Science.gov

Sample records for manipulation orthopedic

  1. Orthopedic evaluation

    NASA Technical Reports Server (NTRS)

    Walden, T.

    1978-01-01

    The clinical performance of the Lixiscope in orthopedics was compared with routine radiography. Portability and size were the major advantages of the Lixiscope. The main disadvantage at this point in time was the Lixiscope's inability to study large areas.

  2. Orthopedic services

    MedlinePlus

    ... MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Orthopedic services URL of this page: //medlineplus.gov/ency/article/ ...

  3. Nanotechnology in orthopedics.

    PubMed

    Garimella, Roja; Eltorai, Adam E M

    2017-03-01

    Nanotechnology has revolutionized science and consumer products for several decades. Most recently, its applications to the fields of medicine and biology have improved drug delivery, medical diagnostics, and manufacturing. Recent research of this modern technology has demonstrated its potential with novel forms of disease detection and intervention, particularly within orthopedics. Nanomedicine has transformed orthopedics through recent advances in bone tissue engineering, implantable materials, diagnosis and therapeutics, and surface adhesives. The potential for nanotechnology within the field of orthopedics is vast and much of it appears to be untapped, though not without accompanying obstacles.

  4. Rabbit orthopedic surgery.

    PubMed

    Rich, Gregory A

    2002-01-01

    Orthopedic surgery in rabbits poses several unique parameters for the veterinary surgeon. It is imperative for the veterinarian to be knowledgeable about the anatomic features of the surgical repair site and to become familiar with a rabbit's pain and discomfort often associated with orthopedic injuries. Handling the perioperative and postoperative pain and potential GI disturbances are crucial for a successful outcome of the surgical case. This article is designed to help the veterinary surgeon prepare for the orthopedic surgical procedure and the peripheral physiologic needs of the rabbit from presentation through recovery.

  5. [Thermoformed orthopedic splints].

    PubMed

    Amoric, M

    1990-12-01

    Initially used to make simple splints, thermoforming has led to the development of a new means of application of orthopedic forces. Here we have presented splints which allow the treatment of Class III, Class II and cases of endomaxillitis.

  6. Lasers in orthopedics

    NASA Astrophysics Data System (ADS)

    Sherk, Henry H.; Rhodes, Anthony L.; Meller, Menachem M.

    1990-06-01

    Orthopedic Surgery is that surgical discipline which deals with the musculoskeletal system. Orthopedists therefore operate on joints, the spine and long bones and engage in such subsecialities as sports medicine, hand surgery, trauma surgery, and joint replacements. Since they must cut and shape bone, cartilage, tendon, and ligament, orthopedists have developed a number of mechanical techniques to achieve these ends and surgical lasers have found few applications in orthopedics because until now they have not been useful for cutting bone. In the past several years, however, there has been considerable interest in several areas within the field of orthopedic surgery that do not entail actual bone surgery and it is expected that as newer and more powerful lasers become available laser osteotomy may become feasible and even routine.

  7. Orthopedic management in myelomeningocele.

    PubMed

    Karol, L A

    1995-04-01

    Paralysis, muscle imbalance, and spasticity resulting from myelomeningocele produce orthopedic deformities that often require surgical correction. Spinal deformities in myelomeningocele are nearly universal, and are difficult to treat because of the absence of posterior elements. Hip dislocations frequently occur, but rarely require treatment. Severe foot deformities are seen in up to 80% of children.

  8. Orthopedic trauma in pregnancy.

    PubMed

    Desai, Pratik; Suk, Michael

    2007-11-01

    Trauma sustained during pregnancy can trigger uncertainty and anxiety for patient and orthopedic surgeon alike. In particular, orthopedic-related injuries raise concerns about preoperative, intraoperative, and postoperative care. In this article, we review common concerns about radiation exposure, leukemia, pain management, anticoagulation, and anesthesia. One finding is that radiation risk is minimal when obtaining x-rays for operative planning, provided that the cumulative dose is within 5 rad. We also address safety concerns about patient positioning and staff radiation exposure. In addition, we found that most anesthetics used in pregnancy are category C (ie, safe). Perioperative opioid use for pain management is recommended with little risk. Regarding anticoagulation, low-molecular-weight heparin and fondaparinux are the safest choices. Last, pregnancy is not a contraindication to operative management of pelvic and acetabular fractures.

  9. Sarcopenia in Orthopedic Surgery.

    PubMed

    Bokshan, Steven L; DePasse, J Mason; Daniels, Alan H

    2016-01-01

    Sarcopenia is a loss of skeletal muscle mass in the elderly that is an independent risk factor for falls, disability, postoperative complications, and mortality. Although its cause is not completely understood, sarcopenia generally results from a complex bone-muscle interaction in the setting of chronic disease and aging. Sarcopenia cannot be diagnosed by muscle mass alone. Diagnosis requires 2 of the following 3 criteria: low skeletal muscle mass, inadequate muscle strength, and inadequate physical performance. Forty-four percent of elderly patients undergoing orthopedic surgery and 24% of all patients 65 to 70 years old are sarcopenic. Although dual-energy x-ray absorptiometry and bioelectrical impedance analysis may be used to measure sarcopenia and are relatively inexpensive and accessible, they are generally considered less specific for sarcopenia compared with computed tomography and magnetic resonance imaging. Sarcopenia has been shown to predict poor outcomes within the medical and surgical populations and has been directly correlated with increases in taxpayer costs. Strengthening therapy and nutritional supplementation have become the mainstays of sarcopenia treatment. Specifically, the American Medical Directors Association has released guidelines for nutritional supplementation. Although sarcopenia frequently occurs with osteoporosis, it is an independent predictor of fragility fractures. Initiatives to diagnose, treat, and prevent sarcopenia in orthopedic patients are needed. Further investigation must also explore sarcopenia as a predictor of surgical outcomes in orthopedic patients.

  10. Orthopedic Injury in Pregnancy.

    PubMed

    Gross, Gilad A; George, James W

    2016-09-01

    There are many reasons why a woman's pregnancy can put her at risk for orthopedic pain and injury. Given the high percentage of pregnant patients experiencing some degree of musculoskeletal pain, it is surprising that this is not an area of wider study. This chapter takes an evidence based approach to help the reader understand the implications of the numerous anatomic and physiologic changes associated with the gravid state, and how they act to promote both discomfort and injury. One-third of pregnant women in America are obese, further increasing risk. Exercise in most pregnancies is recommended and regarded as safe and thus obstetric care providers need to understand risk, diagnostic techniques and treatments.

  11. Superelastic Orthopedic Implant Coatings

    NASA Astrophysics Data System (ADS)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  12. Greening of orthopedic surgery.

    PubMed

    Lee, Rushyuan J; Mears, Simon C

    2012-06-01

    Every year, 4 billion pounds of waste are produced by health care facilities, and the amount continues to increase annually. In response, a movement toward greening health care has been building, with a particular focus on the operating room. Between 20% and 70% of health care waste originates from a hospital's operating room, and up to 90% of operating room waste is improperly sorted and sent for costly and unneeded hazardous waste processing. Recent successful changes include segregation of hospital waste, substitution of the ubiquitous polypropylene plastic wrap used for the sterilization and handling of surgical equipment with metal cases, and the reintroduction of reusable surgical gowns. Orthopedic-related changes include the successful reprocessing and reuse of external fixators, shavers, blades, burs, and tourniquets. These changes have been shown to be environmentally and economically beneficial. Early review indicates that these changes are feasible, but a need exists for further evaluation of the effect on the operating room and flow of the surgical procedure and of the risks to the surgeons and operating room staff. Other key considerations are the effects of reprocessed and reused equipment on patient care and outcome and the role of surgeons in helping patients make informed decisions regarding surgical care. The goals of this study were to summarize the amount and types of waste produced in hospitals and operating rooms, highlight the methods of disposal used, review disposal methods that have been developed to reduce waste and improve recycling, and explore future developments in greening health care.

  13. Moral Dilemmas in Pediatric Orthopedics.

    PubMed

    Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y

    2015-12-01

    All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result.

  14. Diagnostic imaging in bovine orthopedics.

    PubMed

    Kofler, Johann; Geissbühler, Urs; Steiner, Adrian

    2014-03-01

    Although a radiographic unit is not standard equipment for bovine practitioners in hospital or field situations, ultrasound machines with 7.5-MHz linear transducers have been used in bovine reproduction for many years, and are eminently suitable for evaluation of orthopedic disorders. The goal of this article is to encourage veterinarians to use radiology and ultrasonography for the evaluation of bovine orthopedic disorders. These diagnostic imaging techniques improve the likelihood of a definitive diagnosis in every bovine patient but especially in highly valuable cattle, whose owners demand increasingly more diagnostic and surgical interventions that require high-level specialized techniques.

  15. Treatment of severe orthopedic infections.

    PubMed

    Dernell, W S

    1999-09-01

    Severe infections are uncommon following orthopedic surgery, yet they can be frustrating for the veterinarian and owner to treat and can result in devastating consequences for the patient. This article reviews the common causes for postoperative infection, reviews established treatment, and introduces newer methods for treatment and control. A thorough understanding of the pathogenesis, application of appropriate diagnostic procedures, the institution of aggressive treatment regimens, with adherence to established principles, will often result in satisfactory outcomes even with severe orthopedic infections. For those more refractory to treatment, the use of newer treatment methods, specifically locally implantable materials for sustained release of antimicrobials can improve success in the treatment of these more difficult cases.

  16. Decision making in ruminant orthopedics.

    PubMed

    Fessler, J F; Adams, S B

    1996-03-01

    Decision making in ruminant orthopedics is determined by many factors, the most of important of which is age, size, and value of the patient, the nature of the injury, the prognosis for effective treatment and satisfactory healing, the intentions of the client, and the experiences of the veterinarian. Ruminant orthopedics currently is expanding to include the treatment of llamas and small ruminants as companion animals in addition to the treatment of valuable livestock. The future promises increasing sophistication in treatments and an ever higher quality of patient care.

  17. A robot-assisted orthopedic telesurgery system.

    PubMed

    Kong, M; Du, Z; Sun, L; Fu, L; Jia, Z; Wu, D

    2005-01-01

    A robot-assisted orthopedic telesurgery system, named HIT-RAOTS, has been developed according to Chinese conventional operation method. Its main function includes obtaining images with information of position and orientation of fracture, providing fracture information for doctors, assisting the doctors to complete the reposition of fracture and locking operation of intramedullary nail. In this system, a 6-dof force-reflecting master device, with a pantographic parallelogram mechanisms driven by harmonic DC servomotors, is used to control the slave manipulator movement and to translate the force from the operating room to the surgeon console; A slave robot system integrated a 6-dof force sensor, with a parallel manipulator actuated by six AC servomotors, is applied for the accurate repositioning; A virtual simulation system and human-machine interface are also developed. PI controller based on local network is used to realize the teleoperation. Only little irradiation is issued during the reposition. It can assist surgeons to perform bone-setting more safely by reducing irradiation damage to both surgeries and patients, more easily by releasing the surgeons from the heavy operation and more perfect by improving accuracy of reposition.

  18. Orthopedic Management of Spina Bifida

    ERIC Educational Resources Information Center

    Thomson, Jeffrey D.; Segal, Lee S.

    2010-01-01

    The management of orthopedic problems in spina bifida has seen a dramatic change over the past 10 years. The negative effects of spasticity, poor balance, and the tethered cord syndrome on ambulatory function are better appreciated. There is less emphasis on the hip radiograph and more emphasis on the function of the knee and the prevention of…

  19. Erythromycin Seromadesis in Orthopedic Surgery

    PubMed Central

    Salgado, Martin; Fernández, Felipe; Avilés, Carolina; Cordova, Cecilia

    2016-01-01

    Introduction: The presence of postoperative seromadesis is common, corresponding to the presence of serum in the subcutaneous tissue post a surgical event. Erythromycin has been reported as sclerosing, although not in orthopedic surgery. We report a case of erythromycin seromadesis in orthopedic surgery. Case Presentation: We present a case of a 63-year-old woman having undergone femoral prosthesis surgery and total hip replacement with a subfacial seroma without findings of infection, refractory to standard treatment of compression bandages, massage and cleaning surgery in two oportunities. A literature review was undertaken to obtain the therapeutic alternatives where erythromycin seromadesis is chosen with excellent response. Conclusion: Erythromycin sclerotherapy should be considered as an effective and safe option in the treatment of seroma in general surgery and traumatology. More studies are necessary to get a better evidence. We believe that this is the first study of use of erythromycin as sclerotherapy in a traumatology case. PMID:27703947

  20. Orthopedic aspects of competitive swimming.

    PubMed

    Richardson, A B

    1987-07-01

    Orthopedic problems related to competitive swimming are rarely disabling, but can be problematic in preventing training and competition. Most problems are related to the shoulder and knee. Treatment is primarily nonsurgical and directed at relieving symptoms and allowing the athlete to continue with swimming practice. Treatment aids such as ice packing, anti-inflammatory medications, muscle stimulation and electrogalvanic stimulation, strengthening exercises, and static stretching are encouraged; upper arm bands and patellar-stabilizing supports can be adapted to training routines.

