[Subtalar arthrodesis].

PubMed

Fuhrmann, R A; Pillukat, T

2016-06-01

Realignment and stabilization of the hindfoot by subtalar joint arthrodesis. Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction. Inflammation, vascular disturbances, nicotine abuse. Approach dependent on assessment. Lateral approach: Supine position. Incision above the sinus tarsi. Exposure of subtalar joint. Removal of cartilage and breakage of the subchondral sclerosis. In valgus malalignment, interposition of corticocancellous bone segment; in varus malalignment resection of bone segment from the calcaneus. Reposition and temporarily stabilization with Kirschner wires. Imaging of hindfoot alignment. Stabilization with cannulated screws. Posterolateral approach: Prone position. Incision parallel to the lateral Achilles tendon border. Removal of cartilage and breakage of subchondral sclerosis. Medial approach: Supine position. Incision just above and parallel to the posterior tibial tendon. Removal of cartilage and breakage of subchondral sclerosis. Stabilization with screws. Lower leg walker with partial weightbearing. Active exercises of the ankle. After a 6‑week X‑ray, increase of weightbearing. Full weightbearing not before 8 weeks; with interpositioning bone grafts not before 10-12 weeks. Stable walking shoes. Active mobilization of the ankle. Of 43 isolated subtalar arthrodesis procedures, 5 wound healing disorders and no infections developed. Significantly improved AOFAS hindfood score. Well-aligned heel observed in 34 patients; 5 varus and 2 valgus malalignments. Sensory disturbances in 8 patients; minor ankle flexion limitations. Full bone healing in 36 subtalar joints, pseudarthrosis in 4 patients.

[Application of joint reconstruction with autogenous coronoid process graft to treat temporomandibular joint ankylosis].

PubMed

Xie, Qing-tiao; Huang, Xuan-ping; Jiang, Xian-fang; Yang, Yuan-yuan; Li, Hua; Lin, Xi

2013-08-01

To evaluate the clinical effect of joint reconstruction by using autogenous coronoid process graft to treat temporomandibular joint(TMJ) ankylosis. Nine cases of TMJ ankylosis from September 2008 to September 2010 were surgically treated by joint reconstruction with autogenous coronoid process graft, using autogenous articular disc or prosthodontic membrane as interpositional material. Mouth opening, occlusion and cone beam CT(CBCT) were used for evaluation before and after surgery. Satisfactory mouth opening was achieved in all patients and no one got occlusal changes or reankylosis during follow-up. CBCT showed that coronoid process graft reached bone union with the ramus and turned to be round. It is effective to cure TMJ ankylosis through joint reconstruction with autogenous coronoid process graft.

Treatment of osteoarthritis of the first carpometacarpal joint by resection-suspension-interposition arthoplasty using the split abductor pollicis longus tendon.

PubMed

Harenberg, P S; Jakubietz, M G; Jakubietz, R G; Schmidt, K; Meffert, R H

2013-02-01

Reduction of pain and gain of functionality in symptomatic osteoarthritis of the first carpometacarpal joint. Idiopathic, rheumatic, or posttraumatic osteoarthritis of the first carpometacarpal joint. RELATIVE CONTRAINDICATIONS: Poor general condition, poor condition of the hand's soft tissue/skin, chronic regional pain syndrome, current or recent infections of the hand, heavy manual labor (decision on a by-case basis). Supine position, hand pronated or slightly tilted. Upper arm tourniquet (Esmarch's method). Loupe magnification. Incision over the first extensor compartment. Exposure and incision of the thumb's basal joint. Resection of the trapezium. Exposure of the abductor pollicis longus (APL) tendon. Longitudinal split of the tendon harvesting the distally based ulnar part of the tendon. The split APL tendon is wrapped around the flexor carpi radialis (FCR) muscle tendon, suturing it to the tendon and back to itself. The rest of the split APL tendon is placed into the gap between the scaphoid and the first metacarpal bone, which is followed by wound closure. Plaster cast (thumb abduction splint) for 4 weeks. Stable commercially available wrist brace for at least 2 more weeks. There were no significant differences between the FCR arthroplasty (Epping's method) and the APL arthroplasty (Wulle's technique) regarding pain (visual analog scale), disability/usability (DASH score), or range of motion. Patients who had undergone APL arthroplasty showed significantly better grip and pinch strength. Furthermore, the operating time was significantly shorter and scars were significantly smaller in APL arthroplasty.

A Technique for the Management of Concomitant Scaphotrapezoid Arthritis in Patients With Thumb Metacarpotrapezial Arthritis: Interposition Arthroplasty With a Capitate Suture Anchor.

PubMed

Warganich, Tibor; Shin, Alexander Y

2017-06-01

Scaphotrapezoid (ST) arthritis is a common source of pain and disability that typically presents with concomitant basilar thumb arthritis. ST arthritis is often under recognized and under diagnosed as a source of continued pain after successful basilar thumb arthroplasty. Untreated, symptomatic ST arthritis can cause failure of an otherwise successfully executed thumb carpometacarpal arthroplasty due to persistent pain, which is frustrating to the patient and surgeon. Although multiple surgical treatment options have been described for basilar thumb carpometacarpal joint arthritis, there is no gold standard for the treatment of ST arthritis. We describe a surgical technique with a minimal trapezoid excision and interpositional arthroplasty using an acellular allograft secured with a suture anchor in the capitate.

[Comparative clinical study of 2 surgical techniques for trapeziometacarpal osteoarthritis].

PubMed

Martínez-Martínez, F; García-Hortelano, S; García-Paños, J P; Moreno-Fernández, J M; Martín-Ferrero, M Á

2016-01-01

In trapeziometacarpal osteoarthritis (or rhizarthrosis), there is great controversy over the surgical technique to choose: simple trapeziectomy, resection-interposition arthroplasty, interposition arthroplasty suspension-or arthroplasty with implant or prosthesis. These latter 2 are the most used without consensus in the literature on the technique to choose and without sufficient comparative studies. The objective is to compare the 2 techniques most used today: suspension-interposition arthroplasty and arthroplasty with prosthesis. A prospective study was conducted on 15 patients diagnosed with grade 2-3 rhizarthrosis treated with interposition arthroplasty-suspension (group 1) and 15 with prosthesis (group 2) showing clinical outcomes, advantages and disadvantages of each. The study variables were the visual analogue scale (VAS), the DASH questionnaire, the grip strength, the strength of end to end and end-lateral clamp, the joint balance adduction-abduction and preemption-retropositioning, and the opposition. The 2 groups are from 2 different hospitals operated on by a hand surgeon from the Hand Unit. The follow-up time for all patients included in the study was 12 months. The VAS, DASH and grip strength at 12 months did not show significant differences. As regards the strength of end to end and end-lateral clamp, group 2 showed the highest values in all follow-up periods with statistically significant differences. Patient selection and surgical experience is essential, given the satisfactory results of both techniques. Arthroplasty prosthesis is reserved for grades 2 and 3, middle-aged patients, good trapezium architecture, and experienced surgeons. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Interpositional arthroplasty versus reconstruction arthroplasty for temporomandibular joint ankylosis: A systematic review and meta-analysis.

PubMed

Ma, Junli; Jiang, Hua; Liang, Limin

2015-09-01

Interpositional arthroplasty (IA) and reconstruction arthroplasty (RA) are widely used in treating temporomandibular joint ankylosis (TMJA). But the reported clinical outcomes are controversial, the debate over which one is better remains. The Pubmed, EMBASE, OVID EBM Reviews, and Web of science were searched up to Oct 11 2014 without limitation on year, language. Only randomized controlled trials and observational cohort studies with a follow-up of at least 12 months were included. A total of 8 retrospective cohort studies with 234 patients with TMJA were included in metaanalysis. Pooled analysis showed no significant differences in reankylosis (RD: -0.00; 95% CI: -0.08, 0.07; Z=0.06; P =0.95; I(2) =0%), and maximum incisal opening (MD=0.99; 95% CI: -1.43, 3.4, Z=0.8, p=0.42; I(2) =74%) between the IA and RA groups. IA and RA could produce similar outcomes in treating TMJA regarding to rankylosis and maximum incisal opening. Other postoperative complications, such as overgrowth of cartilage, malocclusion and the status of facial development should be evaluated more thoroughly. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Single stage treatment of ankylosis of the temporomandibular joint using patient-specific total joint replacement and virtual surgical planning.

PubMed

Haq, Jahrad; Patel, Nishma; Weimer, Katherine; Matthews, N Shaun

2014-04-01

Ankylosis of the temporomandibular joint (TMJ) is a debilitating condition that can result in pain, trismus, and a poor quality of life. It can be caused by injury, infection, and rheumatoid disease. Current management includes gap arthroplasty, interpositional arthroplasty, and reconstruction. Traditionally, joints are reconstructed using stock implants, or the procedure is done in two stages with an additional computed tomography (CT) scan between the resective and reconstructive procedures and use of stereolithographic models to aid the design of the definitive prostheses. We describe a technique for the resection of ankylosis and reconstruction of the joint in a single operation using virtually designed custom-made implants. Five patients with ankylosis of the TMJ had a single stage operation with reconstruction between 2010 and 2012. All had preoperative high-resolution CT with contrast angiography. During an international web-based teleconference between the surgeon and the engineer a virtual resection of the ankylosis was done using the reconstructed CT images. The bespoke cutting guides and implants were designed virtually at the same time and were then manufactured precisely using computer-aided design and manufacture (CAD-CAM) over 6 weeks. After release of the ankylosis and reconstruction, the patients underwent an exercise regimen to improve mouth opening. Follow-up was for a minimum of 6 months. Four patients had one operation, and one patient had two. Median/Mean maximum incisal opening increased from 0.6mm before operation to 25 mm afterwards (range 23-27), and there was minimal surgical morbidity. This new method effectively treats ankylosis of the TMJ in a single stage procedure. Fewer operations and hospital stays, and the maintenance of overall clinical outcome are obvious advantages. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Flowable resin and marginal gap on tooth third medial cavity involving enamel and radicular cementum: a SEM evaluation of two restoration techniques.

PubMed

Lo Giudice, G; Cicciù, M; Cervino, G; Lizio, A; Visco, A M

2012-01-01

The aim of this study is to investigate the presence and the extent of a possible marginal gap after the interposition of a flowable composite between the composite restoration and the dental structures (enamel and cementum). This technique is also used to eliminate the infiltration in a zone of the cavity preparation that is frequently at a risk of secondary decay. Fifteen human premolars extracted for orthodontic reasons were used for the study. A cavity with mesial and distal margin in enamel and cementum was realized in every tooth. The cavities were then restored with an adhesive system (ScotchBond 3MÔ) and composite (Filtek Supreme 3MÔ); and, a fine layer of flowable composite was applied in the distal margin of each cavity. Scanning electron microscopy (SEM) in secondary electron imaging (S.E.I.) modality was used for the study and identifying the marginal gaps in the composite restorations. Data was investigated on the mesial and distal margin of each cavity at the restoration-enamel interface, and at the restoration-cementum interface. The interfaces were divided in four groups: Group A (enamel/composite); Group B (enamel/flow/composite); Group C (cementum/composite); and, Group D (cementum/flow/composite). By the comparison of the gap's average width found in each group, it is evidenced that the average width of the gap increases when the interface moves from the coronal to the radicular end (Group A 0,1 ± 0,4 μm Vs Group C 12,3 ± 11,6 μm; Group B 0,2 ± 0,8 μm Vs Group D 2,8 ± 6,6 μm). Correlating the measurements of the marginal gap's average width among the Group A and Group B, no significant variations were obtained; and instead, on comparing Group C with Group D, the gap's average width decreases. The interposition of a low elastic modulus composite between the adhesive layer and the composite resin allows an improvement of the cementum-restoration interface by the means of a lower shrinkage stress during polymerization.

[Ankle arthrodesis with interposition graft as a salvage procedure after failed total ankle replacement].

PubMed

Schill, Stephan

2007-12-01

Restoration of painless function to the lower limb by ankle fusion after failure of total ankle arthroplasty. Loose total ankle replacement. Severe ankle destruction and axial deviation in rheumatoid patients. Severe osteoarthritis in the subtalar and ankle joints. Infected total ankle replacement. Severe arterial occlusive disease of the affected extremity. Transfibular approach to the subtalar and ankle joints. Osteotomy and resection of the distal fibula 7-8 cm proximal to the tip of the lateral malleolus. Removal of the prosthetic components, synovectomy, and revitalization of the remaining bone surface. Removal of any residual articular cartilage from the subtalar joint surfaces. Determination of the extent of bone loss and defect filling with horizontally or vertically placed tricortical and cancellous bone graft from the resected fibula and, if necessary, from the ipsilateral anterior iliac crest. Tibiotalocalcaneal arthrodesis by retrograde insertion of a retrograde locking nail. Wound closure in layers. Split below-knee cast. Mobilization with below-knee cast without weight bearing for 6 weeks. Dynamic locking of the intramedullary nail. Partial weight bearing with a walker up to 20 kg for an additional 6 weeks. Gradual increase in weight bearing in accordance with radiologic evidence of consolidation. Fitted orthopedic shoe with rocker-bottom sole, and made to measure insoles. From January 2003 to September 2006, 15 patients with infected ankle prosthesis loosening (six Thompson-Richards prostheses, eight S.T.A.R. prostheses, and one Salto prosthesis) were treated. All patients underwent tibiotalocalcaneal interposition arthrodesis with femoral nailing in retrograde technique. The average AOFAS (American Orthopaedic Foot and Ankle Society) Score was 57.9 points (35-81 points) postoperatively. One patient developed a nonunion and revision surgery will have to be performed. Another patient with delayed wound healing and skin necrosis needed plastic surgery.

Anatomical reconstruction of the fourth brachymetatarsia with one-stage iliac bone and cartilage cap grafting.

PubMed

Woo, Sang Hyun; Bang, Chi Young; Ahn, Hee-Chan; Kim, Sung-Jung; Choi, Jun-Young

2017-05-01

We present a one-stage procedure for lengthening the fourth brachymetatarsia with autogenous iliac bone and cartilage cap grafting for the anatomical reconstruction of the metatarsophalangeal (MTP) joint METHODS: During the last 8 years, 56 feet in 41 patients with congenital brachymetatarsia of the fourth toe were corrected with a one-stage operation to reposition the articular cartilage cap to the distal part of interpositional iliac bone graft at the metatarsal epiphysis. The length of the harvested iliac bone graft was 22.9 mm on average. The mean fixation period was 58.5 days, and the mean gain in length and percentage increase was 20.9 mm and 39%, respectively. MRI showed a stable MTP joint over viable cartilage cap in 83.3% of the cases. Mean postoperative American Orthopedic Foot and Ankle Society lesser MTP-interphalangeal score was 82.0. Neither neurovascular impairment nor recurrence of brachymetatarsia occurred in the mean follow-up period of 43.6 months. All patients were satisfied with the postoperative cosmetic results. Thirteen patients (23.2%) complained of limited active dorsiflexion of the fourth toe, and extensor adhesion was released by extensor tenolysis in only one patient. In a single case of nonunion at the bone graft site, additional surgery was not necessary. Anatomical reconstruction of the fourth brachymetatarsia with one-stage interpositional iliac bone and cartilage cap grafting resulted in excellent cosmetic results and a physiologic MTP joint, providing the benefits of one-stage lengthening with a low complication rate. Therapeutic, IV. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Temporomandibular joint arthroplasty for osteoarthrosis: A series of 24 patients that received a uni- or bilateral inter-positional silicone sheet.

PubMed

Boutault, F; Cavallier, Z; Lauwers, F; Prevost, A

2018-06-01

To evaluate mid-term results from using a silicone sheet for inter-positional arthroplasty in moderate or severe cases of osteoarthrosis of the temporo-mandibular joint (TMJ). To also determine any remaining indications from this method. This retrospective study included patients that underwent surgery between 2008 and 2016. Pre- and post-operative mouth opening (MO), according to inter-incisal distance (mm) and pain score (PS: 0=no pain to 4=very severe pain) were recorded for 24 patients. Patients were divided according to thickness of the silicone sheet (group A: 1.0 mm, group B: 1.5 mm). The cohort included 22 females (92%). Mean age at surgery was 55 years±13 (26-80). Mean length of follow-up was 26 months±24 (6-80). Mean improvement in MO was 8.2 mm (+33%) and of PS was 1.7 (-68%). MO was not improved for two patients and worsened for one. PS score improved for all patients. No statistical difference was found between groups A and B. There was also a tendency for degradation of outcomes over time. The poor reputation of prosthetic discoplasty was not as evident in our series, even though anatomical and functional status seemed to deteriorate over time. This is because total-joint prosthetic replacement is often proposed instead. However, for elderly or fragile patients that have severe pain, and regarding cost-benefit aspects, conventional arthroplasty can still be discussed, especially since French national health-care insurance does not yet support TMJ prosthetic replacement for osteoarthrosis. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Trends in Thumb Carpometacarpal Interposition Arthroplasty in the United States, 2005-2011.

PubMed

Werner, Brian C; Bridgforth, Andrew B; Gwathmey, F Winston; Dacus, A Rashard

2015-08-01

We conducted a study to investigate current trends in carpometacarpal (CMC) interposition arthroplasty across time, sex, age, and region of the United States; per-patient charges and reimbursements; and the association between this procedure and concomitantly performed carpal tunnel syndrome (CTS) and carpal tunnel release (CTR). Patients who underwent CMC interposition arthroplasty (N = 41,171) were identified in a national database. Between 2005 and 2011, the number of patients who had CMC interposition arthroplasty increased 46.2%. Females had the procedure more frequently than males at all time points, though the percentage of patients who were male increased throughout the study period. Of the patients who had CMC interposition arthroplasty, 40.9% also had a diagnosis of CTS. Between 15.5% and 17.3% of these patients had CTR performed concomitantly. Despite a lack of evidence that thumb CMC interposition arthroplasty is superior to other surgical treatment options, the number of patients who are having this procedure has increased significantly. The impetus for these trends requires additional investigation.

Vesicovaginal fistula repair with rectus abdominus myofascial interposition flap.

PubMed

Reynolds, W Stuart; Gottlieb, Lawrence J; Lucioni, Alvaro; Rapp, David E; Song, David H; Bales, Gregory T

2008-06-01

Complex, recurrent vesicovaginal fistulas (VVFs) can be very challenging to repair and often require interposition of nonirradiated, well-vascularized tissue between the urinary system and vagina. We report our experience using a rectus abdominus myofascial (RAM) interposition flap for VVF repair. A retrospective analysis was performed to identify patients who had undergone VVF repair with RAM interposition. Data were collected focusing on preoperative patient characteristics, etiology of VVF, intraoperative parameters, including surgical techniques, and postoperative patient outcomes. We used a RAM interposition flap for VVF repair in 5 patients. All VVFs had developed postoperatively; no patient had received radiotherapy. VVF developed after total abdominal hysterectomy (TAH) or radical cystectomy in 3 and 2 cases, respectively. Both cases of VVF after radical cystectomy occurred in conjunction with orthotopic diversion (neobladder-vaginal fistula). In 3 patients with post-TAH VVF, a total of five previous failed repairs were attempted before RAM interposition. In 1 patient with a neobladder-vaginal fistula, who had received adjuvant chemotherapy, RAM interposition failed, and the patient ultimately required cutaneous urinary diversion after two subsequent failed attempts at repair (68 months of follow-up). The remaining 4 patients (80%) had no evidence of recurrent VVF or voiding abnormalities at a mean follow-up of 19 months (range 8 to 32). Rectus abdominus muscle can be a successful interposition flap during repair of complex, recurrent VVF. In our experience, this has been successful in most cases, particularly in younger patients with nonmalignant processes.

21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Interarticular disc prosthesis (interpositional implant). 872.3970 Section 872.3970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (interpositional implant) is a device that is intended to be an interface between the natural articulating surface...

[Osteoarthritis of the trapeziometacarpal joint in men: different stakes. Results of three surgical techniques].

PubMed

Gallinet, D; Gasse, N; Blanchet, N; Tropet, Y; Obert, L

2011-02-01

Basal thumb arthritis is less common in men, but the functional implication is different in this manual worker or active retired population. The objective was to analyse the results of three surgical procedure in an exclusively men's population. Twenty-eight patients (19 partial trapeziectomy with interposition of a chondrocostal autograft, seven total trapeziectomy and two prosthesis), with a mean age of 69 years old, were reviewed at a mean follow-up of 71 months. Mobility and pain were similar in the three populations. But the strength and Dash scores were better in the cartilage group. Radiologically the length of the thumb ray was greater in the cartilage group and no signs of loosening were observed in the prosthesis group. The surgery of reference in this population is the arthrodesis of the trapeziometacarpal joint. But the lack of mobility is disabling, the strength is questionable and painlessness varies due to high rates of non-union. Only one study compared four surgical procedures in an exclusively male population and total trapeziectomy seemed to give the best results. But this technique carries risk of shortening of the thumb ray. Even if the comparison is difficult, the association of partial trapeziectomy with interposition of costal cartilage graft seems to give better stability to the thumb column by preserving length as well as greater strength compared to total trapeziectomy. We advocate this procedure for basal thumb arthritis in men. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Thumb carpometacarpal osteoarthritis: arthrodesis compared with ligament reconstruction and tendon interposition.

PubMed

Hartigan, B J; Stern, P J; Kiefhaber, T R

2001-10-01

There has been considerable controversy regarding the procedure of choice for treatment of any given stage of osteoarthritis of the thumb carpometacarpal joint. This study was designed to directly compare the clinical results of two common surgical procedures for this condition, trapeziometacarpal arthrodesis and trapezial excision with ligament reconstruction and tendon interposition, in similar patient populations. Between 1988 and 1998, 109 patients (141 thumbs) who were less than sixty years old were treated with one of the two procedures. In a retrospective review, forty-two patients (fifty-eight thumbs) treated with arthrodesis completed an outcome questionnaire and twenty-nine patients (forty-four thumbs) treated with arthrodesis completed the questionnaire and were examined. In the group treated with trapezial excision with ligament reconstruction and tendon interposition, thirty-nine patients (forty-nine thumbs) completed the questionnaire and thirty patients (thirty-eight thumbs) completed the questionnaire and were examined. The average duration of follow-up was sixty-nine months. The groups were similar with regard to age, gender, hand dominance, and duration of follow-up. Subjective evaluation of pain, function, and satisfaction demonstrated no significant difference between the two groups, with >90% of patients satisfied following either procedure. Although grip strength did not differ between the groups, the arthrodesis group had significantly stronger lateral pinch (p < 0.001) and chuck pinch (p < 0.01). The group treated with ligament reconstruction and tendon interposition had a better range of motion with regard to opposition (p < 0.05) and the ability to flatten the hand (p < 0.0001). There was a higher complication rate in the arthrodesis group, with nonunion of the fusion site accounting for the majority of the complications. However, despite a persistent nonunion in six thumbs, those thumbs and the thumbs in which union was obtained did not differ with regard to pain; all of the patients with nonunion had improvement in their pain status compared with preoperatively, and all were very satisfied with the outcome. Peritrapezial arthritis developed in nine patients (fourteen thumbs). This finding was not related to age and did not affect overall pain, function, or satisfaction. Although traditionally arthrodesis and ligament reconstruction and tendon interposition have been indicated in two different patient populations, we compared them in a homogeneous group and found that the two procedures had similar results with regard to pain, function, and satisfaction despite minimal differences in strength and motion. Although complications were more frequent following arthrodesis, most did not affect the overall outcome.

Medial capsular interpositional arthroplasty for severe hallux rigidus.

PubMed

Hahn, Michael Patrick; Gerhardt, Nels; Thordarson, David B

2009-06-01

Multiple surgical options have been described for severe hallux rigidus. One option is capsular interpositional arthroplasty. We report our initial results with a technique using the thicker medial capsule as our interpositional material instead of the dorsal capsule and extensor hallucis brevis (EHB). Twenty-two patients with grade IV hallux rigidus underwent minimal proximal phalanx resection (modified Keller) with preservation of the flexor hallucis brevis (FHB) insertion and medial capsular interpositional arthroplasty. Postoperative AOFAS hallux MTP-IP scores (mean 77.8), and SF-36 scores (mean 68.7 on physical function, 79.5 role limitations) demonstrated clinical improvement compared to historical controls. Alignment and stability were well maintained (mean preoperative HV angle of 11.8 degrees, mean postoperative HV angle of 13.0 degrees). Dorsiflexion/plantarflexion arc of motion showed sustained improvement (mean 38.4 degrees preoperative, mean 62.3 degrees postoperative). These results are comparable to other forms of interpositional arthroplasty and arthrodesis for end stage arthritis of the hallux MTPJ.

Dubious space for Artelon joint resurfacing for basal thumb (trapeziometacarpal joint) osteoarthritis. A systematic review.

PubMed

Smeraglia, Francesco; Mariconda, Massimo; Balato, Giovanni; Di Donato, Sigismondo Luca; Criscuolo, Giovanni; Maffulli, Nicola

2018-06-01

Trapeziometacarpal arthritis is a common and disabling condition. There is no evidence in the literature of superiority of one surgical procedure over others. Several prosthetic implants have been introduced to preserve joint mobility. We searched the on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'artelon', 'thumb', 'carpometacarpal', 'trapeziometacarpal' and 'rhizoarthrosis'; 11 studies were identified. The use of Artelon implant is not recommended because of its high revision rate and worse outcomes compared to conventional techniques. Inert materials subjected to compressive and shearing forces could produce debris and subsequent inflammatory response. There is debate in the published scientific literature regarding the role of preoperative antibiotic profilaxis and post-surgery inflammatory response. Standard techniques such as trapeziectomy alone or combined with interposition or suspensionplasty offer effective treatment for thumb basal joint arthritis. Several prosthetic implants show promising results in terms of pain relief and functional request, but there is a need of long-term randomized controlled trials to demonstrate their equivalence, and eventually superiority, compared to standard techniques.

The use of the Artelon CMC Spacer for osteoarthritis of the basal joint of the thumb.

PubMed

Richard, Marc J; Lunich, Julie A; Correll, Gretchen R

2014-01-01

Favorable clinical outcomes have been reported with the Artelon CMC Spacer, however, several studies have documented complications with the device. The purpose of this study is to review a single surgeon's experience with the Artelon CMC Spacer for the treatment of basal joint arthritis of the thumb. Five thumbs in 6 patients with symptomatic osteoarthritis of the thumb carpometacarpal (CMC) joint were treated with the Artelon CMC Spacer. The mean age of the patients was 60.8 years old. Patients were followed for a mean of 39.3 months (6-63) post-operatively. Complications occurred in 4 of the 6 thumbs and half of the thumbs required at least one secondary operative procedure. A documented foreign-body reaction was present in 2 of the 6 thumbs. The Artelon CMC Spacer is an interposition material that acts as a biologic spacer for arthritic joints while maintaining mechanical strength. Due to an unacceptably high complication rate, we no longer use the Artelon CMC Spacer for the management of basal joint arthritis of the thumb. 4. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Stability of double-row rotator cuff repair is not adversely affected by scaffold interposition between tendon and bone.

PubMed

Beitzel, Knut; Chowaniec, David M; McCarthy, Mary Beth; Cote, Mark P; Russell, Ryan P; Obopilwe, Elifho; Imhoff, Andreas B; Arciero, Robert A; Mazzocca, Augustus D

2012-05-01

Rotator cuff reconstructions may be improved by adding growth factors, cells, or other biologic factors into the repair zone. This usually requires a biological carrier (scaffold) to be integrated into the construct and placed in the area of tendon-to-bone healing. This needs to be done without affecting the constructs mechanics. Hypothesis/ The hypothesis was that scaffold placement, as an interposition, has no adverse effects on biomechanical properties of double-row rotator cuff repair. The purpose of this study was to examine the effect of scaffold interposition on the initial strength of rotator cuff repairs. Controlled laboratory study. Twenty-five fresh-frozen shoulders (mean age: 65.5 ± 8.9 years) were randomly assigned to 5 groups. Groups were chosen to represent a broad spectrum of commonly used scaffold types: (1) double-row repair without augmentation, (2) double-row repair with interposition of a fibrin clot (Viscogel), (3) double-row repair with interposition of a collagen scaffold (Mucograft) between tendon and bone, (4) double-row repair with interposition of human dermis patch (ArthroFlex) between tendon and bone, and (5) double-row repair with human dermis patch (ArthroFlex) placed on top of the repair. Cyclic loading to measure displacement was performed to 3000 cycles at 1 Hz with an applied 10- to 100-N load. The ultimate load to failure was determined at a rate of 31 mm/min. There were no significant differences in mean displacement under cyclic loading, slope, or energy absorbed to failure between all groups (P = .128, P = .981, P = .105). Ultimate load to failure of repairs that used the collagen patch as an interposition (573.3 ± 75.6 N) and a dermis patch on top of the reconstruction (575.8 ± 22.6 N) was higher compared with the repair without a scaffold (348.9 ± 98.8 N; P = .018 and P = .025). No significant differences were found for repairs with the fibrin clot as an interposition (426.9 ± 103.6 N) and the decellularized dermis patch as an interposition (469.9 ± 148.6 N; P = .73 and P = .35). Scaffold augmentation did not adversely affect the zero time strength of the tested standard double-row rotator cuff repairs. An increased ultimate load to failure was observed for 2 of the augmentation methods (collagen patch as an interposition and decellularized dermis patch on top of the reconstruction) compared with the nonaugmented repairs. Scaffolds intended for application of growth factors or cellular components in a repair situation did not adversely jeopardize the stability of the operative construct.

Original treatment for ischaemic stenosis of colon interposition: Report of two cases.

PubMed

Daldoul, S; Moussi, A; Sayari, S; Ben Moussa, M

2017-02-01

The treatment of ischaemic stenosis of colon interposition for oesophageal replacement remains poorly defined. We report two cases of patients operated for ischaemic stenosis of the cervical extremity of the colon interposition for caustic stenosis of the oesophagus. Treatment consisted of resection of the stenosis with creation of a new cervical anastomosis after complete release of the colon graft via a neck and upper midline incision in one patient and a new ileocolic graft exclusively replacing the stenotic segment of the oesophagoplasty in the second patient. These two cases illustrate the complex treatment modalities required for this complication. The treatment of choice of ischaemic stenosis of colon interposition is resection with creation of a new anastomosis, but repeat graft may sometimes be the only available treatment option. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Arthritis of the thumb and digits: current concepts.

PubMed

Bernstein, Richard A

2015-01-01

Osteoarthritis of the hand continues to be a problem in an aging population and affects the proximal and distal interphalangeal, metacarpophalangeal, and carpometacarpal joints in the hands. Heberden nodes develop in the distal interphalangeal joints and typically present as a deformed and enlarged joint and can cause pain. Surgery rarely is necessary because functional difficulties are uncommon; however, there may be problems if the metacarpophalangeal and proximal interphalangeal joints are involved because cartilage destruction generates pain and causes weakness and motion loss. Implant arthroplasty typically can improve pain but does not reliably improve range of motion, and complication and revision rates are substantial. Arthrodesis continues as a treatment for digital osteoarthritis, but the surgeon must balance the risks of complications with the benefits of improved patient outcomes. The opposable thumb, which is critical for hand dexterity and strength, can be severely disabled by basal joint arthritis. The complex architecture of the basal joint continues to be defined by its relationship to the surrounding bony and ligamentous anatomy and its effect on the trapeziometacarpal joint. Nonsurgical treatment may be beneficial, but surgical options, including arthroscopy, osteotomy, and arthroplasty, should be considered if nonsurgical management fails. Prosthetic arthroplasty has a historically poor record; therefore, trapeziectomy remains the hallmark of current reconstructive techniques. Ligament reconstruction and tendon interposition arthroplasty are the most commonly performed surgical procedures, but hematoma distraction arthroplasty and various methods of suspensionplasty also are currently used.

Hallux rigidus: How do I approach it?

PubMed Central

Lam, Aaron; Chan, Jimmy J; Surace, Michele F; Vulcano, Ettore

2017-01-01

Hallux rigidus is a degenerative disease of the first metatarsalphalangeal (MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1st MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intra-articular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient’s goal and expectations, and surgeon’s experience with the technique. PMID:28567339

Pitfalls in diagnosis and management of distal vaginal agenesis: 10-year experience at a single centre.

PubMed

Ugur, M G; Balat, O; Ozturk, E; Bekerecioglu, M; Dikensoy, E

2012-07-01

To discuss common pitfalls in diagnosis and management of distal vaginal agenesis, and summarize 10 years of experience among 11 patients using an interposition full-thickness graft and fibrin glue. Eleven patients with distal vaginal agenesis were evaluated and managed with an interposition full-thickness graft to bridge the gap between the upper vagina and the introitus. Associated renal abnormalities and complications including infection, total lack of skin graft take, stress urinary incontinence, partial graft loss, vaginal stricture and graft uptake were all investigated. The mean age of the patients was 12.91 (standard deviation 1.22) years. All patients had primary amenorrhoea, cryptomenorrhea, and cyclical or constant pelvic pain. None of the patients had associated urological abnormalities, and there were no cases of infection, total lack of skin graft take, stress urinary incontinence, partial graft loss or vaginal stricture. Graft uptake was 100% in 10 of the 11 patients. Four patients have subsequently married and report a satisfactory sex life. Accurate diagnosis of distal vaginal agenesis and careful pre-operative set-up, including evaluation of associated anomalies, bowel preparation, available vaginal stents and a multidisciplinary approach for the potential need for grafts, may be key to success. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Salvage reconstruction of failed interposition arthroplasty at the base of the thumb.

PubMed

Braun, Richard M; Rechnic, Mark; Shah, Kalpit N

2012-12-01

We present an operative procedure designed to revise a failed arthroplasty at the base of the thumb. This report describes a reliable operation that corrects residual instability and malignment which results in thumbs that are weak and painful despite a previous procedure. The operation has also been used as a primary procedure for arthritis of the trapeziometacarpal joint where instability and subluxation was a major component of the problem requiring joint reconstruction. The unique features of this procedure include a reinforced double-thickness tendon graft, a unique tendon anchor, and a fascia lata allograft spacer. Significant functional improvement is anticipated when joint reconstruction provides increased proximal stability. Pinch and grip measurements improve. Pain scores also diminish after the operation. Hand function and patient satisfaction can be substantially improved with revision arthroplasty when the initial operation has failed to provide a thumb that is mobile, stable, and pain free. The technical features of the procedure address reduction of malignment, restoring of anatomic balance, and secure fixation of the proximal apex of the thumb metacarpal which restores thumb reduction position and digital balance.

Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique.

PubMed

Saliba, Issam; Sabbah, Valérie; Poirier, Jackie Bibeau

2018-01-01

To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S) and a new fat interposition total ossicular replacement prosthesis (TORP-F) in pediatric and adult patients and to assess the complication and the undesirable outcome. This is a retrospective study. This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA) to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes' head as a partial ossicular replacement prosthesis. The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52) compared with 40% in the TORP-S group (n = 29). However, the adult cohort shows 79.3% in the TORP-F group (n = 52) compared with 43.75% in the TORP-S group (n = 25). These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group ( P  = .03). The interposition of a fat graft between the legs of the titanium implants (TORP-F) provides superior hearing results compared with a standard procedure (TORP-S) in pediatric and adult populations because of its better stability in the oval window niche.

Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique

PubMed Central

Saliba, Issam; Sabbah, Valérie; Poirier, Jackie Bibeau

2018-01-01

Objective: To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S) and a new fat interposition total ossicular replacement prosthesis (TORP-F) in pediatric and adult patients and to assess the complication and the undesirable outcome. Study design: This is a retrospective study. Methods: This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA) to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes’ head as a partial ossicular replacement prosthesis. Results: The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52) compared with 40% in the TORP-S group (n = 29). However, the adult cohort shows 79.3% in the TORP-F group (n = 52) compared with 43.75% in the TORP-S group (n = 25). These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group (P = .03). Conclusions: The interposition of a fat graft between the legs of the titanium implants (TORP-F) provides superior hearing results compared with a standard procedure (TORP-S) in pediatric and adult populations because of its better stability in the oval window niche. PMID:29326537

Management of surgical and radiation induced rectourethral fistulas with an interposition muscle flap and selective buccal mucosal onlay graft.

PubMed

Vanni, Alex J; Buckley, Jill C; Zinman, Leonard N

2010-12-01

Rectourethral fistulas are a rare but devastating complication of pelvic surgery and radiation. We review, analyze and describe the management and outcomes of nonradiated and radiation/ablation induced rectourethral fistulas during a consecutive 12-year period. We performed a retrospective review of patients undergoing rectourethral fistula repair between January 1, 1998 and December 31, 2009. Patient demographics as well as preoperative, operative and postoperative data were obtained. All rectourethral fistulas were repaired using an anterior transperineal approach with a muscle interposition flap and selective use of a buccal mucosal graft urethral patch onlay. A total of 74 patients with rectourethral fistulas underwent repair with an anterior perineal approach and muscle interposition flap (68 gracilis muscle interposition flaps, 6 other muscle interposition flaps). We compared 35 nonradiated and 39 radiated/ablation induced rectourethral fistulas. Concurrent urethral strictures were present in 11% of nonradiated and 28% of radiated/ablation rectourethral fistulas. At a mean followup of 20 months 100% of nonradiated rectourethral fistulas were closed with 1 procedure while 84% of radiated/ablation rectourethral fistulas were closed in a single stage. Of the patients with nonradiated rectourethral fistulas 97% had the bowel undiverted. Of those undiverted cases 100% were without bowel complication. Of the patients with radiated/ablation rectourethral fistulas 31% required permanent fecal diversion. Successful rectourethral fistula closure can be achieved for nonradiated (100%) and radiation/ablation (84%) rectourethral fistulas using a standard anterior perineal approach with an interposition muscle flap and selective use of buccal mucosal graft, providing a standard for rectourethral fistula repair. Even the most complex radiation/ablation rectourethral fistula can be repaired avoiding permanent urinary and fecal diversion. Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Outcomes for jejunal interposition reconstruction compared with Roux-en-Y anastomosis: A meta-analysis.

PubMed

Fan, Kai-Xi; Xu, Zhong-Fa; Wang, Mei-Rong; Li, Dao-Tang; Yang, Xiang-Shan; Guo, Jing

2015-03-14

To compare the clinical outcomes between jejunal interposition reconstruction and Roux-en-Y anastomosis after total gastrostomy in patients with gastric cancer. A systematic literature search was conducted by two independent researchers on PubMed, EMBASE, the Cochrane Library, Google Scholar, and other English literature databases, as well as the Chinese Academic Journal, Chinese Biomedical Literature Database, and other Chinese literature databases using "Gastrostomy", "Roux-en-Y", and "Interposition" as keywords. Data extraction and verification were performed on the literature included in this study. RevMan 5.2 software was used for data processing. A fixed-effects model was applied in the absence of heterogeneity between studies. A random effects model was applied in the presence of heterogeneity between studies. Ten studies with a total of 762 gastric cancer patients who underwent total gastrostomy were included in this study. Among them, 357 received jejunal interposition reconstruction after total gastrostomy, and 405 received Roux-en-Y anastomosis. Compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR = 0.18, 95%CI: 0.10-0.31; P < 0.001), increased the prognostic nutritional index [weighted mean difference (WMD) = 6.02, 95%CI: 1.82-10.22; P < 0.001], and improved the degree of postoperative weight loss [WMD = 2.47, 95%CI: -3.19-(-1.75); P < 0.001]. However, there is no statistically significant difference in operative time, hospital stay, or incidence of reflux esophagitis. Compared with Roux-en-Y anastomosis, patients who underwent jejunal interposition reconstruction after total gastrostomy had a lower risk of postoperative long-term complications and improved life quality.

Fibrin glue as interposition graft for tarsal coalition.

PubMed

Weatherall, Justin M; Price, Andrew E

2013-01-01

We describe a surgical technique and report outcomes for fibrin glue interposition after resection of a tarsal condition. An institutional review board--approved retrospective review of all pediatric patients with a tarsal coalition managed with resection was conducted between January 2002 and July 2010 by a single surgeon. All coalitions were resected with interposition of fibrin glue. Patients were evaluated for postoperative complications, pain, weight-bearing status, return to sports, and ankle and subtalar range of motion. Six feet without a coalition were used as a control group. Nine patients (12 feet) were identified with mean follow-up of 2.1 years (range, 7-72 months). Pre-operative complaints were predominantly foot and ankle pain. Patients also reported flatfeet and recurrent ankle sprains. There were no reported postoperative complications. All 9 patients were weight-bearing as tolerated and returned to sports by 6 months. Fibrin glue is a safe and reliable alternative to tissue grafts for interposition after resection of a tarsal coalition.

ULNAR NERVE COMPONENT TO INNERVATION OF THUMB CARPOMETACARPAL JOINT

PubMed Central

Miki, Roberto Augusto; Kam, Check C; Gennis, Elisabeth R; Barkin, Jodie A; Riel, Ryan U; Robinson, Philip G; Owens, Patrick W

2011-01-01

Purpose Thumb carpometacarpal (CMC) joint arthritis is one of the most common problems addressed by hand surgeons. The gold standard of treatment for thumb CMC joint arthritis is trapeziectomy, ligament reconstruction and tendon interposition. Denervation of the thumb CMC joint is not currently used to treat arthritis in this joint due to the failure of the procedure to yield significant symptomatic relief. The failure of denervation is puzzling, given that past anatomic studies show the radial nerve is the major innervation of the thumb CMC joint with the lateral antebrachial nerve and the median nerve also innervating this joint. Although no anatomic study has ever shown that the ulnar nerve innervates the CMC joint, due to both the failure of denervation and the success of arthroscopic thermal ablation, we suspect that previous anatomic studies may have overlooked innervation of the thumb CMC joint via the ulnar nerve. Methods We dissected 19 formalin-preserved cadaveric hand-to-mid-forearm specimens. The radial, median and ulnar nerves were identified in the proximal forearm and then followed distally. Any branch heading toward the radial side of the hand were followed to see if they innervated the thumb CMC joint. Results Eleven specimens (58%) had superficial radial nerve innervation to the thumb CMC joint. Nine specimens (47%) had median nerve innervation from the motor branch. Nine specimens (47%) had ulnar nerve innervation from the motor branch. Conclusions We believe this is the first study to demonstrate that the ulnar nerve innervates the thumb CMC joint This finding may explain the poor results seen in earlier attempts at denervation of the thumb CMC, but the more favorable results with techniques such as arthroscopy with thermal ablation. PMID:22096446

21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Interarticular disc prosthesis (interpositional implant). 872.3970 Section 872.3970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3970 Interarticular...

Prospective analysis of temporomandibular joint reconstruction in ankylosis with sternoclavicular graft and buccal fat pad lining.

PubMed

Singh, Virendra; Dhingra, Rahul; Bhagol, Amrish

2012-04-01

To evaluate the feasibility of sternoclavicular graft (SCG) as an adaptive center along with buccal fat pad (BFP) lining for temporomandibular joint (TMJ) reconstruction in TMJ ankylosis. A prospective, preliminary, short-term study with only 6 months' follow-up was performed in 10 patients with TMJ ankylosis. All patients had complete osseous ankylosis, and the mean duration of ankylosis was 6.4 years (range, 3 to 13 years). Interpositional arthroplasty with SCG along with BFP lining was done in all cases. Postoperative clinical and radiographic follow-up was performed for 6 to 9 months. Maximum interincisal opening at 6 months' follow-up was 35.6 ± 4.97 mm (range, 31 to 45 mm). Similarly, protrusive movement at follow-up of 6 months was 2.7 ± 1.25 mm (range, 1.5 to 5.5 mm), whereas laterotrusive movement was 4.1 ± 1.98 mm (range, 1.5 to 7.0 mm) toward the affected side and 2.4 ± 0.99 mm (range, 1 to 4.0 mm) toward the normal side. After 3 months, 9 of 10 patients had no pain on function, and all the patients were relieved of pain at the end of 6 months. On radiographic follow-up at 9 months, there was noticeably significant adaptation and remodeling of SCG as observed on panoramic radiography and computed tomography scan. In all the patients there was some degree of mandibular deviation toward the operated side, although the occlusion was satisfactory and they were pleased with the outcome. On the basis of the findings of this study, we conclude that after release of TMJ ankylosis, reconstruction with SCG combined with interposition of BFP lining followed by vigorous physiotherapy is a successful strategy for the management of TMJ ankylosis with short-term follow-up of 6 months. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Treatment of elbow osteomyelitis with an interposition arthroplasty using a rectus abdominis free flap.

PubMed

Jaiswal, Rohit; Busse, Brittany; Allen, Robert; Sahar, David

2015-05-01

Osteomyelitis of the elbow may be a complex clinical problem. Treatment goals include the eradication of infection and preservation of maximal joint function. Bony debridement may be necessary in addition to elbow joint arthroplasty. The use of synthetic material or allograft as the arthroplasty material may be contraindicated in the setting of infection. The use of free muscle transfer as an arthroplasty medium has not been well described. A 22-year-old paraplegic man developed recurrent osteomyelitis of the right elbow, necessitating extensive bony debridement by the orthopedic surgery team. Reconstruction arthroplasty was performed using a free rectus abdominis muscle flap as the arthroplasty material to serve as a source of biologically active, well-vascularized arthroplasty medium in the presence of ongoing infection. A successful free muscle flap arthroplasty was performed. External fixation and physical therapy were implemented postoperatively. The patient had resolution of osteomyelitis and excellent functional use of the elbow for activities of daily living and wheelchair motion. Elbow arthroplasty in the setting of active infection may be accomplished by means of free tissue muscle transfer. Elimination of infection and acceptable joint function may be possible with this form of reconstruction.

[Application and research progress of subtalar distraction bone block arthrodesis in treatment of calcaneus fracture malunion].

PubMed

Wang, Shanxi; Li, Jun; Huang, Fuguo; Liu, Lei

2017-05-01

To review the application and research progress of subtalar distraction bone block arth-rodesis in the treatment of calcaneus fracture malunion. The recent literature concerning the history, surgical technique, postoperative complication, indications, and curative effect of subtalar distraction arthrodesis with bone graft block interposition in the treatment of calcaneus fracture malunion was summarized and analyzed. Subtalar distraction bone block arthrodesis is one of the main ways to treat calcaneus fracture malunion, including a combined surgery with subtalar arthrodesis and realignment surgery for hindfoot deformity using bone block graft. The advantage is on the base of subtalar joint fusion, through one-time retracting subtalar joint, the posterior articular surface of subtalar joint implants bone block can partially restore calcaneal height, thus improving the function of the foot. Compared with other calcaneal malunion treatments, subtalar distraction arthrodesis is effective to correct complications caused by calcaneus fracture malunion, and it can restore the height of talus and calcaneus, correct loss of talocalcaneal angle, and ease pain. Subtalar distraction bone block arthrodesis has made remarkable progress in the treatment of calcaneus fracture malunion, but it has the disadvantages of postoperative nonunion and absorption of bone block, so further study is needed.

The Influence of Joint Distraction Force on the Soft-Tissue Balance Using Modified Gap-Balancing Technique in Posterior-Stabilized Total Knee Arthroplasty.

PubMed

Nagai, Kanto; Muratsu, Hirotsugu; Takeoka, Yoshiki; Tsubosaka, Masanori; Kuroda, Ryosuke; Matsumoto, Tomoyuki

2017-10-01

During modified gap-balancing technique, there is no consensus on the best method for obtaining appropriate soft-tissue balance and determining the femoral component rotation. Sixty-five varus osteoarthritic patients underwent primary posterior-stabilized total knee arthroplasty using modified gap-balancing technique. The influence of joint distraction force on the soft-tissue balance measurement during the modified gap-balancing technique was evaluated with Offset Repo-Tensor between the osteotomized surfaces at extension, and between femoral posterior condyles and tibial osteotomized surface at flexion of the knee before the resection of femoral posterior condyles. The joint center gap (millimeters) and varus ligament balance (°) were measured under 20, 40, and 60 pounds of joint distraction forces, and the differences in these values at extension and flexion (the value at flexion minus the value at extension) were also calculated. The differences in joint center gap (-6.7, -6.8, and -6.9 mm for 20, 40, and 60 pounds, respectively) and varus ligament balance (3.5°, 3.8°, and 3.8°) at extension and flexion were not significantly different among different joint distraction forces, although the joint center gap and varus ligament balance significantly increased stepwise at extension and flexion as the joint distraction force increased. The difference in joint center gap and varus ligament balance at extension and flexion were consistent even among the different joint distraction forces. This novel index would be useful for the determination of femoral component rotation during the modified gap-balancing technique. Copyright © 2017 Elsevier Inc. All rights reserved.

Asbestos: Securing Untrusted Software with Interposition

DTIC Science & Technology

2005-09-01

consistent intelligible interfaces to different types of resource. Message-based operating systems, such as Accent, Amoeba, Chorus, L4 , Spring...control on self-authenticating capabilities, precluding policies that restrict delegation. L4 uses a strict hierarchy of interpositions, useful for...the OS de- sign space amenable to secure application construction. Similar effects might be possible with message-passing microkernels , or unwieldy

Stapedotomy in osteogenesis imperfecta: a prospective study of 32 consecutive cases.

PubMed

Vincent, Robert; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

2014-12-01

To prospectively evaluate hearing outcomes in patients with osteogenesis imperfecta undergoing primary stapes surgery and to isolate prognostic factors for success. A nonrandomized, open, prospective case series. A tertiary referral center. Twenty-five consecutive patients who underwent 32 primary stapedotomies for osteogenesis imperfecta with evidence of stapes fixation and available postoperative pure-tone audiometry. Primary stapedotomy with vein graft interposition and reconstruction with a regular Teflon piston or bucket handle-type piston. Preoperative and postoperative audiometric evaluation using conventional 4-frequency (0.5, 1, 2, and 4 kHz) audiometry. Air-conduction thresholds, bone-conduction thresholds, and air-bone gap were measured. The overall audiometric results as well as the results of audiometric evaluation at 3 months and at least 1 year after surgery were used. Overall, postoperative air-bone gap closure to within 10 dB was achieved in 88% of cases. Mean (standard deviation) gain in air-conduction threshold was 22 (9.4) dB for the entire case series, and mean (standard deviation) air-bone gap closure was 22 (9.0) dB. Backward multivariate logistic regression showed that a model with preoperative air-bone gap closure and intraoperatively established incus length accurately predicts success after primary stapes surgery. Stapes surgery is a feasible and safe treatment option in patients with osteogenesis imperfecta. Success is associated with preoperative air-bone gap and intraoperatively established incus length.

[Post-traumatic arthritis in the young patient : Treatment options before the endoprosthesis].

PubMed

Burkhart, K J; Hollinger, B

2016-10-01

In the young patient, treatment of post-traumatic elbow arthritis remains difficult. Total elbow arthroplasty must be delayed for as long as possible. Therapy starts with nonoperative treatment. If this fails, operative options can be discussed. The aim of surgery is to provide a functional range of motion with acceptable pain without obstructing future treatment options. Patients with pain at terminal extension and/or flexion may benefit from arthroscopic or open debridement. Patients with advanced osteoarthritis and pain throughout the complete range of motion, who are too young for total elbow arthroplasty, are offered interposition arthroplasty or arthrodesis. Arthrodesis of the elbow leads to significant restrictions in daily life due to the complete loss of extension/flexion. Therefore, arthrodesis is only offered as treatment in exceptional circumstances. Interposition arthroplasty is a reasonable option for the young patient without significant bony defects, which may provide a stable, functional flexion arc with an acceptable pain level. Interposition arthroplasty preserves the revision options of re-interposition arthroplasty as well as the withdrawal to total elbow arthroplasty. Partial and total elbow arthroplasty are treatment options of elbow arthritis but are not subjects of this article.

[A case of vesicovaginal fistula repair with rectus abdominus myofascial interposition flap after radical hysterectomy and radiation therapy].

PubMed

Endo, Yuki; Iigaya, Shigeki; Nishimura, Taiji; Ishii, Naohiro; Kitaoka, Yoshihisa; Kawashima, Toshifumi; Ohara, Chiharu; Hamasaki, Tsutomu; Kondo, Yukihiro

2014-10-01

Vesicovaginal fistulas (VVFs) caused after radiation are difficult to repair and require interposition of non-irradiated, well-vascularized tissue between urinary bladder and vagina. A 48-year-old female suffered cervical cancer and underwent radical hysterectomy followed by radiation therapy which caused VVF. The initial surgical repair performed 3 months after development of VVF, was unsuccessful because of the absence of peritoneum or omentum to interpose between urinary bladder and vagina probably due to history of cesarean section and radical hysterectomy. The second surgical repair was performed 15 months after the first surgery utilizing a rectus abdominus myofascial (RAM) interposition flap. Fifteen months after the second operation, she remains free from incontinence. This case suggests that RAM is useful even for postradiation VVF.

Influence of the Gap Width on the Geometry of the Welded Joint in Hybrid Laser-Arc Welding

NASA Astrophysics Data System (ADS)

Turichin, G.; Tsibulskiy, I.; Kuznetsov, M.; Akhmetov, A.; Mildebrath, M.; Hassel, T.

The aim of this research was the experimental investigation of the influence of the gap width and speed of the welding wire on the changes of the geometry in the welded joint in the hybrid laser-arc welding of shipbuilding steel RS E36. The research was divided into three parts. First, in order to understand the influence of the gap width on the welded joint geometry, experimental research was done using continuous wave fiber laser IPG YLS-15000 with arc rectifier VDU-1500DC. The second part involved study of the geometry of the welded joint and hardness test results. Three macrosections from each welded joint were obtained. Influence of the gap width and welding wire speed on the welded joint geometry was researched in the three lines: in the right side of the plates, middle welded joint and in the root welded joint.

Interposition of a connective tissue graft or a collagen matrix to enhance wound stability - an experimental study in dogs.

PubMed

Burkhardt, Rino; Ruiz Magaz, Vanessa; Hämmerle, Christoph H F; Lang, Niklaus P

2016-04-01

The aim of this study was to evaluate the role of a connective tissue graft (CTG) or a collagen matrix (CM) interpositioned between flaps and non-shedding hard surfaces on wound stability. Sixty bone dehiscence defects were prepared in five Beagle dogs. Three treatments were performed in 12 sites per dog: (1) repositioned flaps were sutured onto instrumented dentin surfaces (control), (2) repositioning of flaps with an interpositioned CTG and (3) repositioning of flaps with the application of a CM. To allow postoperative healing with n = 5 for 1, 3, 7 and 14 days before evaluation, the sutures were removed, incision lines retraced and tensile forces applied to the flaps. The minimum magnitude of forces required to detach the flaps from the wound bed was recorded. After 1 week of healing, 6 N had to be applied to disrupt flaps from their wound bed in the CTG group. In the control group, a similar magnitude of resistance was achieved after 2 weeks (6.1 N). Flap resistance to tearing was highest in the CTG group (maximum 9.1 N) 2 weeks postoperatively. On the third postoperative day, the mean tearing forces of all groups differed significantly, displaying a 50% lower resistance to tearing in the CM compared to the CTG group. In comparison, flap resistance to tearing forces established earlier and in higher magnitude in sites with an interpositioned CTG than in flaps repositioned on dentin or CM. Application of a CTG, sutured to a non-shedding hard surface, significantly increased flap resistance to tearing when applying disrupting forces compared to controls. A less pronounced effect was achieved by interpositioning of a CM. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Arthroscopically assisted elbow interposition arthroplasty without hinged external fixation: surgical technique and patient outcomes.

PubMed

Chauhan, Aakash; Palmer, Bradley A; Baratz, Mark E

2015-06-01

Total elbow arthroplasty is successful in older, lower demand patients but not in the younger, more active individual with severe elbow arthritis. Interposition arthroplasty is an alternative for younger patients who hope to minimize the degree to which arm use is restricted. Interposition arthroplasty traditionally involves release of all ligaments and capsule. As a result, the postoperative care included the use of a hinged external fixator of the elbow to apply distraction and to permit motion during the early phases of healing. We describe a novel surgical technique without a hinged external fixator that allows secure fixation of the interposition graft through arthroscopic assistance and maintains the integrity of the medial collateral ligament with only a takedown and repair of the lateral collateral ligament complex. A retrospective chart review was performed to analyze 4 patients with an average age of 57 years who underwent surgery between 2007 and 2011. The patients were also contacted to assess elbow-specific American Shoulder and Elbow Surgeons and Disabilities of the Arm, Shoulder, and Hand scores. The average follow-up was 3.6 years (range, 2.5-6 years), and 1 patient was converted to a total elbow arthroplasty after 2.5 years because of persistent pain. The remaining 3 patients have done well with regard to pain control, stability, and functional use of the operative extremity. There were no postoperative complications. On the basis of our small series of patients, an arthroscopically assisted elbow interposition arthroplasty without hinged external fixation can provide satisfactory medium-term outcomes as a salvage procedure for a difficult condition with limited options. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

The horizon line, linear perspective, interposition, and background brightness as determinants of the magnitude of the pictorial moon illusion.

PubMed

Jones, Stephanie A H; Wilson, Alexander E

2009-01-01

A total of 110 undergraduate students participated in a series of three experiments that explored the magnitude of the moon illusion in pictures. Experiment 1 examined the role of the number and salience of depth cues and background brightness. Experiment 2 examined the role of the horizon line, linear perspective, interposition, and background brightness. In Experiment 3, comparative distance judgments of the moon as a function of linear perspective, interposition, and the size of the standard moon were obtained. The magnitude of the moon illusion increased as a function of the number and salience of depth cues and changes in background brightness. Experiment 2 failed to support the role of the horizon line in affecting the illusion. Experiment 3 provided additional support for the illusory distance component of the moon illusion.

Interposition vein graft for giant coronary aneurysm repair

NASA Technical Reports Server (NTRS)

Firstenberg, M. S.; Azoury, F.; Lytle, B. W.; Thomas, J. D.

2000-01-01

Coronary aneurysms in adults are rare. Surgical treatment is often concomitant to treating obstructing coronary lesions. However, the ideal treatment strategy is poorly defined. We present a case of successful treatment of a large coronary artery aneurysm with a reverse saphenous interposition vein graft. This modality offers important benefits over other current surgical and percutaneous techniques and should be considered as an option for patients requiring treatment for coronary aneurysms.

Vertical augmentation of the posterior atrophic mandible by interpositional grafts in a split-mouth design: a human tomography evaluation pilot study.

PubMed

Domingues, Eduardo Pinheiro; Ribeiro, Rafael Fernandes; Horta, Martinho Campolina Rebello; Manzi, Flávio Ricardo; Côsso, Maurício Greco; Zenóbio, Elton Gonçalves

2017-10-01

Using computed tomography, to compare vertical and volumetric bone augmentation after interposition grafting with bovine bone mineral matrix (GEISTLICH BIO-OSS ® ) or hydroxyapatite/tricalcium phosphate (STRAUMANN ® BONECERAMIC) for atrophic posterior mandible reconstruction through segmental osteotomy. Seven patients received interposition grafts in the posterior mandible for implant rehabilitation. The computed tomography cone beam images were analysed with OsiriX Imaging Software 6.5 (Pixmeo Geneva, Switzerland) in the pre-surgical period (T0), at 15 days post-surgery (T1) and at 180 days post-surgery (T2). The tomographic analysis was performed by a single trained and calibrated radiologist. Descriptive statistics and nonparametric methods were used to analyse the data. There was a significant difference in vertical and volume augmentation with both biomaterials using the technique (P < 0.05). There were no significant differences (P > 0.05) in volume change of the graft, bone volume augmentation, or augmentation of the maximum linear vertical distance between the two analysed biomaterials. The GEISTLICH BIO-OSS ® and STRAUMANN ® BONECERAMIC interposition grafts exhibited similar and sufficient dimensional stability and volume gain for short implants in the atrophic posterior mandible. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Effects of Elbow Bracing on Medial Elbow Joint Space Gapping Associated With Repetitive Throwing in High School Baseball Players

PubMed Central

Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Takei, Keiichi; Yamamoto, Mitsuru

2017-01-01

Background: Throwing athletes risk medial elbow injury from extreme valgus stress generated across the medial elbow during throwing. Braces have been developed to protect the elbow joint; however, no previous study has investigated the effects of elbow bracing on medial elbow joint space gapping associated with repetitive throwing. Hypothesis/Purpose: The purpose of this study was to investigate the effects of elbow bracing on medial elbow joint space gapping during repetitive throwing. Our hypothesis was that an elbow brace may reduce mechanical stress on the elbow by reducing medial elbow joint space gapping. Study Design: Controlled laboratory study. Methods: Twenty-five high school baseball players participated in this study. Each subject pitched 100 times under 2 conditions: control (without elbow brace) and elbow brace. The ulnohumeral joint space was measured ultrasonically before pitching and after every block of 20 pitches. Measurement of the ulnohumeral joint space was carried out using ultrasound with the forearm hanging by the side. Two-way repeated-measures analysis of variance and post hoc tests were used to compare ulnohumeral joint space with repeated pitching and between the elbow brace and control conditions. Results: In the control condition, ulnohumeral joint space after 60 pitches was significantly greater than that before pitching (P < .01). In contrast, in the elbow brace condition, ulnohumeral joint space was not significantly different after repeated pitching. When comparing these 2 conditions, ulnohumeral joint space in the control condition was significantly greater than that in the elbow brace condition after 60 pitches (P < .01). Conclusion: An elbow brace has the effect of preventing medial elbow joint space gapping with repeated throwing when determined ultrasonically by measuring the ulnohumeral joint space under gravity load. Clinical Relevance: An elbow brace worn during baseball pitching practice may help reduce mechanical stress on the elbow by reducing medial elbow joint space gapping. PMID:28451622

The Effects of Elbow Bracing on Medial Elbow Joint Space Gapping Associated With Repetitive Throwing in High School Baseball Players.

PubMed

Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Takei, Keiichi; Yamamoto, Mitsuru

2017-04-01

Throwing athletes risk medial elbow injury from extreme valgus stress generated across the medial elbow during throwing. Braces have been developed to protect the elbow joint; however, no previous study has investigated the effects of elbow bracing on medial elbow joint space gapping associated with repetitive throwing. The purpose of this study was to investigate the effects of elbow bracing on medial elbow joint space gapping during repetitive throwing. Our hypothesis was that an elbow brace may reduce mechanical stress on the elbow by reducing medial elbow joint space gapping. Controlled laboratory study. Twenty-five high school baseball players participated in this study. Each subject pitched 100 times under 2 conditions: control (without elbow brace) and elbow brace. The ulnohumeral joint space was measured ultrasonically before pitching and after every block of 20 pitches. Measurement of the ulnohumeral joint space was carried out using ultrasound with the forearm hanging by the side. Two-way repeated-measures analysis of variance and post hoc tests were used to compare ulnohumeral joint space with repeated pitching and between the elbow brace and control conditions. In the control condition, ulnohumeral joint space after 60 pitches was significantly greater than that before pitching ( P < .01). In contrast, in the elbow brace condition, ulnohumeral joint space was not significantly different after repeated pitching. When comparing these 2 conditions, ulnohumeral joint space in the control condition was significantly greater than that in the elbow brace condition after 60 pitches ( P < .01). An elbow brace has the effect of preventing medial elbow joint space gapping with repeated throwing when determined ultrasonically by measuring the ulnohumeral joint space under gravity load. An elbow brace worn during baseball pitching practice may help reduce mechanical stress on the elbow by reducing medial elbow joint space gapping.

Robotic-assisted vesicovaginal fistula repair using an extravesical approach without interposition grafting.

PubMed

Kelly, Erin; Wu, Maria Y; MacMillan, J Barry

2018-03-01

Post-hysterectomy vesicovaginal fistula (VVF) is rare. In addition to conventional abdominal and vaginal approaches, robotic-assisted VVF repairs have recently been described. We present a case of an extravesical, robotic-assisted VVF repair, without placement of an interposition graft performed in a Canadian teaching center. A 51-year-old woman presented with urinary incontinence 5 days after laparoscopic hysterectomy. Computed tomography cystogram, cystoscopy, and methylene blue dye test, confirmed a VVF above the bladder trigone. The patient underwent a robotic-assisted VVF repair 3 months after presentation, without complication. An abdominal, extravesical approach was used. Operative time was 116 min and repeat CT cystogram showed no evidence of persistent. We have demonstrated that a VVF repair, using a robotic-assisted, extravesical approach without interposition graft placement, can be safe, less invasive and have a successful outcome at 1 year of follow-up.

The effect of repetitive baseball pitching on medial elbow joint space gapping associated with 2 elbow valgus stressors in high school baseball players.

PubMed

Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Hall, Toby; Amemiya, Katsuya; Mori, Yoshihisa

2018-04-01

To prevent elbow injury in baseball players, various methods have been used to measure medial elbow joint stability with valgus stress. However, no studies have investigated higher levels of elbow valgus stress. This study investigated medial elbow joint space gapping measured ultrasonically resulting from a 30 N valgus stress vs. gravitational valgus stress after a repetitive throwing task. The study included 25 high school baseball players. Each subject pitched 100 times. The ulnohumeral joint space was measured ultrasonographically, before pitching and after each successive block of 20 pitches, with gravity stress or 30 N valgus stress. Two-way repeated measures analysis of variance and Pearson correlation coefficient analysis were used. The 30 N valgus stress produced significantly greater ulnohumeral joint space gapping than gravity stress before pitching and at each successive 20-pitch block (P < .01). For the 2 stress methods, ulnohumeral joint space gapping increased significantly from baseline after 60 pitches (P < .01). Strong significant correlations were found between the 2 methods for measurement of medial elbow joint space gapping (r = 0.727-0.859, P < .01). Gravity stress and 30 N valgus stress may produce different effects with respect to medial elbow joint space gapping before pitching; however, 30 N valgus stress appears to induce greater mechanical stress, which may be preferable when assessing joint instability but also has the potential to be more aggressive. The present results may indicate that constraining factors to medial elbow joint valgus stress matched typical viscoelastic properties of cyclic creep. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Field homogeneity improvement of maglev NdFeB magnetic rails from joints.

PubMed

Li, Y J; Dai, Q; Deng, C Y; Sun, R X; Zheng, J; Chen, Z; Sun, Y; Wang, H; Yuan, Z D; Fang, C; Deng, Z G

2016-01-01

An ideal magnetic rail should provide a homogeneous magnetic field along the longitudinal direction to guarantee the reliable friction-free operation of high temperature superconducting (HTS) maglev vehicles. But in reality, magnetic field inhomogeneity may occur due to lots of reasons; the joint gap is the most direct one. Joint gaps inevitably exist between adjacent segments and influence the longitudinal magnetic field homogeneity above the rail since any magnetic rails are consisting of many permanent magnet segments. To improve the running performance of maglev systems, two new rail joints are proposed based on the normal rail joint, which are named as mitered rail joint and overlapped rail joint. It is found that the overlapped rail joint has a better effect to provide a competitive homogeneous magnetic field. And the further structure optimization has been done to ensure maglev vehicle operation as stable as possible when passing through those joint gaps. The results show that the overlapped rail joint with optimal parameters can significantly reduce the magnetic field inhomogeneity comparing with the other two rail joints. In addition, an appropriate gap was suggested when balancing the thermal expansion of magnets and homogenous magnetic field, which is considered valuable references for the future design of the magnetic rails.

Development of a computational technique to measure cartilage contact area.

PubMed

Willing, Ryan; Lapner, Michael; Lalone, Emily A; King, Graham J W; Johnson, James A

2014-03-21

Computational measurement of joint contact distributions offers the benefit of non-invasive measurements of joint contact without the use of interpositional sensors or casting materials. This paper describes a technique for indirectly measuring joint contact based on overlapping of articular cartilage computer models derived from CT images and positioned using in vitro motion capture data. The accuracy of this technique when using the physiological nonuniform cartilage thickness distribution, or simplified uniform cartilage thickness distributions, is quantified through comparison with direct measurements of contact area made using a casting technique. The efficacy of using indirect contact measurement techniques for measuring the changes in contact area resulting from hemiarthroplasty at the elbow is also quantified. Using the physiological nonuniform cartilage thickness distribution reliably measured contact area (ICC=0.727), but not better than the assumed bone specific uniform cartilage thicknesses (ICC=0.673). When a contact pattern agreement score (s(agree)) was used to assess the accuracy of cartilage contact measurements made using physiological nonuniform or simplified uniform cartilage thickness distributions in terms of size, shape and location, their accuracies were not significantly different (p>0.05). The results of this study demonstrate that cartilage contact can be measured indirectly based on the overlapping of cartilage contact models. However, the results also suggest that in some situations, inter-bone distance measurement and an assumed cartilage thickness may suffice for predicting joint contact patterns. Copyright © 2014 Elsevier Ltd. All rights reserved.

Data correlation and analysis of arc tunnel and wind tunnel tests of RSI joints and gaps. Volume 1: Technical report

NASA Technical Reports Server (NTRS)

Christensen, H. E.; Kipp, H. W.

1974-01-01

Heat transfer data measured in gaps typical of those under consideration for joints in space shuttle reusable surface insulation protection systems have been assimilated, analyzed and correlated. The data were obtained in four NASA facilities. Several types of gaps were investigated with emphasis on simple butt joints. Gap widths ranged from 0.07 to 0.7 cm and depths ranged from 1 to 6 cm. Laminar, transitional and turbulent boundary layer flows over the gap opening were investigated. Three-dimensional heating variations were observed within gaps in the absence of external flow pressure gradients. Heat transfer correlation equations were obtained for several of the tests. Thermal protection system performance with and without gaps was compared for a representative shuttle entry trajectory.

The transport of wear particles in the prosthetic hip joint: a computational fluid dynamics investigation.

PubMed

Hölzer, Andreas; Schröder, Christian; Woiczinski, Matthias; Sadoghi, Patrick; Müller, Peter E; Jansson, Volkmar

2012-02-02

The joint fluid mechanics and transport of wear particles in the prosthetic hip joint were analyzed for subluxation and flexion motion using computational fluid dynamics (CFD). The entire joint space including a moving capsule boundary was considered. It was found that particles suspended in the joint space are drawn into the joint gap between prosthesis cup and head during subluxation, which was also documented by Lundberg et al. (2007; Journal of Biomechanics 40, 1676-1685), however, wear particles remain in the joint gap. Wear particles leave the joint gap during flexion and can finally migrate to the proximal boundaries including the acetabular bone, where the particle deposition can cause osteolysis according to the established literature. Thus, the present study supports the theory of polyethylene wear particle induced osteolysis of the acetabular bone as a major factor in the loosening of hip prosthesis cups. Copyright © 2011 Elsevier Ltd. All rights reserved.

Soft tissue balance changes depending on joint distraction force in total knee arthroplasty.

PubMed

Nagai, Kanto; Muratsu, Hirotsugu; Matsumoto, Tomoyuki; Miya, Hidetoshi; Kuroda, Ryosuke; Kurosaka, Masahiro

2014-03-01

The influence of joint distraction force on intraoperative soft tissue balance was evaluated using Offset Repo-Tensor® for 78 knees that underwent primary posterior-stabilized total knee arthroplasty. The joint center gap and varus ligament balance were measured between osteotomized surfaces using 20, 40 and 60 lbs of joint distraction force. These values were significantly increased at extension and flexion as the distraction force increased. Furthermore, lateral compartment stiffness was significantly lower than medial compartment stiffness. Thus, larger joint distraction forces led to larger varus ligament balance and joint center gap, because of the difference in soft tissue stiffness between lateral and medial compartments. These findings indicate the importance of the strength of joint distraction force in the assessment of soft tissue balance, especially when using gap-balancing technique. © 2014.

The Effect of Gap Angle on Tensile Strength of Preceramic Base Metal Solder Joints.

PubMed

Fattahi, Farnaz; Hashemi Ardakani, Zahra; Hashemi Ardakani, Maryam

2015-12-01

Soldering is a process commonly used in fabricating dental prosthesis. Since most soldered prosthesis fail at the solder joints; the joint strength is of utmost importance. The purpose of this study was to evaluate the effect of gap angle on the tensile strength of base metal solder joints. A total number of 40 Ni-Cr samples were fabricated according to ADA/ISO 9693 specifications for tensile test. Samples were cut at the midpoint of the bar, and were placed at the considered angles by employing an explicitly designed device. They were divided into 4 groups regarding the gap angle; Group C (control group) with parallel gap on steady distance of 0.2mm, Group 1: 10°, Group 2: 20°, and Group3: 30° gap angles. When soldered, the specimens were all tested for tensile strength using a universal testing machine at a cross-head speed of 0.5 mm/min with a preload of 10N. Kruskal-Wallis H test was used to compare tensile strength among the groups (p< 0.05). The mean tensile strength values obtained from the study groups were respectively 307.84, 391.50, 365.18, and 368.86 MPa. The tensile strength was not statistically different among the four groups in general (p≤ 0.490). Making the gap angular at the solder joints and the subsequent unsteady increase of the gap distance would not change the tensile strength of the joint.

Posterior tibial tendon displacement behind the tibia and its interposition in an irreducible isolated ankle dislocation: a case report and literature review

PubMed Central

ORTOLANI, ALESSANDRO; BEVONI, ROBERTO; RUSSO, ALESSANDRO; MARCACCI, MAURILIO; GIROLAMI, MAURO

2016-01-01

Isolated posteromedial ankle dislocation is a rare condition thanks to the highly congruent anatomical configuration of the ankle mortise, in which the medial and lateral malleoli greatly reduce the rotational movement of the talus, and the strength of the ligaments higher than the malleoli affords protection against fractures. However, other factors, like medial malleolus hypoplasia, laxity of the ligaments, peroneal muscle weakness and previous ankle sprains, could predispose to pure dislocation. In the absence of such factors, only a complex high-energy trauma, with a rotational component, can lead to this event. Irreducibility of an ankle dislocation, which is rarely encountered, can be due to soft tissue interposition. Dislocation of the posterior tibial tendon can be the cause of an irreducible talar dislocation; interposition of this tendon, found to have slid posteriorly to the distal tibia and then passed through the tibioperoneal syndesmosis, is reported in just a few cases of ankle fracture-dislocation. PMID:27900312

[Secondary tendon reconstruction on the thumb].

