

To identify the clinical and radiologic predictive factors of rib fractures in stable adult outpatients presenting with chest pain and to determine the utility of dedicated rib radiographs in this population of patients. Following Institutional Review Board approval, we performed a retrospective review of 339 consecutive cases in which a frontal chest radiograph and dedicated rib series had been obtained for chest pain in the outpatient setting. The frontal chest radiograph and dedicated rib series were sequentially reviewed in consensus by two fellowship-trained musculoskeletal radiologists blinded to the initial report. The consensus interpretation of the dedicated rib series was used as the gold standard. Multiple variable logistic regression analysis assessed clinical and radiological factors associated with rib fractures. Fisher exact test was used to assess differences in medical treatment between the 2 groups. Of the 339 patients, 53 (15.6%) had at least 1 rib fracture. Only 20 of the 53 (37.7%) patients' fractures could be identified on the frontal chest radiograph. The frontal chest radiograph had a sensitivity of 38% and specificity of 100% when using the rib series as the reference standard. No pneumothorax, new mediastinal widening or pulmonary contusion was identified. Multiple variable logistic regression analysis of clinical factors associated with the presence of rib fractures revealed a significant association of trauma history (odds ratio 5.7 [p < 0.05]) and age ≥40 (odds radio 3.1 [p < 0.05]). Multiple variable logistic regression analysis of radiographic factors associated with rib fractures in this population demonstrated a significant association of pleural effusion with rib fractures (odds ratio 18.9 [p < 0.05]). Patients with rib fractures received narcotic analgesia in 47.2% of the cases, significantly more than those without rib fractures (21.3%, p < 0.05). None of the patients required hospitalization. In the stable outpatient setting, rib fractures have a higher association with a history of minor trauma and age ≥40 in the adult population. Radiographic findings associated with rib fractures include pleural effusion. The frontal chest radiograph alone has low sensitivity in detecting rib fractures. The dedicated rib series detected a greater number of rib fractures. Although no patients required hospitalization, those with rib fractures were more likely to receive narcotic analgesia. Copyright © 2018 Elsevier Inc. All rights reserved.

Alendronate prevents glucocorticoid-induced osteoporosis in patients with rheumatic diseases

PubMed Central

Kan, Shun-Li; Yuan, Zhi-Fang; Li, Yan; Ai, Jie; Xu, Hong; Sun, Jing-Cheng; Feng, Shi-Qing

2016-01-01

Abstract Glucocorticoid-induced osteoporosis (GIOP) is a serious problem for patients with rheumatic diseases requiring long-term glucocorticoid treatment. Alendronate, a bisphosphonate, has been recommended in the prevention of GIOP. However, the efficacy and safety of alendronate in preventing GIOP remains controversial. We performed a meta-analysis to investigate the efficacy and safety of alendronate in preventing GIOP in patients with rheumatic diseases. We retrieved randomized controlled trials from PubMed, EMBASE, and the Cochrane Library. Two reviewers extracted the data and evaluated the risk of bias and quality of the evidence. We calculated the risk ratio (RR) with a 95% confidence interval (CI) for dichotomous outcomes, and the mean difference (MD) with a 95% CI for continuous outcomes using Review Manager, version 5.3. A total of 339 studies were found, and 9 studies (1134 patients) were included. Alendronate was not able to reduce the incidence of vertebral fractures (RR = 0.63, 95% CI: 0.10–4.04, P = 0.62) and nonvertebral fractures (RR = 0.40, 95% CI: 0.15–1.12, P = 0.08). Alendronate significantly increased the percent change in bone mineral density (BMD) at the lumbar spine (MD = 3.66, 95% CI: 2.58–4.74, P < 0.05), total hip (MD = 2.08, 95% CI: 0.41–3.74, P < 0.05), and trochanter (MD = 1.68, 95% CI: 0.75–2.61, P < 0.05). Significant differences were not observed in the percent change in BMD at the femoral neck (MD = −0.33, 95% CI: −2.79 to 2.13, P = 0.79) and total body (MD = 0.64, 95% CI: −0.06 to 1.34, P = 0.07). No significant differences in the adverse events were observed in patients treated with alendronate versus the controls (RR = 1.00, 95% CI: 0.94–1.07, P = 0.89). The odds of gastrointestinal adverse events were significantly reduced (RR = 0.77, 95% CI: 0.62–0.97, P < 0.05). Our analysis suggests that alendronate can increase the percent change in BMD at the lumbar spine, total hip, and trochanter, and is not associated with an increased incidence of gastrointestinal adverse events; however, the vertebral and nonvertebral fractures cannot be reduced. However, the results should be interpreted with caution due to the poor statistical power. PMID:27336902

Percutaneous pedicle screw fixation through the pedicle of fractured vertebra in the treatment of type A thoracolumbar fractures using Sextant system: an analysis of 38 cases.

PubMed

Wang, Hong-wei; Li, Chang-qing; Zhou, Yue; Zhang, Zheng-feng; Wang, Jian; Chu, Tong-wei

2010-06-01

To prospectively evaluate the feasibility, safety and efficacy of the percutaneous pedicle screw fixation through the pedicle of fractured vertebra in the treatment of type A thoracolumbar fractures using Sextant system in the retrospective non-randomized case-control study. A total of 38 consecutive non-randomized patients with type A thoracolumbar fractures, which had been stabilized posteriorly from December 2006 to March 2009, were examined retrospectively more than 9 months after surgery. Twenty-one patients had been treated conventionally with open pedicle screw fixation (OPSF) and 17 patients received minimally invasive treatment with Sextant percutaneous pedicle screw fixation (SPPSF). As a method of evaluation, the incision size, the intraoperation and postoperative volume of blood loss, operation time, postoperative hospital stay, blood transfusion, the radiological assessment of the sagittal Cobb;s angle, vertebral body angle and vertebral body height were recorded and compared. All patients were followed up for 8-24 months (average 11.6 months). There were significant differences in the incision size, surgical blood loss, surgical draining loss, operation time, hospital stay after operation, blood transfusion, the proportion of antalgic supplement and postoperative incisional VAS between the two groups (P less than 0.05). Mean preoperative kyphotic deformity was 16.0 degree and improved by 9.3 degree after surgery in OPSF group, but 15.2 degree and 10.3 degree respectively in SPPSF group. Mean preoperative angle of the fractured vertebral body was 15.9 degree and improved by 7.9 degree after surgery in OPSF group, but 14.9 degree and 6.6 degree respectively in SPPSF group. Mean anterior vertebral body height (% of normal) was 67.3% before surgery and 95.8% after surgery, but 69.1% and 90.1% respectively in SPPSF group. Mean posterior vertebral body height (% of normal) was 93.3% before surgery and 99.5% after surgery, but 88.9% and 93.3% respectively in SPPSF group. Among the patients whose 9-month follow-up films were available, 3.0 degree of kyphosis correction was lost in OPSF group, but 3.2 degree in SPPSF group. And 1.0 degree of the angle of the fractured vertebral body correction was lost in OPSF group, but 1.5 degree in SPPSF group. Then 3.0% of the anterior vertebral body height correction was lost in OPSF group, but 2.2% in SPPSF group. And 3.0% of the posterior vertebral body height correction was lost in OPSF group, but 2.5% in SPPSF group. The sagittal Cobb's angle, vertebral body angle and anterior height of the fractured vertebra were all significantly different in each group before and after operation (P less than 0.05). There were no significant differences in the postoperative sagittal Cobb's angle, vertebral body angle and the improvement of the vertebral body height and the kyphotic deformity correction between OPSF and SPPSF groups (P larger than 0.05), but there was significant difference in the postoperative anterior height of the fractured vertebra between the two groups (P less than 0.05). The percutaneous pedicle screw fixation through the pedicle of fractured vertebra using Sextant system is a good minimally-invasive surgical therapeutic choice for patients with type A thoracolumbar fracture except for that the SPPSF has a little insufficiency in resuming the anterior height of the fractured vertebra compared with OPSF.

Are Floor-Fractured Craters on Ceres Formed by Cryomagmatism?

NASA Astrophysics Data System (ADS)

Buczkowski, D. L.; Sizemore, H. G.; Bland, M. T.; Scully, J. E. C.; Quick, L. C.; Hughson, K. H. G.; Park, R. S.; Preusker, F.; Raymond, C. A.; Russell, C. T.

2018-06-01

Several of the impact craters on Ceres have sets of fractures on their floors, morphologically similar lunar Floor-Fractured Craters. We present a geomorphic and topographic analysis of the cerean FFCs and propose hypotheses for their formation.

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

Chattopadhyay, J.; Dutta, B.K.; Kushwaha, H.S.

Leak-Before-Break (LBB) is being used to design the primary heat transport piping system of 500 MWe Indian Pressurized Heavy Water Reactors (IPHWR). The work is categorized in three directions to demonstrate three levels of safety against sudden catastrophic break. Level 1 is inherent in the design procedure of piping system as per ASME Sec.III with a well defined factor of safety. Level 2 consists of fatigue crack growth study of a postulated part-through flaw at the inside surface of pipes. Level 3 is stability analysis of a postulated leakage size flaw under the maximum credible loading condition. Developmental work relatedmore » to demonstration of level 2 and level 3 confidence is described in this paper. In a case study on fatigue crack growth on PHT straight pipes for level 2, negligible crack growth is predicted for the life of the reactor. For level 3 analysis, the R6 method has been adopted. A database to evaluate SIF of elbows with throughwall flaws under combined internal pressure and bending moment has been generated to provide one of the inputs for R6 method. The methodology of safety assessment of elbow using R6 method has been demonstrated for a typical pump discharge elbow. In this analysis, limit load of the cracked elbow has been determined by carrying out elasto-plastic finite element analysis. The limit load results compared well with those given by Miller. However, it requires further study to give a general form of limit load solution. On the experimental front, a set of small diameter pipe fracture experiments have been carried out at room temperature and 300{degrees}C. Two important observations of the experiments are - appreciable drop in maximum load at 300{degrees}C in case of SS pipes and out-of-plane crack growth in case of CS pipes. Experimental load deflection curves are finally compared with five J-estimation schemes predictions. A material database of PHT piping materials is also being generated for use in LBB analysis.« less

External Validation of the Garvan Nomograms for Predicting Absolute Fracture Risk: The Tromsø Study

PubMed Central

Ahmed, Luai A.; Nguyen, Nguyen D.; Bjørnerem, Åshild; Joakimsen, Ragnar M.; Jørgensen, Lone; Størmer, Jan; Bliuc, Dana; Center, Jacqueline R.; Eisman, John A.; Nguyen, Tuan V.; Emaus, Nina

2014-01-01

Background Absolute risk estimation is a preferred approach for assessing fracture risk and treatment decision making. This study aimed to evaluate and validate the predictive performance of the Garvan Fracture Risk Calculator in a Norwegian cohort. Methods The analysis included 1637 women and 1355 aged 60+ years from the Tromsø study. All incident fragility fractures between 2001 and 2009 were registered. The predicted probabilities of non-vertebral osteoporotic and hip fractures were determined using models with and without BMD. The discrimination and calibration of the models were assessed. Reclassification analysis was used to compare the models performance. Results The incidence of osteoporotic and hip fracture was 31.5 and 8.6 per 1000 population in women, respectively; in men the corresponding incidence was 12.2 and 5.1. The predicted 5-year and 10-year probability of fractures was consistently higher in the fracture group than the non-fracture group for all models. The 10-year predicted probabilities of hip fracture in those with fracture was 2.8 (women) to 3.1 times (men) higher than those without fracture. There was a close agreement between predicted and observed risk in both sexes and up to the fifth quintile. Among those in the highest quintile of risk, the models over-estimated the risk of fracture. Models with BMD performed better than models with body weight in correct classification of risk in individuals with and without fracture. The overall net decrease in reclassification of the model with weight compared to the model with BMD was 10.6% (p = 0.008) in women and 17.2% (p = 0.001) in men for osteoporotic fractures, and 13.3% (p = 0.07) in women and 17.5% (p = 0.09) in men for hip fracture. Conclusions The Garvan Fracture Risk Calculator is valid and clinically useful in identifying individuals at high risk of fracture. The models with BMD performed better than those with body weight in fracture risk prediction. PMID:25255221

Quantifying irreversible movement in steep, fractured bedrock permafrost on Matterhorn (CH)

NASA Astrophysics Data System (ADS)

Weber, Samuel; Beutel, Jan; Faillettaz, Jérome; Hasler, Andreas; Krautblatter, Michael; Vieli, Andreas

2017-02-01

Understanding rock slope kinematics in steep, fractured bedrock permafrost is a challenging task. Recent laboratory studies have provided enhanced understanding of rock fatigue and fracturing in cold environments but were not successfully confirmed by field studies. This study presents a unique time series of fracture kinematics, rock temperatures and environmental conditions at 3500 m a. s. l. on the steep, strongly fractured Hörnligrat of the Matterhorn (Swiss Alps). Thanks to 8 years of continuous data, the longer-term evolution of fracture kinematics in permafrost can be analyzed with an unprecedented level of detail. Evidence for common trends in spatiotemporal pattern of fracture kinematics could be found: a partly reversible seasonal movement can be observed at all locations, with variable amplitudes. In the wider context of rock slope stability assessment, we propose separating reversible (elastic) components of fracture kinematics, caused by thermoelastic strains, from the irreversible (plastic) component due to other processes. A regression analysis between temperature and fracture displacement shows that all instrumented fractures exhibit reversible displacements that dominate fracture kinematics in winter. Furthermore, removing this reversible component from the observed displacement enables us to quantify the irreversible component. From this, a new metric - termed index of irreversibility - is proposed to quantify relative irreversibility of fracture kinematics. This new index can identify periods when fracture displacements are dominated by irreversible processes. For many sensors, irreversible enhanced fracture displacement is observed in summer and its initiation coincides with the onset of positive rock temperatures. This likely indicates thawing-related processes, such as meltwater percolation into fractures, as a forcing mechanism for irreversible displacements. For a few instrumented fractures, irreversible displacements were found at the onset of the freezing period, suggesting that cryogenic processes act as a driving factor through increasing ice pressure. The proposed analysis provides a tool for investigating and better understanding processes related to irreversible kinematics.