  1. Orthopedic Gene Therapy in 2008

    PubMed Central

    Evans, Christopher H; Ghivizzani, Steven C; Robbins, Paul D

    2008-01-01

    Orthopedic disorders, although rarely fatal, are the leading cause of morbidity and impose a huge socioeconomic burden. Their prevalence will increase dramatically as populations age and gain weight. Many orthopedic conditions are difficult to treat by conventional means; however, they are good candidates for gene therapy. Clinical trials have already been initiated for arthritis and the aseptic loosening of prosthetic joints, and the development of bone-healing applications is at an advanced, preclinical stage. Other potential uses include the treatment of Mendelian diseases and orthopedic tumors, as well as the repair and regeneration of cartilage, ligaments, and tendons. Many of these goals should be achievable with existing technologies. The main barriers to clinical application are funding and regulatory issues, which in turn reflect major safety concerns and the opinion, in some quarters, that gene therapy should not be applied to nonlethal, nongenetic diseases. For some indications, advances in nongenetic treatments have also diminished enthusiasm. Nevertheless, the preclinical and early clinical data are impressive and provide considerable optimism that gene therapy will provide straightforward, effective solutions to the clinical management of several common debilitating disorders that are otherwise difficult and expensive to treat. PMID:19066598

  2. Diagnosis and management of reptile orthopedic injuries.

    PubMed

    Mitchell, Mark A

    2002-01-01

    As veterinarians expand their understanding of the specific husbandry requirements for captive reptiles, nutritionally associated orthopedic injuries should decrease. Orthopedic injuries in wild reptiles, however, will continue to increase as new infrastructure encroaches on the habitats of these animals. Research should be pursued that focuses on improving our understanding of pain management in reptiles, on developing techniques to expedite bone healing, and on creating new orthopedic techniques that provide rigid stabilization without the use of temperature-sensitive materials.

  3. The dedicated orthopedic trauma operating room.

    PubMed

    Min, William; Wolinsky, Philip R

    2011-08-01

    The development and implementation of a dedicated orthopedic trauma operating room (OTOR) that is used for the treatment of orthopedic trauma patients has changed and improved the practice of orthopedic trauma surgery. Advantages noted with OTOR implementation include improvements in morbidity and complication rates, enhancements in the professional and personal lifestyles of the on-call surgeon, and increased physician recruitment and retention in orthopedic traumatology. However, the inappropriate use of the OTOR, which can waste valuable resources and delay the treatment of emergent cases, must be monitored and avoided.

  4. Wholistic orthopedics: Is this the right way to treat geriatric orthopedic patients?

    PubMed Central

    Ebnezar, John; Bali, Yogita; John, Rakesh

    2017-01-01

    Geriatric orthopedic problems poses different challenges in their management. Conventional treatment methods like drugs, physiotherapy and surgeries are inadequate. A Geriatric orthopedic patient suffers as a whole and not in isolation. This article highlights the importance of managing geriatric orthopedic patients as a whole and outlines the various steps of wholistic management. PMID:28149067

  5. EVALUATION OF THE KNOWLEDGE ON COST OF ORTHOPEDIC IMPLANTS AMONG ORTHOPEDIC SURGEONS

    PubMed Central

    Arliani, Gustavo Gonçalves; Sabongi, Rodrigo Guerra; Batista, Alysson Ferreira; Astur, Diego Costa; Falotico, Guilherme Guadagnini; Cohen, Moises

    2016-01-01

    ABSTRACT Objective: To determine the knowledge of Brazilian Orthopedic Surgeons on the costs of orthopedic surgical devices used in surgical implants. Methods: A questionnaire was applied to Brazilian Orthopedic Surgeons during the 46th Brazilian Congress on Orthopedics and Traumatology. Results: Two hundred and one Orthopedic Surgeons completely filled out the questionnaire. The difference between the average prices estimated by the surgeons and the average prices provided by the supplier companies was 47.1%. No differences were found between the orthopedic specialists and other subspecialties on the prices indicated for specific orthopedic implants. However, differences were found among orthopedic surgeons who received visits from representatives of implant companies and those who did not receive those visits on prices indicated for shaver and radiofrequency device. Correlation was found between length of orthopedic experience and prices indicated for shaver and interference screw, and higher the experience time the lower the price indicated by Surgeons for these materials. Conclusion: The knowledge of Brazilian Orthopedic Surgeons on the costs of orthopedic implants is precarious. Reduction of cost of orthopedics materials depends on a more effective communication and interaction between doctors, hospitals and supplier companies with solid orientation programs and awareness for physicians about their importance in this scenario.Level of Evidence III, Cross-Sectional Study. PMID:28243178

  6. Vascular Injury in Orthopedic Trauma.

    PubMed

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N

    2016-07-01

    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.].

  7. Locking mechanism for orthopedic braces

    NASA Technical Reports Server (NTRS)

    Chao, J. I.; Epps, C. H., Jr.

    1981-01-01

    An orthopedic brace locking mechanism is described which under standing or walking conditions cannot be unlocked, however under sitting conditions the mechanism can be simply unlocked so as to permit bending of the patient's knee. Other features of the device include: (1) the mechanism is rendered operable, and inoperable, dependent upon the relative inclination of the brace with respect to the ground; (2) the mechanism is automatically locked under standing or walking conditions and is manually unlocked under sitting conditions; and (3) the mechanism is light in weight and is relatively small in size.

  8. Orthopedic surgery in ancient Egypt

    PubMed Central

    Blomstedt, Patric

    2014-01-01

    Background — Ancient Egypt might be considered the cradle of medicine. The modern literature is, however, sometimes rather too enthusiastic regarding the procedures that are attributed an Egyptian origin. I briefly present and analyze the claims regarding orthopedic surgery in Egypt, what was actually done by the Egyptians, and what may have been incorrectly ascribed to them. Methods — I reviewed the original sources and also the modern literature regarding surgery in ancient Egypt, concentrating especially on orthopedic surgery. Results — As is well known, both literary sources and the archaeological/osteological material bear witness to treatment of various fractures. The Egyptian painting, often claimed to depict the reduction of a dislocated shoulder according to Kocher’s method, is, however, open to interpretation. Therapeutic amputations are never depicted or mentioned in the literary sources, while the specimens suggested to demonstrate such amputations are not convincing. Interpretation — The ancient Egyptians certainly treated fractures of various kinds, and with varying degrees of success. Concerning the reductions of dislocated joints and therapeutic amputations, there is no clear evidence for the existence of such procedures. It would, however, be surprising if dislocations were not treated, even though they have not left traces in the surviving sources. Concerning amputations, the general level of Egyptian surgery makes it unlikely that limb amputations were done, even if they may possibly have been performed under extraordinary circumstances. PMID:25140982

  9. Using Aerospace Technology To Design Orthopedic Implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

    1996-01-01

    Technology originally developed to optimize designs of composite-material aerospace structural components used to develop method for optimizing designs of orthopedic implants. Development effort focused on designing knee implants, long-term goal to develop method for optimizing designs of orthopedic implants in general.

  10. Strategies for achieving orthopedic service line success.

    PubMed

    Lang, Stacey; Powers, Kristi

    2013-12-01

    Healthcare finance leaders can work with orthopedic surgeons to support better outcomes, clinically and financially, by: Establishing innovative partnerships among hospital leaders, orthopedic surgeons, and implant vendors. Developing and enforcing expectations around contracting and vendor behavior. Establishing a forum for open communication. Building a bundled payment structure. Finding ways to differentiate from the competition.

  11. Sawbones laboratory in orthopedic surgical training

    PubMed Central

    Hetaimish, Bandar M.

    2016-01-01

    Sawbones are artificial bones designed to simulate the bone architecture, as well as the bone’s physical properties. The incorporation of sawbones simulation laboratories in many orthopedic training programs has provided the residents with flexibility in learning and scheduling that align with their working hour limitations. This review paper deliberates the organization of sawbones simulation in orthopedic surgical training to enhance trainee’s future learning. In addition, it explores the implications of sawbones simulation in orthopedic surgical teaching and evaluation. It scrutinizes the suitability of practicing on sawbones at the simulation laboratory to improve orthopedic trainee’s learning. This will be followed with recommendations for future enhancement of sawbones simulation-based learning in orthopedic surgical training. PMID:27052276

  12. Applied Nanotechnology and Nanoscience in Orthopedic Oncology.

    PubMed

    Savvidou, Olga D; Bolia, Ioanna K; Chloros, George D; Goumenos, Stavros D; Sakellariou, Vasileios I; Galanis, Evanthia C; Papagelopoulos, Panayiotis J

    2016-09-01

    Nanomedicine is based on the fact that biological molecules behave similarly to nanomolecules, which have a size of less than 100 nm, and is now affecting most areas of orthopedics. In orthopedic oncology, most of the in vitro and in vivo studies have used osteosarcoma or Ewing sarcoma cell lineages. In this article, tumor imaging and treatment nanotechnology applications, including nanostructure delivery of chemotherapeutic agents, gene therapy, and the role of nano-selenium-coated implants, are outlined. Finally, the potential role of nanotechnology in addressing the challenges of drug and radiotherapy resistance is discussed. [Orthopedics. 2016; 39(5):280-286.].

  13. Carbon nanostructures for orthopedic medical applications.

    PubMed

    Yang, Lei; Zhang, Lijuan; Webster, Thomas J

    2011-09-01

    Carbon nanostructures (including carbon nanofibers, nanostructured diamond, fullerene materials and so forth) possess extraordinary physiochemical, mechanical and electrical properties attractive to bioengineers and medical researchers. In the past decade, numerous developments towards the fabrication and biological studies of carbon nanostructures have provided opportunities to improve orthopedic applications. Therefore, the aim of this article is to provide an up-to-date review on carbon nanostructure advances in orthopedic research. Orthopedic medical device applications of carbon nanotubes/carbon nanofibers and nanostructured diamond (including particulate nanodiamond and nanocrystalline diamond coatings) are emphasized here along with other carbon nanostructures that have promising potential. In addition, widely used fabrication techniques for producing carbon nanostructures in both the laboratory and in industry are briefly introduced. In conclusion, carbon nanostructures have demonstrated tremendous promise for orthopedic medical device applications to date, and although some safety, reliability and durability issues related to the manufacturing and implantation of carbon nanomaterials remain, their future is bright.

  14. Antimicrobial technology in orthopedic and spinal implants.

    PubMed

    Eltorai, Adam Em; Haglin, Jack; Perera, Sudheesha; Brea, Bielinsky A; Ruttiman, Roy; Garcia, Dioscaris R; Born, Christopher T; Daniels, Alan H

    2016-06-18

    Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions.

  15. Antimicrobial technology in orthopedic and spinal implants

    PubMed Central

    Eltorai, Adam EM; Haglin, Jack; Perera, Sudheesha; Brea, Bielinsky A; Ruttiman, Roy; Garcia, Dioscaris R; Born, Christopher T; Daniels, Alan H

    2016-01-01

    Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions. PMID:27335811

  16. Arthroscopic training resources in orthopedic resident education.

    PubMed

    Koehler, Ryan; John, Tamara; Lawler, Jeffrey; Moorman, Claude; Nicandri, Gregg

    2015-02-01

    The purpose of this study was to determine the frequency of use, perceived effectiveness, and preference for arthroscopic surgical skill training resources. An electronic survey was sent to orthopedics residents, residency program directors, and orthopedic sports medicine attending physicians in the United States. The frequency and perceived effectiveness of 10 types of adjunctive arthroscopic skills training was assessed. Residents and faculty members were asked to rate their confidence in resident ability to perform common arthroscopic procedures. Surveys were completed by 40 of 152 (26.3%) orthopedic residency program directors, 70 of 426 (16.4%) sports medicine faculty, and 235 of 3,170 (7.4%) orthopedic residents. The use of adjunctive methods of training varied from only 9.8% of programs with virtual reality training to 80.5% of programs that used reading of published materials to develop arthroscopic skill. Practice on cadaveric specimens was viewed as the most effective and preferred adjunctive method of training. Residents trained on cadaveric specimens reported increased confidence in their ability to perform arthroscopic procedures. The resources for developing arthroscopic surgical skill vary considerably across orthopedic residency programs in the United States. Adjunctive training methods were perceived to be effective at supplementing traditional training in the operating room.

  17. Blood utilization in orthopedic and trauma practice

    PubMed Central

    Tayara, Bader Kamal; Al-Faraidy, Moaad Hatim; Al-Sayel, Faisal Abdullah; Al-Omran, Abdallah S; Sadat-Ali, Mir

    2015-01-01

    Objectives: Very little is known about blood utilization in orthopedic and trauma surgery and there is no definite policy in this regard. Our objective is to perform an audit on our practice of blood utilization in the orthopedic department. Methods: We have retrospectively analyzed the data of patients who were admitted between January 2011 and December 2012 to the orthopedic male, female and pediatric wards for which blood products were requested. Results: Three hundred and eight patients were admitted for surgery during the study period. The average age was 35.12 ± 20.4 years and postsurgery they stayed in the hospital for 25.60 ± 10.5 days. Blood products were requested for 223 trauma surgeries. In elective orthopedic procedures, only 42.78% of the blood requested was utilized while in trauma patients it was 55.25%. Conclusions: A substantial amount of blood and its product was used in trauma and elective orthopedic surgeries. There was a major discrepancy between the blood requested and utilized and secondly in the majority single unit transfusion was utilized, which is not within the fundamentals of blood transfusion. PMID:26097818

  18. Robot Manipulators

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Space Shuttle's Remote Manipulator System (Canadarm) is a 50 foot robot arm used to deploy, retrieve or repair satellites in orbit. Initial spinoff version is designed to remove, inspect and replace large components of Ontario Hydro's CANDU nuclear reactors, which supply 50 percent of Ontario Hydro's total power reduction. CANDU robot is the first of SPAR's Remote Manipulator Systems intended for remote materials handling operations in nuclear servicing, chemical processing, smelting and manufacturing. Inco Limited used remote manipulator for remote control mining equipment to enhance safety and productivity of Inco's hardrock mining operations. System not only improves safety in a hazardous operation that costs more than a score of lives annually, it also increases productivity fourfold. Remote Manipulator System Division is also manufacturing a line of industrial robots and developing additional system for nuclear servicing, mining, defense and space operations.