PubMed

Bickert, B; Kremer, T; Kneser, U

2016-12-01

Closed tendon ruptures of the thumb that require secondary reconstruction can affect the extensor pollicis longus (EPL), extensor pollicis brevis (EPB) and flexor pollicis longus (FPL) tendons. Treatment of rupture of the EPB tendon consists of refixation to the bone and temporary transfixation of the joint. In the case of preexisting or posttraumatic arthrosis, definitive arthrodesis of the thumb is the best procedure. Closed ruptures of the EPL and FPL tendons at the wrist joint cannot be treated by direct tendon suture. Rupture of the EPL tendon occurs after distal radius fractures either due to protruding screws or following conservative treatment especially in undisplaced fractures. Transfer of the extensor indicis tendon to the distal EPL stump is a good option and free interposition of the palmaris longus tendon is a possible alternative. The tension should be adjusted to slight overcorrection, which can be checked intraoperatively by performing the tenodesis test. Closed FPL ruptures at the wrist typically occur 3-6 months after osteosynthesis of distal radius fractures with palmar plates and are mostly characterized by crepitation and pain lasting for several weeks. They can be prevented by premature plate removal, synovectomy and carpal tunnel release. For treatment of a ruptured FPL tendon in adult patients the options for tendon reconstruction should be weighed up against the less complicated tenodesis or arthrodesis of the thumb interphalangeal joint.

Treatment of Pisotriquetral Arthritis by Pyrocarbon Interposition Arthroplasty.

PubMed

Bellemère, Philippe; Aribert, Marion; Choughri, Hussein; Leroy, Marc; Gaisne, Etienne

2018-02-01

Purpose  Pisiformectomy is the baseline treatment for pisotriquetral arthritis when medical treatment fails to address the problem. This operation may lead to loss of mobility and strength in the wrist. This study reports the short-term outcomes of a new technique for treating pisotriquetral arthritis using a pisotriquetral interposition arthroplasty with a pyrocarbon implant. Patients and Methods  We performed a clinical and radiographic study on a series of eight patients who received this treatment at a mean follow-up of 2.8 years. We also studied the mobility of the implant and did assessed articular instability using dynamic radiology and fluoroscopy. Results  We observed one proximal dislocation of the implant in one hand which was reoperated to reposition the implant and strengthen the capsule. All patients were satisfied or very satisfied with their operation and had an average functional recovery period of 1.6 months. At the last follow-up, the Mayo Wrist Score (MWS), Quick Disability of Arm Shoulder and Hand (QDASH), and Patient-Rated Wrist Evaluation (PRWE) scores were 89, 18, and 20, respectively. Postoperatively, there was a 22% improvement in the grip strength of the wrists as well as improved mobility, mainly as regards the radioulnar deviation (47% improvement) and the Visual Analogue Scale (VAS) pain scores decreased from 8 preoperatively to 2 at the latest follow-up. The functional radiologic and fluoroscopic study reported good adaptive mobility of the implant in all the patients, without any indication of pisotriquetral joint instability. Conclusion  The short-term results of pisotriquetral arthroplasty using the Pyrocardan implant are encouraging. This new surgical solution appears to be a valid alternative to pisiformectomy or pisotriquetral arthrodesis. Long-term studies are required to confirm these preliminary findings.

[Free tissue transfers with lengthening of vascular pedicle using interpositional vein grafts. About 10 cases].

PubMed

Yeo, S; Perrot, P; Duteille, F

2010-04-01

The realization of free flaps with lack of reliable vessels nearby the loss of substance is a difficult problem for plastic surgeons. We report 10 cases of free tissue transfers with a one-stage technique lengthening the vascular pedicle of the free flap with interpositional vein grafts. Taking into consideration the good results and the low rate of morbidity, the authors emphasize the use of this technique rather than a two-stage procedure. Copyright 2009 Elsevier Masson SAS. All rights reserved.

The Effect of Gap Angle on Tensile Strength of Preceramic Base Metal Solder Joints

PubMed Central

Fattahi, Farnaz; Hashemi Ardakani, Zahra; Hashemi Ardakani, Maryam

2015-01-01

Statement of the Problem Soldering is a process commonly used in fabricating dental prosthesis. Since most soldered prosthesis fail at the solder joints; the joint strength is of utmost importance. Purpose The purpose of this study was to evaluate the effect of gap angle on the tensile strength of base metal solder joints. Materials and Method A total number of 40 Ni-Cr samples were fabricated according to ADA/ISO 9693 specifications for tensile test. Samples were cut at the midpoint of the bar, and were placed at the considered angles by employing an explicitly designed device. They were divided into 4 groups regarding the gap angle; Group C (control group) with parallel gap on steady distance of 0.2mm, Group 1: 10°, Group 2: 20°, and Group3: 30° gap angles. When soldered, the specimens were all tested for tensile strength using a universal testing machine at a cross-head speed of 0.5 mm/min with a preload of 10N. Kruskal-Wallis H test was used to compare tensile strength among the groups (p< 0.05). Results The mean tensile strength values obtained from the study groups were respectively 307.84, 391.50, 365.18, and 368.86 MPa. The tensile strength was not statistically different among the four groups in general (p≤ 0.490). Conclusion Making the gap angular at the solder joints and the subsequent unsteady increase of the gap distance would not change the tensile strength of the joint. PMID:26636118

Joint diseases: from connexins to gap junctions.

PubMed

Donahue, Henry J; Qu, Roy W; Genetos, Damian C

2017-12-19

Connexons form the basis of hemichannels and gap junctions. They are composed of six tetraspan proteins called connexins. Connexons can function as individual hemichannels, releasing cytosolic factors (such as ATP) into the pericellular environment. Alternatively, two hemichannel connexons from neighbouring cells can come together to form gap junctions, membrane-spanning channels that facilitate cell-cell communication by enabling signalling molecules of approximately 1 kDa to pass from one cell to an adjacent cell. Connexins are expressed in joint tissues including bone, cartilage, skeletal muscle and the synovium. Indicative of their importance as gap junction components, connexins are also known as gap junction proteins, but individual connexin proteins are gaining recognition for their channel-independent roles, which include scaffolding and signalling functions. Considerable evidence indicates that connexons contribute to the function of bone and muscle, but less is known about the function of connexons in other joint tissues. However, the implication that connexins and gap junctional channels might be involved in joint disease, including age-related bone loss, osteoarthritis and rheumatoid arthritis, emphasizes the need for further research into these areas and highlights the therapeutic potential of connexins.

Comparison of soft tissue balancing, femoral component rotation, and joint line change between the gap balancing and measured resection techniques in primary total knee arthroplasty: A meta-analysis.

PubMed

Moon, Young-Wan; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Park, Chan-Deok; Lee, Dae-Hee

2016-09-01

This meta-analysis was designed to compare the accuracy of soft tissue balancing and femoral component rotation as well as change in joint line positions, between the measured resection and gap balancing techniques in primary total knee arthroplasty. Studies were included in the meta-analysis if they compared soft tissue balancing and/or radiologic outcomes in patients who underwent total knee arthroplasty with the gap balancing and measured resection techniques. Comparisons included differences in flexion/extension, medial/lateral flexion, and medial/lateral extension gaps (LEGs), femoral component rotation, and change in joint line positions. Finally, 8 studies identified via electronic (MEDLINE, EMBASE, and the Cochrane Library) and manual searches were included. All 8 studies showed a low risk of selection bias and provided detailed demographic data. There was some inherent heterogeneity due to uncontrolled bias, because all included studies were observational comparison studies. The pooled mean difference in gap differences between the gap balancing and measured resection techniques did not differ significantly (-0.09 mm, 95% confidence interval [CI]: -0.40 to +0.21 mm; P = 0.55), except that the medial/LEG difference was 0.58 mm greater for measured resection than gap balancing (95% CI: -1.01 to -0.15 mm; P = 0.008). Conversely, the pooled mean difference in femoral component external rotation (0.77°, 95% CI: 0.18° to 1.35°; P = 0.01) and joint line change (1.17 mm, 95% CI: 0.82 to 1.52 mm; P < 0.001) were significantly greater for the gap balancing than the measured resection technique. The gap balancing and measured resection techniques showed similar soft tissue balancing, except for medial/LEG difference. However, the femoral component was more externally rotated and the joint line was more elevated with gap balancing than measured resection. These differences were minimal (around 1 mm or 1°) and therefore may have little effect on the biomechanics of the knee joint. This suggests that the gap balancing and measured resection techniques are not mutually exclusive.

History of carotid surgery: from ancient greeks to the modern era.

PubMed

Tallarita, Tiziano; Gerbino, Maurizio; Gurrieri, Carmelina; Lanzino, Giuseppe

2013-12-01

A relationship between decreased carotid arterial flow and apoplectic manifestations was already suspected by the ancient Greeks. Early attempts at carotid surgery, however, were limited to emergency arterial ligation in patients with neck trauma. Attempts to suture arterial stumps together to restore blood flow paved the way for Carrel's revolutionary idea of reconstructing the resected or injured arterial segment with an interposition vein graft. DeBakey and Eastcott were the first to perform carotid endarterectomy in North America and the United Kingdom, respectively. In 1959, DeBakey proposed a cooperative study to assess the effectiveness of carotid endarterectomy in the treatment and prevention of ischemic cerebrovascular disease. The study was officially designated the Joint Study of Extracranial Arterial Occlusion and represented the first trial in the United States in which large numbers of patients were randomly allocated to surgical or nonsurgical therapy.

Outcomes After Patch Use in Rotator Cuff Repair.

PubMed

Steinhaus, Michael E; Makhni, Eric C; Cole, Brian J; Romeo, Anthony A; Verma, Nikhil N

2016-08-01

To provide a comprehensive review of clinical outcomes and retear rates after patch use in rotator cuff repair, and to determine the differences between available graft types and techniques. A systematic review was conducted from database (PubMed, Medline, Scopus, Embase) inception to January 2015 for English-language articles reporting outcome data with 9 months' minimum follow-up. Studies were assessed by 2 reviewers who collected pertinent data, with outcomes combined to generate frequency-weighted means. Twenty-four studies met the inclusion criteria. The frequency-weighted mean age was 61.9 years with 35.4 months' follow-up. The mean improvements in postoperative range of motion in the forward elevation, abduction, external rotation, and internal rotation planes were 58.6°, 66.2°, 16.6°, and 16.1°, respectively, and postoperative abduction strength improved by 3.84 kg. American Shoulder and Elbow Surgeons, University of California-Los Angeles, Constant, Penn, and Oxford scores improved by 39.3, 10.7, 40.8, 34.4, and 17.6, respectively. Augmentation and interposition techniques showed similar improvements in range of motion, strength, and patient-reported outcomes (PROs), whereas xenografts showed less improvement in PROs compared with other graft types. Studies reported improvements in pain and activities of daily living (ADLs), with greater than 90% overall satisfaction, although few patients (13%) were able to return to preinjury activity. Whereas interposition and augmentation techniques showed similar improvements in pain and ADLs, xenografts showed less improvement in ADLs than other graft types. The overall retear rate was 25%, with rates of 34% and 12% for augmentation and interposition, respectively, and rates of 44%, 23%, and 15% for xenografts, allografts, and synthetic grafts, respectively. We report improvements in clinical and functional outcomes, with similar results for augmentation and interposition techniques, whereas xenografts showed less improvement than synthetic grafts and allografts in PROs and ADLs. Retear rates may be lower with the interposition technique or in patients with synthetic grafts or allografts. Level IV, systematic review of Level II through IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Early experience with the free lumbar artery perforator flap for breast reconstruction.

PubMed

Peters, Kevin T; Blondeel, Phillip N; Lobo, Fernando; van Landuyt, Koenraad

2015-08-01

Autologous breast reconstruction has become a progressively more popular method of breast reconstruction. A wide variety of perforator flaps have been described and subsequently refined to decrease donor-site morbidity. Recently, the lumbar artery perforator (LAP) flap has been reported as an option for autologous breast reconstruction. This study summarises the prospectively gathered data of 35 free LAP flaps for breast reconstruction in 28 patients. The mean follow-up was 18 months. The internal mammary artery and the venae comitantes were used as recipient vessels in all reconstructions. In 80% of the reconstructions (28 flaps), an interposition graft was used. Six flaps (17%) had to be revised for venous thrombosis. Two of the revised flaps (5.7%) could not be salvaged, and total flap necrosis occurred. The mean operating time was 6 h and 15 min, 6 h and 39 min when an interposition graft was used and 5 h and 23 min when no interposition graft was necessary. The LAP flap should be considered as a further alternative for breast reconstruction in patients in whom a deep inferior epigastric artery perforator (DIEAP) flap is not possible or not desirable. Shaping of this flap is easier compared to any other flaps due to the quality of the lumbar fat and the gluteal extension. An interposition graft is frequently used to facilitate anastomosis, either to lengthen the pedicle or to resolve size mismatch. This is a disadvantage of the LAP flap. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Tarsal Coalitions: Preliminary Results After Operative Excision and Silicone Sheet Interposition in Children.

PubMed

Krief, Elie; Ferraz, Linda; Appy-Fedida, Benjamin; Deroussen, François; Plancq, Marie-Christine; Collet, Louis-Michel; Gouron, Richard

Symptomatic tarsal coalitions that begin in early adolescence are usually treated by resection and interposition (fat, muscle, or bone wax) to prevent recurrence. The purpose of the present retrospective study was to describe our operative technique and report our clinical and radiologic outcomes with sterile silicone sheet interposition after resection of painful tarsal coalitions in 4 children (4 feet). The present series included 1 case of talocalcaneal synchondrosis and 3 of synostosis (2 talocalcaneal and 1 cuboid-navicular). Two validated functional scales were used to assess the patients' overall outcome and satisfaction with the procedure: the American Orthopaedic Foot and Ankle Society ankle-hindfoot score and the Foot Function Index. Conventional radiography, computed tomography with 3-dimensional reconstruction, and magnetic resonance imaging were performed at the final follow-up visit. The mean follow-up period was 40 (range 12 to 80) months. The mean age at surgery was 10.5 (range 8 to 13) years. All patients had achieved their desired activity level at 6 months postoperatively. The mean American Orthopaedic Foot and Ankle Society ankle-hindfoot score was 93.5 (range 74 to 100), and the mean Foot Function Index was 3.25% (range 0% to 13%). No recurrence of the coalition on imaging at the final follow-up visit was observed in this patient series. Sterile silicone sheet interposition can be used to prevent recurrence of tarsal coalition in symptomatic tarsal coalitions after failure of conservative management. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Retrograde stapling of a free cervical jejunal interposition graft: a technical innovation and case report

PubMed Central

2014-01-01

Background Free jejunal interposition is a useful technique for reconstruction of the cervical esophagus. However, the distal anastomosis between the graft and the remaining thoracic esophagus or a gastric conduit can be technically challenging when located very low in the thoracic aperture. We here describe a modified technique for retrograde stapling of a jejunal graft to a failed gastric conduit using a circular stapler on a delivery system. Case presentation A 56 year-old patient had been referred for esophageal squamous cell carcinoma at 20 cm from the incisors. On day 8 after thoracoabdominal esophagectomy with gastric pull-up, an anastomotic leakage was diagnosed. A proximal-release stent was successfully placed by gastroscopy and the patient was discharged. Two weeks later, an esophagotracheal fistula occurred proximal to the esophageal stent. Cervical esophagostomy was performed with cranial closure of the gastric conduit, which was left in situ within the right hemithorax. Three months later, reconstruction was performed using a free jejunal interposition. The anvil of a circular stapler (Orvil®, Covidien) was placed transabdominally through an endoscopic rendez-vous procedure into the gastric conduit. A free jejunal graft was retrogradely stapled to the proximal end of the conduit. Microvascular anastomoses were performed subsequently. The proximal anastomosis of the conduit was completed manually after reperfusion. Conclusions This modified technique allows stapling of a jejunal interposition graft located deep in the thoracic aperture and is therefore a useful method that may help to avoid reconstruction by colonic pull-up and thoracotomy. PMID:25319372

Experience with 32 Pelvic Fracture Urethral Defects Associated with Urethrorectal Fistulas: Transperineal Urethroplasty with Gracilis Muscle Interposition.

PubMed

Guo, Hailin; Sa, Yinglong; Fu, Qiang; Jin, Chongrui; Wang, Lin

2017-07-01

Pelvic fracture urethral defects associated with urethrorectal fistulas are rare and difficult to repair. The aim of this study was to evaluate the efficacy of transperineal urethroplasty with gracilis muscle interposition for the repair of pelvic fracture urethral defects associated with urethrorectal fistulas. We identified 32 patients who underwent transperineal urethroplasty with gracilis muscle interposition to repair pelvic fracture urethral defects associated with urethrorectal fistulas. Patient demographics as well as preoperative, operative and postoperative data were obtained. Mean followup was 33 months (range 6 to 64). The overall success rate was 91% (29 of 32 cases). One-stage repair was successful in 17 of 18 patients (94%) using perineal anastomosis with separation of the corporeal body and in 12 of 14 (86%) using perineal anastomosis with inferior pubectomy and separation of the corporeal body. All 22 patients (100%) without a previous history of repair were successfully treated. However, only 7 of 10 patients (70%) with a previous history of failed urethroplasty and urethrorectal fistula repair were cured. Recurrent urethral strictures developed in 2 cases. One patient was treated successfully with optical internal urethrotomy and the other was treated successfully with tubed perineoscrotal flap urethroplasty. Recurrent urethrorectal fistulas associated with urethral strictures developed in an additional patient. Transperineal urethroplasty with gracilis muscle interposition is a safe and effective surgical procedure for most pelvic fracture urethral defects associated with urethrorectal fistulas. Several other factors may affect its postoperative efficiency. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Data correlation and analysis of arc tunnel and wind tunnel tests of RSI joints and gaps, phase 2. Volume 1: Technical report

NASA Technical Reports Server (NTRS)

Cristensen, H. E.

1975-01-01

Heat transfer data measured in gaps representative of those being employed for joints in the space shuttle reusable surface insulation (RSI) thermal protection systems (TPS) were assimilated, analyzed, and correlated. Several types of gap were investigated with emphasis on simple butt joints. Gap widths ranged from 0.0 to 0.76 cm and depths ranged from 1 to 6 cm. Laminar, transitional, and turbulent boundary layer flows over the gap opening were investigated. The angle between gap axis and external flow was varied between 0 and pi/2 radians. The contoured cross section gap performed significantly better than all other wide gaps and slightly better than all other narrow gap geometries. Three dimensional heating variations were observed within gaps in the absence of external flow pressure gradients. Interactions between heating within gaps and heating of adjacent top tile surfaces were observed. Gaps aligned with the flow were observed to promote boundary layer transition. Heat transfer correlation equations were obtained for many of the tests. The TPS thickness requirements with and without gaps were computed for a current shuttle entry trajectory. Experimental data employed in the study are summarized. A description of each test facility, run schedule and test conditions, model descriptive information, and heat flux data are included.

Esophagogastric separation and abdominal esophagostomy via jejunal interposition: a new operation for extreme forms of pathologic aerophagia.

PubMed

Fukuzawa, Hiroaki; Urushihara, Naoto; Fukumoto, Koji; Sugiyama, Akihide; Mitsunaga, Maki; Watanabe, Kentaro; Hasegawa, Shiro

2011-10-01

Pathologic aerophagia is sometimes seen in patients with neurologic disorders. It rarely causes massive bowel distention, ileus, and volvulus. Here, we report the use of esophagogastric separation and abdominal esophagostomy via jejunal interposition to prevent bowel distention caused by severe aerophagia in 2 patients with neurologic disorders in whom the usual nonoperative methods of management failed. In both cases, swallowed air was evacuated via the jejunostomy, eliminating bowel distention. This operation may be useful in patients with neurologic disorders associated with severe aerophagia. Copyright © 2011 Elsevier Inc. All rights reserved.

Effect of the Interposition of Calcium Phosphate Materials on Tendon-Bone Healing During Repair of Chronic Rotator Cuff Tear.

PubMed

Zhao, Song; Peng, Lingjie; Xie, Guoming; Li, Dingfeng; Zhao, Jinzhong; Ning, Congqin

2014-08-01

The current nature of tendon-bone healing after rotator cuff (RC) repair is still the formation of granulation tissue at the tendon-bone interface rather than the formation of fibrocartilage, which is the crucial structure in native tendon insertion and can be observed after knee ligament reconstruction. The interposition of calcium phosphate materials has been found to be able to enhance tendon-bone healing in knee ligament reconstruction. However, whether the interposition of these kinds of materials can enhance tendon-bone healing or even change the current nature of tendon-bone healing after RC repair still needs to be explored. The interposition of calcium phosphate materials during RC repair would enhance tendon-bone healing or change its current nature of granulation tissue formation into a more favorable process. Controlled laboratory study. A total of 144 male Sprague-Dawley rats underwent unilateral detachment of the supraspinatus tendon, followed by delayed repair after 3 weeks. The animals were allocated into 1 of 3 groups: (1) repair alone, (2) repair with Ca5(PO4)2SiO4 (CPS) bioceramic interposition, or (3) repair with hydroxyapatite (HA) bioceramic interposition at the tendon-bone interface. Animals were sacrificed at 2, 4, or 8 weeks postoperatively, and microcomputed tomography (micro-CT) was used to quantify the new bone formation at the repair site. New fibrocartilage formation and collagen organization at the tendon-bone interface was evaluated by histomorphometric analysis. Biomechanical testing of the supraspinatus tendon-bone complex was performed. Statistical analysis was performed using 1-way analysis of variance. Significance was set at P < .05. The micro-CT analysis demonstrated remarkable osteogenic activity and osteoconductivity to promote new bone formation and ingrowth of CPS and HA bioceramic, with CPS bioceramic showing better results than HA. Histological observations indicated that CPS bioceramic had excellent biocompatibility and biodegradability. At early time points after the RC repair, CPS bioceramic significantly increased the area of fibrocartilage at the tendon-bone interface compared with the control and HA groups. Moreover, CPS and HA bioceramics had significantly improved collagen organization. Biomechanical tests indicated that the CPS and HA groups have greater ultimate load to failure and stiffness than the control group at 4 and 8 weeks, and the CPS specimens exhibited the maximum ultimate load to failure, stiffness, and stress of the healing enthesis. Both CPS and HA bioceramics aid in cell attachment and proliferation and accelerate new bone formation, and CPS bioceramic has a more prominent effect on tendon-to-bone healing. Local application of CPS and HA bioceramic at the tendon-bone interface shows promise in improving healing after rotator cuff tear repair. © 2014 The Author(s).

[Research progress of larger flexion gap than extension gap in total knee arthroplasty].

PubMed

Zhang, Weisong; Hao, Dingjun

2017-05-01

To summarize the progress of larger flexion gap than extension gap in total knee arthro-plasty (TKA). The domestic and foreign related literature about larger flexion gap than extension gap in TKA, and its impact factors, biomechanical and kinematic features, and clinical results were summarized. During TKA, to adjust the relations of flexion gap and extension gap is one of the key factors of successful operation. The biomechanical, kinematic, and clinical researches show that properly larger flexion gap than extension gap can improve both the postoperative knee range of motion and the satisfaction of patients, but does not affect the stability of the knee joint. However, there are also contrary findings. So adjustment of flexion gap and extension gap during TKA is still in dispute. Larger flexion gap than extension gap in TKA is a new joint space theory, and long-term clinical efficacy, operation skills, and related complications still need further study.

Effect of temperature and gap opening rate on the resiliency of candidate solid rocket booster O-ring materials

NASA Technical Reports Server (NTRS)

Lach, Cynthia L.

1992-01-01

In the redesign of the Space Shuttle solid rocket motor following the Challenger accident, the field and nozzle-to-case joints were designed to minimize gap opening caused by internal motor pressurization during ignition. The O-ring seals and glands for these joints were designed both to accommodate structural deflections and to promote pressure assisted sealing. The resiliency behavior of several candidate O-ring materials was evaluated for the effects of temperature and gap opening rates. The performance of three of the elastomeric materials was tested under the specific redesign gap opening requirement. Dynamic flexure conditions unique to launch produce low frequency vibrations in the gap opening. The effect of these vibrations on the ability of the O-ring to maintain contact with the sealing surface was addressed. The resiliency of the O-ring materials was found to be extremely sensitive to variations in temperature and gap opening rate. The top three elastomeric materials tracked the simulated solid rocket booster (SRB) field joint deflection at 75 and 120 F. The external tank/SRB attach strut load vibrations had a negligible effect on the ability of the O-ring to track the simulated SRB field joint deflection.

Preclinical Animal Models for Temporomandibular Joint Tissue Engineering.

PubMed

Almarza, Alejandro J; Brown, Bryan N; Arzi, Boaz; Ângelo, David Faustino; Chung, William; Badylak, Stephen F; Detamore, Michael

2018-06-01

There is a paucity of in vivo studies that investigate the safety and efficacy of temporomandibular joint (TMJ) tissue regeneration approaches, in part due to the lack of established animal models. Review of disease models for study of TMJ is presented herein with an attempt to identify relevant preclinical animal models for TMJ tissue engineering, with emphasis on the disc and condyle. Although degenerative joint disease models have been mainly performed on mice, rats, and rabbits, preclinical regeneration approaches must employ larger animal species. There remains controversy regarding the preferred choice of larger animal models between the farm pig, minipig, goat, sheep, and dog. The advantages of the pig and minipig include their well characterized anatomy, physiology, and tissue properties. The advantages of the sheep and goat are their easier surgical access, low cost per animal, and its high tissue availability. The advantage of the dog is that the joint space is confined, so migration of interpositional devices should be less likely. However, each species has limitations as well. For example, the farm pig has continuous growth until about 18 months of age, and difficult surgical access due to the zygomatic arch covering the lateral aspect of joint. The minipig is not widely available and somewhat costly. The sheep and the goat are herbivores, and their TMJs mainly function in translation. The dog is a carnivore, and the TMJ is a hinge joint that can only rotate. Although no species provides the gold standard for all preclinical TMJ tissue engineering approaches, the goat and sheep have emerged as the leading options, with the minipig as the choice when cost is less of a limitation; and with the dog and farm pig serving as acceptable alternatives. Finally, naturally occurring TMJ disorders in domestic species may be harnessed on a preclinical trial basis as a clinically relevant platform for translation.

Minimum distraction gap: how much ankle joint space is enough in ankle distraction arthroplasty?

PubMed

Fragomen, Austin T; McCoy, Thomas H; Meyers, Kathleen N; Rozbruch, S Robert

2014-02-01

The success of ankle distraction arthroplasty relies on the separation of the tibiotalar articular surfaces. The purpose of this study was to find the minimum distraction gap needed to ensure that the tibiotalar joint surfaces would not contact each other with full weight-bearing while under distraction. Circular external fixators were mounted to nine cadaver ankle specimens. Each specimen was then placed into a custom-designed load chamber. Loads of 0, 350, and 700N were applied to the specimen. Radiographic joint space was measured and joint contact pressure was monitored under each load. The external fixator was then sequentially distracted, and the radiographic joint space was measured under the three different loads. The experiment was stopped when there was no joint contact under 700N of load. The radiographic joint space was measured and the initial (undistracted) radiographic joint space was subtracted from it yielding the distraction gap. The minimum distraction gap (mDG) that would provide total unloading was calculated. The average mDG was 2.4 mm (range, 1.6 to 4.0 mm) at 700N of load, 4.4 mm (range, 3.7 to 5.8 mm) at 350N of load, and 4.9 mm (range, 3.7 to 7.0 mm) at 0N of load. These results suggest that if the radiographic joint space of on a standing X-ray of an ankle undergoing distraction arthroplasty shows a minimum of 5.8 mm of DG, then there will be no contact between joint surfaces during full weight-bearing. Therefore, 5 mm of radiographic joint space, as recommended historically, may not be adequate to prevent contact of the articular surfaces during weight-bearing.

Influence of the Strength Mismatch of a Narrow Gap Welded Joint of SA508 on the Plastic η Factor

NASA Astrophysics Data System (ADS)

Koo, J. M.; Huh, Y.; Seok, C. S.

2012-11-01

In this article, the influence of the strength mismatch of a narrow gap welded joint of SA508 on the η factor was evaluated. The η factor is the principal parameter that determines the plastic portion of the J-integral. The specimens for tensile and hardness tests were collected from piping with narrow gap welding and the stress-strain curve and hardness were obtained from those. From these results, the Ramberg-Osgood (R-O) constant was obtained. Also, the finite element analysis was performed with variations in the strength mismatch and the weld width. The η factor equation considering the strength mismatch and the weld width of a narrow gap welded joint was suggested.

Comparison of soft tissue balancing, femoral component rotation, and joint line change between the gap balancing and measured resection techniques in primary total knee arthroplasty

PubMed Central

Moon, Young-Wan; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Park, Chan-Deok; Lee, Dae-Hee

2016-01-01

Abstract Background: This meta-analysis was designed to compare the accuracy of soft tissue balancing and femoral component rotation as well as change in joint line positions, between the measured resection and gap balancing techniques in primary total knee arthroplasty. Methods: Studies were included in the meta-analysis if they compared soft tissue balancing and/or radiologic outcomes in patients who underwent total knee arthroplasty with the gap balancing and measured resection techniques. Comparisons included differences in flexion/extension, medial/lateral flexion, and medial/lateral extension gaps (LEGs), femoral component rotation, and change in joint line positions. Finally, 8 studies identified via electronic (MEDLINE, EMBASE, and the Cochrane Library) and manual searches were included. All 8 studies showed a low risk of selection bias and provided detailed demographic data. There was some inherent heterogeneity due to uncontrolled bias, because all included studies were observational comparison studies. Results: The pooled mean difference in gap differences between the gap balancing and measured resection techniques did not differ significantly (−0.09 mm, 95% confidence interval [CI]: −0.40 to +0.21 mm; P = 0.55), except that the medial/LEG difference was 0.58 mm greater for measured resection than gap balancing (95% CI: −1.01 to −0.15 mm; P = 0.008). Conversely, the pooled mean difference in femoral component external rotation (0.77°, 95% CI: 0.18° to 1.35°; P = 0.01) and joint line change (1.17 mm, 95% CI: 0.82 to 1.52 mm; P < 0.001) were significantly greater for the gap balancing than the measured resection technique. Conclusion: The gap balancing and measured resection techniques showed similar soft tissue balancing, except for medial/LEG difference. However, the femoral component was more externally rotated and the joint line was more elevated with gap balancing than measured resection. These differences were minimal (around 1 mm or 1°) and therefore may have little effect on the biomechanics of the knee joint. This suggests that the gap balancing and measured resection techniques are not mutually exclusive. PMID:27684862

Design, Construction, Demonstration and Delivery of an Automated Narrow Gap Welding System.

DTIC Science & Technology

1982-06-29

DESIGN, CONSTRUCTION, DEMONSTRATION AND DELIVERY OF WE DA4I &NARROW GAP CONTRACT NO. NOOGOO-81-C-E923 TO DAVID TAYLOR NAVAL RESEARCH AND DEVELOPMENT...the automated * Narrow Gap welding process, is the narrow (3/8 - inch), square-butt joint *design. This narrow joint greatly reduces the volume of weld...AD-i45 495 DESIGN CONSTRUCTION DEMONSTRATION AiND DELIVERY OF RN 1/j AUrOMATED NARROW GAP WELDING SYSTEMI() CRC AUTOMATIC WELDING CO HOUSTON TX 29

Management of traumatic popliteal vein injuries.

PubMed

Ekim, Hasan; Basel, Halil; Odabasi, Dolunay

2012-09-01

The aim of this study was to evaluate different repair methods of popliteal vein injuries, and to assess the relationship between early patency and surgical outcome. Thirty patients with popliteal vein injuries underwent surgical repair procedure at our hospital from March 2000 to April 2010. Patients who were haemodynamically unstable and those with massive bleeding from limb wounds were taken directly to the operating room. Stable patients underwent preoperative colour-flow duplex ultrasonography (CFDU). Our study group consisted of 26 males and 4 females, ranging in age from 17 to 60 years with a mean age of 25.3 ± 5.9 years. The mechanism of trauma was penetrating in 27 patients and blunt in the remaining 3 patients. Treatment included primary venous repair in 11 cases, end-to-end anastomosis in 8, interposition vein graft in 10, and interposition polytetrafluoroethylene (PTFE) graft in 1. There were 26 patients with associated arterial injury, of which 4 cases had primary repair, 9 had end-to-end anastomosis, 11 had saphenous vein graft interposition, and 2 had PTFE graft interposition. Associated bone fracture was seen in 6 patients. There were no deaths. One patient required a below-knee amputation. Postoperative CFDU revealed thrombosed venous repair in 7 cases without any sequelae. Popliteal venous injuries can be repaired with minimal downside and a good early patency rate. Additionally, transient venous patency allows for establishment of venous and lymphatic collateralisation. Alternatively, venous ligation should be considered only in unstable patients who refuse blood transfusion (Jehovah's witnesses). In these victims, adjuvant management may be required such as the use of fasciotomy and anticoagulation treatment. Copyright © 2011 Elsevier Ltd. All rights reserved.

Jejunal pouch with nerve preservation and interposition after total gastrectomy.

PubMed

Kobayashi, I; Ohwada, S; Ohya, T; Yokomori, T; Iesato, H; Morishita, Y

1998-01-01

In this paper, we describe operative technique details and our results with a modified technique for jejunal pouch formation and interposition after total gastrectomy, with an overall aim to achieve results superior to jejunal pouch and Roux-en-Y reconstruction, as reported in the literature. Following total gastrectomy, the jejunum was divided approximately 20 cm distal to the ligament of Treitz. Marginal vessels were not divided in order to preserve the nerves in the 50 cm of distal jejunum which would be used for pouch construction. The pouch was constructed using a linear stapler (Endo GiA, United States Surgical Corp., Norwalk, Conn). A total of 15 gastric cancer patients underwent construction of a nerve-preserving jejunal pouch and interposition following total gastrectomy. None of the patients experienced postoperative complications due to pouch construction. Additionally, discomforts such as dumping or stagnation were not observed. Mild reflux esophagitis occurred in five of the 15 patients and was resolved by oral administration of camostat mesilate. Six months after surgery, the average patient's diet volume and body weight had gradually increased to 79% and 86%, respectively, of the presurgical levels. A dual phase, dual isotope radionucleid pouch emptying study was also performed six months after surgery. The intra-pouch RI retention rate was 47% for liquid food and 53% for solid food 120 minutes after intake. The emptying rate was slower for both solid and liquid food, as compared with healthy individuals. The pouch-emptying test demonstrated a satisfactory retention capacity and an acceptable emptying time as a gastric substitute. The patients who underwent gastric reconstruction with a nerve-preserving jejunal pouch with interposition have experienced a reasonably good quality of life.

Comparative morphometric analysis of 5 interpositional arterial autograft options for adult living donor liver transplantation.

PubMed

Imakuma, E S; Bordini, A L; Millan, L S; Massarollo, P C B; Caldini, E T E G

2014-01-01

In living donor liver transplantation, the right-sided graft presents thin and short vessels, bringing forward a more difficult anastomosis. In these cases, an interpositional arterial autograft can be used to favor the performance of the arterial anastomosis, making the procedure easier and avoiding surgical complications. We compared the inferior mesenteric artery (IMA), the splenic artery (SA), the inferior epigastric artery (IEA), the descending branch of the lateral circumflex femoral artery (LCFA), and the proper hepatic artery (PHA) as options for interpositional autograft in living donor liver transplantation. Segments of at least 3 cm of all 5 arteries were harvested from 16 fresh adult cadavers from both genders through standardized dissection. The analyzed measures were proximal and distal diameter and length. The proximal diameter of the RHA and the distal diameter of the SA, IMA, IEA and the LCFA were compared to the distal diameter of the RHA. The proximal and distal diameters of the SA, IEA and LCFA were compared to study caliber gain of each artery. All arteries except the IMA showed statistical significant difference in relation to the RHA in terms of diameter. Regarding caliber gain, the arteries demonstrated statistical significant difference. All the harvested arteries except PHA were 3 cm in length. The IMA demonstrated the best compatibility with the RHA in terms of diameter and showed sufficient length to be employed as interpositional graft. The PHA, the SA, the IEA and the LCFA presented statistically significant different diameters when compared to the RHA. Among these vessels, only the PHA did not show sufficient mean length. Copyright © 2014 Elsevier Inc. All rights reserved.

Commercially available trabecular metal ankle interpositional spacer for tibiotalocalcaneal arthrodesis secondary to severe bone loss of the ankle.

PubMed

Horisberger, Monika; Paul, Jochen; Wiewiorski, Martin; Henninger, Heath B; Khalifa, Muhammad S; Barg, Alexej; Valderrabano, Victor

2014-01-01

Retrograde tibiotalocalcaneal nailing arthrodesis has proved to be a viable salvage procedure; however, extended bone loss around the ankle has been associated with high rates of nonunion and considerable shortening of the hindfoot. We present the surgical technique and the first 2 cases in which a trabecular metal™ interpositional spacer, specifically designed for tibiotalocalcaneal nailing arthrodesis, was used. The spacer can be implanted using either an anterior or a lateral approach. An integrated hole in the spacer allows a retrograde nail to be inserted, which provides excellent primary stability of the construct. Trabecular metal™ is a well-established and well-described material used to supplement deficient bone stock in surgery of the spine, hip, and knee. It has shown excellent incorporation and reduces the need for auto- and allografts. The trabecular metal™ interpositional ankle spacer is the first trabecular metal spacer designed specifically for ankle surgery. Its shape and variable size will make it a valuable tool for reconstructing bone loss in tibiotalocalcaneal nailing arthrodesis. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Establishment of a rat and guinea pig aortic interposition graft model reveals model-specific patterns of intimal hyperplasia.

PubMed

Gregory, Elaine K; Vercammen, Janet M; Flynn, Megan E; Kibbe, Melina R

2016-12-01

Although the aortic interposition bypass model has been widely used to evaluate biomaterials for bypass grafting, there is no comprehensive description of the procedure or of the distribution of intimal hyperplasia that results. The objectives of this study were to (1) review and summarize approaches of aortic interposition grafting in animal models, (2) determine the pertinent anatomy for this procedure, (3) validate this model in the rat and guinea pig, and (4) compare the distribution of intimal hyperplasia that develops in each species. A literature search was performed in PubMed from 1980 to the present to analyze the use of anesthesia, anticoagulation, antiplatelet agents, graft material, suture, and anastomotic techniques. Using 10-week-old male Sprague-Dawley rats and Hartley guinea pigs, we established pertinent aortic anatomy, developed comparable models, and assessed complications for each model. At 30 days, the graft and associated aorta were explanted, intimal formation was assessed morphometrically, and cellularity was assessed via nuclear counting. We reviewed 30 articles and summarized the pertinent procedural findings. Upon establishing both animal models, key anatomic differences between the species that affect this model were noted. Guinea pigs have a much larger cecum, increased retroperitoneal fat, and lack the iliolumbar vessels compared with the rat. Surgical outcomes for the rat model included a 53% technical success rate and a 32% technical error rate. Surgical outcomes for the guinea pig model included a 69% technical success rate and a 31% technical error rate. These two species demonstrated unique distribution of intimal hyperplasia at 30 days. Intimal hyperplasia in the rat model was greatest at two areas, the proximal graft (5400 μm 2 ; P < .001) and distal graft (2800 μm 2 ; P < .04), whereas the guinea pig model developed similar intimal hyperplasia throughout the graft (4500-5100 μm 2 ; P < .01). In this report, we summarize the literature on the aortic interposition graft model, present a detailed description of the anatomy and aortic interposition graft procedure in the rat and guinea pig, and describe a unique distribution of intimal formation that results in both species. This information will be helpful when designing studies to evaluate novel graft materials in the future. Published by Elsevier Inc.

Porous polyurethaneurea (Artelon) joint spacer compared to trapezium resection and ligament reconstruction.

PubMed

Blount, Andrew L; Armstrong, Shannon D; Yuan, Frank; Burgess, Scott D

2013-09-01

To examine outcomes and complications of the porous polyurethaneurea (Artelon; Small Bone Innovations, Morrisville, PA) spacer compared to traditional surgical treatment of trapeziectomy with ligament reconstruction and tendon interposition (LRTI). A retrospective chart review was undertaken of patients with carpometacarpal (CMC) arthritis who had either placement of an Artelon spacer or LRTI. Patients were brought back to clinic for interview and functional testing. Pain was graded using a visual analog scale. Grip and pinch strength, as well as range of motion at the first CMC joint, were measured. Nine-hole peg, Moberg pickup, and Jebson-Taylor tests were performed. Research and Development 36, Michigan Hand Outcomes, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaires were administered. Thirty-eight patients received Artelon implants into the CMC joint, and 6 were lost to follow-up. Twelve of 32 patients (37%) required revision surgery with removal of implant and salvage arthroplasty. Twenty patients with nonrevised Artelon implants were compared with 10 patients who received 13 LRTI procedures. Patients with Artelon had significantly less pain improvement compared to those receiving the LRTI procedure. In addition, satisfaction was significantly decreased. There was no significant difference in any other functional or quality of life measures. In our practice, use of the Artelon joint spacer resulted in an explantation rate of 37%. Due to these findings, we have abandoned its use for treatment of basilar thumb osteoarthritis. In contrast to previous studies, pain and satisfaction are worse in patients with intact Artelon spacers than those who had received LRTI. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

[Tibiotalocalcaneal arthrodesis using a distally introduced femur nail (DFN)].

PubMed

Grass, René

2005-10-01

Simultaneous arthrodesis of ankle and subtalar joints and, at the same sitting, correction of axial malalignment of hindfoot, treatment of bony defects and of sequelae of circulatory disturbances after multiple previous interventions. Internal stabilization with a short distal femur nail. Restitution of a pain-free weight bearing. Failure of arthrodesis of ankle and subtalar joint causing pain in patients with severely altered bone structures particularly at the level of the talar dome. Malalignment of hind- and/or forefoot after previous arthrodesis of ankle and subtalar joint. Failure of conservative therapy in both above-enumerated conditions. Poor skin or soft-tissue conditions. Reflex sympathetic dystrophy. Acute osteitis/osteomyelitis. Posterolateral approach. Resection of the articular cartilage and the areas of sclerosis of the ankle and of the posterior facet of the subtalar joint. Interposition of bone grafts harvested from the iliac crest. Correction of malalignment of hind- and forefoot. Locked nailing with a short distal femur nail. Fitting of a flexible custom-made arthrodesis boot; weight bearing in boot not exceeding half of body weight until the 8th week. Gait training. After 12 weeks wearing of normal shoes. Radiographs after 6 and 12 weeks. Between February 1, 2002 and September 1, 2003 this technique was performed on 18 feet in 17 patients (three women, 14 men, average age 53 years [38.9-73.7 years]). Average duration of follow-up: 1.2 years (0.6-2.1 years). The goal of surgery was reached in all patients. Subjective assessment: 14 times good, three times satisfactory. Four complications: one loss of nail purchase, one dislocation of locking screw, one breakage of locking bolt, one prolonged bone healing.

Arthroscopic Synovectomy Combined with Autologous Fat Grafting in Early Stages of CMC Osteoarthritis of the Thumb.

PubMed

Kemper, Robert; Wirth, Johanna; Baur, Eva-Maria

2018-04-01

Background  Minimal invasive treatments such as arthroscopic techniques may be adequate to restore the anatomy and functional integrity of the thumb CMC (carpometacarpal) joint. In this paper, we reported the interposition of autologous fat tissue in combination with arthroscopic synovectomy/debridement for early stage of the thumb CMC joint osteoarthritis. Patients and Methods  Twelve patients with a mean age of 46 years with early radiological stages of thumb CMC joint osteoarthritis were included. Evaluation of outcome was measured prior and 3, 12, and 24 months after surgery including, Visual Analog Scale (VAS), QuickDASH, grip and pinch strength, range of motion (ROM), and patient satisfaction. Results  Pain at rest (or with load) was reduced from preoperative 4,7 (8,7) to 2 (5,9) at 3 to 6 months; 1,4 (4,3) at 12 months; and 0,75 (2,7) at 2 years after the surgery. Initial preoperative QuickDASH value of 52 points reduced to 33 (17-65) at 6 months, 23 (2-70) at 12 months, and 20 (11-29) at 24 months after the surgery. Grip strength and thumb pinch with respect to the contralateral untreated thumb was reduced in the first 12 months but recovered subsequently. ROM was equal to the contralateral thumb. Three patients suffered from tendinitis and required surgical treatment. One patient indicated prolonged pain symptoms. No infections were noted and no donor-site morbidity or side effects were detected. Conclusion  Arthroscopic synovectomy combined with autologous fat graft is a reliable surgical option for early thumb CMC joint osteoarthritis and that effect continues for more than 24 months.

Finite Element Analysis of Composite Joint Configurations with Gaps and Overlaps

NASA Technical Reports Server (NTRS)

Krueger, Ronald

2014-01-01

The goal of the current study is to identify scenarios for which thermal and moisture effects become significant in the loading of a composite structure. In the current work, a simple configuration was defined, and material properties were selected. A Fortran routine was created to automate the mesh generation process. The routine was used to create the models for the initial mesh refinement study. A combination of element length and width suitable for further studies was identified. Also, the effect of the overlap length and gap length on computed shear and through-thickness stresses along the bondline of the joints was studied for the mechanical load case. Further, the influence of neighboring gaps and overlaps on these joint stresses was studied and was found to be negligible. The results suggest that for an initial study it is sufficient to focus on one configuration with fixed overlap and gap lengths to study the effects of mechanical, thermal and moisture loading and combinations thereof on computed joint stresses

Vision and spectroscopic sensing for joint tracing in narrow gap laser butt welding

NASA Astrophysics Data System (ADS)

Nilsen, Morgan; Sikström, Fredrik; Christiansson, Anna-Karin; Ancona, Antonio

2017-11-01

The automated laser beam butt welding process is sensitive to positioning the laser beam with respect to the joint because a small offset may result in detrimental lack of sidewall fusion. This problem is even more pronounced in case of narrow gap butt welding, where most of the commercial automatic joint tracing systems fail to detect the exact position and size of the gap. In this work, a dual vision and spectroscopic sensing approach is proposed to trace narrow gap butt joints during laser welding. The system consists of a camera with suitable illumination and matched optical filters and a fast miniature spectrometer. An image processing algorithm of the camera recordings has been developed in order to estimate the laser spot position relative to the joint position. The spectral emissions from the laser induced plasma plume have been acquired by the spectrometer, and based on the measurements of the intensities of selected lines of the spectrum, the electron temperature signal has been calculated and correlated to variations of process conditions. The individual performances of these two systems have been experimentally investigated and evaluated offline by data from several welding experiments, where artificial abrupt as well as gradual deviations of the laser beam out of the joint were produced. Results indicate that a combination of the information provided by the vision and spectroscopic systems is beneficial for development of a hybrid sensing system for joint tracing.

Use of small gap anastomosis for the repair of peripheral nerve injury by cutting and sleeve jointing the epineurium.

PubMed

Wang, Peiji; Zhao, Jiaju; Jiang, Bo; Zhang, Yong

2015-05-01

Although epineurium neurorrhaphy is the most reliable and conventional method for the repair of peripheral nerve injury and is accepted as the gold standard, it is still far from ideal. Many attempts have been made to develop nerve anastomosis techniques. The aim of this study was to investigate the use of small gap anastomosis performed by cutting and sleeve jointing the epineurium for nerve repair. A 12-week study was performed using small gap anastomosis via cutting and sleeve jointing the epineurium, compared with epineurium neurorrhaphy in situ, to repair a rat sciatic nerve rupture. Three experimental groups were included: sham control (n = 8), small gap anastomosis (n = 16), and epineurium neurorrhaphy (n = 16). About 12 weeks after surgery, recovery was assessed with walking track analysis, electrophysiology, hematoxylin and eosin staining, immunohistochemistry, and electron microscopy. The sciatic nerve functional index observed in the small gap anastomosis group was significantly higher than that in the epineurium neurorrhaphy group (p < 0.05). In vivo electrophysiological analysis confirmed that the small gap anastomosis group showed a significantly higher conduction velocity than the epineurium neurorrhaphy group (p < 0.05). Postoperative morphometric analysis revealed better results after small gap anastomosis compared with epineurium neurorrhaphy. Small gap anastomosis via cutting and sleeve jointing the epineurium could be an alternative to epineurium neurorrhaphy for the repair of peripheral nerve injury, particularly, considering that the epineurium originates from native tissue that provides a suitable microenvironment for the selective regeneration of axons. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Index metacarpal fracture after tightrope suspension following trapeziectomy: case report.

PubMed

Khalid, Mohammed; Jones, Matthew L

2012-03-01

Trapeziectomy, by itself or combined with ligament reconstruction/interposition arthroplasty, is commonly performed for advanced trapezial-metacarpal arthritis. Several methods and materials, both autogenous and artificial, are commonly used for ligament reconstruction and interposition arthroplasty. Harvesting autologous tendons adds to operative time and could increase potential surgical complications. Using an artificial material would, in theory, avoid some of these problems. However, this approach is not without its problems. We present a case of index metacarpal fracture after using the Arthrex Mini TightRope (Arthrex, Naples, FL) suture button fixation of the thumb and index metacarpals after complete trapeziectomy. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

[Temporo-mandibular ankylosis].

PubMed

Bénateau, H; Chatellier, A; Caillot, A; Diep, D; Kün-Darbois, J-D; Veyssière, A

2016-09-01

Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring because of bony, fibrous or fibro-osseous fusion. Resulting complications such as speech, chewing, swallowing impediment and deficient oral hygiene may occur. The overall incidence is decreasing but remains significant in some developing countries. The most frequent etiology in developed countries is the post-traumatic ankylosis occurring after condylar fracture. Other causes may be found: infection (decreasing since the advent of antibiotics), inflammation (rheumatoid arthritis and ankylosing spondylitis mainly) and congenital diseases (very rare). Management relies on surgery: resection of the ankylosis block in combination with bilateral coronoidectomy… The block resection may be offset by the interposition temporal fascia flap, a costochondral graft or a TMJ prosthesis according to the loss of height and to the impact on dental occlusion. Postoperative rehabilitation is essential and has to be started early, to be intense and prolonged. Poor rehabilitation is the main cause of ankylosis recurrence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Quantification of effect of sequential posteromedial release on flexion and extension gaps: a computer-assisted study in cadaveric knees.

PubMed

Mullaji, Arun; Sharma, Amit; Marawar, Satyajit; Kanna, Raj

2009-08-01

A novel sequence of posteromedial release consistent with surgical technique of total knee arthroplasty was performed in 15 cadaveric knees. Medial and lateral flexion and extension gaps were measured after each step of the release using a computed tomography-free computer navigation system. A spring-loaded distractor and a manual distractor were used to distract the joint. Posterior cruciate ligament release increased flexion more than extension gap; deep medial collateral ligament release had a negligible effect; semimembranosus release increased the flexion gap medially; reduction osteotomy increased medial flexion and extension gaps; superficial medial collateral ligament release increased medial joint gap more in flexion and caused severe instability. This sequence of release led to incremental and differential effects on flexion-extension gaps and has implications in correcting varus deformity.

Membrane Assisted Palatal Fistula Closure in a Cleft Palate Patient: A Novel Technique.

PubMed

Reddy, G Siva Prasad; Reddy, G Venkateshwara; Sree, P Karuna; Reddy, K Sravan Kumar; Reddy, P Amarnath

2016-03-01

Palatal fistula following cleft palate repair, is one of the considerable complications and remains a challenging problem to the surgeons. The reported recurrence rate of the fistula is between 33% to 37%. Due to fibrosis and poor vascularity of adjacent tissues, high recurrence rates are typical. Closure of palatal fistulas can be achieved by different surgical techniques like local, regional and distant flaps, local turnover flaps, pedicled flaps from oral mucosa, buccal fat pad flaps, inter-positional cartilage grafts can be utilized for management of small fistulas. For larger fistualas, tongue flaps, temporalis muscle flaps, musculomucosal flaps, nasal septal flaps and free flaps can be used. These procedures are often cumbersome and leave a raw nasal or oral surface, which may increase the incidence of postoperative problems or some flaps can be bulky and may require a second-stage procedure. Different synthetic materials such as alloderm, Poly-D and L-Lactic Acid or "PdLLA" and collagen membrane are used in multilayer repair represented by the nasal mucosa, the inter-positional graft and oral mucosa. These interpositional grafts provide a scaffold for in growth of tissues, revascularization and mucosal epithelialization. We present a case of closure of an oronasal fistula, using resorbable collagen membrane in three layered repair to avoid recurrence.

One-stage metatarsal lengthening by allograft interposition: a novel approach for congenital brachymetatarsia.

PubMed

Giannini, Sandro; Faldini, Cesare; Pagkrati, Stavroula; Miscione, Maria Teresa; Luciani, Deianira

2010-07-01

Congenital brachymetatarsia, a shortened metatarsal bone, can be corrected surgically by callus distraction or one-stage lengthening using bone graft. We asked whether one-stage metatarsal lengthening using metatarsal homologous bone graft could improve forefoot function, lead to metatarsal healing, restore metatarsal parabola, and improve cosmetic appearance. We retrospectively reviewed 29 patients (41 feet) in whom we lengthened 50 metatarsals. Surgery consisted of a transverse proximal osteotomy of the metatarsal shaft and interposition of a metatarsal homologous bone graft (average, 13 mm long) fixed with an intramedullary Kirschner wire. Minimum followup was 3 years (mean, 5 years; range, 3-11 years). Bone union was achieved in all cases. The mean preoperative American Orthopaedic Foot and Ankle Society score was 37 points (range, 28-53 points) and the mean postoperative score was 88 points (range, 74-96 points), with an average improvement of 51 points. Radiographically, the mean gain in length was 13 mm (range, 10-15 mm), and the mean percentage increase was 23%. One-stage metatarsal lengthening using interposition of metatarsal homologous bone graft to correct congenital brachymetatarsia has low morbidity for the patient, limited complications, short recovery times, and restores forefoot anatomy. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Phrenic nerve reconstruction in complete video-assisted thoracic surgery.

PubMed

Kawashima, Shun; Kohno, Tadasu; Fujimori, Sakashi; Yokomakura, Naoya; Ikeda, Takeshi; Harano, Takashi; Suzuki, Souichiro; Iida, Takahiro; Sakai, Emi

2015-01-01

Primary or metastatic lung cancer or mediastinal tumours may at times involve the phrenic nerve and pericardium. To remove the pathology en bloc, the phrenic nerve must be resected. This results in phrenic nerve paralysis, which in turn reduces pulmonary function and quality of life. As a curative measure of this paralysis and thus a preventive measure against decreased pulmonary function and quality of life, we have performed immediate phrenic nerve reconstruction under complete video-assisted thoracic surgery, and with minimal additional stress to the patient. This study sought to ascertain the utility of this procedure from an evaluation of the cases experienced to date. We performed 6 cases of complete video-assisted thoracic surgery phrenic nerve reconstruction from October 2009 to December 2013 in patients who had undergone phrenic nerve resection or separation to remove tumours en bloc. In all cases, it was difficult to separate the phrenic nerve from the tumour. Reconstruction involved direct anastomosis in 3 cases and intercostal nerve interposition anastomosis in the remaining 3 cases. In the 6 patients (3 men, 3 women; mean age 50.8 years), we performed two right-sided and four left-sided procedures. The mean anastomosis time was 5.3 min for direct anastomosis and 35.3 min for intercostal nerve interposition anastomosis. Postoperative phrenic nerve function was measured on chest X-ray during inspiration and expiration. Direct anastomosis was effective in 2 of the 3 patients, and intercostal nerve interposition anastomosis was effective in all 3 patients. Diaphragm function was confirmed on X-ray to be improved in these 5 patients. Complete video-assisted thoracic surgery phrenic nerve reconstruction was effective for direct anastomosis as well as for intercostal nerve interposition anastomosis in a small sample of selected patients. The procedure shows promise for phrenic nerve reconstruction and further data should be accumulated over time. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Magnetic Resonance Imaging Zygapophyseal Joint Space Changes (Gapping) in Low Back Pain Patients following Spinal Manipulation and Side Posture Positioning: A Randomized Controlled Mechanisms Trial with Blinding

PubMed Central

Cramer, Gregory D.; Cambron, Jerrilyn; Cantu, Joe A; Dexheimer, Jennifer M.; Pocius, Judith D; Gregerson, Douglas; Fergus, Michael; McKinnis, Ray; Grieve, Thomas J

2013-01-01

Objective The purpose of this study was to quantify lumbar zygapophyseal (Z) joint space separation (gapping) in low back pain (LBP) subjects after spinal manipulative therapy (SMT) or side-posture positioning (SPP). Methods This was a controlled mechanisms trial with randomization and blinding. Acute LBP subjects (N=112, four n=28 MRI protocol groups) had 2 magnetic resonance imaging (MRI) appointments (initial enrollment [M1] and following 2 weeks of chiropractic treatment [M2]; receiving 2 MRI scans of the L4/L5 and L5/S1 Z joints at each MRI appointment. After the first MRI scan of each appointment, subjects were randomized (M1 appointment) or assigned (M2 appointment) into SPP (non-manipulation), SMT (manipulation), or control MRI protocol groups. After SPP or SMT, a second MRI was taken. The central anterior-posterior (A-P) joint space was measured. Difference between most painful side A-P measurements taken post- and pre-intervention was the Z joint “gapping difference.” Gapping differences were compared (ANOVA) among protocol groups. Secondary measures of pain visual analog scale (VAS), verbal numeric pain rating scale (VNPRS), and function Bournemouth questionnaire (BQ) were assessed. Results Gapping differences were significant at the first (adjusted, p=0.01; SPP=0.66 +0.48mm; SMT=0.23 +0.86; control=0.18 +0.71) and second (adjusted, p=0.0005; SPP=0.65 +0.92mm, SMT=0.89 +0.71; control=0.35 +0.32) MRI appointments. VNPRS differences were significant at first MRI appointment (p=0.04) with SMT showing the greatest improvement. VAS and BQ improved after two weeks of care in all groups (both p<0.0001). Conclusions SPP showed greatest gapping at baseline. After two weeks, SMT resulted in greatest gapping. SPP appeared to have additive therapeutic benefit to SMT. PMID:23648055

Effect of gap distance on tensile strength of preceramic base metal solder joints.

PubMed

Fattahi, Farnaz; Motamedi, Milad

2011-01-01

In order to fabricate prostheses with high accuracy and durability, soldering techniques have been introduced to clinical dentistry. However, these prostheses always fail at their solder joints. The purpose of this study was to evaluate the effect of gap distance on the tensile strength of base metal solder joints. Based on ADA/ISO 9693 specifications for tensile test, 40 specimens were fabricated from a Ni-Cr alloy and cut at the midpoint of 3-mm diameter bar and placed at desired positions by a specially designed device. The specimens were divided into four groups of 10 samples according to the desired solder gap distance: Group1: 0.1mm; Group2: 0.25mm; Group3: 0.5mm; and Group4: 0.75mm. After soldering, specimens were tested for tensile strength by a universal testing machine at a cross-head speed of 0.5mm/min with a preload of 10N. The mean tensile strength values of the groups were 162, 307.8, 206.1 and 336.7 MPa, respectively. The group with 0.75-mm gap had the highest and the group with 0.1-mm gap had the lowest tensile strength. Bonferroni test showed that Group1 and Group4 had statistically different values (P=0.023), but the differences between other groups were not sig-nificant at a significance level of 0.05. There was no direct relationship between increasing soldering gap distance and tensile strength of the solder joints.

Hypoglossal-facial-jump-anastomosis without an interposition nerve graft.

PubMed

Beutner, Dirk; Luers, Jan C; Grosheva, Maria

2013-10-01

The hypoglossal-facial-anastomosis is the most often applied procedure for the reanimation of a long lasting peripheral facial nerve paralysis. The use of an interposition graft and its end-to-side anastomosis to the hypoglossal nerve allows the preservation of the tongue function and also requires two anastomosis sites and a free second donor nerve. We describe the modified technique of the hypoglossal-facial-jump-anastomosis without an interposition and present the first results. Retrospective case study. We performed the facial nerve reconstruction in five patients. The indication for the surgery was a long-standing facial paralysis with preserved portion distal to geniculate ganglion, absent voluntary activity in the needle facial electromyography, and an intact bilateral hypoglossal nerve. Following mastoidectomy, the facial nerve was mobilized in the fallopian canal down to its bifurcation in the parotid gland and cut in its tympanic portion distal to the lesion. Then, a tensionless end-to-side suture to the hypoglossal nerve was performed. The facial function was monitored up to 16 months postoperatively. The reconstruction technique succeeded in all patients: The facial function improved within the average time period of 10 months to the House-Brackmann score 3. This modified technique of the hypoglossal-facial reanimation is a valid method with good clinical results, especially in cases of a preserved intramastoidal facial nerve. Level 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Effect of Gap Distance on Tensile Strength of Preceramic Base Metal Solder Joints

PubMed Central

Fattahi, Farnaz; Motamedi, Milad

2011-01-01

Background and aims In order to fabricate prostheses with high accuracy and durability, soldering techniques have been introduced to clinical dentistry. However, these prostheses always fail at their solder joints. The purpose of this study was to evaluate the effect of gap distance on the tensile strength of base metal solder joints. Materials and methods Based on ADA/ISO 9693 specifications for tensile test, 40 specimens were fabricated from a Ni-Cr alloy and cut at the midpoint of 3-mm diameter bar and placed at desired positions by a specially designed device. The specimens were divided into four groups of 10 samples according to the desired solder gap distance: Group1: 0.1mm; Group2: 0.25mm; Group3: 0.5mm; and Group4: 0.75mm. After soldering, specimens were tested for tensile strength by a universal testing machine at a cross-head speed of 0.5mm/min with a preload of 10N. Results The mean tensile strength values of the groups were 162, 307.8, 206.1 and 336.7 MPa, respectively. The group with 0.75-mm gap had the highest and the group with 0.1-mm gap had the lowest tensile strength. Bonferroni test showed that Group1 and Group4 had statistically different values (P=0.023), but the differences between other groups were not sig-nificant at a significance level of 0.05. Conclusion There was no direct relationship between increasing soldering gap distance and tensile strength of the solder joints. PMID:22991610

Anatomical landmarks of the distal femoral condyles are not always parallel to the tibial bone cut surface in flexion during total knee arthroplasty.

PubMed

Itokazu, Maki; Minoda, Yukihide; Ikebuchi, Mitsuhiko; Mizokawa, Shigekazu; Ohta, Yoichi; Nakamura, Hiroaki

2016-08-01

Soft tissue balancing is crucial to the success of total knee arthroplasty (TKA). To create a rectangular flexion joint gap, the rotation of the femoral component is important. The purpose of this study is to determine whether or not anatomical landmarks of the distal femoral condyles are parallel to the tibial bone cut surface in flexion. Forty-eight patients (three male and 45 female) with a mean age of 74years were examined. During the operation, we estimated the flexion joint gap with the following three techniques. 1) a three degree external cut to the posterior condylar line (MR1), 2) a parallel cut to the surgical transepicondylar axis (MR2), and 3) a parallel cut to the anatomical transepicondylar axis (MR3). The flexion joint gap was 1.1±3.0° (mean±standard deviation (SD)) in internal rotation in the case of MR1, 0.9±3.4° in internal rotation in the case of MR2, and 2.1±3.4° in external rotation in the case of MR3. An outlier (flexion joint gap >3.0°) was observed in 12 cases (25%) in MR1, 13 cases (27%) in MR2, and 15 cases (31%) in MR3. The anatomical landmarks of the distal femoral condyles are not always parallel to the tibial bone cut surface in flexion. To create a rectangular flexion joint gap, the rotation of the femoral component rotation is based not only on the anatomical landmarks but also on the ligament balance. Copyright © 2016 Elsevier B.V. All rights reserved.

Metacarpal synostosis: treatment with a longitudinal osteotomy and bone graft substitute interposition.

PubMed

Gottschalk, Hilton P; Bednar, Michael S; Moor, Molly; Light, Terry R

2012-10-01

To describe a case series of congenital metacarpal synostosis treated with longitudinal osteotomy and bone graft substitute interposition. We retrospectively reviewed charts of all patients with metacarpal synostosis treated with a longitudinal osteotomy and bone graft substitute interposition at 2 institutions. Radiographic and clinical appearances were analyzed at initial diagnosis, intraoperatively, and at last follow-up. A total of 10 patients (14 hands) met the inclusion criteria. Six patients (8 hands) demonstrated ring-little finger metacarpal synostosis and 4 patients (6 hands) had a middle-ring finger metacarpal synostosis. The median age at operation was 5 years (range, 2-16 y). Follow-up ranged from 1 to 14 years (average, 3 y). Associated hand anomalies included polydactyly, symbrachydactyly, and clinodactyly. Before surgery, the little finger proximal phalanx was angulated away from the middle finger metacarpal on average 46° (range, 26°-60°), and the angulation between the middle and the ring fingers averaged 43° (range, 26°-50°). Postoperative correction at 1 year was statistically significant for both ring-little finger metacarpal synostosis, average 23° (range, 10°-30°), and middle-ring finger metacarpal synostosis, average 16° (range, 5°-44°). Recurrence of digital abduction was evident in 2 patients who had middle-ring finger metacarpal synostosis. Metacarpal synostosis is an uncommon congenital hand anomaly characterized by the coalescence of 2 adjacent metacarpals. In the most common form, the ring and little finger metacarpals are associated with abduction of the small finger in an awkward position. Use of the described technique is safe and effective, yet concerns remain regarding mild persistent angulation and risk of recurrence. Congenital metacarpal synostosis may be effectively treated with a longitudinal osteotomy, realignment of component metacarpals, and interposition of bone graft substitute. When the procedure is performed at a young age, we recommend follow-up until skeletal maturity to identify recurrence of the deformity. Therapeutic IV. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The role of simultaneous gap arthroplasty and distraction osteogenesis in the management of temporo-mandibular joint ankylosis with mandibular deformity in children.

PubMed

Rao, Krishna; Kumar, Sudhir; Kumar, Vijay; Singh, Arun Kumar; Bhatnagar, Sudhir Kumar

2004-02-01

Temporo-mandibular joint ankylosis is a common cause of acquired deformity in children. Surgical correction of the ankylosis only leaves the patient with an uncorrected mandibular deformity. This study was to evaluate the use of distraction osteogenesis for simultaneous correction of the mandibular deformity. This study was done on six children with temporo-mandibular joint ankylosis and mandibular deformity. Uniaxial double pin distractors with Schanz pins were used in this study. The patients underwent simultaneous gap arthroplasty and mandibular osteotomy (retromolar) with distractor insertion. Distraction was started on the fifth post-operative day. The patients were put on dynamic temporo-mandibular joint exercises on the first post-operative day. All patients had a satisfactory mouth opening on follow-up. Satisfactory cosmetic correction of the mandibular deformity was also achieved in all these patients. Some degree of malocclusion resulted from treatment due to which the patients were placed on orthodontic treatment. Distraction osteogenesis can be used simultaneously with gap arthroplasty in patients with temporo-mandibular ankylosis, for the correction of the mandibular deformity.

Switching algorithm for maglev train double-modular redundant positioning sensors.

PubMed

He, Ning; Long, Zhiqiang; Xue, Song

2012-01-01

High-resolution positioning for maglev trains is implemented by detecting the tooth-slot structure of the long stator installed along the rail, but there are large joint gaps between long stator sections. When a positioning sensor is below a large joint gap, its positioning signal is invalidated, thus double-modular redundant positioning sensors are introduced into the system. This paper studies switching algorithms for these redundant positioning sensors. At first, adaptive prediction is applied to the sensor signals. The prediction errors are used to trigger sensor switching. In order to enhance the reliability of the switching algorithm, wavelet analysis is introduced to suppress measuring disturbances without weakening the signal characteristics reflecting the stator joint gap based on the correlation between the wavelet coefficients of adjacent scales. The time delay characteristics of the method are analyzed to guide the algorithm simplification. Finally, the effectiveness of the simplified switching algorithm is verified through experiments.

Switching Algorithm for Maglev Train Double-Modular Redundant Positioning Sensors

PubMed Central

He, Ning; Long, Zhiqiang; Xue, Song

2012-01-01

High-resolution positioning for maglev trains is implemented by detecting the tooth-slot structure of the long stator installed along the rail, but there are large joint gaps between long stator sections. When a positioning sensor is below a large joint gap, its positioning signal is invalidated, thus double-modular redundant positioning sensors are introduced into the system. This paper studies switching algorithms for these redundant positioning sensors. At first, adaptive prediction is applied to the sensor signals. The prediction errors are used to trigger sensor switching. In order to enhance the reliability of the switching algorithm, wavelet analysis is introduced to suppress measuring disturbances without weakening the signal characteristics reflecting the stator joint gap based on the correlation between the wavelet coefficients of adjacent scales. The time delay characteristics of the method are analyzed to guide the algorithm simplification. Finally, the effectiveness of the simplified switching algorithm is verified through experiments. PMID:23112657

Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids: Effect of Bowel Interposition on Procedure Feasibility and a Unique Bowel Displacement Technique.

PubMed

Kim, Young-Sun; Lim, Hyo Keun; Rhim, Hyunchul

2016-01-01

To evaluate the effect of bowel interposition on assessing procedure feasibility, and the usefulness and limiting conditions of bowel displacement techniques in magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids. Institutional review board approved this study. A total of 375 screening MR exams and 206 MR-HIFU ablations for symptomatic uterine fibroids performed between August 2010 and March 2015 were retrospectively analyzed. The effect of bowel interposition on procedure feasibility was assessed by comparing pass rates in periods before and after adopting a unique bowel displacement technique (bladder filling, rectal filling and subsequent bladder emptying; BRB maneuver). Risk factors for BRB failure were evaluated using logistic regression analysis. Overall pass rates of pre- and post-BRB periods were 59.0% (98/166) and 71.7% (150/209), and in bowel-interposed cases they were 14.6% (7/48) and 76.4% (55/72), respectively. BRB maneuver was technically successful in 81.7% (49/60). Through-the-bladder sonication was effective in eight of eleven BRB failure cases, thus MR-HIFU could be initiated in 95.0% (57/60). A small uterus on treatment day was the only significant risk factor for BRB failure (B = 0.111, P = 0.017). The BRB maneuver greatly reduces the fraction of patients deemed ineligible for MR-HIFU ablation of uterine fibroids due to interposed bowels, although care is needed when the uterus is small.

Healing of Horizontal Intra-alveolar Root Fractures after Endodontic Treatment with Mineral Trioxide Aggregate.

PubMed

Kim, Dohyun; Yue, Wonyoung; Yoon, Tai-Cheol; Park, Sung-Ho; Kim, Euiseong

2016-02-01

The purpose of this retrospective study was to evaluate the healing type and assess the outcome of horizontal intra-alveolar root fractures after endodontic treatment with mineral trioxide aggregate (MTA) as filling material. The clinical database of the Department of Conservative Dentistry at Yonsei University Dental Hospital, Seoul, Korea, was searched for patients with histories of intra-alveolar root fractures and endodontic treatments with MTA between October 2005 and September 2014. Radiographic healing at the fracture line was evaluated independently by 2 examiners and was classified into 4 types according to Andreasen and Hjørting-Hansen. Of the 22 root-fractured teeth that received endodontic treatment with MTA, 19 cases participated in the follow-up after a period of at least 3 months. Seventeen of the 19 teeth (89.5%) exhibited healing of the root fractures. For each healing type, 7 teeth (36.8%) showed healing with calcified tissue, 8 teeth (42.1%) showed interposition of connective tissue, 2 teeth (10.5%) showed interposition of connective tissue and bone, and 2 teeth (10.5%) showed interposition of granulation tissue without healing. Within the limitations of this study, intra-alveolar root fractures showed satisfactory healing outcomes after endodontic treatment with MTA. MTA could be considered to be suitable filling material for the endodontic treatment of horizontal intra-alveolar root fractures. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Kinematic and fatigue biomechanics of an interpositional facet arthroplasty device.

PubMed

Dahl, Michael C; Freeman, Andrew L

2016-04-01

Although approximately 30% of chronic lumbar pain can be attributed to the facets, limited surgical options exist for patients. Interpositional facet arthroplasty (IFA) is a novel treatment for lumbar facetogenic pain designed to provide patients who gain insufficient relief from medical interventional treatment options with long-term relief, filling a void in the facet pain treatment continuum. This study aimed to quantify the effect of IFA on segmental range of motion (ROM) compared with the intact state, and to observe device position and condition after 10,000 cycles of worst-case loading. In situ biomechanical analysis of the lumbar spine following implantation of a novel IFA device was carried out. Twelve cadaveric functional spinal units (L2-L3 and L5-S1) were tested in 7.5 Nm flexion-extension, lateral bending, and torsion while intact and following device implantation. Additionally, specimens underwent 10,000 cycles of worst-case complex loading and were testing in ROM again. Load-displacement and fluoroscopic data were analyzed to determine ROM and to evaluate device position during cyclic testing. Devices and facets were evaluated post testing. Institutional support for implant evaluation was received by Zyga Technology. Range of motion post implantation decreased versus intact, and then was restored post cyclic-testing. Of the tested devices, 6.5% displayed slight movement (0.5-2 mm), all from tight L2-L3 facet joints with misplaced devices or insufficient cartilage. No damage was observed on the devices, and wear patterns were primarily linear. The results from this in situ cadaveric biomechanics and cyclic fatigue study demonstrate that a low-profile, conformable IFA device can maintain position and facet functionality post implantation and through 10,000 complex loading cycles. In vivo conditions were not accounted for in this model, which may affect implant behavior not predictable via a biomechanical study. However, these data along with published 1-year clinical results suggest that IFA may be a valid treatment option in patients with chronic lumbar zygapophysial pain who have exhausted medical interventional options. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Measurement of knee joint gaps without bone resection: "physiologic" extension and flexion gaps in total knee arthroplasty are asymmetric and unequal and anterior and posterior cruciate ligament resections produce different gap changes.

PubMed

Nowakowski, Andrej Maria; Majewski, Martin; Müller-Gerbl, Magdalena; Valderrabano, Victor

2012-04-01

General agreement is that flexion and extension gaps should be equal and symmetrical in total knee arthroplasty (TKA) procedures. However, comparisons using a standard TKA approach to normal knee joints that have not undergone bone resection are currently unavailable. Since bony preparation can influence capsule and ligament tension, our purpose was to perform measurements without this influence. Ten normal cadaveric knees were assessed using a standard medial parapatellar TKA approach with patellar subluxation. Gap measurements were carried out twice each alternating 100 and 200 N per compartment using a prototypical force-determining ligament balancer without the need for bony resection. Initial measurements were performed in extension, followed by 908 of flexion. The ACL was then resected, and finally the PCL was resected, and measurements were carried out in an analogous fashion. In general, the lateral compartment could be stretched further than the medial compartment, and the corresponding flexion gap values were significantly larger. ACL resection predominantly increased extension gaps, while PCL resection increased flexion gaps. Distraction force of 100 N per compartment appeared adequate; increasing to 200 N did not improve the results.