Discriminative capacity of calcaneal quantitative ultrasound and of osteoporosis and fracture risk factors in postmenopausal women with osteoporotic fractures.

PubMed

Hernández, J L; Marin, F; González-Macías, J; Díez-Pérez, A; Vila, J; Giménez, S; Galán, B; Arenas, M S; Suárez, F; Gayola, L; Guillén, G; Sagredo, T; Belenguer, R; Moron, A; Arriaza, E

2004-04-01

Bone fragility fractures constitute the principal complication of osteoporosis. The identification of individuals at high risk of sustaining osteoporotic fractures is important for implementing preventive measures. The purpose of this study is to analyze the discriminative capacity of a series of osteoporosis and fracture risk factors, and of calcaneal quantitative ultrasound (QUS), in a population of postmenopausal women with a history of osteoporotic fracture. A cross-sectional analysis was made of a cohort of 5195 women aged 65 or older (mean +/- SD: 72.3 +/- 5.4 years) seen in 58 primary care centers in Spain. A total of 1042 women (20.1%) presented with a history of osteoporotic fracture. Most fractures (93%) were non-vertebral. Age-adjusted odds ratios corresponding to each decrease in one standard deviation of the different QUS parameters ranged from 1.47 to 1.55 (P < 0.001) for fractures. The age-adjusted multivariate analysis yielded the following risk factors independently associated with a history of osteoporotic fracture: number of fertile years, a family history of fracture, falls in the previous year, a history of chronic obstructive airway disease, the use of antiarrhythmic drugs, and a low value for any of the QUS parameters. The area under the receiver operating characteristic curve of the best model was 0.656. In summary, a series of easily assessable osteoporotic fracture risk factors has been identified. QUS was shown to discriminate between women with and without a history of fracture, and constitutes a useful tool for assessing fracture risk. Various of the vertebral and hip fracture risk factors frequently cited in North American and British populations showed no discriminative capacity in our series--thus suggesting that such factors may not be fully applicable to our population and/or to the predominant type of fractures included in the present study.

Fractography of induction-hardened steel fractured in fatigue and overload

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

Santos, C.G.; Laird, C.

1997-07-01

The fracture surfaces of induction-hardened steel specimens obtained from an auto axle were characterized, macroscopically and microscopically, after being fractured in fatigue and monotonic overload. Specimens were tested in cyclic three-point bending under load control, and the S-N curve was established for specimens that had been notched by spark machining to facilitate fractography. Scanning electron microscopy of the fractured surfaces obtained for lives spanning the range 17,000 to 418,000 cycles revealed diverse fracture morphologies, including intergranular fracture and transgranular fatigue fracture. The results are being offered to assist in the analysis of complex field failures in strongly hardened steel.

Characterizing Fractures Across the Astronaut Corps: Preliminary Findings from Population-Level Analysis

NASA Technical Reports Server (NTRS)

Rossi, Meredith M.; Charvat, Jacqueline; Sibonga, Jean; Sieker, Jeremy

2017-01-01

Despite evidence of bone loss during spaceflight and operational countermeasures to mitigate this loss, the subsequent risk of fracture among astronauts is not known. The physiologic process of diminished bone density and bone recovery during or following spaceflight is multifactorial. Such factors as age, sex, fracture history, and others may combine to increase fracture risk among astronauts. As part of the 2016 Bone Research and Clinical Advisory Panel (RCAP), the authors analyzed data collected on 338 NASA astronauts to describe the demographics, bone-relevant characteristics, and fracture history of the astronaut population. The majority of the population are male (n=286, 84.6%), have flown at least one mission (n=306, 90.5%), and were between the ages of 30 and 49 at first mission (n=296, 96.7% of those with at least one mission). Of the 338 astronauts, 241 (71.3%) experienced a fracture over the course of their lifetime. One hundred and five (43.5%) of these 241 astronauts only experienced a fracture prior to being selected into the Astronaut Corps, whereas 53 (22.0%) only experienced a fracture after selection as an astronaut. An additional 80 astronauts (33.2%) had both pre- and post-selection fractures. The remaining 3 astronauts had a fracture of unknown date, which could not be categorized as pre- or post-selection. Among the 133 astronauts with at least one post-selection fracture, males comprised 90.2% (n=120) compared to 84.5% of the entire Corps, and females accounted for 9.8% (n=13) compared to 15.4% of the Corps. Ninety-seven of the 133 astronauts with post-selection fractures (72.9%) had one fracture event, 22 (16.5%) had two fractures, and 14 (10.5%) had three or more fractures. Some astronauts with multiple fractures suffered these in a single event, such as an automobile accident. The 133 astronauts with a post-selection fracture accounted for a total of 188 fracture events. One hundred and four (78.2%) of astronauts with post-selection fractures experienced those fractures following their first mission (mean 12.7 +/- 11.1 years following first mission; range 14.0 days - 50.6 years). Additional analyses are ongoing and include examination of fracture history, skeletal site, mechanism, and type of fracture, age at time of fracture, time from spaceflight to fracture, as well as multivariable analysis comparing fracture events to non-events. The results of such analyses may reveal trends in risk factors for fracture among the astronaut corps that have yet to be systematically described through a corps-wide approach.

Reliable classification of children’s fractures according to the comprehensive classification of long bone fractures by Müller

PubMed Central

2013-01-01

Background and purpose Guidelines for fracture treatment and evaluation require a valid classification. Classifications especially designed for children are available, but they might lead to reduced accuracy, considering the relative infrequency of childhood fractures in a general orthopedic department. We tested the reliability and accuracy of the Müller classification when used for long bone fractures in children. Methods We included all long bone fractures in children aged < 16 years who were treated in 2008 at the surgical ward of Stavanger University Hospital. 20 surgeons recorded 232 fractures. Datasets were generated for intra- and inter-rater analysis, as well as a reference dataset for accuracy calculations. We present proportion of agreement (PA) and kappa (K) statistics. Results For intra-rater analysis, overall agreement (κ) was 0.75 (95% CI: 0.68–0.81) and PA was 79%. For inter-rater assessment, K was 0.71 (95% CI: 0.61–0.80) and PA was 77%. Accuracy was estimated: κ = 0.72 (95% CI: 0.64–0.79) and PA = 76%. Interpretation The Müller classification (slightly adjusted for pediatric fractures) showed substantial to excellent accuracy among general orthopedic surgeons when applied to long bone fractures in children. However, separate knowledge about the child-specific fracture pattern, the maturity of the bone, and the degree of displacement must be considered when the treatment and the prognosis of the fractures are evaluated. PMID:23245225

The kick with the kite: an analysis of kite surfing related off shore rescue missions in Cape Town, South Africa

PubMed Central

Exadaktylos, A; Sclabas, G; Blake, I; Swemmer, K; McCormick, G; Erasmus, P; Muhm, M; Curatolo, M

2005-01-01

Methods: The observation period for this study started on October 1, 2003 and ended on May 1, 2004 and included 30 air rescue missions. Data and information were collected prospectively. Results: The Air Mercy Service in Cape Town Province responded to 30 requests for help. Twenty five accidents were attributed to inability to detach the kite from the harness. Injuries occurred in five incidents and included fractures of the upper arm, ribs and ankle, and lacerations and contusions to the head and neck. Two patients suffered from hypothermia and one experienced severe exhaustion. All surfers were rescued successfully and there were no fatal accidents. Discussion: The risk potential of this new sport is unclear. Dangerous situations can occur despite proper training and safety precautions due to unpredictable conditions and difficulties with equipment. Safety should be stressed. Surfers should sailing with a fellow kiter and should wear a life vest. More efforts must be taken to make this booming new water sport safer. PMID:15849279

A New Method to Measure Crack Extension in Nuclear Graphite Based on Digital Image Correlation

DOE PAGES

Lai, Shigang; Shi, Li; Fok, Alex; ...

2017-01-01

Graphite components, used as moderators, reflectors, and core-support structures in a High-Temperature Gas-Cooled Reactor, play an important role in the safety of the reactor. Specifically, they provide channels for the fuel elements, control rods, and coolant flow. Fracture is the main failure mode for graphite, and breaching of the above channels by crack extension will seriously threaten the safety of a reactor. In this paper, a new method based on digital image correlation (DIC) is introduced for measuring crack extension in brittle materials. Cross-correlation of the displacements measured by DIC with a step function was employed to identify the advancingmore » crack tip in a graphite beam specimen under three-point bending. The load-crack extension curve, which is required for analyzing the R-curve and tension softening behaviors, was obtained for this material. Furthermore, a sensitivity analysis of the threshold value employed for the cross-correlation parameter in the crack identification process was conducted. Finally, the results were verified using the finite element method.« less

A New Method to Measure Crack Extension in Nuclear Graphite Based on Digital Image Correlation

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

Lai, Shigang; Shi, Li; Fok, Alex

Graphite components, used as moderators, reflectors, and core-support structures in a High-Temperature Gas-Cooled Reactor, play an important role in the safety of the reactor. Specifically, they provide channels for the fuel elements, control rods, and coolant flow. Fracture is the main failure mode for graphite, and breaching of the above channels by crack extension will seriously threaten the safety of a reactor. In this paper, a new method based on digital image correlation (DIC) is introduced for measuring crack extension in brittle materials. Cross-correlation of the displacements measured by DIC with a step function was employed to identify the advancingmore » crack tip in a graphite beam specimen under three-point bending. The load-crack extension curve, which is required for analyzing the R-curve and tension softening behaviors, was obtained for this material. Furthermore, a sensitivity analysis of the threshold value employed for the cross-correlation parameter in the crack identification process was conducted. Finally, the results were verified using the finite element method.« less

Imaging hydraulic fractures at Median Tectonic Line, Japan using multiply generated and scattered tube waves in a shallow VSP experiment

NASA Astrophysics Data System (ADS)

Minato, Shohei; Ghose, Ranajit; Tsuji, Takeshi; Ikeda, Michiharu; Onishi, Kozo

2016-04-01

Tube waves are low frequency guided waves that propagate along a fluid-filled borehole. The analysis of tube waves is a promising approach to image and characterize hydraulic fractures intersecting a borehole. It exploits tube waves generated by an external seismic wavefield which compresses fractures and injects fluid into the borehole. It also utilizes the attenuation of tube waves due to fluid exchange between the fracture and the borehole, which creates scattered waves (reflection and transmission). Conventional approaches consider tube waves due to a single fracture. However, when the spacing between multiple fractures is short relative to the wavelength of the tube waves, the generated and scattered tube waves interfere with each other, making it difficult to isolate the effect of a single fracture. The analysis of closely spaced fractures is important in highly fractured areas, such as a fault zone. In this study, we explore the possibility of prediction and utilization of generated and scattered tube waves due to multiple fractures. We derive a new integral equation of the full tube wavefield using 1D wavefield representation theory incorporating nonwelded interfaces. We adapt the recent developments in modeling tube wave generation/scattering at a fracture. In these models, a fracture is represented as a parallel wall or a thin poloelastic layer. This allowed us to consider the effects of a dynamic fracture aperture with fracture compliances and the permeability. The representation also leads to a new imaging method for the hydraulic fractures, using multiply-generated and scattered tube waves. This is achieved by applying an inverse operator to the observed tube waves, which focuses the tube waves to the depth where they are generated and/or scattered. The inverse operator is constructed by a tube wave Green's function with a known propagation velocity. The Median Tectonic Line (MTL) is the most significant fault in Japan, extending NE-SW for over 1000 km across the Japanese Islands. We observed multiple tube waves in a P-wave VSP experiment in a 250 m deep, vertical borehole located on the MTL at Shikoku, Japan. The borehole televiewer and the core studies show that below 40 m depth, the Sambagawa metamorphic rocks contain highly fractured zones which consist of more than 100 open fractures and more than 30 cataclasites. We predict the full tube wavefield using the values of fracture depth and thickness known from the borehole televiewer. We model the open fractures as parallel-wall fractures and the cataclasites as thin poroelastic layers. Furthermore, we estimate the depth of the hydraulic fractures by applying the inverse operator. The results show that the tube waves could be generated and scattered at these permeable structures. Our preliminary results also indicate the possibility that the effect of the open fractures is more dominant in the generation and scattering of tube waves than that of the cataclasites in this field. The formulation and the results presented in this study and the following discussion will be useful in analysis of tube waves in highly fractured zones, in order to localize and characterize hydraulic fractures.

Vertebral body fracture after anterior cervical discectomy and fusion with zero-profile anchored cages in adjacent levels: a cautionary tale.