  19. [Research and analysis to Shui nationality medicine treatment orthopedics & traumatology].

    PubMed

    Hu, Jian-Shan; Li, Pu; Yang, Yong; Chen, Xin-Chun; Lin, Li

    2013-05-01

    To investigated Shui nationality folk medicine's awareness to orthopedics & traumatology, the history of orthopedics & traumatology treatment, Shui nationality folk doctors' practicing medicine, heritage, diagnosis and treatment methods and tools, etc, through investigated drug resources category and distribution characteristics of Shui nationality medicine to orthopedics & traumatology treatment, explored and finished Shui nationality medicine orthopedics & traumatology treatment theoretical system. After more than 5 years' exploration and finishing, preliminarily formed the theoretical system framework and medicine application characteristics of Shui nationality medicine treating orthopedics & traumatology. Shui nationality medicine treatment orthopedics & traumatology has distinctive national style, and worthy to further exploration and research.

  20. ORTHOPEDIC SURGERY AMONG THE ELDERLY: CLINICAL CHARACTERISTICS

    PubMed Central

    Leme, Luiz Eugênio Garcez; Sitta, Maria do Carmo; Toledo, Manuella; da Silva Henriques, Simone

    2015-01-01

    Care for elderly patients undergoing orthopedic surgery, particularly for those requiring emergency surgery, needs to take into account an analysis of physical capacity and risks specific to elderly individuals, in an attempt to reduce the risks. Nevertheless, these remain high in this group. Despite the risks, procedures developed promptly have a positive effect on these patients’ evolution. Coordinated care, composed of teams of specialists within clinical medicine, geriatrics, orthopedics, anesthesiology and critical care, along with other healthcare professionals, may be highly beneficial for this group of patients. PMID:27027017

  1. [The metal tantalum in orthopedic applications].

    PubMed

    Deng, Juncai; Wang, Yue

    2011-04-01

    This paper describes the biological characteristics of the metal tantalum (Ts) and the application status of tantalum in artificial joints, bone necrosis, spine, defects of bone and other aspects of bone. The early clinical application results of tantalum in bone diseases were satisfactory, but it is necessary to do further study of tantalum in a deep going way, and further detailed comparison between the tantalum with other metals as orthopedics implants. The advantage of tantalum materials as orthopedic implants still needs to be verified by a great deal of clinical cases for a long period of time.

  2. Injectable biodegradable materials for orthopedic tissue engineering.

    PubMed

    Temenoff, J S; Mikos, A G

    2000-12-01

    The large number of orthopedic procedures performed each year, including many performed arthroscopically, have led to great interest in injectable biodegradable materials for regeneration of bone and cartilage. A variety of materials have been developed for these applications, including ceramics, naturally derived substances and synthetic polymers. These materials demonstrate overall biocompatibility and appropriate mechanical properties, as well as promote tissue formation, thus providing an important step towards minimally invasive orthopedic procedures. This review provides a comparison of these materials based on mechanical properties, biocompatibility and regeneration efficacy. Advantages and disadvantages of each material are explained and design criteria for injectable biodegradable systems are provided.

  3. Awareness campaign. Orthopedic Hospital of Oklahoma launches awareness campaign.

    PubMed

    2007-01-01

    The Orthopedic Hospital of Oklahoma is a 25-bed inpatient and outpatient center with one focus: Orthopedics. To acquaint people with its services and build brand awareness to drive market share, the hospital launched a print campaign featuring actual patients.

  4. An Overview of the History of Orthopedic Surgery.

    PubMed

    Swarup, Ishaan; O'Donnell, Joseph F

    Orthopedic surgery has a long and rich history. While the modern term orthopedics was coined in the 1700s, orthopedic principles were beginning to be developed and used during primitive times. The Egyptians continued these practices, and described ways to recognize and manage common orthopedic conditions. The Greeks and Romans subsequently began to study medicine in a systematic manner, and greatly improved our understanding of orthopedic anatomy and surgical technique. After a period of little progress during the Middle Ages, rapid advancement was noted during the Renaissance, including the description of various injuries, improvements in surgical technique, and development of orthopedic hospitals. Collectively, these advances provided the foundation for modern orthopedics. Currently, orthopedic surgery is a rapidly developing field that has benefited from the works of numerous scholars and surgeons. It is important to recognize the successes and failures of the past, in order to advance research and practice as well as improve patient care and clinical outcomes.

  5. Underwater manipulator

    DOEpatents

    Schrum, P.B.; Cohen, G.H.

    1993-04-20

    Self-contained, waterproof, water-submersible, remote-controlled apparatus is described for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer [plus minus]45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer [plus minus]10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  6. Underwater manipulator

    DOEpatents

    Schrum, Phillip B.; Cohen, George H.

    1993-01-01

    Self-contained, waterproof, water-submersible, remote-controlled apparatus is provided for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer .+-.45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer .+-.10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  7. Underwater manipulator

    SciTech Connect

    Schrum, P.B.; Cohen, G.H.

    1992-12-31

    This invention is comprised of a self-contained, waterproof, water-submersible, remote-controlled apparatus provided for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer {plus_minus} 45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer {plus_minus} 10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

  8. Billing and coding knowledge: a comparative survey of professional coders, practicing orthopedic surgeons, and orthopedic residents.

    PubMed

    Wiley, Kevin F; Yousuf, Tariq; Pasque, Charles B; Yousuf, Khalid

    2014-06-01

    Medical knowledge and surgical skills are necessary to become an effective orthopedic surgeon. To run an efficient practice, the surgeon must also possess a basic understanding of medical business practices, including billing and coding. In this study, we surveyed and compared the level of billing and coding knowledge among current orthopedic residents PGY3 and higher, academic and private practice attending orthopedic surgeons, and orthopedic coding professionals. According to the survey results, residents and fellows have a similar knowledge of coding and billing, regardless of their level of training or type of business education received in residency. Most residents would like formal training in coding, billing, and practice management didactics; this is consistent with data from previous studies.

  9. Medical and orthopedic conditions and sports participation.

    PubMed

    Diokno, Eugene; Rowe, Dale

    2010-06-01

    The presence of certain medical or orthopedic conditions need not preclude adolescents from being physically active and participating in sports. The benefits of continued physical activity far outweigh any concerns for potential complications for most such conditions. This article reviews sport participation guidelines for adolescents with conditions that include juvenile chronic arthritis, eye injures, solitary kidney, skin conditions, scoliosis, and spondylolysis.

  10. Orthopedically Handicapped Children in Ohio Public Schools.

    ERIC Educational Resources Information Center

    Naples, Victor J.; Todd, Joseph H.

    The historical development of programs for orthopedically handicapped children, class units and hospital classes approved during 1967-68, and the number of therapy units established are presented. Tables give data on program population: enrollment for years 1962-68, percent of handicaps enrolled, and IQ distributions. Aspects of occupational…

  11. [Orthopedic Problems in Overweight and Obese Children].

    PubMed

    Hoffmann, S; Stücker, R; Rupprecht, M

    2016-03-01

    Overweight and obesity in children and adolescents is a growing problem with an increasing number of patients presenting with comorbidities to pediatricians and orthopedic surgeons. This overview summarizes the most common orthopedic problems in overweight children and obesity and highlights the treatment options in addition to weight reduction and physiotherapy leaded activation. In early infancy a persitent genu varum may be seen as a sign of Blount disease. In the school ages flat feet or persistent knock-knees has a higher incidence in overweight children. The incidence for back pain and osteoporosis are related with overweight and obese. At puberty, the slipped capital epiphysis, which always needs a surgical management, is mostly related to overweight/obese. A symptomatic retroversion of the femur can cause discomfort and lead to a surgical therapy himself.

  12. Orthopedic problems in geriatric dogs and cats.

    PubMed

    Beale, Brian S

    2005-05-01

    Senior dogs and cats with orthopedic injuries and diseases often require a treatment plan that differs from that of younger patients. Injured bone and soft tissues tend to heal more slowly in the geriatric patient. The older animal is likely to have a less competent immune system and may have compromised metabolic and endocrine function. Pre-existing musculoskeletal problems may make ambulation difficult for an animal convalescing from a new orthopedic problem. Special attention is often needed when treating these patients for fractures, joint instability, infection, and neoplasia. In general, issues that should be addressed in the geriatric patient include reducing intraoperative and anesthesia time, enhancing bone and soft tissue healing, return to early function, control of postoperative pain, physical therapy, and proper nutrition.

  13. Orthopedic Implant Waste: Analysis and Quantification.

    PubMed

    Payne, Ashley; Slover, James; Inneh, Ifeoma; Hutzler, Lorraine; Iorio, Richard; Bosco, Joseph A

    2015-12-01

    The steadily increasing demand for orthopedic surgeries and declining rates of reimbursement by Medicare and other insurance providers have led many hospitals to look for ways to control the cost of these surgeries. We reviewed administrative records for a 1-year period and recorded total number of surgical cases, number of cases in which an implant was wasted, and cost of each wasted implant. We determined cost incurred because of implant waste, percentage of cases that involved waste, percentage of total implant cost wasted, and average cost of waste per case. We then analyzed the data to determine if case volume or years in surgical practice affected amount of implant waste. Results showed implant waste represents a significant cost for orthopedic procedures within all subspecialties and is an important factor to consider when developing cost-reduction strategies.

  14. Three-Dimensional Printing in Orthopedic Surgery.

    PubMed

    Eltorai, Adam E M; Nguyen, Eric; Daniels, Alan H

    2015-11-01

    Three-dimensional (3D) printing is emerging as a clinically promising technology for rapid prototyping of surgically implantable products. With this commercially available technology, computed tomography or magnetic resonance images can be used to create graspable objects from 3D reconstructed images. Models can enhance patients' understanding of their pathology and surgeon preoperative planning. Customized implants and casts can be made to match an individual's anatomy. This review outlines 3D printing, its current applications in orthopedics, and promising future directions.

  15. Orthopedic workforce planning in Germany – an analysis of orthopedic accessibility

    PubMed Central

    Müller, Peter; Maier, Werner; Groneberg, David A.

    2017-01-01

    In Germany, orthopedic workforce planning relies on population-to-provider-ratios represented by the ‘official degree of care provision’. However, with geographic information systems (GIS), more sophisticated measurements are available. By utilizing GIS-based technologies we analyzed the current state of demand and supply of the orthopedic workforce in Germany (orthopedic accessibility) with the integrated Floating Catchment Area method. The analysis of n = 153,352,220 distances revealed significant geographical variations on national scale: 5,617,595 people (6.9% of total population) lived in an area with significant low orthopedic accessibility (average z-score = -4.0), whereas 31,748,161 people (39.0% of total population) lived in an area with significant high orthopedic accessibility (average z-score = 8.0). Accessibility was positively correlated with the degree of urbanization (r = 0.49; p<0.001) and the official degree of care provision (r = 0.33; p<0.001) and negatively correlated with regional social deprivation (r = -0.47; p<0.001). Despite advantages of simpler measures regarding implementation and acceptance in health policy, more sophisticated measures of accessibility have the potential to reduce costs as well as improve health care. With this study, significant geographical variations were revealed that show the need to reduce oversupply in less deprived urban areas in order to enable adequate care in more deprived rural areas. PMID:28178335

  16. [Orthopedics and patients under national socialism dictatorship].

    PubMed

    Thomann, K D; Rauschmann, M

    2001-10-01

    The 12-year dictatorship of National Socialism represents a decisive event in the history of orthopedics in Germany. Treatment and care was limited to those patients whose prognosis promised their reintegration into the work force. Those orthopedic patients with mental and psychological handicaps no longer came under the care of orthopedists and were potential candidates for annihilation. Despite concerted efforts to the contrary, as can be gleaned from the lists of topics at the annual meetings, the prevailing political circumstances encumbered scientific activities. The almost total isolation from international contacts had a negative effect. Orthopedists were hindered in their work by the law on sterilization, which provided for sterilization in cases of severe physical deformity. Some orthopedists even considered the presence of hip dysplasia to be an indication. The roles played by Georg Hohmann, Hellmut Eckhardt, Lothar Kreuz, and other leading orthopedists are described in detail. It can be regarded as certain that Hohmann and Eckhardt were able to prevent dire consequences for their orthopedic patients and the profession by cautious tactics. The ethnical problems of involvement with National Socialism are thoroughly discussed.

  17. [The clinical use of Hotz-type orthopedic plate].

    PubMed

    Kamegai, A; Matsuoka, Y; Shimamura, N; Muramatsu, Y; Tanabe, T; Kurenuma, S; Kimura, Y; Shibata, K; Naitoh, K; Kitajima, T

    1988-12-01

    In the present study a Hotz type orthopedic plate was used to improve feeding and physiological growth. In 2 patients with cleft lip it was used to improve feeding and swallowing. In 4 patients with cleft lip and palate it was used to normalize functions and aid physiological growth. The effects of the Hotz orthopedic plate were determined by recording body weight growth, milk volume per day, feeding time and comparison of the study model between before and after using Hotz orthopedic plate. Good physiological growth and improved feeding, were obtoincdinalmostall the patients who wore the Hotz type orthopedic plate correctly.