40 CFR 63.964 - Inspection and monitoring requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Defects include, but are not limited to, visible cracks, holes, or gaps in the closure devices; broken..., visible cracks, holes, or gaps in the closure devices; broken, cracked, or otherwise damaged seals or..., visible cracks, holes, gaps, or other open spaces in the sewer line joints, seals, or other emission...

40 CFR 63.964 - Inspection and monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Defects include, but are not limited to, visible cracks, holes, or gaps in the closure devices; broken..., visible cracks, holes, or gaps in the closure devices; broken, cracked, or otherwise damaged seals or..., visible cracks, holes, gaps, or other open spaces in the sewer line joints, seals, or other emission...

Interposition Dermal Matrix Xenografts: A Successful Alternative to Traditional Treatment of Massive Rotator Cuff Tears.

PubMed

Neumann, Julie A; Zgonis, Miltiadis H; Rickert, Kathleen D; Bradley, Kendall E; Kremen, Thomas J; Boggess, Blake R; Toth, Alison P

2017-05-01

Management of massive rotator cuff tears in shoulders without glenohumeral arthritis remains problematic for surgeons. Repairs of massive rotator cuff tears have failure rates of 20% to 94% at 1 to 2 years postoperatively as demonstrated with arthrography, ultrasound, and magnetic resonance imaging. Additionally, inconsistent outcomes have been reported with debridement alone of massive rotator cuff tears, and limitations have been seen with other current methods of operative intervention, including arthroplasty and tendon transfers. The use of interposition porcine acellular dermal matrix xenograft in patients with massive rotator cuff tears will result in improved subjective outcomes, postoperative pain, function, range of motion, and strength. Case series; Level of evidence, 4. Sixty patients (61 shoulders) were prospectively observed for a mean of 50.3 months (range, 24-63 months) after repair of massive rotator cuff tears with porcine acellular dermal matrix xenograft as an interposition graft. Subjective outcome data were obtained with visual analog scale for pain score (0-10, 0 = no pain) and Modified American Shoulder and Elbow Surgeons (MASES) score. Active range of motion in flexion, external rotation, and internal rotation were recorded. Strength in the supraspinatus and infraspinatus muscles was assessed manually on a 10-point scale and by handheld dynamometer. Ultrasound was used to assess the integrity of the repair during latest follow-up. Mean visual analog scale pain score decreased from 4.0 preoperatively to 1.0 postoperatively ( P < .001). Mean active forward flexion improved from 140.7° to 160.4° ( P < .001), external rotation at 0° of abduction from 55.6° to 70.1° ( P = .001), and internal rotation at 90° of abduction from 52.0° to 76.2° ( P < .001). Supraspinatus manual strength increased from 7.7 to 8.8 ( P < .001) and infraspinatus manual strength from 7.7 to 9.3 ( P < .001). Mean dynamometric strength in forward flexion was 77.7 N in nonoperative shoulders (shoulder that did not undergo surgery) and 67.8 N ( P < .001) in operative shoulders (shoulder that underwent rotator cuff repair with interposition porcine dermal matrix xenograft). Mean dynamometric strength in external rotation was 54.5 N in nonoperative shoulders and 50.1 N in operative shoulders ( P = .04). Average postoperative MASES score was 87.8. Musculoskeletal ultrasound showed that 91.8% (56 of 61) of repairs were fully intact; 3.3% (2 of 61), partially intact; and 4.9% (3 of 61), not intact. Patients who underwent repair of massive rotator cuff tears with interposition porcine acellular dermal matrix graft have good subjective function as assessed by the MASES score. Patients have significant improvement in pain, range of motion, and manual muscle strength. Postoperative ultrasound demonstrated that the repair was completely intact in 91.8% of patients, a vast improvement compared with results previously reported for primary repairs of massive rotator cuff tears.

Fatigue strength of socket welded pipe joint

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

Higuchi, Makoto; Hayashi, Makoto; Yamauchi, Takayoshi

1995-12-01

Fully reversed four point bending fatigue tests were carried out on small diameter socket welded joints made of carbon steels. Experimental parameters were pipe diameter, thicknesses of pipe and socket wall, throat depth and shape of fillet welds, slip-on and diametral gaps in the socket welding, lack of penetration at the root of fillet welds, and peening of fillet welds. In most cases a fatigue crack started from the root of the fillet, but in the case of higher stress amplitude, it tended to start from the toe of fillet. The standard socket welded joint for a pipe with amore » 50 mm nominal diameter showed a relatively low fatigue strength of 46 MPa in stress amplitude at the 10{sup 7} cycles failure life. This value corresponds to about 1/5 of that for the smoothed base metal specimens in axial fatigue. The fatigue strength decreased with increasing pipe diameter, and increased with increasing thickness of the pipe and socket wall. The effects of throat depth and shape of fillet welds on fatigue strength were not significant. Contrary to expectation, the fatigue strength of a socket welded joint without slip-on gap is Higher than that of the joint with a normal gap. A lack of penetration at the root deleteriously reduced fatigue strength, showing 14 MPa in stress amplitude at the 10{sup 7} cycles failure life for the 50 mm diameter socket joint.« less

Occipital-posterior cerebral artery bypass via the occipital interhemispheric approach

PubMed Central

Kazumata, Ken; Yokoyama, Yuka; Sugiyama, Taku; Asaoka, Katsuyuki

2013-01-01

Background: The unavailability of the superficial temporal artery (STA) and the location of lesions pose a more technically demanding challenge when compared with conventional STA-superior cerebellar or posterior cerebral artery (PCA) bypass in vascular reconstruction procedures. To describe a case series of patients with cerebrovascular lesions who were treated using an occipital artery (OA) to PCA bypass via the occipital interhemispheric approach. Methods: We retrospectively reviewed three consecutive cases of patients with cerebrovascular lesions who were treated using OA-PCA bypass. Results: OA-PCA bypass was performed via the occipital interhemispheric approach. This procedure included: (1) OA-PCA bypass (n = 1), and combined OA-posterior inferior cerebellar artery and OA-PCA saphenous vein interposition graft bypass (n = 1) in patients with vertebrobasilar ischemia; (2) OA-PCA radial artery interposition graft bypass in one patient with residual PCA aneurysm. Conclusions: OA-PCA bypass represents a useful alternative to conventional STA-SCA or PCA bypass. PMID:23956933

Aspirin decreases platelet uptake on Dacron vascular grafts in baboons

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

Mackey, W.C.; Connolly, R.J.; Callow, A.D.

The influence of a single dose of aspirin (5.4-7.4 mg/kg) on platelet uptake on 4-mm Dacron interposition grafts was studied in a baboon model using gamma camera scanning for 111-Indium labeled platelets. In vitro assessment of platelet function after aspirin administration revealed that in the baboon, as in the human, aspirin abolished arachidonic acid-induced platelet aggregation, prolonged the lag time between exposure to collagen and aggregation, and decreased plasma thromboxane B2 levels. Aspirin also prolonged the template bleeding time. Scans for 111-Indium labeled platelets revealed that pretreatment with a single dose of aspirin decreased platelet uptake on 4-mm Dacron carotidmore » interposition grafts. This decrease in platelet uptake was associated with a significant improvement in 2-hour graft patency and with a trend toward improved 2-week patency.« less

Characteristics of Extra Narrow Gap Weld of HSLA Steel Welded by Single-Seam per Layer Pulse Current GMA Weld Deposition

NASA Astrophysics Data System (ADS)

Agrawal, B. P.; Ghosh, P. K.

2017-03-01

Butt weld joints are produced using pulse current gas metal arc welding process by employing the technique of centrally laid multi-pass single-seam per layer weld deposition in extra narrow groove of thick HSLA steel plates. The weld joints are prepared by using different combination of pulse parameters. The selection of parameter of pulse current gas metal arc welding is done considering a summarized influence of simultaneously interacting pulse parameters defined by a dimensionless hypothetical factor ϕ. The effect of diverse pulse parameters on the characteristics of weld has been studied. Weld joint is also prepared by using commonly used multi-pass multi-seam per layer weld deposition in conventional groove. The extra narrow gap weld joints have been found much superior to the weld joint prepared by multi-pass multi-seam per layer deposition in conventional groove with respect to its metallurgical characteristics and mechanical properties.

Revascularization of the anterior cerebral artery by Y-shaped superficial temporal artery interposition graft for the treatment of a de novo aneurysm arising at the site of A3-A3 bypass: technical case report.

PubMed

Endo, Hidenori; Sugiyama, Shin-Ichiro; Endo, Toshiki; Fujimura, Miki; Shimizu, Hiroaki; Tominaga, Teiji

2017-12-22

The most frequently used option to reconstruct the anterior cerebral artery (ACA) is an ACA-ACA side-to-side anastomosis. The long-term outcome and complications of this technique are unclear. The authors report a case of a de novo aneurysm arising at the site of A 3 -A 3 anastomosis. A 53-year-old woman underwent A 3 -A 3 side-to-side anastomosis for the treatment of a ruptured right A 2 dissecting aneurysm. At 44 months after surgery, a de novo aneurysm developed at the site of anastomosis. The aneurysm developed in the front wall of the anastomosis site, and projected to the anterosuperior direction. A computational fluid dynamics (CFD) study showed the localized region with high wall shear stress coincident with the pulsation in the front wall of the anastomosis site, where the aneurysm developed. A Y-shaped superficial temporal artery (STA) interposition graft was used successfully to reconstruct both ACAs, and then the aneurysm was trapped. To the authors' knowledge, this is the first case of a de novo aneurysm that developed at the site of an ACA-ACA side-to-side anastomosis. A CFD study showed that hemodynamic stress might be an underlying cause of the aneurysm formation. A Y-shaped STA interposition graft is a useful option to treat this aneurysm. Long-term follow-up is necessary to detect this rare complication after ACA-ACA anastomosis.

Relationship between colon and kidney: a critical point for percutaneous procedures.

PubMed

Atar, Murat; Hatipoglu, Namik Kemal; Soylemez, Haluk; Penbegul, Necmettin; Bozkurt, Yasar; Gumus, Hatice; Sancaktutar, Ahmet Ali; Kuday, Suzan; Bodakci, Mehmet Nuri

2013-04-01

The aim of this study was to determine the frequency of anatomical variations of the colon associated with the kidney. A retrospective analysis was performed on 1000 consecutive abdominal computed tomography (CT) scans performed between July 2010 and September 2011. A line parallel to the horizontal plane was drawn through the posterior edge of each kidney at three renal levels: upper, middle and lower pole. The bowel between the psoas muscle and the kidney was determined as the interposition of the colon. The amount of perinephric fat was estimated and graded. The total number of patients undergoing CT scans was 1000 (male/female = 510/490). The mean age of patients was 42.2 years. Seventeen patients (1.7%) had retrorenal colon, of which 12 (1.2%) were on the left side, three (0.3%) on the right side and two (0.2%) were bilateral. Of these 17 cases, 11 were found at the lower, two at the middle and four at the upper pole of the kidney. There was grade I perirenal fat tissue in 13 and grade II in four cases. Interposition of the colon was detected in 32 (3.2%) patients, 30 (3%) on the right and two (0.2%) on the left. The grade of perirenal fat tissue in patients with colon interposition was as follows: 25 patients grade I, six patients grade II and one patient grade III. In accessing the lower pole of the kidney, especially on the left side, the risk of colonic injury should be taken into consideration during percutaneous procedures, regardless of the patient's age and gender.

The Impact of Nitinol Staples on the Compressive Forces, Contact Area, and Mechanical Properties in Comparison to a Claw Plate and Crossed Screws for the First Tarsometatarsal Arthrodesis.

PubMed

Aiyer, Amiethab; Russell, Nicholas A; Pelletier, Matthew H; Myerson, Mark; Walsh, William R

2016-06-01

Background The optimal fixation method for the first tarsometatarsal arthrodesis remains controversial. This study aimed to develop a reproducible first tarsometatarsal testing model to evaluate the biomechanical performance of different reconstruction techniques. Methods Crossed screws or a claw plate were compared with a single or double shape memory alloy staple configuration in 20 Sawbones models. Constructs were mechanically tested in 4-point bending to 1, 2, and 3 mm of plantar displacement. The joint contact force and area were measured at time zero, and following 1 and 2 mm of bending. Peak load, stiffness, and plantar gapping were determined. Results Both staple configurations induced a significantly greater contact force and area across the arthrodesis than the crossed screw and claw plate constructs at all measurements. The staple constructs completely recovered their plantar gapping following each test. The claw plate generated the least contact force and area at the joint interface and had significantly greater plantar gapping than all other constructs. The crossed screw constructs were significantly stiffer and had significantly less plantar gapping than the other constructs, but this gapping was not recoverable. Conclusions Crossed screw fixation provides a rigid arthrodesis with limited compression and contact footprint across the joint. Shape memory alloy staples afford dynamic fixation with sustained compression across the arthrodesis. A rigid polyurethane foam model provides an anatomically relevant comparison for evaluating the interface between different fixation techniques. Clinical Relevance The dynamic nature of shape memory alloy staples offers the potential to permit early weight bearing and could be a useful adjunctive device to impart compression across an arthrodesis of the first tarsometatarsal joint. Therapeutic, Level V: Bench testing. © 2015 The Author(s).

Shimmed electron beam welding process

DOEpatents

Feng, Ganjiang; Nowak, Daniel Anthony; Murphy, John Thomas

2002-01-01

A modified electron beam welding process effects welding of joints between superalloy materials by inserting a weldable shim in the joint and heating the superalloy materials with an electron beam. The process insures a full penetration of joints with a consistent percentage of filler material and thereby improves fatigue life of the joint by three to four times as compared with the prior art. The process also allows variable shim thickness and joint fit-up gaps to provide increased flexibility for manufacturing when joining complex airfoil structures and the like.

Reduced heat input keyhole welding through improved joint design

NASA Technical Reports Server (NTRS)

Sanders, John M. (Inventor); Harwig, Dennis D. (Inventor)

1993-01-01

An improved high energy density welding method for reducing input keyhole welding prepares the weld joint (8) between two edges (10, 14) of at least one member by separating the edges (10, 14) of the member (12, 16) with a controllable gap (22) by a projecting portion (24) selectively positioned on one edge (10, 14) of the member (12, 16). The projecting portion (24) closely abuts the other edge of the member for maintaining the controlled distance (d) of the controllable gap (22) to enhance the welding method.

Lateral column lengthening using allograft interposition and cervical plate fixation.

PubMed

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

2008-10-01

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

Gap compression/extension mechanism of bacterial flagellar hook as the molecular universal joint.

PubMed

Furuta, Tadaomi; Samatey, Fadel A; Matsunami, Hideyuki; Imada, Katsumi; Namba, Keiichi; Kitao, Akio

2007-03-01

Bacterial flagellar hook acts as a molecular universal joint, transmitting torque produced by the flagellar basal body, a rotary motor, to the flagellar filament. The hook forms polymorphic supercoil structures and can be considered as an assembly of 11 circularly arranged protofilaments. We investigated the molecular mechanism of the universal joint function of the hook by a approximately two-million-atom molecular dynamics simulation. On the inner side of the supercoil, protein subunits are highly packed along the protofilament and no gaps remain for further compression, whereas subunits are slightly separated and are hydrogen bonded through one layer of water molecules on the outer side. As for the intersubunit interactions between protofilaments, subunits are packed along the 6-start helix in a left-handed supercoil whereas they are highly packed along the 5-start helix in a right-handed supercoil. We conclude that the supercoiled structures of the hook in the left- and right-handed forms make maximal use of the gaps between subunits, which we call "gap compression/extension mechanism". Mutual sliding of subunits at the subunit interface accompanying rearrangements of intersubunit hydrogen bonds is interpreted as a mechanism to allow continuous structural change of the hook during flagellar rotation at low energy cost.

Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder

PubMed Central

Anley, Cameron M; Chan, Samuel KL; Snow, Martyn

2014-01-01

The management of patients with irreparable rotator cuff tears remains a challenge for orthopaedic surgeons with the final treatment option in many algorithms being either a reverse shoulder arthroplasty or a tendon transfer. The long term results of these procedures are however still widely debated, especially in younger patients. A variety of arthroscopic treatment options have been proposed for patients with an irreparable rotator cuff tear without the presence of arthritis of the glenohumeral joint. These include a simple debridement with or without a biceps tenotomy, partial rotator cuff repair with or without an interval slide, tuberplasty, graft interposition of the rotator cuff, suprascapular nerve ablation, superior capsule reconstruction and insertion of a biodegradable spacer (Inspace) to depress the humeral head. These options should be considered as part of the treatment algorithm in patients with an irreparable rotator cuff and could be used as either as an interim procedure, delaying the need for more invasive surgery in the physiologically young and active, or as potential definitive procedures in the medically unfit. The aim of this review is to highlight and summarise arthroscopic procedures and the results thereof currently utilised in the management of these challenging patients. PMID:25405083

Zero-profile Anchored Spacer Reduces Rate of Dysphagia Compared With ACDF With Anterior Plating.

PubMed

Hofstetter, Christoph P; Kesavabhotla, Kartik; Boockvar, John A

2015-06-01

Retrospective cohort study. To study clinical and radiologic outcomes after anterior cervical discectomy and fusion (ACDF) using a zero-profile anchored spacer compared with a standard interposition graft with anterior plating. Anterior plating increases fusion rates in ACDF but is associated with higher rates of postoperative dysphagia. Reduction of plate thickness or zero-profile fixation of the interposition graft have been suggested to decrease the incidence of postoperative dysphagia. Retrospective cohort study of 70 consecutive patients of whom the first 35 patients underwent ACDF with anterior plating and the remaining patients received an LDR device. Patient demographics, operative details, neurological impairment, complications, and radiographic imaging were reviewed. Dysphagia occurring in the immediate postoperative period and lasting for >3 months was recorded. Both the zero-profile anchored spacer and a standard interposition graft with anterior plating resulted in improvement of neurological outcome at a mean follow-up time of 13.9 months. Fusion rates were found to be similar between ACDF with anterior plating (96.0%) and LDR (95.2%). Evaluation of postoperative radiographs revealed significantly more swelling of the prevertebral space (20.4±0.9 mm) after implantation of an anterior locking plate compared with a zero-profile device (15.6±0.7 mm, P<0.001). This difference remained significant at 6-month follow-up (P=0.035). Seven patients (20%) with ACDF and plating complained about swallowing difficulties beyond 3 months compared with only 1 patient with the LDR device (P=0.027). The severity of dysphagia was mild in all but 2 patients. Both patients with moderate and severe swallowing difficulties had undergone ACDF with anterior plating. Zero-profile anchored spacers lead to similar clinical and radiographic outcomes compared with ACDF with plating and may carry a lower risk of postoperative dysphagia.

Alaska's Dependence on State Spending. ISER Fiscal Policy Papers, No. 5.

ERIC Educational Resources Information Center

Goldsmith, Scott; And Others

Alaska will face a large fiscal gap and growing budget deficits in the near future. The timing of such fiscal gap open hinges on the joint effect of state budget growth and the oil price change. This paper explains Alaska's dependence on state spending and offers policy options addressing the fiscal gap. State spending: (1) supports nearly one in…

Subcutaneous pedicle propeller flap: An old technique revisited and modified!

PubMed Central

Karki, Durga; Mehta, Nikhil; Narayan, Ravi Prakash

2016-01-01

Background: Post-burn axillary and elbow scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction and extension that should be achieved, respectively, while treating either of the joint. The aim of this paper is to highlight the use of subcutaneous pedicle propeller flap for the management of post-burn axillary and elbow contractures. Methodology: This is a prospective case study of axillary and elbow contractures managed at a tertiary care hospital using propeller flap based on subcutaneous pedicle from 2009 to 2014. Surgical treatment comprised of subcutaneous-based pedicle propeller flap from the normal tissue within the contracture based on central axis pedicle. The flap was rotated axially to break the contracture. The technique further encompassed a modification, a Zig-Zag incision of the flap, which was seen to prevent hypertrophy along the incision line. There was a mean period of 12 months of follow-up. Results: Thirty-eight patients consisting of 22 males and 16 females were included in this study among which 23 patients had Type II axillary contractures and 15 had moderate flexion contractures at elbow joint. The post-operative abduction achieved at shoulder joint had a mean of 168° whereas extension achieved at elbow had a mean of 175°. The functional and aesthetic results were satisfactory. Conclusion: The choice of surgical procedure for reconstruction of post-burn upper extremity contractures should be made according to the pattern of scar contracture and the state of surrounding skin. The choice of subcutaneous pedicle propeller flap should be emphasised because of the superior functional results of flap as well as ease to learn it. Moreover, the modification of propeller flap described achieves better results in terms of scar healing. There is an inter-positioning of healthy skin in between the graft, so it prevents scar band formation all around the flap. PMID:27833285

Subcutaneous pedicle propeller flap: An old technique revisited and modified!

PubMed

Karki, Durga; Mehta, Nikhil; Narayan, Ravi Prakash

2016-01-01

Post-burn axillary and elbow scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction and extension that should be achieved, respectively, while treating either of the joint. The aim of this paper is to highlight the use of subcutaneous pedicle propeller flap for the management of post-burn axillary and elbow contractures. This is a prospective case study of axillary and elbow contractures managed at a tertiary care hospital using propeller flap based on subcutaneous pedicle from 2009 to 2014. Surgical treatment comprised of subcutaneous-based pedicle propeller flap from the normal tissue within the contracture based on central axis pedicle. The flap was rotated axially to break the contracture. The technique further encompassed a modification, a Zig-Zag incision of the flap, which was seen to prevent hypertrophy along the incision line. There was a mean period of 12 months of follow-up. Thirty-eight patients consisting of 22 males and 16 females were included in this study among which 23 patients had Type II axillary contractures and 15 had moderate flexion contractures at elbow joint. The post-operative abduction achieved at shoulder joint had a mean of 168° whereas extension achieved at elbow had a mean of 175°. The functional and aesthetic results were satisfactory. The choice of surgical procedure for reconstruction of post-burn upper extremity contractures should be made according to the pattern of scar contracture and the state of surrounding skin. The choice of subcutaneous pedicle propeller flap should be emphasised because of the superior functional results of flap as well as ease to learn it. Moreover, the modification of propeller flap described achieves better results in terms of scar healing. There is an inter-positioning of healthy skin in between the graft, so it prevents scar band formation all around the flap.

Can interposition of a silicone implant after sapheno-femoral ligation prevent recurrent varicose veins?

PubMed

De Maeseneer, M G; Giuliani, D R; Van Schil, P E; De Hert, S G

2002-11-01

To investigate whether a silicone implant at the sapheno-femoral ligation site could prevent recurrent varicosities. Two non-randomised groups of patients were studied prospectively. In group A 173 patients and 212 limbs had sapheno-femoral ligation, while 172 patients and 210 limbs additionally had a piece (2x3cm) of silicone sheet sutured to the saphenous stump to cover the anterior half of the common femoral vein. The implant was fixed in apposition to the deep vein by carefully closing the cribriform fascia. Colour duplex scanning was performed after 2 and 12 months. In the no implant group neovascularisation was observed in 35 (17%) after 12 months, but only in 13 (6%) limbs treated with a silicone implant (p<0.05). Interposition of a partition of silicone implant seems to lower the incidence of neovascularisation one year after saphenofemoral ligation. This technique may constitute an efficient method to prevent recurrence at the correctly ligated saphenous stump.

Treatment of postparotidectomy Frey syndrome with the interposition of temporalis fascia and sternocleidomastoid flaps.

PubMed

Dai, Xiao-Ming; Liu, Hua; He, Jia; Tu, Min-Song; Yu, Li-Fu; Liu, Liu

2015-05-01

This study was performed to evaluate the effectiveness of overlapping the temporalis fascia flaps (TFFs) and the sternocleidomastoid muscle flaps (SCMFs) as physical barriers to treat established Frey syndrome and concavity after parotidectomy. We retrospectively reviewed 17 patients who underwent corrective procedures with simultaneous TFF and SCMF interposition for the treatment of Frey syndrome. The affected areas of the cheek skin were identified with starch-iodine tests. The facial contours of the patients were classified as bilaterally symmetric (BS), with a slightly shallow (SS) contour on the surgical side, or with a conspicuously shallow (CS) contour on the surgical side. The sample was followed up for a mean of 22 months. The average area of gustatory-sweating positive skin was reduced from 12.80 to 1.32 square centimeters postoperatively. The facial asymmetry secondary to parotidectomy was greatly improved. The authors concluded that this technique was efficacious in ameliorating Frey syndrome and facial concavity secondary to parotidectomy. Copyright © 2015 Elsevier Inc. All rights reserved.

Heterotopic ossification of the elbow after closed reduction and retrograde intramedullary nailing for radial neck fracture treated by anconeus interposition.

PubMed

Sreenivas, T; Menon, Jagdish; Nataraj, A R

2013-12-01

Heterotopic ossification around the elbow can lead to considerable functional disability. We describe a case of a 42-year-old man who developed heterotopic ossification of his elbow after closed reduction of the elbow dislocation and radial neck fracture and retrograde intramedullary nailing for radial neck fracture. During the follow-up after initial surgery, movements of the elbow were gradually deteriorated and diagnosed as heterotopic ossification of the elbow. Implant removal, radial head excision along with heterotopic mass, and also interposition of the anconeus muscle resulted in improvement of his elbow mobility. At 18 months of follow-up, patient had elbow flexion arc of 15°-110°, 70° of supination, and 50° of pronation without recurrence of heterotopic ossification. The uniqueness of this case lies in the treatment of heterotopic ossification of the elbow to prevent its recurrence, which was developed after retrograde intramedullary nailing for radial neck fracture following closed reduction.

Application of Composite Indices for Improving Joint Detection Capabilities of Instrumented Roof Bolt Drills in Underground Mining and Construction

NASA Astrophysics Data System (ADS)

Liu, Wenpeng; Rostami, Jamal; Elsworth, Derek; Ray, Asok

2018-03-01

Roof bolts are the dominant method of ground support in mining and tunneling applications, and the concept of using drilling parameters from the bolter for ground characterization has been studied for a few decades. This refers to the use of drilling data to identify geological features in the ground including joints and voids, as well as rock classification. Rock mass properties, including distribution of joints/voids and strengths of rock layers, are critical factors for proper design of ground support to avoid instability. The goal of this research was to improve the capability and sensitivity of joint detection programs based on the updated pattern recognition algorithms in sensing joints with smaller than 3.175 mm (0.125 in.) aperture while reducing the number of false alarms, and discriminating rock layers with different strengths. A set of concrete blocks with different strengths were used to simulate various rock layers, where the gap between the blocks would represent the joints in laboratory tests. Data obtained from drilling through these blocks were analyzed to improve the reliability and precision of joint detection systems. While drilling parameters can be used to detect the gaps, due to low accuracy of the results, new composite indices have been introduced and used in the analysis to improve the detection rates. This paper briefly discusses ongoing research on joint detection by using drilling parameters collected from a roof bolter in a controlled environment. The performances of the new algorithms for joint detection are also examined by comparing their ability to identify existing joints and reducing false alarms.

Effects of joint configuration for the arc welding of cast Ti-6Al-4V alloy rods in argon.

PubMed

Taylor, J C; Hondrum, S O; Prasad, A; Brodersen, C A

1998-03-01

Titanium and its alloys are more commonly used in prosthodontics and welding has become the most common modality for their joining. Studies on the welding of titanium and its alloys have not quantified this value, though its importance has been suggested. This study compared the strength and properties of the joint achieved at various butt joint gaps by the arc-welding of cast Ti-6Al-4V alloy tensile bars in an argon atmosphere. Forty of 50 specimens were sectioned and welded at four gaps. All specimens underwent tensile testing to determine ultimate tensile strength and percentage elongation, then oxygen analysis and scanning electron microscopy. As no more than 3 samples in any group of 10 actually fractured in the weld itself, a secondary analysis that involved fracture location was initiated. There were no differences in ultimate tensile strength or percentage elongation between specimens with weld gaps of 0.25, 0.50, 0.75, and 1.00 mm and the as-cast specimens. There were no differences in ultimate tensile strength between specimens fracturing in the weld and those fracturing in the gauge in welded specimens; however, as-cast specimens demonstrated a higher ultimate tensile strength than welded specimens that fractured in the weld. Specimens that fractured in the weld site demonstrated less ductility than those that fractured in the gauge in both welded and as-cast specimens, as confirmed by scanning electron microscopy examination. The weld wire showed an oxygen scavenging effect from the as-cast parent alloy. The effects of the joint gap were not significant, whereas the characteristics of the joint itself were, which displayed slightly lower strength and significantly lower ductility (and thus decreased toughness). The arc-welding of cast titanium alloy in argon atmosphere appears to be a reliable and efficient prosthodontic laboratory modality producing predictable results, although titanium casting and joining procedures must be closely controlled to minimize heat effects and oxygen contamination.

Equal Pay for Working Families. National and State Data on the Pay Gap and Its Costs. A Joint Research Project.

ERIC Educational Resources Information Center

Hartmann, Heidi; Allen, Katherine; Owens, Christine

A national study, including state-by-state breakouts, analyzed Census Bureau and Bureau of Labor Statistics data to explore the wage gap. Median weekly earnings of men and women and of minorities and nonminorities were analyzed. Gender-based earnings differences and gender wage gaps were large for all women--and especially large for minority…

Inspection criteria ensure quality control of parallel gap soldering

NASA Technical Reports Server (NTRS)

Burka, J. A.

1968-01-01

Investigation of parallel gap soldering of electrical leads resulted in recommendation on material preparation, equipment, process control, and visual inspection criteria to ensure reliable solder joints. The recommendations will minimize problems in heat-dwell time, amount of solder, bridging conductors, and damage of circuitry.

Bronchobiliary fistula: principles of management.

PubMed

Chua, H K; Allen, M S; Deschamps, C; Miller, D L; Pairolero, P C

2000-10-01

Bronchobiliary fistula is an uncommon entity. Recently, we encountered 2 patients with this problem. Both were treated successfully with resection of the involved pulmonary tissue and interposition of viable tissue between the lung and the fistulous tract. This approach, although invasive, provided a rapid resolution of the patients' problem.

Data correlation and analysis of arc tunnel and wind tunnel tests of RSI joints and gaps. Volume 2: Data base

NASA Technical Reports Server (NTRS)

Christensen, H. E.; Kipp, H. W.

1974-01-01

Wind tunnel tests were conducted to determine the aerodynamic heating created by gaps in the reusable surface insulation (RSI) thermal protection system (TPS) for the space shuttle. The effects of various parameters of the RSI on convective heating characteristics are described. The wind tunnel tests provided a data base for accurate assessment of gap heating. Analysis and correlation of the data provide methods for predicting heating in the RSI gaps on the space shuttle.

Functional Gap Analysis of the Maritime Operations Centers

DTIC Science & Technology

2009-12-01

Messaging Services TBMCS , DJC2 MI.1.3.5 Manage Suspense Control Capability Gap MI.1.3.6 Provide Component IM Cell Services Capability Gap MI.1.4 Provide...Admin Support MSRT MI.1.3.3 Manage Electronic File Plan Capability Gap MI.1.3.4 Manage Messaging Services TBMCS , DJC2 MI.1.3.5 Manage Suspense...1.5.9 Execute C4 Policies & Procedures for the Joint Operations Area GCCS-J, DCGS-N, TBMCS , CENTRIX-M EHQ.1.11 Sub Component Interagency

Development of a procedure for forming assisted thermal joining of tubes

NASA Astrophysics Data System (ADS)

Chen, Hui; Löbbe, Christian; Staupendahl, Daniel; Tekkaya, A. Erman

2018-05-01

With the demand of lightweight design in the automotive industry, not only the wall-thicknesses of tubular components of the chassis or spaceframe are continuously decreased. Also the thicknesses of exhaust system parts are reduced to save material and mass. However, thinner tubular parts bring about additional challenges in joining. Welding or brazing methods, which are utilized in joining tubes with specific requirements concerning leak tightness, are sensitive to the gap between the joining partners. Furthermore, a large joining area is required to ensure the durability of the joint. The introduction of a forming step in the assembled state prior to thermal joining can define and control the gap for subsequent brazing or welding. The mechanical pre-joint resulting from the previously described calibration step also results in easier handling of the tubes prior to thermal joining. In the presented investigation, a spinning process is utilized to produce force-fit joints of varying lengths and diameter reduction and form-fit joints with varying geometrical attributes. The spinning process facilitates a high formability and geometrical flexibility, while at the achievable precision is high and the process forces are low. The strength of the joints is used to evaluate the joint quality. Finally, a comparison between joints produced by forming with subsequent brazing and original tube is conducted, which presents the high performance of the developed procedure for forming assisted thermal joining.

Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

PubMed

Gemeda, Desta Hiko; Sime, Abiot Girma; Hajito, Kifle Woldemichael; Gelalacha, Benti Deresa; Tafese, Wubit; Gebrehiwot, Tsegaye Tewelde

2016-01-01

Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance.

Postoperative Knee Flexion Angle Is Affected by Lateral Laxity in Cruciate-Retaining Total Knee Arthroplasty.

PubMed

Nakano, Naoki; Matsumoto, Tomoyuki; Muratsu, Hirotsugu; Takayama, Koji; Kuroda, Ryosuke; Kurosaka, Masahiro

2016-02-01

Although many studies have reported that postoperative knee flexion is influenced by preoperative conditions, the factors which affect postoperative knee flexion have not been fully elucidated. We tried to investigate the influence of intraoperative soft tissue balance on postoperative knee flexion angle after cruciate-retaining (CR) total knee arthroplasty (TKA) using a navigation and an offset-type tensor. We retrospectively analyzed 55 patients with osteoarthritis who underwent TKA using e.motion-CR (B. Braun Aesculap, Germany) whose knee flexion angle could be measured at 2 years after operation. The exclusion criteria included valgus deformity, severe bony defect, infection, and bilateral TKA. Intraoperative varus ligament balance and joint component gap were measured with the navigation (Orthopilot 4.2; B. Braun Aesculap) while applying 40-lb joint distraction force at 0° to 120° of knee flexion using an offset-type tensor. Correlations between the soft tissue parameters and postoperative knee flexion angle were analyzed using simple linear regression models. Varus ligament balance at 90° of flexion (R = 0.56; P < .001) and lateral compartment gap at 90° of flexion (R = 0.51; P < .001) were positively correlated with postoperative knee flexion angle. In addition, as with past studies, joint component gap at 90° of flexion (R = 0.30; P < .05) and preoperative knee flexion angle (R = 0.63; P < .001) were correlated with postoperative knee flexion angle. Lateral laxity as well as joint component gap at 90° of flexion is one of the most important factors affecting postoperative knee flexion angle in CR-TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

78 FR 17454 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... information barriers, that operate to prevent one trading unit from obtaining knowledge of customer orders... respect to customer orders involving securities for which there is limited pricing information or... Change Relating to Trading Ahead of Customer Orders and Best Execution and Interpositioning Requirements...

Hole of Government: Sealing the Gap in U.S. Stability Operations

DTIC Science & Technology

2010-06-15

including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215... Gap in U.S. Stability Operations” 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR (S) Commander Patrick J...THE GAP IN U.S. STABILITY OPERATIONS by Patrick J. Hannifin CDR, USN A paper submitted to the Faculty of the Joint Advanced

Initial results of finger imaging using photoacoustic computed tomography

NASA Astrophysics Data System (ADS)

van Es, Peter; Biswas, Samir K.; Moens, Hein J. Bernelot; Steenbergen, Wiendelt; Manohar, Srirang

2014-06-01

We present a photoacoustic computed tomography investigation on a healthy human finger, to image blood vessels with a focus on vascularity across the interphalangeal joints. The cross-sectional images were acquired using an imager specifically developed for this purpose. The images show rich detail of the digital blood vessels with diameters between 100 μm and 1.5 mm in various orientations and at various depths. Different vascular layers in the skin including the subpapillary plexus could also be visualized. Acoustic reflections on the finger bone of photoacoustic signals from skin were visible in sequential slice images along the finger except at the location of the joint gaps. Not unexpectedly, the healthy synovial membrane at the joint gaps was not detected due to its small size and normal vascularization. Future research will concentrate on studying digits afflicted with rheumatoid arthritis to detect the inflamed synovium with its heightened vascularization, whose characteristics are potential markers for disease activity.

[Lysis of the incus long process and incudostapedial rebridging ossiculoplasty: comparative study of titanium-gold angle prosthesis Plester-type versus Martin Incudo prosthesis hydroxylapatite].

PubMed

Faye, M B; Martin, C; Schmerber, S

2013-01-01

We report two surgical techniques devised to restore a disrupted incudostapedial joint. Thirty patients underwent rebridging of distal portion of incus long process in the ENT Department of University of Grenoble and Saint-Etienne, between October 1998 and September 2002. Two types of ossicular prostheses were used: A titanium-gold angle prosthesis according to Plester Winkel Kurz (n = 16 patients), and a hydroxylapatite prosthesis as Martin Incudo Prosthesis (n = 14 patients). The average hearing gain in short term is of 8.30 dB for the Martin-Incudo group. It is of 5.23 dB in the Winkel group. Seven and three cases of failures (Residual Rinne > 20 dB) were noticed respectively in the groups Martin-Incudo and Winkel. Seven and four cases of labyrinthisation were observed respectively in the groups Martin-Incudo and Winkel. The average hearing gain in long term is 3.43 dB in the Martin-Incudo group; and 2.85 dB among patients with Winkel Kurz prosthesis. Average residual Rinne is higher than 20 dB in the Winkel group. The hearing gain is not statistically significant between the two groups (p > 0.05). The titanium partial prosthesis did not give good functional results. In the case of a limited lysis (< 2 mm) of the distal portion of incus, we use the cement or cartilage interposition. When ossicular chain cannot be preserved entirely, we privilege incus transposition or a titanium PORP. The Martin-Incudo prosthesis seems interesting in the event of lysis of 2 mm of the long process of incus, nevertheless engineering changes are necessary in order to make rigid the incudostapedial joint.

Periprosthetic wear particle migration and distribution modelling and the implication for osteolysis in cementless total hip replacement.

PubMed

Alidousti, Hamidreza; Taylor, Mark; Bressloff, Neil W

2014-04-01

In total hip replacement (THR), wear particles play a significant role in osteolysis and have been observed in locations as remote as the tip of femoral stem. However, there is no clear understanding of the factors and mechanisms causing, or contributing to particle migration to the periprosthetic tissue. Interfacial gaps provide a route for particle laden joint fluid to transport wear particles to the periprosthetic tissue and cause osteolysis. It is likely that capsular pressure, gap dimensions and micromotion of the gap during cyclic loading of an implant, play defining roles to facilitate particle migration. In order to obtain a better understanding of the above mechanisms and factors, transient two-dimensional computational fluid dynamic simulations have been performed for the flow in the lateral side of a cementless stem-femur system including the joint capsule, a gap in communication with the capsule and the surrounding bone. A discrete phase model to describe particle motion has been employed. Key findings from these simulations include: (1) Particles were shown to enter the periprosthetic tissue along the entire length of the gap but with higher concentrations at both proximal and distal ends of the gap and a maximum rate of particle accumulation in the distal regions. (2) High capsular pressure, rather than gap micromotion, has been shown to be the main driving force for particle migration to periprosthetic tissue. (3) Implant micromotion was shown to pump out rather than draw in particles to the interfacial gaps. (4) Particle concentrations are consistent with known distributions of (i) focal osteolysis at the distal end of the gap and (ii) linear osteolysis along the entire gap length. Copyright © 2014 Elsevier Ltd. All rights reserved.

Narrow gap laser welding

DOEpatents

Milewski, John O.; Sklar, Edward

1998-01-01

A laser welding process including: (a) using optical ray tracing to make a model of a laser beam and the geometry of a joint to be welded; (b) adjusting variables in the model to choose variables for use in making a laser weld; and (c) laser welding the joint to be welded using the chosen variables.

Narrow gap laser welding

DOEpatents

Milewski, J.O.; Sklar, E.

1998-06-02

A laser welding process including: (a) using optical ray tracing to make a model of a laser beam and the geometry of a joint to be welded; (b) adjusting variables in the model to choose variables for use in making a laser weld; and (c) laser welding the joint to be welded using the chosen variables. 34 figs.

Changes in ankle joint motion after Supramalleolar osteotomy: a cadaveric model.

PubMed

Kim, Hak Jun; Yeo, Eui Dong; Rhyu, Im Joo; Lee, Soon-Hyuck; Lee, Yeon Soo; Lee, Young Koo

2017-09-09

Malalignment of the ankle joint has been found after trauma, by neurological disorders, genetic predisposition and other unidentified factors, and results in asymmetrical joint loading. For a medial open wedge supramalleolar osteotomy(SMO), there are some debates as to whether concurrent fibular osteotomy should be performed. We assessed the changes in motion of ankle joint and plantar pressure after supramalleolar osteotomy without fibular osteotomy. Ten lower leg specimens below the knee were prepared from fresh-frozen human cadavers. They were harvested from five males (10 ankles)whose average age was 70 years. We assessed the motion of ankle joint as well as plantar pressure for SS(supra-syndesmotic) SMO and IS(intra-syndesmotic) SMO. After the osteotomy, each specimen was subjected to axial compression from 20 N preload to 350 N representing half-body weight. For the measurement of the motion of ankle joint, the changes in gap and point, angles in ankle joint were measured. The plantar pressure were also recorded using TekScan sensors. The changes in the various gap, point, and angles movements on SS-SMO and IS-SMO showed no statistically significant differences between the two groups. Regarding the shift of plantar center of force (COF) were noted in the anterolateral direction, but not statistically significant. SS-SMO and IS-SMO with intact fibula showed similar biomechanical effect on the ankle joint. We propose that IS-SMO should be considered carefully for the treatment of osteoarthrosis when fibular osteotomy is not performed because lateral cortex fracture was less likely using the intrasyndesmosis plane because of soft tissue support.

Biomechanical study of three kinds of internal fixation for the treatment of sacroiliac joint disruption using biomechanical test and finite element analysis.

PubMed

Wu, Tao; Ren, Xuejiao; Cui, Yunwei; Cheng, Xiaodong; Peng, Shuo; Hou, Zhiyong; Han, Yongtai

2018-06-19

To compare the stability of sacroiliac joint disruption fixed with three kinds of internal fixation using both biomechanical test and finite element analysis. Five embalmed specimens of an adult were used. The symphysis pubis rupture and left sacroiliac joint disruption were created. The symphysis pubis was stabilized with a five-hole plate. The sacroiliac joint disruption was fixed with three kinds of internal fixation in a randomized design. Displacements of the whole specimen and shifts in the gap were recorded. Three-dimensional finite element models of the pelvis, the pelvis with symphysis pubis rupture and left sacroiliac joint disruption, and three kinds of internal fixation techniques were created and analyzed. Under the vertical load, the displacements and shifts in the gap of the pelvis fixed with minimally invasive adjustable plate (MIAP) combined with one iliosacral (IS) screw were the smallest, and the average displacements of the pelvis fixed with an anterior plate were the largest one. The differences among them were significant. In finite element analysis and MIAP combined with one IS screw fixation showed relatively best fixation stability and lowest risks of implant failure than two IS screws fixation and anterior plate fixation. The stability of sacroiliac joint disruption fixed with MIAP combined with one IS screw is better than that fixed with two IS screws and anterior plate under vertical load.

Case report of patients treated with an orthodontic and myofunctional protocol.

PubMed

Saccomanno, S; Antonini, G; D'Alatri, L; D'Angeloantonio, M; Fiorita, A; Deli, R

2014-07-01

Occlusion alterations can be associated to bad habits (such as thumb sucking, oral breathing, atypical swallowing and labial interposition) which can lead to functional anomalies. Three cases are reported with the good results of myofunctional and orthodontic therapy. When there are bad habits, orthodontics should be combined with a myofunctional therapy.

Effect of soldering techniques and gap distance on tensile strength of soldered Ni-Cr alloy joint.

PubMed

Lee, Sang-Yeob; Lee, Jong-Hyuk

2010-12-01

The present study was intended to evaluate the effect of soldering techniques with infrared ray and gas torch under different gap distances (0.3 mm and 0.5 mm) on the tensile strength and surface porosity formation in Ni-Cr base metal alloy. Thirty five dumbbell shaped Ni-Cr alloy specimens were prepared and assigned to 5 groups according to the soldering method and the gap distance. For the soldering methods, gas torch (G group) and infrared ray (IR group) were compared and each group was subdivided by corresponding gap distance (0.3 mm: G3 and IR3, 0.5 mm: G5, IR5). Specimens of the experimental groups were sectioned in the middle with a diamond disk and embedded in solder blocks according to the predetermined distance. As a control group, 7 specimens were prepared without sectioning or soldering. After the soldering procedure, a tensile strength test was performed using universal testing machine at a crosshead speed 1 mm/min. The proportions of porosity on the fractured surface were calculated on the images acquired through the scanning electronic microscope. Every specimen of G3, G5, IR3 and IR5 was fractured on the solder joint area. However, there was no significant difference between the test groups (P > .05). There was a negative correlation between porosity formation and tensile strength in all the specimens in the test groups (P < .05). There was no significant difference in ultimate tensile strength of joints and porosity formations between the gas-oxygen torch soldering and infrared ray soldering technique or between the gap distance of 0.3 mm and 0.5 mm.

Effect of soldering techniques and gap distance on tensile strength of soldered Ni-Cr alloy joint

PubMed Central

Lee, Sang-Yeob

2010-01-01

PURPOSE The present study was intended to evaluate the effect of soldering techniques with infrared ray and gas torch under different gap distances (0.3 mm and 0.5 mm) on the tensile strength and surface porosity formation in Ni-Cr base metal alloy. MATERIALS AND METHODS Thirty five dumbbell shaped Ni-Cr alloy specimens were prepared and assigned to 5 groups according to the soldering method and the gap distance. For the soldering methods, gas torch (G group) and infrared ray (IR group) were compared and each group was subdivided by corresponding gap distance (0.3 mm: G3 and IR3, 0.5 mm: G5, IR5). Specimens of the experimental groups were sectioned in the middle with a diamond disk and embedded in solder blocks according to the predetermined distance. As a control group, 7 specimens were prepared without sectioning or soldering. After the soldering procedure, a tensile strength test was performed using universal testing machine at a crosshead speed 1 mm/min. The proportions of porosity on the fractured surface were calculated on the images acquired through the scanning electronic microscope. RESULTS Every specimen of G3, G5, IR3 and IR5 was fractured on the solder joint area. However, there was no significant difference between the test groups (P > .05). There was a negative correlation between porosity formation and tensile strength in all the specimens in the test groups (P < .05). CONCLUSION There was no significant difference in ultimate tensile strength of joints and porosity formations between the gas-oxygen torch soldering and infrared ray soldering technique or between the gap distance of 0.3 mm and 0.5 mm. PMID:21264189

Rehabilitation of the trigeminal nerve

PubMed Central

Iro, Heinrich; Bumm, Klaus; Waldfahrer, Frank

2005-01-01

When it comes to restoring impaired neural function by means of surgical reconstruction, sensory nerves have always been in the role of the neglected child when compared with motor nerves. Especially in the head and neck area, with its either sensory, motor or mixed cranial nerves, an impaired sensory function can cause severe medical conditions. When performing surgery in the head and neck area, sustaining neural function must not only be highest priority for motor but also for sensory nerves. In cases with obvious neural damage to sensory nerves, an immediate neural repair, if necessary with neural interposition grafts, is desirable. Also in cases with traumatic trigeminal damage, an immediate neural repair ought to be considered, especially since reconstructive measures at a later time mostly require for interposition grafts. In terms of the trigeminal neuralgia, commonly thought to arise from neurovascular brainstem compression, a pharmaceutical treatment is considered as the state of the art in terms of conservative therapy. A neurovascular decompression of the trigeminal root can be an alternative in some cases when surgical treatment is sought after. Besides the above mentioned therapeutic options, alternative treatments are available. PMID:22073060

Simulating the Structural Response of a Preloaded Bolted Joint

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Phillips, Dawn R.; Raju, Ivatury S.

2008-01-01

The present paper describes the structural analyses performed on a preloaded bolted-joint configuration. The joint modeled was comprised of two L-shaped structures connected together using a single bolt. Each L-shaped structure involved a vertical flat segment (or shell wall) welded to a horizontal segment (or flange). Parametric studies were performed using elasto-plastic, large-deformation nonlinear finite element analyses to determine the influence of several factors on the bolted-joint response. The factors considered included bolt preload, washer-surface-bearing size, edge boundary conditions, joint segment length, and loading history. Joint response is reported in terms of displacements, gap opening, and surface strains. Most of the factors studied were determined to have minimal effect on the bolted-joint response; however, the washer-bearing-surface size affected the response significantly.

STS-115 MS MacLean holds Yeast GAP in the FWD MDDK of the Space Shuttle Atlantis during Joint Operations

NASA Image and Video Library

2006-09-19

S115-E-07273 (9-21 Sept. 2006) --- Astronaut Heidemarie M. Stefanyshyn-Piper, STS-115 mission specialist, works with the Yeast-Group Activation Packs (Yeast-GAP) on the middeck of Space Shuttle Atlantis. Yeast-GAP experiment studies the effects of genetic changes of yeast cells exposed to the space environment. The results will help scientists to understand how cells respond to radiation and microgravity.

STS-115 MS MacLean holds Yeast GAP in the FWD MDDK of the Space Shuttle Atlantis during Joint Operations

NASA Image and Video Library

2006-09-19

S115-E-07274 (9-21 Sept. 2006) --- Astronaut Heidemarie M. Stefanyshyn-Piper, STS-115 mission specialist, works with the Yeast-Group Activation Packs (Yeast-GAP) on the middeck of Space Shuttle Atlantis. Yeast-GAP experiment studies the effects of genetic changes of yeast cells exposed to the space environment. The results will help scientists to understand how cells respond to radiation and microgravity.

Is It Safe to Re-Harvest the Anterior Iliac Crest to Manage Le Fort I Interpositional Defects in Young Adults With a Repaired Cleft?

PubMed

Posnick, Jeffrey C; Gray, James A

2015-12-01

Re-harvesting the anterior iliac crest to obtain autogenous bone grafts is a controversial practice. The purpose of this study was to assess the feasibility and associated disability of re-harvesting the anterior iliac crest. To address the research purpose, the authors executed a retrospective case series study. The sample consisted of young adult patients with cleft (<26 yr old) with prior harvesting of the anterior iliac crest during mixed dentition for management of an alveolar cleft(s) and then re-harvesting of the same donor site for management of interpositional defects after Le Fort I advancement. Wound-healing parameters were reviewed at the donor and recipient sites. A survey questionnaire was provided after completion of treatment to document patient perception of early and any long-term donor-site disability. Descriptive statistics were computed for the variables. The sample was composed of 27 patients with a mean age at re-harvesting of 17 years (range, 14 to 25 yr). Patients underwent on average 7.4-mm horizontal advancement, 2.4-mm lengthening, and 2.6-mm transverse expansion of the maxilla. Adequate bone graft was re-harvested to accomplish objectives in all cases. There were no perioperative complications at the donor or recipient sites. Twenty-six of the 27 patients (97%) had fewer donor-site recovery difficulties at the time of re-harvesting compared with the first time graft was taken. There were no cases of lateral femoral cutaneous nerve injury and no long-term discomfort with walking, running, or other activities. The study confirms the safety and efficacy of re-harvesting corticocancellous bone from the anterior iliac crest for management of interpositional defects associated with Le Fort I advancement in young adults with a repaired cleft. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Interaction of color and geometric cues in depth perception: when does "red" mean "near"?

PubMed

Guibal, Christophe R C; Dresp, Birgitta

2004-12-01

Luminance and color are strong and self-sufficient cues to pictorial depth in visual scenes and images. The present study investigates the conditions under which luminance or color either strengthens or overrides geometric depth cues. We investigated how luminance contrast associated with the color red and color contrast interact with relative height in the visual field, partial occlusion, and interposition to determine the probability that a given figure presented in a pair is perceived as "nearer" than the other. Latencies of "near" responses were analyzed to test for effects of attentional selection. Figures in a pair were supported by luminance contrast (Experiment 1) or isoluminant color contrast (Experiment 2) and combined with one of the three geometric cues. The results of Experiment 1 show that the luminance contrast of a color (here red), when it does not interact with other colors, produces the same effects as achromatic luminance contrasts. The probability of "near" increases with the luminance contrast of the color stimulus, the latencies for "near" responses decrease with increasing luminance contrast. Partial occlusion is found to be a strong enough pictorial cue to support a weaker red luminance contrast. Interposition cues lose out against cues of spatial position and partial occlusion. The results of Experiment 2, with isoluminant displays of varying color contrast, reveal that red color contrast on a light background supported by any of the three geometric cues wins over green or white supported by any of the three geometric cues. On a dark background, red color contrast supported by the interposition cue loses out against green or white color contrast supported by partial occlusion. These findings reveal that color is not an independent depth cue, but is strongly influenced by luminance contrast and stimulus geometry. Systematically shorter response latencies for stronger "near" percepts demonstrate that selective visual attention reliably detects the most likely depth cue combination in a given configuration.

Early and long-term results after reconstructive surgery in 42 children and two young adults with renovascular hypertension due to fibromuscular dysplasia and middle aortic syndrome.

PubMed

Sandmann, W; Dueppers, P; Pourhassan, S; Voiculescu, A; Klee, D; Balzer, K M

2014-05-01

This retrospective study presents the early and late results of pediatric patients who underwent reconstructive surgery for renovascular hypertension (RVH) between 1979 and 2009. From 1979 to 2009 44 patients (male 22; mean age 13±5.2 years, range 1-19 years; early childhood 7 [1-6 years], middle childhood 5 [7-10 years]; adolescents 32 [11-19 years]) with renovascular hypertension underwent surgery for abdominal aortic stenoses (n=6), renal artery stenosis (RAS) (n=25) or for combined lesions (n=13). Nineteen aortic stenoses (bypass/interposition 10/5, patch dilatation/thromboendarterectomy 2/2), 51 renal arteries (interposition 36, resection+reimplantation 13, patch dilatation/aneurysmorraphy 1 each), and 10 visceral arteries (resection+reimplantation 6, interposition 3, patch dilatation 1) were reconstructed. Each patient underwent duplex studies and if required intra-arterial digital subtraction angiography. Reoperations within 30 postoperative days were required in four (9%) of the patients for occlusion of four arteries (6%), achieving a combined technical success rate of 94%. After 114±81 months 36 patients were re-examined by duplex and magnetic resonance angiography (2 not surgery-related deaths 7/12 years postoperatively, 8 patients lived abroad). Twelve patients had required a second and three a third procedure. Hypertension was cured early/late postoperatively in 27%/56%, improved in 41%/44%, and remained unchanged in 32%/0%. Best late results were obtained in patients with isolated aortic disease and at the age of middle childhood. Reconstructive surgery for pediatric RVH yields good results at every age and every type of lesion. However, these children should be followed up closely and to avoid early cardiovascular disease and death in later life, surgery should not be delayed. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Primary surgical repair of coarctation of the aorta in adolescents and adults: intermediate results and consequences of hypertension.

PubMed

Rajbanshi, Bijoy G; Joshi, Dikshya; Pradhan, Sidhartha; Gautam, Navin C; Timala, Rabindra; Shakya, Urmila; Sharma, Apurb; Biswakarma, Gangaram; Sharma, Jyotindra

2018-06-22

Coarctation of the aorta is known to present with hypertension in older patients; we reviewed our experience and assessed the outcome of hypertension following surgical correction. From April 2004 to date, 43 patients above the age of 12 underwent coarctation of the aorta repair. The mean age was 20.4 + 9.7 years (maximum 56 years); 21 (48.8%) were older than 18 years and 28 (65.1%) were men. Thirty (69.8%) patients had hypertension. Fourteen (32.6%) had a bicuspid aortic valve; 11 (25.6%) had patent ductus arteriosus; 6 (14%) had myxomatous mitral valve; 4 (9.3%) had ascending aortic aneurysms; and 2 (4.7%) had descending aneurysms. Surgical correction included resection and interposition of a tube graft in 31 (72.1%), an end-to-end anastomosis in 6 (14%) and patch aortoplasty in 3 (7%). Three (7%) patients required an extra-anatomical bypass: 1 had a long segment coarctation of the aorta, and 2 had a Bentall procedure with an ascending-to-descending aortic bypass. Staged procedures were done for concomitant disease in 4 (9.3%). There was 1 death: a 56-year-old woman died of refractory ventricular fibrillation during surgery. Thirty (69.8%) patients were discharged with antihypertensive medication. At a follow-up of 2.8 ± 2.2 years (maximum 9.2 years), the number of hypertensive patients decreased (17/36; 47.2%) (P = 0.042). Univariable predictors for persistence of hypertension revealed the use of an interpositional tube graft for repair (odds ratio 13.855, confidence interval 0.000-0.001; P = 0.001) as an indicator, whereas there were no independent predictors for persistence of hypertension. Surgical intervention is warranted irrespective of age and helps correct and control hypertension better; however, significant numbers of patients still require antihypertensive medication and regular monitoring. Intervention using an interposition tube graft may affect the prevalence of hypertension.

Computer guided restoration of joint line and femoral offset in cruciate substituting total knee arthroplasty.

PubMed

Shetty, Gautam M; Mullaji, Arun; Bhayde, Sagar

2012-10-01

This prospective study aimed to evaluate radiographically, change in joint line and femoral condylar offset with the optimized gap balancing technique in computer-assisted, primary, cruciate-substituting total knee arthroplasties (TKAs). One hundred and twenty-nine consecutive computer-assisted TKAs were evaluated radiographically using pre- and postoperative full-length standing hip-to-ankle, antero-posterior and lateral radiographs to assess change in knee deformity, joint line height and posterior condylar offset. In 49% of knees, there was a net decrease (mean 2.2mm, range 0.2-8.4mm) in joint line height postoperatively whereas 46.5% of knees had a net increase in joint line height (mean 2.5mm, range 0.2-11.2mm). In 93% of the knees, joint line was restored to within ± 5 mm of preoperative values. In 53% of knees, there was a net increase (mean 2.9 mm, range 0.2-12 mm) in posterior offset postoperatively whereas 40% of knees had a net decrease in posterior offset (mean 4.2mm, range 0.6-20mm). In 82% of knees, the posterior offset was restored within ± 5 mm of preoperative values. Based on radiographic evaluation in extension and at 30° flexion, the current study clearly demonstrates that joint line and posterior femoral condylar offset can be restored in the majority of computer-assisted, cruciate-substituting TKAs to within 5mm of their preoperative value. The optimized gap balancing feature of the computer software allows the surgeon to simulate the effect of simultaneously adjusting femoral component size, position and distal femoral resection level on joint line and posterior femoral offset. Copyright © 2011 Elsevier B.V. All rights reserved.

Swelling in the upper arm: the presentation and management of an isolated brachial artery aneurysm

PubMed Central

Alagaratnam, S; Lau, T; Munro, M; Loh, A

2011-01-01

True aneurysms of the brachial artery are uncommon. We describe the presentation and surgical management of an isolated, brachial artery aneurysm in a 64-year-old woman. Excision of the aneurysm and long saphenous venous interposition grafting was performed with no postoperative complications and histology demonstrated true aneurysmal degeneration. PMID:21943445

Comparison of microstructure and mechanical properties of ultra-narrow gap laser and gas-metal-arc welded S960 high strength steel

NASA Astrophysics Data System (ADS)

Guo, Wei; Li, Lin; Dong, Shiyun; Crowther, Dave; Thompson, Alan

2017-04-01

The microstructural characteristics and mechanical properties, including micro-hardness, tensile properties, three-point bending properties and Charpy impact toughness at different test temperatures of 8 mm thick S960 high strength steel plates were investigated following their joining by multi-pass ultra-narrow gap laser welding (NGLW) and gas metal arc welding (GMAW) techniques. It was found that the microstructure in the fusion zone (FZ) for the ultra-NGLW joint was predominantly martensite mixed with some tempered martensite, while the FZ for the GMAW joint was mainly consisted of ferrite with some martensite. The strength of the ultra-NGLW specimens was comparable to that of the base material (BM), with all welded specimens failed in the BM in the tensile tests. The tensile strength of the GMAW specimens was reduced approximately by 100 MPa when compared with the base material by a broad and soft heat affected zone (HAZ) with failure located in the soft HAZ. Both the ultra-NGLW and GMAW specimens performed well in three-point bending tests. The GMAW joints exhibited better impact toughness than the ultra-NGLW joints.

Reliability and precision of stress sonography of the ulnar collateral ligament.

PubMed

Bica, David; Armen, Joseph; Kulas, Anthony S; Youngs, Kevin; Womack, Zachary

2015-03-01

Musculoskeletal sonography has emerged as an additional diagnostic tool that can be used to assess medial elbow pain and laxity in overhead throwers. It provides a dynamic, rapid, and noninvasive modality in the evaluation of ligamentous structural integrity. Many studies have demonstrated the utility of dynamic sonography for medial elbow and ulnar collateral ligament (UCL) integrity. However, evaluating the reliabilityand precision of these measurements is critical if sonography is ultimately used as a clinical diagnostic tool. The purpose of this study was to evaluate the reliability and precision of stress sonography applied to the medial elbow. We conducted a cross-sectional study during the 2011 baseball off-season. Eighteen National Collegiate Athletic Association Division I pitchers were enrolled, and 36 elbows were studied. Using sonography, the medial elbow was assessed, and measurements of the UCL length and ulnohumeral joint gapping were performed twice under two conditions (unloaded and loaded) and bilaterally. Intraclass correlation coefficients (0.72-0.94) and standard errors of measurements (0.3-0.9 mm) for UCL length and ulnohumeral joint gapping were good to excellent. Mean differences between unloaded and loaded conditions for the dominant arms were 1.3 mm (gapping; P < .001) and 1.4 mm (UCL length; P < .001). Medial elbow stress sonography is a reliable and precise method for detecting changes in ulnohumeral joint gapping and UCL lengthening. Ultimately, this method may provide clinicians valuable information regarding the medial elbow's response to valgus loading and may help guide treatment options. © 2015 by the American Institute of Ultrasound in Medicine.

The gap technique does not rotate the femur parallel to the epicondylar axis.

PubMed

Matziolis, Georg; Boenicke, Hinrich; Pfiel, Sascha; Wassilew, Georgi; Perka, Carsten

2011-02-01

In the analysis of painful total knee replacements, the surgical epicondylar axis (SEA) has become established as a standard in the diagnosis of femoral component rotation. It remains unclear whether the gap technique widely used to determine femoral rotation, when applied correctly, results in a rotation parallel to the SEA. In this prospective study, 69 patients (69 joints) were included who received a navigated bicondylar surface replacement due to primary arthritis of the knee joint. In 67 cases in which a perfect soft-tissue balancing of the extension gap (<1° asymmetry) was achieved, the flexion gap and the rotation of the femoral component necessary for its symmetry was determined and documented. The femoral component was implanted additionally taking into account the posterior condylar axis and the Whiteside's line. Postoperatively, the rotation of the femoral component to the SEA was determined and this was used to calculate the angle between a femur implanted according to the gap technique and the SEA. If the gap technique had been used consistently, it would have resulted in a deviation of the femoral components by -0.6° ± 2.9° (-7.4°-5.9°) from the SEA. The absolute deviation would have been 2.4° ± 1.8°, with a range between 0.2° and 7.4°. Even if the extension gap is perfectly balanced, the gap technique does not lead to a parallel alignment of the femoral component to the SEA. Since the clinical results of this technique are equivalent to those of the femur first technique in the literature, an evaluation of this deviation as a malalignment must be considered critically.

Effects of medial meniscal posterior horn avulsion and repair on meniscal displacement.

PubMed

Hein, Christopher N; Deperio, Jennifer Gurske; Ehrensberger, Mark T; Marzo, John M

2011-06-01

Medial meniscal posterior root avulsion (MMRA) leads to deleterious alteration of medial joint compartment loading profiles and increased risk of medial degenerative changes. Surgical repair restores more normal biomechanics to the knee. Our hypothesis is that MMRA will cause medial meniscal (MM) extrusion and gap formation between the root attachment site and MM. Meniscal root repair will restore the ability of the meniscus to resist extrusion, and reduce gap formation at the defect. Seven fresh frozen human cadaveric knees were dissected and mechanically loaded using a servo-hydraulic load frame (MTS ®) with 0 and 1800 N. The knees were tested under three conditions: native, avulsed, and repaired. Four measurements were obtained: meniscal displacement anteriorly, medially, posteriorly, and gap distance between the root attachment site and MM after transection and repair. The medial displacement of the avulsed MM (3.28 mm) was significantly greater (p < 0.001) than the native knee (1.60mm) and repaired knee (1.46 mm). Gap formation is significantly larger in the avulsed compared to repaired state at 0 (p < 0.02) and 1800N (p < 0.02) and also larger with loading in both avulsed (p < 0.05) and repaired (p < 0.02) conditions. Therefore, MMRA results in MM extrusion from the joint and gap formation between the MM root and the MM. Subsequent surgical repair reduces meniscal displacement and gap formation at the defect. Copyright © 2010 Elsevier B.V. All rights reserved.

Braided Carbon Fiber Rope Flow Characteristics. Degree awarded by Utah Univ.

NASA Technical Reports Server (NTRS)

Heman, J. R. C.; McCool, A. (Technical Monitor)

2000-01-01

I am submitting the following technical subject for consideration as a thesis topic for the master degree: The reusable solid rocket motor (RSRM) nozzle internal joints are being evaluated for the incorporation of a carbon fiber rope (CFR) as a thermal barrier. The CFR is approximately 0.260 in. diameter and is composed of approximately 12,000 carbon fibers, woven in ten sheaths or layers. The CFR is manufactured by a sub-tier vendor and subsequently several of its manufacturing details are proprietary to that vendor. The CFR design intent is to prevent hot motor combustion products and slag from intruding into the joint scaling area while still approaching a vented joint design to avoid the detriments of gas jet impingement. As a member of the Heat Transfer section at Thiokol Propulsion, two main goals exist as part of this NASA funded design effort: (1) development of flow model through the CFR and (2) development of a heat transfer model through the CFR. While both models are needed and most probably interrelated, the gas flow model is being targeted as the subject matter. Essentially, the topic would be "Modeling of Gas Flow through a Braided Carbon Fiber Rope". An AIAA journal or conference paper is being considered through Thiokol/NASA as well. A sub-scale CFR flow test fixture was designed to simulate the relative levels of CFR compression. The test fixture provides the means to measure gas mass flow rate upstream of the CFR and the pressure and temperature both upstream and downstream of the CFR. The test fixture was designed to eliminate the possibility of dynamic gapping at the CFR location and provide minimal flow resistance to ambient for gases exiting the rope. The data collected in the experiment will be evaluated to define a permeability/flow resistance model. Two possibilities exist for the flow characteristics through the CFR from choked flow to strictly friction driven. A test matrix for evaluating the CFR has been compiled, which addresses both of these characteristics. The range of pressures to be tested covers a relatively low delta pressure where non-choked flow is impossible, while the high pressure shown is dictated by the RSRM joint operating pressure where choking is possible. The test matrix, was also designed for a range of rope compressions or test fixture gaps ranging from 0.025" to 0.070". These gaps are controlled by the range of RSRM full-scale hardware joint gaps that will be expected by virtue of the joint design.

Brazed Joints Design and Allowables: Discuss Margins of Safety in Critical Brazed Structures

NASA Technical Reports Server (NTRS)

FLom, Yury

2009-01-01

This slide presentation tutorial discusses margins of safety in critical brazed structures. It reviews: (1) the present situation (2) definition of strength (3) margins of safety (4) design allowables (5) mechanical testing (6) failure criteria (7) design flowchart (8) braze gap (9) residual stresses and (10) delayed failures. This presentation addresses the strength of the brazed joints, the methods of mechanical testing, and our ability to evaluate the margins of safety of the brazed joints as it applies to the design of critical and expensive brazed assemblies.

75 FR 71479 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... Series (Order Audit Trail System); NASD Rule 2320 (Best Execution and Interpositioning); NASD Rule 2400 Series (Commissions, Mark-Ups and Charges); NASD IM-2110-2 (Trading Ahead of Customer Limit Order); and... prepared to purchase or sell at that price and under the conditions stated at the time of the offer to buy...

Articular Cartilage Increases Transition Zone Regeneration in Bone-tendon Junction Healing

PubMed Central

Qin, Ling; Lee, Kwong Man; Leung, Kwok Sui

2008-01-01

The fibrocartilage transition zone in the direct bone-tendon junction reduces stress concentration and protects the junction from failure. Unfortunately, bone-tendon junctions often heal without fibrocartilage transition zone regeneration. We hypothesized articular cartilage grafts could increase fibrocartilage transition zone regeneration. Using a goat partial patellectomy repair model, autologous articular cartilage was harvested from the excised distal third patella and interposed between the residual proximal two-thirds bone fragment and tendon during repair in 36 knees. We evaluated fibrocartilage transition zone regeneration, bone formation, and mechanical strength after repair at 6, 12, and 24 weeks and compared them with direct repair. Autologous articular cartilage interposition resulted in more fibrocartilage transition zone regeneration (69.10% ± 14.11% [mean ± standard deviation] versus 8.67% ± 7.01% at 24 weeks) than direct repair at all times. There was no difference in the amount of bone formation and mechanical strength achieved. Autologous articular cartilage interposition increases fibrocartilage transition zone regeneration in bone-tendon junction healing, but additional research is required to ascertain the mechanism of stimulation and to establish the clinical applicability. PMID:18987921

Hot wire anemometer measurements in the unheated air flow tests of the SRB nozzle-to-case joint

NASA Technical Reports Server (NTRS)

Ramachandran, N.

1988-01-01

Hot-Wire Anemometer measurements made in the Solid Rocket Booster (SRB) nozzle-to-case joint are discussed. The study was undertaken to glean additional information on the circumferential flow induced in the SRB nozzle joint and the effect of this flow on the insulation bonding flaws. The tests were conducted on a full-scale, 2-D representation of a 65-in long segment of the SRB nozzle joint, with unheated air as the working fluid. Both the flight Mach number and Reynolds number were matched simultaneously and different pressure gradients imposed along the joint face were investigated. Hot-wire anemometers were used to obtain velocity data for different joint gaps and debond configurations. The procedure adopted for hot-wire calibration and use is outlined and the results from the tests summarized.

Effect of Boundary Condition on the Shear Behaviour of Rock Joints in the Direct Shear Test

NASA Astrophysics Data System (ADS)

Bahaaddini, M.

2017-05-01

The common method for determination of the mechanical properties of the rock joints is the direct shear test. This paper aims to study the effect of boundary condition on the results of direct shear tests. Experimental studies undertaken in this research showed that the peak shear strength is mostly overestimated. This problem is more pronounced for steep asperities and under high normal stresses. Investigation of the failure mode of these samples showed that tensile cracks are generated at the boundary of sample close to the specimen holders and propagated inside the intact materials. In order to discover the reason of observed failure mechanism in experiments, the direct shear test was simulated using PFC2D. Results of numerical models showed that the gap zone size between the upper and lower specimen holders has a significant effect on the shear mechanism. For the high gap size, stresses concentrate at the vicinity of the tips of specimen holders and result in generation and propagation of tensile cracks inside the intact material. However, by reducing the gap size, stresses are concentrated on asperities, and damage of specimen at its boundary is not observed. Results of this paper show that understanding the shear mechanism of rock joints is an essential step prior to interpreting the results of direct shear tests.

Bridging the Gap: From Ivory to Corporate Tower. Proceedings of the ABCA Midwest Regional Conference (Ames, Iowa, April 19-20, 1984).

ERIC Educational Resources Information Center

Pearson, Patricia, Ed.

Proceedings drawn from a conference on business communication, the 21 papers in this collection are grouped under the headings Corporate Tower Views, Bridging the Gap, and Ivory Tower Views to better reflect the joint concerns of professional communicators on the job as well as the concerns of those who teach business communication. Among the…

Report on Progress Toward Security and Stability in Afghanistan

DTIC Science & Technology

2010-04-01

which has resulted in continued capability gaps in the Combined Joint Statement of Requirements (CJSOR) from unresourced requirements not filled by...international partners. The most notable gap is the requirement for trainers and mentors to support development of the ANSF. U.S. Forces are taking...made at the December 2009 NATO Foreign Ministerial and February 2010 NATO Force Generation Conference. The December conference yielded contributions

Comparison of joint designs for laser welding of cast metal plates and wrought wires.

PubMed

Takayama, Yasuko; Nomoto, Rie; Nakajima, Hiroyuki; Ohkubo, Chikahiro

2013-01-01

The purpose of the present study was to compare joint designs for the laser welding of cast metal plates and wrought wire, and to evaluate the welded area internally using X-ray micro-focus computerized tomography (micro-CT). Cast metal plates (Ti, Co-Cr) and wrought wires (Ti, Co-Cr) were welded using similar metals. The specimens were welded using four joint designs in which the wrought wires and the parent metals were welded directly (two designs) or the wrought wires were welded to the groove of the parent metal from one or both sides (n = 5). The porosity and gap in the welded area were evaluated by micro-CT, and the maximum tensile load of the welded specimens was measured with a universal testing machine. An element analysis was conducted using an electron probe X-ray microanalyzer. The statistical analysis of the results was performed using Bonferroni's multiple comparisons (α = 0.05). The results included that all the specimens fractured at the wrought wire when subjected to tensile testing, although there were specimens that exhibited gaps due to the joint design. The wrought wires were affected by laser irradiation and observed to melt together and onto the filler metal. Both Mo and Sn elements found in the wrought wire were detected in the filler metal of the Ti specimens, and Ni was detected in the filler metal of the Co-Cr specimens. The four joint designs simulating the designs used clinically were confirmed to have adequate joint strength provided by laser welding.

The Influence of the Heat-Affected Zone Mechanical Properties on the Behaviour of the Welding in Transverse Plate-to-Tube Joints.

PubMed

Lozano, Miguel; Serrano, Miguel A; López-Colina, Carlos; Gayarre, Fernando L; Suárez, Jesús

2018-02-09

Eurocode 3 establishes the component method to analytically characterize the structural joints between beam and columns. When one of the members involved in the joint is a hollow section (i.e., a tube) there is a lack of information for the specific components present in the joint. There are two different ways to bridge the gap: experimental testing on the actual beam column joints involving tubular sections; or numerical modelization, typically by means of finite element analysis. For this second option, it is necessary to know the actual mechanical properties of the material. As long as the joint implies a welding process, there is a concern related to how the mechanical properties in the heat-affected zone (HAZ) influence the behavior of the joint. In this work, some coupons were extracted from the HAZ of the beam-column joint. The coupons were tested and the results were implemented in the numerical model of the joint, in an attempt to bring it closer to the experimental results of the tested joints.