PubMed

Mattei, Tobias A; Teles, Alisson R; Dinh, Dzung H

2016-01-05

Zero-profile (also called self-locking, anchored or stand-alone cages) have been recently proposed as an interesting alternative for anterior cervical discectomy and fusion (ACDF), as they are supposed to reduce the rates of post-operative cage extrusion without necessarily incurring in the additional surgical time and increased rates of dysphagia associated with plating. Nevertheless, the exact indications of zero-profile anchored cages have not yet been established in the literature. To report the first case of a vertebral body fracture between the blades of zero-profile anchored cages after ACDFs in adjacent levels and to review the available literature on hardware-related complications after multi-level ACDFs with zero-profile anchored cages. Case report and systematic literature review. The authors report the first case of a vertebral body fracture between the blades of zero-profile anchored cages after ACDFs in adjacent levels. The patient presented with refractory mechanical neck pain at the 1-month post-operative follow-up, ultimately requiring a posterior instrumented fusion. A comprehensive systematic literature review on the available data regarding the safety, complications as well as radiological and clinical outcomes of zero-profile anchored cages is also performed. In the reported case, the use of zero-profile anchored cages in adjacent levels on the cervical spine led to a fracture of the vertebral body between the cages at the 1-month follow-up, with anterior avulsion of the part of the vertebral body where the blades from the two cages converged. According to the systematic literature review which included 409 patients from 10 different clinical series (with a total cumulative follow-up of approximately 535 patients-year), there were only two reported hardware-related complications after ACDF with zero-profile anchored cages, none of them involving fracture at the level of convergence of blades or screws. Although hardware-related complications after the use of zero-profile anchored cages seem to be rare events, future biomechanical and clinical studies are warranted in order to evaluate the safety of employing such devices for the treatment of multilevel degenerative disc disease in the cervical spine.

Timing of Surgery for Spinal Fractures Associated with Systemic Trauma: A Need for a Strategic and Systemic Approach.

PubMed

Koksal, Ismet; Alagoz, Fatih; Celik, Haydar; Yildirim, Ali Erdem; Akin, Tezcan; Guvenc, Yahya; Karatay, Mete; Erdem, Yavuz

An underestimated evaluation of systemic organs in cases with spinal fractures might jeopardize the intervention for treatment and future complications with an increased morbidity and mortality are almost warranted. In the present study, a retrospective analysis of spinal fracture cases associated with systemic trauma was performed to assess surgical success. A retrospective analysis of patients with thoracolumbar fractures who were admitted to the emergency unit between September 2012 and September 2014 was used for the study. The cases were categorized according to age, sex, reason of trauma, associated trauma, neurological condition and treatment details and results were analysed using SPSS 14.0 for Windows. The most common reason of trauma is detected as falls in 101 cases (64.3%). Radiological evaluation of spinal fractures revealed a compression fracture in 106 cases (67.5%) and other fractures in 51 cases (32.5%). Surgical treatment for spinal fracture was performed in 60.5% of the cases and conservative approach was preferred in 39.5% cases. In non-compressive spinal fractures, an associated pathology like head trauma, lower extremity fracture or neurological deficit was found to be higher in incidence (p < 0.05). Necessity for surgical intervention was found to be more prominent in this group (p < 0.05). However, the fracture type was not found to be associated with morbidity and mortality (p < 0.05). A surgical intervention for a spinal fracture necessitating surgery should rather be performed right after stabilization of the systemic condition which might be associated with decreased morbidity and mortality.

Head injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and football.

PubMed

Delaney, J Scott

2004-03-01

To examine the number and rates of head injuries occurring in the community as a whole for the team sports of ice hockey, soccer, and football by analyzing data from patients presenting to US emergency departments (EDs) from 1990 to 1999. Retrospective analysis. Data compiled for the US Consumer Product Safety Commission using the National Electronic Injury Surveillance System were used to generate estimates for the total number of head injuries, concussions, internal head injuries, and skull fractures occurring on a national level from the years 1990 to 1999. These data were combined with yearly participation figures to generate rates of injuries presenting to the ED for each sport. There were an estimated 17,008 head injuries from ice hockey, 86,697 from soccer, and 204,802 from football that presented to US EDs from 1990 to 1999. The total number of concussions presenting to EDs in the United States over the same period was estimated to be 4820 from ice hockey, 21,715 from soccer, and 68,861 from football. While the rates of head injuries, concussions, and combined concussions/internal head injuries/skull fractures presenting to EDs per 10,000 players were not always statistically similar for all 3 sports in each year data were available, they were usually comparable. While the total numbers of head injuries, concussions, and combined concussions/skull fractures/internal head injuries presenting to EDs in the United States are different for ice hockey, soccer, and football for the years studied, the yearly rates for these injuries are comparable among all 3 sports.

In Vitro Evaluation of the Effect of Chemical and Thermal Stress of the Mechanical Properties of Periodontal Curettes under Simulated Conditions of Sharpening Wear.

PubMed

De Pedro, Daniel; Puglisi, Rosario; Levi, Paul; Pascual, Andrés; Nart, José

To determine whether chemical and thermal stress as well as sharpening are aspects that must be considered to determine when a curette has become too weak to be used safely without the threat of breakage. A total sample of 35 curette blades was divided into 2 principal groups, control (groups 1 to 3) and experimental (groups 4 to 6). The control group was divided into 3 colour-coded groups of 19 similar curette blades and was only subjected to progressive sharpening wear (not sterilised). The test group included 16 Gracey curette blades that were subjected to various degrees of progressive wear and different numbers of sterilisation cycles in 3 subgroups (subgroup 4 had 5 sterilisation cycles; subgroup 5 had 30 cycles and experimental subgroup 6 had 55 cycles). Using a universal testing machine, all blades were tested for strength until they fractured. No evidence was found that the simple presence or absence of sterilisation cycles produced a statistically significant difference between the two studied groups (sterilised and not sterilised). However, when comparing the six subgroups that underwent different numbers of sterilisation cycles, the analysis showed that the more sterilisation cycles a curette underwent, the more likely the curette was to fracture (p = 0.047). Sterilisation by itself does not produce a significant change in the fracture strength, whereas the number of sterilisation cycles clearly weakens the instrument. Sterilisation is a factor to control when evaluating the life of a periodontal curette for the patients' and professionals' safety.

Clinical factors affecting pathological fracture and healing of unicameral bone cysts

PubMed Central

2014-01-01

Background Unicameral bone cyst (UBC) is the most common benign lytic bone lesion seen in children. The aim of this study is to investigate clinical factors affecting pathological fracture and healing of UBC. Methods We retrospectively reviewed 155 UBC patients who consulted Nagoya musculoskeletal oncology group hospitals in Japan. Sixty of the 155 patients had pathological fracture at presentation. Of 141 patients with follow-up periods exceeding 6 months, 77 were followed conservatively and 64 treated by surgery. Results The fracture risk was significantly higher in the humerus than other bones. In multivariate analysis, ballooning of bone, cyst in long bone, male sex, thin cortical thickness and multilocular cyst were significant adverse prognostic factors for pathological fractures at presentation. The healing rates were 30% and 83% with observation and surgery, respectively. Multivariate analysis revealed that fracture at presentation and history of biopsy were good prognostic factors for healing of UBC in patients under observation. Conclusion The present results suggest that mechanical disruption of UBC such as fracture and biopsy promotes healing, and thus watchful waiting is indicated in these patients, whereas patients with poor prognostic factors for fractures should be considered for surgery. PMID:24884661

Clinical factors affecting pathological fracture and healing of unicameral bone cysts.

PubMed

Urakawa, Hiroshi; Tsukushi, Satoshi; Hosono, Kozo; Sugiura, Hideshi; Yamada, Kenji; Yamada, Yoshihisa; Kozawa, Eiji; Arai, Eisuke; Futamura, Naohisa; Ishiguro, Naoki; Nishida, Yoshihiro

2014-05-17

Unicameral bone cyst (UBC) is the most common benign lytic bone lesion seen in children. The aim of this study is to investigate clinical factors affecting pathological fracture and healing of UBC. We retrospectively reviewed 155 UBC patients who consulted Nagoya musculoskeletal oncology group hospitals in Japan. Sixty of the 155 patients had pathological fracture at presentation. Of 141 patients with follow-up periods exceeding 6 months, 77 were followed conservatively and 64 treated by surgery. The fracture risk was significantly higher in the humerus than other bones. In multivariate analysis, ballooning of bone, cyst in long bone, male sex, thin cortical thickness and multilocular cyst were significant adverse prognostic factors for pathological fractures at presentation. The healing rates were 30% and 83% with observation and surgery, respectively. Multivariate analysis revealed that fracture at presentation and history of biopsy were good prognostic factors for healing of UBC in patients under observation. The present results suggest that mechanical disruption of UBC such as fracture and biopsy promotes healing, and thus watchful waiting is indicated in these patients, whereas patients with poor prognostic factors for fractures should be considered for surgery.

A decision-analytic approach to predict state regulation of hydraulic fracturing.

PubMed

Linkov, Igor; Trump, Benjamin; Jin, David; Mazurczak, Marcin; Schreurs, Miranda

2014-01-01

The development of horizontal drilling and hydraulic fracturing methods has dramatically increased the potential for the extraction of previously unrecoverable natural gas. Nonetheless, the potential risks and hazards associated with such technologies are not without controversy and are compounded by frequently changing information and an uncertain landscape of international politics and laws. Where each nation has its own energy policies and laws, predicting how a state with natural gas reserves that require hydraulic fracturing will regulate the industry is of paramount importance for potential developers and extractors. We present a method for predicting hydraulic fracturing decisions using multiple-criteria decision analysis. The case study evaluates the decisions of five hypothetical countries with differing political, social, environmental, and economic priorities, choosing among four policy alternatives: open hydraulic fracturing, limited hydraulic fracturing, completely banned hydraulic fracturing, and a cap and trade program. The result is a model that identifies the preferred policy alternative for each archetypal country and demonstrates the sensitivity the decision to particular metrics. Armed with such information, observers can predict each country's likely decisions related to natural gas exploration as more data become available or political situations change. Decision analysis provides a method to manage uncertainty and address forecasting concerns where rich and objective data may be lacking. For the case of hydraulic fracturing, the various political pressures and extreme uncertainty regarding the technology's risks and benefits serve as a prime platform to demonstrate how decision analysis can be used to predict future behaviors.

How reliable and accurate is the AO/OTA comprehensive classification for adult long-bone fractures?

PubMed

Meling, Terje; Harboe, Knut; Enoksen, Cathrine H; Aarflot, Morten; Arthursson, Astvaldur J; Søreide, Kjetil

2012-07-01

Reliable classification of fractures is important for treatment allocation and study comparisons. The overall accuracy of scoring applied to a general population of fractures is little known. This study aimed to investigate the accuracy and reliability of the comprehensive Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association classification for adult long-bone fractures and identify factors associated with poor coding agreement. Adults (>16 years) with long-bone fractures coded in a Fracture and Dislocation Registry at the Stavanger University Hospital during the fiscal year 2008 were included. An unblinded reference code dataset was generated for the overall accuracy assessment by two experienced orthopedic trauma surgeons. Blinded analysis of intrarater reliability was performed by rescoring and of interrater reliability by recoding of a randomly selected fracture sample. Proportion of agreement (PA) and kappa (κ) statistics are presented. Uni- and multivariate logistic regression analyses of factors predicting accuracy were performed. During the study period, 949 fractures were included and coded by 26 surgeons. For the intrarater analysis, overall agreements were κ = 0.67 (95% confidence interval [CI]: 0.64-0.70) and PA 69%. For interrater assessment, κ = 0.67 (95% CI: 0.62-0.72) and PA 69%. The accuracy of surgeons' blinded recoding was κ = 0.68 (95% CI: 0.65- 0.71) and PA 68%. Fracture type, frequency of the fracture, and segment fractured significantly influenced accuracy whereas the coder's experience did not. Both the reliability and accuracy of the comprehensive Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association classification for long-bone fractures ranged from substantial to excellent. Variations in coding accuracy seem to be related more to the fracture itself than the surgeon. Diagnostic study, level I.

Bone scan as a screening test for missed fractures in severely injured patients.

PubMed

Lee, K-J; Jung, K; Kim, J; Kwon, J

2014-12-01

In many cases, patients with severe blunt trauma have multiple fractures throughout the body. These fractures are not often detectable by history or physical examination, and their diagnosis can be delayed or even missed. Thus, screening test fractures of the whole body is required after initial management. We performed this study to evaluate the reliability of bone scans for detecting missed fractures in patients with multiple severe traumas and we analyzed the causes of missed fractures by using bone scan. A bone scan is useful as a screening test for fractures of the entire body of severe trauma patients who are passed the acute phase. We reviewed the electronic medical records of severe trauma patients who underwent a bone scan from September 2009 to December 2010. Demographic and medical data were compared and statistically analyzed to determine whether missed fractures were detected after bone scan in the two groups. A total of 382 patients who had an injury severity score [ISS] greater than 16 points with multiple traumas visited the emergency room. One hundred and thirty-one patients underwent bone scan and 81 patients were identified with missed fractures by bone scan. The most frequent location for missed fractures was the rib area (55 cases, 41.98%), followed by the extremities (42 cases, 32.06%). The missed fractures that required surgery or splint were most common in extremities (11 cases). In univariate analysis, higher ISS scores and mechanism of injury were related with the probability that missed fractures would be found with a bone scan. The ISS score was statistically significant in multivariate analysis. Bone scan is an effective method of detecting missed fractures among patients with multiple severe traumas. Level IV, retrospective study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Increasing hip fracture rates among older adults in Ecuador: analysis of the National Hospital Discharge System, 1999-2016.