  18. Impact of a Musculoskeletal Clerkship on Orthopedic Surgery Applicant Diversity.

    PubMed

    London, Daniel A; Calfee, Ryan P; Boyer, Martin I

    Orthopedic surgery lacks racial and sexual diversity, which we hypothesized stems from absence of exposure to orthopedics during medical school. We conducted a study to determine whether diversity of matched orthopedic surgery residency applicants increased after introduction of a required third-year rotation. We compared 2 groups: precurriculum and postcurriculum. The postcurriculum group was exposed to a required 1-month musculoskeletal rotation during the third year of medical school. Comparisons were made of percentage of total students exposed to orthopedics, percentage who applied to and matched to orthopedic surgery, and proportion of women and underrepresented minorities. A prospective survey was used to determine when students chose orthopedics and what influenced their decisions. The required rotation increased the percentage of third-year students rotating on orthopedics (25%) with no change in application rate (6%). It also led to an 81% relative increase in the proportion of female applicants and a 101% relative increase in underrepresented minority applicants. According to survey data, 79% of students chose orthopedics during their third year, and 88% thought they were influenced by their rotation. A required third-year rotation exposes more medical students to orthopedics and increases the diversity of matching students.

  19. Prevention of VTE in Orthopedic Surgery Patients

    PubMed Central

    Francis, Charles W.; Johanson, Norman A.; Curley, Catherine; Dahl, Ola E.; Schulman, Sam; Ortel, Thomas L.; Pauker, Stephen G.; Colwell, Clifford W.

    2012-01-01

    Background: VTE is a serious, but decreasing complication following major orthopedic surgery. This guideline focuses on optimal prophylaxis to reduce postoperative pulmonary embolism and DVT. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: In patients undergoing major orthopedic surgery, we recommend the use of one of the following rather than no antithrombotic prophylaxis: low-molecular-weight heparin; fondaparinux; dabigatran, apixaban, rivaroxaban (total hip arthroplasty or total knee arthroplasty but not hip fracture surgery); low-dose unfractionated heparin; adjusted-dose vitamin K antagonist; aspirin (all Grade 1B); or an intermittent pneumatic compression device (IPCD) (Grade 1C) for a minimum of 10 to 14 days. We suggest the use of low-molecular-weight heparin in preference to the other agents we have recommended as alternatives (Grade 2C/2B), and in patients receiving pharmacologic prophylaxis, we suggest adding an IPCD during the hospital stay (Grade 2C). We suggest extending thromboprophylaxis for up to 35 days (Grade 2B). In patients at increased bleeding risk, we suggest an IPCD or no prophylaxis (Grade 2C). In patients who decline injections, we recommend using apixaban or dabigatran (all Grade 1B). We suggest against using inferior vena cava filter placement for primary prevention in patients with contraindications to both pharmacologic and mechanical thromboprophylaxis (Grade 2C). We recommend against Doppler (or duplex) ultrasonography screening before hospital discharge (Grade 1B). For patients with isolated lower-extremity injuries requiring leg immobilization, we suggest no thromboprophylaxis (Grade 2B). For patients undergoing knee arthroscopy without a history

  20. Orthopedic resident anatomy review course: a collaboration between anatomists and orthopedic surgeons.

    PubMed

    DeFriez, Curtis B; Morton, David A; Horwitz, Daniel S; Eckel, Christine M; Foreman, K Bo; Albertine, Kurt H

    2011-01-01

    A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months for all of its residents. The primary purpose of the course is to renew competencies in basic science disciplines so that incoming residents more quickly reach a level of functional proficiency and to afford senior residents a platform to teach their junior colleagues. Before 2005, this course was conducted with minimal participation from anyone outside of the Department of Orthopaedics. Many of the residents voiced concerns that the educational benefits were not proportionate to the time invested. To improve the teaching of orthopedic-related anatomy, an educational collaboration between the Departments of Neurobiology and Anatomy and Orthopaedics was established in 2004 and continues to the present time. The major objectives of refining the course pedagogy, developing a Course Manual and Dissection Guide, and evaluating the results by administering a course survey questionnaire are described in this article. Implementation of all facets of the revised course has resulted in better participation by orthopedic faculty and more favorable reviews by the participating residents. Based on current levels of interest and positive comments from course participants, the Anatomy and Orthopedic faculty course directors plan to continue to develop course materials and pedagogy.

  1. Orthopedic Resident Anatomy Review Course: A Collaboration between Anatomists and Orthopedic Surgeons

    ERIC Educational Resources Information Center

    DeFriez, Curtis B.; Morton, David A.; Horwitz, Daniel S.; Eckel, Christine M.; Foreman, K. Bo; Albertine, Kurt H.

    2011-01-01

    A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months…

  2. Hunting stand-related injuries in orthopedics.

    PubMed

    Lebus, George F; Krueger, Chad A; Stinner, Daniel J; Mir, Hassan R

    2014-09-01

    Hunting remains an extremely popular recreational activity, with nearly 15 million Americans receiving a hunting license annually. Precautions have helped decrease accidents, but hunting-related injuries remain relatively common. The majority of severe, hunting-related accidents involve either a fall from a hunting platform or an accidental shooting. Both of these mechanisms frequently result in orthopedic injuries, many of which require operative care. Although firearms-associated injury has seemingly decreased, hunting platform falls and their sequelae are increasing. Understanding the mechanisms of these injuries and increasing awareness of them may minimize their morbidity and mortality or help prevent them altogether.

  3. Imaging of orthopedic trauma and surgery

    SciTech Connect

    Berquist, T.H.

    1985-01-01

    This book presents papers on imaging techniques for diagnosis of trauma of bones. A comparative evaluation is presented for planning of proper diagnosis and treatment. Various techniques discussed are routine radiography; computerized tomography, NMR imaging, angiography, ultrasonography; and use of radioisotopes. The mechanism of injury of bone joints of upper and lower limbs and spine is discussed after discussing the anatomy of each in the beginning of each paper. Topics titled are healing of fractures; fractures of pelvis; knee; shoulder; foot and ankle; fractures of humerus; stress fractures; and orthopedic radiology. Prosthesis use and plastic surgery of joints is also discussed.

  4. Computer assisted 3D pre-operative planning tool for femur fracture orthopedic surgery

    NASA Astrophysics Data System (ADS)

    Gamage, Pavan; Xie, Sheng Quan; Delmas, Patrice; Xu, Wei Liang

    2010-02-01

    Femur shaft fractures are caused by high impact injuries and can affect gait functionality if not treated correctly. Until recently, the pre-operative planning for femur fractures has relied on two-dimensional (2D) radiographs, light boxes, tracing paper, and transparent bone templates. The recent availability of digital radiographic equipment has to some extent improved the workflow for preoperative planning. Nevertheless, imaging is still in 2D X-rays and planning/simulation tools to support fragment manipulation and implant selection are still not available. Direct three-dimensional (3D) imaging modalities such as Computed Tomography (CT) are also still restricted to a minority of complex orthopedic procedures. This paper proposes a software tool which allows orthopedic surgeons to visualize, diagnose, plan and simulate femur shaft fracture reduction procedures in 3D. The tool utilizes frontal and lateral 2D radiographs to model the fracture surface, separate a generic bone into the two fractured fragments, identify the pose of each fragment, and automatically customize the shape of the bone. The use of 3D imaging allows full spatial inspection of the fracture providing different views through the manipulation of the interactively reconstructed 3D model, and ultimately better pre-operative planning.

  5. Disparities in internet use among orthopedic outpatients.

    PubMed

    Walsh, Kenneth P; Rehman, Saqib; Goldhirsh, Jessie

    2014-02-01

    Internet access has lagged behind for patients with lower incomes and from certain ethnic groups. This study investigated the possible improvement of access to health-related information on the Internet for all patients in an urban outpatient setting, regardless of socioeconomic background. A 28-question survey was completed by 100 orthopedic outpatients evaluating associations between their age, ethnicity, income, or education level and their access to the Internet. The survey also examined how patients used the Internet to obtain information about their medical condition, their privacy concerns when conducting online research, and their use of mobile phones as a primary means of Internet access. The Internet was used by 57% of orthopedic outpatients in this urban setting. Internet access decreased with advancing age but increased with increasing income and education, findings consistent with similar studies. Despite the inability to identify an association between ethnicity and Internet access in this patient population, fewer Latinos (33%) than whites (67%) or African Americans (77%) sought information about their medical condition. Among patients who used a mobile phone as the primary method for online access, 74% were African American or Latino and 26% were white. This difference in mobile phone use for online access suggests that mobile phones have provided ethnic minorities with greater Internet access and thus may have narrowed the digital divide among the races.

  6. RAPID MANUFACTURING SYSTEM OF ORTHOPEDIC IMPLANTS

    PubMed Central

    Relvas, Carlos; Reis, Joana; Potes, José Alberto Caeiro; Fonseca, Fernando Manuel Ferreira; Simões, José Antonio Oliveira

    2015-01-01

    This study, aimed the development of a methodology for rapid manufacture of orthopedic implants simultaneously with the surgical intervention, considering two potential applications in the fields of orthopedics: the manufacture of anatomically adapted implants and implants for bone loss replacement. This work innovation consists on the capitation of the in situ geometry of the implant by direct capture of the shape using an elastomeric material (polyvinylsiloxane) which allows fine detail and great accuracy of the geometry. After scanning the elastomeric specimen, the implant is obtained by machining using a CNC milling machine programmed with a dedicated CAD/CAM system. After sterilization, the implant is able to be placed on the patient. The concept was developed using low cost technology and commercially available. The system has been tested in an in vivo hip arthroplasty performed on a sheep. The time increase of surgery was 80 minutes being 40 minutes the time of implant manufacturing. The system developed has been tested and the goals defined of the study achieved enabling the rapid manufacture of an implant in a time period compatible with the surgery time. PMID:27004181

  7. Improving Response Rates among Students with Orthopedic and Multiple Disabilities

    ERIC Educational Resources Information Center

    Wilkens, Christian P.; Kuntzler, Patrice M.; Cardenas, Shaun; O'Malley, Eileen; Phillips, Carolyn; Singer, Jacqueline; Stoeger, Alex; Kindler, Keith

    2014-01-01

    One challenge teachers of students with orthopedic and multiple disabilities face is providing sufficient time and opportunity to communicate. This challenge is universal across countries, schools, and settings: teachers want students to communicate because communication lies at the core of what makes us human. Yet students with orthopedic and…

  8. Breastfeeding is early functional jaw orthopedics (an introduction).

    PubMed

    Page, D C

    2001-01-01

    Breastfeeding places beneficial orthopedic forces on the jaws, similar to the forces of Functional Jaw Orthopedics--the newest form of orthodontics. To date most breastfeeding benefits have been attributed to the content of mother's milk. The true orthopedic benefits of breastfeeding, suckling, deserve more definitive attention and research. Breastfeeding is early preventive Functional Jaw Orthopedics because breastfeeding forces impact the jaws during a very rapid period of infant jaw growth. Breast suckling aids proper development of the jaws which form the gateway to the human airway. Bottle, pacifier and digit sucking deform jaws and airways. Forward forces of suckling clearly oppose the backward forces of sucking. Dentists who understand the positive impact of forward orthopedic forces on the jaws should support and advocate exclusive breastfeeding for about 6 months.

  9. Biomaterial systems for orthopedic tissue engineering

    NASA Astrophysics Data System (ADS)

    Spoerke, Erik David

    2003-06-01

    The World Health Organization has estimated that one out of seven Americans suffers from a musculoskeletal impairment, annually incurring 28.6 million musculoskeletal injuries---more than half of all injuries. Bone tissue engineering has evolved rapidly to address this continued health concern. In the last decade, the focus of orthopedic biomaterials design has shifted from the use of common engineering metals and plastics to smart materials designed to mimic nature and elicit favorable bioresponse. Working within this new paradigm, this thesis explores unique chemical and materials systems for orthopedic tissue engineering. Improving on current titanium implant technologies, porous titanium scaffolds were utilized to better approximate the mechanical and structural properties of natural bone. These foam scaffolds were enhanced with bioactive coatings, designed to enhance osteoblastic implant colonization. The biopolymer poly(L-lysine) was incorporated into both hydroxypatite and octacalcium phosphate mineral phases to create modified organoapatite and pLys-CP coatings respectively. These coatings were synthesized and characterized on titanium surfaces, including porous structures such as titanium mesh and titanium foam. In addition, in vitro osteoblastic cell culture experiments probed the biological influences of these coatings. Organoapatite (OA) accelerated preosteoblastic colonization of titanium mesh and improved cellular ingrowth into titanium foam. Alternatively, the thin, uniform pLys-CP coating demonstrated significant potential as a substrate for chemically binding biological molecules and supramolecular assemblies. Biologically, pLys-CP demonstrated enhanced cellular attachment over titanium and inorganic calcium phosphate controls. Supramolecular self-assembled nanofiber assemblies were also explored both as stand-alone tissue engineering gels and as titanium coatings. Self-supporting nanofiber gels induced accelerated, biomimetic mineralization

  10. Interobserver variability in Pirani clubfoot severity scoring system between the orthopedic surgeons

    PubMed Central

    Jain, Saurabh; Ajmera, Anand; Solanki, Mahendra; Verma, Alok

    2017-01-01

    Background: Congenital talipes equinovarus (clubfoot) is one of the most common congenital pediatric orthopedic foot deformity, which varies in severity and clinical course. Assessment of severity of the club foot deformity is essential to assess the initial severity of deformity, to monitor the progress of treatment, to prognosticate, and to identify early relapse. Pirani's scoring system is most acceptable and popular for club foot deformity assessment because it is simple, quick, cost effective, and easy. Since the scoring system is subjective in nature it has inter- and intra-observer variability, it is widely used. Hence, the interobserver variability between orthopedic surgeons in assessing the club foot severity by Pirani scoring system. Materials and Methods: We assessed the interobserver variability between five orthopedic surgeons of comparable skills, in assessing the club foot severity by Pirani scoring system in 80 feet of 60 children (20 bilateral and 40 unilateral) with club foot deformity. All the five different orthopedic surgeons were familiar with Pirani clubfoot severity scoring and Ponseti cast manipulation, as they had already worked in CTEV clinics for at least 2 months. Each of them independently scored, each foot as per the Pirani clubfoot scoring system and recorded total score (TS), Midfoot score (MFS), Hind foot score (HFS), posterior crease (PC), emptiness of heel (EH), rigidity of equnius (RE), medial crease (MC), curvature of lateral border (CLB), and lateral head of talus (LHT). Interobserver variability was calculated using kappa statistic for each of these signs and was judged as poor (0.00–0.20), fair (0.21–0.40), moderate (0.41–0.60), substantial (0.61–0.80), or almost perfect (0.81–1.00). Results: The mean age was 137 days (range 21-335) days. The mean Pirani score was 3.86. We found the overall consistency to be substantial for overall score (total score kappa - 0.71) and also for midfoot (0.68) and hindfoot (0

  11. Bioactive glass coatings for orthopedic metallic implants

    SciTech Connect

    Lopez-Esteban, Sonia; Saiz, Eduardo; Fujino, Sigheru; Oku, Takeo; Suganuma, Katsuaki; Tomsia, Antoni P.