Method for selecting minimum width of leaf in multileaf adjustable collimator while inhibiting passage of particle beams of radiation through sawtooth joints between collimator leaves

DOEpatents

Ludewigt, Bernhard; Bercovitz, John; Nyman, Mark; Chu, William

1995-01-01

A method is disclosed for selecting the minimum width of individual leaves of a multileaf adjustable collimator having sawtooth top and bottom surfaces between adjacent leaves of a first stack of leaves and sawtooth end edges which are capable of intermeshing with the corresponding sawtooth end edges of leaves in a second stack of leaves of the collimator. The minimum width of individual leaves in the collimator, each having a sawtooth configuration in the surface facing another leaf in the same stack and a sawtooth end edge, is selected to comprise the sum of the penetration depth or range of the particular type of radiation comprising the beam in the particular material used for forming the leaf; plus the total path length across all the air gaps in the area of the joint at the edges between two leaves defined between lines drawn across the peaks of adjacent sawtooth edges; plus at least one half of the length or period of a single sawtooth. To accomplish this, in accordance with the method of the invention, the penetration depth of the particular type of radiation in the particular material to be used for the collimator leaf is first measured. Then the distance or gap between adjoining or abutting leaves is selected, and the ratio of this distance to the height of the sawteeth is selected. Finally the number of air gaps through which the radiation will pass between sawteeth is determined by selecting the number of sawteeth to be formed in the joint. The measurement and/or selection of these parameters will permit one to determine the minimum width of the leaf which is required to prevent passage of the beam through the sawtooth joint.

Weld-brazing - a new joining process. [combination resistance spot welding and brazing of titanium alloys

NASA Technical Reports Server (NTRS)

Bales, T. T.; Royster, D. M.; Arnold, W. E., Jr.

1972-01-01

A joining process designated weld brazing which combines resistance spot welding and brazing has been developed. Resistance spot welding is used to position and align the parts as well as to establish a suitable faying surface gap for brazing. Fabrication is then completed by capillary flow of the braze alloy into the joint. The process has been used successfully to fabricate Ti-6Al-4V titanium alloy joints using 3003 aluminum braze alloy. Test results obtained on single overlap and hat-stiffened structural specimens show that weld brazed joints are superior in tensile shear, stress rupture, fatigue, and buckling than joint fabricated by spotwelding or brazing. Another attractive feature of the process is that the brazed joints is hermetically sealed by the braze material.

Accurate joint space quantification in knee osteoarthritis: a digital x-ray tomosynthesis phantom study

NASA Astrophysics Data System (ADS)

Sewell, Tanzania S.; Piacsek, Kelly L.; Heckel, Beth A.; Sabol, John M.

2011-03-01

The current imaging standard for diagnosis and monitoring of knee osteoarthritis (OA) is projection radiography. However radiographs may be insensitive to markers of early disease such as osteophytes and joint space narrowing (JSN). Relative to standard radiography, digital X-ray tomosynthesis (DTS) may provide improved visualization of the markers of knee OA without the interference of superimposed anatomy. DTS utilizes a series of low-dose projection images over an arc of +/-20 degrees to reconstruct tomographic images parallel to the detector. We propose that DTS can increase accuracy and precision in JSN quantification. The geometric accuracy of DTS was characterized by quantifying joint space width (JSW) as a function of knee flexion and position using physical and anthropomorphic phantoms. Using a commercially available digital X-ray system, projection and DTS images were acquired for a Lucite rod phantom with known gaps at various source-object-distances, and angles of flexion. Gap width, representative of JSW, was measured using a validated algorithm. Over an object-to-detector-distance range of 5-21cm, a 3.0mm gap width was reproducibly measured in the DTS images, independent of magnification. A simulated 0.50mm (+/-0.13) JSN was quantified accurately (95% CI 0.44-0.56mm) in the DTS images. Angling the rods to represent knee flexion, the minimum gap could be precisely determined from the DTS images and was independent of flexion angle. JSN quantification using DTS was insensitive to distance from patient barrier and flexion angle. Potential exists for the optimization of DTS for accurate radiographic quantification of knee OA independent of patient positioning.

Joint Probabilistic Projection of Female and Male Life Expectancy

PubMed Central

Raftery, Adrian E.; Lalic, Nevena; Gerland, Patrick

2014-01-01

BACKGROUND The United Nations (UN) produces population projections for all countries every two years. These are used by international organizations, governments, the private sector and researchers for policy planning, for monitoring development goals, as inputs to economic and environmental models, and for social and health research. The UN is considering producing fully probabilistic population projections, for which joint probabilistic projections of future female and male life expectancy at birth are needed. OBJECTIVE We propose a methodology for obtaining joint probabilistic projections of female and male life expectancy at birth. METHODS We first project female life expectancy using a one-sex method for probabilistic projection of life expectancy. We then project the gap between female and male life expectancy. We propose an autoregressive model for the gap in a future time period for a particular country, which is a function of female life expectancy and a t-distributed random perturbation. This method takes into account mortality data limitations, is comparable across countries, and accounts for shocks. We estimate all parameters based on life expectancy estimates for 1950–2010. The methods are implemented in the bayesLife and bayesPop R packages. RESULTS We evaluated our model using out-of-sample projections for the period 1995–2010, and found that our method performed better than several possible alternatives. CONCLUSIONS We find that the average gap between female and male life expectancy has been increasing for female life expectancy below 75, and decreasing for female life expectancy above 75. Our projections of the gap are lower than the UN’s 2008 projections for most countries and so lead to higher projections of male life expectancy. PMID:25580082

Surgical treatment of benign tracheo-oesophageal fistulas with tracheal resection and oesophageal primary closure: is the muscle flap really necessary?

PubMed

Camargo, José Jesus; Machuca, Tiago Noguchi; Camargo, Spencer Marcantônio; Lobato, Vivalde F; Medina, Carlos Remolina

2010-03-01

Nowadays, despite the advances of the low-pressure high-volume cuffs, post-intubation tracheo-oesophageal fistula (TEF) still poses a major challenge to thoracic surgeons. The original technique includes interposition of muscle flaps between suture lines to avoid recurrence. It is not clear if this manoeuvre is indispensable and, in fact, we and others have faced problems with it. Our aim is to present our experience with TEF management in a consecutive group with no muscle interposition. From June 1992 to November 2007, we evaluated 14 patients presenting with TEF, with a mean age of 44 years (from 18 to 79 years). Thirteen patients had a prolonged intubation history. The remaining case was a 40-year-old male with congenital TEF. Three patients had been previously submitted to failed repairs in other institutions. Ten patients had associated tracheal stenosis, which was subglottic in three of them. Regarding surgical technique, in all cases, we performed a single-staged procedure, which consisted of tracheal resection and anastomosis with double-layer oesophageal closure. In none of our cases was a muscle flap interposed between suture lines. All operations were performed through a cervical incision; however, in one case, an extension with partial sternotomy was required. There was no operative mortality. Thirteen patients were extubated in the first 24h after the procedure, while one patient required 48 h of mechanical ventilation. Four complications were recorded: one each of pneumonia and left vocal cord paralysis and two small tracheal dehiscences managed with a T-tube and a tracheostomy tube. After discharge, three patients returned to their native cities and were lost to follow-up. The remaining 11 patients have been followed up by a mean of 32 months (from three to 108 months), with 10 presenting excellent and one good anatomic and functional results. The single-staged repair with tracheal resection and anastomosis with oesophageal closure provides good short- and mid-term results for TEF management. The interposition of a muscle flap between suture lines may not be crucial to prevent recurrence. Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Intracapsular origin of the long head of the biceps tendon with glenoid avulsion of the glenohumeral ligaments.

PubMed

Parikh, Shital N; Bonnaig, Nicolas; Zbojniewicz, Andrew

2011-11-09

An 18-year-old woman presented with a history of recurrent glenohumeral dislocations involving her right dominant shoulder. Physical examination suggested physiologic hyperlaxity and anterior instability. Magnetic resonance arthrography demonstrated an anomalous intracapsular origin of the long head of the biceps tendon (LHBT), with normal-appearing LHBT in the intertubercular groove. Diagnostic arthroscopy confirmed the absence of the LHBT attachment on the superior labrum. Instead, the LHBT originated from the capsule of the shoulder joint. Diagnostic arthroscopy also revealed glenoid avulsion of the glenohumeral ligaments (GAGL) lesion as a tear in the anterior-inferior capsule near its insertion on the glenoid and labrum. An arthroscopic anterior capsulolabral repair was performed with rotator interval closure by imbrication of superior and middle glenohumeral ligaments. A retrospective review of the magnetic resonance arthrogram identified irregularity and interposition of contrast between the capsule and the anterior-inferior labrum that was reproduced in the abduction-external rotation view corresponding with the GAGL lesion seen at arthroscopy. At 12 months postoperatively, the patient demonstrated full range of motion and no signs of instability. This case report helps to raise awareness about 2 rare shoulder lesions: the anomalous origin of LHBT and the GAGL lesion. Diagnosing such lesions on preoperative magnetic resonance imaging may aid in operative planning and avoid unexpected intraoperative findings. Copyright 2011, SLACK Incorporated.

Detection of micro gap weld joint by using magneto-optical imaging and Kalman filtering compensated with RBF neural network

NASA Astrophysics Data System (ADS)

Gao, Xiangdong; Chen, Yuquan; You, Deyong; Xiao, Zhenlin; Chen, Xiaohui

2017-02-01

An approach for seam tracking of micro gap weld whose width is less than 0.1 mm based on magneto optical (MO) imaging technique during butt-joint laser welding of steel plates is investigated. Kalman filtering(KF) technology with radial basis function(RBF) neural network for weld detection by an MO sensor was applied to track the weld center position. Because the laser welding system process noises and the MO sensor measurement noises were colored noises, the estimation accuracy of traditional KF for seam tracking was degraded by the system model with extreme nonlinearities and could not be solved by the linear state-space model. Also, the statistics characteristics of noises could not be accurately obtained in actual welding. Thus, a RBF neural network was applied to the KF technique to compensate for the weld tracking errors. The neural network can restrain divergence filter and improve the system robustness. In comparison of traditional KF algorithm, the RBF with KF was not only more effectively in improving the weld tracking accuracy but also reduced noise disturbance. Experimental results showed that magneto optical imaging technique could be applied to detect micro gap weld accurately, which provides a novel approach for micro gap seam tracking.

Bone cement: how effective is it at restoring hearing in isolated incudostapedial erosion?

PubMed

Watson, G J; Narayan, S

2014-08-01

To determine the effectiveness of biocements in rebridging isolated incudostapedial erosion. A review of the use of biocements for isolated incudostapedial joint erosion was performed on publications from 1998 to 2012 available from Medline, Embase and Pubmed. Inclusion criteria were papers published in English, case series or comparative studies with more than 10 patients, isolated incudostapedial erosion through chronic ear disease, minimal air-bone gap less than 20 dB (or air-bone gap less than 10 dB) and follow up for at least one year. In 108 patients, rebridging ossiculoplasty was performed using hydroxyapatite cement. Closure of air-bone gaps less than 20 dB and less than 10 dB was achieved in 80-94.4 per cent and 29-75 per cent, respectively. Glass ionomer cement was used in 318 patients. Closure of air-bone gaps less than 20 dB and less than 10 dB was achieved in 74-94 per cent and 40-76 per cent, respectively. Biocements can be successfully used to close isolated incudostapedial erosions. Larger comparative prospective studies documenting the length of eroded incus and types of reformation of the incudostapedial joint, with standardised reporting, are needed in the future.

Packaging of ferroelectric liquid crystal-on-silicon spatial light modulators

NASA Astrophysics Data System (ADS)

Lin, W.; Morozova, Nina D.; Ju, TehHua; Zhang, Weidong; Lee, Yung-Cheng; McKnight, Douglas J.; Johnson, Kristina M.

1996-11-01

A self-pulling soldering technology has been demonstrated for assembling liquid crystal on silicon (LCOS) spatial light modulators (SLMs). One of the major challenges in manufacturing the LCOS modules is to reproducibly control the thickness of the gap between the very large scale integrated circuit (VLSI) chip and the cover glass. The liquid crystal material is sandwiched between the VLSI chop and the cover glass which is coated with a transparent conductor. Solder joints with different profiles and sizes have been designed to provide surface tension forces to control the gap accommodating the ferroelectric liquid crystal layer in the range of a micron level with sub- micron uniformity. The optimum solder joint design is defined as a joint that results in the maximum pulling force. This technology provides an automatic, batch assembly process for a LCOS SLM through one reflow process. Fluxless soldering technology is used to assemble the module. This approach avoids residues from chemical of flux and oxides, and eliminates potential contamination to the device. Two different LCOS SLM designs and the process optimization are described.

Thermal Analysis of a Carbon Fiber Rope Barrier for Use in the Reusable Solid Rocket Motor Nozzle Joint-2

NASA Technical Reports Server (NTRS)

Clayton, J. Louie

2002-01-01

This study provides development and verification of analysis methods used to assess performance of a carbon fiber rope (CFR) thermal barrier system that is currently being qualified for use in Reusable Solid Rocket Motor (RSRM) nozzle joint-2. Modeled geometry for flow calculations considers the joint to be vented with the porous CFR barriers placed in the 'open' assembly gap. Model development is based on a 1-D volume filling approach where flow resistances (assembly gap and CFRs) are defined by serially connected internal flow and the porous media 'Darcy' relationships. Combustion gas flow rates are computed using the volume filling code by assuming a lumped distribution total joint fill volume on a per linear circumferential inch basis. Gas compressibility, friction and heat transfer are included in the modeling. Gas-to-wall heat transfer is simulated by concurrent solution of the compressible flow equations and a large thermal 2-D finite element (FE) conduction grid. The derived numerical technique loosely couples the FE conduction matrix with the compressible gas flow equations. Free constants that appear in the governing equations are calibrated by parametric model comparison to hot fire subscale test results. The calibrated model is then used to make full-scale motor predictions using RSRM aft dome environments. Model results indicate that CFR thermal barrier systems will provide a thermally benign and controlled pressurization environment for the RSRM nozzle joint-2 primary seal activation.

Thermal Analysis of a Carbon Fiber Rope Barrier for Use in the Reusable Solid Rocket Motor Nozzle Joint-2

NASA Technical Reports Server (NTRS)

Clayton, J. Louie; Phelps, Lisa (Technical Monitor)

2001-01-01

This study provides for development and verification of analysis methods used to assess performance of a carbon fiber rope (CFR) thermal barrier system that is currently being qualified for use in Reusable Solid Rocket Motor (RSRM) nozzle joint-2. Modeled geometry for flow calculations considers the joint to be vented with the porous CFR barriers placed in the "open' assembly gap. Model development is based on a 1-D volume filling approach where flow resistances (assembly gap and CFRs) are defined by serially connected internal flow and the porous media "Darcy" relationships. Combustion gas flow rates are computed using the volume filling code by assuming a lumped distribution total joint fill volume on a per linear circumferential inch basis. Gas compressibility, friction and heat transfer are included in the modeling. Gas-to-wall heat transfer is simulated by concurrent solution of the compressible flow equations and a large thermal 2-D finite element (FE) conduction grid. The derived numerical technique loosely couples the FE conduction matrix with the compressible gas flow equations, Free constants that appear in the governing equations are calibrated by parametric model comparison to hot fire subscale test results. The calibrated model is then used to make full-scale motor predictions using RSRM aft dome environments. Model results indicate that CFR thermal barrier systems will provide a thermally benign and controlled pressurization environment for the RSRM nozzle joint-2 primary seal activation.

Effect of Segregation of Secondary Phase Particles and "S" Line on Tensile Fracture Behavior of Friction Stir-Welded 2024Al-T351 Joints

NASA Astrophysics Data System (ADS)

Zhang, Z.; Xiao, B. L.; Ma, Z. Y.

2013-09-01

A 5-mm-thick 2024Al-T351 plate was friction stir welded (FSWed) at welding speeds of 100, 200, and 400 mm min-1 with a constant rotation rate of 800 rpm, and the microstructure and tensile fracture behavior of the joints were investigated in detail. FSW resulted in the redistribution of secondary phase particles along the recrystallized grain boundaries at the nugget zone (NZ), forming linear segregation bands consisting of secondary phase particles. The segregation bands, mainly present in the shoulder-driven zone, were believed to result from periodic material flow, with the average band spacing on the longitudinal and horizontal cross sections equal to the tool advancement per revolution. At a low welding speed of 100 mm min-1, in spite of the highest density of segregation bands, the FSWed 2024Al-T351 joint fractured along the low hardness zone (LHZ) of the heat-affected zone because of large hardness gap between NZ and LHZ. Increasing the welding speed to 200 and 400 mm min-1 reduced both the hardness gap between NZ and LHZ and the density of segregation bands. In this case, the segregation bands played a role, resulting in unusual fracture of the joints along the segregation bands. The "S" line originated from the oxide film on the initial butting surfaces and did not affect the fracture behavior of the FSWed 2024Al-T351 joints.

Biomechanical Analysis of Treadmill Locomotion on the International Space Station

NASA Technical Reports Server (NTRS)

De Witt, J. K.; Fincke, R. S.; Guilliams, M. E.; Ploutz-Snyder, L. L.

2011-01-01

Treadmill locomotion exercise is an important aspect of ISS exercise countermeasures. It is widely believed that an optimized treadmill exercise protocol could offer benefits to cardiovascular and bone health. If training heart rate is high enough, treadmill exercise is expected to lead to improvements in aerobic fitness. If impact or bone loading forces are high enough, treadmill exercise may be expected to contribute to improved bone outcomes. Ground-based research suggests that joint loads increase with increased running speed. However, it is unknown if increases in locomotion speed results in similar increases in joint loads in microgravity. Although data exist regarding the biomechanics of running and walking in microgravity, a majority were collected during parabolic flight or during investigations utilizing a microgravity analog. The Second Generation Treadmill (T2) has been in use on the International Space Station (ISS) and records the ground reaction forces (GRF) produced by crewmembers during exercise. Biomechanical analyses will aid in understanding potential differences in typical gait motion and allow for modeling of the human body to determine joint and muscle forces during exercise. By understanding these mechanisms, more appropriate exercise prescriptions can be developed that address deficiencies. The objective of this evaluation is to collect biomechanical data from crewmembers during treadmill exercise prior to and during flight. The goal is to determine if locomotive biomechanics differ between normal and microgravity environments and to determine how combinations of subject load and speed influence joint loading during in-flight treadmill exercise. Further, the data will be used to characterize any differences in specific bone and muscle loading during locomotion in these two gravitational conditions. This project maps to the HRP Integrated Research Plan risks including Risk of Bone Fracture (Gap B15), Risk of Early Onset Osteoporosis Due to Spaceflight (Gap B15), Risk of Impaired Performance Due to Reduced Muscle Mass, Strength, and Endurance (Gaps M3, M4, M6, Ml, M8, M9) and Risk of reduced Physical Performance Capabilities Due to Reduce Aerobic Capacity (Gaps M7, M8, M9).

Wide gap active brazing of ceramic-to-metal-joints for high temperature applications

NASA Astrophysics Data System (ADS)

Bobzin, K.; Zhao, L.; Kopp, N.; Samadian Anavar, S.

2014-03-01

Applications like solid oxide fuel cells and sensors increasingly demand the possibility to braze ceramics to metals with a good resistance to high temperatures and oxidative atmospheres. Commonly used silver based active filler metals cannot fulfill these requirements, if application temperatures higher than 600°C occur. Au and Pd based active fillers are too expensive for many fields of use. As one possible solution nickel based active fillers were developed. Due to the high brazing temperatures and the low ductility of nickel based filler metals, the modification of standard nickel based filler metals were necessary to meet the requirements of above mentioned applications. To reduce thermally induced stresses wide brazing gaps and the addition of Al2O3 and WC particles to the filler metal were applied. In this study, the microstructure of the brazed joints and the thermo-chemical reactions between filler metal, active elements and WC particles were analyzed to understand the mechanism of the so called wide gap active brazing process. With regard to the behavior in typical application oxidation and thermal cycle tests were conducted as well as tensile tests.

Enabling Joint Commission Medication Reconciliation Objectives with the HL7 / ASTM Continuity of Care Document Standard

PubMed Central

Dolin, Robert H.; Giannone, Gay; Schadow, Gunther

2007-01-01

We sought to determine how well the HL7 / ASTM Continuity of Care Document (CCD) standard supports the requirements underlying the Joint Commission medication reconciliation recommendations. In particular, the Joint Commission emphasizes that transition points in the continuum of care are vulnerable to communication breakdowns, and that these breakdowns are a common source of medication errors. These transition points are the focus of communication standards, suggesting that CCD can support and enable medication related patient safety initiatives. Data elements needed to support the Joint Commission recommendations were identified and mapped to CCD, and a detailed clinical scenario was constructed. The mapping identified minor gaps, and identified fields present in CCD not specifically identified by Joint Commission, but useful nonetheless when managing medications across transitions of care, suggesting that a closer collaboration between the Joint Commission and standards organizations will be mutually beneficial. The nationally recognized CCD specification provides a standards-based solution for enabling Joint Commission medication reconciliation objectives. PMID:18693823

Enabling joint commission medication reconciliation objectives with the HL7 / ASTM Continuity of Care Document standard.

PubMed

Dolin, Robert H; Giannone, Gay; Schadow, Gunther

2007-10-11

We sought to determine how well the HL7/ASTM Continuity of Care Document (CCD) standard supports the requirements underlying the Joint Commission medication reconciliation recommendations. In particular, the Joint Commission emphasizes that transition points in the continuum of care are vulnerable to communication breakdowns, and that these breakdowns are a common source of medication errors. These transition points are the focus of communication standards, suggesting that CCD can support and enable medication related patient safety initiatives. Data elements needed to support the Joint Commission recommendations were identified and mapped to CCD, and a detailed clinical scenario was constructed. The mapping identified minor gaps, and identified fields present in CCD not specifically identified by Joint Commission, but useful nonetheless when managing medications across transitions of care, suggesting that a closer collaboration between the Joint Commission and standards organizations will be mutually beneficial. The nationally recognized CCD specification provides a standards-based solution for enabling Joint Commission medication reconciliation objectives.

Understanding the reliability of solder joints used in advanced structural and electronics applications: Part 1 - Filler metal properties and the soldering process

DOE PAGES

Vianco, Paul T.

2017-02-01

Soldering technology has made tremendous strides in the past half-century. Whether structural or electronic, all solder joints must provide a level of reliability that is required by the application. This Part 1 report examines the effects of filler metal properties and soldering process on joint reliability. Solder alloy composition must have the appropriate melting and mechanical properties that suit the product's assembly process(es) and use environment. The filler metal must also optimize solderability (wetting-and-spreading) to realize the proper joint geometry. Here, the soldering process also affects joint reliability. The choice of flux and thermal profile support the solderability performance ofmore » the molten filler metal to successfully fill the gap and complete the fillet.« less

Functional outcomes of conservatively managed acute ruptures of the Achilles tendon.

PubMed

Lawrence, J E; Nasr, P; Fountain, D M; Berman, L; Robinson, A H N

2017-01-01

This prospective cohort study aims to determine if the size of the tendon gap following acute rupture of the Achilles tendon shows an association with the functional outcome following non-operative treatment. All patients presenting within two weeks of an acute unilateral rupture of the Achilles tendon between July 2012 and July 2015 were considered for the study. In total, 38 patients (nine female, 29 male, mean age 52 years; 29 to 78) completed the study. Dynamic ultrasound examination was performed to confirm the diagnosis and measure the gap between ruptured tendon ends. Outcome was assessed using dynamometric testing of plantarflexion and the Achilles tendon Total Rupture score (ATRS) six months after the completion of a rehabilitation programme. Patients with a gap ≥ 10 mm with the ankle in the neutral position had significantly greater peak torque deficit than those with gaps < 10 mm (mean 23.3%; 7% to 52% vs 14.3%; 0% to 47%, p = 0.023). However, there was no difference in ATRS between the two groups (mean score 87.2; 74 to 100 vs 87.4; 68 to 97, p = 0.467). There was no significant correlation between gap size and torque deficit (τ = 0.103), suggesting a non-linear relationship. There was also no significant correlation between ATRS and peak torque deficit (τ = -0.305). This is the first study to identify an association between tendon gap and functional outcome in acute rupture of the Achilles tendon. We have identified 10 mm as a gap size at which deficits in plantarflexion strength become significantly greater, however, the precise relationship between gap size and plantarflexion strength remains unclear. Large, multicentre studies will be needed to clarify this relationship and identify population subgroups in whom deficits in peak torque are reflected in patient-reported outcome measures. Cite this article: Bone Joint J 2017;99-B:87-93. ©2017 The British Editorial Society of Bone & Joint Surgery.

Congenital Stapes Ankylosis in Children: Surgical Findings and Results in 35 Cases.

PubMed

Vincent, Robert; Wegner, Inge; Kamalski, Digna M A; Bittermann, Arnold J N; Grolman, Wilko

2016-04-01

To evaluate surgical findings and hearing results in children undergoing middle ear surgery for congenital stapes ankylosis with or without other ossicular malformations (Teunissen and Cremers class I and class II malformations). A nonrandomized, nonblinded case series of prospectively collected data. A tertiary referral center. Twenty-eight consecutive pediatric patients who underwent 35 surgical procedures for congenital stapes ankylosis with or without other ossicular malformations and had available postoperative pure-tone audiometry. Primary stapedotomy with vein graft interposition and reconstruction with a Teflon piston, bucket handle prosthesis or total ossicular replacement prosthesis. Pre- and postoperative audiometric evaluation using four-frequency (0.5, 1, 2, and 4 kHz) audiometry. Air-conduction thresholds, bone-conduction thresholds, and air-bone gaps (ABGs) were measured. Postoperative audiometry was performed at 3, 6, 9, 12, 18, and 24 months after surgery and at a yearly interval thereafter. Overall, a postoperative ABG closure of 10 dB or less was achieved in 73% of class I cases and in 50% of class II cases. A postoperative ABG closure of 20 dB or less was achieved in 77% of class I cases and 67% of class II cases. Postoperative sensorineural hearing loss occurred in one class I case (4%) and none of the class II cases. Stapedotomy is a safe and feasible treatment option in children with congenital stapes ankylosis.

Brazil on the Rise: Implications on U.S. Policies

DTIC Science & Technology

2012-04-01

Brazilian Joint Counternarcotics Opportunity………….6 U.S. Efforts in Bolivia Brazil Fills the U.S. Counternarcotics Gap in Bolivia Future for...efforts Brazil has undertaken with Bolivia, one can see how a multilateral effort in the region yields better results to address the situation...form of Brazil. Brazil Fills the U.S. Counternarcotics Gap in Bolivia In 1998 there was reportedly little to no narcotics transiting Brazil, and

Coatings Would Protect Polymers Against Atomic Oxygen

NASA Technical Reports Server (NTRS)

Banks, Bruce A.; Rutledge, Sharon K.

1995-01-01

Proposed interposition of layers of silver oxide tens to hundreds of angstroms thick between polymeric substrates and overlying films helps protect substrates against chemical attack by monatomic oxygen. In original application, polymer substrate would be, sheet of polyimide supporting array of solar photovoltaic cells on spacecraft in low orbit around Earth. Concept also applicable to protection of equipment in terrestrial laboratory and industrial vacuum and plasma chambers in which monatomic oxygen present.

Vascularized interpositional periosteal connective tissue flap: A modern approach to augment soft tissue

PubMed Central

Agarwal, Chitra; Deora, Savita; Abraham, Dennis; Gaba, Rohini; Kumar, Baron Tarun; Kudva, Praveen

2015-01-01

Context: Nowadays esthetics plays an important role in dentistry along with function of the prosthesis. Various soft tissue augmentation procedures are available to correct the ridge defects in the anterior region. The newer technique, vascularized interpositional periosteal connective tissue (VIP-CT) flap has been introduced, which has the potential to augment predictable amount of tissue and has many benefits when compared to other techniques. Aim: The study was designed to determine the efficacy of the VIP-CT flap in augmenting the ridge defect. Materials and Methods: Ten patients with Class III (Seibert's) ridge defects were treated with VIP-CT flap technique before fabricating fixed partial denture. Height and width of the ridge defects were measured before and after the procedure. Subsequent follow-up was done every 3 months for 1-year. Statistical Analysis Used: Paired t-test was performed to detect the significance of the procedure. Results: The surgical site healed uneventfully. The predictable amount of soft tissue augmentation had been achieved with the procedure. The increase in height and width of the ridge was statistically highly significant. Conclusion: The VIP-CT flap technique was effective in augmenting the soft tissue in esthetic area that remained stable over a long period. PMID:25810597

Scalp Free Flap Reconstruction Using Anterolateral Thigh Flap Pedicle for Interposition Artery and Vein Grafts

PubMed Central

Park, Jun Hyung; Eun, Suk Chan; Lee, Jong Hoon; Hong, Sung Hee; Kim, Chin Whan

2012-01-01

We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had 4×3 cm and 6×5 cm scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested. The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis. PMID:22783493

Proximal gastrectomy with jejunal interposition and TGRY anastomosis for proximal gastric cancer.

PubMed

Zhao, Ping; Xiao, Shuo-Meng; Tang, Ling-Chao; Ding, Zhi; Zhou, Xiang; Chen, Xiao-Dong

2014-07-07

To compare the short-term outcomes of patients who underwent proximal gastrectomy with jejunal interposition (PGJI) with those undergoing total gastrectomy with Roux-en-Y anastomosis (TGRY). From January 2009 to January 2011, thirty-five patients underwent PGJI, and forty-one patients underwent TGRY. The surgical efficacy and short-term follow-up outcomes were compared between the two groups. There were no differences in the demographic and clinicopathological characteristics. The mean operation duration and postoperative hospital stay in the PGJI group were statistically longer than those in the TGRY group (P = 0.00). No anastomosis leakage was observed in two groups. No statistically significant difference was found in endoscopic findings, Visick grade or serum albumin level. The single-meal food intake in the PGJI group was more than that in the TGRY group (P = 0.00). The PG group showed significantly better hemoglobin levels in the second year (P = 0.02). The two-year survival rate was not significantly different (PGJI vs TGRY, 93.55% vs 92.5%, P = 1.0). PGJI is a safe, radical surgical method for proximal gastric cancer and leads to better outcomes in terms of the single-meal food intake and hemoglobin level, compared with TGRY in the short term.

T-joints of Ti alloys with hybrid laser-MIG welding: macro-graphic and micro-hardness analyses

NASA Astrophysics Data System (ADS)

Spina, R.; Sorgente, D.; Palumbo, G.; Scintilla, L. D.; Brandizzi, M.; Satriano, A. A.; Tricarico, L.

2012-03-01

Titanium alloys are characterized by high mechanical properties and elevated corrosion resistance. The combination of laser welding with MIG/GMAW has proven to improve beneficial effects of both processes (keyhole, gap-bridging ability) while limiting their drawbacks (high thermal gradient, low mechanical resistance) In this paper, the hybrid Laser-GMAW welding of Ti-6Al-4V 3-mm thick sheets is investigated using a specific designed trailing shield. The joint geometry was the double fillet welded T-joint. Bead morphologies, microstructures and mechanical properties (micro-hardness) of welds were evaluated and compared to those achieved for the base metals.

Spacing distribution functions for the one-dimensional point-island model with irreversible attachment

NASA Astrophysics Data System (ADS)

González, Diego Luis; Pimpinelli, Alberto; Einstein, T. L.

2011-07-01

We study the configurational structure of the point-island model for epitaxial growth in one dimension. In particular, we calculate the island gap and capture zone distributions. Our model is based on an approximate description of nucleation inside the gaps. Nucleation is described by the joint probability density pnXY(x,y), which represents the probability density to have nucleation at position x within a gap of size y. Our proposed functional form for pnXY(x,y) describes excellently the statistical behavior of the system. We compare our analytical model with extensive numerical simulations. Our model retains the most relevant physical properties of the system.

A Pilot Study of Common Bile Duct Reconstruction with CorMatrix Extracellular Matrix in Swine (Sus scrofa)

DTIC Science & Technology

2015-02-06

additional pages if necessary.) PROTOCOL#: FDG20140008A DATE: 6 February 2015 PROTOCOL TITLE: A Pilot Study of Common Bile Duct Reconstruction with...obstruction or bile peritonitis. This was reported to the IACUC chair. 9. REDUCTION, REFINEMENT, OR REPLACEMENT OF ANIMAL USE; REPLACEMENT...benefit the DoD/USAF? We developed a porcine model of common bile duct injury and interposition grafting, gained experience managing these patients

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

Lockwood, Jr., Neil; McLellan, Jason G; Crossley, Brian

The Resident Fish Stock Status above Chief Joseph and Grand Coulee Dams Project, commonly known as the Joint Stock Assessment Project (JSAP) is a management tool using ecosystem principles to manage artificial fish assemblages and native fish in altered environments existing in the Columbia River System above Chief Joseph and Grand Coulee Dams (blocked area). The three-phase approach of this project will enhance the fisheries resources of the blocked area by identifying data gaps, filling data gaps with research, and implementing management recommendations based on research results. The Blocked Area fisheries information housed in a central location will allow managersmore » to view the entire system while making decisions, rather than basing management decisions on isolated portions of the system. The JSAP (NWPPC program measure 10.8B.26) is designed and guided jointly by fisheries managers in the blocked area and the Columbia Basin blocked area management plan (1998). The initial year of the project (1997) identified the need for a central data storage and analysis facility, coordination with the StreamNet project, compilation of blocked area fisheries information, and a report on the ecological condition of the Spokane River System. These needs were addressed in 1998 by acquiring a central location with a data storage and analysis system, coordinating a pilot project with StreamNet, compiling fisheries distribution data throughout the blocked area, identifying data gaps based on compiled information, and researching the ecological condition of the Spokane River. In order to ensure that any additional information collected throughout the life of this project will be easily stored and manipulated by the central storage facility, it was necessary to develop standardized methodologies between the JSAP fisheries managers. The use of common collection and analytical tools is essential to the process of streamlining joint management decisions. In 1999 and 2000 the project began to address some of the identified data gaps, throughout the blocked area, with a variety of newly developed sampling projects, as well as, continuing with ongoing data collection of established projects.« less

Development of Thermal Barriers For Solid Rocket Motor Nozzle Joints

NASA Technical Reports Server (NTRS)

Steinetz, Bruce M.; Dunlap, Patrick H., Jr.

2000-01-01

Joints in the Space Shuttle solid rocket motors are sealed by O-rings to contain combustion gases inside the rocket that reach pressures of up to 900 psi and temperatures of up to 5500 F. To provide protection for the O-rings, the motors are insulated with either phenolic or rubber insulation. Gaps in the joints leading up to the O-rings are filled with polysulfide joint-fill compounds as an additional level of protection. The current RSRM nozzle-to-case joint design incorporating primary, secondary, and wiper O-rings experiences gas paths through the joint-fill compound to the innermost wiper O-ring in about one out of every seven motors. Although this does not pose a safety hazard to the motor, it is an undesirable condition that NASA and rocket manufacturer Thiokol want to eliminate. Each nozzle-to-case joint gas path results in extensive reviews and evaluation before flights can be resumed. Thiokol and NASA Marshall are currently working to improve the nozzle-to-case joint design by implementing a more reliable J-leg design that has been used successfully in the field and igniter joint. They are also planning to incorporate the NASA Glenn braided carbon fiber thermal barrier into the joint. The thermal barrier would act as an additional level of protection for the O-rings and allow the elimination of the joint-fill compound from the joint.

Smoothing spline ANOVA frailty model for recurrent event data.

PubMed

Du, Pang; Jiang, Yihua; Wang, Yuedong

2011-12-01

Gap time hazard estimation is of particular interest in recurrent event data. This article proposes a fully nonparametric approach for estimating the gap time hazard. Smoothing spline analysis of variance (ANOVA) decompositions are used to model the log gap time hazard as a joint function of gap time and covariates, and general frailty is introduced to account for between-subject heterogeneity and within-subject correlation. We estimate the nonparametric gap time hazard function and parameters in the frailty distribution using a combination of the Newton-Raphson procedure, the stochastic approximation algorithm (SAA), and the Markov chain Monte Carlo (MCMC) method. The convergence of the algorithm is guaranteed by decreasing the step size of parameter update and/or increasing the MCMC sample size along iterations. Model selection procedure is also developed to identify negligible components in a functional ANOVA decomposition of the log gap time hazard. We evaluate the proposed methods with simulation studies and illustrate its use through the analysis of bladder tumor data. © 2011, The International Biometric Society.

The Joint Expeditionary Culture Gap

DTIC Science & Technology

2004-05-26

and three, politically powerful lobbies- feminists , homosexuals, even the disabled-will be enraged that the force you have assembled does not look... therapy of victimhood.61 Present recruiting methodology stresses incentives and boasts benefits, while undermining the privilege and honor of

Partial Versus Total Trapeziectomy Thumb Arthroplasty: An Expertise-based Feasibility Study

PubMed Central

Levis, Carolyn; Patel, Pinkal; Murphy, Jessica; Duku, Eric

2018-01-01

Background: There are numerous surgical techniques for the treatment of first carpometacarpal joint osteoarthritis, however, controversy exists as to whether outcomes differ between techniques. This feasibility study aimed to determine if a large-scale, health-related quality of life and functional outcomes study comparing 2 surgical techniques, complete trapeziectomy with ligament reconstruction and tendon interposition (T + LRTI) versus partial trapeziectomy and tendon interposition (PT + TI) arthroplasty, is possible. Methods: Patients with advanced stage arthritis (Eaton stages II–IV) of the thumb were invited to undergo either T + LRTI or PT + TI at 1 of the 2 hand surgery practices. Feasibility outcomes included: (1) Process: recruitment rate; (2) Resources: eligibility rate, eligibility criteria, retention, and compliance rates (completion of health-related quality of life questionnaires, Disabilities of the Arm, Shoulder, and Hand, EuroQol-5D-3L, and SF-36, and functional measurements, grip, key pinch, and tip pinch strength, at 1-week preoperatively and 1, 3, 6, and 12 months postoperatively); (3) Management: determining the practices’ commitment to the study; and (4) Scientific: calculation of the variances and treatment effect sizes (ES) of differences between procedures. Data from baseline measurements and 6-month follow-up were used for analysis. Results: Sixty patients were screened, of which 34 (57%) were eligible for surgery. Twenty-one (81%) of the 26 ineligible patients were excluded due to previous or additional planned surgical procedures on the same hand, particularly carpal tunnel release (n = 17). Twenty patients consented; 12 in the T + LRTI and 8 in the PT + TI group. The highest completion rate for the 3 questionnaires and the functional measurements, for both groups was at 6-month time point. Compliance rates for questionnaire completion at 6-months were calculated at 50% and 75% for the T + LRTI and PT + TI group, respectively. Functional measurement completion rate was 50% and 63% for T + LRTI and PT + TI groups, respectively. Treatment ES were group dependent, with Disabilities of the Arm, Shoulder, and Hand, EuroQol-5D-3L usual activities and anxiety/depression showing a large ES in the PT + TI group; the T + LRTI group showed large ES in EQ-5D state of health today. Conclusions: Authors conclude that a large-scale study is feasible and dependent on: (1) increasing sample size to account for the high attrition rate; (2) liberalizing inclusion criteria to include patients with carpal tunnel syndrome; (3) allotting more time at follow-up visits to ensure completion of all measurements; and (4) increasing staff involvement (ie, develop rapport with patients and maintain stability with research assistants). PMID:29707461

Forming Completely Penetrated Welded T-joints when Pulsed Arc Welding

NASA Astrophysics Data System (ADS)

Krampit, N. Yu; Krampit, M. A.; Sapozhkov, A. S.

2016-04-01

The paper is focused on revealing the influence of welding parameters on weld formation when pulsed arc welding. As an experimental sample a T-joint over 10 mm was selected. Welding was carried out in flat position, which required no edge preparation but provided mono-directional guaranteed root penetration. The following parameters of welding were subjected to investigation: gap in the joint, wire feed rate and incline angles of the torch along and across the weld axis. Technological recommendations have been made with respect to pulsed arc welding; the cost price of product manufacturing can be reduced on their basis due to reduction of labor input required by machining, lowering consumption of welding materials and electric power.

Outcome Following Spinal Accessory to Suprascapular (Spinoscapular) Nerve Transfer in Infants with Brachial Plexus Birth Injuries

PubMed Central

Ruchelsman, David E.; Ramos, Lorna E.; Alfonso, Israel; Price, Andrew E.; Grossman, Agatha

2009-01-01

The purpose of this study is to evaluate the value of distal spinal accessory nerve (SAN) transfer to the suprascapular nerve (SSN) in children with brachial plexus birth injuries in order to better define the application and outcome of this transfer in these infants. Over a 3-year period, 34 infants with brachial plexus injuries underwent transfer of the SAN to the SSN as part of the primary surgical reconstruction. Twenty-five patients (direct repair, n = 20; interposition graft, n = 5) achieved a minimum follow-up of 24 months. Fourteen children underwent plexus reconstruction with SAN-to-SSN transfer at less than 9 months of age, and 11 underwent surgical reconstruction at the age of 9 months or older. Mean age at the time of nerve transfer was 11.6 months (range, 5–30 months). At latest follow-up, active shoulder external rotation was measured in the arm abducted position and confirmed by review of videos. The Gilbert and Miami shoulder classification scores were utilized to report shoulder-specific functional outcomes. The effects of patient age at the time of nerve transfer and the use of interpositional nerve graft were analyzed. Overall mean active external rotation measured 69.6°; mean Gilbert score was 4.1 and the mean Miami score was 7.1, corresponding to overall good shoulder functional outcomes. Similar clinical and shoulder-specific functional outcomes were obtained in patients undergoing early (<9 months of age, n = 14) and late (>9 months of age, n = 11) SAN-to-SSN transfer and primary plexus reconstruction. Nine patients (27%) were lost to follow-up and are not included in the analysis. Optimum results were achieved following direct transfer (n = 20). Results following the use of an interpositional graft (n = 5) were rated satisfactory. No patient required a secondary shoulder procedure during the study period. There were no postoperative complications. Distal SAN-to-SSN (spinoscapular) nerve transfer is a reliable option for shoulder reinnervation in infants with brachial plexus birth injuries. Direct transfer seems to be the optimum method. The age of the patient does not seem to significantly impact on outcome. PMID:19882190

Long-term functional and oncological outcomes of patients undergoing sural nerve interposition grafting during robot-assisted laparoscopic radical prostatectomy.

PubMed

Zorn, Kevin C; Bernstein, Andrew J; Gofrit, Ofer N; Shikanov, Sergey A; Mikhail, Albert A; Song, David H; Zagaja, Gregory P; Shalhav, Arieh L

2008-05-01

For men with high-volume or high-grade prostate cancer, wide excision of the ipsilateral neurovascular bundle is commonly performed. The concept of nerve reconstruction is intriguing as a feasible approach to preserve sexual function (SF). We sought to evaluate the functional, pathologic, and oncologic outcomes of men who underwent robot-assisted sural-nerve graft (SNG) interposition. Between February 2003 and May 2007, 1175 consecutive men underwent robot-assisted laparoscopic radical prostatectomy (RLRP). Database analysis identified 27 men who had SNG: 4 bilateral (BL) and 23 unilateral (UL). SF was prospectively evaluated preoperatively and at 1, 3, 6, 12, and 24 months postoperatively using validated questionnaires. Positive surgical margins (PSMs), biochemical recurrence (BCR), and potency were evaluated. Compared with RLRP patients without SNG, patients with SNG were younger (57.2 v 61.8 years, P=0.02), had a higher Gleason score (P=0.02), and had a higher clinical and pathologic stage (P<0.001 for both). Mean surgical time was significantly longer (349 v 195 min, P<0.001) in patients with SNG. With a mean follow-up of 26.1 months, 11 (47.8%) patients with UL-SNG and zero men with BL-SNG regained potency. No significant difference in SF was observed between UL nerve sparing and no SNG (56%) compared with UL nerve sparing with UL-SNG (P=0.44). Rates of return-to-baseline SF (RTB-SF) at 6, 12, and 24 months were 11%, 36% and 45% for UL-SNG, respectively, which were also comparable to UL nerve sparing only (P>0.05). No patient (0%) in the BL-SNG group ever achieved RTB-SF status at any time point. PSMs were observed in 37% (10/27) of all patients. BCR occurred in nine patients (33.3%), seven of whom had PSM (78%); treatment failure occurred within 6 months of surgery, necessitating androgen deprivation therapy. Despite optimism regarding SNG, long-term functional outcomes have been disappointing, particularly for BL nerve interposition. UL-SNG functional outcomes do not appear to improve outcomes when compared with men with UL nerve preservation. With the greater risk of PSM and BCR in patients who are considered candidates for SNG, newer treatment modalities are needed to cure their disease while preserving SF.

[Possibilities and results of surgical treatment of benign tracheoesophageal fistula].

PubMed

Krajc, T; Janík, M; Lucenic, M; Benej, R; Harustiak, S

2010-08-01

Review of literature and a single-institution retrospective analysis of possibilities and results of various surgical techniques in treatment of benign tracheoesophageal fistula (TEF). Between 1995 and 2010, 26 patients with benign tracheoesophageal fistula of various etiology underwent surgical treatment at the Department of Thoracic Surgery of Slovak Medical University and Faculty Hospital in Bratislava. The majority of patients had a postintubation TEF (21 cases), two fistulas were of traumatic origin, one iatrogenic, one congenital with adulthood manifestation and one tracheo-neoesophageal (TNEF) following an esophagectomy for carcinoma via extended cervical approach with lymphadenectomy and sternal retraction adpoted from transcervical extended mediastinal lymphadenectomy. We review the possible means of surgical treatment of TEF, of which we most frequently used segmental tracheal resection with end-to-end anastomosis and a non-overlying suture of the esophageal defect without muscle flap interposition (16 patients), transsection of the fistula with muscular flap interposition via cervical (2 patients) or transthoracic (1 patient) approach; or a T-tube insertion with (1 patient) or without (5 patients) discision and suture of the TEF. The only tracheo-neoesophageal fistula in our experience had been treated by neoesophagectomy, covering of tracheal defect by intercostal muscle flap and cervical esophagostomy. Short- and long-term results of TEF treatment in our institution have been favourable, with perioperative mortality of 3.8% (the patient with tracheo-neoesophageal fistula). Morbidity included 1 partial tracheal anastomotic dehiscence, 3 temporary left recurrent nerve palsies, temporary deglutition disorders (15 patients), tracheal anastomosis granulations in 1 patient and 2 wound infections. Out of 26 patients 15 (58%) are being followed-up on a regular basis, all with good (12 patients) or satisfactory (3 patients) functional results. In the paper we analyze the advantages and disadvantages of various techniques and their alternatives in the treatment of TEF. As the most reliable and suitable solution for patients with postintubation TEF, breathing spontaneously and with acceptable nutritional status, we favour segmental trachea resection with end-to-end anastomosis and esophageal suture without muscle interposition, regardless of presence of concomitant tracheal stenosis. Fistulae of other etiologies require diverse approaches, especially tailored with respect to their location. Management of tracheo-neoesophageal fistula following esophagectomy for carcinoma is extremely demanding. Therefore, it is crucial to adhere to basic rules of prevention of such benign but potentially fatal entities as TEF and TNEF.

Significant effect of the posterior tibial slope and medial/lateral ligament balance on knee flexion in total knee arthroplasty.

PubMed

Fujimoto, Eisaku; Sasashige, Yoshiaki; Masuda, Yasuji; Hisatome, Takashi; Eguchi, Akio; Masuda, Tetsuo; Sawa, Mikiya; Nagata, Yoshinori

2013-12-01

The intra-operative femorotibial joint gap and ligament balance, the predictors affecting these gaps and their balances, as well as the postoperative knee flexion, were examined. These factors were assessed radiographically after a posterior cruciate-retaining total knee arthroplasty (TKA). The posterior condylar offset and posterior tibial slope have been reported as the most important intra-operative factors affecting cruciate-retaining-type TKAs. The joint gap and balance have not been investigated in assessments of the posterior condylar offset and the posterior tibial slope. The femorotibial gap and medial/lateral ligament balance were measured with an offset-type tensor. The femorotibial gaps were measured at 0°, 45°, 90° and 135° of knee flexion, and various gap changes were calculated at 0°-90° and 0°-135°. Cruciate-retaining-type arthroplasties were performed in 98 knees with varus osteoarthritis. The 0°-90° femorotibial gap change was strongly affected by the posterior condylar offset value (postoperative posterior condylar offset subtracted by the preoperative posterior condylar offset). The 0°-135° femorotibial gap change was significantly correlated with the posterior tibial slope and the 135° medial/lateral ligament balance. The postoperative flexion angle was positively correlated with the preoperative flexion angle, γ angle and the posterior tibial slope. Multiple-regression analysis demonstrated that the preoperative flexion angle, γ angle, posterior tibial slope and 90° medial/lateral ligament balance were significant independent factors for the postoperative knee flexion angle. The flexion angle change (postoperative flexion angle subtracted by the preoperative flexion angle) was also strongly correlated with the preoperative flexion angle, posterior tibial slope and 90° medial/lateral ligament balance. The postoperative flexion angle is affected by multiple factors, especially in cruciate-retaining-type TKAs. However, it is important to pay attention not only to the posterior tibial slope, but also to the flexion medial/lateral ligament balance during surgery. A cruciate-retaining-type TKA has the potential to achieve both stability and a wide range of motion and to improve the patients' activities of daily living.

Use of clinical and computed tomography findings to assess long-term unsatisfactory outcome after femoral head and neck ostectomy in four large breed dogs.

PubMed

Ober, Ciprian; Pestean, Cosmin; Bel, Lucia; Taulescu, Marian; Milgram, Joshua; Todor, Adrian; Ungur, Rodica; Leșu, Mirela; Oana, Liviu

2018-05-10

Femoral head and neck ostectomy (FHNO) is a salvage surgical procedure intended to eliminate hip joint laxity associated pain in the immature dog, or pain due to secondary osteoarthritis in the mature dog. The outcome of the procedure is associated with the size of the dog but the cause of a generally poorer outcome in larger breeds has not been determined. The objective of this study was to assess the long-term results of FHNO associated with unsatisfactory functional outcome by means of clinical examination and computed tomography (CT) scanning. Four large mixed breed dogs underwent FHNO in different veterinary clinics. Clinical and CT scanning evaluations were carried out long time after the procedures had been done. Hip pain, muscle atrophy, decreased range of motion and chronic lameness were observed at clinical examination. Extensive remodelling, unacceptable bone-on-bone contact with bony proliferation involving the femoral neck and acetabulum, but also excessive removal with bone lysis were observed by CT scanning. Revision osteotomy was performed in one dog. Deep gluteal muscle interposition was used, but no improvements were observed postoperatively. This is the first report on the evaluation of three-dimensional CT reconstructions of the late bone remodelling associated with poor clinical outcome in large dogs. The study shows that FHNO could lead to severe functional deficits in large breed dogs. An extensive follow-study is necessary to more accurately determine the frequency of such complications.

A study on fatigue strength reduction factor for small diameter socket welded pipe joints

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

Higuchi, Makoto; Nakagawa, Akira; Hayashi, Makoto

1996-12-01

Factors that may exert influence on the fatigue strength of small diameter socket welded joints of nominal diameter in the 20--50 mm range have been investigated by the fully reversed four-point bending fatigue test with the material, diameter, pipe schedule, throat depth, bead shape, slip-on gap, and root defect as the testing parameters. The fatigue strength of socket joints depended acutely on the diameter. When the diameter is large, the fatigue strength tended to be low and the fracture is of the root-failure mode; when it is small, on the other hand, the fatigue strength is high and the fracturemore » is of the toe-failure mode. Stainless steel proved to be superior to carbon steel; it gave rise to 1.37 times the fatigue strength of the latter for socket joints of nominal diameter 50 mm; the fatigue strength reduction factor determined at 10{sup 7} cycles with respect to the fatigue strength of smooth base metal in the fully reversed fatigue was about 4 for stainless steel and about 5 for carbon steel. The fatigue strength was higher, the larger the Sche number (i.e., the thicker the pipe wall); it was improved markedly by placing one final refinement pass on the toe or by eliminating the slip-on gap. An empirical formula relating the size of the root defect to the fatigue strength reduction has been proposed.« less

Minimally invasive repair of the tibialis anterior tendon using a semitendinosus autograft.

PubMed

Michels, Frederick; Van Der Bauwhede, Jan; Oosterlinck, Dirk; Thomas, Sam; Guillo, Stéphane

2014-03-01

Ruptures of the tibialis anterior tendon are rare but can cause substantial functional deficiencies. The literature regarding the treatment of such injuries is very limited. Atraumatic ruptures often occur in the presence of an abnormal tendon structure, and retraction often makes end-to-end repair impossible. With traumatic lesions, the risk of developing both adhesions and scar tissue is high. This study assesses the results of a surgical reconstruction using the interposition of a semitendinosus tendon autograft in 12 patients. Three patients had a traumatic rupture, and 9 patients had an atraumatic rupture. In 8 patients, the procedure was carried out using a minimally invasive technique. The average postoperative American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score was 95.7 in the atraumatic group and 94.7 in the traumatic group. Active dorsiflexion was possible after 2 to 3 weeks. We believe that the interposition of a strong, healthy tendon facilitated healing and allowed early weight bearing. All patients had good recovery of dorsiflexion and gait. Repairing a ruptured tibialis anterior tendon using a semitendinosus autograft was a reliable technique and offered a good result. With the minimally invasive approach, there was no need to divide the extensor retinaculum, which we believe allowed faster recovery and reduced the risk of adhesions and wound healing problems. Level IV, retrospective case series.

Development of upper tract stones in patients with congenital neurogenic bladder.

PubMed

Stephany, Heidi A; Clayton, Douglass B; Tanaka, Stacy T; Thomas, John C; Pope, John C; Brock, John W; Adams, Mark C

2014-02-01

Patients with neurogenic bladder are at increased risk of developing upper tract stones. We hypothesized that patients with lower urinary tract stone disease are at greater risk of developing upper tract stones. We performed a 10-year retrospective case-control study of patients with neurogenic bladder to determine the association between bladder and upper tract stones. Independent risk factors for upper tract stones were assessed. Cases and controls were matched 1:1. Univariable analysis was performed by Fisher's exact test and the Mann-Whitney U test. Multivariable logistic regression was performed. 52 cases and controls were identified. Cases were significantly more likely to be non-ambulatory, have bowel-urinary tract interposition, thoracic level dysraphism, and history of bladder stones. On multivariable analysis, independent predictors of stone formation were male sex (OR 2.82; p = 0.02), dysraphism involving the thoracic spine (OR 3.37; p = 0.014) bowel-urinary tract interposition (OR 2.611; p = 0.038), and a history of bladder stones (OR 3.57; p = 0.015). Patients with neurogenic bladder are at increased risk for upper tract stones. The presence of bladder stones may herald the development of upper tract stones. The predictors of stone disease identified should guide prospective studies to better understand the natural history of upper tract stone development in this population. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Impact of very advanced donor age on hepatic artery thrombosis after liver transplantation.

PubMed

Cescon, Matteo; Zanello, Matteo; Grazi, Gian Luca; Cucchetti, Alessandro; Ravaioli, Matteo; Ercolani, Giorgio; Del Gaudio, Massimo; Lauro, Augusto; Morelli, Maria Cristina; Pinna, Antonio Daniele

2011-08-27

The impact of advanced donor age on hepatic artery thrombosis (HAT) after liver transplantation (LT) is controversial. We analyzed the incidence of and risk factors for HAT in LT with donors aged 70 years or older. Eighty patients were transplanted between 1998 and 2002 (group A) and 132 between 2003 and 2008 (group B). In the more recent approach to hepatic artery (HA) reconstruction, the donor HA was systematically preferred to the Carrel patch/celiac trunk, the reconstruction of donor accessory right HA on the donor gastroduodenal artery significantly increased, and the use of interposition grafts was minimized. Group B showed higher Model for End-stage Liver Disease score, lower ischemia time, and lower use of the folding technique/mesenteric conduits. There were 10 cases of HAT (4.7%): 8 (10%) in group A and 2 (1.5%) in group B (P=0.007). Early HAT occurred in 7 (8.8%) patients in group A and in 2 (1.5%) in group B (P=0.02). Group A (P=0.01), anatomical variations of HA (P=0.005), and the use of interposition grafts (P=0.004) were all factors independently affecting HAT. A low incidence of late HAT was observed in single-center LTs with very old donors. Early HAT decreased over time to largely acceptable rates because of more appropriate technical management.

Critical bending moment of implant-abutment screw joint interfaces: effect of torque levels and implant diameter.

PubMed

Tan, Ban Fui; Tan, Keson B; Nicholls, Jack I

2004-01-01

Critical bending moment (CBM), the moment at which the external nonaxial load applied overcomes screw joint preload and causes loss of contact between the mating surfaces of the implant screw joint components, was measured with 2 types of implants and 2 types of abutments. Using 4 test groups of 5 implant-abutment pairs, CBM at the implant-abutment screw joint was measured at 25%, 50%, 75%, and 100% of the manufacturer's recommended torque levels. Regular Platform (RP) Nobel Biocare implants (3.75 mm diameter), Wide Platform (WP) Nobel Biocare implants (5.0 mm diameter), CeraOne abutments, and Multiunit abutments were used. Microstrain was measured as loads were applied to the abutment at various distances from the implant-abutment interface. Strain instrumentation logged the strain data dynamically to determine the point of gap opening. All torque applications and strain measurements were repeated 5 times. For the CeraOne-RP group, the mean CBMs were 17.09 Ncm, 35.35 Ncm, 45.63 Ncm, and 62.64 Ncm at 25%, 50%, 75%, and 100% of the recommended torque level, respectively. For the CeraOne-WP group, mean CBMs were 28.29 Ncm, 62.97 Ncm, 92.20 Ncm, and 127.41 Ncm; for the Multiunit-RP group, 16.08 Ncm, 21.55 Ncm, 34.12 Ncm, and 39.46 Ncm; and for the Multiunit-WP group, 15.90 Ncm, 32.86 Ncm, 43.29 Ncm, and 61.55 Ncm at the 4 different torque levels. Two-way analysis of variance (ANOVA) (P < .001) revealed significant effects for the test groups (F = 2738.2) and torque levels (F = 2969.0). The methodology developed in this study allows confirmation of the gap opening of the screw joint for the test groups and determination of CBM at different torque levels. CBM was found to differ among abutment systems, implant diameters, and torque levels. The torque levels recommended by the manufacturer should followed to ensure screw joint integrity.

Autocorrelation Function for Monitoring the Gap between The Steel Plates During Laser Welding

NASA Astrophysics Data System (ADS)

Mrna, Libor; Hornik, Petr

Proper alignment of the plates prior to laser welding represents an important factor that determines the quality of the resulting weld. A gap between the plates in a butt or overlap joint affects the oscillations of the keyhole and the surrounding weld pool. We present an experimental study of the butt and overlap welds with the artificial gap of the different thickness of the plates. The welds were made on a 2 kW fiber laser machine for the steel plates and the various welding parameters settings. The eigenfrequency of the keyhole oscillations and its changes were determined from the light emissions of the plasma plume using an autocorrelation function. As a result, we describe the relations between the autocorrelation characteristics, the thickness of the gap between plates and the weld geometry.

Development of the weld-braze joining process

NASA Technical Reports Server (NTRS)

Bales, T. T.; Royster, D. M.; Arnold, W. E., Jr.

1973-01-01

A joining process, designated weld-brazing, was developed which combines resistance spot welding and brazing. Resistance spot welding is used to position and aline the parts, as well as to establish a suitable faying-surface gap for brazing. Fabrication is then completed at elevated temperature by capillary flow of the braze alloy into the joint. The process was used successfully to fabricate Ti-6Al-4V alloy joints by using 3003 aluminum braze alloy and should be applicable to other metal-braze systems. Test results obtained on single-overlap and hat-stiffened panel specimens show that weld-brazed joints were superior in tensile shear, stress rupture, fatigue, and buckling compared with joints fabricated by conventional means. Another attractive feature of the process is that the brazed joint is hermetically sealed by the braze material, which may eliminate many of the sealing problems encountered with riveted or spot welded structures. The relative ease of fabrication associated with the weld-brazing process may make it cost effective over conventional joining techniques.

The role of joint ventures in bridging the gap between research and management

USDA-ARS?s Scientific Manuscript database

No single entity can effectively address conservation planning and actions for migratory bird species that move across continents annually to fulfill their habitat needs. Successful landscape-level conservation requires cooperation and coordination of efforts among individual conservation entities....

Malleus-to-footplate prosthetic interposition: experience with 265 patients.

PubMed

Colletti, V; Fiorino, F G

1999-03-01

Absence of the long process of the incus with or without absence of the stapes head accounts for more than 80% of ossicular discontinuities. Total or partial replacement prostheses, made of various materials, are interposed to restore the transfer function of the middle ear. To simplify ossicular reconstruction, reduce operative times and costs, improve functional outcomes, and avoid the risk of infections, we have adopted, during the past 10 years, a technique that makes use of a personally designed alloplastic prosthetic device. The prosthesis connects the malleus to the footplate, even in the presence of the stapes superstructure. This malleus-to-footplate prosthesis consists in a plastipore-coated steel piston and hydroxyapatite head, complete with a groove. The groove is placed beneath the malleus neck after dissection of the tensor tympani tendon and the shaft of the piston on the footplate. Two hundred ninety primary ossiculoplasties with the malleus-to-footplate prostheses were performed in 265 patients from 1986 to 1995 in the ENT Department of the University of Verona. The average postoperative air-bone gap at 0.5 to 3 kHz was 11 dB at 1 year and 14 dB at 5 years. These outcomes are significantly better than those personally obtained previously with ossicular or alloplastic prostheses. No extrusions occurred. The structural characteristics of the malleus-to-foot-plate prosthesis endow the prosthesis with a high degree of biocompatibility and stability and optimal sound-transfer function. The rationale for this particular ossiculoplasty procedure is discussed.

Pelvic modelling and the comparison between plate position for double pelvic osteotomy using artificial cancellous bone and finite element analysis.

PubMed

McCartney, William; MacDonald, Bryan; Ober, Ciprian Andrei; Lostado-Lorza, Rubén; Gómez, Fátima Somovilla

2018-03-20

Finite element analysis was used to compare fixation methods for double pelvic osteotomy (DPO). Using 3D scanning a stereolithography (stl) image was produced of a canine pelvis and this was subsequently refined in computer aided design (CAD). Using the CAD files, the images were imported in MSC Marc software to produce a working finite element (FE) model with 3 dimensional tetrahedral elements with linear shaped functions. The dimensions of a precontoured pelvic osteotomy plate with eight screws and a twisted seven screw straight plate were used to build the 2 fixations implants for the FE models. An equivalent load of 300 N was applied progressively on all FE models in order to facilitate its convergence. The load was applied in a distributed manner on the femur-hip joint contact area in order to simulate the actual behavior of the joint. The aim of the present study was to analyze the difference in stiffness and behavior under loading between a lateral vs ventral plate fixation, with unlocked screws and different gap scenarios, for stabilization of a pelvic osteotomy using finite element analysis. From both configurations the maximum displacement of the ventral plate with 7 screws without gap had a value of 1.988 mm, while in the DPO plate had a maximum displacement of 2.191 mm. The load applied for each of the different configurations studied when a gap of 1° was considered and also when a condition of no gap was considered. The ventral plate was stiffer than the lateral plate when a gap was not present. When the gap was closed in the ventral plate, the stiffness increased until a point that remained constant. Ventral plate fixation can be as or more stiff as lateral plate fixation and provides flexible fixation. This behavior should reduce screw loosening. Using ventral plate fixation is recommended to reduce screw loosening or failure.

High Energy Laser Joint Technology Office: a mission overview

NASA Astrophysics Data System (ADS)

Seeley, Don D.; Slater, John M.

2004-10-01

The High Energy Laser Joint Technology Office (HEL-JTO) was established in 2000 for the purpose of developing and executing a comprehensive investment strategy for HEL science and technology that would underpin weapons development. The JTO is currently sponsoring 80 programs across industry, academia, and government agencies with a budget of approximately $60 million. The competitively awarded programs are chosen to advance the current state of the art in HEL technology and fill technology gaps, thus providing a broad capability that can be harvested in acquisition programs by the military services.

Improved Abutting Edges For Welding In Keyhole Mode

NASA Technical Reports Server (NTRS)

Harwing, Dennis D.; Sanders, John M.

1994-01-01

Welds of better quality made, and/or heat input reduced. Improved shapes devised for abutting edges of metal pieces to be joined by plasma arc welding in keyhole mode, in which gas jet maintains molten hole ("keyhole") completely through thickness of weld joint. Edges of metal pieces to be welded together machined to provide required combination gap and shaped, thin sections. Shapes and dimensions chosen to optimize weld in various respects; e.g., to enhance penetration of keyhole or reduce heat input to produce joint of given thickness.

Investigation on microstructure and properties of narrow-gap laser welding on reduced activation ferritic/martensitic steel CLF-1 with a thickness of 35 mm

NASA Astrophysics Data System (ADS)

Wu, Shikai; Zhang, Jianchao; Yang, Jiaoxi; Lu, Junxia; Liao, Hongbin; Wang, Xiaoyu

2018-05-01

Reduced activation ferritic martensitic (RAFM) steel is chosen as a structural material for test blanket modules (TBMs) to be constructed in International Thermonuclear Experimental Reactor (ITER) and China Fusion Engineering Test Reactor (CFETR). Chinese specific RAFM steel named with CLF-1 has been developed for CFETR. In this paper, a narrow-gap groove laser multi-pass welding of CLF-1 steel with thickness of 35 mm is conduced by YLS-15000 fiber laser. Further, the microstructures of different regions in the weld joint were characterized, and tensile impact and micro-hardness tests were carried out for evaluating the mecharical properties. The results show that the butt weld joint of CLF-1 steel with a thickness of 35 mm was well-formed using the optimal narrow-gap laser filler wire welding and no obvious defects was found such as incomplete fusion cracks and pores. The microstructures of backing layer is dominated by lath martensites and the Heat-Affected Zone (HAZ) was mainly filled with two-phase hybrid structures of secondary-tempering sorbites and martensites. The filler layer is similar to the backing layer in microstructures. In tensile tests, the tensile samples from different parts of the joint all fractured at base metal (BM). The micro-hardness of weld metal (WM) was found to be higher than that of BM and the Heat-Affected Zone (HAZ) exhibited no obvious softening. After post weld heat treatment (PWHT), it can be observed that the fusion zone of the autogenous welding bead and the upper filling beads mainly consist of lath martensites which caused the lower impact absorbing energy. The HAZ mainly included two-phase hybrid structures of secondary-tempering sorbites and martensites and exhibited favorable impact toughness.

Effect of temperature and O-ring gland finish on sealing ability of Viton V747-75

NASA Technical Reports Server (NTRS)

Lach, Cynthia L.

1993-01-01

As a part of the redesign project of the Space Shuttle solid rocket motor (SRM) following the Challenger accident, the field joint was redesigned to minimize the relative joint motion caused by internal motor pressurization during ignition. The O-ring seals and glands for the field joint were designed both to accommodate structural deflections and to promote pressure-assisted sealing. Tests were conducted in various face seal fixtures to evaluate the ability of Viton V747-75 O-rings to seal for a range of temperatures and surface finishes of the redesigned O-ring gland. The effect of surface finish on the sealing performance and wear characteristics of the O-rings was evaluated during simulated launch conditions that included low-frequency vibrations, gap openings, and rapid pressurizations. The effect of contamination on the sealing performance was also investigated. The O-rings sealed throughout the 75 deg F leak check test and for the seal tests from 50 deg F to 120 deg F for the range of surface finishes investigated. Although abrasions were found in the O-rings from pressurization against the rougher finishes, these abrasions were not detrimental to sealing. Below 50 deg F, Viton V747-75 O-rings were insufficiently resilient to track the test gap opening.

Knee Osteoarthritis Treatment with the KineSpring Knee Implant System: A Report of Two Cases

PubMed Central

Hayes, David A.; Miller, Larry E.; Block, Jon E.

2012-01-01

Osteoarthritis (OA) is a leading cause of disability in middle-aged and older adults with the prevalence expected to increase by 40% by 2025. This dramatic projected increase in OA reflects, in large part, the alarming obesity epidemic. Indeed, it is now well understood that abnormal loading across the knee joint due to malalignment and/or excessive weight gain is responsible for accelerating OA progression. Consequently, there is a therapeutic need for alternative knee OA treatments that directly address joint overload to fill the gap between ineffective conservative care and invasive joint-modifying surgical procedures. We describe two cases that presented with bilateral knee OA resistant to conservative treatments, each with one knee previously and unsuccessfully treated with high tibial osteotomy to improve alignment and the contralateral knee successfully treated with a joint-preserving, load-absorbing implant (KineSpring Knee Implant System). PMID:23304590

Effects of gap width on droplet transfer behavior in ultra-narrow gap laser welding of high strength aluminum alloys

NASA Astrophysics Data System (ADS)

Song, Chaoqun; Dong, Shiyun; Yan, Shixing; He, Jiawu; Xu, Binshi; He, Peng

2017-10-01

Ultra-narrow gap laser welding is a novel method for thick high strength aluminum alloy plate for its lower heat input, less deformation and higher efficiency. To obtain a perfect welding quality, it is vital to control the more complex droplet transfer behavior under the influence of ultra-narrow gap groove. This paper reports the effects of gap width of groove on droplet transfer behavior in ultra-narrow gap laser welding of 7A52 aluminum alloy plates by a high speed camera, using an ER 5356 filler wire. The results showed that the gap width had directly effects on droplet transfer mode and droplet shape. The droplet transfer modes were, in order, both-sidewall transfer, single-sidewall transfer, globular droplet transfer and bridging transfer, with different droplet shape and transition period, as the gap width increased from 2 mm to 3.5mm. The effect of gap width on lack of fusion was also studied to analyze the cause for lack of fusion at the bottom and on the sidewall of groove. Finally, with a 2.5 mm U-type parallel groove, a single-pass joint with no lack of fusion and other macro welding defects was successfully obtained in a single-sidewall transfer mode.

The effect of muscle weakness on the capability gap during gross motor function: a simulation study supporting design criteria for exoskeletons of the lower limb.

PubMed

Afschrift, Maarten; De Groote, Friedl; De Schutter, Joris; Jonkers, Ilse

2014-08-04

Enabling persons with functional weaknesses to perform activities of daily living (ADL) is one of the main challenges for the aging society. Powered orthoses, or exoskeletons, have the potential to support ADL while promoting active participation of the user. For this purpose, assistive devices should be designed and controlled to deliver assistance as needed (AAN). This means that the level of assistance should bridge the capability gap, i.e. the gap between the capabilities of the subjects and the task requirements. However, currently the actuators of exoskeletons are mainly designed using inverse dynamics (ID) based calculations of joint moments. The goal of the present study is to calculate the capability gap for the lower limb during ADL when muscle weakness is present, which is needed for appropriate selection of actuators to be integrated in exoskeletons. A musculoskeletal model (MM) is used to calculate the joint kinematics, joint kinetics and muscle forces of eight healthy subjects during ADL (gait, sit-to-stand, stand-to-sit, stair ascent, stair descent). Muscle weakness was imposed to the MM by a stepwise decrease in maximal isometric force imposed to all muscles. Muscle forces were calculated using static optimization. In order to compensate for muscle weakness, ideal moment actuators that represent the motors of an exoskeleton in the simulation were added to deliver AAN required to perform the task. The ID approach overestimates the required assistance since it relies solely on the demands of the task, whereas the AAN approach incorporates the capabilities of the subject. Furthermore, the ID approach delivers continuous support whereas the AAN approach targets the period where a capability gap occurs. The level of muscle weakness for which the external demands imposed by ADL can no longer be met by active muscle force production, is respectively 40%, 70%, 80% and 30%. The present workflow allows estimating the AAN during ADL for different levels of muscle weakness, which can be used in the mechatronic design and control of powered exoskeletons. The AAN approach is a more physiological approach than the ID approach, since the MM accounts for the subject-specific capabilities of the user.

Reusable Solid Rocket Motor Nozzle Joint-4 Thermal Analysis

NASA Technical Reports Server (NTRS)

Clayton, J. Louie

2001-01-01

This study provides for development and test verification of a thermal model used for prediction of joint heating environments, structural temperatures and seal erosions in the Space Shuttle Reusable Solid Rocket Motor (RSRM) Nozzle Joint-4. The heating environments are a result of rapid pressurization of the joint free volume assuming a leak path has occurred in the filler material used for assembly gap close out. Combustion gases flow along the leak path from nozzle environment to joint O-ring gland resulting in local heating to the metal housing and erosion of seal materials. Analysis of this condition was based on usage of the NASA Joint Pressurization Routine (JPR) for environment determination and the Systems Improved Numerical Differencing Analyzer (SINDA) for structural temperature prediction. Model generated temperatures, pressures and seal erosions are compared to hot fire test data for several different leak path situations. Investigated in the hot fire test program were nozzle joint-4 O-ring erosion sensitivities to leak path width in both open and confined joint geometries. Model predictions were in generally good agreement with the test data for the confined leak path cases. Worst case flight predictions are provided using the test-calibrated model. Analysis issues are discussed based on model calibration procedures.

Does patella position influence ligament balancing in total knee arthroplasty?