PubMed

Orces, Carlos H; Gavilanez, Enrique Lopez

2017-12-07

The Ecuadorian hospital discharge system examined trends in hip fracture hospitalization rates among older adults. A significant upward trend in hip fracture rates occurred in both genders over the study period. Previous research has reported increasing hip fracture rates in Ecuador. Thus, this study aimed to extend previous findings by examining the nationwide incidence of hip fractures among adults aged 65 years and older between 1999 and 2016. A secondary objective was to compare hip fracture trends among older Ecuadorians with their counterparts in the United States (U.S.). The National Hospital Discharge System and the Healthcare Cost and Utilization Project net were assessed to identify older adults hospitalized with a principal diagnosis of hip fractures in Ecuador and the U.S., respectively. The Joinpoint regression analysis software was used to examine the average annual percent change in hip fracture rates. A total of 20,091 adults with a mean age of 82.3 (SD 8.1) years were hospitalized with a principal diagnosis of hip fractures during the study period. After an adjustment for age, hip fracture rates increased annually on average by 4.6% (95% CI 3.8%, 5.4%) from 96.4/100,000 in 1999 to 173.1/100,000 persons in 2016. Between 1999 and 2014, hip fracture age-adjusted rates decreased on average by - 2.5% (95% CI - 2.7%, - 2.3%) among older adults in the U.S. while hip fracture rates steadily increased by 4.6% (95% CI, 3.6%, 5.7%) per year in their Ecuadorian counterparts. Hip fracture rates markedly increased among older adults in Ecuador. The present findings should alert public health authorities to implement policies of osteoporosis awareness and prevention in Ecuador.

Analysis of Shock and High-Rate Data for Ceramics: Strength and Failure of Brittle Solids

DTIC Science & Technology

2007-07-01

Fracture Damage............................................................................... 31 Residual Projectile Velocity... Fracture ............................................................................................ 36 VI Closure...Project No. 17168 2 exploration of ceramic strength in the ballistic event – in particular the failure, or fracture , wave phenomena. Another objective is

77 FR 37477 - Federal Motor Vehicle Safety Standards; Glazing Materials

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-21

... 4. Half Pound Ball Drop--Tempered Glass 5. Fracture Test 6. Shot Bag and Dart Drop Tests 7. Half... Rapporteurs) that assist WP.29 in researching, analyzing and developing technical regulations. One of the GRs... proposal concerning markings for GTRs in general, at the one-hundred-and- fortieth session of WP.29 in...

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

Grissom, M.C.

This bibliography includes 4715 citations arranged in the broad subject categories: reserves and exploration; site geology and hydrology; drilling, fracturing, and mining; oil production, recovery, and refining; properties and composition; direct uses and by-products; health and safety; marketing and economics; waste research and management; environmental aspects; regulations; and general. There are corporate, author, subject, contract number, and report number indexes.

Towards Mechanochemistry of Fracture and Cohesion: General Introduction and the Simplest Model of Velcro

DTIC Science & Technology

2010-09-01

reports. This project is aimed at a combined theoretical and experimental analysis of adhesives. The theoretical part of it is based on usage of... Theoretical Difficulties in the Thermodynamics of Heterogeneous Systems and Fracture 3 3. Thermodynamic Model of Velcro 7 3.1 Derivation of Equations 5 and 6...mechanochemical systems). Among those are fracture of solids , analysis of solid explosives , chemical reactions in solids , environmental stress corrosion and

Comparison of Surface Properties in Natural and Artificially Generated Fractures in a Crystalline Rock

NASA Astrophysics Data System (ADS)

Vogler, Daniel; Walsh, Stuart D. C.; Bayer, Peter; Amann, Florian

2017-11-01

This work studies the roughness characteristics of fracture surfaces from a crystalline rock by analyzing differences in surface roughness between fractures of various types and sizes. We compare the surface properties of natural fractures sampled in situ and artificial (i.e., man-made) fractures created in the same source rock under laboratory conditions. The topography of the various fracture types is compared and characterized using a range of different measures of surface roughness. Both natural and artificial, and tensile and shear fractures are considered, along with the effects of specimen size on both the geometry of the fracture and its surface characterization. The analysis shows that fracture characteristics are substantially different between natural shear and artificial tensile fractures, while natural tensile fracture often spans the whole result domain of the two other fracture types. Specimen size effects are also evident, not only as scale sensitivity in the roughness metrics, but also as a by-product of the physical processes used to generate the fractures. Results from fractures generated with Brazilian tests show that fracture roughness at small scales differentiates fractures from different specimen sizes and stresses at failure.

Study of the Rock Mass Failure Process and Mechanisms During the Transformation from Open-Pit to Underground Mining Based on Microseismic Monitoring

NASA Astrophysics Data System (ADS)

Zhao, Yong; Yang, Tianhong; Bohnhoff, Marco; Zhang, Penghai; Yu, Qinglei; Zhou, Jingren; Liu, Feiyue

2018-05-01

To quantitatively understand the failure process and failure mechanism of a rock mass during the transformation from open-pit mining to underground mining, the Shirengou Iron Mine was selected as an engineering project case study. The study area was determined using the rock mass basic quality classification method and the kinematic analysis method. Based on the analysis of the variations in apparent stress and apparent volume over time, the rock mass failure process was analyzed. According to the recent research on the temporal and spatial change of microseismic events in location, energy, apparent stress, and displacement, the migration characteristics of rock mass damage were studied. A hybrid moment tensor inversion method was used to determine the rock mass fracture source mechanisms, the fracture orientations, and fracture scales. The fracture area can be divided into three zones: Zone A, Zone B, and Zone C. A statistical analysis of the orientation information of the fracture planes orientations was carried out, and four dominant fracture planes were obtained. Finally, the slip tendency analysis method was employed, and the unstable fracture planes were obtained. The results show: (1) The microseismic monitoring and hybrid moment tensor analysis can effectively analyze the failure process and failure mechanism of rock mass, (2) during the transformation from open-pit to underground mining, the failure type of rock mass is mainly shear failure and the tensile failure is mostly concentrated in the roof of goafs, and (3) the rock mass of the pit bottom and the upper of goaf No. 18 have the possibility of further damage.

Stress fluctuations in fracture networks from theoretical and numerical models

NASA Astrophysics Data System (ADS)

Davy, P.; Darcel, C.; Mas Ivars, D.; Le Goc, R.

2017-12-01

We analyze the spatial fluctuations of stress in a simple tridimensional model constituted by a population of disc-shaped fractures embedded in an elastic matrix with uniform and isotropic properties. The fluctuations arise from the classical stress enhancement at fracture tips and stress shadowing around fracture centers that are amplified or decreased by the interactions between close-by fractures. The distribution of local stresses is calculated at the elementary mesh scale with the 3DEC numerical program based on the distinct element method. As expected, the stress distributions vary with fracture density, the larger is the density, the wider is the distribution. For freely slipping fractures, it is mainly controlled by the percolation parameter p (i.e., the total volume of spheres surrounding fractures). For stresses smaller than the remote deviatoric stress, the distribution depends only on for the range of density that has been studied. For large stresses, the distribution decreases exponentially when increasing stress, with a characteristic stress that increases with entailing a widening of the stress distribution. We extend the analysis to fractures with plane resistance defined by an elastic shear stiffness ks and a slip Coulomb threshold. A consequence of the fracture plane resistance is to lower the stress perturbation in the surrounding matrix by a factor that depends on the ratio between ks and a fracture-matrix stiffness km mainly dependent on the ratio between Young modulus and fracture size. km is also the ratio between the remote shear stress and the displacement across the fracture plane in the case of freely slipping fractures. A complete analytical derivation of the expressions of the stress perturbations and of the fracture displacements is obtained and checked with numerical simulations. In the limit ks >> km, the stress perturbation tends to 0 and the stress state is spatially uniform. The analysis allows us to quantify the intensity of the stress fluctuations in fractured rocks as a function of both the fracture network characteristics (density and size distribution), and the mechanical properties (fracture shear stiffness vs matrix elastic properties).

Characterization of cracking behavior using posttest fractographic analysis

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

Kobayashi, T.; Shockey, D.A.

A determination of time to initiation of stress corrosion cracking in structures and test specimens is important for performing structural failure analysis and for setting inspection intervals. Yet it is seldom possible to establish how much of a component's lifetime represents the time to initiation of fracture and how much represents postinitiation crack growth. This exploratory research project was undertaken to examine the feasibility of determining crack initiation times and crack growth rates from posttest examination of fracture surfaces of constant-extension-rate-test (CERT) specimens by using the fracture reconstruction applying surface topography analysis (FRASTA) technique. The specimens used in this studymore » were Type 304 stainless steel fractured in several boiling water reactor (BWR) aqueous environments. 2 refs., 25 figs., 2 tabs.« less

Delamination and debonding of materials

NASA Technical Reports Server (NTRS)

Johnson, W. S. (Editor)

1985-01-01

The general topics consist of stress analysis, mechanical behavior, and fractography/NDI of composite laminates. Papers are presented on a dynamic hybrid finite-element analysis for interfacial cracks in composites, energy release rate during delamination crack growth in composite laminates, matrix deformation and fracture in graphite-reinforced epoxies, and the role of delamination and damage development on the strength of thick notched laminates. In addition, consideration is given to a new ply model for interlaminar stress analysis, a fracture mechanics approach for designing adhesively bonded joints, the analysis of local delaminations and their influence on composite laminate behavior, and moisture and temperature effects on the mixed-mode delamination fracture of unidirectional graphite/epoxy.

Experimental Study and Fractal Analysis on the Anisotropic Performance of Explosively Welded Interfaces of 304 Stainless Steel/245 Carbon Steel

NASA Astrophysics Data System (ADS)

Fu, Yanshu; Qiu, Yaohui; Li, Yulong

2018-03-01

The mechanical anisotropy of an explosive welding composite plate made of 304 stainless steel/245 steel was studied through shear experiments performed on explosively welded wavy interfaces along several orientation angles. The results indicated that the strength and the fracture energy of samples significantly varied with the orientation angles. The fracture surfaces of all samples were observed using a scanning electron microscope and through three-dimensional structure microscopy. The periodic features of all the fracture surfaces were clearly shown in different fracture modes. The fractal dimension of the fracture surfaces was calculated based on the fractal geometry by the box-counting method in MATLAB. The cohesive element model was used to analyze the fracture energy according to the physical dependence of the fractal dimension on thermodynamic entropy and interface separation energy. The fracture energy was an exponential function of the fractal dimension value, which was in good agreement with the experimental results. All results were validated for effective use in the application of anisotropy analysis to the welded interface and structural optimization of explosively welded composite plates.

The effect of range and ammunition type on fracture patterns in porcine postcranial flat bones.

PubMed

Fragkouli, Kleio; Al Hakeem, Eyad; Bulut, Ozgur; Simmons, Tal

2018-01-01

Pig half-carcasses were shot in scapulae, ribs and mandibles with either 0.243 hunting rifle using high velocity expanding ammunition (N = 30) or AK47 using full metal jacketed (FMJ) ammunition (N = 12) from a range of either 5 or 20 m. Fracture patterns related to distance of fire and ammunition type were compared on de-fleshed, macerated, and reconstructed bones. For expanding ammunition, location of fracture on ribs affected the resulting pattern. Scapulae shot from 5 m presented a comminuted pattern different from those shot from 20 m. Mandibles shot from 20 m showed a characteristic radiating pattern at entrance with the opposite ramus un-fractured; those shot from 5 m exhibited fractures to both rami. Using decision tree analysis provided accuracies of 93.8% for scapulae and 87.5% for mandibles. For FMJ, no distance dependent fracture differences were apparent in any bone. Decision tree analysis facilitated the interpretation of fracture patterns caused by projectile trauma. Copyright © 2017. Published by Elsevier Ltd.

RSRM nozzle actuator bracket/lug fracture mechanics qualification test

NASA Technical Reports Server (NTRS)

Kelley, Peggy

1993-01-01

This is the final report for the actuator bracket/lug fracture mechanics qualification test. The test plan (CTP-0071) outlined a two-phase test program designed to answer questions about the fracture criticality of the redesigned solid rocket motor (RSRM) nozzle actuator bracket. An analysis conducted using the NASA/FLAGRO fracture mechanics computer program indicated that the actuator bracket might be a fracture critical component. In the NASA/FLAGRO analysis, a simple lug model was used to represent the actuator bracket. It was calculated that the bracket would fracture if subjected to an actuator stall load in the presence of a 0.10 in. corner crack at the actuator attachment hole. The 0.10 in. crack size corresponds to the nondestructive inspection detectability limit for the actuator bracket. The inspection method used is the dye penetrant method. The actuator stall load (103,424 lb) is the maximum load which the actuator bracket is required to withstand during motor operation. This testing was designed to establish the accuracy of the analytical model and to directly determine whether the actuator bracket is capable of meeting fracture mechanics safe-life requirements.

Experimental Study and Fractal Analysis on the Anisotropic Performance of Explosively Welded Interfaces of 304 Stainless Steel/245 Carbon Steel

NASA Astrophysics Data System (ADS)

Fu, Yanshu; Qiu, Yaohui; Li, Yulong

2018-05-01

The mechanical anisotropy of an explosive welding composite plate made of 304 stainless steel/245 steel was studied through shear experiments performed on explosively welded wavy interfaces along several orientation angles. The results indicated that the strength and the fracture energy of samples significantly varied with the orientation angles. The fracture surfaces of all samples were observed using a scanning electron microscope and through three-dimensional structure microscopy. The periodic features of all the fracture surfaces were clearly shown in different fracture modes. The fractal dimension of the fracture surfaces was calculated based on the fractal geometry by the box-counting method in MATLAB. The cohesive element model was used to analyze the fracture energy according to the physical dependence of the fractal dimension on thermodynamic entropy and interface separation energy. The fracture energy was an exponential function of the fractal dimension value, which was in good agreement with the experimental results. All results were validated for effective use in the application of anisotropy analysis to the welded interface and structural optimization of explosively welded composite plates.