    2003-06-30

    The objective of this work is to develop bioactive glass coatings for metallic orthopedic implants. A new family of glasses in the SiO2-Na2O-K2O-CaO-MgO-P2O5 system has been synthesized and characterized. The glass properties (thermal expansion, softening and transformation temperatures, density and hardness) are in line with the predictions of established empirical models. The optimized firing conditions to fabricate coatings on Ti-based and Co-Cr alloys have been determined and related to the glass properties and the interfacial reactions. Excellent adhesion to alloys has been achieved through the formation of 100-200 nm thick interfacial layers (Ti5Si3 on Ti-based alloys and CrOx on Co-Cr). Finally, glass coatings, approximately 100 mu m thick, have been fabricated onto commercial Ti alloy-based dental implants.

  12. Distraction osteogenesis: application to dentofacial orthopedics.

    PubMed

    Yen, S L

    1997-12-01

    Distraction osteogenesis is a surgical-orthopedic method for lengthening bone by separating or distracting a fracture callus. This technique has a long history in limb lengthening and has recently been used to lengthen mandibles and maxillae in human patients. Distraction osteogenesis represents a powerful method of producing unlimited quantities of living bone which can be formed along any plane of space. Because this method uses local host tissue, it offers many advantages over bone grafting. In the author's experience, large (10-22 mm) antero-posterior and vertical corrections of mandibles can be achieved using this technique. The purpose of this article is to review its biological basis and discuss recent clinical applications. This article reviews the history, theory, current management, and limitations of distraction osteogenesis in treating craniofacial anomalies.

  13. Enhancing orthopedic implant bioactivity: refining the nanotopography.

    PubMed

    Wang, Guocheng; Moya, Sergio; Lu, ZuFu; Gregurec, Danijela; Zreiqat, Hala

    2015-01-01

    Advances in nanotechnology open up new possibilities to produce biomimetic surfaces that resemble the cell in vivo growth environment at a nanoscale level. Nanotopographical changes of biomaterials surfaces can positively impact the bioactivity and ossointegration properties of orthopedic and dental implants. This review introduces nanofabrication techniques currently used or those with high potential for use as surface modification of biomedical implants. The interactions of nanotopography with water, proteins and cells are also discussed, as they largely determine the final success of the implants. Due to the well-documented effects of surface chemistry and microtopography on the bioactivity of the implant, we here elaborate on the ability of the nanofabrication techniques to combine the dual (multi) modification of surface chemistry and/or microtopography.

  14. Animal models of orthopedic implant infection.

    PubMed

    An, Y H; Friedman, R J

    1998-01-01

    Prosthetic infection following total joint replacement can have catastrophic results both physically and psychologically for patients, leading to complete failure of the arthroplasty, possible amputation, prolonged hospitalization, and even death. Although with the use of prophylactic antibiotics and greatly improved operating room techniques the infection rate has decreased markedly during the years, challenges still remain for better preventive and therapeutic measures. In this review the in vivo experimental methods for studies of prosthetic infection are discussed, concentrating on (1) the animal models that have been established and the use of these animal models for studies of pathogenesis of bacteria, behavior of biofilm, effect of biomaterials on prosthetic infection rate, and the effect of infection on biomaterial surfaces, and (2) how to design and conduct an animal model of orthopedic prosthetic infection including animal selection, implant fabrication, bacterial inoculation, surgical technique, and the methods for evaluating the results.

  15. Correct coding for the orthopedic surgeon.

    PubMed

    Malek, M Mike; Friedman, Melvin M; Beach, William

    2002-04-01

    Coding accurately is one of the main principles of a successful practice. Some changes that we will see shortly include deletion of the term "separate procedure," deletion of the term "with and/or without," deletion of the term "any method," revision of the criteria for choosing E/M levels, and 52 new and revised Hand Surgery codes. Some other changes to come will be category II and category III codes. More changes are occurring as this is written, and the best advice is to stay tuned. It is obvious to the authors that coding is mainly for reimbursement purposes. The orthopedic surgeon must remain vigilant and must not pass this task on to someone else. Ignorance of coding methods is not an excuse [2]. We must all watch carefully and speak up when necessary. In this day of decreasing reimbursement, we can all increase our revenue stream without working any harder if we code our work properly, completely, and promptly.

  16. Orthopedic surgical analyzer for percutaneous vertebroplasty

    NASA Astrophysics Data System (ADS)

    Tack, Gye Rae; Choi, Hyung Guen; Lim, Do H.; Lee, Sung J.

    2001-05-01

    Since the spine is one of the most complex joint structures in the human body, its surgical treatment requires careful planning and high degree of precision to avoid any unwanted neurological compromises. In addition, comprehensive biomechanical analysis can be very helpful because the spine is subject to a variety of load. In case for the osteoporotic spine in which the structural integrity has been compromised, it brings out the double challenges for a surgeon both clinically and biomechanically. Thus, we have been developing an integrated medical image system that is capable of doing the both. This system is called orthopedic surgical analyzer and it combines the clinical results from image-guided examination and the biomechanical data from finite element analysis. In order to demonstrate its feasibility, this system was applied to percutaneous vertebroplasty. Percutaneous vertebroplasty is a surgical procedure that has been recently introduced for the treatment of compression fracture of the osteoporotic vertebrae. It involves puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate pain relief. However, treatment failures due to excessive PMMA volume injection have been reported as one of complications. It is believed that control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Since the degree of the osteoporosis can influence the porosity of the cancellous bone in the vertebral body, the injection volume can be different from patient to patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient. In addition, biomechanical effects due to the changes in PMMA volume and bone mineral density (BMD) level were investigated by constructing clinically

  17. A New Culture of Transparency: Industry Payments to Orthopedic Surgeons.

    PubMed

    Lopez, Joseph; Ahmed, Rizwan; Bae, Sunjae; Hicks, Caitlin W; El Dafrawy, Mostafa; Osgood, Greg M; Segev, Dorry L

    2016-11-01

    Under the Physician Payments Sunshine Act, "payments or transfers of value" by biomedical companies to physicians must be disclosed through the Open Payments Program. Designed to provide transparency of financial transactions between medication and device manufacturers and health care providers, the Open Payments Program shows financial relationships between industry and health care providers. Awareness of this program is crucial because its interpretation or misinterpretation by patients, physicians, and the general public can affect patient care, clinical practice, and research. This study evaluated nonresearch payments by industry to orthopedic surgeons. A retrospective cross-sectional review of the first wave of Physician Payments Sunshine Act data (August through December 2013) was performed to characterize industry payments to orthopedic surgeons by subspecialty, amount, type, origin, and geographic distribution. During this 5-month period, orthopedic surgeons (n=14,828) received $107,666,826, which included 3% of those listed in the Open Payments Program and 23% of the total amount paid. Of orthopedic surgeons who received payment, 45% received less than $100 and 1% received $100,000 or more. Median payment (interquartile range) was $119 ($34-$636), and mean payment was $7261±95,887. The largest payment to an individual orthopedic surgeon was $7,849,711. The 2 largest payment categories were royalty or license fees (68%) and consulting fees (13%). During the study period, orthopedic surgeons had substantial financial ties to industry. Of orthopedic surgeons who received payments, the largest proportion (45%) received less than $100 and only 1% received large payments (≥$100,000). The Open Payments Program offers insight into industry payments to orthopedic surgeons. [Orthopedics. 2016; 39(6):e1058-e1062.].

  18. Orthopedic Health: Osteoarthritis— What You Should Know (quiz)

    MedlinePlus

    ... Bar Home Current Issue Past Issues Orthopedic Health Osteoarthritis— What You Should Know Past Issues / Spring 2009 ... Javascript on. How much do you know about osteoarthritis, its causes, and its therapies? Take this quiz ...

  19. Biofilm Disrupting Technology for Orthopedic Implants: What's on the Horizon?

    PubMed

    Connaughton, Alexander; Childs, Abby; Dylewski, Stefan; Sabesan, Vani J

    2014-01-01

    The use of orthopedic implants in joints has revolutionized the treatment of patients with many debilitating chronic musculoskeletal diseases such as osteoarthritis. However, the introduction of foreign material into the human body predisposes the body to infection. The treatment of these infections has become very complicated since the orthopedic implants serve as a surface for multiple species of bacteria to grow at a time into a resistant biofilm layer. This biofilm layer serves as a protectant for the bacterial colonies on the implant making them more resistant and difficult to eradicate when using standard antibiotic treatment. In some cases, the use of antibiotics alone has even made the bacteria more resistant to treatment. Thus, there has been surge in the creation of non-antibiotic anti-biofilm agents to help disrupt the biofilms on the orthopedic implants to help eliminate the infections. In this study, we discuss infections of orthopedic implants in the shoulder then we review the main categories of anti-biofilm agents that have been used for the treatment of infections on orthopedic implants. Then, we introduce some of the newer biofilm disrupting technology that has been studied in the past few years that may advance the treatment options for orthopedic implants in the future.

  20. Orthopedic surgery and its complication in systemic lupus erythematosus

    PubMed Central

    Mak, Anselm

    2014-01-01

    Systemic lupus erythematosus (SLE) is a multi-systemic immune-complex mediated autoimmune condition which chiefly affects women during their prime year. While the management of the condition falls into the specialty of internal medicine, patients with SLE often present with signs and symptoms pertaining to the territory of orthopedic surgery such as tendon rupture, carpal tunnel syndrome, osteonecrosis, osteoporotic fracture and infection including septic arthritis, osteomyelitis and spondylodiscitis. While these orthopedic-related conditions are often debilitating in patients with SLE which necessitate management by orthopedic specialists, a high index of suspicion is necessary in diagnosing these conditions early because lupus patients with potentially severe orthopedic conditions such as osteomyelitis frequently present with mild symptoms and subtle signs such as low grade fever, mild hip pain and back tenderness. Additionally, even if these orthopedic conditions can be recognized, complications as a result of surgical procedures are indeed not uncommon. SLE per se and its various associated pharmacological treatments may pose lupus patients to certain surgical risks if they are not properly attended to and managed prior to, during and after surgery. Concerted effort of management and effective communication among orthopedic specialists and rheumatologists play an integral part in enhancing favorable outcome and reduction in postoperative complications for patients with SLE through thorough pre-operative evaluation, careful peri-operative monitoring and treatment, as well as judicious postoperative care. PMID:24653977

  1. [Technical orthopedics. Importance in an increasingly operatively oriented faculty].

    PubMed

    Greitemann, B; Maronna, U

    2013-10-01

    The foundation of the German Society for Orthopedics in 1901 was due to a separation from the faculty of surgery because a surgical approach alone did not adequately deal with the symptoms. Orthopedists were initially considered as a fringe group. The conservative treatment approach was initially at the forefront and operative measures were a side line. The main aim was the rehabilitation of patients into a normal life as best as possible. In the conservative area treatment with orthopedic technical aids and appliances rapidly came to play an important role and a great multitude of technical appliances were developed with sometimes very different possible applications. Despite the clearly improved operative treatment approaches in orthopedics and trauma surgery, technical orthopedics still plays a substantial role even today. Healing and supportive aids and appliances are of decisive importance for the treatment of a multitude of diseases and handicaps. They stabilize and improve operative treatment results and often result in new approaches. This depends on cooperation between technicians, therapists and physicians in a team, even in the scientific field. Evidence-based studies on the effectiveness of technical aids are currently still uncommon but recently some clear evidence for effectiveness could be shown. Scientifically this is a very varied field of work. The demographic development presents new requirements which must be dealt with. Technical solutions are often very promising especially in this field. Technical orthopedics remains an important component of the specialty of orthopedics and trauma surgery and with an increasing tendency due to more recent research and development.