PubMed

Yoon, Jung-Ro; Oh, Kwang-Jun; Wang, Joon Ho; Yang, Jae-Hyuk

2015-07-01

In vivo comparative gap measurements were performed in three different patella positions (reduced, subluxated and everted) using offset-type-force-controlled-spreader-system. Prospectively, 50 knees were operated by total knee arthroplasty using a navigation-assisted gap-balancing technique. The offset-type-force-controlled-spreader-system was used for gap measurements. This commercially available instrument allows controllable tension in patella-reduced position. The mediolateral gaps of knee extension (0°) and flexion (90°) angle were recorded in three different patella positions; reduced, subluxated and everted. Any gap differences of more than 3 mm were considered as a meaningful difference. Correlation between the difference with the demographic data, preoperative radiologic alignment and intraoperative data was analysed. For statistical analysis, ANOVA and Pearson's correlation test were used. The gaps in patella eversion demonstrated smaller gaps both in knee extension and flexion position compared to the gaps of patella reduction position. The amount of decreased gaps was more definite in knee flexion position. Statistically significant difference was observed for the lateral gap of patella eversion compared to gap of patella reduction in knee flexion position (p < 0.05). There were notable cases of variability in knee flexion position. Significant portion of 12 (24 %) knees of patella subluxation and 33 (66 %) knees of patella evertion demonstrated either increased or decreased gaps in knee flexion position compared to the gaps of patella reduction position. The gaps in patella eversion demonstrated smaller gaps both in knee extension and flexion position compared to the gaps of patella reduction position. The amount of decreased gaps was more definite in knee flexion position. Therefore, the intraoperative patellar positioning has influence on the measurement of the joint gap. Keeping the patella in reduced position is important during gap balancing. I.

Fast, Nonspattering Inert-Gas Welding

NASA Technical Reports Server (NTRS)

Gilbert, Jeffrey L.

1991-01-01

Proposed welding technique combines best features of metal (other than tungsten)/inert-gas welding, plasma arc welding, and tungsten/inert-gas welding. Advantages include: wire fed to weld joint preheated, therefore fed at high speed without spattering; high-frequency energy does not have to be supplied to workpiece to initiate welding; size of arc gap not critical, power-supply control circuit adjusts voltage across gap to compensate for changes; only low gas-flow rate needed; welding electrode replaced easily as prefabricated assembly; external wire-feeding manipulator not needed; and welding process relatively forgiving of operator error.

Waveguide module comprising a first plate with a waveguide channel and a second plate with a raised portion in which a sealing layer is forced into the waveguide channel by the raised portion

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

Strassner, II, Bernd H.; Liedtke, Richard; McDonald, Jacob Jeremiah

The various technologies presented herein relate to utilizing a sealing layer of malleable material to seal gaps, etc., at a joint between edges of a waveguide channel formed in a first plate and a surface of a clamping plate. A compression pad is included in the surface of the clamping plate and is dimensioned such that the upper surface of the pad is less than the area of the waveguide channel opening on the first plate. The sealing layer is placed between the waveguide plate and the clamping plate, and during assembly of the waveguide module, the compression pad deformsmore » a portion of the sealing layer such that it ingresses into the waveguide channel opening. Deformation of the sealing layer results in the gaps, etc., to be filled, improving the operational integrity of the joint.« less

Research study on materials processing in space experiment number M512. [adhesion-cohesion properties of liquid metals under weightlessness conditions in Skylab

NASA Technical Reports Server (NTRS)

Tobin, J. M.; Kossowsky, R.

1973-01-01

Adhesion of the melted metals to the adjacent solid metals, and cohesion of the liquid metal to itself appeared to be equally as strong in zero gravity as on earth. Similar cut edge bead periodicity in cut thin plate, and similar periodic chevron patterns in full penetration welds were seen. The most significant practical result is that the design of braze joints for near zero gravity can be very tolerant of dimensional gaps in the joint. This conclusion is based on a comparison of narrow, wide and variable gap widths. Brazing is very practical as a joining or repairing technique for metal structures at zero gravity. The operation of the hardware developed to locate successive small (0.6 cm) diameter cylinders in the focus of the battery powered EB unit, melt the various metal specimens and deploy some liquid metal drops to drift in space, was generally successful. However, the sphericity and surface roughness were far from those of ball bearings.

Do nice guys--and gals--really finish last? The joint effects of sex and agreeableness on income.

PubMed

Judge, Timothy A; Livingston, Beth A; Hurst, Charlice

2012-02-01

Sex and agreeableness were hypothesized to affect income, such that women and agreeable individuals were hypothesized to earn less than men and less agreeable individuals. Because agreeable men disconfirm (and disagreeable men confirm) conventional gender roles, agreeableness was expected to be more negatively related to income for men (i.e., the pay gap between agreeable men and agreeable women would be smaller than the gap between disagreeable men and disagreeable women). The hypotheses were supported across 4 studies. Study 1 confirmed the effects of sex and agreeableness on income and that the agreeableness-income relationship was significantly more negative for men than for women. Study 2 replicated these results, controlling for each of the other Big Five traits. Study 3 also replicated the interaction and explored explanations and paradoxes of the relationship. A 4th study, using an experimental design, yielded evidence for the argument that the joint effects of agreeableness and gender are due to backlash against agreeable men.

Gap analysis: a method to assess core competency development in the curriculum.

PubMed

Fater, Kerry H

2013-01-01

To determine the extent to which safety and quality improvement core competency development occurs in an undergraduate nursing program. Rapid change and increased complexity of health care environments demands that health care professionals are adequately prepared to provide high quality, safe care. A gap analysis compared the present state of competency development to a desirable (ideal) state. The core competencies, Nurse of the Future Nursing Core Competencies, reflect the ideal state and represent minimal expectations for entry into practice from pre-licensure programs. Findings from the gap analysis suggest significant strengths in numerous competency domains, deficiencies in two competency domains, and areas of redundancy in the curriculum. Gap analysis provides valuable data to direct curriculum revision. Opportunities for competency development were identified, and strategies were created jointly with the practice partner, thereby enhancing relevant knowledge, attitudes, and skills nurses need for clinical practice currently and in the future.

Explaining the Widening Education Gap in Mortality among U.S. White Women

PubMed Central

Montez, Jennifer Karas; Zajacova, Anna

2013-01-01

Over the last half century the gap in mortality across education levels grew in the United States, and since the mid-1980s the growth was especially pronounced among white women. The reasons for the growth among white women are unclear. We investigated three explanations—social-psychological factors, economic circumstances, and health behaviors—for the widening education gap in mortality across 1997-2006 among white women 45-84 years of age. We used data from the National Health Interview Survey Linked Mortality File (N=46,744; deaths=4,053). We found little support for social-psychological factors; however, economic circumstances and health behaviors jointly explained the growing education gap in mortality to statistical nonsignificance. Employment and smoking were the most important individual components. Increasing high school graduation rates, reducing smoking prevalence, and designing work-family policies that help women find and maintain desirable employment may reduce mortality inequalities among women. PMID:23723344

Explaining the widening education gap in mortality among U.S. white women.

PubMed

Montez, Jennifer Karas; Zajacova, Anna

2013-06-01

Over the past half century the gap in mortality across education levels has grown in the United States, and since the mid-1980s, the growth has been especially pronounced among white women. The reasons for the growth among white women are unclear. We investigated three explanations-social-psychological factors, economic circumstances, and health behaviors-for the widening education gap in mortality from 1997 to 2006 among white women aged 45 to 84 years using data from the National Health Interview Survey Linked Mortality File (N = 46,744; 4,053 deaths). Little support was found for social-psychological factors, but economic circumstances and health behaviors jointly explained the growing education gap in mortality to statistical nonsignificance. Employment and smoking were the most important individual components. Increasing high school graduation rates, reducing smoking prevalence, and designing work-family policies that help women find and maintain desirable employment may reduce mortality inequalities among women.

Detection of defects in laser welding of AZ31B magnesium alloy in zero-gap lap joint configuration by a real-time spectroscopic analysis

NASA Astrophysics Data System (ADS)

Harooni, Masoud; Carlson, Blair; Kovacevic, Radovan

2014-05-01

The effect of surface oxide layer existing at the lap-joint faying surface of magnesium sheets is investigated on the keyhole dynamics of the weld pool and weld bead qualities. It is observed that by removing the oxide layer from the faying surface of the lap joint, a high quality weld can be achieved in the laser welding process. However, the presence of an oxide layer deteriorates the quality of the weld by forming pores at the interface of the two overlapped sheets. The purpose of this paper is to identify the correlation between the integrity of the weld and the interaction between the laser and material. A spectroscopy sensor was applied to detect the spectra emitted from a plasma plume during the laser welding of AZ31B magnesium alloy in a zero-gap lap joint configuration. The electron temperature was calculated by applying a Boltzmann plot method based on the detected spectra, and the correlation between the pore formation and the spectral signals was studied. The laser molten pool and the keyhole condition were monitored in real-time by a high speed charge-coupled device (CCD) camera. A green laser was used as an illumination source in order to detect the influence of the oxide layer on the dynamic behavior of the molten pool. Results revealed that the detected spectrum and weld defects had a meaningful correlation for real-time monitoring of the weld quality during laser welding of magnesium alloys.

RSRM Nozzle-to-Case Joint J-leg Development

NASA Technical Reports Server (NTRS)

Albrechtsen, Kevin U.; Eddy, Norman F.; Ewing, Mark E.; McGuire, John R.

2003-01-01

Since the beginning of the Space Shuttle Reusable Solid Rocket Motor (RSRM) program, nozzle-to-case joint polysulfide adhesive gas paths have occurred on several flight motors. These gas paths have allowed hot motor gases to reach the wiper O-ring. Even though these motors continue to fly safely with this condition, a desire was to reduce such occurrences. The RSRM currently uses a J-leg joint configuration on case field joints and igniter inner and outer joints. The J-leg joint configuration has been successfully demonstrated on numerous RSRM flight and static test motors, eliminating hot gas intrusion to the critical O-ring seals on these joints. Using the proven technology demonstrated on the case field joints and igniter joints, a nozzle-to-case joint J-leg design was developed for implementation on RSRM flight motors. This configuration provides an interference fit with nozzle fixed housing phenolics at assembly, with a series of pressurization gaps incorporated outboard of the joint mating surface to aid in joint pressurization and to eliminate any circumferential flow in this region. The joint insulation is bonded to the nozzle phenolics using the same pressure sensitive adhesive used in the case field joints and igniter joints. An enhancement to the nozzle-to-case joint J-leg configuration is the implementation of a carbon rope thermal barrier. The thermal barrier is located downstream of the joint bondline and is positioned within the joint in a manner where any hot gas intrusion into the joint passes through the thermal barrier, reducing gas temperatures to a level that would not affect O-rings downstream of the thermal barrier. This paper discusses the processes used in reaching a final nozzle-to-case joint J-leg design, provides structural and thermal results in support of the design, and identifies fabrication techniques and demonstrations used in arriving at the final configuration.

Collaboration between Academics and Teachers: A Complex Relationship

ERIC Educational Resources Information Center

Bevins, Stuart; Price, Gareth

2014-01-01

Collaboration between academics and teachers has become increasingly prevalent over recent years. Whether its aim is joint research or continuing professional development for teachers, collaboration seems to offer a realistic opportunity for reducing the perceived gap between theory and practice. However, collaboration is not merely academics and…

Interposition of a reversed jejunal segment enhances intestinal adaptation in short bowel syndrome: an experimental study on pigs.

PubMed

Digalakis, Michail; Papamichail, Michail; Glava, Chryssoula; Grammatoglou, Xanthippi; Sergentanis, Theodoros N; Papalois, Apostolos; Bramis, John

2011-12-01

Interposition of a reversed intestinal segment as a factor facilitating intestinal adaptation has been experimentally investigated. Controversy exists about its efficacy in terms of body weight improvement, direction of luminal changes, and underlying mechanisms. This study aims to provide a comprehensive approach. The pigs were randomly allocated to two groups: (1) short bowel (SB) group (n=8) and (2) short bowel reverse jejunal segment (SB-RS) group (n=8). On postoperative d 3, 30, and 60, intestinal transit time was measured; body weight and serum albumin were measured on baseline, as well as on postoperative d 30 and 60. After sacrifice, histopathologic and immunohistochemical (PCNA, activated caspase-3) evaluation followed. Transit time was numerically longer in SB-RS group at all time points; the difference reached statistical significance on d 60. No statistically significant differences were observed concerning body weight or serum albumin. In the SB-RS group, a statistically significant increase in muscle thickness, crypt depth, villus height, and PCNA immunostaining, and a decrease in caspase-3 positive (+) cell count were documented both at the jejunal and ileal level. The reversed jejunal segment seemed able to enhance intestinal adaptation at a histopathologic level, as well as to favorably modify transit time. These putatively beneficial actions were not reflected upon body weight. The decrease in apoptosis was caspase-3-dependent. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

The Effects of Platelet-Rich Plasma on Bone Marrow Stromal Cell Transplants for Tendon Healing In Vitro

PubMed Central

Morizaki, Yutaka; Zhao, Chunfeng; An, Kai-Nan; Amadio, Peter C.

2010-01-01

Purpose In this study we investigated the effect of platelet-rich plasma (PRP) and bone-marrow derived stromal cell (BMSC)-seeded interposition in an in vitro canine tendon repair model. Methods Bone marrow, peripheral blood, and tendons were harvested from mixed breed dogs. BMSC were cultured and passaged from adherent cells of bone marrow suspension. PRP was purified from peripheral blood using a commercial kit. 192 flexor digitorum profundus tendons were used for the study. Tendons repaired with a simple suture were used as a control group. In treatment groups, a collagen gel patch was interposed at the tendon repair site prior to suture. There were three treatment groups according to the type of collagen patch; a patch with PRP, a patch with BMSC, and a patch with PRP and BMSC. The repaired tendons were evaluated by biomechanical testing and by histological survey after 2 and 4 weeks in tissue culture. To evaluate viability, cells were labeled with PKH26 and surveyed under confocal microscopy after culture. Results The maximum breaking strength and stiffness of the healing tendons with the BMSC-seeded PRP patch was significantly higher than the healing tendons without a patch or with a cell-seeded patch (p<0.02). Viable BMSC were present at both 2 and 4 weeks. Conclusions PRP enhanced the effect of BMSC-seeded collagen gel interposition in this in vitro model. Based on these results we now plan to investigate this effect in vivo. PMID:20951509

Dissimilar Brazed Joints Between Steel and Tungsten Carbide

NASA Astrophysics Data System (ADS)

Voiculescu, I.; Geanta, V.; Binchiciu, H.; Iovanas, D.; Stefanoiu, R.

2017-06-01

Brazing is a joining process used to obtain heterogeneous assemblies between different materials, such as steels, irons, non-ferrous metals, ceramics etc. Some application, like asphalt cutters, require quick solutions to obtain dissimilar joints at acceptable costs, given the very short period of operation of these parts. This paper presents some results obtained during the brazing of dissimilar joints between steel and tungsten carbide by using different types of Ag-Cu system filler materials alloyed with P and Sn. The brazing techniques used were oxygen-gas flame and induction joining. The brazing behaviour was analysed in cross sections by optical and electron microscopy. The metallographic analysis enhanced the adhesion features and the length of penetration in the joining gap. The melting range of the filler materials was measured using thermal analysis.

Joint IKI/ROSCOSMOS - NASA Science Definition Team and concept mission to Venus based on Venera-D

NASA Astrophysics Data System (ADS)

Zasova, L.; Senske, D.; Economou, T.; Eismont, N.; Esposito, L.; Gerasimov, M.; Gorinov, D.; Ignatiev, N.; Ivanov, M.; Jessup, K. Lea; Khatuntsev, I.; Korablev, O.; Kremic, T.; Limaye, S.; Lomakin, I.; Martynov, A.; Ocampo, A.; Vaisberg, O.; Burdanov, A.

2017-09-01

NASA and IKI/Roscosmos established in 2015 a Joint Science Definition Team (JSDT), a key task of which was to codify the synergy between the goals of Venera-D with those of NASA. In addition, the JSDT studied potential NASA provided mission augmentations (experiments /elements) that could to fill identified science gaps. The first report to NASA - IKI/Roscosmos was provided in January 2017. The baseline Venera-D concept includes two elements, and orbiter and a lander, with potential contributions consisting of an aerial platform/balloon, small long-lived surface stations or a sub-satellite.

Methodological factors affecting joint moments estimation in clinical gait analysis: a systematic review.

PubMed

Camomilla, Valentina; Cereatti, Andrea; Cutti, Andrea Giovanni; Fantozzi, Silvia; Stagni, Rita; Vannozzi, Giuseppe

2017-08-18

Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e. ground reaction forces, skin marker trajectories, etc.) through biomechanical modelling. In particular, the estimation of joint moments during motion is grounded on several modelling assumptions: (1) body segmental and joint kinematics is derived from the trajectories of markers and by modelling the human body as a kinematic chain; (2) joint resultant (net) loads are, usually, derived from force plate measurements through a model of segmental dynamics. Therefore, both measurement errors and modelling assumptions can affect the results, to an extent that also depends on the characteristics of the motor task analysed (i.e. gait speed). Errors affecting the trajectories of joint centres, the orientation of joint functional axes, the joint angular velocities, the accuracy of inertial parameters and force measurements (concurring to the definition of the dynamic model), can weigh differently in the estimation of clinically interpretable joint moments. Numerous studies addressed all these methodological aspects separately, but a critical analysis of how these aspects may affect the clinical interpretation of joint dynamics is still missing. This article aims at filling this gap through a systematic review of the literature, conducted on Web of Science, Scopus and PubMed. The final objective is hence to provide clear take-home messages to guide laboratories in the estimation of joint moments for the clinical practice.

Common Bolted Joint Analysis Tool

NASA Technical Reports Server (NTRS)

Imtiaz, Kauser

2011-01-01

Common Bolted Joint Analysis Tool (comBAT) is an Excel/VB-based bolted joint analysis/optimization program that lays out a systematic foundation for an inexperienced or seasoned analyst to determine fastener size, material, and assembly torque for a given design. Analysts are able to perform numerous what-if scenarios within minutes to arrive at an optimal solution. The program evaluates input design parameters, performs joint assembly checks, and steps through numerous calculations to arrive at several key margins of safety for each member in a joint. It also checks for joint gapping, provides fatigue calculations, and generates joint diagrams for a visual reference. Optimum fastener size and material, as well as correct torque, can then be provided. Analysis methodology, equations, and guidelines are provided throughout the solution sequence so that this program does not become a "black box:" for the analyst. There are built-in databases that reduce the legwork required by the analyst. Each step is clearly identified and results are provided in number format, as well as color-coded spelled-out words to draw user attention. The three key features of the software are robust technical content, innovative and user friendly I/O, and a large database. The program addresses every aspect of bolted joint analysis and proves to be an instructional tool at the same time. It saves analysis time, has intelligent messaging features, and catches operator errors in real time.

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

Bahrdt, J.; Baecker, H.-J.; Frentrup, W.

Helmholtzzentrum Berlin has built an APPLE II undulator for the storage ring PETRA III. The device has a total length of 5m and a minimum gap of 11mm. The high magnetic forces in particular in the inclined mode have been analyzed by means of finite element methods (FEM). Specific mechanic components such as flexible joints have been optimized to cope with the gap- and shift-dependent 3D-forces and a sophisticated control and drive system has been implemented. After completion of the device, detailed laser interferometer measurements for all operation modes have been performed. The data are compared to the FEM simulations.

The Evolution of Medical Training Simulation in the U.S. Military.

PubMed

Linde, Amber S; Kunkler, Kevin

2016-01-01

The United States has been at war since 2003. During that time, training using Medical Simulation technology has been developed and integrated into military medical training for combat medics, nurses and surgeons. Efforts stemming from the Joint Programmatic Committee-1 (JPC-1) Medical Simulation and Training Portfolio has allowed for the improvement and advancement in military medical training by focusing on research in simulation training technology in order to achieve this. Based upon lessons learned capability gaps have been identified concerning the necessity to validate and enhance combat medial training simulators. These capability gaps include 1) Open Source/Open Architecture; 2) Modularity and Interoperability; and 3) Material and Virtual Reality (VR) Models. Using the capability gaps, JPC-1 has identified important research endeavors that need to be explored.

Future Research Opportunities in Peri-Prosthetic Joint Infection Prevention.

PubMed

Berbari, Elie; Segreti, John; Parvizi, Javad; Berríos-Torres, Sandra I

Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty. A panel of PJI content experts identified nine PJI prevention research opportunities based on both evidence gaps identified through the guideline development process (transfusion, immunosuppressive therapy, anticoagulation, orthopedic space suit, and biofilm) and expert opinion (anesthesia, operative room environment, glycemic control, and Staphylococcus aureus nasal screening and decolonization. This article offers a road map for PJI prevention research.

Long-term follow-up and late complications following treatment of pediatric urologic disorders.

PubMed

Akhavan, Ardavan; Stock, Jeffrey A

2011-01-01

Many pediatric urologic disorders have sequelae that may affect patients well into adulthood. Despite adequate treatment, many patients are at risk for progressive urologic deterioration years after surgical reconstruction. While many pediatric urologists follow their patients years after surgery, screening for late complications is a shared responsibility with primary care providers. This article discusses potential late complications and appropriate follow-up for patients who have a history of ureteral reimplantation, pyeloplasty, hypospadias repair, posterior urethral valve ablation, and intestinal interposition. Copyright © 2011 Elsevier Inc. All rights reserved.

Isentropic compressive wave generator impact pillow and method of making same

DOEpatents

Barker, Lynn M.

1985-01-01

An isentropic compressive wave generator and method of making same. The w generator comprises a disk or flat "pillow" member having component materials of different shock impedances formed in a configuration resulting in a smooth shock impedance gradient over the thickness thereof for interpositioning between an impactor member and a target specimen for producing a shock wave of a smooth predictable rise time. The method of making the pillow member comprises the reduction of the component materials to a powder form and forming the pillow member by sedimentation and compressive techniques.

Isentropic compressive wave generator and method of making same

DOEpatents

Barker, L.M.

An isentropic compressive wave generator and method of making same are disclosed. The wave generator comprises a disk or flat pillow member having component materials of different shock impedances formed in a configuration resulting in a smooth shock impedance gradient over the thickness thereof for interpositioning between an impactor member and a target specimen for producing a shock wave of a smooth predictable rise time. The method of making the pillow member comprises the reduction of the component materials to a powder form and forming the pillow member by sedimentation and compressive techniques.

Initial assessment of strategic plans for improving the performance of veterinary services in developing countries: a review of OIE PVS gap analysis reports.

PubMed

Weaver, J; Leon, E; Edan, M; D'Alessio, F

2012-08-01

The World Organisation for Animal Health (OIE) carries out Gap Analysis missions (if a country so wishes) as part of its programme to assess and improve the Performance of Veterinary Services (the 'PVS Pathway') in Member Countries. These Gap Analysis missions have found that many national Veterinary Services comply to only a limited extent with the international standards established by the OIE and that their competence is compromised by poor governance. This failure threatens animal and public health not only nationally but also internationally. The OIE PVS Gap Analysis reports reviewed found that all the Veterinary Services have a strong vision and commitmentto improvement but are held back by a weak chain of command, inadequate and outdated legislation, insufficient funding, weak technical competencies, compromised technical independence, poor communications and limited joint programmes. There are weaknesses across all the core technical areas of trade, animal health, veterinary public health and veterinary laboratories and also in the overall management of the Veterinary Services. The OIE PVS Gap Analysis missions recommend significant increases in budget in all countries.

Gender, Resources Across the Life Course, and Cognitive Functioning in Egypt

PubMed Central

YOUNT, KATHRYN M.

2008-01-01

In this article, I evaluate the life-course determinants of cognitive functioning among 1,003 women and men aged 50 and older in Ismailia, Egypt. Three questions motivate this analysis: (1) Do older women have poorer cognitive functioning than do older men?; (2) Do cognitive resources accrued in childhood and adulthood have net positive associations with later-life cognitive functioning for women and men?; and (3) To what extent do differences in the amounts and effects of women’s and men’s cognitive resources account for gaps in their cognitive functioning? Compared with men, women have lower Modified-Mini Mental Status Exam (M-MMSE) scores for overall cognitive functioning. Cognitive resources in childhood and adulthood are jointly associated with the M-MMSE score. About 83% of the gender gap in mean M-MMSE scores is attributable to gaps in men’s and women’s attributes across the life course. Gender gaps in childhood cognitive resources—and especially schooling attainment—account for the largest share (18%) of the residual gender gap in cognitive functioning. PMID:19110904

Quantitative Approach to Collaborative Learning: Performance Prediction, Individual Assessment, and Group Composition

ERIC Educational Resources Information Center

Cen, Ling; Ruta, Dymitr; Powell, Leigh; Hirsch, Benjamin; Ng, Jason

2016-01-01

The benefits of collaborative learning, although widely reported, lack the quantitative rigor and detailed insight into the dynamics of interactions within the group, while individual contributions and their impacts on group members and their collaborative work remain hidden behind joint group assessment. To bridge this gap we intend to address…

Welding Wires To Thin Thermocouple Films

NASA Technical Reports Server (NTRS)

Holanda, Raymond; Kim, Walter S.; Danzey, Gerald A.; Pencil, Eric; Wadel, Mary

1993-01-01

Parallel-gap resistance welding yields joints surviving temperatures of about 1,000 degrees C. Much faster than thermocompression bonding. Also exceeds conductive-paste bonding and sputtering thin films through porous flame-sprayed insulation on prewelded lead wires. Introduces no foreign material into thermocouple circuit and does not require careful control of thickness of flame-sprayed material.

Bringing the Teacher into Teacher Preparation: Learning from Mentor Teachers in Joint Methods Activities

ERIC Educational Resources Information Center

Wood, Marcy B.; Turner, Erin E.

2015-01-01

Studies of mathematics teacher preparation frequently lament the divide between the more theoretically based university methods course and the practically grounded classroom field experience. In many instances, attempts to mediate this gap involve creating hybrid or third spaces, which seek to dissipate the differences in knowledge status as…

Light-curve modelling constraints on the obliquities and aspect angles of the young Fermi pulsars

NASA Astrophysics Data System (ADS)

Pierbattista, M.; Harding, A. K.; Grenier, I. A.; Johnson, T. J.; Caraveo, P. A.; Kerr, M.; Gonthier, P. L.

2015-03-01

In more than four years of observation the Large Area Telescope on board the Fermi satellite has identified pulsed γ-ray emission from more than 80 young or middle-aged pulsars, in most cases providing light curves with high statistics. Fitting the observed profiles with geometrical models can provide estimates of the magnetic obliquity α and of the line of sight angle ζ, yielding estimates of the radiation beaming factor and radiated luminosity. Using different γ-ray emission geometries (Polar Cap, Slot Gap, Outer Gap, One Pole Caustic) and core plus cone geometries for the radio emission, we fit γ-ray light curves for 76 young or middle-aged pulsars and we jointly fit their γ-ray plus radio light curves when possible. We find that a joint radio plus γ-ray fit strategy is important to obtain (α,ζ) estimates that can explain simultaneously detectable radio and γ-ray emission: when the radio emission is available, the inclusion of the radio light curve in the fit leads to important changes in the (α,ζ) solutions. The most pronounced changes are observed for Outer Gap and One Pole Caustic models for which the γ-ray only fit leads to underestimated α or ζ when the solution is found to the left or to the right of the main α-ζ plane diagonal respectively. The intermediate-to-high altitude magnetosphere models, Slot Gap, Outer Gap, and One pole Caustic, are favoured in explaining the observations. We find no apparent evolution of α on a time scale of 106 years. For all emission geometries our derived γ-ray beaming factors are generally less than one and do not significantly evolve with the spin-down power. A more pronounced beaming factor vs. spin-down power correlation is observed for Slot Gap model and radio-quiet pulsars and for the Outer Gap model and radio-loud pulsars. The beaming factor distributions exhibit a large dispersion that is less pronounced for the Slot Gap case and that decreases from radio-quiet to radio-loud solutions. For all models, the correlation between γ-ray luminosity and spin-down power is consistent with a square root dependence. The γ-ray luminosities obtained by using the beaming factors estimated in the framework of each model do not exceed the spin-down power. This suggests that assuming a beaming factor of one for all objects, as done in other studies, likely overestimates the real values. The data show a relation between the pulsar spectral characteristics and the width of the accelerator gap. The relation obtained in the case of the Slot Gap model is consistent with the theoretical prediction. Appendices are available in electronic form at http://www.aanda.org

Light-curve modelling constraints on the obliquities and aspect angles of the young Fermi pulsars

DOE PAGES

Pierbattista, M.; Harding, A. K.; Grenier, I. A.; ...

2015-02-10

In more than four years of observation the Large Area Telescope on board the Fermi satellite has identified pulsed γ-ray emission from more than 80 young or middle-aged pulsars, in most cases providing light curves with high statistics. Fitting the observed profiles with geometrical models can provide estimates of the magnetic obliquity α and of the line of sight angle ζ, yielding estimates of the radiation beaming factor and radiated luminosity. Using different γ-ray emission geometries (Polar Cap, Slot Gap, Outer Gap, One Pole Caustic) and core plus cone geometries for the radio emission, we fit γ-ray light curves formore » 76 young or middle-aged pulsars and we jointly fit their γ-ray plus radio light curves when possible. We find that a joint radio plus γ-ray fit strategy is important to obtain (α,ζ) estimates that can explain simultaneously detectable radio and γ-ray emission: when the radio emission is available, the inclusion of the radio light curve in the fit leads to important changes in the (α,ζ) solutions. The most pronounced changes are observed for Outer Gap and One Pole Caustic models for which the γ-ray only fit leads to underestimated α or ζ when the solution is found to the left or to the right of the main α-ζ plane diagonal respectively. The intermediate-to-high altitude magnetosphere models, Slot Gap, Outer Gap, and One pole Caustic, are favoured in explaining the observations. We find no apparent evolution of α on a time scale of 106 years. For all emission geometries our derived γ-ray beaming factors are generally less than one and do not significantly evolve with the spin-down power. A more pronounced beaming factor vs. spin-down power correlation is observed for Slot Gap model and radio-quiet pulsars and for the Outer Gap model and radio-loud pulsars. The beaming factor distributions exhibit a large dispersion that is less pronounced for the Slot Gap case and that decreases from radio-quiet to radio-loud solutions. For all models, the correlation between γ-ray luminosity and spin-down power is consistent with a square root dependence. The γ-ray luminosities obtained by using the beaming factors estimated in the framework of each model do not exceed the spin-down power. This suggests that assuming a beaming factor of one for all objects, as done in other studies, likely overestimates the real values. The data show a relation between the pulsar spectral characteristics and the width of the accelerator gap. Furthermore, the relation obtained in the case of the Slot Gap model is consistent with the theoretical prediction.« less

Light-Curve Modelling Constraints on the Obliquities and Aspect Angles of the Young Fermi Pulsars

NASA Technical Reports Server (NTRS)

Pierbattista, M.; Harding, A. K.; Grenier, I. A.; Johnson, T. J.; Caraveo, P. A.; Kerr, M.; Gonthier, P. L.

2015-01-01

In more than four years of observation the Large Area Telescope on board the Fermi satellite has identified pulsed gamma-ray emission from more than 80 young or middle-aged pulsars, in most cases providing light curves with high statistics. Fitting the observed profiles with geometrical models can provide estimates of the magnetic obliquity alpha and of the line of sight angle zeta, yielding estimates of the radiation beaming factor and radiated luminosity. Using different gamma-ray emission geometries (Polar Cap, Slot Gap, Outer Gap, One Pole Caustic) and core plus cone geometries for the radio emission, we fit gamma-ray light curves for 76 young or middle-aged pulsars and we jointly fit their gamma-ray plus radio light curves when possible. We find that a joint radio plus gamma-ray fit strategy is important to obtain (alpha, zeta) estimates that can explain simultaneously detectable radio and gamma-ray emission: when the radio emission is available, the inclusion of the radio light curve in the fit leads to important changes in the (alpha, gamma) solutions. The most pronounced changes are observed for Outer Gap and One Pole Caustic models for which the gamma-ray only fit leads to underestimated alpha or zeta when the solution is found to the left or to the right of the main alpha-zeta plane diagonal respectively. The intermediate-to-high altitude magnetosphere models, Slot Gap, Outer Gap, and One pole Caustic, are favored in explaining the observations. We find no apparent evolution of a on a time scale of 106 years. For all emission geometries our derived gamma-ray beaming factors are generally less than one and do not significantly evolve with the spin-down power. A more pronounced beaming factor vs. spin-down power correlation is observed for Slot Gap model and radio-quiet pulsars and for the Outer Gap model and radio-loud pulsars. The beaming factor distributions exhibit a large dispersion that is less pronounced for the Slot Gap case and that decreases from radio-quiet to radio-loud solutions. For all models, the correlation between gamma-ray luminosity and spin-down power is consistent with a square root dependence. The gamma-ray luminosities obtained by using the beaming factors estimated in the framework of each model do not exceed the spin-down power. This suggests that assuming a beaming factor of one for all objects, as done in other studies, likely overestimates the real values. The data show a relation between the pulsar spectral characteristics and the width of the accelerator gap. The relation obtained in the case of the Slot Gap model is consistent with the theoretical prediction.

Fatigue properties of dissimilar metal laser welded lap joints

NASA Astrophysics Data System (ADS)

Dinsley, Christopher Paul

This work involves laser welding austenitic and duplex stainless steel to zinc-coated mild steel, more specifically 1.2mm V1437, which is a Volvo Truck Coiporation rephosphorised mild steel. The work investigates both tensile and lap shear properties of similar and dissimilar metal laser welded butt and lap joints, with the majority of the investigation concentrating on the fatigue properties of dissimilar metal laser welded lap joints. The problems encountered when laser welding zinc-coated steel are addressed and overcome with regard to dissimilar metal lap joints with stainless steel. The result being the production of a set of guidelines for laser welding stainless steel to zinc-coated mild steel. The stages of laser welded lap joint fatigue life are defined and the factors affecting dissimilar metal laser welded lap joint fatigue properties are analysed and determined; the findings suggesting that dissimilar metal lap joint fatigue properties are primarily controlled by the local stress at the internal lap face and the early crack growth rate of the material at the internal lap face. The lap joint rotation, in turn, is controlled by sheet thickness, weld width and interfacial gap. Laser welded lap joint fatigue properties are found to be independent of base material properties, allowing dissimilar metal lap joints to be produced without fatigue failure occurring preferentially in the weaker parent material, irrespective of large base material property differences. The effects of Marangoni flow on the compositions of the laser weld beads are experimentally characterised. The results providing definite proof of the stirring mechanism within the weld pool through the use of speeds maps for chromium and nickel. Keywords: Laser welding, dissimilar metal, Zinc-coated mild steel, Austenitic stainless steel, Duplex stainless steel, Fatigue, Lap joint rotation, Automotive.

Carbon Nanotubes: Molecular Electronic Components

NASA Technical Reports Server (NTRS)

Srivastava, Deepak; Saini, Subhash; Menon, Madhu

1997-01-01

The carbon Nanotube junctions have recently emerged as excellent candidates for use as the building blocks in the formation of nanoscale molecular electronic networks. While the simple joint of two dissimilar tubes can be generated by the introduction of a pair of heptagon-pentagon defects in an otherwise perfect hexagonal graphene sheet, more complex joints require other mechanisms. In this work we explore structural characteristics of complex 3-point junctions of carbon nanotubes using a generalized tight-binding molecular-dynamics scheme. The study of pi-electron local densities of states (LDOS) of these junctions reveal many interesting features, most prominent among them being the defect-induced states in the gap.

Tool Measures Depths of Defects on a Case Tang Joint

NASA Technical Reports Server (NTRS)

Ream, M. Bryan; Montgomery, Ronald B.; Mecham, Brent A.; Keirstead, Bums W.

2005-01-01

A special-purpose tool has been developed for measuring the depths of defects on an O-ring seal surface. The surface lies in a specially shaped ringlike fitting, called a capture feature tang, located on an end of a cylindrical segment of a case that contains a solid-fuel booster rocket motor for launching a space shuttle. The capture feature tang is a part of a tang-and-clevis, O-ring joint between the case segment and a similar, adjacent cylindrical case segment. When the segments are joined, the tang makes an interference fit with the clevis and squeezes the O-ring at the side of the gap.

The behavior of bonded doubler splices for composite sandwich panels

NASA Technical Reports Server (NTRS)

Zeller, T. A.; Weisahaar, T. A.

1980-01-01

The results of an investigation into the behavior of adhesively bonded doubler splices of two composite material sandwich panels are presented. The splices are studied from three approaches: analytical; numerical (finite elements); and experimental. Several parameters that characterize the splice are developed to determine their influence upon joint strength. These parameters are: doubler overlap length; core stiffness; laminate bending stiffness; the size of the gap between the spliced sandwich panels; and room and elevated temperatures. Similarities and contrasts between these splices and the physically similar single and double lap joints are discussed. The results of this investigation suggest several possible approaches to improving the strength of the sandwich splices.

Spacing distribution functions for 1D point island model with irreversible attachment

NASA Astrophysics Data System (ADS)

Gonzalez, Diego; Einstein, Theodore; Pimpinelli, Alberto

2011-03-01

We study the configurational structure of the point island model for epitaxial growth in one dimension. In particular, we calculate the island gap and capture zone distributions. Our model is based on an approximate description of nucleation inside the gaps. Nucleation is described by the joint probability density p xy n (x,y), which represents the probability density to have nucleation at position x within a gap of size y. Our proposed functional form for p xy n (x,y) describes excellently the statistical behavior of the system. We compare our analytical model with extensive numerical simulations. Our model retains the most relevant physical properties of the system. This work was supported by the NSF-MRSEC at the University of Maryland, Grant No. DMR 05-20471, with ancillary support from the Center for Nanophysics and Advanced Materials (CNAM).

An alternative treatment option for scaphoid nonunion advanced collapse (SNAC) and radioscaphoid osteoarthritis: early results of a prospective study on the pyrocarbon adaptive proximal scaphoid implant (APSI).

PubMed

Daruwalla, Zubin J; Davies, Kirstenlee; Shafighian, Ali; Gillham, Nicholas R

2013-06-01

Scaphoid nonunion advanced collapse (SNAC) and radioscaphoid osteoarthritis are difficult to treat. Options include proximal row carpectomy (PRC), four corner fusion (4CF) and wrist arthroplasty or arthrodesis. However, with inevitable disease progression, a significant proportion of patients undergo total wrist fusion. This reduces function by abolishing wrist movement. We review the preliminary results of a pyrocarbon interpositional radiocarpal implant in a small cohort of patients from our prospective study and challenge the assumption that there are no surgical alternatives. This study prospectively studied 12 consecutive pyrocarbon Interpositional arthroplasty day cases over 3 years. Patients were assessed using level of pain, ranges of motion, grip strength, key pinch, type of and time to return to work and the disabilities of the arm, shoulder and hand (DASH) score, both preoperatively and postoperatively. Radiographs were also taken and patient satisfaction recorded. All 12 patients could be contacted and were satisfied with their surgery. There were no immediate, early or late postoperative complications associated with the procedure. Promising results were noted in terms of pain, ranges of motion, grip strength, key pinch, type of and time to return to work, DASH scores, photographs and radiographs. The mean follow-up was 18 months, range between 11 months and 3 years. Our early results are encouraging, warrant further and longer studies and support the use of pyrocarbon implants as a primary procedure in what is a generally young and active subgroup of patients.

Outcome of different facial nerve reconstruction techniques.

PubMed

Mohamed, Aboshanif; Omi, Eigo; Honda, Kohei; Suzuki, Shinsuke; Ishikawa, Kazuo

There is no technique of facial nerve reconstruction that guarantees facial function recovery up to grade III. To evaluate the efficacy and safety of different facial nerve reconstruction techniques. Facial nerve reconstruction was performed in 22 patients (facial nerve interpositional graft in 11 patients and hypoglossal-facial nerve transfer in another 11 patients). All patients had facial function House-Brackmann (HB) grade VI, either caused by trauma or after resection of a tumor. All patients were submitted to a primary nerve reconstruction except 7 patients, where late reconstruction was performed two weeks to four months after the initial surgery. The follow-up period was at least two years. For facial nerve interpositional graft technique, we achieved facial function HB grade III in eight patients and grade IV in three patients. Synkinesis was found in eight patients, and facial contracture with synkinesis was found in two patients. In regards to hypoglossal-facial nerve transfer using different modifications, we achieved facial function HB grade III in nine patients and grade IV in two patients. Facial contracture, synkinesis and tongue atrophy were found in three patients, and synkinesis was found in five patients. However, those who had primary direct facial-hypoglossal end-to-side anastomosis showed the best result without any neurological deficit. Among various reanimation techniques, when indicated, direct end-to-side facial-hypoglossal anastomosis through epineural suturing is the most effective technique with excellent outcomes for facial reanimation and preservation of tongue movement, particularly when performed as a primary technique. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Long-term comparison of boomerang-shaped jejunal interposition and Billroth-I reconstruction after distal gastrectomy.

PubMed

Sasaki, Kinro; Miyachi, Kazuhito; Yoda, Norihito; Onodera, Shinichi; Satomura, Hitoshi; Otsuka, Kichiro; Nakajima, Masanobu; Yamaguchi, Satoru; Sunagawa, Masakatsu; Kato, Hiroyuki

2015-05-01

Billroth-I (BI) is a simple, physiological method of reconstruction following distal gastrectomy. In actuality, postoperative QOL is by no means favorable due to the high incidence of post-gastrectomy syndrome. The aim of this study is to assess the safety and efficacy of boomerang-shaped jejunal interposition (BJI) after distal gastrectomy. Sixty-six patients with early gastric cancer underwent the BI procedure (n = 33) or BJI (n = 33) after distal gastrectomy, following which they were compared for 5 years. Tumor characteristics, operative details, postoperative complications and complaints, number of meals, and body weight were analyzed. Patients were followed up by endoscopy every 12 months. There were no significant differences in the incidence of postoperative complications. The incidence of heartburn (30 vs. 0 %, P = 0.0009) and oral bitterness (33 vs. 6 %, P = 0.0112) were significantly lower in the BJI cases. Endoscopic findings revealed significantly lower incidences of reflux esophagitis (24 vs. 0 %, P = 0.0051) and remnant gastritis (70 vs. 3 %, P < 0.0001) in the BJI group. The incidence of food stasis was low in both groups (12 vs. 15 %). In the BJI group, 30 patients (90 %) were eating 3 meals/day within 12 months, whereas in the BI group, 16 patients (48 %) were still eating 5 meals/day at 12 months or later. BJI is as safe as BI, but is better in terms of improvement in bile reflux and food intake without stasis. This procedure, therefore, appears to be a useful method for reconstruction after distal gastrectomy.

EARLY REPAIR OF POST-HYSTERECTOMY VESICOVAGINAL FISTULAE THROUGH A LAPAROSCOPIC TRANSPERITONEAL EXTRAVESICAL APPROACH. EXPERIENCE OF A SINGLE CENTER.

PubMed

Giusti, G; Lucci Chiarissi, M; Abate, D; De Vita, G; Angioni, S; De Lisa, A

2018-06-06

To verify the feasibility and effectiveness of the correction of Vesicovaginal fistulae (VVF) through a laparoscopic transperitoneal extravesical approach and TachoSil application as interposition tissue. VVF are the most common fistulae of the urinary tract and even today there is no agreement over the preferred approach to treat this kind of pathologic condition. We retrospectively analysed the data of women who, from July 2010 to July 2017, underwent early laparoscopic transperitoneal extravesical VVF repair. Patients were placed in the lithotomy position. Five operating ports were placed. After the resection of the VVF, the vesical and vaginal edges were closed in 2 layers. Finally two layers of TachoSil (4cmx4cm) were placed between the sutures. Several variables were considered in the perioperative period. Patients were re-evaluated at one and 3 months after surgery. 16 patients underwent VVF repair. Mean duration of the surgery was 106 minutes, mean length of stay was 3.2 days. No High grade complications according to Clavien-Dindo were reported. At 1 month all patients showed complete continence and at 3 months they reported a good quality of life. The laparoscopic approach described enables adequate repair of VVF. The use of Tachosil is straightforward and atraumatic, and may be considered as an alternative to tissue flap interposition. Finally, we confirm that the early approach is not an hazard in such a disabling disease and can be adopted to restore as soon as possible a good quality of life for patients. Copyright © 2018. Published by Elsevier Inc.

Immediate postoperative complications of combined penetrating rectal and bladder injuries.

PubMed

Crispen, Paul L; Kansas, Bryan T; Pieri, Paola G; Fisher, Carol; Gaughan, John P; Pathak, Abhijit S; Mydlo, Jack H; Goldberg, Amy J

2007-02-01

Combined penetrating trauma involving the rectum and bladder has been associated with increased postoperative morbidity. Specific complications resulting from these injuries include colovesical fistula, urinoma, and abscess formation. A retrospective review of Temple University Hospital trauma database was performed. Patients were categorized by having an isolated rectal (n = 29), isolated bladder (n = 16), or combined injury (n = 24). Records were reviewed for sex, age, site of injury, location of rectal and bladder injuries, operative intervention, fistula formation, urinoma formation, abscess formation, time to urinary catheter removal, length of intensive care unit stay, and length of hospital stay. Patient sex and age did not differ significantly between groups, nor was there a significant difference in location of rectal injury between groups. Presacral drainage was utilized in all patients with extraperitoneal injuries. Fecal diversion was performed in all patients, except two with intraperitoneal rectal injuries. Omental flap interposition between rectal and bladder injuries was utilized in one patient. No significant difference was noted in immediate postoperative complications between groups including fistula, urinoma, and abscess formation. However, all cases of colovesical fistula (n = 2) and urinoma (n = 2) formation were noted in those patients with rectal and posterior bladder injuries. Combined rectal and bladder injuries were not associated with an increase in immediate postoperative complications compared with isolated rectal and bladder injuries. However, postoperative fistula and urinoma formation occurred only in patients with a combined rectal and posterior bladder injury. Consequently, these patients may benefit from omental flap interposition between injuries to decrease fistula and urinoma formation.

[Vascularloops in reconstructive microsurgery: A review of the literature].

PubMed

Shipkov, H; Traikova, N; Voinov, P; Boucher, F; Braye, F; Mojallal, A

2014-02-01

The success of free tissue transfer depends on the quality of vascular micro-anastomosis and recipient vessels. Adequate recipient vessels are sometimes not available near the recipient site for they can be either destroyed or of poor quality (radiotherapy, traumatism). In such cases, good quality recipient vessels are at a distance from the reconstructed site. If this distance is important flap pedicle lengthening implies - for the artery, for the vein or for both flap artery and vein. This lengthening can be carried out in two manners - by interpositional vein grafts (VG) or by a vascular loop (VL) in one or two stages. The aim of this study was to review the utilisation of VL and their type since their introduction in the clinical practice of reconstructive microsurgery. Two main types of VL are used - BV by VG and VL "in situ". Both of them can be carried out in one or two stages. Each of these techniques has its advantages and disadvantages. The overall data from the literature shows that VL are indicated in cases where both artery and vein are damaged or destroyed. There is not enough evidence concerning the VL in one or two stages but there are some tendencies in favour of the VL in one stage. The technique of VL seems to be more avantageous over the interpositional VG but with a smaller success rate compared to free-flaps with direct anastomosis to recipient vessels. Further studies are necessary to investigate these controversial questions. Copyright © 2013. Published by Elsevier SAS.

Asymmetric band gaps in a Rashba film system

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

Carbone, C.; Moras, P.; Sheverdyaeva, P. M.

The joint effect of exchange and Rashba spin-orbit interactions is examined on the surface and quantum well states of Ag 2 Bi -terminated Ag films grown on ferromagnetic Fe(110). The system displays a particular combination of time-reversal and translational symmetry breaking that strongly influences its electronic structure. Angle-resolved photoemission reveals asymmetric band-gap openings, due to spin-selective hybridization between Rashba-split surface states and exchange-split quantum well states. This results in an unequal number of states along positive and negative reciprocal space directions. We suggest that the peculiar asymmetry of the discovered electronic structure can have significant influence on spin-polarized transport properties.

Performance Evaluation of Nose Cap to Silica Tile Joint of RLV-TD under the Simulated Flight Environment using Plasma Wind Tunnel Facility

NASA Astrophysics Data System (ADS)

Pillai, Aravindakshan; Krishnaraj, K.; Sreenivas, N.; Nair, Praveen

2017-12-01

Indian Space Research Organisation, India has successfully flight tested the reusable launch vehicle through launching of a demonstration flight known as RLV-TD HEX mission. This mission has given a platform for exposing the thermal protection system to the real hypersonic flight thermal conditions and thereby validated the design. In this vehicle, the nose cap region is thermally protected by carbon-carbon followed by silica tiles with a gap in between them for thermal expansion. The gap is filled with silica fibre. Base material on which the C-C is placed is made of molybdenum. Silica tile with strain isolation pad is bonded to aluminium structure. These interfaces with a variety of materials are characterised with different coefficients of thermal expansion joined together. In order to evaluate and qualify this joint, model tests were carried out in Plasma Wind Tunnel facility under the simultaneous simulation of heat flux and shear levels as expected in flight. The thermal and flow parameters around the model are determined and made available for the thermal analysis using in-house CFD code. Two tests were carried out. The measured temperatures at different locations were benign in both these tests and the SiC coating on C-C and the interface were also intact. These tests essentially qualified the joint interface between C-C and molybdenum bracket and C-C to silica tile interface of RLV-TD.

Dual-beam laser welding of AZ31B magnesium alloy in zero-gap lap joint configuration

NASA Astrophysics Data System (ADS)

Harooni, Masoud; Carlson, Blair; Kovacevic, Radovan

2014-03-01

Porosity within laser welds of magnesium alloys is one of the main roadblocks to achieving high quality joints. One of the causes of pore formation is the presence of pre-existing coatings on the surface of magnesium alloy such as oxide or chromate layers. In this study, single-beam and dual-beam laser heat sources are investigated in relation to mitigation of pores resulting from the presence of the as-received oxide layer on the surface of AZ31B-H24 magnesium alloy during the laser welding process. A fiber laser with a power of up to 4 kW is used to weld samples in a zero-gap lap joint configuration. The effect of dual-beam laser welding with different beam energy ratios is studied on the quality of the weld bead. The purpose of this paper is to identify the beam ratio that best mitigates pore formation in the weld bead. The laser molten pool and the keyhole condition, as well as laser-induced plasma plume are monitored in real-time by use of a high speed charge-coupled device (CCD) camera assisted with a green laser as an illumination source. Tensile and microhardness tests were used to measure the mechanical properties of the laser welded samples. Results showed that a dual-beam laser configuration can effectively mitigate pore formation in the weld bead by a preheating-welding mechanism.

Assisting Parents and In-Laws: Gender, Type of Assistance, and Couples' Employment

ERIC Educational Resources Information Center

Chesley, Noelle; Poppie, Kyle

2009-01-01

We use 1995 MIDUS data (n = 2,085) to assess whether the gender gap in help persists across different types of help (unpaid task assistance, emotional support, financial assistance) to parents and in-laws. We also examine whether joint employment patterns influence levels of help. Persistent gender differences are identified in levels of emotional…

When Tensions between Ideology and Practice Become Personal: Unpacking Mentorship in Early Childhood Teacher Education

ERIC Educational Resources Information Center

Yoon, Haeny S.; Larkin, Kelly Ann

2018-01-01

University-based teacher education programs are criticized for being too theoretical, disconnected from the everyday realities of schools. To bridge this gap, teacher education programs give students year-long field experiences under the joint tutelage of mentor teachers and university faculty. However, this assumes that mentor teachers will not…

The Association between Cyber Victimization and Subsequent Cyber Aggression: The Moderating Effect of Peer Rejection

ERIC Educational Resources Information Center

Wright, Michelle F.; Li, Yan

2013-01-01

Adolescents experience various forms of strain in their lives that may contribute jointly to their engagement in cyber aggression. However, little attention has been given to this idea. To address this gap in the literature, the present longitudinal study examined the moderating influence of peer rejection on the relationship between cyber…

Use of Sexuality-Focused Entertainment Media in Sex Education

ERIC Educational Resources Information Center

Neustifter, Ruth; Blumer, Markie L. C.; O'Reilly, Jessica; Ramirez, Francisco

2015-01-01

The literature on the impact of entertainment media on sex education is typically pathology-focused, unclear regarding the effects of such usage, and void of dialogue between those who actually work in the areas of sexuality education and entertainment. To address this gap, this paper is the product of joint authorship between media figures from…

Land cover change map comparisons using open source web mapping technologies

Treesearch

Erik Lindblom; Ian Housman; Tony Guay; Mark Finco; Kevin Megown

2015-01-01

The USDA Forest Service is evaluating the status of current landscape change maps and assessing gaps in their information content. These activities have been occurring under the auspices of the Landscape Change Monitoring System (LCMS) project, which is a joint effort between USFS Research, USFS Remote Sensing Applications Center (RSAC), USGS Earth Resources...

Effectiveness of Hip External Rotator Strengthening Exercise in Korean Postural Bowleg Women.

PubMed

Park, Seong Hoon; Lee, Jun Won; Kim, Joo Hyun; Tak, Kyoung Seok; Lee, Byeong Ho; Suh, In Suck

2017-08-01

Postural bowleg is a subclinical entity with both aesthetic and functional outcomes and appears to be common in East Asian countries. Internal rotation of the hip joint is associated with varus alignment at the knee joint of the bowleg. Strengthening exercise for the hip external rotator muscles seems to be effective in improving varus alignment of bowleg, but no standardized exercise program exists. A standardized active resistance strengthening exercise for hip external rotator muscles could improve varus alignment of the lower limb in bowlegged Korean women. In this article, a case series study was conducted to observe changes following a standardized 3-month program using equipment designed for strengthening of the hip external rotator muscles. Photogrammetric and radiographic data were used to compare the gap between knees and tibiofemoral (TF) angles before and after the exercise program. As a result, on average, the knee gap decreased by 1.6 cm. The TF angle decreased by 1.5°. Regression analysis revealed a statistically significant association between changes in knee gap and TF angle. The standardized 3-month active resistance strengthening exercise program of hip external rotator muscles was effective in improving postural deviation and cosmetic outcomes in bowlegged Korean women. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Reusable Solid Rocket Motor Nozzle Joint 5 Redesign

NASA Technical Reports Server (NTRS)

Lui, R. C.; Stratton, T. C.; LaMont, D. T.

2003-01-01

Torque tension testing of a newly designed Reusable Solid Rocket Motor nozzle bolted assembly was successfully completed. Test results showed that the 3-sigma preload variation was as expected at the required input torque level and the preload relaxation were within the engineering limits. A shim installation technique was demonstrated as a simple process to fill a shear lip gap between nozzle housings in the joint region. A new automated torque system was successfully demonstrated in this test. This torque control tool was found to be very precise and accurate. The bolted assembly performance was further evaluated using the Nozzle Structural Test Bed. Both current socket head cap screw and proposed multiphase alloy bolt configurations were tested. Results indicated that joint skip and bolt bending were significantly reduced with the new multiphase alloy bolt design. This paper summarizes all the test results completed to date.

Static and dynamic deflection studies of the SRM aft case-nozzle joint

NASA Technical Reports Server (NTRS)

Christian, David C.; Kos, Lawrence D.; Torres, Isaias

1989-01-01

The redesign of the joints on the solid rocket motor (SRM) has prompted the need for analyzing the behavior of the joints using several different types of analyses. The types of analyses performed include modal analysis, static analysis, transient response analysis, and base driving response analysis. The forces used in these analyses to drive the mathematical model include SRM internal chamber pressure, nozzle blowout and side forces, shuttle vehicle lift-off dynamics, SRM pressure transient rise curve, gimbal forces and moments, actuator gimbal loads, and vertical and radial bolt preloads. The math model represented the SRM from the aft base tangent point (1,823.95 in) all the way back to the nozzle, where a simplified, tuned nozzle model was attached. The new design used the radial bolts as an additional feature to reduce the gap opening at the aft dome/nozzle fixed housing interface.

A new approach to depict bone surfaces in finger imaging using photoacoustic tomography

NASA Astrophysics Data System (ADS)

Biswas, S. K.; van Es, P.; Steenbergen, W.; Manohar, S.

2015-03-01

Imaging the vasculature close around the finger joints is of interest in the field of rheumatology. Locally increased vasculature in the synovial membrane of these joints can be a marker for rheumatoid arthritis. In previous work we showed that part of the photoacoustically induced ultrasound from the epidermis reflects on the bone surface within the finger. These reflected signals could be wrongly interpreted as new photoacoustic sources. In this work we show that a conventional ultrasound reconstruction algorithm, that considers the skin as a collection of ultrasound transmitters and the PA tomography probe as the detector array, can be used to delineate bone surfaces of a finger. This can in the future assist in the localization of the joint gaps. This can provide us with a landmark to localize the region of the inflamed synovial membrane. We test the approach on finger mimicking phantoms.

Nonparametric methods for analyzing recurrent gap time data with application to infections after hematopoietic cell transplant.

PubMed

Lee, Chi Hyun; Luo, Xianghua; Huang, Chiung-Yu; DeFor, Todd E; Brunstein, Claudio G; Weisdorf, Daniel J

2016-06-01

Infection is one of the most common complications after hematopoietic cell transplantation. Many patients experience infectious complications repeatedly after transplant. Existing statistical methods for recurrent gap time data typically assume that patients are enrolled due to the occurrence of an event of interest, and subsequently experience recurrent events of the same type; moreover, for one-sample estimation, the gap times between consecutive events are usually assumed to be identically distributed. Applying these methods to analyze the post-transplant infection data will inevitably lead to incorrect inferential results because the time from transplant to the first infection has a different biological meaning than the gap times between consecutive recurrent infections. Some unbiased yet inefficient methods include univariate survival analysis methods based on data from the first infection or bivariate serial event data methods based on the first and second infections. In this article, we propose a nonparametric estimator of the joint distribution of time from transplant to the first infection and the gap times between consecutive infections. The proposed estimator takes into account the potentially different distributions of the two types of gap times and better uses the recurrent infection data. Asymptotic properties of the proposed estimators are established. © 2015, The International Biometric Society.

Nonparametric methods for analyzing recurrent gap time data with application to infections after hematopoietic cell transplant

PubMed Central

Lee, Chi Hyun; Huang, Chiung-Yu; DeFor, Todd E.; Brunstein, Claudio G.; Weisdorf, Daniel J.

2015-01-01

Summary Infection is one of the most common complications after hematopoietic cell transplantation. Many patients experience infectious complications repeatedly after transplant. Existing statistical methods for recurrent gap time data typically assume that patients are enrolled due to the occurrence of an event of interest, and subsequently experience recurrent events of the same type; moreover, for one-sample estimation, the gap times between consecutive events are usually assumed to be identically distributed. Applying these methods to analyze the post-transplant infection data will inevitably lead to incorrect inferential results because the time from transplant to the first infection has a different biological meaning than the gap times between consecutive recurrent infections. Some unbiased yet inefficient methods include univariate survival analysis methods based on data from the first infection or bivariate serial event data methods based on the first and second infections. In this paper, we propose a nonparametric estimator of the joint distribution of time from transplant to the first infection and the gap times between consecutive infections. The proposed estimator takes into account the potentially different distributions of the two types of gap times and better uses the recurrent infection data. Asymptotic properties of the proposed estimators are established. PMID:26575402

Investigation of atmospheric pressure glow microdischarge between flat cathode and needle anode in helium and argon

NASA Astrophysics Data System (ADS)

Astafiev, Alexander; Belyaev, Vladimir; Zamchii, Roman; Kudryavtsev, Anatoly; Stepanova, Olga; Chen, Zhaoquan

2016-09-01

DC atmospheric-pressure glow microdischarge was generated between a flat cathode and needle anode with a diameter of 100 μm in a special chamber with helium or argon. Dependences of discharge parameters on an interelectrode gap was investigated with an original experimental setup based on a movable arm on the hinge joint which allowed changing the gap with a step of 5 μm. The gap was varied from 5 to 700 μm. Discharge current was 1-21 mA. Such discharge cell has a very low interelectrode capacitance and provides increasing the stability of the discharge against arc formation (transition to RC oscillations mode) at low currents of 1 mA. A weak dependence of discharge voltage across the gap was revealed in helium at 100-250 μm between the electrodes (normal discharge). In contrast to this, glow microdischarge in argon has a descending current-voltage characteristic and unstable nature. The discharge voltage depending on the gap changes significantly slower than in helium. According to our estimations, the strength of electrical field of positive glow in argon is 5 times lower than in helium. Saint Petersburg State University (Grant No. 0.37.218.2016).

Implantation of Vascular Grafts Lined with Genetically Modified Endothelial Cells

NASA Astrophysics Data System (ADS)

Wilson, James M.; Birinyi, Louis K.; Salomon, Robert N.; Libby, Peter; Callow, Allan D.; Mulligan, Richard C.

1989-06-01

The possibility of using the vascular endothelial cell as a target for gene replacement therapy was explored. Recombinant retroviruses were used to transduce the lacZ gene into endothelial cells harvested from mongrel dogs. Prosthetic vascular grafts seeded with the genetically modified cells were implanted as carotid interposition grafts into the dogs from which the original cells were harvested. Analysis of the graft 5 weeks after implantation revealed genetically modified endothelial cells lining the luminal surface of the graft. This technology could be used in the treatment of atherosclerosis disease and the design of new drug delivery systems.

STA-ACA bypass using the ipsilateral free STA graft as an interposition graft and A3-A3 anastomosis for treatment of bilateral ACA steno-occlusive ischemia.

PubMed

Horiuchi, Tetsuyoshi; Ichinose, Shunsuke; Agata, Masahiro; Ito, Kiyoshi; Hongo, Kazuhiro

2018-04-01

Anterior cerebral artery (ACA)-related ischemia is a rare entity in patients with atherosclerosis. Some surgical treatments are reported to date. We present the modification of intracranial-intracranial and intracranial-extracranial bypasses for symptomatic bilateral ACA steno-occlusive disease. The A3-A3 bypass followed by the superficial temporal artery-ACA bypass using the ipsilateral free superficial temporal artery graft is useful without harvesting of the radial artery. Bilateral ACA steno-occlusive induced ischemia can be treated with tailored bypass procedures.

Engineering analysis and test results of the pre-stage planetary gear trains for wrist rotation and pitch assembly and azimuth and elevation assembly of the extendable stiff arm manipulator kit assembly

NASA Technical Reports Server (NTRS)

Morris, R. N.

1973-01-01

In order to improve the performance capability of the Extendable Stiff Arm Manipulator (ESAM) it was necessary to increase the overall gear ratio by a factor of approximately four. This is accomplished with minimum effect to existing hardware by the interposition of a planetary gear transmission between the respective drive motors and the harmonic drive transmissions. The engineering analysis in support of this design approach and the subsequent no-load test results are reported.

Gradual digital lengthening with autologous bone graft and external fixation for correction of flail toe in a patient with Raynaud's disease.

PubMed

Lamm, Bradley M; Ades, Joe K

2009-01-01

Iatrogenic flail toe is a complication of hammertoe surgery that occurs when an overaggressive resection of the proximal phalanx occurs. This can cause both functional and cosmetic concerns for the patient. We present a case report of the correction of a flail second toe in a patient with Raynaud's disease. The correction was achieved by means of gradual soft tissue lengthening with external fixation and an interposition autologous bone graft digital arthrodesis. After 5 months, this 2-stage procedure lengthened, stabilized, and restored the function of the toe. 4.

A novel surgical procedure of vagal nerve, lower esophageal sphincter, and pyloric sphincter-preserving nearly total gastrectomy reconstructed by single jejunal interposition, and postoperative quality of life.

PubMed

Tomita, Ryouichi

2005-01-01

For early gastric cancer total gastrectomy (TG) has so far been essentially unavoidable. We performed the nearly TG reconstructed by single jejunal interposition preservation of the vagal nerve, lower esophageal sphincter (LES) and pyloric sphincter (D1 or D2 lymph node dissection, curability A) as a function-preserving surgical technique (i.e. NTG) to improve postoperative quality of life (QOL). In this report, the application criteria and points of the technique are outlined. QOL in patients after NTG was also compared with those after TG. Sixteen subjects who underwent NTG (12 men and 4 women subjects at age 30 to 70 years, mean 55.6 years) were interviewed to inquire about abdominal symptoms and compared with 20 patients after conventional TG (excision with D2 lymph node, radical curability A) reconstructed by single jejunal interposition without preserving the vagal nerve, LES, and pyloric sphincter (i.e. TGI; 14 men and 6 women at age 26 to 70 years, mean 54.8 years). The former was named group A and the latter group B. Included were cases with early cancer localizing at the upper third and middle stomach, 2cm or further in distance from oral-side margin of the cancer to esophagogastric mucosal junction; and 3.5cm or further in distance from anal-side margin of the cancer to the pyloric sphincter. In excision with the lymph node, hepatic and celiac branches were preserved. To preserve LES, the abdominal esophagus was completely preserved. The pyloric antrum was also preserved at 1.5cm from the pyloric sphincter. The substitute stomach was created as a 30-cm-long single jejunal segment having orthodromic peristaltic movement. The operative procedure in group A significantly improved postoperative gastrointestinal symptoms such as appetite loss (p=0.0004), weight loss (p=0.0369), reflux esophagitis (RE) (p=0.0163), early dumping syndrome (p=0.0163), endoscopic RE (p=0.0311), and postgastrectomy cholecystolithiasis (p=0.0163) compared with group B. Oral intake per one meal 5 years after operation compared with that before operation was better in group A than in group B (p=0.0703). Postoperative epigastric fullness was significantly detected in group A compared with group B (p=0.0072). The proposed surgical technique of NTG is a function-preserving surgery appropriate to improve QOL of subjects with early gastric cancer. There was a defect in this technique of postprandial feeling of epigastric fullness. We think that a gut motility improvement agent is necessary to improve postprandial epigastric fullness after NTG.

MNASA as a Test for Carbon Fiber Thermal Barrier Development

NASA Technical Reports Server (NTRS)

Bauer, Paul; McCool, Alex (Technical Monitor)

2001-01-01

A carbon fiber rope thermal barrier is being evaluated as a replacement for the conventional room temperature vulcanizing (RTV) thermal barrier that is currently used to protect o-rings in Reusable Solid Rocket Motor (RSRM) nozzle joints. Performance requirements include its ability to cool any incoming, hot propellant gases that fill and pressurize the nozzle joints, filter slag and particulates, and to perform adequately in various joint assembly conditions as well as dynamic flight motion. Modified National Aeronautics and Space Administration (MNASA) motors, with their inherent and unique ability to replicate select RSRM internal environment features, were an integral step in the development path leading to full scale RSRM static test demonstration of the carbon fiber rope (CFR) joint concept. These 1/4 scale RSRM motors serve to bridge the gap between the other classes of subscale test motors (extremely small and moderate duration, or small scale and short duration) and the critical asset RSRM static test motors. A series of MNASA tests have been used to demonstrate carbon fiber rope performance and have provided rationale for implementation into a full-scale static motor and flight qualification.

Inner edge magnetisms in carbon honeycombs

NASA Astrophysics Data System (ADS)

Liu, Xiaofei; Guo, Wanlin

2018-04-01

We show by comprehensive ab initio calculations that sp2 carbon honeycombs recently synthesised by Krainyukova et al. [Phys. Rev. Lett. 116, 055501 (2016)] exhibit antiferromagnetism, not only at the inner edge of the zigzag ribbon component but also at the chain of sp2 carbon that joins three zigzag ribbons. The π antiferromagnetism at the joint chain has spin orientations that alternatively change along the axis and stems from a super-exchange mechanism. Along with the spin-polarization, the joint chain conduction channel opens an energy gap. The spin-polarization of the zigzag edge due to the magnetic instability of the localized edge states is less stable in energy. Through hole doping, the zigzag edge antiferromagnetism is enhanced and stabilized as the magnetic ground state, along with the re-opening of the joint chain conduction channel. When the carbon honeycombs are reconstructed into sp3-sp2 hybrid honeycombs, the π states of the joint are diminished, but the zigzag edge magnetism is preserved. Our results propose carbon honeycombs as novel magnetic carbon with competing polarization configurations.

Method and device for tensile testing of cable bundles

DOEpatents

Robertson, Lawrence M; Ardelean, Emil V; Goodding, James C; Babuska, Vit

2012-10-16

A standard tensile test device is improved to accurately measure the mechanical properties of stranded cables, ropes, and other composite structures wherein a witness is attached to the top and bottom mounting blocks holding the cable under test. The witness is comprised of two parts: a top and a bottom rod of similar diameter with the bottom rod having a smaller diameter stem on its upper end and the top rod having a hollow opening in its lower end into which the stem fits forming a witness joint. A small gap is present between the top rod and the larger diameter portion of the bottom rod. A standard extensometer is attached to the top and bottom rods of the witness spanning this small witness gap. When a force is applied to separate the mounting blocks, the gap in the witness expands the same length that the entire test specimen is stretched.

[Interposition arthrodesis of the ankle].

PubMed

Vienne, Patrick

2005-10-01

Bony fusion of the ankle in a functionally favorable position for restitution of a painless weight bearing while avoiding a leg length discrepancy. Disabling, painful osteoarthritis of the ankle with extensive bone defect secondary to trauma, infection, or serious deformities such as congenital malformations or diabetic osteoarthropathies. Acute joint infection. Severe arterial occlusive disease of the involved limb. Lateral approach to the distal fibula. Fibular osteotomy 7 cm proximal to the tip of the lateral malleolus and posterior flipping of the distal fibula. Exposure of the ankle. Removal of all articular cartilage and debridement of the bone defect. Determination of the size of the defect and harvesting of a corresponding tricortical bone graft from the iliac crest. Also harvesting of autogenous cancellous bone either from the iliac crest or from the lateral part of the proximal tibia. Insertion of the tricortical bone graft and filling of the remaining defect with cancellous bone. Fixation with three 6.5-mm titanium lag screws. Depending on the extent of the defect additional stabilization of the bone graft with a titanium plate. Fixation of the lateral fibula on talus and tibia with two 3.5-mm titanium screws for additional support. Wound closure in layers. Split below-knee cast with the ankle in neutral position. Between January 2002 and January 2004 this technique was used in five patients with extensive bone defects (four women, one man, average age 57 years [42-77 years]). No intra- or early postoperative complications. The AOFAS (American Orthopedic Foot and Ankle Society) Score was improved from 23 points preoperatively to 76 points postoperatively (average follow-up time of 25 months). Two patients developed a nonunion and underwent a revision with an ankle arthrodesis nail. A valgus malposition after arthrodesis in one patient was corrected with a supramalleolar osteotomy.

Are allogenic or xenogenic screws and plates a reasonable alternative to alloplastic material for osteosynthesis--a histomorphological analysis in a dynamic system.

PubMed

Jacobsen, C; Obwegeser, J A

2010-12-01

Despite invention of titanium and resorbable screws and plates, still, one of the main challenges in bone fixation is the search for an ideal osteosynthetic material. Biomechanical properties, biocompatibility, and also cost effectiveness and clinical practicability are factors for the selection of a particular material. A promising alternative seems to be screws and plates made of bone. Recently, xenogenic bone pins and screws have been invented for use in joint surgery. In this study, screws made of allogenic sheep and xenogenic human bone were analyzed in a vital and dynamic sheep-model and compared to conventional titanium screws over a standard period of bone healing of 56 days with a constant applied extrusion force. Biomechanical analysis and histomorphological evaluation were performed. After 56 days of insertion xenogenic screws made of human bone showed significantly larger distance of extrusion of on average 173.8 μm compared to allogenic screws made of sheep bone of on average 27.8 and 29.95 μm of the titanium control group. Severe resorption processes with connective tissue interposition were found in the histomorphological analysis of the xenogenic screws in contrast to new bone formation and centripetal vascularization of the allogenic bone screw, as well as in processes of incorporation of the titanium control group. The study showed allogenic cortical bone screws as a substantial alternative to titanium screws with good biomechanical properties. In contrast to other reports a different result was shown for the xenogenic bone screws. They showed insufficient holding strength with confirmative histomorphological signs of degradation and insufficient osseointegration. Before common clinical use of xenogenic osteosynthetic material, further evaluation should be performed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Anatomy of a Joint: Comparing Self-Reported and Actual Dose of Cannabis and Tobacco in a Joint, and How These Are Influenced by Controlled Acute Administration.

PubMed

Hindocha, Chandni; Freeman, Tom P; Curran, H Valerie

2017-01-01

Introduction: Major gaps exist in the measurement of cannabis exposure. The accuracy of self-reported cannabis and tobacco dose per joint is poorly characterized and has never been investigated following acute cannabis/tobacco exposure. Using an innovative "Roll a Joint" paradigm, this study aims to (1) compare estimated and actual dose of cannabis and tobacco per joint at baseline and (2) examine the acute effects of cannabis and/or tobacco on estimated and actual dose. Materials and Methods: We investigated this by using a randomized, double-blind, placebo-controlled crossover 2 (active cannabis, placebo cannabis)×2 (active tobacco, placebo tobacco) design in a laboratory setting. Participants were 24 recreational cousers of cannabis and tobacco. At baseline, they were asked to measure out the amount of cannabis and tobacco they would put in an average joint for themselves (dose per joint). Then, on each of four drug administration sessions, participants were again asked to do this for a joint they would want to smoke "right now." Self-reported and actual amount was recorded (g). Results: At baseline, the estimated amount of cannabis per joint (0.28±0.23 g) was double the actual amount (0.14±0.12 g) ( p =0.003, d =0.723). No difference emerged between estimated (0.43±0.25 g) and actual (0.35±0.15 g) ( p =0.125) amount of tobacco per joint. Compared to placebo, active cannabis reduced the actual dose of both cannabis ( p =0.035) and tobacco ( p <0.001) they put in a joint. Participants accurately estimated this reduction for tobacco ( p =0.014), but not for cannabis ( p =0.680). Conclusions: Self-reported dose per joint is accurate for tobacco but dramatically overestimates cannabis exposure and therefore should be viewed with caution. Cannabis administration reduced the amount of cannabis and tobacco added to joints, suggesting a reduction in dose during a smoking session. The "Roll A Joint" paradigm should be implemented for better accuracy in assessing dose per joint.