Fracture analysis of a transversely isotropic high temperature superconductor strip based on real fundamental solutions

NASA Astrophysics Data System (ADS)

Gao, Zhiwen; Zhou, Youhe

2015-04-01

Real fundamental solution for fracture problem of transversely isotropic high temperature superconductor (HTS) strip is obtained. The superconductor E-J constitutive law is characterized by the Bean model where the critical current density is independent of the flux density. Fracture analysis is performed by the methods of singular integral equations which are solved numerically by Gauss-Lobatto-Chybeshev (GSL) collocation method. To guarantee a satisfactory accuracy, the convergence behavior of the kernel function is investigated. Numerical results of fracture parameters are obtained and the effects of the geometric characteristics, applied magnetic field and critical current density on the stress intensity factors (SIF) are discussed.

Evaluation of production tests in oil wells stimulated by massive acid fracturing offshore Qatar

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

McDonald, S.W.

This paper presents the evaluation of pressure-buildup data from production tests in wells that have been stimulated by massive acid fracturing. Fracture type curves are used in combination with conventional semilog analysis techniques. Fracture characteristics are calculated from a match of the early-time pressure data with the type curves, and reservoir characteristics are calculated from a conventional semilog plot of late-time data. Unexpectedly high formation permeabilities are evaluated, and fracture half-lengths are much shorter than design values.

Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures.

PubMed

Nosewicz, Tomasz L; Beerekamp, M Suzan H; De Muinck Keizer, Robert-Jan O; Schepers, Tim; Maas, Mario; Niek van Dijk, C; Goslings, J Carel

2016-08-01

Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. 100 ankle fractures requiring operative treatment were prospectively included (46 men, 54 women; mean age 44 ± 14 years, range 20-77). All ankle fractures (conventional radiography; 71 Weber B, 22 Weber C, 1 Weber A, 4 isolated medial malleolus and 2 isolated posterior malleolus fractures) were treated by open reduction and internal fixation. Multidetector computed tomography (CT) was performed postoperatively. For each OCL, the location, size, and Loomer OCL classification (CT modified Berndt and Harty classification) were determined. The subjective Foot and Ankle Outcome Scoring (FAOS) was used for clinical outcome at 1 year. OCLs were found in 10/100 ankle fractures (10.0%). All OCLs were solitary talar lesions. Four OCLs were located posteromedial, 4 posterolateral, 1 anterolateral, and 1 anteromedial. There were 2 type I OCLs (subchondral compression), 6 type II OCLs (partial, nondisplaced fracture) and 2 type IV OCLs (displaced fracture). Mean OCL size (largest diameter) was 4.4 ± 1.7 mm (range, 1.7 mm to 6.2 mm). Chi-square analysis showed no significant association between ankle fracture type and occurrence of OCLs. OCLs did occur only in Lauge-Hansen stage III/IV ankle fractures. There were no significant differences in FAOS outcome between patients with or without OCLs. Ten percent of investigated ankle fractures had associated OCLs on CT. Although no significant association between fracture type and OCL was found, OCLs only occurred in Lauge-Hansen stage III/IV ankle fractures. With the numbers available, OCLs did not significantly affect clinical outcome at 1 year according to FAOS. Level IV, observational study. © The Author(s) 2016.

Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors.

PubMed

Nambu, Atsushi; Onishi, Hiroshi; Aoki, Shinichi; Tominaga, Licht; Kuriyama, Kengo; Araya, Masayuki; Saito, Ryoh; Maehata, Yoshiyasu; Komiyama, Takafumi; Marino, Kan; Koshiishi, Tsuyota; Sawada, Eiichi; Araki, Tsutomu

2013-02-07

As stereotactic body radiotherapy (SBRT) is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT). The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED) was calculated with a range of α/β ratios (1-10 Gy). Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41), and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients.

Hydraulic anisotropy characterization of pneumatic-fractured sediments using azimuthal self potential gradient

USGS Publications Warehouse

Wishart, D.N.; Slater, L.D.; Schnell, D.L.; Herman, G.C.

2009-01-01

The pneumatic fracturing technique is used to enhance the permeability and porosity of tight unconsolidated soils (e.g. clays), thereby improving the effectiveness of remediation treatments. Azimuthal self potential gradient (ASPG) surveys were performed on a compacted, unconsolidated clay block in order to evaluate their potential to delineate contaminant migration pathways in a mechanically-induced fracture network. Azimuthal resistivity (ARS) measurements were also made for comparative purposes. Following similar procedures to those used in the field, compressed kaolinite sediments were pneumatically fractured and the resulting fracture geometry characterized from strike analysis of visible fractures combined with strike data from optical borehole televiewer (BHTV) imaging. We subsequently injected a simulated treatment (electrolyte/dye) into the fractures. Both ASPG and ARS data exhibit anisotropic geoelectric signatures resulting from the fracturing. Self potentials observed during injection of electrolyte are consistent with electrokinetic theory and previous laboratory results on a fracture block model. Visual (polar plot) analysis and linear regression of cross plots show ASPG lobes are correlated with azimuths of high fracture strike density, evidence that the ASPG anisotropy is a proxy measure of hydraulic anisotropy created by the pneumatic fracturing. However, ARS data are uncorrelated with fracture strike maxima and resistivity anisotropy is probably dominated by enhanced surface conduction along azimuths of weak 'starter paths' formed from pulverization of the clay and increases in interfacial surface area. We find the magnitude of electrokinetic SP scales with the applied N2 gas pressure gradient (??PN2) for any particular hydraulically-active fracture set and that the positive lobe of the ASPG anomaly indicates the flow direction within the fracture network. These findings demonstrate the use of ASPG in characterizing the effectiveness of (1) pneumatic fracturing and (2) defining likely flow directions of remedial treatments in unconsolidated sediments and rock. ?? 2008 Elsevier B.V. All rights reserved.

Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS.

PubMed

Svedbom, Axel; Borgström, Fredrik; Hernlund, Emma; Ström, Oskar; Alekna, Vidmantas; Bianchi, Maria Luisa; Clark, Patricia; Curiel, Manuel Díaz; Dimai, Hans Peter; Jürisson, Mikk; Uusküla, Anneli; Lember, Margus; Kallikorm, Riina; Lesnyak, Olga; McCloskey, Eugene; Ershova, Olga; Sanders, Kerrie M; Silverman, Stuart; Tamulaitiene, Marija; Thomas, Thierry; Tosteson, Anna N A; Jönsson, Bengt; Kanis, John A

2018-03-01

The International Costs and Utilities Related to Osteoporotic fractures Study is a multinational observational study set up to describe the costs and quality of life (QoL) consequences of fragility fracture. This paper aims to estimate and compare QoL after hip, vertebral, and distal forearm fracture using time-trade-off (TTO), the EuroQol (EQ) Visual Analogue Scale (EQ-VAS), and the EQ-5D-3L valued using the hypothetical UK value set. Data were collected at four time-points for five QoL point estimates: within 2 weeks after fracture (including pre-fracture recall), and at 4, 12, and 18 months after fracture. Health state utility values (HSUVs) were derived for each fracture type and time-point using the three approaches (TTO, EQ-VAS, EQ-5D-3L). HSUV were used to estimate accumulated QoL loss and QoL multipliers. In total, 1410 patients (505 with hip, 316 with vertebral, and 589 with distal forearm fracture) were eligible for analysis. Across all time-points for the three fracture types, TTO provided the highest HSUVs, whereas EQ-5D-3L consistently provided the lowest HSUVs directly after fracture. Except for 13-18 months after distal forearm fracture, EQ-5D-3L generated lower QoL multipliers than the other two methods, whereas no equally clear pattern was observed between EQ-VAS and TTO. On average, the most marked differences between the three approaches were observed immediately after the fracture. The approach to derive QoL markedly influences the estimated QoL impact of fracture. Therefore the choice of approach may be important for the outcome and interpretation of cost-effectiveness analysis of fracture prevention.

Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors

PubMed Central

2013-01-01

Background As stereotactic body radiotherapy (SBRT) is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Methods Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT). The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED) was calculated with a range of α/β ratios (1–10 Gy). Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Results Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41), and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Conclusions Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients. PMID:23391264

Factors influencing the incidence of maxillofacial fractures.

PubMed

Chrcanovic, Bruno Ramos

2012-03-01

Maxillofacial injuries occur in a significant proportion of trauma patients. Trauma causes considerable economic expense due to procedural costs, the time a patient is off work, and the associated loss of income. For these reasons, it is an important health and economic issue. The aim of this study is to discuss the factors that may influence the incidence of maxillofacial fractures. As it is necessary to determine trends to help guide the development of new methods of injury prevention, preventative measures are also discussed. An electronic search was undertaken in March 2011, including articles published between 1980 and 2011 with the terms "facial fractures" and "maxillofacial fractures" in the title. The texts of epidemiological studies were reviewed in order to identify factors that may influence the incidence of maxillofacial fractures. From the selected articles, ten factors were identified: age, gender, geographic region and cultural aspects, socioeconomic status, temporal and climatic influence, use of alcohol and drugs, compliance with road traffic legislation, domestic violence, osteoporosis, and etiology of the maxillofacial trauma. Care of injured patients should include not only management of the acute phase, but also combine preventive programs and interventional programs aimed at reducing the incidence of maxillofacial fractures. Therefore, there is a need to ensure strict compliance of traffic rules and regulations, implement improvement in automotive safety devices, organize prevention programs to minimize assaults, implement school education in alcohol abuse and handling potentially hostile situations (especially for men), improve protection during sporting activities, and legislate wearing of protective headgear in workers. Preventive strategies remain the cheapest way to reduce direct and indirect costs of the sequelae of trauma. Societal attitudes and behaviors must be modified before a significant reduction in the incidence of maxillofacial fractures will be seen.

Role of Induced and Natural Imbibition in Frac Fluid Transport and Fate in Gas Shales, March 28-29, 2011

EPA Pesticide Factsheets

Hydraulic fracture modeling and fracture surface area calculations determined from pressure decay analysis and reservoir numerical flow simulation support estimates of created hydraulic fracture surface areas of 24-60 MM sq ft.

Reactive transport studies at the Raymond Field Site

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

Freifeld, B.; Karasaki, K.; Solbau, R.

1995-12-01

To ensure the safety of a nuclear waste repository, an understanding of the transport of radionuclides from the repository nearfield to the biosphere is necessary. At the Raymond Field Site, in Raymond, California, tracer tests are being conducted to test characterization methods for fractured media and to evaluate the equipment and tracers that will be used for Yucca Mountain`s fracture characterization. Recent tracer tests at Raymond have used reactive cations to demonstrate transport with sorption. A convective-dispersive model was used to simulate a two-well recirculating test with reasonable results. However, when the same model was used to simulate a radiallymore » convergent tracer test, the model poorly predicted the actual test data.« less

A research park for studying processes in unsaturated fractured media

NASA Astrophysics Data System (ADS)

Baker, Kristine; McLing, Travis; Street, Leah; Schafer, Annette; Ansley, Shannon; Hull, Larry; Holt, Robert; Roback, Robert; Jones, Catherine

A field research site has been developed to explore the combined use of physical experiments and mathematical modeling to analyze large-scale infiltration and chemical transport through the unsaturated media overlying the Snake River Plain Aquifer in southeastern Idaho. This site offers opportunities to observe water and contaminant migration influenced by fluid dynamics and microbial activity through heterogeneous-porous and fractured media.At many waste disposal facilities, the presence of toxic or radioactive wastes between the land surface and underlying aquifers poses a serious and ongoing threat to public health and safety.To reduce the risk associated with these industrial and Cold War by-products, a combination of remediation and long-term monitoring will be required.

Environmental Justice analysis in Hydraulic Fracturing Analysis, June 13, 2011

EPA Pesticide Factsheets

This planning document describes the quality assurance/quality control activities and technical requirements that will be used during the research study, using an index-based approach to compare a nationally representative set of well sites fractured.

Prevalence of Temporal Bone Fractures in Patients with Mandibular Fractures Using Multidetector-Row CT.

PubMed

Ogura, I; Kaneda, T; Sasaki, Y; Buch, K; Sakai, O

2015-06-01

Temporal bone fracture after mandibular trauma is thought to be rare, and its prevalence has not been reported in the literature. The purpose of this study was to investigate the prevalence of temporal bone fractures in patients with mandibular fractures and the relationship between temporal bone fractures and the mandibular fracture location using multidetector-row computed tomography (MDCT). A prospective study was performed in 201 patients with mandibular fractures who underwent 64-MDCT scans. The mandibular fracture locations were classified as median, paramedian, angle, and condylar types. Statistical analysis for the relationship between prevalence of temporal bone fractures and mandibular fracture locations was performed using χ(2) test with Fisher's exact test. A P-value < 0.05 was considered statistically significant. The percentage of cases with temporal bone fracture was 3.0 % of all patients with mandibular fractures and 19.0 % of those with multiple mandibular fractures of paramedian and condylar type. There was a significant relationship between the incidence of temporal bone fracture and the paramedian- and condylar-type mandibular fracture (P = 0.001). Multiple mandibular fractures of paramedian and condylar type may be a stronger indicator for temporal bone fractures. This study suggests that patients with mandibular fracture, especially the paramedian and condylar type, should be examined for coexisting temporal bone fracture using MDCT.

Investigation of the safety effects of knee bolster air bag deployment in similar real-world crash comparisons.