  2. Orthopedic rehabilitation using the "Rutgers ankle" interface.

    PubMed

    Girone, M; Burdea, G; Bouzit, M; Popescu, V; Deutsch, J E

    2000-01-01

    A novel ankle rehabilitation device is being developed for home use, allowing remote monitoring by therapists. The system will allow patients to perform a variety of exercises while interacting with a virtual environment (VE). These game-like VEs created with WorldToolKit run on a host PC that controls the movement and output forces of the device via an RS232 connection. Patients will develop strength, flexibility, coordination, and balance as they interact with the VEs. The device will also perform diagnostic functions, measuring the ankle's range of motion, force exertion capabilities and coordination. The host PC transparently records patient progress for remote evaluation by therapists via our existing telerehabilitation system. The "Rutgers Ankle" Orthopedic Rehabilitation Interface uses double-acting pneumatic cylinders, linear potentiometers, and a 6 degree-of-freedom (DOF) force sensor. The controller contains a Pentium single-board computer and pneumatic control valves. Based on the Stewart platform, the device can move and supply forces and torques in 6 DOFs. A proof-of-concept trial conducted at the University of Medicine and Dentistry of New Jersey (UMDNJ) provided therapist and patient feedback. The system measured the range of motion and maximum force output of a group of four patients (male and female). Future medical trials are required to establish clinical efficacy in rehabilitation.

  3. Computer-assisted surgery in orthopedic oncology

    PubMed Central

    Gerbers, Jasper G; Stevens, Martin; Ploegmakers, Joris JW; Bulstra, Sjoerd K; Jutte, Paul C

    2014-01-01

    Background and purpose — In orthopedic oncology, computer-assisted surgery (CAS) can be considered an alternative to fluoroscopy and direct measurement for orientation, planning, and margin control. However, only small case series reporting specific applications have been published. We therefore describe possible applications of CAS and report preliminary results in 130 procedures. Patients and methods — We conducted a retrospective cohort study of all oncological CAS procedures in a single institution from November 2006 to March 2013. Mean follow-up time was 32 months. We categorized and analyzed 130 procedures for clinical parameters. The categories were image-based intralesional treatment, image-based resection, image-based resection and reconstruction, and imageless resection and reconstruction. Results — Application to intralesional treatment showed 1 inadequate curettage and 1 (other) recurrence in 63 cases. Image-based resections in 42 cases showed 40 R0 margins; 16 in 17 pelvic resections. Image-based reconstruction facilitated graft creation with a mean reconstruction accuracy of 0.9 mm in one case. Imageless CAS was helpful in resection planning and length- and joint line reconstruction for tumor prostheses. Interpretation — CAS is a promising new development. Preliminary results show a high number of R0 resections and low short-term recurrence rates for curettage. PMID:25140984

  4. Intraoperative Manipulation for Flexion Contracture During Total Knee Arthroplasty.

    PubMed

    Matsui, Yoshio; Minoda, Yukihide; Fumiaki, Inori; Nakagawa, Sigeru; Okajima, Yoshiaki; Kobayashi, Akio

    2016-11-01

    Joint gap balancing during total knee arthroplasty (TKA) is important for ensuring postoperative joint stability and range of motion. Although the joint gap should be balanced to ensure joint stability, it is not easy to achieve perfect balancing during TKA. In particular, relative extension gap shortening can induce flexion contracture. Intraoperative manipulation is often empirically performed. This study evaluated the tension required for this manipulation and investigated the influence of intraoperative manipulation on the joint gap in cadaveric knees. Total knee arthroplasty was performed in 6 cadaveric knees from whole body cadavers. Flexion contracture was induced using an insert that was 4 mm thicker than the extension gap, and intraoperative manipulation was performed. Study measurements included the changes in the joint gap after manipulation at 6 positions, with the knee bending from extension to 120° flexion, and the manipulation tension that was required to create a 4-mm increase in the gap. The manipulation tension needed to create a 4-mm increase in the extension gap was 303±17 N. The changes in the joint gap after manipulation were 0.4 mm, 0.6 mm, 0.2 mm, -0.2 mm, -0.4 mm, and -0.6 mm at 0°, 30°, 45°, 60°, 90°, and 120° flexion, respectively. Therefore, the joint gap was not significantly changed by the manipulation. Intraoperative manipulation does not resolve flexion contracture. Therefore, if flexion contracture occurs during TKA, treatment with additional bone cutting and soft tissue release is likely more appropriate than manipulation. [Orthopedics. 2016; 39(6):e1070-e1074.].

  5. The Current Perspectives of Stem Cell Therapy in Orthopedic Surgery

    PubMed Central

    Akpancar, Serkan; Tatar, Oner; Turgut, Hasan; Akyildiz, Faruk; Ekinci, Safak

    2016-01-01

    Context Musculoskeletal injuries may be painful, troublesome, life limiting and also one of the global health problems. There has been considerable amount of interest during the past two decades to stem cells and tissue engineering techniques in orthopedic surgery, especially to manage special and compulsive injuries within the musculoskeletal system. Evidence Acquisition The aim of this study was to present a literature review regarding the most recent progress in stem cell procedures and current indications in orthopedics clinical care practice. The Medline and PubMed library databases were searched for the articles related with stem cell procedures in the field of orthopedic surgery and additionally the reference list of each article was also included to provide a comprehensive evaluation. Results Various sources of stem cells have been studied for orthopedics clinical care practice. Stem cell therapy has successfully used for major orthopedic procedures in terms of bone-joint injuries (fractures-bone defects, nonunion, and spinal injuries), osteoarthritis-cartilage defects, ligament-tendon injuries, femoral head osteonecrosis and osteogenesis imperfecta. Stem cells have also used in bone tissue engineering in combining with the scaffolds and provided faster and better healing of tissues. Conclusions Large amounts of preclinical studies have been made of stem cells and there is an increasing interest to perform these studies within the human population but preclinical studies are insufficient; therefore, much more and efficient studies should be conducted to evaluate the efficacy and safety of stem cells. PMID:28144608

  6. Orthostetrics: Management of Orthopedic Conditions in the Pregnant Patient.

    PubMed

    Matthews, Leslie J; McConda, David B; Lalli, Trapper A J; Daffner, Scott D

    2015-10-01

    Managing orthopedic conditions in pregnant patients leads to challenges that must be carefully considered so that the safety of both the mother and the fetus is maintained. Both perioperative and intraoperative considerations must be made based on physiologic changes during pregnancy, risks of radiation, and recommendations for monitoring. Operative timing, imaging, and medication selection are also factors that may vary based on trimester and clinical scenario. Pregnancy introduces unique parameters that can result in undesirable outcomes for both mother and fetus if not handled appropriately. Ultimately, pregnant patients offer a distinct challenge to the orthopedic surgeon in that the well-being of 2 patients must be considered in all aspects of care. In addition, not only does pregnancy affect the management of orthopedic conditions but the pregnant state also causes physiologic changes that may actually induce various pathologies. These pregnancy-related orthopedic conditions can interfere with an otherwise healthy pregnancy and should be recognized as possible complications. Although the management of orthopedic conditions in pregnancy is often conservative, pregnancy does not necessarily preclude safely treating pathologies operatively. When surgery is considered, regional anesthesia provides less overall drug exposure to the fetus and less variability in fetal heart rate. Intraoperative fluoroscopy can be used when appropriate, with 360° fetal shielding if possible. Lateral decubitus positioning is ideal to prevent hypotension associated with compression of the inferior vena cava.

  7. The Economic Burden of Orthopedic Surgery Residency Interviews on Applicants

    PubMed Central

    Fogel, Harold A.; Finkler, Elissa S.; Wu, Karen; Schiff, Adam P.; Nystrom, Lukas M.

    2016-01-01

    Background The intense competition for orthopedic surgery residency positions influences the interview process. The financial impact on residency applicants is less well understood. The purpose of the present study was to define the economic burden of the orthopedic surgery residency interview process while additionally describing how applicants finance the expense. Methods We distributed surveys to 48 nonrotating applicants at our institution’s residency interview days for the 2015 match year. The survey consisted of eleven questions specific to the costs of interviewing for orthopedic surgery residency positions. Results The survey response rate was 90% (43/48). Applicants applied to a median of 65 orthopedic surgery residency programs (range 21-88) and targeted a median of 15 interviews (range 12-25). The mean cost estimate for a single interview was $450 (range $200-800) and the cost estimate for all interviews was $7,119 (range $2,500-15,000). Applicants spent a mean of $344 (range $0-750) traveling to our interview. Seventy-two percent borrowed money to finance their interview costs and 28% canceled interviews for financial reasons. Conclusions The financial cost of interviewing for orthopedic surgery is substantial and a majority of applicants add to their educational debt by taking out loans to finance interviews. Future considerations should be made to minimize these costs for an already financially burdened population. PMID:27528831

  8. The effects of maitland orthopedic manual therapy on improving constipation.

    PubMed

    Koo, Ja-Pung; Choi, Jung-Hyun; Kim, Nyeon-Jun

    2016-10-01

    [Purpose] This study aimed to examine the effects of interventions on constipation and to provide basic data for physical therapy in internal medicine. [Subjects and Methods] The colon transit times of 30 subjects were measured and after the interventions. Fifteen subjects were assigned to a Maitland orthopedic manual therapy group, and 15 subjects were assigned to a dietary fiber group. [Results] The analysis of changes in colon transit time showed statistically significant differences in left colon transit time, rectosigmoid colon transit time, and total colon transit time for the Maitland orthopedic manual therapy group and statistically significant differences in rectosigmoid colon transit time and total colon transit time for the dietary fiber group. An analysis of group differences in the effects of Maitland orthopedic manual therapy and dietary fiber showed that the Maitland orthopedic manual therapy group achieved statistically significantly larger declines in rectosigmoid colon transit time and total colon transit time compared with the dietary fiber group. [Conclusion] This study confirmed that Maitland orthopedic manual therapy can be an effective treatment method for internal conditions such as functional constipation by almost normalizing the colon transit time, not only by improving the symptoms of constipation but also by facilitating intestinal movements.

  9. Desktop teleradiology in support of rural orthopedic trauma care.

    PubMed Central

    Reid, J. G.; McGowan, J. J.; Ricci, M. A.; McFarlane, G.

    1997-01-01

    Research has shown that diagnostic quality images for most teleradiology applications requires a sophisticated telemedicine system and access to a large amount of bandwidth. While the ideal standards have been set by those involved in evaluating teleradiology, these standards are impractical for many small rural health centers which deliver routine trauma care. While there is no disagreement about the ultimate need for this level of teleradiology support, the purpose of this research was to determine whether Orthopedists would be able to read plain radiographs of orthopedic trauma injuries using a desktop teleradiology system in support of rural trauma care. METHOD: Two radiology residents and two orthopedic residents viewed forty radiographs, twenty through a desktop teleradiology system and twenty in person. Diagnostic findings and certainty of diagnosis were recorded. FINDINGS: There was no statistically significant difference between modalities in orthopedic residents' ability to correctly diagnose orthopedic trauma injuries. Further, for those instances when the diagnosis was imprecise, the residents were aware of their inability to make an accurate diagnosis. CONCLUSION: Although the study was relatively limited and further research needs to be done, the use of desktop teleradiology in support of rural orthopedic trauma consultation is a promising alternative to the more expensive forms of telemedicine technology. PMID:9357657

  10. The effects of maitland orthopedic manual therapy on improving constipation

    PubMed Central

    Koo, Ja-Pung; Choi, Jung-Hyun; Kim, Nyeon-Jun

    2016-01-01

    [Purpose] This study aimed to examine the effects of interventions on constipation and to provide basic data for physical therapy in internal medicine. [Subjects and Methods] The colon transit times of 30 subjects were measured and after the interventions. Fifteen subjects were assigned to a Maitland orthopedic manual therapy group, and 15 subjects were assigned to a dietary fiber group. [Results] The analysis of changes in colon transit time showed statistically significant differences in left colon transit time, rectosigmoid colon transit time, and total colon transit time for the Maitland orthopedic manual therapy group and statistically significant differences in rectosigmoid colon transit time and total colon transit time for the dietary fiber group. An analysis of group differences in the effects of Maitland orthopedic manual therapy and dietary fiber showed that the Maitland orthopedic manual therapy group achieved statistically significantly larger declines in rectosigmoid colon transit time and total colon transit time compared with the dietary fiber group. [Conclusion] This study confirmed that Maitland orthopedic manual therapy can be an effective treatment method for internal conditions such as functional constipation by almost normalizing the colon transit time, not only by improving the symptoms of constipation but also by facilitating intestinal movements. PMID:27821950

  11. Progress in nonprehensile manipulation

    SciTech Connect

    Mason, M.T.

    1999-11-01

    This paper reviews my recent research in robotic manipulation and speculates on potentially fruitful directions for future work. My recent work is focused on nonprehensile manipulation: manipulating objects without grasping them. In particular, the paper surveys work on a single joint robot that orients parts on a conveyor belt; a robot that uses dynamics to snatch, roll, or throw objects; hitting things to position them; manipulating things whose shapes are not completely known; and integration of manipulation with locomotion. In the future, a broad view of robotics will allow us to focus on fundamental principles and at the same time address a variety of new applications.

  12. Homo quintadus, computers and ROOMS (repetitive ocular orthopedic motion stress).

    PubMed

    Grant, A H

    1990-04-01

    Inherent conflict exists between computer systems and ocular physiology of Homo quintadus. Adverse ocular side effects of excessive saccades, excyclotorsion, supraduction, excessive field-of-fixation usage, capitas extension, astigmatic changes, otostatic reflex mismatching, and needless orthopedic malfunctions are imposed upon computer operators. Although the orthopedic dysfunctions are commonly grouped under the heading of Repetitive Strain Injuries (RSI), the inextricable linkage to poor ocular-neurological function argues for postulation of a broader schema entitled Repetitive Ocular Orthopedic Motion Stress (ROOMS). Concepts of good tool usage, total tactile familiarity, total proprioceptive familiarity, and visual cone-of-comfort clash with the installed-equipment base and indicate need for an integrated computer work station to facilitate near covisualization of screen/keyboard and to afford freedom-of-choice for optimal hand/eye synchronicity. The advocacy of computer operators' needs by user-welfare groups, universities, labor unions, and government agencies are portents for achieving genuine improvements.