Multi-Scale Computational Modeling of Ni-Base Superalloy Brazed Joints for Gas Turbine Applications

NASA Astrophysics Data System (ADS)

Riggs, Bryan

Brazed joints are commonly used in the manufacture and repair of aerospace components including high temperature gas turbine components made of Ni-base superalloys. For such critical applications, it is becoming increasingly important to account for the mechanical strength and reliability of the brazed joint. However, material properties of brazed joints are not readily available and methods for evaluating joint strength such as those listed in AWS C3.2 have inherent challenges compared with testing bulk materials. In addition, joint strength can be strongly influenced by the degree of interaction between the filler metal (FM) and the base metal (BM), the joint design, and presence of flaws or defects. As a result, there is interest in the development of a multi-scale computational model to predict the overall mechanical behavior and fitness-for-service of brazed joints. Therefore, the aim of this investigation was to generate data and methodology to support such a model for Ni-base superalloy brazed joints with conventional Ni-Cr-B based FMs. Based on a review of the technical literature a multi-scale modeling approach was proposed to predict the overall performance of brazed joints by relating mechanical properties to the brazed joint microstructure. This approach incorporates metallurgical characterization, thermodynamic/kinetic simulations, mechanical testing, fracture mechanics and finite element analysis (FEA) modeling to estimate joint properties based on the initial BM/FM composition and brazing process parameters. Experimental work was carried out in each of these areas to validate the multi-scale approach and develop improved techniques for quantifying brazed joint properties. Two Ni-base superalloys often used in gas turbine applications, Inconel 718 and CMSX-4, were selected for study and vacuum furnace brazed using two common FMs, BNi-2 and BNi-9. Metallurgical characterization of these brazed joints showed two primary microstructural regions; a soft, ductile a-Ni phase that formed at the joint interface and a hard, brittle multi-phase centerline eutectic. CrB and Ni3B type borides were identified in the eutectic region via electron probe micro-analysis, and a boron diffusion gradient was observed in the BM adjacent to the joint. The volume fraction of centerline eutectic was found to be highly dependent on the extent of the boron diffusion that occurred during brazing and therefore a function of the primary process parameters; hold time, temperature, FM/BM composition, and joint gap. Thermo-Calc(TM) and DICTRA(TM) simulations were used to model the BM dissolution, isothermal solidification and phase transformations that occurred during brazing to predict the final joint microstructure based on these process parameters. Good agreement was found between experimental and simulated joint microstructures at various joint gaps demonstrating the application of these simulations for brazed joints. However, thermodynamic/kinetic databases available for brazing FMs were limited. A variety of mechanical testing was performed to determine the mechanical properties of CMSX-4/BNi-2 and IN718/BNi-2 brazed joints including small-scale tensile tests, standard-size butt joints and lap shear tests. Small-scale tensile testing provided a novel method for studying microstructure-property relationships in brazed joints and indicated that both joint strength and ductility decrease significantly with an increase in the volume fraction of centerline eutectic. In-situ observations during small-scale testing also showed strain localization and crack initiation occurs around the hard, eutectic phases in the joint microstructure during loading. The average tensile strength for standard-size IN718/BNi-2 butt joints containing a low volume fraction of centerline eutectic was found to be 152.8 ksi approximately 90% of the BM yield strength (˜170 ksi). The average lap shear FM stress was found to decrease from 70 to 20 ksi for IN718/BNi-2 joints and from 50 to 15 ksi for CMSX-4/BNi-2 as the overlap was increased from 1T to 5T due to non-uniform stress/strain distribution across the joint. Digital image correlation techniques and FEA models of the lap shear brazed joints were developed to assess the strain distributions across the overlap. Results were used to validate the use of damage zone models for predicting the load carrying capacity of lap shear brazed joints and suggest that the damage zone is independent of the overlap length. To account for the presence of flaws and defects in fitness-for-service assessments of brazed joints determination of the average fracture toughness (KIC) is necessary. Currently no standard exists to measure the KIC for brazed joints, so three test methods were evaluated in this investigation on IN718/BNi-2 brazed joints. The compact tension and double cantilever beam test methods were found to give the most conservative KIC values of 16.42 and 14.42 ksivin respectively. Linear-elastic FEA models of the test specimens were used to validate the calculated KIC values. Similar to joint strength the fracture toughness appeared to be strongly influenced by the volume fraction of centerline eutectic phases. (Abstract shortened by ProQuest.).

Description of and preliminary tests results for the Joint Damping Experiment (JDX)

NASA Technical Reports Server (NTRS)

Bingham, Jeffrey G.; Folkman, Steven L.

1995-01-01

An effort is currently underway to develop an experiment titled joint Damping E_periment (JDX) to fly on the Space Shuttle as Get Away Special Payload G-726. This project is funded by NASA's IN-Space Technology Experiments Program and is scheduled to fly in July 1995 on STS-69. JDX will measure the influence of gravity on the structural damping of a three bay truss having clearance fit pinned joints. Structural damping is an important parameter in the dynamics of space structures. Future space structures will require more precise knowledge of structural damping than is currently available. The mission objectives are to develop a small-scale shuttle flight experiment that allows researchers to: (1) characterize the influence of gravity and joint gaps on structural damping and dynamic behavior of a small-scale truss model, and (2) evaluate the applicability of low-g aircraft test results for predicting on-orbit behavior. Completing the above objectives will allow a better understanding and/or prediction of structural damping occurring in a pin jointed truss. Predicting damping in joints is quite difficult. One of the important variables influencing joint damping is gravity. Previous work has shown that gravity loads can influence damping in a pin jointed truss structure. Flying this experiment as a GAS payload will allow testing in a microgravity environment. The on-orbit data (in micro-gravity) will be compared with ground test results. These data will be used to help develop improved models to predict damping due to pinned joints. Ground and low-g aircraft testing of this experiment has been completed. This paper describes the experiment and presents results of both ground and low-g aircraft tests which demonstrate that damping of the truss is dramatically influenced by gravity.

Effects of Resection of Posterior Condyles of Femur on Extension Gap of Knee Joint in Total Knee Arthroplasty.

PubMed

Seo, Seung-Suk; Kim, Chang-Wan; Seo, Jin-Hyuk; Kim, Do-Hun; Kim, Ok-Gul; Lee, Chang-Rack

2017-06-01

When evaluating the effects of the preparation of the flexion gap on the extension gap in total knee arthroplasty (TKA), the effects of posterior condylar resection and osteophyte removal on the extension gap should be differentiated. Although the amount of osteophytes differs between patients, posterior condylar resection is a procedure that is routinely implemented in TKA. The aim of this study was to assess the effects of the resection of the posterior condyle of the femur on the extension gap in posterior-stabilized (PS) TKA. We enrolled 40 knees that underwent PS TKA between July 2010 and February 2011 with no or minimal osteophytes in the posterior compartment and a varus deformity of <15°. We measured the extension gap before and after the resection of the posterior condyle of the femur using a tensor under 20 and 40 lb of distraction force. Under 20 lb of distraction force, the average extension gap was 13.3 mm (standard deviation [SD], 1.6) before and 13.8 mm (SD, 1.6) after posterior condylar resection. Under 40 lb of distraction force, the average extension gap was 15.1 mm (SD, 1.5) before and 16.1 mm (SD, 1.7) after posterior condylar resection. The resection of the posterior condyle of the femur in PS TKA increased the extension gap. However, this increase was only by approximately 1 mm. In conclusion, posterior condylar resection does increase the extension gap by approximately 1 mm. However, in most case, this change in unlikely to be clinically important. Copyright © 2017 Elsevier Inc. All rights reserved.

Influence of the posterior tibial slope on the flexion gap in total knee arthroplasty.

PubMed

Okazaki, Ken; Tashiro, Yasutaka; Mizu-uchi, Hideki; Hamai, Satoshi; Doi, Toshio; Iwamoto, Yukihide

2014-08-01

Adjusting the joint gap length to be equal in both extension and flexion is an important issue in total knee arthroplasty (TKA). It is generally acknowledged that posterior tibial slope affects the flexion gap; however, the extent to which changes in the tibial slope angle directly affect the flexion gap remains unclear. This study aimed to clarify the influence of tibial slope changes on the flexion gap in cruciate-retaining (CR) or posterior-stabilizing (PS) TKA. The flexion gap was measured using a tensor device with the femoral trial component in 20 cases each of CR- and PS-TKA. A wedge plate with a 5° inclination was placed on the tibial cut surface by switching its front-back direction to increase or decrease the tibial slope by 5°. The flexion gap after changing the tibial slope was compared to that of the neutral slope measured with a flat plate that had the same thickness as that of the wedge plate center. When the tibial slope decreased or increased by 5°, the flexion gap decreased or increased by 1.9 ± 0.6mm or 1.8 ± 0.4mm, respectively, with CR-TKA and 1.2 ± 0.4mm or 1.1 ± 0.3mm, respectively, with PS-TKA. The influence of changing the tibial slope by 5° on the flexion gap was approximately 2mm with CR-TKA and 1mm with PS-TKA. This information is useful when considering the effect of manipulating the tibial slope on the flexion gap when performing CR- or PS-TKA. Copyright © 2014 Elsevier B.V. All rights reserved.

Leaders and Laggards: A State-by-State Report Card on Educational Innovation

ERIC Educational Resources Information Center

Hess, Frederick M.; Boser, Ulrich

2009-01-01

This report, produced jointly by the U.S. Chamber of Commerce, the Center for American Progress, and Frederick M. Hess of the American Enterprise Institute, is a call to action in response to how poorly states measured up on key indicators of educational innovation. The report is the first-ever attempt to evaluate the innovation gap in American…

Leveraging Simulation Against the F-16 Flying Training Gap

DTIC Science & Technology

2005-11-01

must leverage emerging simulation technology into combined flight training to counter mission employment complexity created by technology itself...two or more of these stand-alone simulators creates a mission training center (MTC), which when further networked create distributed mission...operations (DMO). Ultimately, the grand operational vision of DMO is to interconnect non-collocated users creating a “virtual” joint training environment

Electronic structures of C u 2 O , C u 4 O 3 , and CuO: A joint experimental and theoretical study

DOE PAGES

Wang, Y.; Lany, S.; Ghanbaja, J.; ...

2016-12-14

We present a joint experimental and theoretical study for the electronic structures of copper oxides including Cu 2O, CuO, and the metastable mixed-valence oxide Cu 4O 3. The optical band gap is determined by experimental optical absorption coefficient, and the electronic structure in valence and conduction bands is probed by photoemission and electron energy loss spectroscopies, respectively. Furthermore, we compare our experimental results with many-body GW calculations utilizing an additional on-site potential for d-orbital energies that facilitates tractable and predictive computations. The side-by-side comparison between the three oxides, including a band insulator (Cu2O) and two Mott/charge-transfer insulators (CuO, Cu 4Omore » 3) leads to a consistent picture for the optical and band-structure properties of the Cu oxides, strongly supporting indirect band gaps of about 1.2 and 0.8 eV in CuO and Cu 4O 3, respectively. This comparison also points towards surface oxidation and reduction effects that can complicate the interpretation of the photoemission spectra.« less

Improvements to the Tendon-Actuated Lightweight In-Space MANipulator (TALISMAN)

NASA Technical Reports Server (NTRS)

Doggett, William R.; Dorsey, John T.; Jones, Thomas C.; Lodding, Kenneth N.; Ganoe, George G.; Mercer, David; King, Bruce D.

2015-01-01

Devices for manipulating and precisely placing payloads are critical for efficient space operations including berthing of spacecraft, in-space assembly, construction and repair. Key to the success of many NASA space activities has been the availability of long-reach crane-like devices such as the Shuttle Remote Manipulation System (SRMS) and the Space Station Remote Manipulation System (SSRMS). These devices have been used for many operations including berthing visiting spacecraft to the International Space Station, deployment of spacecraft, space station assembly, astronaut positioning, payload transfer, and spacecraft inspection prior to atmospheric re-entry. Retiring the Space Transportation System has led to the removal of the SRMS from consideration for in-space missions, thus creating a capability gap. Recognizing this gap, work was initiated at NASA on a new architecture for long-reach space manipulators. Most current devices are constructed by joining revolute joints with carbon composite tubes, with the joints accounting for the majority of the device mass. For example in the case of the SRMS, the entire device mass is 410 kg (904 lbm); the joint structure, motors, gear train, cabling, etc., accounts for the majority of the system mass because the carbon composite tubes mass is 46 kg (101 lbm). An alternate space manipulator concept, the Tendon-Actuated Lightweight In-Space MANipulator (TALISMAN) was created to address deficiencies in the current state-of-the-art in long-reach manipulators. The antagonistic tendon actuated joint architecture allows the motors actuating the joint to be removed from the joint axis, which simplifies the joint design while simultaneously providing mechanical advantage for the motors. The improved mechanical advantage, in turn, reduces the size and power requirements for the motor and gear train. This paper will describe recent architectural improvements to the TALISMAN design that: 1) improve the operational robustness of the system by enabling maneuvers not originally possible by varying the TALISMAN geometry; 2) enable efficient active antagonistic control of a joint while sharing cable between antagonistic tension networks; and 3) uses a unique arrangement of differential capstans to reduce motor torque requirements by an order of magnitude. The paper will also summarize recent efforts to enable autonomous deployment of a TALISMAN including the deployment concept of operations and associated hardware system design. The deployment forces are provided by the same motor systems that are used for articulation, thus reducing the mass associated with the deployment system. The deployment approach is being tested on a TALISMAN prototype which is designed to provide the same operational performance as a shuttle-class manipulator. The prototype has been fabricated and is operational in a new facility at NASA Langley Research Center that has a large area (15.2 m by 21.3 m [50 ft by 70 ft]) air-bearing floor.

Trigger wrist caused by avascular necrosis of the capitate: a case report.

PubMed

Matsui, Yuichiro; Kawamura, Daisuke; Kida, Hiroaki; Hatanaka, Kanako C; Iwasaki, Norimasa

2018-03-27

Trigger wrist is a rare condition first described by Marti in 1960, and various causes have been reported. The condition mostly occurs with finger flexion and extension, and rarely with flexion and extension of the wrist itself. Avascular necrosis of the capitate is also a rare condition, first described by Jönsson in 1942. While some reports of this condition have been published, little is known about its etiology. Therefore, no established treatment exists. We report a case of trigger wrist caused by avascular necrosis of the capitate. A 16-year-old right-handed male who was a high school handball player was referred to our department from a nearby hospital 5 months after the onset of pain in the dorsal aspect of the right wrist, with an unknown cause. At the previous hospital, imaging findings led to a diagnosis of avascular necrosis of the capitate, and conservative treatment with a wrist brace did not improve the pain. At the initial visit to our department, the patient was noted to have a painful trigger wrist that was brought on by wrist flexion and extension. Preoperative imaging findings led to a diagnosis of trigger wrist caused by capitolunate instability secondary to avascular necrosis of the capitate. We performed a partial excision of the proximal capitate with tendon ball interposition. Two years after surgery, the patient's clinical outcome was favorable, with no recurrence of wrist pain or triggering. Both trigger wrist and avascular necrosis of the capitate are rare disorders. When a patient presents with painful triggering at the wrist, surgeons must bear in mind that avascular necrosis of the capitate may result in this phenomenon. We recommend partial excision of the proximal capitate with tendon ball interposition for the treatment of this lesion.

Balloon dilatation in esophageal strictures in epidermolysis bullosa and the role of anesthesia.

PubMed

Gollu, Gulnur; Ergun, Ergun; Ates, Ufuk; Can, Ozlem S; Dindar, Huseyin

2017-02-01

Esophageal involvement, which causes stricture, is a complication in epidermolysis bullosa. This causes dysphagia and malnutrition and leads to deterioration of skin lesions in these patients. The charts of 11 patients with epidermolysis bullosa and esophageal stricture who were included into dilatation program between 2003 and 2015 were retrospectively reviewed. Seven of the patients were female and four were male. The median age was 14 (2-32) years. The mean body weight of patients was 27.8 (9-51) kg. The location and number of strictured parts of the esophagus were previously evaluated with upper gastrointestinal contrast study and after that flexible endoscopy was used for dilatation. Eight patients had middle esophageal, three patients had proximal esophageal and one of them had both proximal and middle esophageal strictures. The strictures were dilated 56 times in total (mean 5 times). One patient underwent gastrostomy and was medically followed-up after a perforation occurrence during the dilatation procedure. In a 32-year-old female patient, colon interposition was performed after four dilatations since optimal nutritional and developmental status could not be achieved. The dilatation program of nine patients is still in progress. Seven of them can easily swallow solid food but two of them have some difficulties in swallowing between dilatations. One patient rejected the program and quitted, while one patient refused colon interposition and died because of complications related to amyloidosis during the dilatation program. After resolution of the swallowing problem, skin lesions were observed to heal quickly. Epidermolysis bullosa is a rare cause of dysphagia. Esophageal balloon dilatation with flexible endoscopy is a safe and efficient method in patients with this condition. © 2016 International Society for Diseases of the Esophagus.

Secure fixation of femoral bone plug with a suspensory button in anatomical anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft

PubMed Central

TAKETOMI, SHUJI; INUI, HIROSHI; NAKAMURA, KENSUKE; YAMAGAMI, RYOTA; TAHARA, KEITARO; SANADA, TAKAKI; MASUDA, HIRONARI; TANAKA, SAKAE; NAKAGAWA, TAKUMI

2015-01-01

Purpose the efficacy and safety of using a suspensory button for femoral fixation in anatomical anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BPTB) graft have not been established. The purpose of the current study was to evaluate bone plug integration onto the femoral socket and migration of the bone plug and the EndoButton (EB) (Smith & Nephew, Andover, MA, USA) after rectangular tunnel ACL reconstruction with BPTB autograft. Methods thirty-four patients who underwent anatomical rectangular ACL reconstruction with BPTB graft using EB for femoral fixation and in whom three-dimensional (3D) computed tomography (CT) was performed one week and one year after surgery were included in this study. Bone plug integration onto the femoral socket, bone plug migration, soft tissue interposition, EB migration and EB rotation were evaluated on 3D CT. The clinical outcome was also assessed and correlated with the imaging outcomes. Results the bone plug was integrated onto the femoral socket in all cases. The incidence of bone plug migration, soft tissue interposition, EB migration and EB rotation was 15, 15, 9 and 56%, respectively. No significant association was observed between the imaging outcomes. The postoperative mean Lysholm score was 97.1 ± 5.0 points. The postoperative side-to-side difference, evaluated using a KT-2000 arthrometer, averaged 0.5 ± 1.3 mm. There were no complications associated with EB use. Imaging outcomes did not affect the postoperative KT side-to-side difference. Conclusions the EB is considered a reliable device for femoral fixation in anatomical rectangular tunnel ACL reconstruction with BPTB autograft. Level of evidence Level IV, therapeutic case series. PMID:26889465

Prospective Single-Arm, Multi-Center Trial of a Patient-Specific Interpositional Knee Implant: Early Clinical Results

PubMed Central

Koeck, F.X; Luring, C; Goetz, J; Handel, M; Tingart, M; Grifka, J; Beckmann, J

2011-01-01

Background: The treatment of unicompartmental arthritis in younger patients is challenging. The aim of this study is to report final safety and efficacy analysis results for the iForma patient–specific interpositional device, which is designed for the treatment of isolated medial or lateral compartment arthritis of the knee. Methods: From June 2005 to June 2008 78 subjects (42 men, 36 women) received an iForma implant. The mean age was 53 years, the mean Body Mass Index 29.0. We surveyed the WOMAC scores, the visual analog pain scale and the Knee Society Scores. Results: The mean follow up was 16.4 months. The mean WOMAC knee scores increased from 48.3 before surgery to 71.3 after 24 months. A reduction in pain was achieved for all five pain measures using a standard visual analog scale (VAS). Knee Society Knee Score improved from 39.2 before to 61.9 24 month after surgery. The Knee Society Function Scores improved form preoperative 64.5 to 82.5 2 years postoperative. The preoperative range of motion could be restored. The overall revision rate was 24%. 15 implants were removed early, 4 knees were revised without implant removal. Conclusion: Within narrow indication of patients with unicompartmental disease, the iForma device can provide improvement in knee function and reduction in pain, however, with a significant higher risk of early revision compared to traditional arthroplasty. Respecting this limitation it may be an alternative option for arthritic patients with unicompartmental disease who have contraindications to High Tibial Osteotomy or are too young for knee replacement; the iForma device further has the distinct advantage of time and cost saving compared to those procedures. PMID:21552462

Stability of implants placed in augmented posterior mandible after alveolar osteotomy using resorbable nonceramic hydroxyapatite or intraoral autogenous bone: 12-month follow-up.

PubMed

Dottore, Alexandre M; Kawakami, Paulo Y; Bechara, Karen; Rodrigues, Jose Augusto; Cassoni, Alessandra; Figueiredo, Luciene C; Piattelli, Adriano; Shibli, Jamil Awad

2014-06-01

This prospective, controlled split-mouth study evaluated the stability of dental implants placed in the augmented mandibular areas with alveolar segmental "sandwich" osteotomies using nonceramic hydroxyapatite (ncHA) or autogenous bone. This study included 11 bilaterally partially edentulous mandibular patients in a split-mouth design. Alveolar augmentation osteotomies were performed bilaterally with interpositional ncHA graft (test group) or interpositional intraoral autogenous bone graft (control group). After 6 months of healing, four implants (two implants in each side) were placed in each patient. Forty-four implants were inserted and loaded after 6-month healing period. At 1-year follow-up, radiographic, prosthetic, and resonance frequency analysis parameters were assessed. Success criteria included absence of pain, sensitivity, suppuration, and implant mobility; absence of continuous peri-implant radiolucency; and distance between the implant shoulder and the first visible bone contact (DIB) < 2 mm. After a 1-year loading period, the overall implant survival rate was 95.45%, with two implant losses (one of each group). Among the surviving implants (42 out of 44), two did not fulfill the success criteria; therefore, the implant success was 90.90%. DIB was 0.71 ± 0.70 and 0.84 ± 0.72 mm for ncHA and autogenous bone grafts, respectively (p > .05). Implant stability measurements were similar between the groups during the 12-month follow-up (p > .05). Within the limits of this study, the implants placed either in sites augmented with ncHA or autogenous bone seem to represent a safe and successful procedure, at least, after 12-month follow-up. © 2012 Wiley Periodicals, Inc.

The high failure rate of biologic resurfacing of the glenoid in young patients with glenohumeral arthritis.

PubMed

Strauss, Eric J; Verma, Nikhil N; Salata, Michael J; McGill, Kevin C; Klifto, Christopher; Nicholson, Gregory P; Cole, Brian J; Romeo, Anthony A

2014-03-01

The current study evaluated the outcomes of biologic resurfacing of the glenoid using a lateral meniscus allograft or human acellular dermal tissue matrix at intermediate-term follow-up. Forty-five patients (mean age, 42.2 years) underwent biologic resurfacing of the glenoid, and 41 were available for follow-up at a mean of 2.8 years. Lateral meniscal allograft resurfacing was used in 31 patients and human acellular dermal tissue matrix interposition in 10. Postoperative range of motion and clinical outcomes were assessed at the final follow-up. The overall clinical failure rate was 51.2%. The lateral meniscal allograft cohort had a failure rate of 45.2%, with a mean time to failure of 3.4 years. Human acellular dermal tissue matrix interposition had a failure rate of 70.0%, with a mean time to failure of 2.2 years. Overall, significant improvements were seen compared with baseline with respect to the visual analog pain score (3.0 vs. 6.3), American Shoulder and Elbow Surgeons score (62.0 vs. 36.8), and Simple Shoulder Test score (7.0 vs. 4.0). Significant improvements were seen for forward elevation (106° to 138°) and external rotation (31° to 51°). Despite significant improvements compared with baseline values, biologic resurfacing of the glenoid resulted in a high rate of clinical failure at intermediate follow-up. Our results suggest that biologic resurfacing of the glenoid may have a minimal and as yet undefined role in the management of glenohumeral arthritis in the young active patient over more traditional methods of hemiarthroplasty or total shoulder arthroplasty. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Longitudinal study of esophageal mucosal damage after esophagectomy and gastric interposition: relationship between reflux-related mucosal injury and Notch signaling

PubMed Central

Yuan, Yong; Tong, Tie-Jun; Zeng, Xiao-Xi; Yang, Yu-Shang; Wang, Zhi-Qiang; Wang, Yun-Cang; Gou, Jun-He

2017-01-01

Background Esophagectomy with gastric interposition could serve as a good human reflux model to study the molecular pathogenesis of esophageal mucosal damage induced by gastroesophageal reflux. This study was to investigate the role of Notch signaling in reflux injury of esophageal mucosa. Methods Patients undergoing Ivor-Lewis esophagectomy for early stage esophageal squamous cell carcinoma were included. Follow-ups were scheduled at 6, 18, 36 and 48 months postoperatively, including reflux symptom assessment, endoscopic and histological evaluation of esophageal mucosal damage. The expressions of Notch1 and its downstream target gene Hes1 were evaluated by real-time polymerase chain reaction (PCR) and immunohistochemistry (IHC). Results Forty-four out of 48 patients completed four follow-ups. Injuries of esophageal remnant confirmed by endoscopical and histological examinations were both more often with a longer postoperative period (P<0.05). The mRNA expression levels of Notch1 and Hes1 were decreased in a time-dependent manner after operation (P<0.001). Notch1 and Hes1 mRNA levels were significantly higher in normal squamous mucosa than in esophagitis, and higher in esophagitis than in metaplasia (P<0.05). Immunohistochemical study also demonstrated a similar protein expression pattern. Samples with endoscopic evidence of mucosal damage exhibited lower expression of Notch1 mRNA levels as compared to biopsies without visualized damage (P=0.035). Conclusions This is the first longitudinal study on Notch signaling in human esophagectomy model, our preliminary findings suggest decreased Notch signaling might be involved in the development of mucosa damage caused by gastroesophageal reflux. PMID:29312733

Gangrene of the oesophago-gastric junction caused by strangulated hiatal hernia: operative challenge or surgical dead end.

PubMed

Schweigert, M; Dubecz, A; Ofner, D; Stein, H J

2014-06-01

Gangrene of the oesophago-gastric junction due to incarcerated hiatal hernia is an extremely uncommon emergency situation which was first recognized in the late nineteenth century. Early symptoms are mainly unspecific and so diagnosis is often considerably delayed. Aim of the study is to share experience in dealing with this devastating condition. We encountered three male patients with gangrene of the oesophago-gastric junction caused by strangulated hiatal hernia within the last years. Clinical symptoms, surgical procedures and outcomes were retrospectively analyzed. Furthermore, we provide a history outline on the evolving surgical management from the preliminary reports of the nineteenth century up to modern times. Early symptoms were massive vomiting accompanied by retrosternal and epigastric pain. Hiatal hernia was already known in all patients. Nevertheless, clinical presentation was initially misdiagnosed as cardiovascular disorders. Upon emergency laparotomy gangrene of the oesophago-gastric junction was obvious while in one case even necrosis of the whole stomach occurred after considerable delayed diagnosis. Transmediastinal esophagectomy with resection of the proximal stomach and gastric pull up with cervical anastomosis was performed in two cases. Oesophago-gastrectomy with delayed reconstruction by retrosternal colonic interposition was mandatory in the case of complete gastric gangrene. Finally all sufferers recuperated well. Strangulation of hiatal hernia with subsequent gangrene of the oesophago-gastric junction is a life-threatening condition. Straight diagnosis is mandatory to avoid further necrosis of the proximal gastrointestinal tract as well as severe septic disease. Surgical strategies have considerably varied throughout the last 100 years. In our opinion transmediastinal oesophagectomy with interposition of a gastric tube and cervical anastomosis should be the procedure of choice if the distal stomach is still viable. Otherwise oesophago-gastrectomy is unavoidable. Delayed cervical anastomosis or reconstruction is advisable in instable, septic patients.

Anterior Cervical Discectomy and Fusion (ACDF): Comparison Between Zero Profile Implants and Anterior Cervical Plate and Spacer.

PubMed

Alimi, Marjan; Njoku, Innocent; Hofstetter, Christoph P; Tsiouris, Apostolos J; Kesavabhotla, Kartik; Boockvar, John; Navarro-Ramirez, Rodrigo; Härtl, Roger

2016-04-17

Interposition grafts combined with anterior plating currently remain the gold standard for anterior cervical discectomy and fusion. The use of anterior plates increases fusion rates but may be associated with higher rates of postoperative dysphagia. The aim of the current study was to determine the clinical and radiological outcomes following anterior cervical discectomy and fusion (ACDF) using zero-profile anchored spacers versus standard interposition grafts with anterior plating. This was a retrospective case series. A total of 53 male and 51 female consecutive patients (164 total operated levels) who underwent ACDF between 2007 and 2011 were included. The mean clinical follow-up was 15.7 ± 1.2 (SEM) months for patients with zero-profile implants and 14.8 ± 2.1 months for patients with conventional ACDF with anterior plating. Patient demographics, operative details, clinical outcomes, complications, and radiographic imaging were reviewed. Dysphagia was determined using the Bazaz criteria. Clinical outcome scores improved in both groups as measured by the modified Japanese Orthopedic Association and Nurick scores. Zero-profile constructs gave rise to significantly less prevertebral soft tissue swelling compared to constructs with anterior plates postoperatively (15.74 ± 0.52 as compared to 20.48 ± 0.85 mm, p < 0.001) and at the latest follow-up (10.88 ± 0.39 mm vs. 13.72 ± 0.67 mm, p < 0.001). There was a significant difference in the incidence of dysphagia at the latest follow-up (1.5% vs. 20%, p=0.001, zero-profile vs. anterior plate, respectively). Zero-profile implants lead to functional outcomes similar to standard anterior plate constructs. Avoiding the use of an anterior locking plate may decrease the risk of persistent postoperative dysphagia.

Management of traumatic brachial artery injuries: A report on 49 patients

PubMed Central

Ekim, Hasan; Tuncer, Mustafa

2009-01-01

BACKGROUND AND OBJECTIVE: The brachial artery is the most frequently injured artery in the upper extremity due to its vulnerability. The purpose of our study was to review our experience with brachial artery injuries over a 9-year period, describing the type of injury, surgical procedures, complications, and associated injuries. PATIENTS AND METHODS: Forty-nine patients with brachial artery injury underwent surgical repair procedures at our hospital, from the beginning of May 1999 to the end of June 2008. The brachial artery injuries were diagnosed by physical examination and Doppler ultrasonography. Depending on the mode of presentation, patients were either taken immediately to the operating room for bleeding control and vascular repair or were assessed by preoperative duplex ultrasonography. RESULTS: This study group consisted of 43 males and 6 females, ranging in age from 6 to 65 years with a mean (SD) age of 27.9 (6.7) years. The mechanism of trauma was penetrating in 45 patients and blunt in the remaining 4 patients. Stab injury was the most frequent form of penetrating trauma (24 of 45). Treatment included primary arterial repair in 5 cases, end-to-end anastomosis in 28 cases, interposition vein graft in 15 cases, and interposition-ringed polytetrafluoroethylene graft in 1 case. Associated injuries were common and included venous injury (14), bone fracture (5), and peripheral nerve injury (11). Fifteen patients developed postoperative complications. One patient underwent an above-elbow amputation. CONCLUSIONS: Prompt and appropriate management of the brachial artery injuries, attention to associated injuries, and a readiness to revise the vascular repair early in the event of failure will maximize patient survival and upper extremity salvage. PMID:19318753

Management of traumatic popliteal vascular injuries in a level I trauma center: A 6-year experience.

PubMed

Sciarretta, Jason D; Macedo, Francisco Igor B; Otero, Christian A; Figueroa, Jose N; Pizano, Louis R; Namias, Nicholas

2015-06-01

Popliteal vascular trauma remains a challenging entity, and carries the greatest risk of limb loss among the lower extremity vascular injuries. Operative management of traumatic popliteal vascular injuries continues to evolve. We aim at describing our experience with such complex injuries, with associated patterns of injury, diagnostic and therapeutic challenges, and outcomes. From January 2006 to September 2011, 191 adult trauma patients presented to an urban level I trauma center in Miami, Florida with traumatic lower extremity vascular injuries. Variables collected included age, gender, mechanism of injury, and clinical status at presentation. Surgical data included vessel injury, technical aspects of repair, associated complications and outcomes. Forty-seven (24.6%) patients were diagnosed with traumatic popliteal vascular injuries. Mean age was 38.1 ± 16.1 years, and the majority of patients were males (43 patients, 91.4%). There were 21 (44.7%) penetrating injuries, and 26 (55.3%) blunt injuries. Vascular repair with saphenous venous interposition graft and PTFE (polytetrafluoroethylene) grafting were performed in 36 (70.7%) and 2 (3.9%) patients, respectively. Blunt popliteal injuries were significantly more associated with major tissue loss, and length of hospital and intensive care unit (ICU) stays. The risk for amputation is increased with longer ICU stays and the use of PTFE grafting for vascular repair. The overall mortality rate in this series was 8.5%. Blunt popliteal vascular injuries are associated with increased morbidity compared to penetrating trauma. Early restoration of blood perfusion, frequent use of interposition grafts with autogenous saphenous vein, and liberal use of fasciotomies play important role to achieve acceptable outcomes. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

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

Chen, Jianbin

The microstructure and mechanical properties of resistance-spot-welded A5052 aluminum alloy and DP 600 dual-phase steel joint were studied. The fusion zone (FZ) and heat-affected zone (HAZ) of DP 600 exhibited lath martensite and ferrite-martensite structures, respectively. The microstructure of FZ and HAZ in the A5052 side was composed of cellular crystals and the boundary region of FZ exhibited a columnar crystal morphology. A Fe{sub 2}Al{sub 5} intermetallic compound (IMC) layer with 3.3 μm thickness was found adjacent to the DP 600 side, whereas a needle-shaped Fe{sub 4}Al{sub 13} IMC layer with length of 0.67 μm to 15.8 μm was foundmore » adjacent to the aluminum alloy side. The maximum tensile shear load of the A5052/DP 600 joint was 5.5 KN, with a corresponding molten nugget diameter of 6.3 mm. The fracture morphology of the optimized A5052/DP 600 joint was mainly an elongated dimple fracture accompanied by cleavage fracture. - Highlights: •A5052 and DP 600 with large gaps in properties were investigated by RSW. •The microstructures of RSW joints in DP 600/A5052 were examined detailedly. •The micro/macro-characteristics and strength relations of joints were analyzed.« less

Upper limb joint forces and moments during underwater cyclical movements.

PubMed

Lauer, Jessy; Rouard, Annie Hélène; Vilas-Boas, João Paulo

2016-10-03

Sound inverse dynamics modeling is lacking in aquatic locomotion research because of the difficulty in measuring hydrodynamic forces in dynamic conditions. Here we report the successful implementation and validation of an innovative methodology crossing new computational fluid dynamics and inverse dynamics techniques to quantify upper limb joint forces and moments while moving in water. Upper limb kinematics of seven male swimmers sculling while ballasted with 4kg was recorded through underwater motion capture. Together with body scans, segment inertial properties, and hydrodynamic resistances computed from a unique dynamic mesh algorithm capable to handle large body deformations, these data were fed into an inverse dynamics model to solve for joint kinetics. Simulation validity was assessed by comparing the impulse produced by the arms, calculated by integrating vertical forces over a stroke period, to the net theoretical impulse of buoyancy and ballast forces. A resulting gap of 1.2±3.5% provided confidence in the results. Upper limb joint load was within 5% of swimmer׳s body weight, which tends to supports the use of low-load aquatic exercises to reduce joint stress. We expect this significant methodological improvement to pave the way towards deeper insights into the mechanics of aquatic movement and the establishment of practice guidelines in rehabilitation, fitness or swimming performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Octopuses use a human-like strategy to control precise point-to-point arm movements.

PubMed

Sumbre, Germán; Fiorito, Graziano; Flash, Tamar; Hochner, Binyamin

2006-04-18

One of the key problems in motor control is mastering or reducing the number of degrees of freedom (DOFs) through coordination. This problem is especially prominent with hyper-redundant limbs such as the extremely flexible arm of the octopus. Several strategies for simplifying these control problems have been suggested for human point-to-point arm movements. Despite the evolutionary gap and morphological differences, humans and octopuses evolved similar strategies when fetching food to the mouth. To achieve this precise point-to-point-task, octopus arms generate a quasi-articulated structure based on three dynamic joints. A rotational movement around these joints brings the object to the mouth . Here, we describe a peripheral neural mechanism-two waves of muscle activation propagate toward each other, and their collision point sets the medial-joint location. This is a remarkably simple mechanism for adjusting the length of the segments according to where the object is grasped. Furthermore, similar to certain human arm movements, kinematic invariants were observed at the joint level rather than at the end-effector level, suggesting intrinsic control coordination. The evolutionary convergence to similar geometrical and kinematic features suggests that a kinematically constrained articulated limb controlled at the level of joint space is the optimal solution for precise point-to-point movements.

Laxity after complete release of the medial collateral ligament in primary total knee arthroplasty.

PubMed

Cho, Woo-Shin; Byun, Seong-Eun; Lee, Sang-Jun; Yoon, Jaeyoun

2015-06-01

Medial collateral ligament (MCL) release is one of the essential steps toward the achievement of ligament balancing during the total knee arthroplasty (TKA) in patients with varus deformity. When the varus deformity is severe, complete release of the MCL until balanced is often required. However, it is believed that complete MCL release may lead to catastrophic laxity. The purpose of this prospective study is to compare the medial joint gap opening in postoperative valgus stress radiograph in patients with complete MCL release against patients with partial release. Out of 209 primary TKAs performed for degenerative osteoarthritis, complete MCL release was required in 33 cases (group I) by sub-periosteal detachment at proximal tibia using periosteal elevator. For the remaining 176 knees (group II), partial release of MCL was done. At postoperative 6 months and 1 year, both groups were evaluated for comparing the joint gap on valgus stress radiographs using modified Telos device in 0°, 45°, and 90° of flexion. Additional parameters which were analyzed included preoperative varus and valgus stress radiographs in full extension and pre- and postoperative mechanical alignment in each group. The knee range of motion (ROM) and clinical scores were evaluated at 1-year follow-up. The mean values of the joint opening on the postoperative valgus stress test with the knee joint extended, and in the 45° and 90° flexed states at 6 months and at 1 year postoperatively in group I were not statistically significantly different from those of group II. The clinical scores also did not show a statistically significant difference between two groups. There was a statistically significant difference in ROM between two groups, pre- and postoperatively and the difference was 5°, respectively. This study suggests that complete MCL release for ligament balancing is a safe procedure and does not lead to postoperative laxity.

International survey on the management of esophageal atresia.

PubMed

Zani, Augusto; Eaton, Simon; Hoellwarth, Michael E; Puri, Prem; Tovar, Juan; Fasching, Guenter; Bagolan, Pietro; Lukac, Marija; Wijnen, Rene; Kuebler, Joachim F; Cecchetto, Giovanni; Rintala, Risto; Pierro, Agostino

2014-02-01

Because many aspects of the management of esophageal atresia (EA) are still controversial, we evaluated the practice patterns of this condition across Europe. A survey was completed by 178 delegates (from 45 [27 European] countries; 88% senior respondents) at the EUPSA-BAPS 2012. Approximately 66% of respondents work in centers where more than five EA repairs are performed per year. Preoperatively, 81% of respondents request an echocardiogram, and only 43% of respondents routinely perform preoperative bronchoscopy. Approximately 94% of respondents prefer an open approach, which is extrapleural in 71% of respondents. There were no differences in use of thoracoscopy between Europeans (10%) and non-Europeans (11%, p = nonsignificant). Approximately 60% of respondents measure the gap intraoperatively. A transanastomotic tube (90%) and chest drain (69%) are left in situ. Elective paralysis is adopted by 56% of respondents mainly for anastomosis tension (65%). About 72% of respondents routinely request a contrast study on postoperative day 7 (2-14). Approximately 54% of respondents use parenteral nutrition, 40% of respondents start transanastomotic feeds on postoperative day 1, and 89% of respondents start oral feeds after postoperative day 5. Pure EA: 46% of respondents work in centers that repair two or more than two pure EA a year. About 60% of respondents opt for delayed primary anastomosis at 3 months (1-12 months) with gastrostomy formation without esophagostomy. Anastomosis is achieved with open approach by 85% of respondents. About 47% of respondents attempt elongation of esophageal ends via Foker technique (43%) or with serial dilations with bougies (41%). Approximately 67% of respondents always attempt an anastomosis. Gastric interposition is the commonest esophageal substitution. Many aspects of EA management are lacking consensus. Minimally invasive repair is still sporadic. We recommend establishment of an EA registry. Georg Thieme Verlag KG Stuttgart · New York.

2014-2015 Partnership accomplishments report on joint activities: National Gap Analysis Program and LANDFIRE

USGS Publications Warehouse

Davidson, Anne; McKerrow, Alexa; Long, Don; Earnhardt, Todd

2015-01-01

The intended target audience for this document initially is management and project technical specialist and scientists involved in the Gap Analysis Program (GAP) and the Landscape Fire and Resource Management Planning Tools - (LANDFIRE) program to help communicate coordination activities to all involved parties. This document is also intended to give background information in other parts of the USGS and beyond, although some details given are relatively oriented to management of the respective programs. Because the Gap Analysis Program (GAP) and the Landscape Fire and Resource Management Planning Tools - LANDFIRE programs both rely on characterizations of land cover using similar scales and resolutions, the programs have been coordinating their work to improve scientific consistency and efficiency of production. Initial discussions and informal sharing of ideas and work began in 2008. Although this collaboration was fruitful, there was no formal process for reporting results, plans, or outstanding issues, nor was there any formally-defined coordinated management team that spanned the two programs. In 2012, leadership from the two programs agreed to strengthen the coordination of their respective work efforts. In 2013 the GAP and LANDFIRE programs developed an umbrella plan of objectives and components related to three mutual focus areas for the GAP and LANDFIRE collaboration for the years 2013 and 2014 (GAP/LANDFIRE 2013). The evolution of this partnership resulted in the drafting of an inter-program Memorandum of Understanding (MOU) in 2014. This MOU identified three coordination topics relevant to the two programs participating at this point in the MOU history: Vegetation mappingDisturbance classesFormal quality assessment

Anatomy of a Joint: Comparing Self-Reported and Actual Dose of Cannabis and Tobacco in a Joint, and How These Are Influenced by Controlled Acute Administration

PubMed Central

Hindocha, Chandni; Freeman, Tom P.; Curran, H. Valerie

2017-01-01

Abstract Introduction: Major gaps exist in the measurement of cannabis exposure. The accuracy of self-reported cannabis and tobacco dose per joint is poorly characterized and has never been investigated following acute cannabis/tobacco exposure. Using an innovative “Roll a Joint” paradigm, this study aims to (1) compare estimated and actual dose of cannabis and tobacco per joint at baseline and (2) examine the acute effects of cannabis and/or tobacco on estimated and actual dose. Materials and Methods: We investigated this by using a randomized, double-blind, placebo-controlled crossover 2 (active cannabis, placebo cannabis)×2 (active tobacco, placebo tobacco) design in a laboratory setting. Participants were 24 recreational cousers of cannabis and tobacco. At baseline, they were asked to measure out the amount of cannabis and tobacco they would put in an average joint for themselves (dose per joint). Then, on each of four drug administration sessions, participants were again asked to do this for a joint they would want to smoke “right now.” Self-reported and actual amount was recorded (g). Results: At baseline, the estimated amount of cannabis per joint (0.28±0.23 g) was double the actual amount (0.14±0.12 g) (p=0.003, d=0.723). No difference emerged between estimated (0.43±0.25 g) and actual (0.35±0.15 g) (p=0.125) amount of tobacco per joint. Compared to placebo, active cannabis reduced the actual dose of both cannabis (p=0.035) and tobacco (p<0.001) they put in a joint. Participants accurately estimated this reduction for tobacco (p=0.014), but not for cannabis (p=0.680). Conclusions: Self-reported dose per joint is accurate for tobacco but dramatically overestimates cannabis exposure and therefore should be viewed with caution. Cannabis administration reduced the amount of cannabis and tobacco added to joints, suggesting a reduction in dose during a smoking session. The “Roll A Joint” paradigm should be implemented for better accuracy in assessing dose per joint. PMID:29082319

Marine Special Operations Helicopter Unit: Viability in the Joint Force of 2020

DTIC Science & Technology

2012-04-18

competitive globalized environment will increase the requirements for aviation support. With a dedicated Marine Special Operations Helicopter Squadron...efficiency in planning, training, and execution will provide for precise timely and accurate organic fires, direct mobility support, and reduce the...Fulfilling the gap in Marine Special Operations Command with a dedicated Marine special operations helicopter unit is necessary. Concisely, this will

The Maintenance Gap: Deferred Repair and Renovation in the Nation's Elementary and Secondary Schools. A Joint Report.

ERIC Educational Resources Information Center

Council of the Great City Schools, Washington, DC.

Data from 100 school systems in 34 states show that public schools are in a state of critical disrepair. The physical deterioration of the schools is the result of a variety of factors--including the rapid increase in energy prices, state tax and expenditure limitation measures, and health and safety requirements--that have reduced spending for…

Closing the College Attainment Gap between the U.S. and Most Educated Countries, and the Contributions to Be Made by the States

ERIC Educational Resources Information Center

Kelly, Patrick J.

2010-01-01

In February 2009, President Barack Obama told a joint session of Congress: "By 2020, America will once again have the highest proportion of college graduates in the world". Higher education policymakers across the country were immediately encouraged by this statement, and a variety of policy organizations quickly set out to calculate the…

The roles of competition and habitat in the dynamics of populations and species distributions Ecology

Treesearch

Charles B. Yackulic; Janice Reid; James D. Nichols; James E. Hines; Raymond Davis; Eric Forsman

2014-01-01

The role of competition in structuring biotic communities at fine spatial scales is well known from detailed process-based studies. Our understanding of competition’s importance at broader scales is less resolved and mainly based on static species distribution maps. Here, we bridge this gap by examining the joint occupancy dynamics of an invading species (Barred Owl,...

78 FR 60937 - Joint Industry Plan; Order Approving the Fifth Amendment to the National Market System Plan to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... immediately enter a Limit State if the National Best Offer equals the Lower Limit Band and does not cross the... from occurring outside of the specified price bands.\\6\\ These limit up-limit down requirements would be... moves (as opposed to erroneous trades or momentary gaps in liquidity). \\5\\ 17 CFR 242.600(b)(47). See...

Reframing Stability Operations: using Social Science to Identify Pillars of Stability Operations to Bridge the Gap Between the Principles of Joint Operations and Stability Operations Framework

DTIC Science & Technology

2009-12-11

demographics, and instability. Many of the essays contained within Too Poor detail issues related to Military Aged Males (MAMs) and the effects of youth......cohorts who come of working age with more education than previous generations are particularly vulnerable when they are unable to find “appropriate

A Cyberspace Command and Control Model

DTIC Science & Technology

2009-02-17

control of Commander, Joint Functional Component Commander – Network Warfare (JFCC-NW).3 This arrangement further creates gaps and seams as the DoD...technological advances and increases in the use and pervasiveness of cyberspace coupled with aggressive 5 adversaries create a volatile environment. Both...intrusions, combine to create an environment of frustrating ambiguity. The correct military response lies in establishing a C2 structure for this

Open Knee: Open Source Modeling & Simulation to Enable Scientific Discovery and Clinical Care in Knee Biomechanics

PubMed Central

Erdemir, Ahmet

2016-01-01

Virtual representations of the knee joint can provide clinicians, scientists, and engineers the tools to explore mechanical function of the knee and its tissue structures in health and disease. Modeling and simulation approaches such as finite element analysis also provide the possibility to understand the influence of surgical procedures and implants on joint stresses and tissue deformations. A large number of knee joint models are described in the biomechanics literature. However, freely accessible, customizable, and easy-to-use models are scarce. Availability of such models can accelerate clinical translation of simulations, where labor intensive reproduction of model development steps can be avoided. The interested parties can immediately utilize readily available models for scientific discovery and for clinical care. Motivated by this gap, this study aims to describe an open source and freely available finite element representation of the tibiofemoral joint, namely Open Knee, which includes detailed anatomical representation of the joint's major tissue structures, their nonlinear mechanical properties and interactions. Three use cases illustrate customization potential of the model, its predictive capacity, and its scientific and clinical utility: prediction of joint movements during passive flexion, examining the role of meniscectomy on contact mechanics and joint movements, and understanding anterior cruciate ligament mechanics. A summary of scientific and clinically directed studies conducted by other investigators are also provided. The utilization of this open source model by groups other than its developers emphasizes the premise of model sharing as an accelerator of simulation-based medicine. Finally, the imminent need to develop next generation knee models are noted. These are anticipated to incorporate individualized anatomy and tissue properties supported by specimen-specific joint mechanics data for evaluation, all acquired in vitro from varying age groups and pathological states. PMID:26444849

Open Knee: Open Source Modeling and Simulation in Knee Biomechanics.

PubMed

Erdemir, Ahmet

2016-02-01

Virtual representations of the knee joint can provide clinicians, scientists, and engineers the tools to explore mechanical functions of the knee and its tissue structures in health and disease. Modeling and simulation approaches such as finite element analysis also provide the possibility to understand the influence of surgical procedures and implants on joint stresses and tissue deformations. A large number of knee joint models are described in the biomechanics literature. However, freely accessible, customizable, and easy-to-use models are scarce. Availability of such models can accelerate clinical translation of simulations, where labor-intensive reproduction of model development steps can be avoided. Interested parties can immediately utilize readily available models for scientific discovery and clinical care. Motivated by this gap, this study aims to describe an open source and freely available finite element representation of the tibiofemoral joint, namely Open Knee, which includes the detailed anatomical representation of the joint's major tissue structures and their nonlinear mechanical properties and interactions. Three use cases illustrate customization potential of the model, its predictive capacity, and its scientific and clinical utility: prediction of joint movements during passive flexion, examining the role of meniscectomy on contact mechanics and joint movements, and understanding anterior cruciate ligament mechanics. A summary of scientific and clinically directed studies conducted by other investigators are also provided. The utilization of this open source model by groups other than its developers emphasizes the premise of model sharing as an accelerator of simulation-based medicine. Finally, the imminent need to develop next-generation knee models is noted. These are anticipated to incorporate individualized anatomy and tissue properties supported by specimen-specific joint mechanics data for evaluation, all acquired in vitro from varying age groups and pathological states. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Connexin43 Mediated Delivery of ADAMTS5 Targeting siRNAs from Mesenchymal Stem Cells to Synovial Fibroblasts.

PubMed

Liu, Shuo; Niger, Corinne; Koh, Eugene Y; Stains, Joseph P

2015-01-01

Osteoarthritis is a joint-destructive disease that has no effective cure. Human mesenchymal stem cells (hMSCs) could offer therapeutic benefit in the treatment of arthritic diseases by suppressing inflammation and permitting tissue regeneration, but first these cells must overcome the catabolic environment of the diseased joint. Likewise, gene therapy also offers therapeutic promise given its ability to directly modulate key catabolic factors that mediate joint deterioration, although it too has limitations. In the current study, we explore an approach that combines hMSCs and gene therapy. Specifically, we test the use of hMSC as a vehicle to deliver ADAMTS5 (an aggrecanase with a key role in osteoarthritis)-targeting siRNAs to SW982 synovial fibroblast-like cells via connexin43 containing gap junctions. Accordingly, we transduced hMSCs with ADAMTS5-targeting shRNA or non-targeted shRNA, and co-cultured them with synovial fibroblasts to allow delivery of siRNAs from hMSC to synovial fibroblasts. We found that co-culture of hMSCs-shRNA-ADAMTS5 and synovial fibroblasts reduced ADAMTS5 expression relative to co-culture of hMSCs-shRNA-control and synovial fibroblasts. Furthermore, ADAMTS5 was specifically reduced in the synovial fibroblasts populations as determined by fluorescence-activated cell sorting, suggesting transfer of the siRNA between cells. To test if Cx43-containing gap junctions are involved in the transfer of siRNA, we co-cultured hMSCs-shRNA-ADAMTS5 cells with synovial fibroblasts in which connexin43 was knocked down. Under these conditions, ADAMTS5 levels were not inhibited by co-culture, indicating that connexin43 mediates the delivery of siRNA from hMSCs to synovial fibroblasts. In total, our findings demonstrate that hMSCs can function as donor cells to host and deliver siRNAs to synovial fibroblasts via connexin43 gap junction in vitro. These data may have implications in the combination of hMSCs and gene therapy to treat diseases like osteoarthritis, in vivo.

Seismic Tomography of the Sacramento -- San Joaquin River Delta: Joint P-wave/Gravity and Ambient Noise Methods

NASA Astrophysics Data System (ADS)

Teel, Alexander C.

The Sacramento -- San Joaquin River Delta (SSJRD) is an area that has been identified as having high seismic hazard but has resolution gaps in the seismic velocity models of the area due to a scarcity of local seismic stations and earthquakes. I present new three-dimensional (3D) P-wave velocity (Vp) and S-wave velocity (Vs) models for the SSJRD which fill in the sampling gaps of previous studies. I have created a new 3D seismic velocity model for the SSJRD, addressing an identified need for higher resolution velocity models in the region, using a new joint gravity/body-wave tomography algorithm. I am able to fit gravity and arrival-time residuals jointly using an empirical density-velocity relationship to take advantage of existing gravity data in the region to help fill in the resolution gaps of previous velocity models in the area. I find that the method enhances the ability to resolve the relief of basin structure relative to seismic-only tomography at this location. I find the depth to the basement to be the greatest in the northwest portion of the SSJRD and that there is a plateau in the basement structure beneath the southeast portion of the SSJRD. From my findings I infer that the SSJRD may be prone to focusing effects and basin amplification of ground motion. A 3D, Vs model for the SSJRD and surrounding area was created using ambient noise tomography. The empirical Green's functions are in good agreement with published cross-correlations and match earthquake waveforms sharing similar paths. The group velocity and shear velocity maps are in good agreement with published regional scale models. The new model maps velocity values on a local scale and successfully recovers the basin structure beneath the Delta. From this Vs model I find the maximum depth of the basin to reach approximately 15 km with the Great Valley Ophiolite body rising to a depth of 10 km east of the SSJRD. We consider our basement-depth estimates from the Vp model to be more robust than from the Vs model.

6. Workers laying up the graphite core of the 105B ...

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

6. Workers laying up the graphite core of the 105-B file. In the lower-left can be seen a portion of the rear face of the pile, the top of its shielding wall, and the gun barrels protruding through it. The inside of the front face of the pile and its gun barrels can be seen toward the upper-right side. The angled top of the front shielding wall can be seen in the picture. All four walls were "stepped" in this manner where they joined with another wall or the ceiling to form a "labyrinth" joint, so that radiation would not have a straight route through any gaps in the joints. D-3045 - B Reactor, Richland, Benton County, WA

Magellan/Galileo solder joint failure analysis and recommendations

NASA Technical Reports Server (NTRS)

Ross, Ronald G., Jr.

1989-01-01

On or about November 10, 1988 an open circuit solder joint was discovered in the Magellan Radar digital unit (DFU) during integration testing at Kennedy Space Center (KSC). A detailed analysis of the cause of the failure was conducted at the Jet Propulsion Laboratory leading to the successful repair of many pieces of affected electronic hardware on both the Magellan and Galileo spacecraft. The problem was caused by the presence of high thermal coefficient of expansion heat sink and conformal coating materials located in the large (0.055 inch) gap between Dual Inline Packages (DIPS) and the printed wiring board. The details of the observed problems are described and recommendations are made for improved design and testing activities in the future.

Role for Primary Repair of Deltoid Ligament Complex in Ankle Fractures.

PubMed

Rigby, Ryan B; Scott, Ryan T

2018-04-01

Acute deltoid injuries may occur with ankle fractures. They are often left to heal without repair, possibly leading to chronic medial ankle instability. Stress radiographs identify the need for surgical repair of fractures or soft tissue damage. Gravity stress views have benefits over manually stressing the ankle. MRI can explore the extent of medial soft tissue injuries. Arthroscopy can evaluate and potentially treat deltoid injuries. Interposition of the deltoid may preclude adequate fracture reduction. Except with deltoid tear, fractures should be reduced and fixated, then the deltoid assessed. With persistent instability, primary repair may prevent long-term sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

Tubular duplication of the oesophagus presenting with dysphagia.

PubMed

Saha, A K; Kundu, A K

2014-06-01

Duplications of the alimentary tract are rare congenital malformations, with the ileum being the most commonly affected site, followed by the oesophagus. Among oesophageal duplications, cystic duplication is the most common and the tubular variety, the rarest. Herein, we report a rare case of tubular oesophageal duplication, complicated by adenosquamous carcinoma at the lower end of the oesophagus, in a 32-year-old man who presented with progressive dysphagia. Although proton pump inhibitors may relieve dysphagia, oesophagectomy and gastric interpositioning should be the first-line treatment for patients with tubular oesophageal duplication, in order to reduce the risk of malignant transformation at the lower end of the oesophagus.

Laser Brazing with Beam Scanning: Experimental and Simulative Analysis

NASA Astrophysics Data System (ADS)

Heitmanek, M.; Dobler, M.; Graudenz, M.; Perret, W.; Göbel, G.; Schmidt, M.; Beyer, E.

Laser beam brazing with copper based filler wire is a widely established technology for joining zinc-coated steel plates in the body-shop. Successful applications are the divided tailgate or the zero-gap joint, which represents the joint between the side panel and the roof-top of the body-in-white. These joints are in direct view to the customer, and therefore have to fulfil highest optical quality requirements. For this reason a stable and efficient laser brazing process is essential. In this paper the current results on quality improvement due to one dimensional laser beam deflections in feed direction are presented. Additionally to the experimental results a transient three-dimensional simulation model for the laser beam brazing process is taken into account. With this model the influence of scanning parameters on filler wire temperature and melt pool characteristics is analyzed. The theoretical predictions are in good accordance with the experimental results. They show that the beam scanning approach is a very promising method to increase process stability and seam quality.

The Effects of a Functional Elbow Brace on Medial Joint Stability: A Case Study

PubMed Central

Pincivero, Danny M.; Rijke, Arie M.; Heinrichs, Kristinn; Perrin, David H.

1994-01-01

Medical elbow ligament sprains in athletics can be traumatic and disabling. In this case report, we outline the effect of a prototype functional elbow brace on joint stability in a female collegiate javelin thrower with an ulnar collateral ligament sprain. A valgus force to both elbows was applied using graded stress radiography (Telos GA-II/E stress device) at 0, 5, 10, and 15 kiloPascals (kPa) of pressure. The increase in gap width between the coronoid process and the medial epicondyle was measured from anteroposterior radiographs to determine medial displacement. The brace resulted in less displacement in both injured and noninjured ulnar collateral ligament; injured ulnar collateral ligament demonstrated greater displacement regardless of condition. The brace restored medial stability to the elbow joint by 49%, 38%, and 35% at 5, 10, and 15 kPa of pressure, respectively. The application of the brace may be useful in athletes with ulnar collateral ligament injuries. ImagesFig 1Fig 2 PMID:16558285

Transient Pressure Test Article (TPTA) 1.1 and 1.1A, volume 1

NASA Technical Reports Server (NTRS)

Rebells, Clarence A.

1988-01-01

This final test report presents the results obtained during the static hot firing and cold-gas high Q tests of the first Transient Pressure Test Article (TPTA) 1.1. The TPTA consisted of field test joints A and B, which were the original RSRM J-insulation configuration, with a metal capture feature. It also consisted of a flight configuration nozzle-to-case test joint (Joint D) with shorter vent slots. Fluorocarbon O-rings were used in all the test joints. The purpose of the TPTA tests is to evaluate and characterize the RSMR field and nozzle-to-case joints under the influence of ignition and strut loads during liftoff anf high Q. All objectives of the cold-gas high Q (TPTA 1.1A) test were met and all measurements were close to predicted values. During the static hot-firing test (TPTA 1.1), the motor was inadvertently plugged by the quench injector plug, making it a more severe test, although no strut loads were applied. The motor was depressurized after approximately 11 min using an auxiliary system, and no anomalies were noted. In the static hot-firing test, pressure was incident on the insulation and the test joint gaps were within the predicted range. During the static hot-firing test, no strut loads were applied because the loading system malfunctioned. For this test, all measurements were within range of similar tests performed without strut loads.

Preserving transfer independence among individuals with spinal cord injury.

PubMed

Nyland, J; Quigley, P; Huang, C; Lloyd, J; Harrow, J; Nelson, A

2000-11-01

Literature review. Upper extremity (UE) joint degeneration, particularly at the shoulder, detrimentally influences functional independence, quality of life, cardiovascular disease risk, and life expectancy of individuals following spinal cord injury (SCI). This review (1) describes UE use for transfers among individuals with SCI; (2) describes contributing factors associated with UE joint degeneration and loss of transfer independence; (3) summarizes and identifies gaps in existing research; and (4) provides suggestions for future research. Investigations of wheelchair transfer related UE joint and function preservation among individuals with SCI should consider factors including age and length of time from SCI onset, interface between subject-wheelchair, pain, shoulder joint range of motion (ROM) and muscle strength deficiencies or imbalances, exercise capacity and tolerance for the physical strain of activities of daily living (ADL), body mass and composition, previous UE injury or disease history, and transfer techniques. Existing studies of transfers among individuals with SCI have relied on small groups of either asymptomatic or non-impaired subjects, with minimal integration of kinematic, kinetic and electromyographic data. Descriptions of UE joint ROM, forces, and moments produced during transfers are lacking. Biomechanical measurement and computer modeling have provided increasingly accurate tools for acquiring the data needed to guide intervention planning to prevent UE joint degeneration and preserve function among individuals with SCI. The identification of stressful sub-components during transfers will enable intervening clinicians and engineers who design and modify assistive and adaptive devices to better serve individuals with SCI.

Progress and achievements of R&D activities for the ITER vacuum vessel

NASA Astrophysics Data System (ADS)

Nakahira, M.; Takahashi, H.; Koizumi, K.; Onozuka, M.; Ioki, K.

2001-04-01

The Full Scale Sector Model Project, which was initiated in 1995 as one of the Seven Large Projects for ITER R&D, has been continued with the joint effort of the ITER Joint Central Team and the Japanese, Russian Federation and United States Home Teams. The fabrication of a full scale 18° toroidal sector, which is composed of two 9° sectors spliced at the port centre, was successfully completed in September 1997 with a dimensional accuracy of +/-3 mm for the total height and total width. Both sectors were shipped to the test site at the Japan Atomic Energy Research Institute and the integration test of the sectors was begun in October 1997. The integration test involves the adjustment of field joints, automatic narrow gap tungsten inert gas welding of field joints with splice plates and inspection of the joints by ultrasonic testing, as required for the initial assembly of the ITER vacuum vessel. This first demonstration of field joint welding and the performance test of the mechanical characteristics were completed in May 1998, and all the results obtained have satisfied the ITER design. In addition to these tests, integration with the midplane port extension fabricated by the Russian Home Team by using a fully remotized welding and cutting system developed by the US Home Team was completed in March 2000. The article describes the progress, achievements and latest status of the R&D activities for the ITER vacuum vessel.

Device for measuring hole elongation in a bolted joint

NASA Technical Reports Server (NTRS)

Wichorek, Gregory R. (Inventor)

1987-01-01

A device to determine the operable failure mode of mechanically fastened lightweight composite joints by measuring the hole elongation of a bolted joint is disclosed. The double-lap joint test apparatus comprises a stud, a test specimen having a hole, two load transfer plates, and linear displacement measuring instruments. The test specimen is sandwiched between the two load transfer plates and clamped together with the stud. Spacer washers are placed between the test specimen and each load transfer plate to provide a known, controllable area for the determination of clamping forces around the hole of the specimen attributable to bolt torque. The spacer washers also provide a gap for the mounting of reference angles on each side of the test specimen. Under tensile loading, elongation of the hole of the test specimen causes the stud to move away from the reference angles. This displacement is measured by the voltage output of two linear displacement measuring instruments that are attached to the stud and remain in contact with the reference angles throughout the tensile loading. The present invention obviates previous problems in obtaining specimen deformation measurements by monitoring the reference angles to the test specimen and the linear displacement measuring instruments to the stud.

The Joint Damping Experiment (JDX)

NASA Technical Reports Server (NTRS)

Folkman, Steven L.; Bingham, Jeff G.; Crookston, Jess R.; Dutson, Joseph D.; Ferney, Brook D.; Ferney, Greg D.; Rowsell, Edwin A.

1997-01-01

The Joint Damping Experiment (JDX), flown on the Shuttle STS-69 Mission, is designed to measure the influence of gravity on the structural damping of a high precision three bay truss. Principal objectives are: (1) Measure vibration damping of a small-scale, pinjointed truss to determine how pin gaps give rise to gravity-dependent damping rates; (2) Evaluate the applicability of ground and low-g aircraft tests for predicting on-orbit behavior; and (3) Evaluate the ability of current nonlinear finite element codes to model the dynamic behavior of the truss. Damping of the truss was inferred from 'Twang' tests that involve plucking the truss structure and recording the decay of the oscillations. Results are summarized as follows. (1) Damping, rates can change by a factor of 3 to 8 through changing the truss orientation; (2) The addition of a few pinned joints to a truss structure can increase the damping by a factor as high as 30; (3) Damping is amplitude dependent; (4) As gravity induced preloads become large (truss long axis perpendicular to gravity vector) the damping is similar to non-pinjointed truss; (5) Impacting in joints drives higher modes in structure; (6) The torsion mode disappears if gravity induced preloads are low.

Difficulty of distinguishing product states locally

NASA Astrophysics Data System (ADS)

Croke, Sarah; Barnett, Stephen M.

2017-01-01

Nonlocality without entanglement is a rather counterintuitive phenomenon in which information may be encoded entirely in product (unentangled) states of composite quantum systems in such a way that local measurement of the subsystems is not enough for optimal decoding. For simple examples of pure product states, the gap in performance is known to be rather small when arbitrary local strategies are allowed. Here we restrict to local strategies readily achievable with current technology: those requiring neither a quantum memory nor joint operations. We show that even for measurements on pure product states, there can be a large gap between such strategies and theoretically optimal performance. Thus, even in the absence of entanglement, physically realizable local strategies can be far from optimal for extracting quantum information.

Balanced Flexion and Extension Gaps Are Not Always of Equal Size.

PubMed

Kinsey, Tracy L; Mahoney, Ormonde M

2018-04-01

It has been widely accepted in total knee arthroplasty (TKA) that flexion and extension gaps in the disarticulated knee during surgery should be equalized. We hypothesized that tensioning during assessment of the flexion gap can induce temporary widening of the gap due to posterior tibial translation. We aimed to describe posterior tibial translation at flexion gap (90°) assessments and assess the correlation of tibial translation with laxity (flexion space increase) using constrained and non-constrained inserts. Imageless navigation was used to measure flexion angle, tibial position relative to the femoral axis, and lateral/medial laxity in 30 patients undergoing primary TKA. Trialing was conducted using posteriorly stabilized and cruciate retaining trials of the same size to elucidate the association of posterior tibial translation with changes in joint capsule laxity at 90° knee flexion. All patients demonstrated posterior tibial translation during flexion gap assessment relative to their subsequent final implantation [mean ± standard deviation (range), 11.3 ± 4.4 (4-21) mm]. Positive linear correlation [r = 0.69, 95% confidence interval (CI) 0.44-0.84, P ≤ .001] was demonstrated between translations [8.7 ± 2.4 (3-13) mm] and laxity changes [2.9° ± 2.0° (-0.7° to 7.4°)] at 90° of flexion. Posterior tibial translation can cause artifactual widening of the flexion gap during gap balancing in posteriorly stabilized TKA, which can be of sufficient magnitude to alter femoral component size selection for some patients. Recognition and management of these intra-operative dynamics for optimal kinematics could be feasible with the advent of robotic applications. Copyright © 2017 Elsevier Inc. All rights reserved.

Afghan National Security Forces: Closing the Gap Before 2014

DTIC Science & Technology

2013-03-20

To) 20-03-2013 Master of Military Studies Research Paper September 2012 - March 2013 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Afghan National...this paper , security force assistance (SFA) will be used as an umbrella term which incorporates training, advising, and mentoring. In the last ten...predominantly throughout this paper because according to the Joint Center for International Security Force Assistance, SFA “equates to those activities

Velocity gap mode of capillary electrophoresis developed for high-resolution chiral separations.

PubMed

Li, Xue; Li, Youxin; Zhao, Lumeng; Shen, Jianguo; Zhang, Yong; Bao, James J

2014-10-01

A new CE method based on velocity gap (VG) theory has been developed for high-resolution chiral separations. In VG, two consecutive electric fields are adopted to drive analytes passing through two capillaries, which are linked together through a joint. The joint is immersed inside another buffer vial which has conductivity communication with the buffer inside the capillary. By adjusting the field strengths onto the two capillaries, it is possible to observe different velocities of an analyte when it passes through those two capillaries and there would be a net velocity change (NVC) for the same analyte. Different analytes may have different NVC which may be specifically meaningful for enantioseparations because enantiomers are usually hard to resolve. By taking advantage of this NVC, it is possible to enhance the resolution of a chiral separation if a proper voltage program is applied. The feasibility of using NVC to enhance chiral separation was demonstrated in the separations of three pairs of enantiomers: terbutaline, chlorpheniramine, and promethazine. All separations started with partial separation in a conventional CE and were significantly improved under the same experimental conditions. The results indicated that VG has the potential to be used to improve the resolving power of CE in chiral separations. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Governance of Offshore IT Outsourcing at Shell Global Functions IT-BAM Development and Application of a Governance Framework to Improve Outsourcing Relationships

NASA Astrophysics Data System (ADS)

de Jong, Floor; van Hillegersberg, Jos; van Eck, Pascal; van der Kolk, Feiko; Jorissen, Rene

The lack of effective IT governance is widely recognized as a key inhibitor to successful global IT outsourcing relationships. In this study we present the development and application of a governance framework to improve outsourcing relationships. The approach used to developing an IT governance framework includes a meta model and a customization process to fit the framework to the target organization. The IT governance framework consists of four different elements (1) organisational structures, (2) joint processes between in- and outsourcer, (3) responsibilities that link roles to processes and (4) a diverse set of control indicators to measure the success of the relationship. The IT governance framework is put in practice in Shell GFIT BAM, a part of Shell that concluded to have a lack of management control over at least one of their outsourcing relationships. In a workshop the governance framework was used to perform a gap analysis between the current and desired governance. Several gaps were identified in the way roles and responsibilities are assigned and joint processes are set-up. Moreover, this workshop also showed the usefulness and usability of the IT governance framework in structuring, providing input and managing stakeholders in the discussions around IT governance.

Effect of Gold on the Microstructural Evolution and Integrity of a Sintered Silver Joint

DOE PAGES

Muralidharan, Govindarajan; Leonard, Donovan N.; Meyer, Harry M.

2017-01-05

There is a need for next-generation, high-performance power electronic packages and systems employing wide band gap devices to operate at high temperatures in automotive and electric grid applications. Sintered silver joints are currently being evaluated as an alternative to Pb-free solder joints. Of particular interest is the development of joints based on silver paste consisting of nanoscale or micron scale particles that can be processed without the application of an external pressure. Microstructural evolution at the interface of a pressureless sintered silver joint formed between a SiC die with a Ti/Ni/Au metallization and an Active Metal Brazed substrate with Agmore » metallization at 250 °C was evaluated using Scanning Electron Microscopy, X-ray microanalysis, and X-ray Photo Electron Spectroscopy. Results from Focused Ion Beam cross-sections show that during sintering, the pores in the sintered region close to the Au layer tend to be smaller and are oriented predominantly with their longer dimension oriented parallel to the interface. With further densification, this results in the alignment of small pores parallel to the interface, creating a path for easy crack propagation. Lastly, X-ray microchemical analyses results confirm interdiffusion between Au and Ag and that a region with poor mechanical strength is formed at the edge of this region of interdiffusion.« less

Mode jumping of split-ring resonator metamaterials controlled by high-permittivity BST and incident electric fields

PubMed Central

Fu, Xiaojian; Zeng, Xinxi; Cui, Tie Jun; Lan, Chuwen; Guo, Yunsheng; Zhang, Hao Chi; Zhang, Qian

2016-01-01

We investigate the resonant modes of split-ring resonator (SRR) metamaterials that contain high-permittivity BST block numerically and experimentally. We observe interesting mode-jumping phenomena from the BST-included SRR absorber structure as the excitation wave is incident perpendicularly to the SRR plane. Specifically, when the electric field is parallel to the SRR gap, the BST block in the gap will induce a mode jumping from the LC resonance to plasmonic resonance (horizontal electric-dipole mode), because the displacement current excited by the Mie resonance in the dielectric block acts as a current channel in the gap. When the electric field is perpendicular to the gap side, the plasmonic resonance mode (vertical electric-dipole mode) in SRR changes to two joint modes contributed simultaneously by the back layer, SRR and BST block, as a result of connected back layer and SRR layer by the displacement current in the BST dielectric block. Based on the mode jumping effect as well as temperature and electric-field dependent dielectric constant, the BST-included SRR metamaterials may have great potentials for the applications in electromagnetic switches and widely tunable metamaterial devices. PMID:27502844

[EFFECTIVENESS COMPARISON OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION BETWEEN BY AUTOLOGOUS AND ALLOGENEIC TENDON GRAFTS COMBINED WITH HOOK PLATE FIXATION FOR TREATING ACROMIOCLAVICULAR JOINT DISLOCATION].

PubMed

Yin, Fei; Sun, Zhenzhong; Wei, Xuming; Liu, Xueguang; Zhou, Ming; Zhuang, Yin; Song, Sheng

2016-05-08

To compare the effectiveness of coracoclavicular ligament reconstruction between by using autologous plantaris tendon graft combined with hook plate fixation and allogeneic tendon graft combined with hook plate fixation for treating acromiocavicular joint dislocation. Thirty-three patients with acromioclavicular joint dislocation who accorded with the inclusion criteria between January 2013 and June 2014 were assigned into 2 groups. The patients were treated with autologous plantaris tendon graft combined with hook plate fixation in group A ( n =17), and with allogeneic tendon graft combined with hook plate fixation in group B ( n =16). Thirteen-one patients was followed up more than 12 months (15 in group A and 16 in group B). There was no significant difference in gender, age, cause of injury, sides, time between injury and surgery, and type of dislocation ( P >0.05). The assessments included operation time, hospitalization time, hospitalization expenses, shoulder range of motion, gap of acromioclavicular, Constant-Murley scores, and visual analogue scale (VAS) for pain. The operation time of group A was significantly longer than that of group B, and the hospitalization expense was significantly lower than that of group B ( P <0.05). There was no significant difference in hospitalization time ( t =1.046, P =0.316). The incisions healed by first intention, and hook plate was removed after 3 months. The mean follow-up time was 21.3 months (range, 19-34 months) in group A and was 23.7 months (range, 18-37 months) in group B. X-ray examination showed no osteolysis. There was no significant difference in gap of acromiocavicular between 2 groups at preoperation, 1 week after operation, and last follow-up ( P >0.05). No redislocation of acromioclavicular joint and rejection reaction occurred during follow-up. At last follow-up, there was no significant difference in shoulder range of motion, Constant-Murley score, and VAS score between 2 groups ( P >0.05). Coracoclavicular ligament reconstruction by autologous plantaris tendon or allogeneic tendon graft combined with hook plate fixation for the treatment of acromioclavicular joint dislocation can achieve good effectiveness. The appropriate treatment should be chosen according to the patient's economic situation.