PubMed

Weaver, Ashley A; Loftis, Kathryn L; Stitzel, Joel D

2013-01-01

The lower extremity is the most frequently injured body region and knee-thigh-hip (KTH) injuries account for half of these injuries. Knee bolster air bags (KBABs) have been incorporated in some vehicles to serve as an additional restraint for the occupant's knees and reduce KTH injuries. To investigate the safety benefits of KBABs, similar frontal crashes with opposing KBAB deployment were selected from the Crash Injury Research and Engineering Network (CIREN) database. An 8-point similarity scoring algorithm was used to quantify crash and occupant similarity and select case comparisons. A total of 183 cases without a KBAB were scored for similarity to 9 KBAB cases. These similarity scores were used to select 31 final case comparisons. The effect of KBAB deployment on occupant injury patterns was investigated with a particular focus on KTH injuries. Over half of the occupants exposed to a KBAB sustained no KTH injuries and a reduction in femur fractures was observed in KBAB occupants (P = .036). However, increases in proximal tibia/fibula and foot/ankle fractures were observed in KBAB occupants (P = .022 and .002, respectively). Mildly significant decreases in pelvic fractures and Abbreviated Injury Scale (AIS) 2+ head injuries were observed in the KBAB occupants, supporting the notion that KBABs reduce forward occupant excursion (P = .094 and .055, respectively). Investigation of each case comparison yielded further insight into the reasons for injury pattern differences between cases with opposing KBAB deployment. In addition to KBAB deployment status, differences in occupant factors (age, height, and weight) and crash factors (delta V and belt use) between the cases for a particular comparison could explain variation in injury patterns. The current study presents a preliminary in-depth qualitative and quantitative assessment of KBAB safety benefits. However, further investigation is recommended to provide conclusive evidence of KBAB effectiveness.

Decreased Radiation Exposure Among Orthopedic Residents Is Maintained When Using the Mini C-Arm After Undergoing Radiation Safety Training.

PubMed

Gendelberg, David; Hennrikus, William L; Sawyer, Carissa; Armstrong, Douglas; King, Steven

2017-09-01

The resident curriculum of the American Board of Orthopaedic Surgery emphasizes radiation safety. Gendelberg showed that, immediately after a program on fluoroscopic safety, residents used less radiation when using the mini C-arm to reduce pediatric fractures. The current study evaluated whether this effect lasted. Residents underwent a new annual 3-hour session on mini C-arm use and radiation. Group A included 53 reductions performed before training. Group B included 45 reductions performed immediately after training. Group C included 46 reductions performed 11 months later. For distal radius fractures, exposure time and amount were 38.1 seconds and 83.1 mR, respectively, for group A; 26.7 seconds and 32.6 mR, respectively, for group B; and 24.1 seconds and 40.0 mR, respectively, for group C. When radiation time and amount were compared between group B and group C, P values were .525 and .293, respectively. When group C and group A were compared, P values were <.05 and <.01, respectively. For both bone forearm fractures, exposure time and amount were 41.2 seconds and 90.9 mR, respectively, for group A; 28.9 seconds and 30.4 mR, respectively, for group B; and 31.2 seconds and 43.6 mR, respectively, for group C. When radiation time and amount were compared between group B and group C, P values were .704 and .117, respectively. When group C and group A were compared, P values were .183 and .004, respectively. No significant difference in radiation exposure was noted immediately after training vs 11 months later. A sustained decrease in radiation exposure occurred after an educational program on safe mini C-arm use. [Orthopedics. 2017; 40(5):e788-e792.]. Copyright 2017, SLACK Incorporated.

X-ray fractography on fatigue fractured surface of austenitic stainless steel

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

Yajima, Zenjiro; Tokuyama, Hideki; Kibayashi, Yasuo

1995-12-31

X-ray diffraction observation of the material internal structure beneath fracture surfaces provide fracture analysis with useful information to investigate the conditions and mechanisms of fracture. X-ray fractography is a generic name given to this technique. In the present study, X-ray fractography was applied to fatigue fracture surfaces of austenitic stainless steel (AISI 304) which consisted of solution treatment. The fatigue tests were carried out on compact tension (CT) specimens. The plastic strain on the fracture surface was estimated from measuring the line broadening of X-ray diffraction profiles. The line broadening of X-ray diffraction profiles was measured on and beneath fatiguemore » fracture surfaces. The depth of the plastic zone left on fracture surfaces was evaluated from the line broadening. The results are discussed on the basis of fracture mechanics.« less

The National Hip Fracture Database (NHFD) - Using a national clinical audit to raise standards of nursing care.

PubMed

Johansen, Antony; Boulton, Christopher; Hertz, Karen; Ellis, Michael; Burgon, Vivienne; Rai, Sunil; Wakeman, Rob

2017-08-01

The National Hip Fracture Database (NHFD) is a key clinical governance programme for staff working in trauma wards across England, Wales and Northern Ireland. It uses prospectively collected information about the 65,000 people who present with hip fracture each year, and links these with information about the quality of care and outcome for each individual. The NHFD can, therefore, provide a picture of the care offered to frail older people with this injury - people who, between them, occupy nearly half of inpatient trauma beds. The NHFD uses its website (www.nhfd.co.uk) to feed back live information to each of the countries' 180 trauma units - allowing them to bench mark their performance against national standards, and against that in other hospitals. This helps to develop a consensus over the best care for frail older people in areas where national guidance is not yet available. This article shows how the NHFD is contributing to four key aspects of patient safety and nursing care: the prevention of pressure ulcers and post-operative delirium, the monitoring of falls incidence across hospitals and nutritional assessment of patients with hip fracture. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hip fracture risk and cadmium in erythrocytes: a nested case-control study with prospectively collected samples.

PubMed

Sommar, Johan Nilsson; Pettersson-Kymmer, Ulrika; Lundh, Thomas; Svensson, Olle; Hallmans, Göran; Bergdahl, Ingvar A

2014-02-01

Several studies have investigated the relation between bone mass density and cadmium exposure, but only few studies have been performed on fractures and biomarkers of cadmium. This study analyzed the association between hip fracture risk and cadmium in erythrocytes (Ery-Cd). Prospective samples from the Northern Sweden Health and Disease Study's biobank were used for 109 individuals who later in life had sustained a low-trauma hip fracture, matched with two controls of the same age and gender. The mean concentration of Ery-Cd (±SD) in case samples was 1.3 ± 1.4 versus 0.9 ± 1.0 μg/L in controls. The odds ratio (OR) was 1.63 [95% confidence interval (CI) 1.10-2.42] for suffering a hip fracture for each microgram per liter increase in Ery-Cd. However, when taking smoking into consideration (never, former, or current), neither Ery-Cd nor smoking showed a statistically significant increase in fracture risk. Using multiple conditional logistic regression with BMI, height, and smoking, the estimated OR for a 1-μg/L increase in Ery-Cd was 1.52 (95% CI 0.77-2.97). Subgroup analysis showed an increased fracture risk among women (OR = 1.94, 95% CI 1.18-3.20, for a 1 μg/L increase), which also remained in the multiple analysis (OR = 3.33, 95% CI 1.29-8.56). This study shows that fracture risk is associated with Ery-Cd. It is, however, not possible to draw firm conclusions on whether cadmium is the causal factor or whether other smoking-related factors cause this association. Subgroup analysis shows that cadmium is a risk factor for hip fracture among women.

In-situ stress and fracture permeability in a fault-hosted geothermal reservoir at Dixie Valley, Nevada

USGS Publications Warehouse

Hickman, Stephen; Barton, Colleen; Zoback, Mark; Morin, Roger; Sass, John; Benoit, Richard; ,

1997-01-01

As part of a study relating fractured rock hydrology to in-situ stress and recent deformation within the Dixie Valley Geothermal Field, borehole televiewer logging and hydraulic fracturing stress measurements were conducted in a 2.7-km-deep geothermal production well (73B-7) drilled into the Stillwater fault zone. Borehole televiewer logs from well 73B-7 show numerous drilling-induced tensile fractures, indicating that the direction of the minimum horizontal principal stress, Shmin, is S57 ??E. As the Stillwater fault at this location dips S50 ??E at approximately 3??, it is nearly at the optimal orientation for normal faulting in the current stress field. Analysis of the hydraulic fracturing data shows that the magnitude of Shmin is 24.1 and 25.9 MPa at 1.7 and 2.5 km, respectively. In addition, analysis of a hydraulic fracturing test from a shallow well 1.5 km northeast of 73B-7 indicates that the magnitude of Shmin is 5.6 MPa at 0.4 km depth. Coulomb failure analysis shows that the magnitude of Shmin in these wells is close to that predicted for incipient normal faulting on the Stillwater and subparallel faults, using coefficients of friction of 0.6-1.0 and estimates of the in-situ fluid pressure and overburden stress. Spinner flowmeter and temperature logs were also acquired in well 73B-7 and were used to identify hydraulically conductive fractures. Comparison of these stress and hydrologic data with fracture orientations from the televiewer log indicates that hydraulically conductive fractures within and adjacent to the Stillwater fault zone are critically stressed, potentially active normal faults in the current west-northwest extensional stress regime at Dixie Valley.

[Mechanics analysis of fracture of orthodontic wires].

PubMed

Wang, Yeping; Sun, Xiaoye; Zhang, Longqi

2003-03-01

Fracture problem of orthodontic wires was discussed in this paper. The calculation formulae of bending stress and tensile stress were obtained. All main factors that affect bending stress and tensile stress of orthodontic wires were analyzed and discussed. It was concluded that the main causes of fracture of orthodontic wires were fatigue and static disruption. Some improving proposals for preventing fracture of orthodontic wires were put forward.

An Equivalent Fracture Modeling Method

NASA Astrophysics Data System (ADS)

Li, Shaohua; Zhang, Shujuan; Yu, Gaoming; Xu, Aiyun

2017-12-01

3D fracture network model is built based on discrete fracture surfaces, which are simulated based on fracture length, dip, aperture, height and so on. The interesting area of Wumishan Formation of Renqiu buried hill reservoir is about 57 square kilometer and the thickness of target strata is more than 2000 meters. In addition with great fracture density, the fracture simulation and upscaling of discrete fracture network model of Wumishan Formation are very intense computing. In order to solve this problem, a method of equivalent fracture modeling is proposed. First of all, taking the fracture interpretation data obtained from imaging logging and conventional logging as the basic data, establish the reservoir level model, and then under the constraint of reservoir level model, take fault distance analysis model as the second variable, establish fracture density model by Sequential Gaussian Simulation method. Increasing the width, height and length of fracture, at the same time decreasing its density in order to keep the similar porosity and permeability after upscaling discrete fracture network model. In this way, the fracture model of whole interesting area can be built within an accepted time.

Description and analysis of cored hydraulic fractures -- Lost Hills field, Kern County, California

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

Fast, R.E.; Murer, A.S.; Timmer, R.S.

1994-05-01

An inclined observation well was drilled in shallow (2,000 ft) Opal-A diatomite. Seven sand-propped hydraulic fractures were cored and recovered. The hydraulic fractures were found within 5[degree] of the azimuth measured with tilt meters and were tilted 15[degree] from vertical, oriented perpendicular to the formation bedding dip. Hydraulic fractures widths ranged from less than one sand grain (40/60 mesh) to 0.4 in. Scanning electron microscopy (SEM) examination of fracture faces showed no damage to the matrix from proppant embedment or compaction, and no evidence of guard residue was detected in the proppant pack or on the formation face. Fractures appearmore » to be considerably longer than modeled. Three closely spaced fractures are interpreted to be branches of a single hydraulic fracture treatment. This paper presents a description of the fractures recovered during coring in Well OO2. Findings related to fracture dimensions and orientations, fracture sources, fracture permeability measurements, and fracture characteristics (proppant embedment, presence of gel residue) are presented. Implications related to field development are discussed.« less

Predicting driver from front passenger using only the postmortem pattern of injury following a motor vehicle collision.

PubMed

Curtin, Eleanor; Langlois, Neil E I

2007-10-01

This study aimed to establish whether post-mortem injury patterns can assist in distinguishing drivers from front seat passengers among victims of motor vehicle collisions without regard to collision type, vehicle type or if safety equipment had been used. Injuries sustained by 206 drivers and 91 front seat passengers were catalogued from post-mortem reports. Injuries were coded for the body region, depth and location of the injury. Statistical analysis was used to detect injuries capable of discriminating between driver and passenger. Drivers were more likely to sustain the following injuries: brain injury; fractures to the right femur, right posterior ribs, base of skull, right humerus and right shoulder; and superficial wounds at the right lateral and posterior thigh, right face, right and left anterior knee, right anterior shoulder, lateral right arm and forearm and left anterior thigh. Front passengers were more vulnerable to splenic injury; fractures to the left posterior and anterior ribs, left shoulder and left femur; and superficial wounds at the left anterior shoulder region and left lateral neck. Linear discriminant analysis generated a model for predicting seating position based on the presence of injury to certain regions of the body; the overall predictive accuracy of the model was 69.3%. It was found that driver and front passenger fatalities receive different injury patterns from motor vehicle collisions, regardless of collision type. A larger study is required to improve the predictive accuracy of this model and to ascertain its value to forensic medicine.

Relationship between body mass index and fracture risk is mediated by bone mineral density.