  13. Computer assisted outcomes research in orthopedics: total joint replacement.

    PubMed

    Arslanian, C; Bond, M

    1999-06-01

    Long-term studies are needed to determine clinically relevant outcomes within the practice of orthopedic surgery. Historically, the patient's subjective feelings of quality of life have been largely ignored. However, there has been a strong movement toward measuring perceived quality of life through such instruments as the SF-36. In a large database from an orthopedic practice results are presented. First, computerized data entry using touch screen technology is not only cost effective but user friendly. Second, patients undergoing hip or knee arthroplasty surgeries make statistically significant improvements in seven of the eight domains of the SF-36 in the first 3 months after surgery. Additional statistically significant improvements over the next 6 to 12 months are also seen. The data are presented here in detail to demonstrate the benefits of a patient outcomes program, to enhance the understanding and use of outcomes data and to encourage further work in outcomes measurement in orthopedics.

  14. Orthopedic Manifestations of Mobius Syndrome: Case Series and Survey Study

    PubMed Central

    McClure, Philip; Booy, David; Katarincic, Julia; Eberson, Craig

    2016-01-01

    Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively. Poland's Syndrome was present in 17% and 30%. In addition to these findings, 27% of patients reported having difficulty with anesthesia, including difficulty in intubation and airway problems. Conclusion. An increased prevalence of scoliosis, clubfoot, transverse limb deficiencies, and Poland's Syndrome is identified in the setting of Mobius Syndrome. In the setting of several deformities often requiring surgical correction, a high incidence of anesthetic difficulty is noted and should be discussed with patients and other providers during surgical planning. PMID:26977161

  15. Applications of Metal Additive Manufacturing in Veterinary Orthopedic Surgery

    NASA Astrophysics Data System (ADS)

    Harrysson, Ola L. A.; Marcellin-Little, Denis J.; Horn, Timothy J.

    2015-03-01

    Veterinary medicine has undergone a rapid increase in specialization over the last three decades. Veterinarians now routinely perform joint replacement, neurosurgery, limb-sparing surgery, interventional radiology, radiation therapy, and other complex medical procedures. Many procedures involve advanced imaging and surgical planning. Evidence-based medicine has also become part of the modus operandi of veterinary clinicians. Modeling and additive manufacturing can provide individualized or customized therapeutic solutions to support the management of companion animals with complex medical problems. The use of metal additive manufacturing is increasing in veterinary orthopedic surgery. This review describes and discusses current and potential applications of metal additive manufacturing in veterinary orthopedic surgery.

  16. The practicing orthopedic surgeon's guide to managing long bone metastases.

    PubMed

    Cheung, Felix H

    2014-01-01

    Long bone skeletal metastases are common in the United States, with more than 280,000 new cases every year. Most of these will be managed by the on-call orthopedic surgeon. A practical primer is offered for the evaluation and surgical management for the practicing orthopedist, including questions to ask during the history, pertinent physical examination findings, appropriate imaging requests, proper laboratory work, and biopsy options. Finally, 7 scenarios are presented to encompass most situations a practicing orthopedic surgeon will encounter, and guidelines for treatment and referral are offered.

  17. Nanomedicine applications in orthopedic medicine: state of the art

    PubMed Central

    Mazaheri, Mozhdeh; Eslahi, Niloofar; Ordikhani, Farideh; Tamjid, Elnaz; Simchi, Abdolreza

    2015-01-01

    The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges. PMID:26451110

  18. Nanomedicine applications in orthopedic medicine: state of the art.

    PubMed

    Mazaheri, Mozhdeh; Eslahi, Niloofar; Ordikhani, Farideh; Tamjid, Elnaz; Simchi, Abdolreza

    2015-01-01

    The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges.

  19. Novel nanostructured hydroxyapatite coating for dental and orthopedic implants

    NASA Astrophysics Data System (ADS)

    Liu, Huinan; Jiang, Wenping; Malshe, Ajay

    2009-09-01

    A novel hybrid coating process, combining NanoSpray® (built on electrostatic spray coating) technology with microwave sintering process, was developed for synthesizing hydroxyapatite- (HA-) based nanostructured coating with favorable properties for dental and orthopedic implants. Specifically, HA nanoparticles were deposited on commercially pure titanium substrates using NanoSpray technique to produce the HA coating, which was then sintered in a microwave furnace under controlled conditions. The study showed that the use of NanoSpray followed by microwave sintering results in nanoscale HA coating for dental/orthopedic application.

  20. Orthopedic conditions of small ruminants. Llama, sheep, goat, and deer.

    PubMed

    Kaneps, A J

    1996-03-01

    Diagnosis and treatment of diseases of the foot, infectious arthritis, angular limb deformities, patellar luxation, tendon contracture and injuries, and fractures encountered in sheep, goats, llamas, and deer are reviewed. These species share similar orthopedic problems to cattle, but management conditions, particularly for pet animals, may place special demands on the veterinarian treating these disease conditions. The mild temperament and relatively small body size of these animals make them excellent candidates for treatment of orthopedic problems often not amenable to practical treatment in larger or more fractious animals.

  1. Giant optical manipulation.

    PubMed

    Shvedov, Vladlen G; Rode, Andrei V; Izdebskaya, Yana V; Desyatnikov, Anton S; Krolikowski, Wieslaw; Kivshar, Yuri S

    2010-09-10

    We demonstrate a new principle of optical trapping and manipulation increasing more than 1000 times the manipulation distance by harnessing strong thermal forces while suppressing their stochastic nature with optical vortex beams. Our approach expands optical manipulation of particles into a gas media and provides a full control over trapped particles, including the optical transport and pinpoint positioning of ∼100  μm objects over a meter-scale distance with ±10  μm accuracy.

  2. Microfluidics for manipulating cells.

    PubMed

    Mu, Xuan; Zheng, Wenfu; Sun, Jiashu; Zhang, Wei; Jiang, Xingyu

    2013-01-14

    Microfluidics, a toolbox comprising methods for precise manipulation of fluids at small length scales (micrometers to millimeters), has become useful for manipulating cells. Its uses range from dynamic management of cellular interactions to high-throughput screening of cells, and to precise analysis of chemical contents in single cells. Microfluidics demonstrates a completely new perspective and an excellent practical way to manipulate cells for solving various needs in biology and medicine. This review introduces and comments on recent achievements and challenges of using microfluidics to manipulate and analyze cells. It is believed that microfluidics will assume an even greater role in the mechanistic understanding of cell biology and, eventually, in clinical applications.

  3. Manipulator mounted transfer platform

    DOEpatents

    Dobbins, James C.; Hoover, Mark A.; May, Kay W.; Ross, Maurice J.

    1990-01-01

    A transfer platform for the conveyance of objects by a manipulator includes a bed frame and saddle clamp secured along an edge of the bed frame and adapted so as to secure the bed frame to a horizontal crosspiece of the manipulator. The platform may thus move with the manipulator in a reciprocal linear path defined by a guide rail. A bed insert may be provided for the support of conveyed objects and a lifting bail may be provided to permit the manipulator arm to install the bed frame upon the crosspiece under remote control.

  4. 21 CFR 888.5850 - Nonpowered orthopedic traction apparatus and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nonpowered orthopedic traction apparatus and accessories. 888.5850 Section 888.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... orthopedic traction apparatus and accessories. (a) Identification. A nonpowered orthopedic traction...

  5. 21 CFR 888.5850 - Nonpowered orthopedic traction apparatus and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonpowered orthopedic traction apparatus and accessories. 888.5850 Section 888.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... orthopedic traction apparatus and accessories. (a) Identification. A nonpowered orthopedic traction...

  6. The Special Orthopedic Hospital—Past and Present

    PubMed Central

    Platt, Harry

    1964-01-01

    Pioneer orthopedic institutions established in Europe in the late 18th and early 19th centuries, and in the U.S.A. in the second half of the 19th and the first decade of the 20th century, can trace their ancestry in ideas back to the practice and teachings of Hippocrates. Experience in treatment of great numbers of injured soldiers in the First World War opened a new era in reconstructive surgery of the locomotor system. After the Second World War, in advanced nations the pattern of crippling diseases showed a spectacular change. Problems that justify the existence of large special orthopedic hospitals are, in children, the more complex congenital deformities, cerebral palsies, and the increasing number of injuries due to hazards of modern life; in the adult, the reconstructive surgery of trauma and of arthritis. In modern orthopedic hospitals physicians have joined orthopedic surgeons in the study of the natural history of the various forms of arthritis. These centres provide facilities for biomechanical research and postgraduate training which acute general hospitals cannot offer. PMID:14228224

  7. Looking at the Social Activity for Adolescents with Orthopedic Impairments

    ERIC Educational Resources Information Center

    Biastro, Leslie; Frank, Heather; Larwin, Karen H.

    2015-01-01

    Adolescents with identified orthopedic impairments are often less likely to participate in social activities outside of the school setting. However, the adolescents who are able to participate in activities have higher social skills, more academic successes, and show more satisfaction in their roles as family member or friend. The aim of this…

  8. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... affect a child's learning. An orthopedic impairment involves muscles, bones, or joints and...

  9. 45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....12 Section 1308.12 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... affect a child's learning. An orthopedic impairment involves muscles, bones, or joints and...

  10. Higher Education and Students with Orthopedic Disabilities: A Survey Instrument.

    ERIC Educational Resources Information Center

    Singh, Delar K.

    A survey instrument is presented that was used in a national survey of 160 colleges and universities to explore facilities and services to students with orthopedic disabilities. The survey contains 33 items that focus on the following areas: structural accessibility, academic accessibility, dorm-living, and recreational opportunities. The total…

  11. Outpatient parenteral antimicrobial therapy for orthopedic infections - a successful public healthcare experience in Brazil.

    PubMed

    Oliveira, Priscila Rosalba; Felix, Cassia da Silva; Carvalho, Vladimir Cordeiro de; Giovani, Arlete Mazzini; Reis, Rosangela Suarti Dos; Beraldo, Marisa; Albuquerque, Edmir Peralta; Ferreira, Walter Cintra; Silva, Jorge Dos Santos; Lima, Ana Lucia Lei

    2016-01-01

    Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions

  12. Actuability of Underactuated Manipulators

    DTIC Science & Technology

    1994-06-01

    of a manipulator with passive joints in operational space. IEEE Transactions on Robotics and Automation, 9(1), February 1993. [6] !irohiko Arai and...Susumu Tachi Position control of a manipulator with passive joints using dynamic coupling. IEEE Transactions on Robotics and Automation, 7(4), August

  13. Linearization of Robot Manipulators

    NASA Technical Reports Server (NTRS)

    Kreutz, Kenneth

    1987-01-01

    Four nonlinear control schemes equivalent. Report discusses theory of nonlinear feedback control of robot manipulator, emphasis on control schemes making manipulator input and output behave like decoupled linear system. Approach, called "exact external linearization," contributes efforts to control end-effector trajectories, positions, and orientations.

  14. Mainstreaming Preschoolers: Children with Orthopedic Handicaps. A Guide for Teachers, Parents, and Others Who Work with Orthopedically Handicapped Preschoolers.

    ERIC Educational Resources Information Center

    Kieran, Shari Stokes; And Others

    This guide to mainstreaming preschoolers with orthopedic handicaps is one of a series of eight manuals on mainstreaming preschoolers developed by Project Head Start. The guide is addressed to parents, teachers, and other professionals and paraprofessionals. Chapter I presents information on the meaning, benefits and implementation of…

  15. Manipulator comparative testing program

    SciTech Connect

    Draper, J.V.; Handel, S.J.; Sundstrom, E.; Herndon, J.N.; Fujita, Y.; Maeda, M.

    1986-01-01

    The Manipulator Comparative Testing Program examined differences among manipulator systems from the United States and Japan. The manipulator systems included the Meidensha BILARM 83A, the Model M-2 of Central Research Laboratories Division of Sargent Industries (CRL), and the GCA Corporation PaR Systems Model 6000. The site of testing was the Remote Operations Maintenance Demonstration (ROMD) facility, operated by the Fuel Recycle Division in the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory (ORNL). In all stages of testing, operators using the CRL Model M-2 manipulator had consistently lower times to completion and error rates than they did using other machines. Performance was second best with the Meidensha BILARM 83A in master-slave mode. Performance with the BILARM in switchbox mode and the PaR 6000 manipulator was approximately equivalent in terms of criteria recorded in testing. These data show no impact of force reflection on task performance.

  16. Cell manipulation in microfluidics.

    PubMed

    Yun, Hoyoung; Kim, Kisoo; Lee, Won Gu

    2013-06-01

    Recent advances in the lab-on-a-chip field in association with nano/microfluidics have been made for new applications and functionalities to the fields of molecular biology, genetic analysis and proteomics, enabling the expansion of the cell biology field. Specifically, microfluidics has provided promising tools for enhancing cell biological research, since it has the ability to precisely control the cellular environment, to easily mimic heterogeneous cellular environment by multiplexing, and to analyze sub-cellular information by high-contents screening assays at the single-cell level. Various cell manipulation techniques in microfluidics have been developed in accordance with specific objectives and applications. In this review, we examine the latest achievements of cell manipulation techniques in microfluidics by categorizing externally applied forces for manipulation: (i) optical, (ii) magnetic, (iii) electrical, (iv) mechanical and (v) other manipulations. We furthermore focus on history where the manipulation techniques originate and also discuss future perspectives with key examples where available.