Essential roles for lines in mediating leg and antennal proximodistal patterning and generating a stable Notch signaling interface at segment borders.

PubMed

Greenberg, Lina; Hatini, Victor

2009-06-01

The Drosophila leg imaginal disc provides a paradigm with which to understand the fundamental developmental mechanisms that generate an intricate appendage structure. Leg formation depends on the subdivision of the leg proximodistal (PD) axis into broad domains by the leg gap genes. The leg gap genes act combinatorially to initiate the expression of the Notch ligands Delta (Dl) and Serrate (Ser) in a segmental pattern. Dl and Ser induce the expression of a set of transcriptional regulators along the segment border, which mediate leg segment growth and joint morphogenesis. Here we show that Lines accumulates in nuclei in the presumptive tarsus and the inter-joints of proximal leg segments and governs the formation of these structures by destabilizing the nuclear protein Bowl. Across the presumptive tarsus, lines modulates the opposing expression landscapes of the leg gap gene dachshund (dac) and the tarsal PD genes, bric-a-brac 2 (bab), apterous (ap) and BarH1 (Bar). In this manner, lines inhibits proximal tarsal fates and promotes medial and distal tarsal fates. Across proximal leg segments, lines antagonizes bowl to promote Dl expression by relief-of-repression. In turn, Dl signals asymmetrically to stabilize Bowl in adjacent distal cells. Bowl, then, acts cell-autonomously, together with one or more redundant factors, to repress Dl expression. Together, lines and bowl act as a binary switch to generate a stable Notch signaling interface between Dl-expressing cells and adjacent distal cell. lines plays analogous roles in developing antennae, which are serially homologous to legs, suggesting evolutionarily conserved roles for lines in ventral appendage formation.

The influence of joint parameters on normal fault evolution and geometry: a parameter study using analogue modeling

NASA Astrophysics Data System (ADS)

Kettermann, Michael; von Hagke, Christoph; Urai, Janos L.

2017-04-01

Dilatant faults often form in rocks containing pre-existing joints, but the effects of joints on fault segment linkage and fracture connectivity is not well understood. Studying evolution of dilatancy and influence of fractures on fault development provides insights into geometry of fault zones in brittle rocks and will eventually allow for predicting their subsurface appearance. In an earlier study we recognized the effect of different angles between strike direction of vertical joints and a basement fault on the geometry of a developing fault zone. We now systematically extend the results by varying geometric joint parameters such as joint spacing and vertical extent of the joints and measuring fracture density and connectivity. A reproducibility study shows a small error-range for the measurements, allowing for a confident use of the experimental setup. Analogue models were carried out in a manually driven deformation box (30x28x20 cm) with a 60° dipping pre-defined basement fault and 4.5 cm of displacement. To produce open joints prior to faulting, sheets of paper were mounted in the box to a depth of 5 cm at a spacing of 2.5 cm. We varied the vertical extent of the joints from 5 to 50 mm. Powder was then sieved into the box, embedding the paper almost entirely (column height of 19 cm), and the paper was removed. During deformation we captured structural information by time-lapse photography that allows particle imaging velocimetry analyses (PIV) to detect localized deformation at every increment of displacement. Post-mortem photogrammetry preserves the final 3-dimensional structure of the fault zone. A counterintuitive result is that joint depth is of only minor importance for the evolution of the fault zone. Even very shallow joints form weak areas at which the fault starts to form and propagate. More important is joint spacing. Very large joint spacing leads to faults and secondary fractures that form subparallel to the basement fault. In contrast, small joint spacing results in fault strands that only localize at the pre-existing joints, and secondary fractures that are oriented at high angles to the pre-existing joints. With this new set of experiments we can now quantitatively constrain how (i) the angle between joints and basement fault, (ii) the joint depth and (iii) the joint spacing affect fault zone parameters such as (1) the damage zone width, (2) the density of secondary fractures, (3) map-view area of open gaps or (4) the fracture connectivity. We apply these results to predict subsurface geometries of joint-fault networks in cohesive rocks, e.g. basaltic sequences in Iceland and sandstones in the Canyonlands NP, USA.

Knee joint forces: prediction, measurement, and significance

PubMed Central

D’Lima, Darryl D.; Fregly, Benjamin J.; Patil, Shantanu; Steklov, Nikolai; Colwell, Clifford W.

2011-01-01

Knee forces are highly significant in osteoarthritis and in the survival and function of knee arthroplasty. A large number of studies have attempted to estimate forces around the knee during various activities. Several approaches have been used to relate knee kinematics and external forces to internal joint contact forces, the most popular being inverse dynamics, forward dynamics, and static body analyses. Knee forces have also been measured in vivo after knee arthroplasty, which serves as valuable validation of computational predictions. This review summarizes the results of published studies that measured knee forces for various activities. The efficacy of various methods to alter knee force distribution, such as gait modification, orthotics, walking aids, and custom treadmills are analyzed. Current gaps in our knowledge are identified and directions for future research in this area are outlined. PMID:22468461

A fully redundant power hinge for LANDSAT-D appendages

NASA Technical Reports Server (NTRS)

Mamrol, F. E.; Matteo, D. N.

1981-01-01

The configuration and testing of a power driven hinge for deployment of the solar array and antenna boom for the LANDSAT-D spacecraft is discussed. The hinge is fully mechanically and electrically redundant and, thereby, can sustain a single point failure of any one motor (or its power supply), speed reducer, or bearing set without loss of its ability to function. This design utilizes the capability of the stepper motor drive to remove the flexibility of the drive train from the joint stiffness equation when the hinge is loaded against its stop. This feature precludes gapping of the joint under spacecraft maneuver loads even in the absence of a latching feature. Thus, retraction is easily accomplished by motor reversal without the need for a solenoid function to remove the latch.

MovAid- a novel device for advanced rehabilitation monitoring.

PubMed

Gupta, Prashant; Verma, Piyush; Gupta, Rakesh; Verma, Bhawna

2015-08-01

The present article introduces a new device "MovAid" which helps to measure and monitor rehabilitation. It has two main components- "MovAid device" and the "MovAid Smart Phone Application". The device connects wirelessly to the MovAid smart phone application via Bluetooth. It has electronic sensors to measure three important parameters of the patient- Angle of Joint Bent, Lift from the ground and Orientation of the limb. A mono-axis flex sensor to measure the degree of joint bent and a 3-axis accelerometer and gyroscope to measure the orientation of the limb and lift from the ground have been used. MovAid system bridges the gap between caretakers and patients, empowering both in ways never thought of before, by providing detailed and accurate data on every move.

Gap-balancing technique combined with patient-specific instrumentation in TKA.

PubMed

Hommel, Hagen; Perka, Carsten

2015-11-01

Combining patient-specific instrumentation (PSI) with a balancer device in total knee arthroplasty (TKA) to achieve functional femoral rotational alignment is a novel technique. The primary goal of this study was to introduce a new method to combine PSI with a gap-balancing technique and to determine the impact of the technique on rotation of the femoral component. Twenty-five primary TKAs (15 women, 10 men) were prospectively studied. All TKAs involved PSI with an associated gap-balancing device. Front plane alignment was performed intraoperatively with the PSI, followed by rectangular, symmetrical extension and creation of a flexion gap using the balancer device to set the femoral rotation. Femoral component rotation was between 3° internal and 6° external rotation versus the transepicondylar axis. There were no postoperative signs of patellofemoral dysfunction. In no cases was the resulting joint line displacement >3 mm. The mean elevation was 1.2 ± 0.9 mm (range 0-3). The leg axis was straight in all cases (±3°), at a mean of 1.6° ± 1.0° varus (range 0°-3° varus). PSI was with the gap-balancing technique was successfully used without affecting anatomical alignment. With the balancer device, PSI can be used more widely than techniques based solely on landmarks, as the soft-tissue tension can be taken into account, thus virtually eliminating flexion instabilities.

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

Crain, Steven P.; Yang, Shuang-Hong; Zha, Hongyuan

Access to health information by consumers is ham- pered by a fundamental language gap. Current attempts to close the gap leverage consumer oriented health information, which does not, however, have good coverage of slang medical terminology. In this paper, we present a Bayesian model to automatically align documents with different dialects (slang, com- mon and technical) while extracting their semantic topics. The proposed diaTM model enables effective information retrieval, even when the query contains slang words, by explicitly modeling the mixtures of dialects in documents and the joint influence of dialects and topics on word selection. Simulations us- ing consumermore » questions to retrieve medical information from a corpus of medical documents show that diaTM achieves a 25% improvement in information retrieval relevance by nDCG@5 over an LDA baseline.« less

Structure of nascent replicative form DNA of coliphage M13

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

Dasgupta, S.; Mitra, S.

Nascent replicative form type II (RFII) DNA of coliphage M13 synthesized in an Escherichia coli mutant deficient in the 5' ..-->.. 3' exonuclease associated with DNA polymerase I contains ribonucleotides that are retained in the covalently closed RFI DNA sealed in vitro by the joint action of T5 phage DNA polymerase and T4 phage DNA ligase. These RFI molecules are labile to alkali and RNase H, unlike the RFI produced either in vivo or from RFII with E. coli DNA polymerase I and E. coli DNA ligase. The ribonucleotides are located at one site and predominantly in one strand ofmore » the nascent RF DNA. Furthermore, these molecules contain multiple small gaps, randomly located, and one large gap in the intracistronic region.« less

Leaf seal for inner and outer casings of a turbine

DOEpatents

Schroder, Mark Stewart; Leach, David

2002-01-01

A plurality of arcuate, circumferentially extending leaf seal segments form an annular seal spanning between annular sealing surfaces of inner and outer casings of a turbine. The ends of the adjoining seal segments have circumferential gaps to enable circumferential expansion and contraction of the segments. The end of a first segment includes a tab projecting into a recess of a second end of a second segment. Edges of the tab seal against the sealing surfaces of the inner and outer casings have a narrow clearance with opposed edges of the recess. An overlying cover plate spans the joint. Leakage flow is maintained at a minimum because of the reduced gap between the radially spaced edges of the tab and recess, while the seal segments retain the capacity to expand and contract circumferentially.

Preparing for the Proven Inevitable: An Urban Operations Training Strategy for America’s Joint Force

DTIC Science & Technology

2006-01-01

initiatives focused on tactical-level preparation are notably so. Services should retain the responsibility and authority to determine the extent to...proximity of Service home stations and major training rotations, we determined that one of these four facilities should be included in each of the ...proposals and would require adjustments in the design of training and funding. Step 3: Identify the Gap Between Requirements and Capabilities Determining

EFA Mid-Decade Assessment Meeting Report. Annual EFA Coordinators Meeting/EFA Mid-Decade Assessment Planning Meeting (7th, Bangkok, Thailand, October 24-29, 2005)

ERIC Educational Resources Information Center

Tung, Ko-Chih

2006-01-01

Six Education For All (EFA) goals were agreed to in the World Education Forum in Dakar, Senegal in 2000. Since then, UNESCO Bangkok, UNICEF and the Regional Thematic Working Group on EFA have been jointly assisting countries in conducting assessment of progress and gaps towards the EFA goals and mid-term review of policies and reforms. In October…

Risk Management Approach & Progress in Cd and Cr6+ Elimination

DTIC Science & Technology

2014-11-18

Documentation Available by 2015? Gaps Conversion Coating- Aluminum Avionics/Electrical- Class 3 9 7 Medium yes- joint service/OEM/ NASA effort to...Optimized conditions validated by NASA . – FRC validation: immersion process – Based on data from the lab Surtec 650V optimization, an 1800-gallon tank...acting similarly, 650V not • Plans: scale up to 80 gallon process line; assess Metalast TCP/HF- EPA and Henkel products; further study 650V

Army Air Commandos: A New Organization for Army Special Operations Aviation Foreign Internal Defense

DTIC Science & Technology

2014-06-13

AFSOC-managed AvFID program? How can USASOAC assimilate the RWAvFID mission into its portfolio without unacceptable decrement to its other core...was exploring options to strengthen its FID portfolio .2 USSOCOM’s focus shift combined with the AvFID capability gap would begin a process that would...security environment, US national strategy, and present capabilities. For the joint force this has meant investment, divestment, and rebalancing across

Surgical Exposure to Control the Distal Internal Carotid Artery at the Base of the Skull during Carotid Aneurysm Repair.

PubMed

Davis, Laura; Zeitouni, Anthony; Makhoul, Nicholas; Steinmetz, Oren K

2016-07-01

Extracranial carotid artery aneurysms are rare. Treatment options for these lesions include endovascular interventions, such as coiling and stenting, or surgical reconstruction, such as resection and primary reanastomosis, or interposition bypass grafting. In this report, we describe the surgical technique used to perform surgical repair of an internal carotid artery aneurysm extending up to the base of the skull. Anterior exposure of the infratemporal fossa and distal control of the carotid artery at the level of the carotid canal was achieved through a transcervical approach, performing double mandibular osteotomies with superior reflection of the middle mandibular section. Copyright © 2016 Elsevier Inc. All rights reserved.

Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix.

PubMed

Emodi, Omri; Ginini, Jiriys George; van Aalst, John A; Shilo, Dekel; Naddaf, Raja; Aizenbud, Dror; Rachmiel, Adi

2018-03-01

Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix

PubMed Central

Emodi, Omri; van Aalst, John A.; Shilo, Dekel; Naddaf, Raja; Aizenbud, Dror; Rachmiel, Adi

2018-01-01

Summary: Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate. PMID:29707449

Repair of orbital floor fractures with absorbable gelatin film.

PubMed

Mermer, R W; Orban, R E

1995-01-01

Many materials have been utilized for the repair of orbital floor fractures. Absorbable gelatin film is a bioabsorbable sheeting material that is manufactured from denatured collagen. This material is appropriate for the repair of smaller orbital floor defects (5 mm or less) and trapdoor-type fractures; it is used with larger defects as an interpositional graft material between the periorbital tissues and as an orbital floor reconstruction plate or mesh. Sixteen cases consisting of both types of defects were retrospectively examined clinically and radiographically. Satisfactory results were obtained in all of these cases, including no adverse ocular signs or implant rejection, good facial form, good function, and acceptable postoperative radiography results.

Distal Ulnar Artery Aneurysm Repair by End-to-End Technique: A Case Report.

PubMed

Cotroneo, Attilio; Barillà, David; Armienti, Felice; Martinelli, Gian Luca; Diena, Marco

2018-01-01

We report the case of a 33-year-old man presented with a posttraumatic 20-mm left ulnar artery aneurysm without intraluminal thrombus in the left hypothenar eminence. The patient reported left hand paresthesia. Because of symptoms and the embolic risk, we decide to plan an aneurysm resection and an interposition graft with inverted basilic vein for adequacy diameter (∼2 mm), but an end-to-end anastomosis was performed instead. We think that the posttraumatic distal artery aneurysm could be treated without a bypass but, after a meticulous anatomic dissection, with a microvascular anastomosis between the artery stumps. Copyright © 2017 Elsevier Inc. All rights reserved.

Proximal femoral resection and articulated hip distraction with an external fixator for the treatment of painful spastic hip dislocations in pediatric patients with spastic quadriplegia.

PubMed

Lampropulos, Mario; Puigdevall, Miguel H; Zapozko, Daniel; Malvárez, Héctor R

2008-01-01

We describe the results obtained with an alternative method of treatment for spastic painful hip dislocations in nonambulatory patients, which consists of a proximal femoral resection with capsular interposition arthroplasty, and the addition of a hinged external fixator for postoperative articulated hip distraction to allow for an immediate upright position and the ability to sit in a wheelchair. We performed this technique in three patients (four hips) with a mean age at the time of surgery of 15 years. Postoperatively, clinical improvement was observed in all four hips, with respect to pain relief, sitting tolerance, perineal care and functional range of motion.

Near-nadir scan overlap in Earth observations from VIIRS and MODIS

NASA Astrophysics Data System (ADS)

Blonski, Slawomir; Cao, Changyong

2017-09-01

Satellite multi-detector cross-track scanners, such as MODIS (Moderate Resolution Imaging Spectroradiometer) and VIIRS (Visible-Infrared Imaging Radiometer Suite), require synchronization of optical and orbital characteristics to avoid gaps in Earth coverage between scans. Prelaunch tests have revealed that such scan-to-scan gaps will occur near nadir in VIIRS observations from the future JPSS-1 (Joint Polar Satellite System) and JPSS-2 satellites. Our analysis of VIIRS geolocation products shows that the gaps do not occur for the instrument currently on orbit onboard the S-NPP (Suomi National Polar-orbiting Partnership) spacecraft. When the same analysis is applied to the MODIS data products, it reveals that small, near-nadir gaps exist in MODIS observations from both Aqua and Terra satellites. Although magnitude of the MODIS scan overlap gaps (up to 100 m for Terra and 25/175 m for Aqua) is quite small in comparison to the 1-km pixels, it is rather significant for the bands with the 250-m and 500-m pixels. Despite the size of the gaps, it appears that their effects on scientific analyses (e.g., NDVI) have not been reported since launch of the MODIS instruments. Because the gaps currently predicted for the JPSS-1 and -2 VIIRS are similar in size to the ones occurring for MODIS, one can expect that their effects on science data will be similarly negligible. A model that uses S-NPP orbit data as well as the S-NPP VIIRS telescope's focal length and scan rate predicts the overlap that agrees very well with the analysis of the geolocation data. For JPSS-1/-2 VIIRS focal length and scan rate, the model predicts scan overlap gaps of more than 100 m. With a shorter focal length and a faster scan rate than for the JPSS-1/-2 VIIRS, the scan overlap gaps are expected to be avoided altogether for VIIRS on the future JPSS-3 and -4 satellites.

Flight motor set 360L001 (STS-26R). (Reconstructed dynamic loads analysis)

NASA Technical Reports Server (NTRS)

Call, V. B.

1989-01-01

A transient analysis was performed to correlate the predicted versus measured behavior of the Redesigned Solid Rocket Booster (RSRB) during Flight 360L001 (STS-26R) liftoff. Approximately 9 accelerometers, 152 strain gages, and 104 girth gages were bonded to the motors during this event. Prior to Flight 360L001, a finite element model of the RSRB was analyzed to predict the accelerations, strains, and displacements measured by this developmental flight instrumentation (DFI) within an order of magnitude. Subsequently, an analysis has been performed which uses actual Flight 360L001 liftoff loading conditions, and makes more precise predictions for the RSRB structural behavior. Essential information describing the analytical model, analytical techniques used, correlation of the predicted versus measured RSRB behavior, and conclusions, are presented. A detailed model of the RSRB was developed and correlated for use in analyzing the motor behavior during liftoff loading conditions. This finite element model, referred to as the RSRB global model, uses super-element techniques to model all components of the RSRB. The objective of the RSRB global model is to accurately predict deflections and gap openings in the field joints to an accuracy of approximately 0.001 inch. The model of the field joint component was correlated to Referee and Joint Environment Simulation (JES) tests. The accuracy of the assembled RSRB global model was validated by correlation to static-fire tests such DM-8, DM-9, QM-7, and QM-8. This validated RSRB global model was used to predict RSRB structural behavior and joint gap opening during Flight 360L001 liftoff. The results of a transient analysis of the RSRB global model with imposed liftoff loading conditions are presented. Rockwell used many gage measurements to reconstruct the load parameters which were imposed on the RSRB during the Flight 360L001 liftoff. Each load parameter, and its application, is described. Also presented are conclusions and recommendations based on the analysis of this load case and the resulting correlation between predicted and measured RSRB structural behavior.

The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis

PubMed Central

Clifford, Anton G; Gabriel, Stefan M; O’Connell, Mary; Lowe, David; Miller, Larry E; Block, Jon E

2013-01-01

Symptomatic medial compartment knee osteoarthritis (OA) is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA) is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA. PMID:23717052

Standard versus physiologic bone preparation in total knee arthroplasty and the effect on joint space opening.

PubMed

Burkhart, Timothy A; Herman, Benjamin V; Perry, Kevin; Vandekerckhove, Pieter-Jan; Howard, James; Lanting, Brent

2017-11-01

Total knee arthroplasty is an effective treatment for osteoarthritis. Restoration of physiologic varus alignment may restore the native soft tissue tension and improve outcomes. Six paired fresh-frozen knee specimens were used to perform total knee arthroplastys. The left and right sides of were randomly assigned to have either a physiologic alignment cut or a standard of care neutral alignment bony cut prior to the implantation. Loads of 100 and 200N were applied at 0, 30, 60, and 90° of flexion and the magnitude of the medial and lateral compartment distraction was measured. The loads were applied with the knee specimen intact and post arthroplasty. The physiologic alignment had no difference between medial and lateral gaps at either load. With 100N of load the physiologic alignment had a greater gap at 90° than at full extension while the standard alignment had significantly more gap at 60° of flexion than full extension. The physiologic alignment had a significantly greater gap with the implant compared to the intact condition at both loads. The standard alignment had no significant difference in overall gap between the implant and intact condition with any load. Although performing a physiologic aligned TKA resulted in medial-lateral soft tissue balance, the flexion gap was found to have greater magnitude than the intact knee. Notably, a neutral aligned TKA was found to be balanced, but also was found to recreate the intact knee flexion gaps. These results suggest that coronal plane stability can be achieved with physiologic alignment objectives, but the clinician needs to be aware of the potential to have greater laxity than the intact and neutral alignment surgical objectives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neocondyle distraction osteogenesis in the management of temporomandibular joint ankylosis: Report of five cases with review of literature.

PubMed

Sharma, Ravi; Manikandhan, R; Sneha, P; Parameswaran, Anantanarayanan; Kumar, J Naveen; Sailer, Hermann F

2017-01-01

Management of temporomandibular joint (TMJ) ankylosis is a challenging and rather daunting task owing to complex abnormal anatomy and its sequel to craniofacial structures. Various autogenous grafts and alloplastic materials have been tried with variable success for creation of a near-normal joint. In recent years, neocondyle distraction has added a new dimension to the management of TMJ ankylosis. The aim of this paper is to describe the role of neocondyle distraction in TMJ ankylosis. Neocondyle distraction was carried out in five patients with TMJ ankylosis following gap arthroplasty. Computed tomogram scans were taken before surgery and 1-year postdistraction for surgical planning and postoperative assessment, respectively. The intraoral distractors (KLS Martin, Jacksonville, FL, USA) were used in this study. All five patients reported with adequate mouth opening and functional jaw movements. The procedure was well tolerated by all the patients. None of the patients underwent reankylosis following neocondyle distraction. With proper surgical planning and distraction protocol, neocondyle distraction is an effective and safe technique for TMJ reconstruction and preventing reankylosis.

Joint passive radar tracking and target classification using radar cross section

NASA Astrophysics Data System (ADS)

Herman, Shawn M.

2004-01-01

We present a recursive Bayesian solution for the problem of joint tracking and classification of airborne targets. In our system, we allow for complications due to multiple targets, false alarms, and missed detections. More importantly, though, we utilize the full benefit of a joint approach by implementing our tracker using an aerodynamically valid flight model that requires aircraft-specific coefficients such as wing area and vehicle mass, which are provided by our classifier. A key feature that bridges the gap between tracking and classification is radar cross section (RCS). By modeling the true deterministic relationship that exists between RCS and target aspect, we are able to gain both valuable class information and an estimate of target orientation. However, the lack of a closed-form relationship between RCS and target aspect prevents us from using the Kalman filter or its variants. Instead, we rely upon a sequential Monte Carlo-based approach known as particle filtering. In addition to allowing us to include RCS as a measurement, the particle filter also simplifies the implementation of our nonlinear non-Gaussian flight model.

Joint passive radar tracking and target classification using radar cross section

NASA Astrophysics Data System (ADS)

Herman, Shawn M.

2003-12-01

We present a recursive Bayesian solution for the problem of joint tracking and classification of airborne targets. In our system, we allow for complications due to multiple targets, false alarms, and missed detections. More importantly, though, we utilize the full benefit of a joint approach by implementing our tracker using an aerodynamically valid flight model that requires aircraft-specific coefficients such as wing area and vehicle mass, which are provided by our classifier. A key feature that bridges the gap between tracking and classification is radar cross section (RCS). By modeling the true deterministic relationship that exists between RCS and target aspect, we are able to gain both valuable class information and an estimate of target orientation. However, the lack of a closed-form relationship between RCS and target aspect prevents us from using the Kalman filter or its variants. Instead, we rely upon a sequential Monte Carlo-based approach known as particle filtering. In addition to allowing us to include RCS as a measurement, the particle filter also simplifies the implementation of our nonlinear non-Gaussian flight model.

Mathematical Model and Calibration Experiment of a Large Measurement Range Flexible Joints 6-UPUR Six-Axis Force Sensor

PubMed Central

Zhao, Yanzhi; Zhang, Caifeng; Zhang, Dan; Shi, Zhongpan; Zhao, Tieshi

2016-01-01

Nowadays improving the accuracy and enlarging the measuring range of six-axis force sensors for wider applications in aircraft landing, rocket thrust, and spacecraft docking testing experiments has become an urgent objective. However, it is still difficult to achieve high accuracy and large measuring range with traditional parallel six-axis force sensors due to the influence of the gap and friction of the joints. Therefore, to overcome the mentioned limitations, this paper proposed a 6-Universal-Prismatic-Universal-Revolute (UPUR) joints parallel mechanism with flexible joints to develop a large measurement range six-axis force sensor. The structural characteristics of the sensor are analyzed in comparison with traditional parallel sensor based on the Stewart platform. The force transfer relation of the sensor is deduced, and the force Jacobian matrix is obtained using screw theory in two cases of the ideal state and the state of flexibility of each flexible joint is considered. The prototype and loading calibration system are designed and developed. The K value method and least squares method are used to process experimental data, and in errors of kind Ι and kind II linearity are obtained. The experimental results show that the calibration error of the K value method is more than 13.4%, and the calibration error of the least squares method is 2.67%. The experimental results prove the feasibility of the sensor and the correctness of the theoretical analysis which are expected to be adopted in practical applications. PMID:27529244

Titanium clip ball joint: a partial ossicular reconstruction prosthesis.

PubMed

Beutner, Dirk; Luers, Jan Christoffer; Bornitz, Matthias; Zahnert, Thomas; Huttenbrink, Karl-Bernd

2011-06-01

To describe a new titanium clip prosthesis for partial ossicular reconstruction with a micro ball joint in the headplate for compensation of tympanic membrane displacements. Laboratory experiments followed by 18 consecutive patients. A micro ball joint was implemented into a headplate of titanium middle ear prosthesis. First, the new prosthesis was tested in the laboratory in temporal bone experiments. Second, the new prosthesis was clinically installed in 18 patients. Results of laser Doppler vibrometry and force measurements in the laboratory experiments, analysis of a questionnaire, and preoperative and postoperative pure tone audiometry. The frictional resistance in the joint was measured to be 12 mN that should allow for adequate mobility under physiologic conditions. The effective sound transmission of the prosthesis was demonstrated by laser Doppler vibrometry. Intraoperatively, the installation of the prosthesis was always straightforward with headplate prosthesis shaft angles between 60 and 90 degrees. Postoperatively, pure tone audiometry revealed satisfying hearing results with a remaining average air-bone gap of 18.2 dB over the frequencies 500, 1,000, 2,000, and 3,000 Hz. No signs of prosthesis dislocation were discovered within the follow-up period of approximately 6 months. The experimental data show that the new modified prosthesis headplate fulfills the requirements necessary for sound transmission. The joint allows the plate to follow movements of the tympanic membrane. This characteristic in conjunction with the proven clip design ensure for optimal prosthesis placement and effectiveness.

Effect of Cortical Screw Diameter on Reduction and Stabilization of Type III Distal Phalanx Fractures: An Equine Cadaveric Study.

PubMed

Kay, Alastair T; Durgam, Sushmitha; Stewart, Matthew; Joslyn, Stephen; Schaeffer, David J; Horn, Gavin; Kesler, Richard; Chew, Peter

2016-11-01

To compare reduction of type III distal phalangeal fractures using 4.5 and 5.5 mm cortical screws placed in lag fashion and an intact hoof capsule model. Cadaveric experimental study. Hooves from 12 adult horses (n=24). Sagittal fractures were created in pairs of distal phalanges after distal interphalangeal joint disarticulation and were reduced with either 4.5 or 5.5 mm cortical screws placed in lag fashion. Contralateral phalanges served as non-reduced controls. Fracture reduction following screw placement was assessed by comparing pre-reduction and post-reduction fracture gap measurements from radiographs using paired t-tests. Effects of incremental loading (0, 135, 270, 540, 800, 1070, and 1335 kg) on fracture gaps in 6 phalanges reduced with 4.5 mm screws and 5 phalanges reduced with 5.5 mm screws were measured from fluoroscopic images and assessed by 2-way ANOVA. Significance was set at P<.05. Type III distal phalanx fractures were reliably created. Only 5.5 mm cortical screws, not 4.5 mm screws, significantly reduced fracture gaps and constrained fracture gap expansion 3 cm distal to the articular surface. Compressive loading closed the fracture gaps at the articular surface in both non-reduced control groups and those reduced with either 5.5 or 4.5 mm screws. The 5.5 mm cortical screws were more effective than 4.5 mm screws in reducing type III distal phalanx fractures and restricting distal fracture gap expansion under load. © Copyright 2016 by The American College of Veterinary Surgeons.

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

Hun, Diana E.; Atchley, Jerald Allen; Childs, Phillip W.

Estimates for 2010 indicate that infiltration in residential buildings was responsible for 2.85 quads of energy (DOE 2014), which is about 3% of the total energy consumed in the US. One of the mechanisms being implemented to reduce this energy penalty is the use of air barriers as part of the building envelope. These technologies decrease airflow through major leakage sites such as oriented strand board (OSB) joints, and gaps around penetrations (e.g., windows, doors, pipes, electrical outlets) as indicated by Hun et al. (2014). However, most air barrier materials do not properly address leakage spots such as wall-to-roof jointsmore » and wall-to-foundation joints because these are difficult to seal, and because air barrier manufacturers usually do not provide adequate instructions for these locations. The present study focuses on characterizing typical air leakage sites in wall assemblies with air barrier materials.« less

[Latest progress on diagnosis and treatment of glenohumeral instability].

PubMed

Zhao, Gang; Liu, Yu-Jie

2014-02-01

As a common and frequently-occurring disease,glenohumeral instability is become one of disease which restrict upper limb activity. The diagnosis of this disease is easy, but it is very difficult to assess the degree of periarticular soft tissue injuries. With the development of magnetic resonance imaging and arthroscopy, MRA become the gold standard for evaluation of glenoid labrum, joint capsule and ligaments injury. The traditional manual reduction is a fast, simple method, but often can cause adverse consequences,such as rotator cuff tear,ligament relaxation,and habitual dislocation. Open operation can rebuild stability of joint,but with many new treatment methods,especially the arthroscopic reconstruction has gradually replaced the open operation, and become the mainstream trend, but for the long-term effect of capsular tightening surgery, rotator cuff gap closure is not clear,it is need further follow-up observation.

Medicaid: State and Federal Actions Have Been Taken to Improve Children's Access to Dental Services, but Gaps Remain. Report to Congressional Requesters. GAO-09-723

ERIC Educational Resources Information Center

US Government Accountability Office, 2009

2009-01-01

Children's access to Medicaid dental services is a long-standing concern. The tragic case of a 12-year-old boy who died from an untreated infected tooth that led to a fatal brain infection renewed attention to this issue. He was enrolled in Medicaid--a joint federal and state program that provides health care coverage, including dental care, for…

Close Air Support in a Joint Environment: Disconnect Between the Services and How Can Close Air Support Be Improved

DTIC Science & Technology

2013-04-05

military expecting technology to close the gap between the lack of CAS training and the expected pilot proficiency in multiple roles? To be an... Research Project. Carlisle Barracks: U.S. Army War College, 19 March 2004. McGrath, John. Fire for Effect: Field Artillery and Close Air Support in...including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations

Photonic Waveguide Choke Joint with Absorptive Loading

NASA Technical Reports Server (NTRS)

Wollack, Edward J. (Inventor); U-Yen, Kongpop (Inventor); Chuss, David T. (Inventor)

2016-01-01

A photonic waveguide choke includes a first waveguide flange member having periodic metal tiling pillars, a dissipative dielectric material positioned within an area between the periodic metal tiling pillars and a second waveguide flange member disposed to be coupled with the first waveguide flange member and in spaced-apart relationship separated by a gap. The first waveguide flange member has a substantially smooth surface, and the second waveguide flange member has an array of two-dimensional pillar structures formed therein.

Revision Ligament Reconstruction Tendon Interposition for Trapeziometacarpal Arthritis: A Case-Control Investigation

PubMed Central

Sadhu, Anita; Calfee, Ryan P.; Guthrie, Andre; Wall, Lindley B.

2016-01-01

Purpose To test the null hypothesis that there is no difference in patient-reported and objective outcomes of revision ligament reconstruction and tendon interposition (LRTI) compared to primary LRTI. Methods This case-control investigation enrolled 10 patients who had undergone revision LRTI at a tertiary care center. All patients had previously undergone primary trapeziectomy with LRTI. Patients with a minimum of two years of follow-up were eligible. All patients completed an in-office study evaluation. Controls (treated only with primary LRTI) were matched from our practice to reach a 1:2 case to control ratio. Outcome measures included Michigan Hand Questionnaire (primary outcome), Quick Disability of the Arm, Hand, and Shoulder (QuickDASH) Questionnaire, VAS for pain and improvement, and physical examination. Statistical analyses were conducted to compare the patient groups. Results Revision LRTI patients reported significantly worse outcomes on all measured standardized questionnaires compared with primary patients. The Michigan Hand Questionnaire indicated worse overall outcomes (54 versus 79) as well as worse pain, appearance, and ability to complete activities of daily living. Revision LRTI patients also reported more impairment (QuickDASH 47 versus 23), greater pain (VAS pain 6.3 versus 1), and less improvement after surgery (VAS improvement 2.7 versus 7.9). There was also a significantly higher rate of patient-reported depression in the revision LRTI group (50% versus 10% of primary LRTI patients). We did not find a significant difference in objective outcomes of pinch strength, grip strength, and thumb palmar abduction between the two groups. Conclusion Following revision LRTI patient-reported outcomes indicate worse perceived function and greater pain than expected following primary LRTI despite similar motion and strength. Revision surgery can be offered in the setting of persistent or recurrent symptoms, but patients should be counseled that improvement of symptoms is unpredictable. PMID:27751779

Postoperative long-term evaluation of interposition reconstruction compared with Roux-en-Y after total gastrectomy in gastric cancer: prospective randomized controlled trial.

PubMed

Ishigami, Sumiya; Natsugoe, Shoji; Hokita, Shuichi; Aoki, Teruaki; Kashiwagi, Hideyuki; Hirakawa, Kosei; Sawada, Tetsuji; Yamamura, Yoshitaka; Itoh, Seiji; Hirata, Koichi; Ohta, Keiichiro; Mafune, Kenichi; Nakane, Yasushi; Kanda, Tatsuo; Furukawa, Hiroshi; Sasaki, Iwao; Kubota, Tetsuro; Kitajima, Masaki; Aikou, Takashi

2011-09-01

The postoperative clinical superiority of the interposition of jejunum reconstruction (INT) to Roux-en-Y reconstruction (RY) after total gastrectomy has not been clarified. Postoperative quality of life (QOL) was evaluated between the 2 methods by a multi-institutional prospective randomized trial. A total of 103 patients with gastric cancer were prospectively randomly divided into groups for RY (n = 51) or INT reconstruction (n = 52) after total gastrectomy. They were stratified by sex, age, institute, histology, and degree of lymph node dissection. Postoperatively, body mass index (BMI) and nutritional conditions were measured serially, and QOL and postoperative squalor scores were evaluated at 3, 12, and 60 months and compared between the 2 groups. After removing patients who did not complete the follow-up survey or censured cases, 24 patients in the RY group and 18 patients in the INT group were clinically available and their postoperative status was assessed. QOL scores were increased and complication scores were improved in the postoperative periods (P < .01). Postoperative BMI significantly deteriorated compared with preoperative BMI in each group. The postoperative QOL and complication scores at 60 months after surgery were significantly better than those at 3 months after surgery in each group (P < .01). However, there was no significant difference of QOL scores and postoperative complication scores between the 2 reconstruction groups. The nutritional condition in the INT group was nearly the same as that in the RY group. Although our patient sample was small and patients who did not complete the follow-up survey were present, we could not identify any clinical difference between INT and RY after total gastrectomy 60 months after surgery. The safer and simpler RY method may be a more suitable reconstruction method than INT after total gastrectomy. Copyright © 2011. Published by Elsevier Inc.

Management of iatrogenic urorectal fistulae in men with pelvic cancer

PubMed Central

Martins, Francisco E.; Martins, Natália M.; Pinheiro, Luís Campos; Ferraz, Luís; Xambre, Luís; Lopes, Tomé M.

2017-01-01

Introduction Urorectal fistula (URF) is a devastating complication of pelvic cancer treatments and a surgical challenge for the reconstructive surgeon. We report a series of male patients with URF resulting from pelvic cancer treatments, specifically prostate (PCa), bladder (BCa), and rectal cancer (RCa), and explore the differences and impact on outcomes between purely surgical and non-surgical treatment modalities. Methods Between October 2008 and June 2015, 15 male patients, aged 59–78 years (mean 67), with URF induced by pelvic cancer treatments were identified in our institutions. Patients with a history of diverticulitis, inflammatory bowel disease, or other benign conditions were excluded. We reviewed the patients’ medical records for symptoms, diagnostic tests performed, type and etiology of the fistula, type of surgical reconstruction, followup, and outcomes. Results Fourteen patients underwent surgical reconstruction. One patient developed metastatic disease before URF repair and, therefore, was excluded from this study. Mean followup (FU) was 32.7 months (14–79). All patients received diverting colostomy and temporary urinary diversion. An exclusively transperineal approach was used in nine (64.3%) patients and a combined abdominoperineal in five (35.7%). Overall successful URF closure was achieved in 12 (85.7%) patients, nine (64.3%) of whom at the first reconstructive attempt, two (14.3%) after two attempts (in our institution), and one (7.1%) after three attempts (two of which elsewhere). An interposition flap was used in seven (50%) patients. Surgical reconstruction failed ultimately in two (14.3%) patients who still have a colostomy and do not wish any further reconstruction. Conclusions Our study has several limitations, including its retrospective nature and the heterogeneity of our small patient cohort. Nonetheless, although surgical reconstruction of URF may be extremely difficult and complex in the non-surgical/energy ablation patients, its successful reconstruction is possible in most through a transperineal, or a more aggressive abdominoperineal, approach with tissue interposition in selected patients. PMID:29382460

Surgical therapy in Barrett's esophagus.

PubMed Central

DeMeester, T R; Attwood, S E; Smyrk, T C; Therkildsen, D H; Hinder, R A

1990-01-01

Seventy-six patients with Barrett's esophagus were cared for during a 10-year period. Fifty-six patients (74%) presented with complications of the disease. There were 20 strictures, 7 giant ulcers, 11 cases of dysplasia, and 29 patients with carcinoma. In patients with benign disease, 93% had mechanically defective sphincters and 83% had peristaltic failure of the lower esophageal body. Esophageal pH monitoring showed excessive esophageal exposure to pH less than 4 in 93% and excessive exposure to pH more than 7 in 34% of the patients tested. Ninety-three per cent of patients with excessive alkaline exposure had complications, compared to only 44% with normal alkaline exposure (p less than 0.01). Gastric pH monitoring, serum gastrin levels, and gastric acid analysis supported a duodenal source for the alkaline exposure. Antireflux surgery was performed using Nissen fundoplication in 30, Belsey partial fundoplication in 3, and Collis-Belsey gastroplasty in 2. Six required resection with colon interposition. Good symptomatic control was achieved in 77% after antireflux surgery. Four patients had symptoms and signs of duodenogastric reflux; three required a bile diversion procedure. Fifteen patients had an en bloc curative resection with colon interposition. One patient with high-grade dysplasia on biopsy was found to have intramucosal carcinoma after simple esophagectomy. Five tumors were intramucosal, seven were intramural, and four were transmural. Lymph node involvement occurred only in the latter two. Actuarial survival 5 years after curative resection was 53%. Median survival time for patients after palliative resection or no resection was 12 months. Study of en bloc specimens indicated that extent of resection should be adapted to extent of disease: esophagectomy for intramucosal disease, en bloc esophagectomy with splenic preservation for intramural and transmural disease. Serum CEA was useful in detecting recurrent disease after surgery when the primary tumor stained positively for CEA. Images Figs. 11A-D. Figs. 11A-D. PMID:2222018

Formation of porous inner architecture at the interface of magnetic pulse welded Al/Cu joints

NASA Astrophysics Data System (ADS)

Sapanathan, T.; Raoelison, R. N.; Yang, K.; Buiron, N.; Rachik, M.

2016-10-01

Porous inner architecture has been revealed at the interface of magnetic pulse welded aluminum/copper (Al/Cu) joints. These materials could serve the purpose of heterogeneous architectured materials, while their makeup of inner architecture of porous interface with the pore sizes of sub-micron to a few microns, could offer potential attributes in energy storage application. Two welding cases with various impact intensities are compared. An input voltage of 6.5 kV with an initial air gap of 1.5 mm and a higher voltage of 7.5 kV with a large initial air gap of 5 mm are respectively considered as two cases with low and high velocity impacts. Overall morphology of the porous medium was revealed at the interface either in layered or pocketed structures. The allocation of the porous zone and pore sizes vary with the impact condition. The low velocity impact welding conditions also produces smaller pores compared to the high velocity impact case, where the pore sizes varies in submicron to a few microns (<10μm). By investigating the potential mechanism of the porous zone formation, it was identified that a combined phenomena of cavitation and coalescence play a major role in nucleation and growth of the pores where a rapid cooling that eventually freezes the porous structure at the interface.

Ankylosis of temporomandibular joints after mandibular distraction osteogenesis in patients with Nager syndrome: Report of two cases and literature review.

PubMed

Wu, Cheng Chun; Sakahara, Daisuke; Imai, Keisuke

2017-10-01

Nager syndrome, also known as Nager acrofacial dysostosis, was first described by Nager and de Reynier in 1948. The patients commonly present with micrognathia, and a preventive tracheostomy is necessary when there are symptoms of upper airway obstruction. Mandibular distraction osteogenesis is considered as an effective procedure, which not only improves micrognathia but also minimizes the chances of tracheostomy. However, mandibular distraction osteogenesis has some complications such as relapse, teeth injury, infection, and injury of the temporomandibular joints (TMJs). In this study, the author reported two patients with Nager syndrome who suffered from ankylosis of TMJs after mandibular distraction osteogenesis. In addition, a comprehensive literature review of post-distraction ankylosis of TMJs in patients with Nager syndrome was performed. Few studies demonstrated the condition of TMJs after mandibular distraction osteogenesis, and three studies were identified from the review. One study reported ankylosis of bilateral coronoid processes, in which coronoidectomies were necessary. Another study reported the use of prostheses to replace the ankylosed joints in a patient who had undergone many surgeries of the joints, such as gap arthroplasties, reconstructions with costochondral grafts, etc. One other study raised the concept of unloading the condyles during the mandibular distraction to prevent subsequent ankylosis. It seems that multiple factors are related to the ankylosis of TMJs after mandibular distraction osteogenesis in patients with Nager syndrome. Prevention of post-distraction ankylosis of the joints is important because the treatment is difficult and not always effective. We should conduct more studies about protection of the joints during mandibular distraction in the future. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

The steps to forming a joint venture IPP in Poland

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

Allen, Z.; Colligan, M.J.

Poland represents the largest market in Central Europe with 38 million people and an installed electrical generating capacity of about 32 gigawatts. Since 1989, when the process of governmental restructuring along free market principals began, the allure to IPP developers has been evident, but is of yet unrealized. The natural model for IPP development in Poland would seem to be joint ventures with Polish generating companies. These enterprises already have sites, franchises, and a going business to contribute to a joint company. There are a number of reasons why so few deals have been concluded in Poland to date, andmore » a number of barriers still exist that tend to hamper the realization of project finance funded power joint ventures. But, these barriers are not insurmountable. Overcoming them in the context of a joint venture relationship with a domestic partner requires patience, work, and an ability to bridge the gaps between the realities of working in a post-Communist environment and the practicalities of structuring projects that can be financed in the international capital markets. The new Energy Law in Poland establishes a framework for a viable private sector power generation business. But the enabling regulations are yet to be published or approved. There is still effective political risk on account of the uncertainty this creates. Pressure is mounting on the Polish Government, especially due to its expressed interest in joining the EU, to get the power sector to operate on private sector terms, if not in private hands. The trends are pointing in the direction of increased market driven policies and practices. The conclusion is that, despite the delays of the past, independent power projects will start to happen in Poland on a joint venture basis, with increasing frequency in the next years.« less

Experimental signatures of the inverted phase in InAs/GaSb coupled quantum wells

NASA Astrophysics Data System (ADS)

Karalic, Matija; Mueller, Susanne; Mittag, Christopher; Pakrouski, Kiryl; Wu, QuanSheng; Soluyanov, Alexey A.; Troyer, Matthias; Tschirky, Thomas; Wegscheider, Werner; Ensslin, Klaus; Ihn, Thomas

2016-12-01

Transport measurements are performed on InAs/GaSb double quantum wells at zero and finite magnetic fields applied parallel and perpendicular to the quantum wells. We investigate a sample in the inverted regime where electrons and holes coexist, and compare it with another sample in the noninverted semiconducting regime. The activated behavior in conjunction with a strong suppression of the resistance peak at the charge neutrality point in a parallel magnetic field attest to the topological hybridization gap between electron and hole bands in the inverted sample. We observe an unconventional Landau level spectrum with energy gaps modulated by the magnetic field applied perpendicular to the quantum wells. This is caused by a strong spin-orbit interaction provided jointly by the InAs and the GaSb quantum wells.

Hydrogen Safety Sensor Performance and Use Gap Analysis: Preprint

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

Buttner, William J; Burgess, Robert M; Schmidt, Kara

Hydrogen sensors are recognized as an important technology for facilitating the safe implementation of hydrogen as an alternative fuel, and there are numerous reports of a sensor alarm successfully preventing a potentially serious event. However, gaps in sensor metrological specifications, as well as in their performance for some applications, exist.The U.S. Department of Energy (DOE) Fuel Cell Technology Office published a short list of critical gaps in the 2007 and 2012 multiyear project plans; more detailed gap analyses were independently performed by the JRC and NREL. There have been, however, some significant advances in sensor technologies since these assessments, includingmore » the commercial availability of hydrogen sensors with fast response times (t90 less than 1 s, which had been an elusive DOE target since 2007), improved robustness to chemical poisons, improved selectivity, and improved lifetime and stability. These improvements, however, have not been universal and typically pertain to select platforms or models. Moreover, as hydrogen markets grow and new applications are being explored, more demands will be imposed on sensor performance. The hydrogen sensor laboratories at NREL and JRC are currently updating the hydrogen safety sensor gap analysis through direct interaction with international stakeholders in the hydrogen community, especially end-users. NREL and the JRC are currently organizing a series of workshops (in Europe and the U.S.) with sensor developers, end-users, and other stakeholders in 2017 to identify technology gaps and to develop a path forward to address them. One workshop is scheduled for May 10 in Brussels, Belgium at the Headquarters of the Fuel Cell and Hydrogen Joint Undertaking. A second workshop is planned at the National Renewable Energy Laboratory in Golden, CO, USA. This presentation will review improvements in sensor technologies in the past 5 to 10 years, identify gaps in sensor performance and use requirements, and identify potential research strategies to address the gaps. The presentation will also summarize the outcomes of the Hydrogen Sensors Workshops.« less

Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

PubMed

Jankowski, Irene M; Nadzam, Deborah Morris

2011-06-01

Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

Hydroxyapatite collagen scaffold with autologous bone marrow aspirate for mandibular condylar reconstruction.

PubMed

Howlader, Debraj; Vignesh, U; Bhutia, Dichen P; Pandey, Rahul; Kumar, Sumit; Chandra, Tulika; Mehrotra, Divya

2017-09-01

This study was designed with the aim to assess the efficiency of hydroxyapatite/collagen (HA/Col) bio-scaffold with bone marrow aspirate (BMA) to reconstruct mandibular condyle in patients with temporomandibular joint (TMJ) ankylosis. Seven pediatric patients with TMJ ankylosis, who visited our outpatient clinic and whose parents opted for this procedure, were included in this study. After a history and clinical examination for TMJ movements, computed tomography (CT) scans were obtained. Interposition arthroplasty, with or without coronoidectomy, was performed to gain at least 35 mm of mouth opening. A 2-ml quantity of BMA was aspirated from the posterior iliac crest. A HA/Col block was carved to shape the condyle, and was fixed to the ramus using a plate and screws. A collagen sponge soaked in BMA was interposed in between the graft and ramal end, and the temporal fascia was rotated between the glenoid fossa and graft. Physiotherapy was started on postoperative day 10. All patients were followed up for 1 year. Success was graded on the basis of the mouth opening and TMJ score based on efficiency of chewing, speech, activity, recreation, mood, and anxiety on a five-point ordinal scale. The mean age was 9.71 years (range 5-14 years), and the male-to-female ratio was 5:2. The mean preoperative mouth opening was 4.14 mm, which improved to 34.57 mm at 1-year follow-up. The mean protrusive movement improved from 0 to 2.86 mm. The mean success score was 4.43 out of 5. The mean TMJ score improved from 2.38 to 3.94. A HA/Col bio-scaffold with bone marrow aspirate is a safe and cost-effective alternative for reconstruction of the mandibular condyle, particularly in growing individuals with high osteogenic potential. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The epidemiology of vascular injury in the wars in Iraq and Afghanistan.

PubMed

White, Joseph M; Stannard, Adam; Burkhardt, Gabriel E; Eastridge, Brian J; Blackbourne, Lorne H; Rasmussen, Todd E

2011-06-01

Blood vessel trauma leading to hemorrhage or ischemia presents a significant cause of morbidity and mortality after battlefield injury. The objective of this study is to characterize the epidemiology of vascular injury in the wars of Iraq and Afghanistan, including categorization of anatomic patterns, mechanism, and management of casualties. The Joint Theater Trauma Registry was interrogated (2002-2009) for vascular injury in US troops to identify specific injury (group 1) and operative intervention (group 2) groups. Battle-related injuries (nonreturn to duty) were used as the denominator to establish injury rates. Mechanism of injury was compared between theaters of war and the management strategies of ligation versus revascularization (repair and interposition grafting) reported. Group 1 included 1570 Troops injured in Iraq (OIF) (n = 1390) and Afghanistan (OEF) (n = 180). Mechanism included explosive (73%), gunshot (27%), and other (<1%) with explosive more common in OIF than OEF (P < 0.05). During this period, 13,076 battle-related injuries occurred resulting in a specific rate of 12% (1570 of 13,076), which was higher in OIF than OEF (12.5% vs 9% respectively; P < 0.05). Of group 1, 60% (n = 940) sustained injury to major or proximal vessels and 40% (n = 630) to minor or distal vessels (unknown vessel, n = 27). Group 2 (operative) comprised 1212 troops defining an operative rate of 9% (1212 of 13,076) and included ligation (n = 660; 54%) or repair (n = 552; 46%). Peak rates in OIF and OEF occurred in November 2004 (15%) and August 2009 (11%), respectively and correlated with combat operational tempo. The rate of vascular injury in modern combat is 5 times that reported in previous wars and varies according to theater of war, mechanism of injury and operational tempo. Methods of reconstruction are now applied to nearly half of the vascular injuries and should be a focus of training for combat surgery. Selective ligation of vascular injury remains an important management strategy, especially for minor or distal vessel injuries.

Myeloperoxidase Antineutrophil Cytoplasmic Antibody (MPO-ANCA) Associated Crescentic and Necrotizing Glomerulonephritis (GN) with Membranoproliferative GN Features.

PubMed

Koda, Ryo; Nagahori, Katsuhiro; Kitazawa, Atsushi; Imanishi, Yuji; Yoshino, Atsunori; Kawamoto, Shinya; Ueda, Yoshihiko; Takeda, Tetsuro

2016-01-01

A 77-year-old man presented with a fever, non-productive cough, and edema formation. A laboratory analysis showed an elevated creatinine level (2.5 mg/dL), a high titer of myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) (99 U/mL), positive reaction for antinuclear antibody (×320), hematuria, and massive proteinuria (3.33 g/day). A renal biopsy revealed crescentic and necrotizing glomerulonephritis (GN) with membranoproliferative GN features [double contour appearance of the glomerular basement membrane, granular deposition of immunoglobulin (Ig) G, IgM, and C3 along the capillary wall, subendothelial and subepithelial deposits with mesangial interposition]. A potential relationship between MPO-ANCA associated GN and membranoproliferative GN is discussed.

Novel application and serial evaluation of tissue-engineered portal vein grafts in a murine model.

PubMed

Maxfield, Mark W; Stacy, Mitchel R; Kurobe, Hirotsugu; Tara, Shuhei; Yi, Tai; Cleary, Muriel A; Zhuang, Zhen W; Rodriguez-Davalos, Manuel I; Emre, Sukru H; Iwakiri, Yasuko; Shinoka, Toshiharu; Breuer, Christopher K

2017-12-01

Surgical management of pediatric extrahepatic portal vein obstruction requires meso-Rex bypass using autologous or synthetic grafts. Tissue-engineered vascular grafts (TEVGs) provide an alternative, but no validated animal models using portal TEVGs exist. Herein, we preclinically assess TEVGs as portal vein bypass grafts. TEVGs were implanted as portal vein interposition conduits in SCID-beige mice, monitored by ultrasound and micro-computed tomography, and histologically assessed postmortem at 12 months. TEVGs remained patent for 12 months. Histologic analysis demonstrated formation of neovessels that resembled native portal veins, with similar content of smooth muscle cells, collagen type III and elastin. TEVGs are feasible portal vein conduits in a murine model. Further preclinical evaluation of TEVGs may facilitate pediatric clinical translation.

STS-114: Discovery Question & Answer with Joint Crew on ISS

NASA Technical Reports Server (NTRS)

2005-01-01

STS-114 Commander Eileen Collins, Pilot James Kelly, Mission Specialists Souichi Noguchi, Stephen Robinson, Charles Camarda, Andrew Thomas, Wendy Lawrence, and Expedition 11 Commander Sergei Krikalev and Flight Engineer John Phillips answers questions from United States, Japanese and Russian News media in the Destiny laboratory of the International Space Station. Risk, safety, extravehicular activities, spacewalks, re-entry, gap fillers, tiles, flight operations, flight crew activities, team work, and life in space are topics covered with the News media.

Quantitative understanding of explosive stimulus transfer

NASA Technical Reports Server (NTRS)

Schimmel, M. L.

1973-01-01

The mechanisms of detonation transfer across hermetically sealed interfaces created by necessary interruptions in high explosive trains, such as at detonators to explosive columns, field joints in explosive columns, and components of munitions fuse trains are demostrated. Reliability of detonation transfer is limited by minimizing explosive quantities, the use of intensitive explosives for safety, and requirements to propagate across gaps and angles dictated by installation and production restraints. The major detonation transfer variables studied were: explosive quanity, sensitivity, and thickness, and the separation distances between donor and acceptor explosives.

Subjective Straight Ahead Orientation in Microgravity

NASA Technical Reports Server (NTRS)

Clement, G.; Reschke, M. F.; Wood, S. J.

2015-01-01

This joint ESA NASA study will address adaptive changes in spatial orientation related to the subjective straight ahead and the use of a vibrotactile sensory aid to reduce perceptual errors. The study will be conducted before and after long-duration expeditions to the International Space Station (ISS) to examine how spatial processing of target location is altered following exposure to microgravity. This study addresses the sensorimotor research gap to "determine the changes in sensorimotor function over the course of a mission and during recovery after landing."

Joint and Interdependent Requirements: A Case Study in Solving the Naval Surface Fire Support Capabilities Gap

DTIC Science & Technology

2007-05-17

inch long ra projectiles against Viet Cong positions to ranges over 35 miles – 60,000 yards - inland. Additionally, a 5- inch rocket assisted projectile...ship. The 100 mile rocket assisted shell was approximately twenty inches too long to work within the existing handling system. The 278 mile rocket... assisted shell was fourteen inches too long for the Iowa class ship’s ammunition handling equi However, if shortened to seventy-six inches, this

Photonic Choke-Joints for Dual Polarization Waveguides

NASA Technical Reports Server (NTRS)

Wollack, Edward J. (Inventor); U-Yen, Kongpop (Inventor); Chuss, David T. (Inventor)

2014-01-01

A waveguide structure for a dual polarization waveguide includes a first flange member, a second flange member, and a waveguide member disposed in each of the first flange member and second flange member. The first flange member and the second flange member are configured to be coupled together in a spaced-apart relationship separated by a gap. The first flange member has a substantially smooth surface, and the second flange member has an array of two-dimensional pillar structures formed therein.

A Comparative Assessment of the Navy’s Future Naval Capabilities (FNC) Process and Joint Staff Capability Gap Assessment Process as Related to Pacific Commands (PACOM) Integrated Priority List Submission

DTIC Science & Technology

2013-04-01

University Eugene Rex Jalao, Arizona State University and University of the Philippines Christopher Auger, Lars Baldus, Brian Yoshimoto, J. Robert...Approach to Agile Acquisition Timothy Boyce, Iva Sherman, and Nicholas Roussel Space and Naval Warfare Systems Center Pacific Challenge-Based...Problem Solving as a Mechanism for Adaptive Change Kathryn Aten and John T . Dillard Naval Postgraduate School A Comparative Assessment of the Navy’s

New approach in bivariate drought duration and severity analysis

NASA Astrophysics Data System (ADS)

Montaseri, Majid; Amirataee, Babak; Rezaie, Hossein

2018-04-01

The copula functions have been widely applied as an advance technique to create joint probability distribution of drought duration and severity. The approach of data collection as well as the amount of data and dispersion of data series can last a significant impact on creating such joint probability distribution using copulas. Usually, such traditional analyses have shed an Unconnected Drought Runs (UDR) approach towards droughts. In other word, droughts with different durations would be independent of each other. Emphasis on such data collection method causes the omission of actual potentials of short-term extreme droughts located within a long-term UDR. Meanwhile, traditional method is often faced with significant gap in drought data series. However, a long-term UDR can be approached as a combination of short-term Connected Drought Runs (CDR). Therefore this study aims to evaluate systematically two UDR and CDR procedures in joint probability of drought duration and severity investigations. For this purpose, rainfall data (1971-2013) from 24 rain gauges in Lake Urmia basin, Iran were applied. Also, seven common univariate marginal distributions and seven types of bivariate copulas were examined. Compared to traditional approach, the results demonstrated a significant comparative advantage of the new approach. Such comparative advantages led to determine the correct copula function, more accurate estimation of copula parameter, more realistic estimation of joint/conditional probabilities of drought duration and severity and significant reduction in uncertainty for modeling.

Evidence from Individual Inference for High-Dimensional Coexistence: Long-Term Experiments on Recruitment Response

PubMed Central

Clark, James S.; Soltoff, Benjamin D.; Powell, Amanda S.; Read, Quentin D.

2012-01-01

Background For competing species to coexist, individuals must compete more with others of the same species than with those of other species. Ecologists search for tradeoffs in how species might partition the environment. The negative correlations among competing species that would be indicative of tradeoffs are rarely observed. A recent analysis showed that evidence for partitioning the environment is available when responses are disaggregated to the individual scale, in terms of the covariance structure of responses to environmental variation. That study did not relate that variation to the variables to which individuals were responding. To understand how this pattern of variation is related to niche variables, we analyzed responses to canopy gaps, long viewed as a key variable responsible for species coexistence. Methodology/Principal Findings A longitudinal intervention analysis of individual responses to experimental canopy gaps with 12 yr of pre-treatment and 8 yr post-treatment responses showed that species-level responses are positively correlated – species that grow fast on average in the understory also grow fast on average in response to gap formation. In other words, there is no tradeoff. However, the joint distribution of individual responses to understory and gap showed a negative correlation – species having individuals that respond most to gaps when previously growing slowly also have individuals that respond least to gaps when previously growing rapidly (e.g., Morus rubra), and vice versa (e.g., Quercus prinus). Conclusions/Significance Because competition occurs at the individual scale, not the species scale, aggregated species-level parameters and correlations hide the species-level differences needed for coexistence. By disaggregating models to the scale at which the interaction occurs we show that individual variation provides insight for species differences. PMID:22393349

A Gap Analysis Needs Assessment Tool to Drive a Care Delivery and Research Agenda for Integration of Care and Sharing of Best Practices Across a Health System.

PubMed

Golden, Sherita Hill; Hager, Daniel; Gould, Lois J; Mathioudakis, Nestoras; Pronovost, Peter J

2017-01-01

In a complex health system, it is important to establish a systematic and data-driven approach to identifying needs. The Diabetes Clinical Community (DCC) of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality developed a gap analysis tool and process to establish the system's current state of inpatient diabetes care. The collectively developed tool assessed the following areas: program infrastructure; protocols, policies, and order sets; patient and health care professional education; and automated data access. For the purposes of this analysis, gaps were defined as those instances in which local resources, infrastructure, or processes demonstrated a variance against the current national evidence base or institutionally defined best practices. Following the gap analysis, members of the DCC, in collaboration with health system leadership, met to identify priority areas in order to integrate and synergize diabetes care resources and efforts to enhance quality and reduce disparities in care across the system. Key gaps in care identified included lack of standardized glucose management policies, lack of standardized training of health care professionals in inpatient diabetes management, and lack of access to automated data collection and analysis. These results were used to gain resources to support collaborative diabetes health system initiatives and to successfully obtain federal research funding to develop and pilot a pragmatic diabetes educational intervention. At a health system level, the summary format of this gap analysis tool is an effective method to clearly identify disparities in care to focus efforts and resources to improve care delivery. Copyright © 2016 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Hemi-wedge osteotomy in the management of large angular deformities around the knee joint.

PubMed

El-Alfy, Barakat Sayed

2016-08-01

Angular deformity around the knee joint is a common orthopedic problem. Many options are available for the management of such problem with varying degrees of success and failure. The aim of the present study was to assess the results of hemi-wedge osteotomy in the management of big angular deformities about the knee joint. Twenty-eight limbs in 21 patients with large angular deformities around the knee joint were treated by the hemi-wedge osteotomy technique. The ages ranged from 12 to 43 years with an average of 19.8 years. The deformity ranged from 20° to 40° with a mean of 30.39° ± 5.99°. The deformities were genu varum in 12 cases and genu valgum in 9 cases. Seven cases had bilateral deformities. Small wedge was removed from the convex side of the bone and put in the gap created in the other side after correction of the deformity. At the final follow-up, the deformity was corrected in all cases except two. Full range of knee movement was regained in all cases. The complications included superficial wound infection in two cases, overcorrection in one case, pain along the lateral aspect of the knee in one case and recurrence of the deformity in one case. No cases were complicated by nerve injury or vascular injury. Hemi-wedge osteotomy is a good method for treatment of deformities around the knee joint. It can correct large angular deformities without major complications.

Collateral ligament strains during knee joint laxity evaluation before and after TKA.

PubMed

Delport, Hendrik; Labey, Luc; De Corte, Ronny; Innocenti, Bernardo; Vander Sloten, Jos; Bellemans, Johan

2013-08-01

Passive knee stability is provided by the soft tissue envelope. There is consensus among orthopedic surgeons that good outcome in Total Knee Arthroplasty requires equal tension in the medial/lateral compartment of the knee joint, as well as equal tension in the flexion/extension gap. The purpose of this study was to quantify the ligament laxity in the normal non-arthritic knee before and after Posterior-Stabilized Total Knee Arthroplasty. We hypothesized that the Medial/Lateral Collateral Ligament shows minimal changes in length when measured directly by extensometers in the native human knee during varus/valgus laxity testing. We also hypothesized that due to differences in material properties and surface geometry, native laxity is difficult to reconstruct using a Posterior-Stabilized Total Knee. Six specimens were used to perform this in vitro cadaver test using extensometers to provide numerical values for laxity and varus-valgus tilting in the frontal plane. This study enabled a precise measurement of varus-valgus laxity as compared with the clinical assessment. The strains in both ligaments in the replaced knee were different from those in the native knee. Both ligaments were stretched in extension, in flexion the Medial Collateral Ligament tends to relax and the Lateral Collateral Ligament remains tight. As material properties and surface geometry of the replaced knee add stiffness to the joint, we recommend to avoid overstuffing the joint, when using this type of Posterior-Stabilized Total Knee Arthroplasty, in order to obtain varus/valgus laxity close to the native joint. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ultrasound of the small joints of the hands and feet: current status

PubMed Central

2007-01-01

The aim of this article was to review the current status of ultrasound imaging of patients with rheumatological disorders of the hands and feet. Ultrasound machines with high-resolution surface probes are readily available in most radiology departments and can be used to address important clinical questions posed by the rheumatologist and sports and rehabilitation physician. There is increasing evidence that ultrasound detects synovitis that is silent to clinical examination. Detection and classification of synovitis and the early detection of bone erosions are important in clinical decision making. Ultrasound has many advantages over other imaging techniques with which it is compared, particularly magnetic resonance. The ability to carry out a rapid assessment of many widely spaced joints, coupled with clinical correlation, the ability to move and stress musculoskeletal structures and the use of ultrasound to guide therapy accurately are principal amongst these. The use of colour flow Doppler studies provides a measure of neovascularisation within the synovial lining of joints and tendons, and within tendons themselves, that is not available with other imaging techniques. Disadvantages compared to MRI include small field of view, poor image presentation, and difficulty in demonstrating cartilage and deep joints in their entirety. Contrast-enhanced magnetic resonance provides a better measure of capillary permeability and extracellular fluid than does ultrasound. The ability to image simultaneously multiple small joints in the hands and feet and their enhancement characteristics cannot be matched with ultrasound, though future developments in 3-D ultrasound may narrow this gap. Magnetic resonance provides a more uniform and reproducible image for long-term follow-up studies. PMID:17712556

JANNAF 37th Combustion Subcommittee Meeting. Volume 1

NASA Technical Reports Server (NTRS)

Fry, Ronald S. (Editor); Gannaway, Mary T. (Editor)

2000-01-01

This volume, the first of two volumes is a compilation of 59 unclassified/unlimited-distribution technical papers presented at the Joint Army-Navy-NASA-Air Force (JANNAF) 37th Combustion Subcommittee (CS) meeting held jointly with the 25th Airbreathing Propulsion Subcommittee (APS), 19th Propulsion Systems Hazards Subcommittee (PSHS), and 1st Modeling and Simulation Subcommittee (MSS) meetings. The meeting was held 13-17 November 2000 at the Naval Postgraduate School and Hyatt Regency Hotel, Monterey, California. Topics covered at the CS meeting include: a keynote address on the Future Combat Systems, and review of a new JANNAF Modeling and Simulation Subcommittee, and technical papers on gun propellant burning rate, gun tube erosion, advanced gun propulsion concepts, ETC guns, novel gun propellants; liquid, hybrid and novel propellant combustion; solid propellant combustion kinetics, GAP, ADN and RDX combustion, sandwich combustion, metal combustion, combustion instability, and motor combustion instability.

A study of cervical spine kinematics and joint capsule strain in rear impacts using a human FE model.

PubMed

Kitagawa, Yuichi; Yasuki, Tsuyoshi; Hasegawa, Junji

2006-11-01

Many efforts have been made to understand the mechanism of whiplash injury. Recently, the cervical facet joint capsules have been focused on as a potential site of injury. An experimental approach has been taken to analyze the vertebral motion and to estimate joint capsule stretch that was thought to be a potential cause of pain. The purpose of this study is to analyze the kinematics of the cervical facet joint using a human FE model in order to better understand the injury mechanism. The Total Human Model for Safety (THUMS) was used to visually analyze the local and global kinematics of the spine. Soft tissues in the neck were newly modeled and introduced into THUMS for estimating the loading level in rear impacts. The model was first validated against human test data in the literature by comparing vertebrae motion as well as head and neck responses. Joint capsule strain was estimated from a maximum principal strain output from the elements representing the capsule tissues. A rear-end collision was then simulated using THUMS and a prototype seat model, assuming a delta-V of 25 km/h. The trajectory of the vertebrae was analyzed in a local coordinate system defined along the joint surface. Strain growth in the joint capsules was explained, as related to contact events between the occupant and the seat. A new seat concept was proposed to help lessen the loading level to the neck soft tissues. The foam material of the seat back was softened, the initial gap behind the head was reduced and the head restraint was stiffened for firm support. The lower seat back frame was also reinforced to withstand the impact severity at the given delta-V. Another rear impact simulation was conducted using the new seat concept model to examine the effectiveness of the new concept. The joint capsule strain was found to be relatively lower with the new seat concept. The study also discusses the influence of seat parameters to the vertebral motion and the resultant strain in the joint capsules. The meaning of the contact timing of the head to the head restraint was examined based on the results in terms of correlation with injury indicators such as NIC and the joint capsule strain.

Feasibility Assessment of Thermal Barrier Seals for Extreme Transient Temperatures

NASA Technical Reports Server (NTRS)

Steinetz, Bruce M.; Dunlap, Patrick H., Jr.

1998-01-01

The assembly joints of modem solid rocket motor cases are generally sealed using conventional O-ring type seals. The 5500+ F combustion gases produced by rocket motors are kept a safe distance away from the seals by thick layers of phenolic insulation. Special compounds are used to fill insulation gaps leading up to the seals to prevent a direct flowpath to them. Design criteria require that the seals should not experience torching or charring during operation, or their sealing ability would be compromised. On limited occasions, NASA has observed charring of the primary O-rings of the Space Shuttle solid rocket nozzle assembly joints due to parasitic leakage paths opening up in the gap-fill compounds during rocket operation. NASA is investigating different approaches for preventing torching or charring of the primary O-rings. One approach is to implement a braided rope seal upstream of the primary O-ring to serve as a thermal barrier that prevents the hot gases from impinging on the O-ring seals. This paper presents flow, resiliency, and thermal resistance for several types of NASA rope seals braided out of carbon fibers. Burn tests were performed to determine the time to burn through each of the seals when exposed to the flame of an oxyacetylene torch (5500 F), representative of the 5500 F solid rocket motor combustion temperatures. Rope seals braided out of carbon fibers endured the flame for over six minutes, three times longer than solid rocket motor burn time. Room and high temperature flow tests are presented for the carbon seals for different amounts of linear compression. Room temperature compression tests were performed to assess seal resiliency and unit preloads as a function of compression. The thermal barrier seal was tested in a subscale "char" motor test in which the seal sealed an intentional defect in the gap insulation. Temperature measurements indicated that the seal blocked 2500 F combustion gases on the upstream side with very little temperature rise on the downstream side.

Evaluation of oil-leakage of multi-layered resin-hose clamped with metal nipple and sleeve

NASA Astrophysics Data System (ADS)

Matsuoka, Kenta; Okubo, Kazuya; Fujii, Toru; Nakamura, Chihiro; Fujishita, Yushi; Kusu, Fuko; Matsushita, Masato; Yoshihara, Ryota

2018-03-01

The purpose of this study is to investigate the path of occurred oil-leakage of multi-layered resin-hose as one of multifunctional materials around the caulked joint with a metal nipple and sleeve when excessive cyclic internal pressure was applied onto the hose. Equivalent cyclic axial tensile force was substitutively applied to the hose, where same degree of normal stress was produced in longitudinal direction. Excessive 3 and 5 times of the standard load was applied to the hose. Cyclic loading was paused at every 1000 and 10000 cycles and then designed internal pressure was applied to the hose by a hand-operated pump with water in order to check whether the leakage was occurred around the joint and surface of the hose for safety evaluation. Cyclic fatigue life was defined as the number of loading cycles in which the leakage and the initial damage which was the passage of the ultrasonic wave was observed on the cyclic test. Test results showed the fatigue life at which leakage of water was observed was increased 20 times in case of K=3 compared to that in case of K=5. The cycles of initial damage detected by the ultrasonic wave were passed was increased 3.3 times in case of K=3 compared to that in case of K=5. The fluorescent agent penetrated from the core layer of resin hose to the reinforcement layer in which a half cross section along longitudinal direction in failed specimens was observed after the leak test. The original specimens had the gap between the resin-hose and the nipple and then the gap extended and connected during fatigue cyclic. In this study, it was observed that oil was leaked through narrow gap between the nipple and core layer of resin hose.

Solid state effects on the electronic structure of H2OEP.

PubMed

Marsili, M; Umari, P; Di Santo, G; Caputo, M; Panighel, M; Goldoni, A; Kumar, M; Pedio, M

2014-12-28

We present the results of a joint experimental and theoretical investigation concerning the effect of crystal packing on the electronic properties of the H2OEP molecule. Thin films, deposited in ultra high vacuum on metal surfaces, are investigated by combining valence band photoemission, inverse photoemission, and X-ray absorption spectroscopy. The spectra of the films are compared, when possible, with those measured in the gas phase. Once many-body effects are included in the calculations through the GW method, the electronic structure of H2OEP in the film and gas phase are accurately reproduced for both valence and conduction states. Upon going from an isolated molecule to the film phase, the electronic gap shrinks significantly and the lowest unoccupied molecular orbital (LUMO) and LUMO + 1 degeneracy is removed. The calculations show that the reduction of the transport gap in the film is entirely addressable to the enhancement of the electronic screening.

Ferromagnetic ordering and halfmetallic state in a shandite: Co3Sn2S2

NASA Astrophysics Data System (ADS)

Schnelle, Walter; Leithe-Jasper, Andreas; Rosner, Helge; Weihrich, Richard

2013-03-01

The rapid advance in spintronics challenges an improved understanding of the underlying microscopic properties. Here, we present a joint experimental and theoretical study of Co3Sn2S2 (shandite) and related compounds. From magnetic susceptibility, specific heat and magneto-transport measurements on a shandite single crystal sample we find a phase transition to a ferromagnetic metallic state at 177 K with a saturation moment of 0.92 μB/f.u. Full potential electronic structure calculations within the local spin density approximation result in a halfmetallic ferromagnetic groundstate with a moment of 1 μB/f.u. and a tiny gap in the minority spin channel. The calculated structure optimization and structure variations show that the size of the gap is rather sensitive to the lattice geometry. Possiblities to stabilize the halfmetallic ferromagnetic behavior by various substitutions have been studied theoretically and will be discussed.