PubMed

Chan, Mei Y; Frost, Steve A; Center, Jacqueline R; Eisman, John A; Nguyen, Tuan V

2014-11-01

The relationship between body mass index (BMI) and fracture risk is controversial. We sought to investigate the effect of collinearity between BMI and bone mineral density (BMD) on fracture risk, and to estimate the direct and indirect effect of BMI on fracture with BMD being the mediator. The study involved 2199 women and 1351 men aged 60 years or older. BMI was derived from baseline weight and height. Femoral neck BMD was measured by dual-energy X-ray absorptiometry (DXA; GE-LUNAR, Madison, WI, USA). The incidence of fragility fracture was ascertained by X-ray reports from 1991 through 2012. Causal mediation analysis was used to assess the mediated effect of BMD on the BMI-fracture relationship. Overall, 774 women (35% of total women) and 258 men (19%) had sustained a fracture. Approximately 21% of women and 20% of men were considered obese (BMI ≥ 30). In univariate analysis, greater BMI was associated with reduced fracture risk in women (hazard ratio [HR] 0.92; 95% confidence interval [CI], 0.85 to 0.99) and in men (HR 0.77; 95% CI, 0.67 to 0.88). After adjusting for femoral neck BMD, higher BMI was associated with greater risk of fracture in women (HR 1.21; 95% CI, 1.11 to 1.31) but not in men (HR 0.96; 95% CI, 0.83 to 1.11). Collinearity had minimal impact on the BMD-adjusted results (variance inflation factor [VIF] = 1.2 for men and women). However, in mediation analysis, it was found that the majority of BMI effect on fracture risk was mediated by femoral neck BMD. The overall mediated effect estimates were -0.048 (95% CI, -0.059 to -0.036; p < 0.001) in women and -0.030 (95% CI, -0.042 to -0.018; p < 0.001) in men. These analyses suggest that there is no significant direct effect of BMI on fracture, and that the observed association between BMI and fracture risk is mediated by femoral neck BMD in both men and women. © 2014 American Society for Bone and Mineral Research.

Numerical and Statistical Analysis of Fractures in Mechanically Dissimilar Rocks of Limestone Interbedded with Shale from Nash Point in Bristol Channel, South Wales, UK.

NASA Astrophysics Data System (ADS)

Adeoye-Akinde, K.; Gudmundsson, A.

2017-12-01

Heterogeneity and anisotropy, especially with layered strata within the same reservoir, makes the geometry and permeability of an in-situ fracture network challenging to forecast. This study looks at outcrops analogous to reservoir rocks for a better understanding of in-situ fracture networks and permeability, especially fracture formation, propagation, and arrest/deflection. Here, fracture geometry (e.g. length and aperture) from interbedded limestone and shale is combined with statistical and numerical modelling (using the Finite Element Method) to better forecast fracture network properties and permeability. The main aim is to bridge the gap between fracture data obtained at the core level (cm-scale) and at the seismic level (km-scale). Analysis has been made of geometric properties of over 250 fractures from the blue Lias in Nash Point, UK. As fractures propagate, energy is required to keep them going, and according to the laws of thermodynamics, this energy can be linked to entropy. As fractures grow, entropy increases, therefore, the result shows a strong linear correlation between entropy and the scaling exponent of fracture length and aperture-size distributions. Modelling is used to numerically simulate the stress/fracture behaviour in mechanically dissimilar rocks. Results show that the maximum principal compressive stress orientation changes in the host rock as the fracture-induced stress tip moves towards a more compliant (shale) layer. This behaviour can be related to the three mechanisms of fracture arrest/deflection at an interface, namely: elastic mismatch, stress barrier and Cook-Gordon debonding. Tensile stress concentrates at the contact between the stratigraphic layers, ahead of and around the propagating fracture. However, as shale stiffens with time, the stresses concentrated at the contact start to dissipate into it. This can happen in nature through diagenesis, and with greater depth of burial. This study also investigates how induced fractures propagate and interact with existing discontinuities in layered rocks using analogue modelling. Further work will introduce the Maximum Entropy Method for more accurate statistical modelling. This method is mainly useful to forecast likely fracture-size probability distributions from incomplete subsurface information.

Topological design of all-ceramic dental bridges for enhancing fracture resistance.

PubMed

Zhang, Zhongpu; Chen, Junning; Li, Eric; Li, Wei; Swain, Michael; Li, Qing

2016-06-01

Layered all-ceramic systems have been increasingly adopted in major dental prostheses. However, ceramics are inherently brittle, and they often subject to premature failure under high occlusion forces especially in the posterior region. This study aimed to develop mechanically sound novel topological designs for all-ceramic dental bridges by minimizing the fracture incidence under given loading conditions. A bi-directional evolutionary structural optimization (BESO) technique is implemented within the extended finite element method (XFEM) framework. Extended finite element method allows modeling crack initiation and propagation inside all-ceramic restoration systems. Following this, BESO searches the optimum distribution of two different ceramic materials, namely porcelain and zirconia, for minimizing fracture incidence. A performance index, as per a ratio of peak tensile stress to material strength, is used as a design objective. In this study, the novel XFEM based BESO topology optimization significantly improved structural strength by minimizing performance index for suppressing fracture incidence in the structures. As expected, the fracture resistance and factor of safety of fixed partial dentures structure increased upon redistributing zirconia and porcelain in the optimal topological configuration. Dental CAD/CAM systems and the emerging 3D printing technology were commercially available to facilitate implementation of such a computational design, exhibiting considerable potential for clinical application in the future. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Challenges of Estimating Fracture Risk with DXA: Changing Concepts About Bone Strength and Bone Density.

PubMed

Licata, Angelo A

2015-07-01

Bone loss due to weightlessness is a significant concern for astronauts' mission safety and health upon return to Earth. This problem is monitored with bone densitometry (DXA), the clinical tool used to assess skeletal strength. DXA has served clinicians well in assessing fracture risk and has been particularly useful in diagnosing osteoporosis in the elderly postmenopausal population for which it was originally developed. Over the past 1-2 decades, however, paradoxical and contradictory findings have emerged when this technology was widely employed in caring for diverse populations unlike those for which it was developed. Although DXA was originally considered the surrogate marker for bone strength, it is now considered one part of a constellation of factors-described collectively as bone quality-that makes bone strong and resists fracturing, independent of bone density. These characteristics are beyond the capability of routine DXA to identify, and as a result, DXA can be a poor prognosticator of bone health in many clinical scenarios. New clinical tools are emerging to make measurement of bone strength more accurate. This article reviews the historical timeline of bone density measurement (dual X-ray absorptiometry), expands upon the clinical observations that modified the relationship of DXA and bone strength, discusses some of the new clinical tools to predict fracture risk, and highlights the challenges DXA poses in the assessment of fracture risk in astronauts.

Osteogenesis imperfecta type V: Genetic and clinical findings in eleven Chinese patients.

PubMed

Liu, Yi; Wang, Jiawei; Ma, Doudou; Lv, Fang; Xu, Xiaojie; Xia, Weibo; Jiang, Yan; Wang, Ou; Xing, Xiaoping; Zhou, Peiran; Wang, Jianyi; Yu, Wei; Li, Mei

2016-11-01

Osteogenesis imperfecta (OI) type V is a rare inherited disease characterized by multiple fractures, intraosseous membrane calcification, and hypercallus formation. We investigate the causative gene, phenotype and also observe the effects of zoledronic acid in Chinese OI type V patients. The clinical phenotype and causative gene mutation was investigated in eleven patients with type V OI. Patients were given a dose of zoledronic acid 5mg intravenously. Fracture incidence and Z-score of bone mineral density (BMD) were evaluated. Serum levels of biomarkers such as cross linked C-telopeptide of type I collagen (β-CTX) and safety parameters were assessed. The c.-14C>T mutation in the 5' untranslated region of IFITM5 was detected in all patients. The phenotype was largely variable, and no significant correlation of genotype and phenotype was found. After one dose of zoledronic acid infusion, fracture incidence significantly dropped from 2fractures/year before treatment to 0fracture/year after treatment (P=0.01). Z score of lumbar spine BMD elevated from -2.6 to -1.3 (P<0.001). Serum β-CTX level decreased by 50% (P<0.05). No serious adverse event was found. No obvious correlation was found between the genotype and phenotype. Zoledronic acid had significantly skeletal protective effects in OI of type V. Copyright © 2016 Elsevier B.V. All rights reserved.

Vitamin D serum levels are associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture.

PubMed

Gumieiro, David Nicoletti; Murino Rafacho, Bruna Paola; Buzati Pereira, Bruna Letícia; Cavallari, Karelin Alvisi; Tanni, Suzana Erico; Azevedo, Paula Schmidt; Polegato, Bertha Furlan; Mamede Zornoff, Leonardo Antonio; Dinhane, Daniel Innocenti; Innocenti Dinhane, Kandir Genésio; Cação Pereira, Gilberto José; de Paiva, Sergio Alberto Rupp; Minicucci, Marcos Ferreira

2015-01-01

The aim of this study was to evaluate the association between serum levels of 25(OH) vitamin D3 with midupper arm muscle circumference (MUAMC), handgrip strength and length of hospital stay (LOS) after hip fracture. In total, 102 consecutive patients with hip fracture over the age of 65 were admitted to the orthopedic unit and prospectively evaluated. All of the patients were treated according to specific protocols depending on the type of fracture. Anthropometric measurements and handgrip strength were performed, and blood samples were taken for serum biochemistry and 25(OH) vitamin D3 analysis within the first 72 h of admission. All of the patients were followed during their hospital stay, and the length of stay was recorded. Of the patients, two were excluded because of pathologic fractures. In total, 100 patients with a mean age of 80 ± 7 y were included in the analysis. Among these patients, 73% were female, and 37% had vitamin D deficiency. The median LOS was 7 (5-11) d. Patients with vitamin D deficiency had lower handgrip strength in univariate analysis. In the multiple linear regression analysis with robust standard error, serum vitamin D levels adjusted by age and sex were associated with handgrip strength but not with MUAMC and LOS after hip fracture. In conclusion, vitamin D serum levels were associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture. Copyright © 2015 Elsevier Inc. All rights reserved.

An efficient hydro-mechanical model for coupled multi-porosity and discrete fracture porous media

NASA Astrophysics Data System (ADS)

Yan, Xia; Huang, Zhaoqin; Yao, Jun; Li, Yang; Fan, Dongyan; Zhang, Kai

2018-02-01

In this paper, a numerical model is developed for coupled analysis of deforming fractured porous media with multiscale fractures. In this model, the macro-fractures are modeled explicitly by the embedded discrete fracture model, and the supporting effects of fluid and fillings in these fractures are represented explicitly in the geomechanics model. On the other hand, matrix and micro-fractures are modeled by a multi-porosity model, which aims to accurately describe the transient matrix-fracture fluid exchange process. A stabilized extended finite element method scheme is developed based on the polynomial pressure projection technique to address the displacement oscillation along macro-fracture boundaries. After that, the mixed space discretization and modified fixed stress sequential implicit methods based on non-matching grids are applied to solve the coupling model. Finally, we demonstrate the accuracy and application of the proposed method to capture the coupled hydro-mechanical impacts of multiscale fractures on fractured porous media.

Lower Jump Power Rather Than Muscle Mass Itself is Associated with Vertebral Fracture in Community-Dwelling Elderly Korean Women.

PubMed

Lee, Eun Young; Lee, Su Jin; Kim, Kyoung Min; Seo, Da Hea; Lee, Seung Won; Choi, Han Sol; Kim, Hyeon Chang; Youm, Yoosik; Kim, Chang Oh; Rhee, Yumie

2017-06-01

Sarcopenia is considered to be a risk factor for osteoporotic fracture, which is a major health problem in elderly women. In this study, we aimed to investigate the association of sarcopenia, with regard to muscle mass and function, with prevalent vertebral fracture in community-dwelling elderly women. We recruited 1281 women aged 64 to 87 years from the Korean Urban Rural Elderly cohort study. Muscle mass and function were measured using bioimpedance analysis and jumping mechanography. Skeletal muscle index (SMI) and jump power were used as an indicator of muscle mass and function, respectively. Among the participants, we observed 282 (18.9%) vertebral fractures and 564 (44.0%) osteoporosis. Although age, body mass index, and prevalence of osteoporosis increased as both SMI and jump power decreased, prevalence of vertebral fracture increased only when jump power decreased. In univariate analysis, compared with the highest quartile of jump power, the lowest quartile had a significant odds ratio of 2.80 (95% CI 1.79-4.36) for vertebral fracture. This association between jump power and vertebral fracture remained significant, with an odds ratio of 3.04 (95% CI 1.77-5.23), even after adjusting for other risk factors including age, bone mineral density, previous fracture, and cognitive function. In contrast, there was no association between SMI and vertebral fracture. Based on our results, low jump power, but not SMI, is associated with vertebral fracture in community-dwelling elderly Korean women. This finding suggests that jump power may have a more important role than muscle mass itself for osteoporotic fracture.

High prevalence of simultaneous rib and vertebral fractures in patients with hip fracture.

PubMed

Lee, Bong-Gun; Sung, Yoon-Kyoung; Kim, Dam; Choi, Yun Young; Kim, Hunchul; Kim, Yeesuk

2017-02-01

The purpose was to evaluate the prevalence and location of simultaneous fracture using bone scans in patients with hip fracture and to determine the risk factors associated with simultaneous fracture. One hundred eighty two patients with hip fracture were reviewed for this study. Clinical parameters and bone mineral density (BMD) of the lumbar vertebra and femoral neck were investigated. To identify acute simultaneous fracture, a bone scan was performed at 15.4±4.1days after hip fracture. The prevalence and location of simultaneous fracture were evaluated, and multivariate logistic regression analysis was performed to determine the risk factors. Simultaneous fracture was observed in 102 of 182 patients, a prevalence of 56.0%. Rib fracture was the most common type of simultaneous fracture followed by rib with vertebral fracture. The BMD of the lumbar vertebra was significantly lower in patients with simultaneous fracture (p=0.044) and was identified as an independent risk factor (odds ratio: OR 0.05, 95% confidence interval: CI 0.01-0.57). The prevalence of simultaneous fracture was relatively high among patients with hip fracture, and BMD was significantly lower in patients with simultaneous fracture than in patients without it. Surgeons should be aware of the possibility of simultaneous fracture in patients with hip fracture. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intrinsic and extrinsic risk factors for nonunion after nonoperative treatment of midshaft clavicle fractures.