Explaining the Muslim employment gap in Western Europe: individual-level effects and ethno-religious penalties.

PubMed

Connor, Phillip; Koenig, Matthias

2015-01-01

It is well-documented that Muslims experience economic disadvantages in Western European labor markets. However, few studies comprehensively test individual-level explanations for the Muslim employment gap. Using data from the European Social Survey, this research note briefly examines the role of individual-level differences between Muslims and non-Muslims in mediating employment differences. Results reveal that human capital, migration background, religiosity, cultural values, and perceptions of discrimination jointly account for about 40% of the employment variance between Muslims and non-Muslims. Model specifications for first- and second-generation Muslim immigrants reveal a similar pattern, with migration background and perceived discrimination being of key relevance in mediating employment difference. While individual-level effects are indeed relevant, unexplained variance suggests that symbolic boundaries against Islam may still translate into tangible ethno-religious penalties. Copyright © 2014 Elsevier Inc. All rights reserved.

Solution-processed soldering of carbon nanotubes for flexible electronics.

PubMed

Rao, K D M; Radha, B; Smith, K C; Fisher, T S; Kulkarni, G U

2013-02-22

We report a simple lithography-free, solution-based method of soldering of carbon nanotubes with Ohmic contacts, by taking specific examples of multi-walled carbon nanotubes (MWNTs). This is achieved by self-assembling a monolayer of soldering precursor, Pd(2+) anchored to 1,10 decanedithiol, onto which MWNTs could be aligned across the gap electrodes via solvent evaporation. The nanosoldering was realized by thermal/electrical activation or by both in sequence. Electrical activation and the following step of washing ensure selective retention of MWNTs spanning across the gap electrodes. The soldered joints were robust enough to sustain strain caused during the bending of flexible substrates as well as during ultrasonication. The estimated temperature generated at the MWNT-Au interface using an electro-thermal model is ∼150 °C, suggesting Joule heating as the primary mechanism of electrical activation. Further, the specific contact resistance is estimated from the transmission line model.

Laser Beam Oscillation Strategies for Fillet Welds in Lap Joints

NASA Astrophysics Data System (ADS)

Müller, Alexander; Goecke, Sven-F.; Sievi, Pravin; Albert, Florian; Rethmeier, Michael

Laser beam oscillation opens up new possibilities of influencing the welding process in terms of compensation of tolerances and reduction of process emissions that occur in industrial applications, such as in body-in-white manufacturing. The approaches are to adapt the melt pool width in order to generate sufficient melt volume or to influence melt pool dynamics, e.g. for a better degassing. Welding results are highly dependent on the natural frequency of the melt pool, the used spot diameter and the oscillation speed of the laser beam. The conducted investigations with an oscillated 300 μm laser spot show that oscillation strategies, which are adjusted to the joining situation improve welding result for zero-gap welding as well as for bridging gaps to approximately 0.8 mm. However, a complex set of parameters has to be considered in order to generate proper welding results. This work puts emphasize on introducing them.

The microbiome in allergic disease: Current understanding and future opportunities-2017 PRACTALL document of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology.

PubMed

Huang, Yvonne J; Marsland, Benjamin J; Bunyavanich, Supinda; O'Mahony, Liam; Leung, Donald Y M; Muraro, Antonella; Fleisher, Thomas A

2017-04-01

PRACTALL is a joint initiative of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology to provide shared evidence-based recommendations on cutting-edge topics in the field of allergy and immunology. PRACTALL 2017 is focused on what has been established regarding the role of the microbiome in patients with asthma, atopic dermatitis, and food allergy. This is complemented by outlining important knowledge gaps regarding its role in allergic disease and delineating strategies necessary to fill these gaps. In addition, a review of progress in approaches used to manipulate the microbiome will be addressed, identifying what has and has not worked to serve as a baseline for future directions to intervene in allergic disease development, progression, or both. Copyright © 2017. Published by Elsevier Inc.

The microbiome in allergic disease: Current understanding and future opportunities—2017 PRACTALL document of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology

PubMed Central

Huang, Yvonne J.; Marsland, Benjamin J.; Bunyavanich, Supinda; O’Mahony, Liam; Leung, Donald Y. M.; Muraro, Antonella; Fleisher, Thomas A.

2018-01-01

PRACTALL is a joint initiative of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology to provide shared evidence-based recommendations on cutting-edge topics in the field of allergy and immunology. PRACTALL 2017 is focused on what has been established regarding the role of the microbiome in patients with asthma, atopic dermatitis, and food allergy. This is complemented by outlining important knowledge gaps regarding its role in allergic disease and delineating strategies necessary to fill these gaps. In addition, a review of progress in approaches used to manipulate the microbiome will be addressed, identifying what has and has not worked to serve as a baseline for future directions to intervene in allergic disease development, progression, or both. PMID:28257972

Transport distraction osteogenesis as a method of reconstruction of the temporomandibular joint following gap arthroplasty for post-traumatic ankylosis in children: a clinical and radiological prospective assessment of outcome.

PubMed

Bansal, V; Singh, S; Garg, N; Dubey, P

2014-02-01

This clinical and radiographic study investigated the use of transport distraction osteogenesis in unilateral temporomandibular joint (TMJ) ankylosis patients. Six patients aged between 4 and 8 years were selected for the study; the mean preoperative maximal inter-incisal opening (MIO) was 3.5mm without lateral and protrusive mandibular movements. The ankylotic mass along with the posterior border of the ascending ramus was exposed via 'lazy-S' incision. A gap arthroplasty was performed, followed by a 'reverse L' osteotomy on the posterior border of the ramus. In-house manufactured extraoral distraction devices were used for this prospective study. Follow-up clinical and radiographic evaluation was carried out for 13-27 months after completion of the activation period. After a mean follow-up of 19 months, the mean MIO was 29.1mm and the lateral and protrusive movements changed from none to slight. Cone beam computed tomography images of all patients showed remodelled neocondyle created by transport distraction osteogenesis with no statistically significant differences observed for average cancellous bone density, trabecular number, and trabecular spacing between the neocondyle of the operated side (test) and the condyle of the non-operated side (control). Neocondyle formation by transport distraction osteogenesis using the in-house distraction device is a promising treatment option for TMJ reconstruction in ankylosis patients. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A conceptual framework for understanding the perspectives on the causes of the science-practice gap in ecology and conservation.

PubMed

Bertuol-Garcia, Diana; Morsello, Carla; N El-Hani, Charbel; Pardini, Renata

2018-05-01

Applying scientific knowledge to confront societal challenges is a difficult task, an issue known as the science-practice gap. In Ecology and Conservation, scientific evidence has been seldom used directly to support decision-making, despite calls for an increasing role of ecological science in developing solutions for a sustainable future. To date, multiple causes of the science-practice gap and diverse approaches to link science and practice in Ecology and Conservation have been proposed. To foster a transparent debate and broaden our understanding of the difficulties of using scientific knowledge, we reviewed the perceived causes of the science-practice gap, aiming to: (i) identify the perspectives of ecologists and conservation scientists on this problem, (ii) evaluate the predominance of these perspectives over time and across journals, and (iii) assess them in light of disciplines studying the role of science in decision-making. We based our review on 1563 sentences describing causes of the science-practice gap extracted from 122 articles and on discussions with eight scientists on how to classify these sentences. The resulting process-based framework describes three distinct perspectives on the relevant processes, knowledge and actors in the science-practice interface. The most common perspective assumes only scientific knowledge should support practice, perceiving a one-way knowledge flow from science to practice and recognizing flaws in knowledge generation, communication, and/or use. The second assumes that both scientists and decision-makers should contribute to support practice, perceiving a two-way knowledge flow between science and practice through joint knowledge-production/integration processes, which, for several reasons, are perceived to occur infrequently. The last perspective was very rare, and assumes scientists should put their results into practice, but they rarely do. Some causes (e.g. cultural differences between scientists and decision-makers) are shared with other disciplines, while others seem specific to Ecology and Conservation (e.g. inadequate research scales). All identified causes require one of three general types of solutions, depending on whether the causal factor can (e.g. inadequate research questions) or cannot (e.g. scientific uncertainty) be changed, or if misconceptions (e.g. undervaluing abstract knowledge) should be solved. The unchanged predominance of the one-way perspective over time may be associated with the prestige of evidence-based conservation and suggests that debates in Ecology and Conservation lag behind trends in other disciplines towards bidirectional views ascribing larger roles to decision-makers. In turn, the two-way perspective seems primarily restricted to research traditions historically isolated from mainstream conservation biology. All perspectives represented superficial views of decision-making by not accounting for limits to human rationality, complexity of decision-making contexts, fuzzy science-practice boundaries, ambiguity brought about by science, and different types of knowledge use. However, joint knowledge-production processes from the two-way perspective can potentially allow for democratic decision-making processes, explicit discussions of values and multiple types of science use. To broaden our understanding of the interface and foster productive science-practice linkages, we argue for dialogue among different research traditions within Ecology and Conservation, joint knowledge-production processes between scientists and decision-makers and interdisciplinarity across Ecology, Conservation and Political Science in both research and education. © 2017 Cambridge Philosophical Society.

Is the treatment gap in knee osteoarthritis real? A qualitative study of surgeons' perceptions.

PubMed

Li, Chuan Silvia; Pathy, Rubini; Adili, Anthony; Avram, Victoria; Barasi, Mohamed A; Mundi, Raman; Niroopan, Gavinn; Bhandari, Mohit

2013-01-01

Knee osteoarthritis (OA) is a chronic condition characterized by loss of joint cartilage that leads to persistent pain, loss of function, and disability. It has been reported that a treatment gap exists in a subset of knee OA patients who are unresponsive to conservative treatment yet are unsuitable for or unwilling to undergo more invasive, irreversible, surgical procedures. Ten orthopedic healthcare professionals participated in a focus group (n=5) and semistructured interviews (n=5). We explored their perceptions on the treatment gap in knee OA patients and their opinions of the KineSpring® Knee Implant System. Among the responses of orthopedic healthcare professionals, we identified seven themes: (1) Delaying operative treatment for knee OA patients is very important. (2) Unrealistic expectations of younger patients play an important role in management of knee OA. (3) A treatment gap does exist. (4) Management of knee OA should be tailored to the individual patient. (5) The ability to delay total knee replacement without compromising the ability to do it in the future is important for the acceptance of the KineSpring System. (6) Improving patient lives by decreasing pain, improving function, and potentially delaying arthroplasty is important. (7) A well-designed randomized control trial and further evidence regarding the KineSpring System is desired. Orthopedic healthcare professionals are enthusiastic about the prospect of the KineSpring System as an option to help close the treatment gap in knee OA. Focusing only on clinical trials with long-term data may be impractical and deprive patients and society of benefits that can be gained while trial data are maturing.

Medial Elbow Joint Space Increases With Valgus Stress and Decreases When Cued to Perform A Maximal Grip Contraction.

PubMed

Pexa, Brett S; Ryan, Eric D; Myers, Joseph B

2018-04-01

Previous research indicates that the amount of valgus torque placed on the elbow joint during overhead throwing is higher than the medial ulnar collateral ligament (UCL) can tolerate. Wrist and finger flexor muscle activity is hypothesized to make up for this difference, and in vitro studies that simulated activity of upper extremity musculature, specifically the flexor digitorum superficialis and flexor carpi ulnaris, support this hypothesis. To assess the medial elbow joint space at rest, under valgus stress, and under valgus stress with finger and forearm flexor contraction by use of ultrasonography in vivo. Controlled laboratory study. Participants were 22 healthy males with no history of elbow dislocation or UCL injury (age, 21.25 ± 1.58 years; height, 1.80 ± 0.08 m; weight, 79.43 ± 18.50 kg). Medial elbow joint space was measured by use of ultrasonography during 3 separate conditions: at rest (unloaded), under valgus load (loaded), and with a maximal grip contraction under a valgus load (loaded-contracted) in both limbs. Participants lay supine with their arm abducted 90° and elbow flexed 30° with the forearm in full supination. A handgrip dynamometer was placed in the participants' hand to grip against during the contracted condition. Images were reduced in ImageJ to assess medial elbow joint space. A 2-way (condition × limb) repeated-measures analysis of variance and Cohen's d effect sizes were used to assess changes in medial elbow joint space. Post hoc testing was performed with a Bonferroni adjustment to assess changes within limb and condition. The medial elbow joint space was significantly larger in the loaded condition (4.91 ± 1.16 mm) compared with the unloaded condition (4.26 ± 1.23 mm, P < .001, d = 0.712) and the loaded-contracted condition (3.88 ± 0.94 mm, P < .001, d = 1.149). No significant change was found between the unloaded and loaded-contracted conditions ( P = .137). Medial elbow joint space increases under a valgus load and then decreases when a maximal grip contraction is performed. This indicates that wrist and finger flexor muscle contraction may assist in limiting medial elbow joint space, a result similar to findings of previous research in vitro. Muscle activation of the upper extremity limits the medial elbow joint space, suggesting that injury prevention programs for throwing athletes should incorporate exercises for the elbow, wrist, and hand to limit excessive medial elbow joint space gapping during activities that create high valgus load.

Initial evaluation of the use of USPIO cell labeling and noninvasive MR monitoring of human tissue-engineered vascular grafts in vivo.

PubMed

Nelson, G N; Roh, J D; Mirensky, T L; Wang, Y; Yi, T; Tellides, G; Pober, J S; Shkarin, P; Shapiro, E M; Saltzman, W M; Papademetris, X; Fahmy, T M; Breuer, C K

2008-11-01

This pilot study examines noninvasive MR monitoring of tissue-engineered vascular grafts (TEVGs) in vivo using cells labeled with iron oxide nanoparticles. Human aortic smooth muscle cells (hASMCs) were labeled with ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles. The labeled hASMCs, along with human aortic endothelial cells, were incorporated into eight TEVGs and were then surgically implanted as aortic interposition grafts in a C.B-17 SCID/bg mouse host. USPIO-labeled hASMCs persisted in the grafts throughout a 3 wk observation period and allowed noninvasive MR imaging of the human TEVGs for real-time, serial monitoring of hASMC retention. This study demonstrates the feasibility of applying noninvasive imaging techniques for evaluation of in vivo TEVG performance.

Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

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

Lenton, James, E-mail: jlenton@doctors.org.u; Davies, John; Homer-Vanniasinkam, S.

An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms withmore » stent-grafts has not been previously reported in the adolescent population.« less

Facial Nerve Trauma: Evaluation and Considerations in Management

PubMed Central

Gordin, Eli; Lee, Thomas S.; Ducic, Yadranko; Arnaoutakis, Demetri

2014-01-01

The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. In cases where motor end plates are still intact but a primary repair or graft is not feasible, a nerve transfer should be employed. When complete muscle atrophy has occurred, regional muscle transfer or free flap reconstruction is an option. When dynamic reanimation cannot be undertaken, static procedures offer some benefit. Adjunctive tools such as botulinum toxin injection and biofeedback can be helpful. Several new treatment modalities lie on the horizon which hold potential to alter the current treatment algorithm. PMID:25709748

Evaluation of the thermal conductance of flip-chip bonding structure utilizing the measurement based on Fourier's law of heat conduction at steady-state

NASA Astrophysics Data System (ADS)

Wu, Chia-Yu; Huang, Yin-Hsien; Wu, Hsin-Han; Hsieh, Tsung-Eong

2018-06-01

Fourier's law of heat conduction at steady-state was adopted to establish a measurement method utilizing platinum (Pt) thin-film electrodes as the heater and the temperature sensor. The thermal conductivities (κ's) of Pyrex glass, an epoxy resin and a commercial underfill for flip-chip devices were measured and a good agreement with previously reported values was obtained. The thermal boundary resistances (RTBR's) of Pt/sample interfaces were also extracted for discussing their influence on the thermal conduction of samples. Afterward, the flip-chip samples with 2×2 solder joint array utilizing Si wafers as the die and the substrate, without and with the underfills, were prepared and their thermal conductance were measured. For the sample without underfill, the air presenting in the gap of die and the substrate led to the poor thermal conductance of sample. With the insertion of underfills, the thermal conductance of flip-chip samples improved. The resistance to heat transfer across Si/underfill interfaces was also suppressed and to promote the thermal conductance of samples. The thermal properties of underfill and RTBR at Si/underfill interface were further implanted in the calculation of thermal conductance of flip-chip samples containing various solder joint arrays. The increasing number of solder joints diminished the influence of thermal conduction of underfill and RTBR of Si/underfill interface on the thermal conductance of samples. The insertion of underfill with high-κ value might promote the heat conductance of samples containing low-density solder joint arrays; however, it became insignificant in improving the heat conductance of samples containing high-density solder joint arrays.

Critical bending moment of four implant-abutment interface designs.

PubMed

Lee, Frank K; Tan, Keson B; Nicholls, Jack I

2010-01-01

Critical bending moment (CBM), defined as the bending moment at which the external nonaxial load applied overcomes screw joint preload and causes loss of contact between the mating surfaces of the implant screw joint components, was measured for four different implants and their single-tooth replacement abutments. CBM at the implant-abutment screw joint for four implant-abutment test groups was measured in vitro at 80%, 100%, and 120% of the manufacturers' recommended torque levels. Regular-platform implants with their corresponding single-tooth abutments were used. Microstrain was measured while known loads were applied to the abutment at known distances from the implant-abutment interface. Strain instrumentation was used to record the strain data dynamically to determine the point of gap opening. All torque applications and strain measurements were repeated five times for the five samples in each group. For the Branemark/CeraOne assemblies, the mean CBMs were 72.14 Ncm, 102.21 Ncm, and 119.13 Ncm, respectively, at 80%, 100%, and 120% of the manufacturer's recommended torque. For the Replace/Easy assemblies, mean CBMs were 86.20 Ncm, 109.92 Ncm, and 120.93 Ncm; for the Biomet 3i/STA assemblies, they were 67.97 Ncm, 83.14 Ncm, and 91.81 Ncm; and for the Lifecore/COC assemblies, they were 58.32 Ncm, 76.79 Ncm, and 78.93 Ncm. Two-way analysis of variance revealed significant effects for the test groups and torque levels. Subsequent tests confirmed that significant differences existed between test groups and torque levels. The results appear to confirm the primary role of the compressive preload imparted by the abutment screw in maintaining screw joint integrity. CBM was found to differ among implant systems and torque levels. Torque levels recommended by the manufacturer should be followed to ensure screw joint integrity.

JOINT MOBILIZATION IN THE MANAGEMENT OF PERSISTENT INSERTIONAL ACHILLES TENDINOPATHY: A CASE REPORT.

PubMed

Jayaseelan, Dhinu J; Post, Andrew A; Mischke, John J; Sault, Josiah D

2017-02-01

Insertional Achilles tendinopathy (IAT) can be a challenging condition to manage conservatively. Eccentric exercise is commonly used in the management of chronic tendinopathy; however, it may not be as helpful for insertional tendon problems as compared to mid-portion dysfunction. While current evidence describing the physical therapy management of IAT is developing, gaps still exist in descriptions of best practice. The purpose of this case report is to describe the management of a patient with persistent IAT utilizing impairment-based joint mobilization, self-mobilization, and exercise. A 51-year-old male was seen in physical therapy for complaints of posterior heel pain and reduced running capacity. He was seen by multiple physical therapists previously, but reported continued impairment, and functional restriction. Joint-based non-thrust mobilization and self-mobilization exercise were performed to enhance his ability to run and reduce symptoms. The subject was seen for four visits over the course of two months. He made clinically significant improvements on the Foot and Ankle Activity Measure and Victorian Institute of Sport Assessment-Achilles tendon outcomes, was asymptomatic, and participated in numerous marathons. Improvements were maintained at one-year follow-up. Mobility deficits can contribute to the development of tendinopathy, and without addressing movement restrictions, symptoms and functional decline related to tendinopathy may persist. Joint-directed manual therapy may be a beneficial intervention in a comprehensive plan of care in allowing patients with chronic tendon changes to optimize function. Therapy, Level 4.

Biomechanics of Pediatric Manual Wheelchair Mobility

PubMed Central

Slavens, Brooke A.; Schnorenberg, Alyssa J.; Aurit, Christine M.; Tarima, Sergey; Vogel, Lawrence C.; Harris, Gerald F.

2015-01-01

Currently, there is limited research of the biomechanics of pediatric manual wheelchair mobility. Specifically, the biomechanics of functional tasks and their relationship to joint pain and health is not well understood. To contribute to this knowledge gap, a quantitative rehabilitation approach was applied for characterizing upper extremity biomechanics of manual wheelchair mobility in children and adolescents during propulsion, starting, and stopping tasks. A Vicon motion analysis system captured movement, while a SmartWheel simultaneously collected three-dimensional forces and moments occurring at the handrim. A custom pediatric inverse dynamics model was used to evaluate three-dimensional upper extremity joint motions, forces, and moments of 14 children with spinal cord injury (SCI) during the functional tasks. Additionally, pain and health-related quality of life outcomes were assessed. This research found that joint demands are significantly different amongst functional tasks, with greatest demands placed on the shoulder during the starting task. Propulsion was significantly different from starting and stopping at all joints. We identified multiple stroke patterns used by the children, some of which are not standard in adults. One subject reported average daily pain, which was minimal. Lower than normal physical health and higher than normal mental health was found in this population. It can be concluded that functional tasks should be considered in addition to propulsion for rehabilitation and SCI treatment planning. This research provides wheelchair users and clinicians with a comprehensive, biomechanical, mobility assessment approach for wheelchair prescription, training, and long-term care of children with SCI. PMID:26442251

Biomechanics of Pediatric Manual Wheelchair Mobility.

PubMed

Slavens, Brooke A; Schnorenberg, Alyssa J; Aurit, Christine M; Tarima, Sergey; Vogel, Lawrence C; Harris, Gerald F

2015-01-01

Currently, there is limited research of the biomechanics of pediatric manual wheelchair mobility. Specifically, the biomechanics of functional tasks and their relationship to joint pain and health is not well understood. To contribute to this knowledge gap, a quantitative rehabilitation approach was applied for characterizing upper extremity biomechanics of manual wheelchair mobility in children and adolescents during propulsion, starting, and stopping tasks. A Vicon motion analysis system captured movement, while a SmartWheel simultaneously collected three-dimensional forces and moments occurring at the handrim. A custom pediatric inverse dynamics model was used to evaluate three-dimensional upper extremity joint motions, forces, and moments of 14 children with spinal cord injury (SCI) during the functional tasks. Additionally, pain and health-related quality of life outcomes were assessed. This research found that joint demands are significantly different amongst functional tasks, with greatest demands placed on the shoulder during the starting task. Propulsion was significantly different from starting and stopping at all joints. We identified multiple stroke patterns used by the children, some of which are not standard in adults. One subject reported average daily pain, which was minimal. Lower than normal physical health and higher than normal mental health was found in this population. It can be concluded that functional tasks should be considered in addition to propulsion for rehabilitation and SCI treatment planning. This research provides wheelchair users and clinicians with a comprehensive, biomechanical, mobility assessment approach for wheelchair prescription, training, and long-term care of children with SCI.

Distraction osteogenesis for management of obstructive sleep apnoea in temporomandibular joint ankylosis patients before the release of joint.

PubMed

Yadav, Rahul; Bhutia, Ongkila; Shukla, Garima; Roychoudhury, Ajoy

2014-07-01

To evaluate the effects of distraction osteogenesis in management of obstructive sleep apnoea patients secondary to temporomandibular joints ankylosis. Fifteen patients were included in study. Preoperatively the patients were worked up for polysomnography and CT scans. Only those patients with Apnoea-hypopnoea index >15 events/h denoting moderate to severe obstructive sleep apnoea were included in the study. Distraction osteogenesis was followed with 5 days latency period in adult patients and 0 days for children. Rate of distraction was 1 mm/day for adults and 2 mm/day for children till the mandibular incisors were in reverse overjet. After 3 months post distraction assessment was done using polysomnography and CT scan. TMJ ankylosis was released by doing gap arthroplasty after distraction osteogenesis. Post distraction improvement was seen in clinical features of OSA like daytime sleepiness and snoring. Epworth sleepiness scale improved from a mean of 10.25 to 2.25. Polysomnographic analysis also showed improvement in all cases with apnoea-hypopnoea index from 57.03 to 6.67 per hour. Lowest oxygen saturation improved from 64.47% to 81.20% and average minimum oxygen saturation improved from 92.17% to 98.19%. Body mass index improved from a mean of 18.26 to 21.39 kg/m2. Distraction osteogenesis is a stable and beneficial treatment option for temporomandibular joint ankylosis patients with obstructive sleep apnoea. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Subsurface Microbes Expanding the Tree of Life

ScienceCinema

Banfield, Jillian

2018-02-14

Jillian Banfield, Ph.D., UC Berkeley Professor and Berkeley Lab Earth Sciences Division staff scientist and long-time user of the DOE Joint Genome Institute’s resources shares her perspective on how the DOE JGI helps advance her research addressing knowledge gaps related to the roles of subsurface microbial communities in biogeochemical cycling. The video was filmed near the town of Rifle, Colorado at the primary field site for Phase I of the Subsurface Systems Scientific Focus Area 2.0 sponsored by the DOE Office of Biological and Environmental Research.

Genome-wide transcriptional profiling data from chronic cutaneous lupus erythematosus (CCLE) peripheral blood.

PubMed

Dey-Rao, R; Sinha, A A

2015-03-01

The disease Lupus erythematosus (LE), exhibits a variety of clinical manifestations with potentially wide-ranging multi-organ damage to joints, tendons, kidney, lung, heart, blood vessels, central nervous system and skin [1,2] Systemic changes are likely to trigger organ specific manifestation of the disease. Here, we provide the data examined to address the gap in knowledge regarding causes and mechanisms contributing to the autoimmune attack on skin in chronic cutaneous lupus erythematosus (CCLE). The raw gene expression data files (CEL files) are provided with this article [3].

Interprofessional communication and teambuilding using applied improvisational exercises.

PubMed

Campbell, Candace

2014-01-01

According to The Joint Commission (TJC), the most frequently cited root cause of sentinel events is ineffective communication or miscommunication (TJC, 2002, 2012). The need to improve communication among health care professionals is a high priority because of the serious consequences of poor communication for everyone involved, on both personal and corporate levels. Applied improvisational exercises (AlEs) comprise a strategy for enhancing interprofessional communication (IPC). This article asks: What are the challenges inherent in IPC and teambuilding in the health care setting, and how can AIE help bridge the communication gap?

AIR VEHICLES INTEGRATION AND TECHNOLOGY RESEARCH (AVIATR) Task Order 0015: Predictive Capability for Hypersonic Structural Response and Life Prediction Phase 1 - Identification of Knowledge Gaps

DTIC Science & Technology

2010-08-01

using load - bearing tanks with parasitic TPS was considered to be a lower weight design when all details were accounted for. The cold structure...share one very key element with the design of load bearing hot structure – the design drive toward thin gauge metallic skin under complex and coupled...39 skin panel joints and their susceptibility to high acoustic loading coupled with transient heating, and hot structure skin deflections and

The Joint NASA/FAA/DoD Conference on Aging Aircraft (2nd) Held in Williamsburg, Virginia on 31 August-3 September 1998. Part 1

DTIC Science & Technology

1999-01-01

the previous sortie. 47 Portable Maintenance Data Store (PMDS). The PMDS is a solid state memory device approximately the same size as an...Engine Titanium Consortium Portable Scanner Bridging the gap between rapid imaging and robots is a class of inspection devices called scanners...patterns on the image to change . Thus, a region approximately the size of the sensor element (3 inches in diameter) can be inspected at one time, and an

Evaluating the Subjective Straight Ahead Before and After Spaceflight

NASA Technical Reports Server (NTRS)

Campbell, D. J.; Wood, S. J.; Reschke, M. F.; Clement, G.

2017-01-01

This joint European Space Agency (ESA) - NASA study will address adaptive changes in spatial orientation related to the subjective straight ahead and the use of a vibrotactile sensory aid to reduce perceptual errors. The study will be conducted before and after long duration expeditions to the International Space Station (ISS) to examine how spatial processing of target location is altered following exposure to microgravity. This study addresses the sensorimotor research gap to "determine the changes in sensorimotor function over the course of a mission and during recovery after landing."

Three-dimensional moment arms and architecture of chimpanzee (Pan troglodytes) leg musculature

PubMed Central

Holowka, Nicholas B; O'Neill, Matthew C

2013-01-01

The muscular and skeletal morphology of the chimpanzee ankle and foot differs from that of humans in many important respects. However, little information is available on the moment arms and architecture of the muscles that function around chimpanzee ankle and foot joints. The main goals of this study were to determine the influence of changes in leg and foot position on the moment arms of these muscle–tendon units (MTUs), and provide new measurements of their architecture. Three-dimensional moment arm data were collected from two adult, cadaveric Pan troglodytes specimens for 11 MTUs that cross the ankle and foot joints. Tendon-excursion measurements were made throughout the full range of plantarflexion–dorsiflexion (PF–DF) and eversion–inversion (EV–IN), including repeated measurements for mm. gastrocnemius at 0 °, 45 °, 90 ° and 135 ° of knee flexion. The total range of motion was calculated from three-dimensional joint motion data while ensuring that foot movement was restricted to a single plane. Measurements of muscle mass, fascicle length, pennation angle and physiological cross-sectional area were then collected for each MTU. Our results demonstrate that joint position has a significant effect on moment arm lengths, and that in some cases this effect is counterintuitive. These new data contribute to filling a significant gap in previously published chimpanzee moment arm data, providing a comprehensive characterization of the MTUs that move the chimpanzee ankle and foot joints. They also provide empirical support to the notion that chimpanzees have larger ranges of motion at these joints than humans. Comparison of osteometric estimates of moment arm lengths to direct tendon-excursion measures provides some guidance for the use of skeletal features in estimations of PF–DF moment arms. Finally, muscle architecture data are consistent with the findings of previous studies, and increase the sample size of the chimpanzee data that are currently available. PMID:24117363

Experience with the use of a partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft.

PubMed

Birk, Stephanie; Brase, Christoph; Hornung, Joachim

2014-08-01

In the further development of alloplastic prostheses for use in middle ear surgery, the Dresden and Cologne University Hospitals, working together with a company, introduced a new partial ossicular replacement prosthesis in 2011. The ball-and-socket joint between the prosthesis and the shaft mimics the natural articulations between the malleus and incus and between the incus and stapes, allowing reaction to movements of the tympanic membrane graft, particularly during the healing process. Retrospective evaluation To reconstruct sound conduction as part of a type III tympanoplasty, partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft was implanted in 60 patients, with other standard partial ossicular replacement prosthesis implanted in 40 patients and 64 patients. Pure-tone audiometry was carried out, on average, 19 and 213 days after surgery. Results of the partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft were compared with those of the standard prostheses. Early measurements showed a mean improvement of 3.3 dB in the air-bone gap (ABG) with the partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft, giving similar results than the standard implants (6.6 and 6.0 dB, respectively), but the differences were not statistically significant. Later measurements showed a statistically significant improvement in the mean ABG, 11.5 dB, compared with 4.4 dB for one of the standard partial ossicular replacement prosthesis and a tendency of better results to 6.9 dB of the other standard prosthesis. In our patients, we achieved similarly good audiometric results to those already published for the partial ossicular replacement prosthesis with a ball-and-socket joint between the plate and the shaft. Intraoperative fixation posed no problems, and the postoperative complication rate was low.

Chondral lesions in the patellofemoral joint in MRI: Intra-individual comparison of short-tau inversion recovery sequence (STIR) with 2D multiple-echo data image combination sequence (MEDIC).

PubMed

Bodelle, Boris; Luboldt, Wolfgang; Wichmann, Julian L; Fischer, Sebastian; Vogl, Thomas J; Beeres, Martin

2016-01-01

To determine the value of the 2D multiple-echo data image combination (MEDIC) sequence relative to the short-tau inversion recovery (STIR) sequence regarding the depiction of chondral lesions in the patellofemoral joint. During a period of 6 month patients with acute pain at the anterior aspect of the knee, joint effusion and suspected chondral lesion defect in the patellofemoral joint underwent MRI including axial MEDIC and STIR imaging. Patients with chondral lesions in the patellofemoral joint on at least one sequence were included. The MEDIC and STIR sequence were quantitatively compared regarding the patella cartilage-to-effusion contrast-to-noise ratio (CNR) and qualitatively regarding the depiction of chondral lesions independently scored by two radiologists on a 3-point scale (1 = not depicted; 2 = blurred depicted; 3 = clearly depicted) using the Wilcoxon-Mann-Whitney-Test. For the analysis of inter-observer agreement the Cohen's Weighted Kappa test was used. 30 of 58 patients (male: female, 21:9; age: 44 ± 12 yrs) revealed cartilage lesions (fissures, n = 5 including fibrillation; gaps, n = 15; delamination, n = 7; osteoarthritis, n = 3) and were included in this study. The STIR-sequence was significantly (p < 0.001) superior to the MEDIC-sequence regarding both, the patella cartilage-to-effusion CNR (mean CNR: 232 ± 61 vs. 40 ± 16) as well as the depiction of chondral lesion (mean score: 2.83 ± 0.4 vs. 1.75 ± 0.7) with substantial inter-observer agreement in the rating of both sequences (κ = 0.76-0.89). For the depiction of chondral lesions in the patellofemoral joint, the axial STIR-sequence should be chosen in preference to the axial MEDIC-sequence.

Development of Thermal Barriers for Solid Rocket Motor Nozzle Joints

NASA Technical Reports Server (NTRS)

Steinetz, Bruce M.; Dunlap, Patrick H., Jr.

1999-01-01

The Space Shuttle solid rocket motor case assembly joints are sealed using conventional 0-ring seals. The 5500+F combustion gases are kept a safe distance away from the seals by thick layers of insulation. Special joint-fill compounds are used to fill the joints in the insulation to prevent a direct flowpath to the seals. On a number of occasions. NASA has observed in several of the rocket nozzle assembly joints hot gas penetration through defects in the joint- fill compound. The current nozzle-to-case joint design incorporates primary, secondary and wiper (inner-most) 0-rings and polysulfide joint-fill compound. In the current design, 1 out of 7 motors experience hot gas to the wiper 0-ring. Though the condition does not threaten motor safety, evidence of hot gas to the wiper 0-ring results in extensive reviews before resuming flight. NASA and solid rocket motor manufacturer Thiokol are working to improve the nozzle-to-case joint design by implementing a more reliable J-leg design and a thermal barrier, This paper presents burn-resistance, temperature drop, flow and resiliency test results for several types of NASA braided carbon-fiber thermal barriers. Burn tests were performed to determine the time to burn through each of the thermal barriers when exposed to the flame of an oxy-acetylene torch (5500 F), representative of the 5500 F solid rocket motor combustion temperatures. Thermal barriers braided out of carbon fibers endured the flame for over 6 minutes, three times longer than solid rocket motor burn time. Tests were performed on two thermal barrier braid architectures, denoted Carbon-3 and Carbon-6, to measure the temperature drop across and along the barrier in a compressed state when subjected to the flame of an oxyacetylene torch. Carbon-3 and Carbon-6 thermal barriers were excellent insulators causing temperature drops through their diameter of up to a 2800 and 2560 F. respectively. Gas temperature 1/4" downstream of the thermal barrier were within the downstream Viton 0-ring temperature limit of 600 F. Carbon-6 performed extremely well in subscale rocket "char" motor tests when subjected to hot gas at 3200 F for an 11 second rocket firing, simulating the maximum downstream joint cavity fill time. The thermal barrier reduced the incoming hot gas temperature by 2200 F in an intentionally oversized gap defect, spread the incoming jet flow, and blocked hot slag, thereby offering protection to the downstream 0-rings.

Contemporary management of isolated iliac aneurysms.

PubMed

Krupski, W C; Selzman, C H; Floridia, R; Strecker, P K; Nehler, M R; Whitehill, T A

1998-07-01

Because isolated common iliac artery aneurysms are infrequent, are difficult to detect and treat, and have traditionally been associated with high operative mortality rates in reported series, we analyzed the outcomes of operative repair of 31 isolated common iliac artery aneurysms in 21 patients to ascertain morbidity and mortality rates with contemporary techniques of repair. A retrospective review study was conducted in a university teaching hospital and a Department of Veterans Affairs Medical Center. Perioperative mortality and operative morbidity rates were examined in 17 men and four women with isolated common iliac artery aneurysms between 1984 and 1997. Ages ranged from 38 to 87 years (mean 69 +/- 8 years). Slightly more than half of the cases were symptomatic, with abdominal pain, neurologic, claudicative, genitourinary, or hemodynamic symptoms. One aneurysm had ruptured and one was infected. There was one iliac artery-iliac vein fistula. All aneurysms involved the common iliac artery. Coexistent unilateral or bilateral external iliac aneurysms were present in four patients; there were three accompanying internal iliac aneurysms. Overall, 52% of patients had unilateral aneurysms and 48% had bilateral aneurysms. Aneurysms ranged in maximal diameter from 2.5 to 12 cm (mean 5.6 +/- 2 cm). No patients were unavailable for follow-up, which averaged 5.5 years. Nineteen patients underwent direct operative repair of isolated iliac aneurysms. One patient had placement of an endoluminal covered stent graft; another patient at high risk had percutaneous placement of coils within the aneurysm to occlude it in conjunction with a femorofemoral bypass graft. Patients with bilateral aneurysms underwent aortoiliac or aortofemoral interposition grafts, whereas unilateral aneurysms were managed with local interposition grafts. There were no deaths in the perioperative period. Only one elective operation (5%) resulted in a significant complication, compartment syndrome requiring fasciotomy. The patient treated with the covered stent required femorofemoral bypass when the stent occluded 1 week after the operation. The patient treated with coil occlusion of a large common iliac aneurysm died 2 years later when the aneurysm ruptured. Isolated iliac artery aneurysms can be managed with much lower mortality and morbidity rates than aneurysm previously been reported by using a systematic operative approach. Percutaneous techniques may be less durable and effective than direct surgical repair.

Functional jejunal interposition, a reconstruction procedure, promotes functional outcomes after total gastrectomy.

PubMed

Ding, Xuewei; Yan, Fang; Liang, Han; Xue, Qiang; Zhang, Kuo; Li, Hui; Ren, Xiubao; Hao, Xishan

2015-04-15

Functional jejunal interposition (FJI) has been applied as a reconstruction procedure to maintain the jejunal continuity and duodenal food passage after total gastrectomy in patients with gastric cancer. The purpose of this study was to evaluate clinical efficacy of the FJI procedure by comparing the functional outcomes of FJI to Roux-en-Y after total gastrectomy in gastric cancer patients, and investigate physiologic mechanisms by which FJI exerts beneficial outcomes in beagles. Patients with stage I-IV gastric cancer without metastasis and recurrence one year after surgery were enrolled in this retrospective study. Seventy one patients received FJI and seventy nine patients received Roux-en-Y after total gastrectomy. We evaluated the nutritional status at three and twelve months and incidence of complications up to twelve months after surgery. Beagles receiving sham operation, FJI, or Roux-en-Y after total gastrectomy were sacrificed forty eight hours postoperatively. Beagles were gavaged with active carbon for evaluating the intestinal transit rate. Intestinal tissues from the duodenojejunal anastomosis were collected for examining interstitial cells of Cajal (ICC), inflammation, and apoptosis. Compared to the bodyweight before surgery, the bodyweight loss at three and twelve months after surgery in patients receiving FJI was significant less than that in patients with Roux-en-Y. Patients with the FJI procedure showed significant increase of blood hemoglobin and total protein, compared to those at one month after surgery, and the prognostic nutrition index scores at three and twelve months after surgery. The incidence rates of post-operative complications, including reflux esophagitis, dumping syndrome, and Roux-en-Y syndrome were decreased in patients with FJI. Compared to beagles receiving Roux-en-Y, more ICC in the intestinal submuocsa, less intestinal epithelial cell apoptosis, and decreased inflammation in serosal side of the intestine were found in the FJI group. The intestinal transit rate in FJI group was lower than that in Roux-en Y group, indicating that FJI benefits food storage. The FJI procedure promotes nutritional recovery and decreases post-operative complications in gastric cancer patients after total gastrectomy, which may be through ameliorating intestinal inflammation and damage and reducing ICC loss to preserve food reservoir function and intestinal motility.

Level of evidence gap in orthopedic research.

PubMed

Baldwin, Keith D; Bernstein, Joseph; Ahn, Jaimo; McKay, Scott D; Sankar, Wudbhav N

2012-09-01

Level of evidence is the most widely used metric for the quality of a publication, but instances exist in which a Level I study is neither feasible nor desirable. The goal of this study was to evaluate the level of evidence gap in current orthopedic research, which the authors defined as the disparity between the level of evidence that would be required to optimally answer the primary research question and the level of evidence that was actually used. Five orthopedic surgeons (K.D.B., J.B., J.A., S.D.M., W.N.S.) evaluated blinded articles from the first 6 months of 2010 in the Journal of Bone and Joint Surgery (American Volume) (JBJS-Am), classifying the study type and design and extracting a primary research question from each article. Each evaluator then defined the study type and method, along with the level of evidence that would ideally be used to address the primary research question. The level of evidence gap was then calculated by subtracting the actual level of evidence of the manuscript from the level of evidence of the idealized study. Of the 64 JBJS-Am manuscripts eligible for analysis, the average level of evidence was between Level II and III (mean, 2.73). The average level of evidence gap was 1.06 compared with the JBJS-Am-designated level of evidence and 1.28 compared with the evaluators' assessment. Because not all questions require Level I studies, level of evidence alone may not be the best metric for the quality of orthopedic surgery literature. Instead, the authors' concept of a level of evidence gap may be a better tool for assessing the state of orthopedic research publications. Copyright 2012, SLACK Incorporated.

Heat shock protein 70 stimulation of the deoxyribonucleic acid base excision repair enzyme polymerase β

PubMed Central

Mendez, Frances; Kozin, Elliott; Bases, Robert

2003-01-01

Base excision repair (BER) of damaged deoxyribonucleic acid (DNA) is a multistep process during which potentially lethal abasic sites temporarily exist. Repair of these lesions is greatly stimulated by heat shock protein 70 (Hsp70), which enhances strand incision and removal of the abasic sites by human apurinic-apyrimidinic endonuclease (HAP1). The resulting single-strand gaps must then be filled in. Here, we show that Hsp70 and its 48- and 43-kDa N-terminal domains greatly stimulated filling in the single-strand gaps by DNA polymerase β, a novel finding that extends the role of Hsps in DNA repair. Incorporation of deoxyguanosine monophosphate (dGMP) to fill in single-strand gaps in DNA phagemid pBKS by DNA polymerase β was stimulated by Hsp70. Truncated proteins derived from the C-terminus of Hsp70 as well as unrelated proteins were less effective, but proteins derived from the N-terminus of Hsp70 remained efficient stimulators of DNA polymerase β repair of DNA single-strand gaps. In agreement with these results, repair of a gap in a 30-bp oligonucleotide by polymerase β also was strongly stimulated by Hsp70 although not by a truncated protein from the C-terminus of Hsp70. Sealing of the repaired site in the oligonucleotide by human DNA ligase 1 was not specifically stimulated by Hsp-related proteins. Results presented here now implicate and extend the role of Hsp70 as a partner in the enzymatic repair of damaged DNA. The participation of Hsp70 jointly with base excision enzymes improves repair efficiency by mechanisms that are not yet understood. PMID:14627201

Of mice and men: how animal models advance our understanding of T-cell function in RA.

PubMed

Kobezda, Tamás; Ghassemi-Nejad, Sheida; Mikecz, Katalin; Glant, Tibor T; Szekanecz, Zoltán

2014-03-01

The involvement of autoreactive T cells in the pathogenesis of rheumatoid arthritis (RA) as well as in autoimmune animal models of arthritis has been well established; however, unanswered questions, such as the role of joint-homing T cells, remain. Animal models of arthritis are superb experimental tools in demonstrating how T cells trigger joint inflammation, and thus can help to further our knowledge of disease mechanisms and potential therapies. In this Review, we discuss the similarities and differences in T-cell subsets and functions between RA and mouse arthritis models. For example, various T-cell subsets are involved in both human and mouse arthritis, but differences might exist in the cytokine regulation and plasticity of these cells. With regard to joint-homing T cells, an abundance of synovial T cells is present in humans compared with mice. On the other hand, local expansion of type 17 T-helper (TH17) cells is observed in some animal models, but not in RA. Finally, whereas T-cell depletion therapy essentially failed in RA, antibody targeting of T cells can work, at least preventatively, in most arthritis models. Clearly, additional human and animal studies are needed to fill the gap in our understanding of the specific contribution of T-cell subsets to arthritis in mice and men.

Attic construction with sheathing-applied insulation

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

Rose, W.B.

1995-12-31

Two years of study at a building research laboratory have been applied to cathedralized residential attic construction. Cathedralized attics are rafter-framed or truss-framed attics with flat ceilings in which the insulation is placed against the underside of the roof sheathing rather than on top of the ceiling drywall. The potential benefits of sheathing-applied insulation are considerable and are due to the fact that the attic space becomes part of the conditioned volume. Concern is often expressed that moisture damage may occur in the sheathing. The intent of the current study was to address those concerns. This study allowed an assessmentmore » of the performance of cathedralized ceilings, given the following construction variables: (1) ventilation vs. no ventilation, (2) continuous air chute construction vs. stuffed insulation construction, and (3) opens joints in exposed kraft facing vs. taped joints. The results were compared to a concurrent study of the performance of cathedral ceilings with sloped ceiling drywall. The results show that having an air chute that ensures an air gap between the sheathing and the top of the insulation is the critical factor. Ventilation and the taping of joints were minor determinants of the moisture performance of the sheathing. These results are consistent with the results of normal cathedral ceiling construction performance.« less

Eyes that bind us: Gaze leading induces an implicit sense of agency.

PubMed

Stephenson, Lisa J; Edwards, S Gareth; Howard, Emma E; Bayliss, Andrew P

2018-03-01

Humans feel a sense of agency over the effects their motor system causes. This is the case for manual actions such as pushing buttons, kicking footballs, and all acts that affect the physical environment. We ask whether initiating joint attention - causing another person to follow our eye movement - can elicit an implicit sense of agency over this congruent gaze response. Eye movements themselves cannot directly affect the physical environment, but joint attention is an example of how eye movements can indirectly cause social outcomes. Here we show that leading the gaze of an on-screen face induces an underestimation of the temporal gap between action and consequence (Experiments 1 and 2). This underestimation effect, named 'temporal binding,' is thought to be a measure of an implicit sense of agency. Experiment 3 asked whether merely making an eye movement in a non-agentic, non-social context might also affect temporal estimation, and no reliable effects were detected, implying that inconsequential oculomotor acts do not reliably affect temporal estimations under these conditions. Together, these findings suggest that an implicit sense of agency is generated when initiating joint attention interactions. This is important for understanding how humans can efficiently detect and understand the social consequences of their actions. Copyright © 2017 Elsevier B.V. All rights reserved.

A Computational Model of Torque Generation: Neural, Contractile, Metabolic and Musculoskeletal Components

PubMed Central

Callahan, Damien M.; Umberger, Brian R.; Kent-Braun, Jane A.

2013-01-01

The pathway of voluntary joint torque production includes motor neuron recruitment and rate-coding, sarcolemmal depolarization and calcium release by the sarcoplasmic reticulum, force generation by motor proteins within skeletal muscle, and force transmission by tendon across the joint. The direct source of energetic support for this process is ATP hydrolysis. It is possible to examine portions of this physiologic pathway using various in vivo and in vitro techniques, but an integrated view of the multiple processes that ultimately impact joint torque remains elusive. To address this gap, we present a comprehensive computational model of the combined neuromuscular and musculoskeletal systems that includes novel components related to intracellular bioenergetics function. Components representing excitatory drive, muscle activation, force generation, metabolic perturbations, and torque production during voluntary human ankle dorsiflexion were constructed, using a combination of experimentally-derived data and literature values. Simulation results were validated by comparison with torque and metabolic data obtained in vivo. The model successfully predicted peak and submaximal voluntary and electrically-elicited torque output, and accurately simulated the metabolic perturbations associated with voluntary contractions. This novel, comprehensive model could be used to better understand impact of global effectors such as age and disease on various components of the neuromuscular system, and ultimately, voluntary torque output. PMID:23405245

2016 American Indian/Alaska Native/Native Hawaiian Areas (AIANNH) Michigan, Minnesota, and Wisconsin

EPA Pesticide Factsheets

The TIGER/Line shapefiles and related database files (.dbf) are an extract of selected geographic and cartographic information from the U.S. Census Bureau's Master Address File / Topologically Integrated Geographic Encoding and Referencing (MAF/TIGER) Database (MTDB). The MTDB represents a seamless national file with no overlaps or gaps between parts, however, each TIGER/Line shapefile is designed to stand alone as an independent data set, or they can be combined to cover the entire nation. The American Indian/Alaska Native/Native Hawaiian (AIANNH) Areas Shapefile includes the following legal entities: federally recognized American Indian reservations and off-reservation trust land areas, state-recognized American Indian reservations, and Hawaiian home lands (HHLs). The statistical entities included are Alaska Native village statistical areas (ANVSAs), Oklahoma tribal statistical areas (OTSAs), tribal designated statistical areas (TDSAs), and state designated tribal statistical areas (SDTSAs). Joint use areas are also included in this shapefile refer to areas that are administered jointly and/or claimed by two or more American Indian tribes. The Census Bureau designates both legal and statistical joint use areas as unique geographic entities for the purpose of presenting statistical data. The Bureau of Indian Affairs (BIA) within the U.S. Department of the Interior (DOI) provides the list of federally recognized tribes and only provides legal boundary infor

Motivation, characterization, and strategy for tissue engineering the temporomandibular joint disc.

PubMed

Detamore, Michael S; Athanasiou, Kyriacos A

2003-12-01

The purpose of this review is to serve as the standard point of reference in guiding researchers investigating the tissue engineering of the temporomandibular joint (TMJ) disc. Tissue engineering of the TMJ disc is in its infancy, and currently there exists a gap between the tissue engineering community and the TMJ characterization community. The primary goal is to help bridge that gap by consolidating the characterization studies here as a reference to researchers attempting to tissue engineer the TMJ disc. A brief review of TMJ anatomy is provided, along with a description of relevant pathology, current treatment, and a rationale for engineering the TMJ disc. The biochemical composition and organization of the disc are reviewed, including glycosaminoglycan (GAG) and collagen content. The collagen of the disc is almost exclusively type I and primarily runs anteroposteriorly through the center and in a ringlike fashion around the periphery. The GAG content is approximately an order of magnitude less than that of hyaline cartilage, and although the distribution is not entirely clear, it seems as though chondroitin and dermatan sulfate are by far the primary GAGs. Cellular characterization and mechanical properties under compression, tension, and shear are reviewed as well. The cells of the disc are not chondrocytes, but rather resemble fibrocytes and fibrochondrocytes and may be of the same lineage. Mechanically, the disc is certainly anisotropic and nonhomogeneous. Finally, a review of efforts in tissue engineering and cell culture studies of the disc is provided and we close with a description of the direction we envision/propose for successful tissue engineering of the TMJ disc.

Microstructure of a safe-end dissimilar metal weld joint (SA508-52-316L) prepared by narrow-gap GTAW

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

Ming, Hongliang

The microstructure, residual strain and interfacial chemical composition distribution of a safe-end dissimilar metal weld joint (DMWJ, SA508-52-316L) prepared by narrow-gap gas-tungsten arc welding (NG-GTAW) were studied by optical microscope (OM) and scanning electron microscope equipped with an energy dispersive X-ray microanalysis (SEM/EDX) and an electron back scattering diffraction (EBSD) system. Complex microstructure and chemical composition distribution are found, especially at the SA508-52 interface and the 52-316L interface. In brief, a complicated microstructure transition exists within the SA508 heat affected zone (HAZ); the residual strain, the fraction of high angle random grain boundaries and low angle boundaries decrease with increasingmore » the distance from the fusion boundary in 316L HAZ; neither typical type II boundary nor obvious carbon-depleted zone is found near the SA508-52 interface; dramatic and complicated changes of the contents of the main elements, Fe, Cr and Ni, are observed at the distinct interfaces, especially at the SA508-52 interface. No carbon concentration is found at the SA508-52 interface. - Highlights: •Residual strain and GBCD change as a function of the distance from FB in 316L HAZ. •Neither type II boundary nor obvious carbon-depleted zone is found in SA508 HAZ. •No carbon concentration is found at the SA508-52 interface. •The middle part of the DMWJ has the highest residual strain.« less

On the matter of synovial fluid lubrication: implications for Metal-on-Metal hip tribology.

PubMed

Myant, Connor; Cann, Philippa

2014-06-01

Artificial articular joints present an interesting, and difficult, tribological problem. These bearing contacts undergo complex transient loading and multi axes kinematic cycles, over extremely long periods of time (>10 years). Despite extensive research, wear of the bearing surfaces, particularly metal-metal hips, remains a major problem. Comparatively little is known about the prevailing lubrication mechanism in artificial joints which is a serious gap in our knowledge as this determines film formation and hence wear. In this paper we review the accepted lubrication models for artificial hips and present a new concept to explain film formation with synovial fluid. This model, recently proposed by the authors, suggests that interfacial film formation is determined by rheological changes local to the contact and is driven by aggregation of synovial fluid proteins. The implications of this new mechanism for the tribological performance of new implant designs and the effect of patient synovial fluid properties are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Capillary test specimen, system, and methods for in-situ visualization of capillary flow and fillet formation

DOEpatents

Hall, Aaron C.; Hosking, F. Michael ,; Reece, Mark

2003-06-24

A capillary test specimen, method, and system for visualizing and quantifying capillary flow of liquids under realistic conditions, including polymer underfilling, injection molding, soldering, brazing, and casting. The capillary test specimen simulates complex joint geometries and has an open cross-section to permit easy visual access from the side. A high-speed, high-magnification camera system records the location and shape of the moving liquid front in real-time, in-situ as it flows out of a source cavity, through an open capillary channel between two surfaces having a controlled capillary gap, and into an open fillet cavity, where it subsequently forms a fillet on free surfaces that have been configured to simulate realistic joint geometries. Electric resistance heating rapidly heats the test specimen, without using a furnace. Image-processing software analyzes the recorded images and calculates the velocity of the moving liquid front, fillet contact angles, and shape of the fillet's meniscus, among other parameters.

Controlling a rabbet load and air/oil seal temperatures in a turbine

DOEpatents

Schmidt, Mark Christopher

2002-01-01

During a standard fired shutdown of a turbine, a loaded rabbet joint between the fourth stage wheel and the aft shaft of the machine can become unloaded causing a gap to occur due to a thermal mismatch at the rabbet joint with the bearing blower turned on. An open or unloaded rabbet could cause the parts to move relative to each other and therefore cause the rotor to lose balance. If the bearing blower is turned off during a shutdown, the forward air/oil seal temperature may exceed maximum design practice criterion due to "soak-back." An air/oil seal temperature above the established maximum design limits could cause a bearing fire to occur, with catastrophic consequences to the machine. By controlling the bearing blower according to an optimized blower profile, the rabbet load can be maintained, and the air/oil seal temperature can be maintained below the established limits. A blower profile is determined according to a thermodynamic model of the system.

Joint External Evaluation—Development and Scale-Up of Global Multisectoral Health Capacity Evaluation Process

PubMed Central

Bell, Elizabeth; Ijaz, Kashef; Bartee, Maureen; Fernandez, Jose; Burris, Hannah; Sliter, Karen; Nikkari, Simo; Chungong, Stella; Rodier, Guenael; Jafari, Hamid

2017-01-01

The Joint External Evaluation (JEE), a consolidation of the World Health Organization (WHO) International Health Regulations 2005 (IHR 2005) Monitoring and Evaluation Framework and the Global Health Security Agenda country assessment tool, is an objective, voluntary, independent peer-to-peer multisectoral assessment of a country’s health security preparedness and response capacity across 19 IHR technical areas. WHO approved the standardized JEE tool in February 2016. The JEE process is wholly transparent; countries request a JEE and are encouraged to make its findings public. Donors (e.g., member states, public and private partners, and other public health institutions) can support countries in addressing identified JEE gaps, and implementing country-led national action plans for health security. Through July 2017, 52 JEEs were completed, and 25 more countries were scheduled across WHO’s 6 regions. JEEs facilitate progress toward IHR 2005 implementation, thereby building trust and mutual accountability among countries to detect and respond to public health threats. PMID:29155678

Gentamicin release from commercially-available gentamicin-loaded PMMA bone cements in a prosthesis-related interfacial gap model and their antibacterial efficacy.

PubMed

Neut, Daniëlle; Kluin, Otto S; Thompson, Jonathan; van der Mei, Henny C; Busscher, Henk J

2010-11-10

Around about 1970, a gentamicin-loaded poly (methylmethacrylate) (PMMA) bone cement brand (Refobacin Palacos R) was introduced to control infection in joint arthroplasties. In 2005, this brand was replaced by two gentamicin-loaded follow-up brands, Refobacin Bone Cement R and Palacos R + G. In addition, another gentamicin-loaded cement brand, SmartSet GHV, was introduced in Europe in 2003. In the present study, we investigated differences in gentamicin release and the antibacterial efficacy of the eluent between these four cement brands. 200 μm-wide gaps were made in samples of each cement and filled with buffer in order to measure the gentamicin release. Release kinetics were related to bone cement powder particle characteristics and wettabilities of the cement surfaces. Gaps were also inoculated with bacteria isolated from infected prostheses for 24 h and their survival determined. Gentamicin release and bacterial survival were statistically analysed using the Student's t-test. All three Palacos variants showed equal burst releases but each of the successor Palacos cements showed significantly higher sustained releases. SmartSet GHV showed a significantly higher burst release, while its sustained release was comparable with original Palacos. A gentamicin-sensitive bacterium did not survive in the high gentamicin concentrations in the interfacial gaps, while a gentamicin-resistant strain did, regardless of the type of cement used. Survival was independent of the level of burst release by the bone cement. Although marketed as the original gentamicin-loaded Palacos cement, orthopaedic surgeons should be aware that the successor cements do not appear to have the same release characteristics as the original one. Overall, high gentamicin concentrations were reached inside our prosthesis-related interfacial gap model. These concentrations may be expected to effectively decontaminate the prosthesis-related interfacial gap directly after implantation, provided that these bacteria are sensitive for gentamicin.

Repair of tracheo-oesophageal fistula.

PubMed

Muniappan, Ashok; Mathisen, Douglas J

2016-01-01

Acquired non-malignant tracheo-oesophageal fistula (TOF) most commonly develops after prolonged intubation or tracheostomy. It may also develop after trauma, oesophagectomy, laryngectomy and other disparate conditions. TOF leads to respiratory compromise secondary to chronic aspiration and pulmonary sepsis. Difficulty with oral intake usually leads to nutritional compromise. After diagnosis, the goals are to eliminate or reduce ongoing pulmonary contamination and to restore proper nutrition. Operative repair of benign TOF is generally performed through a cervical approach. The majority of patients require tracheal resection and reconstruction to address concomitant tracheal or laryngotracheal stenosis. Muscle flap interposition between tracheal and oesophageal repairs reduces the risk of fistula recurrence. Operative repair of the fistula is associated with generally good outcomes with a minimal risk of mortality. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

A new use of K-Y jelly as a gonioscopy fluid.

PubMed Central

Mehta, H. K.

1984-01-01

Methylcellulose drops varying in strength between 0.3% and 2.0% and isotonic saline are the fluids currently used for gonioscopy and posterior segment examination of the eye with diagnostic contact lenses. The author reports the use of K-Y jelly for such examinations in over 80 patients after having it used on his own eyes without any immediate or delayed ill effects. No observable difference was found between saline drops, methylcellulose drops of 0.3% and 2.0%, and K-Y jelly as regards the visibility of the anterior and posterior segments of the eyes. The more viscous fluids of 2% methylcellulose and K-Y jelly were more convenient to use, as they rarely allowed interposition of air bubbles between the cornea and the contact lens. K-Y jelly was well tolerated by all subjects. PMID:6477858

Radiological and histological variants of thanatophoric dysplasia are associated with common mutations in FGFR-3

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

Nerlich, A.G.; Freisinger, P.; Bonaventure, J.

1996-05-03

We describe two fetuses of the 21st week of gestation that share some macroscopic, radiologic, and histologic findings of thanatophoric dysplasia (TD), but also show distinct differences from the usual subtypes of TD. These differences mainly comprise the lack of facial abnormality, only mild reduction of chondrocyte proliferation and hypertrophy, and the lack of fibrous tissue interposition between cartilage and periosteal bone. Thus, these two cases may represent a distinct variant of thanatophoric dysplasia. The molecular analysis of the FGF-R-3 gene demonstrated in both cases mutations which were not significantly different from those of other cases of TD. Thus, themore » phenotypic modulation within the subtypes of TD may be influenced by additional and yet unknown factors. 16 refs., 4 figs., 1 tab.« less

Observation of Phase-Filling Singularities in the Optical Dielectric Function of Highly Doped n-Type Ge.

PubMed

Xu, Chi; Fernando, Nalin S; Zollner, Stefan; Kouvetakis, John; Menéndez, José

2017-06-30

Phase-filling singularities in the optical response function of highly doped (>10^{19}  cm^{-3}) germanium are theoretically predicted and experimentally confirmed using spectroscopic ellipsometry. Contrary to direct-gap semiconductors, which display the well-known Burstein-Moss phenomenology upon doping, the critical point in the joint density of electronic states associated with the partially filled conduction band in n-Ge corresponds to the so-called E_{1} and E_{1}+Δ_{1} transitions, which are two-dimensional in character. As a result of this reduced dimensionality, there is no edge shift induced by Pauli blocking. Instead, one observes the "original" critical point (shifted only by band gap renormalization) and an additional feature associated with the level occupation discontinuity at the Fermi level. The experimental observation of this feature is made possible by the recent development of low-temperature, in situ doping techniques that allow the fabrication of highly doped films with exceptionally flat doping profiles.

Quantitative studies on inner interfaces in conical metal joints using hard x-ray inline phase contrast radiography

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

Zabler, S.; Rack, T.; Nelson, K.

2010-10-15

Quantitative investigation of micrometer and submicrometer gaps between joining metal surfaces is applied to conical plug-socket connections in dental titanium implants. Microgaps of widths well beyond the resolving power of industrial x-ray systems are imaged by synchrotron phase contrast radiography. Furthermore, by using an analytical model for the relatively simple sample geometry and applying it to numerical forward simulations of the optical Fresnel propagation, we show that quantitative measurements of the microgap width down to 0.1 {mu}m are possible. Image data recorded at the BAMline (BESSY-II light source, Germany) are presented, with the resolving power of the imaging system beingmore » 4 {mu}m in absorption mode and {approx}14 {mu}m in phase contrast mode (z{sub 2}=0.74 m). Thus, phase contrast radiography, combined with numerical forward simulations, is capable of measuring the widths of gaps that are two orders of magnitude thinner than the conventional detection limit.« less

Age of the Subducting Philippine Sea Slab and Mechanism of Low-Frequency Earthquakes

NASA Astrophysics Data System (ADS)

Hua, Yuanyuan; Zhao, Dapeng; Xu, Yixian; Liu, Xin

2018-03-01

Nonvolcanic low-frequency earthquakes (LFEs) usually occur in young and warm subduction zones under condition of near-lithostatic pore fluid pressure. However, the relation between the LFEs and the subducting slab age has never been documented so far. Here we estimate the lithospheric age of the subducting Philippine Sea (PHS) slab beneath the Nankai arc by linking seismic tomography and a plate reconstruction model. Our results show that the LFEs in SW Japan take place in young parts ( 17-26 Myr) of the PHS slab. However, no LFE occurs beneath the Kii channel where the PHS slab is very young ( 15 Myr) and thin ( 29 km), forming an LFE gap there. According to the present results and previous works, we think that the LFE gap at the Kii channel is caused by joint effects of several factors, including the youngest slab age, high temperature, low fluid content, high permeability of the overlying plate, a slab tear, and hot upwelling flow below the PHS slab.

Do gender gaps in education and health affect economic growth? A cross-country study from 1975 to 2010.

PubMed

Mandal, Bidisha; Batina, Raymond G; Chen, Wen

2018-05-01

We use system-generalized method-of-moments to estimate the effect of gender-specific human capital on economic growth in a cross-country panel of 127 countries between 1975 and 2010. There are several benefits of using this methodology. First, a dynamic lagged dependent econometric model is suitable to address persistence in per capita output. Second, the generalized method-of-moments estimator uses dynamic properties of the data to generate appropriate instrumental variables to address joint endogeneity of the explanatory variables. Third, we allow the measurement error to include unobserved country-specific effect and random noise. We include two gender-disaggregated measures of human capital-education and health. We find that gender gap in health plays a critical role in explaining economic growth in developing countries. Our results provide aggregate evidence that returns to investments in health systematically differ across gender and between low-income and high-income countries. Copyright © 2018 John Wiley & Sons, Ltd.

Study of Electromigration-Induced Failures on Cu Pillar Bumps Joined to OSP and ENEPIG Substrates

NASA Astrophysics Data System (ADS)

Hsiao, Yu-Hsiang; Lin, Kwang-Lung; Lee, Chiu-Wen; Shao, Yu-Hsiu; Lai, Yi-Shao

2012-12-01

This work studies electromigration (EM)-induced failures on Cu pillar bumps joined to organic solderability preservative (OSP) on Cu substrates (OSP-bumps) and electroless Ni(P)/electroless Pd/immersion Au (ENEPIG) under bump metallurgy (UBM) on Cu substrates (ENEPIG-bumps). Two failure modes (Cu pad consumption and gap formation) were found with OSP-bumps, but only one failure mode (gap formation) was found with ENEPIG-bumps. The main interfacial compound layer was the Cu6Sn5 compound, which suffered significant EM-induced dissolution, eventually resulting in severe Cu pad consumption at the cathode side for OSP-bumps. A (Cu,Ni)6Sn5 layer with strong resistance to EM-induced dissolution exists at the joint interface when a nickel barrier layer is incorporated at the cathode side (Ni or ENEPIG), and these imbalanced atomic fluxes result in the voids and gap formation. OSP-bumps showed better lifetime results than ENEPIG-bumps for several current stressing conditions. The inverse Cu atomic flux ( J Cu,chem) which diffuses from the Cu pad to cathode side retards the formation of voids. The driving force for J Cu,chem comes from the difference in chemical potential between the (Cu,Ni)6Sn5 and Cu6Sn5 phases.

Microstructural Characterization of High Burn-up Mixed Oxide Fast Reactor Fuel

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

Melissa C. Teague; Brian P. Gorman; Steven L. Hayes

2013-10-01

High burn-up mixed oxide fuel with local burn-ups of 3.4–23.7% FIMA (fissions per initial metal atom) were destructively examined as part of a research project to understand the performance of oxide fuel at extreme burn-ups. Optical metallography of fuel cross-sections measured the fuel-to-cladding gap, clad thickness, and central void evolution in the samples. The fuel-to-cladding gap closed significantly in samples with burn-ups below 7–9% FIMA. Samples with burn-ups in excess of 7–9% FIMA had a reopening of the fuel-to-cladding gap and evidence of joint oxide-gain (JOG) formation. Signs of axial fuel migration to the top of the fuel column weremore » observed in the fuel pin with a peak burn-up of 23.7% FIMA. Additionally, high burn-up structure (HBS) was observed in the two highest burn-up samples (23.7% and 21.3% FIMA). The HBS layers were found to be 3–5 times thicker than the layers found in typical LWR fuel. The results of the study indicate that formation of JOG and or HBS prevents any significant fuel-cladding mechanical interaction from occurring, thereby extending the potential life of the fuel elements.« less

Mechanical contributors to sex differences in idiopathic knee osteoarthritis

PubMed Central

2012-01-01

The occurrence of knee osteoarthritis (OA) increases with age and is more common in women compared with men, especially after the age of 50 years. Recent work suggests that contact stress in the knee cartilage is a significant predictor of the risk for developing knee OA. Significant gaps in knowledge remain, however, as to how changes in musculoskeletal traits disturb the normal mechanical environment of the knee and contribute to sex differences in the initiation and progression of idiopathic knee OA. To illustrate this knowledge deficit, we summarize what is known about the influence of limb alignment, muscle function, and obesity on sex differences in knee OA. Observational data suggest that limb alignment can predict the development of radiographic signs of knee OA, potentially due to increased stresses and strains within the joint. However, these data do not indicate how limb alignment could contribute to sex differences in either the development or worsening of knee OA. Similarly, the strength of the knee extensor muscles is compromised in women who develop radiographic and symptomatic signs of knee OA, but the extent to which the decline in muscle function precedes the development of the disease is uncertain. Even less is known about how changes in muscle function might contribute to the worsening of knee OA. Conversely, obesity is a stronger predictor of developing knee OA symptoms in women than in men. The influence of obesity on developing knee OA symptoms is not associated with deviation in limb alignment, but BMI predicts the worsening of the symptoms only in individuals with neutral and valgus (knock-kneed) knees. It is more likely, however, that obesity modulates OA through a combination of systemic effects, particularly an increase in inflammatory cytokines, and mechanical factors within the joint. The absence of strong associations of these surrogate measures of the mechanical environment in the knee joint with sex differences in the development and progression of knee OA suggests that a more multifactorial and integrative approach in the study of this disease is needed. We identify gaps in knowledge related to mechanical influences on the sex differences in knee OA. PMID:23259740

Mechanical contributors to sex differences in idiopathic knee osteoarthritis.

PubMed

Nicolella, Daniel P; O'Connor, Mary I; Enoka, Roger M; Boyan, Barbara D; Hart, David A; Resnick, Eileen; Berkley, Karen J; Sluka, Kathleen A; Kwoh, C Kent; Tosi, Laura L; Coutts, Richard D; Havill, Lorena M; Kohrt, Wendy M

2012-12-23

The occurrence of knee osteoarthritis (OA) increases with age and is more common in women compared with men, especially after the age of 50 years. Recent work suggests that contact stress in the knee cartilage is a significant predictor of the risk for developing knee OA. Significant gaps in knowledge remain, however, as to how changes in musculoskeletal traits disturb the normal mechanical environment of the knee and contribute to sex differences in the initiation and progression of idiopathic knee OA. To illustrate this knowledge deficit, we summarize what is known about the influence of limb alignment, muscle function, and obesity on sex differences in knee OA. Observational data suggest that limb alignment can predict the development of radiographic signs of knee OA, potentially due to increased stresses and strains within the joint. However, these data do not indicate how limb alignment could contribute to sex differences in either the development or worsening of knee OA. Similarly, the strength of the knee extensor muscles is compromised in women who develop radiographic and symptomatic signs of knee OA, but the extent to which the decline in muscle function precedes the development of the disease is uncertain. Even less is known about how changes in muscle function might contribute to the worsening of knee OA. Conversely, obesity is a stronger predictor of developing knee OA symptoms in women than in men. The influence of obesity on developing knee OA symptoms is not associated with deviation in limb alignment, but BMI predicts the worsening of the symptoms only in individuals with neutral and valgus (knock-kneed) knees. It is more likely, however, that obesity modulates OA through a combination of systemic effects, particularly an increase in inflammatory cytokines, and mechanical factors within the joint. The absence of strong associations of these surrogate measures of the mechanical environment in the knee joint with sex differences in the development and progression of knee OA suggests that a more multifactorial and integrative approach in the study of this disease is needed. We identify gaps in knowledge related to mechanical influences on the sex differences in knee OA.

Why do spinal manipulation techniques take the form they do? Towards a general model of spinal manipulation.

PubMed

Evans, David W

2010-06-01

For centuries, techniques used to manipulate joints in the spine have been passed down from one generation of manipulators to the next. Today, spinal manipulation is in the curious position that positive clinical effects have now been demonstrated, yet the theoretical base underpinning every aspect of its use is still underdeveloped. An important question is posed in this masterclass: why do spinal manipulation techniques take the form they do? From the available literature, two factors appear to provide an answer: 1. Action of a force upon vertebrae. Any 'direct' spinal manipulation technique requires that the patient be orientated in such a way that force is applied perpendicular to the overlying skin surface so as to act upon the vertebrae beneath. If the vertebral motion produced by 'directly' applied force is insufficient to produce the desired effect (e.g. cavitation), then force must be applied 'indirectly', often through remote body segments such as the head, thorax, abdomen, pelvis, and extremities. 2. Spinal segment morphology. A new hypothesis is presented. Spinal manipulation techniques exploit the morphology of vertebrae by inducing rotation at a spinal segment, about an axis that is always parallel to the articular surfaces of the constituent zygapophysial joints. In doing so, the articular surfaces of one zygapophysial joint appose to the point of contact, resulting in migration of the axis of rotation towards these contacting surfaces, and in turn this facilitates gapping of the other (target) zygapophysial joint. Other variations in the form of spinal manipulation techniques are likely to depend upon the personal style and individual choices of the practitioner.

Transient Pressure Test Article Test Program

NASA Technical Reports Server (NTRS)

Vibbart, Charles M.

1989-01-01

The Transient Pressure Test Article (TPTA) test program is being conducted at a new test facility located in the East Test Area at the National Aeronautics and Space Administration's (NASA's) Marshall Space Flight Center (MSFC) in Huntsville, Alabama. This facility, along with the special test equipment (STE) required for facility support, was constructed specifically to test and verify the sealing capability of the Redesigned Solid Rocket Motor (RSRM) field, igniter, and nozzle joints. The test article consists of full scale RSRM hardware loaded with inert propellant and assembled in a short stack configuration. The TPTA is pressurized by igniting a propellant cartridge capable of inducing a pressure rise rate which stimulates the ignition transient that occurs during launch. Dynamic loads are applied during the pressure cycle to simulate external tank attach (ETA) strut loads present on the ETA ring. Sealing ability of the redesigned joints is evaluated under joint movement conditions produced by these combined loads since joint sealing ability depends on seal resilience velocity being greater than gap opening velocity. Also, maximum flight dynamic loads are applied to the test article which is either pressurized to 600 psia using gaseous nitrogen (GN2) or applied to the test article as the pressure decays inside the test article on the down cycle after the ignition transient cycle. This new test facility is examined with respect to its capabilities. In addition, both the topic of test effectiveness versus space vehicle flight performance and new aerospace test techniques, as well as a comparison between the old SRM design and the RSRM are presented.