PubMed

Liu, W; Xiao, J; Ji, F; Xie, Y; Hao, Y

2015-04-01

The optimal treatment of midshaft clavicle fractures remains controversial. Nonunion is usually considered to be an uncommon complication following a nonoperatively treated clavicle fracture. Not every midshaft clavicular fractures shares the same risk of developing nonunion after nonoperative treatment. The present study was performed to identify the intrinsic and extrinsic independent factors that are independently predictive of nonunion in patients with midshaft clavicular fractures after nonoperative treatment. We performed a retrospective study of a series of 804 patients (391 men and 413 women with a median age of 51.3 years) with a radiographically confirmed midshaft clavicle fracture, which was treated nonoperatively. There were 96 patients who underwent nonunion. Putative intrinsic (patient-related) and extrinsic (injured-related) risk factors associated with nonunion were determined with the use of bivariate and multivariate statistical analyses. By bivariate analysis, the risk of nonunion was significantly increased by several intrinsic risk factors including age, sex, and smoking and extrinsic risk factors including displacement of the fracture and the presence of comminution (P<0.05 for all). On multivariate analysis, smoking (OR=4.16, 95% CI: 1.01-14.16), fracture displacement (OR=7.81, 95% CI: 2.27-25.38) and comminution of fracture (OR=3.86, 95% CI: 1.16-13.46) were identified as independent predictive factors. The risk factors for nonunion after nonoperative treatment of midshaft clavicle fractures are multifactorial. Smoking, fracture displacement and comminution of fracture are independent predictors for an individual likelihood of nonunion. Further studies are still required to evaluate these factors in the future. Level III, case-control study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

QAPP for Hydraulic Fracturing (HF) Surface Spills Data Analysis

EPA Pesticide Factsheets

This QAPP provides information concerning the analysis of spills associated with hydraulic fracturing. This project is relevant to both the chemical mixing and flowback and produced water stages of the HF water cycle as found in the HF Study Plan.

Patterns of Pediatric Mandible Fractures in the United States.

PubMed

Owusu, James A; Bellile, Emily; Moyer, Jeffrey S; Sidman, James D

2016-01-01

The mandible is arguably the most frequently fractured facial bone in children. However, facial fractures are rare in children compared with adults, resulting in few large studies on patterns of pediatric facial fractures. To report the patterns, demographics, and cause of pediatric mandible fractures across the United States. A retrospective analysis was conducted of the Healthcare Cost and Utilization Project's National Emergency Department Sample from January 1 to December 31, 2012, using the International Classification of Disease, Ninth Revision, codes for mandible fractures (802.20-802.39) among patients 18 years and younger who presented to emergency departments. Demographics, fracture site, and fracture mechanism were analyzed to identify factors associated with fractures. Analysis was conducted from July 9 to July 28, 2015. There were 1984 records, representing a weighted estimate of 8848 cases of pediatric mandible fracture. The mean patient age was 14.0 years (95% CI, 13.6-14.3). The male to female ratio was 4:1 and females were comparatively younger, with a mean age of 12.5 years (95% CI, 11.8-13.1; P < .001). The most frequently fractured sites were the condyle, in 1288 patients (14.6% [95% CI, 12.6%-16.5%]), and the angle, in 1252 patients (14.1% [12.4%-15.9%]). Associated intracranial injuries occurred in 756 patients (8.5% [7.1%-10.0%]), and cervical spine fractures occurred in 393 (4.4% [3.5%-5.4%]). The fracture site and mechanism of injury varied with age and sex. For patients 12 years and younger, the most frequent fracture site was the condyle, accounting for 636 fractures (27.9% [24.2%-31.6%]), and the most frequent cause was falls, accounting for 692 fractures (30.3% [25.9%-34.8%]). In teenaged patients (13-18 years), the angle was the most frequent fracture site, accounting for 1157 fractures (17.6% [15.6%-19.6%]), and the most frequent cause was assault, accounting for 2619 fractures (39.9% [36.4%-43.3%]). For male patients, the angle was the predominant site, accounting for 1053 fractures (15.0% [13.1%-16.8%]), and the leading cause was assault, accounting for 2360 fractures (33.5% [30.2%-36.9%]). For female patients, the condyle was the most frequent site, accounting for 369 fractures (20.3% [16.0%-24.6%]), and the leading cause was falls, accounting for 422 fractures (23.2% [18.6%-28.0%]). In this study, age and sex disparities among pediatric mandible fractures were identified. Younger patients and female patients tend to have condyle fractures caused more commonly by falls while older patients and male patients tend to have angle fractures caused by assault. NA.

Correlative fractography: combining scanning electron microscopy and light microscopes for qualitative and quantitative analysis of fracture surfaces.

PubMed

Hein, Luis Rogerio de Oliveira; de Oliveira, José Alberto; de Campos, Kamila Amato

2013-04-01

Correlative fractography is a new expression proposed here to describe a new method for the association between scanning electron microscopy (SEM) and light microscopy (LM) for the qualitative and quantitative analysis of fracture surfaces. This article presents a new method involving the fusion of one elevation map obtained by extended depth from focus reconstruction from LM with exactly the same area by SEM and associated techniques, as X-ray mapping. The true topographic information is perfectly associated to local fracture mechanisms with this new technique, presented here as an alternative to stereo-pair reconstruction for the investigation of fractured components. The great advantage of this technique resides in the possibility of combining any imaging methods associated with LM and SEM for the same observed field from fracture surface.

Temporal profile of inflammatory response to fracture and hemorrhagic shock: Proposal of a novel long-term survival murine multiple trauma model.

PubMed

Kleber, Christian; Becker, Christopher A; Malysch, Tom; Reinhold, Jens M; Tsitsilonis, Serafeim; Duda, Georg N; Schmidt-Bleek, Katharina; Schaser, Klaus D

2015-07-01

Hemorrhagic shock (hS) interacts with the posttraumatic immune response and fracture healing in multiple trauma. Due to the lack of a long-term survival multiple trauma animal models, no standardized analysis of fracture healing referring the impact of multiple trauma on fracture healing was performed. We propose a new long-term survival (21 days) murine multiple trauma model combining hS (microsurgical cannulation of carotid artery, withdrawl of blood and continuously blood pressure measurement), femoral (osteotomy/external fixation) and tibial fracture (3-point bending technique/antegrade nail). The posttraumatic immune response was measured via IL-6, sIL-6R ELISA. The hS was investigated via macrohemodynamics, blood gas analysis, wet-dry lung ration and histologic analysis of the shock organs. We proposed a new murine long-term survival (21 days) multiple trauma model mimicking clinical relevant injury patterns and previously published human posttraumatic immune response. Based on blood gas analysis and histologic analysis of shock organs we characterized and standardized our murine multiple trauma model. Furthermore, we revealed hemorrhagic shock as a causative factor that triggers sIL-6R formation underscoring the fundamental pathophysiologic role of the transsignaling mechanism in multiple trauma. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

A descriptive study of accidental skeletal injuries and non-accidental skeletal injuries of child maltreatment.

PubMed

Ghanem, Maha A H; Moustafa, Tarek A; Megahed, Haidy M; Salama, Naglaa; Ghitani, Sara A

2018-02-01

Lack of awareness and recognition of child maltreatment is the major reason behind underreporting. All victims often interact with the health care system for routine or emergency care. In several research works, non-accidental fractures are the second most common injury in maltreated children and it is represented up to one-third of cases. To determine the incidence of different types of accidental and non-accidental skeletal injuries among children, estimate the severity of injuries according to the modified injury severity score and to determine the degree of fractures either closed or opened (Gustiloe-Anderson open fracture classification). Moreover, identifying fractures resulting from child abuse and neglect. This aimed for early recognition of non-accidental nature of fractures in child maltreatment that can prevent further morbidity and mortality. A descriptive study was carried out on all children (109) with skeletal injuries who were admitted to both Main Alexandria and El-Hadara Orthopedic and Traumatology University Hospitals during six months. History, physical examination and investigations were done for the patients. A detailed questionnaire was taken to diagnose child abuse and neglect. Gustiloe-Anderson open fracture classification was used to estimate the degree of open fractures. Out of 109 children, twelve cases (11%) were categorized as child maltreatment. One case was physical abuse, eight cases (7.3%) were child neglect and three cases (2.8%) were labour exploitation. Road traffic accidents (RTA) was the commonest cause of skeletal injuries followed by falling from height. Regarding falls, they included 4 cases of stair falls in neglected children and another four cases of falling from height (balcony/window). The remaining 36 cases of falls were accidental. The skeletal injuries were in the form of fractures in 99 cases, dislocation in two cases, both fracture and/or dislocation in three cases, and bone deformity from brachial plexus injury in five cases. Fractures of the lower limb (42.2%) and both bones of the forearm (35%) represented the highest incidence of skeletal injuries in children. 54.5% of fractures due to neglect were lower limb fractures due to falling from height. Ninety-nine cases were diagnosed as long bone fractures and classified as the following; eighty patients as closed fractures, six patients as open grade I fractures, three patients as open grade II fractures, three patients as open grade IIIA fractures, four patients as open grade IIIB fractures and three patients as open grade IIIC fractures. Cases of neglect and child abuse represented 11% of all the studied cases, where neglect was the main cause. RTA and falling from height represented the most common cause of skeletal injury in children. Most fractures due to neglect were lower limb fractures resulting from falling from height. This demonstrates the need for early detection of neglect and child maltreatment aiming for early initiation of parental educational programs about child care and safety. Misinterpretation of skeletal injuries due to neglect or abuse can be avoided by proper training of orthopedic and traumatology staff on signs of child neglect and abuse. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Test load verification through strain data analysis

NASA Technical Reports Server (NTRS)

Verderaime, V.; Harrington, F.

1995-01-01

A traditional binding acceptance criterion on polycrystalline structures is the experimental verification of the ultimate factor of safety. At fracture, the induced strain is inelastic and about an order-of-magnitude greater than designed for maximum expected operational limit. At this extreme strained condition, the structure may rotate and displace at the applied verification load such as to unknowingly distort the load transfer into the static test article. Test may result in erroneously accepting a submarginal design or rejecting a reliable one. A technique was developed to identify, monitor, and assess the load transmission error through two back-to-back surface-measured strain data. The technique is programmed for expediency and convenience. Though the method was developed to support affordable aerostructures, the method is also applicable for most high-performance air and surface transportation structural systems.

Failure analysis of an aluminum alloy material framework component induced by casting defects

NASA Astrophysics Data System (ADS)

Li, Bo; Hu, Weiye

2017-09-01

Failure analysis on a fractured radome framework component was carried out through visual observations, metallographic examination using optical microscope, fractog-raphy inspections using scanning electron microscope and chemical composition analysis. The failed frame was made of casting Al-Si7-Mg0.4 aluminum alloy. It had suffered a former vi-bration performance tests. It was indicated that the fractures were attributed to fatigue cracks which were induced by casting porosities at the outer surfaces of frame. Failure analysis was carefully conducted for the semi-penetrating crack appearing on the framework. According to the fractography inspected by scanning electron microscope, it was indicated that numerous casting porosities at the outer surface of the framework played the role of multiple fracture sources due to some applied stresses. Optical microstructure observations suggested that the dendrite-shaped casting porosities largely contributed to the crack-initiation. The groove-shaped structure at roots of spatial convex-bodies on the edge of casting porosities supplied the preferred paths of the crack-propagation. Besides, the brittle silicon eutectic particles distrib-uting along grain boundaries induced the intergranular fracture mode in the region of the over-load final fracture surface.

Predictors of the postoperative range of finger motion for comminuted periarticular metacarpal and phalangeal fractures treated with a titanium plate.

PubMed

Shimizu, Takamasa; Omokawa, Shohei; Akahane, Manabu; Murata, Keiichi; Nakano, Kenichi; Kawamura, Kenji; Tanaka, Yasuhito

2012-06-01

Plate and screw fixation was introduced for complex fractures of the hand. Several risk factors for a poor functional outcome have been identified, but there is a paucity of evidence regarding predictors of finger stiffness in difficult hand fractures. The purpose of this prospective cohort study was to identify independent prognostic factors of the postoperative total active motion (%TAM) in the treatment of metacarpal and phalangeal fractures. Seventy-two patients (62 males, 10 females; 37±15 years) with periarticular fractures involving metaphyseal comminution and displacement were evaluated at a minimum of 1 year following surgery. There were 49 phalangeal bone fractures, 30 intra-articular fractures and 20 associated soft-tissue injuries. The locations of plate placement were lateral in 42 patients and dorsal in 30. The mean duration from injury to surgery was 7.6 days (range, 0-40 days). There were eight examined variables related to patient characteristics (age, gender and hand dominance), fracture characteristics (fracture location, joint involvement and associated soft-tissue injury) and surgical variables (location of plate placement and duration from injury to surgery). Univariate and multivariate linear regression analysis were used to identify the degree to which variables affect %TAM at the final follow-up. Univariate analysis indicated moderate correlations of %TAM with fracture location, associated soft-tissue injury and age. Multiple linear regression modelling including fracture location, age and associated soft-tissue injury resulted in formulae that could account for 46.3% of the variability in %TAM: fracture location (β=-0.388, p<0.001), age (β=-0.339, p<0.001) and associated soft-tissue injury (β=-0.296, p=0.002). Phalangeal fracture, increasing age and associated soft-tissue injury were important risk factors to identify the postoperative %TAM in the treatment of comminuted periarticular metacarpal or phalangeal fracture with a titanium plate. Copyright © 2012 Elsevier Ltd. All rights reserved.