  17. Osteopathic Manipulative Treatment

    PubMed Central

    Campbell, Shannon M.; Walkowski, Stevan

    2012-01-01

    Dermatological diseases, such as dysesthesia syndromes, stasis dermatoses, and hyperhidrosis are difficult to treat due to their complex etiologies. Current theories suggest these diseases are caused by physiological imbalances, such as nerve impingement, localized tissue congestion, and impaired autonomic regulation. Osteopathic manipulative therapy targets these physiological dysfunctions and may serve as a beneficial therapeutic option. Osteopathic manipulative therapy techniques include high velocity low amplitude, muscle energy, counterstrain, myofascial release, craniosacral, and lymphatic drainage. An osteopathic manipulative therapy technique is chosen based on its physiological target for a particular disease. Osteopathic manipulative therapy may be useful alone or in combination with standard therapeutic options. However, due to the lack of standardized trials supporting the efficacy of osteopathic manipulative therapy treatment for dermatological disease, randomized, well-controlled studies are necessary to confirm its therapeutic value. PMID:23125887

  18. Anthropomorphic Remote Manipulator

    NASA Technical Reports Server (NTRS)

    Jau, Bruno M.

    1991-01-01

    Two-armed telerobot undergoing development manipulates objects with dexterity approaching that of human. Designed to be remotely operated by human. Operator wears harness with exoskeletonlike sleeves and gloves; remote manipulator follows operator's arm, hand, and finger movements and feeds back position and force information so operator has sense of manipulating object held by telerobot. Developed for use in outer space. Suited for such terrestrial uses as handling materials and maintaining equipment in hazardous environments where mechanical dexterity and nearly instantaneous feedback of sensory information needed.

  19. Update: Biochemistry of Genetic Manipulation.

    ERIC Educational Resources Information Center

    Barker, G. R.

    1983-01-01

    Various topics on the biochemistry of genetic manipulation are discussed. These include genetic transformation and DNA; genetic expression; DNA replication, repair, and mutation; technology of genetic manipulation; and applications of genetic manipulation. Other techniques employed are also considered. (JN)

  20. Hepatitis C virus infection: knowledge in the orthopedic community.

    PubMed

    Flowerdew, J M; McGrory, B J

    2000-04-01

    A survey with 14 questions pertaining to the natural history, infectiveness, and diagnosis and treatment of hepatitis C viral infection was given to all practicing orthopedic surgeons in Portland, Maine. Possible responses were "true," "false," or "don't know" to the 14 statements. A question regarding any interest in learning more about the hepatitis C virus was also posed. Most (82%, 23/28) surgeons completed the questionnaire. A total of 72% of the responses were either wrong or marked "don't know"; most (83%) of the respondents wanted to know more about the infection about hepatitis C viral infection. Not only are orthopedic surgeons at risk for exposure to this virus, but also they are often the first to notify a patient of a positive result after routine hepatitis C testing of autologous predonated blood. Education programs and journal reviews should be directed toward this goal.

  1. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective

    PubMed Central

    Zheng, Guoyan; Nolte, Lutz P.

    2015-01-01

    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined. PMID:26779486

  2. Radiation exposure from fluoroscopy during orthopedic surgical procedures

    SciTech Connect

    Riley, S.A. )

    1989-11-01

    The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of this study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.

  3. Computer-Assisted Orthopedic Surgery: Current State and Future Perspective.

    PubMed

    Zheng, Guoyan; Nolte, Lutz P

    2015-01-01

    Introduced about two decades ago, computer-assisted orthopedic surgery (CAOS) has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

  4. Potential utility of liposome bupivacaine in orthopedic surgery.

    PubMed

    Lonner, Jess H; Scuderi, Giles R; Lieberman, Jay R

    2015-03-01

    Management of postsurgical analgesia is an important consideration in orthopedic procedures, including joint arthroplasty. Inadequate postsurgical analgesia is associated with increased hospital length of stay, delayed ambulation, and reduced exercise capacity. In this article, we review the potential contribution of a prolonged-release liposomal formulation of bupivacaine as part of a multimodal analgesic regimen after orthopedic surgery. Controlled studies across multiple surgical settings have demonstrated that, compared with placebo and bupivacaine HCl, liposome bupivacaine in a single administration provides postsurgical analgesia for up to 72 hours, delays use of rescue medication, and reduces postsurgical opioid consumption. Liposome bupivacaine has been well tolerated in clinical studies and has had a low rate of treatment-related adverse events. To date, there has been no signal of cardiac toxicity, chondrolysis, or delayed wound healing associated with liposome bupivacaine.

  5. Dielectrophoresis for Bioparticle Manipulation

    PubMed Central

    Qian, Cheng; Huang, Haibo; Chen, Liguo; Li, Xiangpeng; Ge, Zunbiao; Chen, Tao; Yang, Zhan; Sun, Lining

    2014-01-01

    As an ideal method to manipulate biological particles, the dielectrophoresis (DEP) technique has been widely used in clinical diagnosis, disease treatment, drug development, immunoassays, cell sorting, etc. This review summarizes the research in the field of bioparticle manipulation based on DEP techniques. Firstly, the basic principle of DEP and its classical theories are introduced in brief; Secondly, a detailed introduction on the DEP technique used for bioparticle manipulation is presented, in which the applications are classified into five fields: capturing bioparticles to specific regions, focusing bioparticles in the sample, characterizing biomolecular interaction and detecting microorganism, pairing cells for electrofusion and separating different kinds of bioparticles; Thirdly, the effect of DEP on bioparticle viability is analyzed; Finally, the DEP techniques are summarized and future trends in bioparticle manipulation are suggested. PMID:25310652

  6. Remote manipulator dynamic simulation

    NASA Technical Reports Server (NTRS)

    Wild, E. C.; Donges, P. K.; Garand, W. A.

    1972-01-01

    A simulator to generate the real time visual scenes required to perform man in the loop investigations of remote manipulator application and design concepts for the space shuttle is described. The simulated remote manipulator consists of a computed display system that uses a digital computer, the electronic scene generator, an operator's station, and associated interface hardware. A description of the capabilities of the implemented simulation is presented. The mathematical models and programs developed for the simulation are included.

  7. Mending injured athletes: a track record of orthopedic advances.

    PubMed

    Schnirring, Lisa

    2003-09-01

    Physicians have long been closely allied with competitive sports. In 157 AD, Galen served as a physician to Greek gladiators.(1) Severe musculoskeletal trauma certainly shortened the careers of ancient pugilists who survived their matches. However, modern gladiators-from pick-up basketball players to football professionals-often get to "play another day" because of advances in orthopedic surgery, particularly those of the last 30 years.

  8. Business and Practice Management Knowledge Deficiencies in Graduating Orthopedic Residents.

    PubMed

    Miller, D Joshua; Throckmorton, Thomas W; Azar, Frederick M; Beaty, James H; Canale, S Terry; Richardson, David R

    2015-10-01

    We conducted a study to determine the general level of knowledge that orthopedic residents have on business and practice management topics at graduation and to evaluate the level of knowledge that practicing orthopedic surgeons need in order to function effectively in a medical practice. Residency graduates from a single training program were asked to complete a survey that gathered demographic information and had surgeons rate their understanding of 9 general business and practice management skills and the importance of these skills in their current practice situation. The amount of necessary business knowledge they lacked at graduation was defined as a functional knowledge deficiency (FKD) and was calculated as the difference between the reported importance of a topic in current practice and the level of understanding of that topic at graduation (larger FKD indicates greater deficiency). Those in physician-managed practices reported significantly higher levels of understanding of economic analytical tools than those in nonphysician-managed practices. There were no other statistically significant differences among groups. Hospital-employed physicians had the lowest overall FKD (4.0), followed by those in academic practices (5.1) and private practices (5.9). Graduating orthopedic surgeons appear to be inadequately prepared to effectively manage business issues in their practices, as evidenced by the low overall knowledge levels and high FKDs.

  9. Variability in Trauma Case Volume in Orthopedic Surgery Residents

    PubMed Central

    Blood, Travis D.; Gil, Joseph A.; Born, Christopher T.; Daniels, Alan H.

    2017-01-01

    Orthopedic trauma surgery is a critical component of resident education. Surgical case logs obtained from the Accreditation Council of Graduate Medical Students from 2009 to 2013 for orthopedic surgery residents were examined for variability between the 90th and 10th percentiles in regards to the volume of cases performed. There was an upward trend in the mean number of cases performed by senior residents from 484.4 in 2009 to 534.5 in 2013, representing a 10.3% increase. There was a statistically significant increase in the number of cases performed for humerus/elbow, forearm/wrist, and pelvis/hip during this period (P<0.05). Although the difference between the 10th and 90th percentile case volumes narrowed over the study period, the difference between these groups remained significant in 2013 (P=0.02). In 2013, all categories of trauma cases had a greater than 2.2-fold difference between the 10th and 90th percentile of residents for numbers of trauma cases performed. Although case volume is not the sole determinant of residency education and competency, evidence suggests that case volume plays a crucial role in surgeon confidence and efficiency in performing surgery. Further studies are needed to better understand the effect of this variability seen among residents performing orthopedic trauma surgery. PMID:28286621

  10. Overview of ultrasound usage trends in orthopedic and sports physiotherapy

    PubMed Central

    2012-01-01

    Background The purpose of this study is to examine current beliefs about the use, the clinical importance, the theoretical fundamentals and the utilization criteria of therapeutic ultrasound (TUS) among physical therapists on the clinical practice in orthopedic and sports physiotherapy in Brazil. Methods A brief survey was developed based on previous studies and was sent to 55 physical therapists with advanced competency in orthopedics and sports physiotherapy. The questions addressed general topics about the professional profile and ultrasound usage and dosage. Results Our data show the wide availability and frequent use of TUS in this sample of physical therapists. TUS is used in distinct musculoskeletal injuries and/or disorders in both acute and chronic conditions. Muscles, tendons and ligaments represented the major structures where TUS is used. Questions on the basic theory of TUS demonstrated a lack of knowledge of the ultrasound physiological effects as well as its interaction with biological tissues and TUS absolute contraindication. Conclusion A Brazilian profile about the US usage and dosage in orthopedic and sports physiotherapy is presented and highlights the need for a continuous upgrading process and further research into its effects. PMID:22871050

  11. Orthopedic cellular therapy: An overview with focus on clinical trials

    PubMed Central

    Noh, Moon Jong; Lee, Kwan Hee

    2015-01-01

    In this editorial, the authors tried to evaluate the present state of cellular therapy in orthopedic field. The topics the authors try to cover include not only the clinical trials but the various research areas as well. Both the target diseases for cellular therapy and the target cells were reviewed. New methods to activate the cells were interesting to review. Most advanced clinical trials were also included because several of them have advanced to phase III clinical trials. In the orthopedic field, there are many diseases with a definite treatment gap at this time. Because cellular therapies can regenerate damaged tissues, there is a possibility for cellular therapies to become disease modifying drugs. It is not clear whether cellular therapies will become the standard of care in any of the orthopedic disorders, however the amount of research being performed and the number of clinical trials that are on-going make the authors believe that cellular therapies will become important treatment modalities within several years. PMID:26601056

  12. [What do orthopedic surgeons need to know from radiologists?].

    PubMed

    Portabella, F; Pablos, O; Agulló, J L

    2012-09-01

    The diagnosis of tumors and pseudotumors depends on three pillars: the clinician, the radiologist, and the pathologist. The first two can establish a presumptive diagnosis on the basis of the clinical presentation and findings on complementary tests, whereas the pathologist will have to reach the definitive diagnosis after analyzing the biopsy specimens. Obviously, the clinician and radiologist should reach a consensus regarding the diagnostic orientation; however, for this to happen there must be a relationship between the two professionals and they must work together for the benefit of the patient. Orthopedic surgeons, like any other group of specialists, would like to have radiologists working in their own center who are dedicated to the organ/system they treat, in this case the locomotor apparatus, and who can provide them with their opinion about the different images obtained. This point is very important and especially so for tumors, because this type of disease is uncommon and few specialists are dedicated to it. For this reason, when faced with a lesion that has the characteristics of a tumor, orthopedic surgeons would like radiologists to give the most accurate description of the images as possible, defining the characteristics of benignity or malignancy of the process as well as indicating the risk of fracture in a metastatic lesion. On the other hand, orthopedic surgeons would ask for a clear and comprehensible description of the images obtained in complementary tests, because orthopedic surgeons have less experience in this type of images and they are often difficult to interpret. Another aspect that is often mentioned in discussions among orthopedic surgeons is the importance of having a radiology department that performs interventional procedures. Radiologists that perform interventional procedures can facilitate our work very much, both in the diagnosis and in the treatment of certain bone tumors. Finally, we would like to stress the importance of

  13. Micro manipulator motion control to counteract macro manipulator structural vibrations

    SciTech Connect

    Lew, J.Y.; Trudnowski, D.J.; Evans, M.S.; Bennett, D.W.

    1995-02-01

    Inertial force damping control by micro manipulator modulation is proposed to suppress the vibrations of a micro/macro manipulator system. The proposed controller, developed using classical control theory, is added to the existing control system. The proposed controller uses real-time measurements of macro manipulator flexibility to adjust the motion of the micro manipulator to counteract structural vibrations. Experimental studies using an existing micro/macro flexible link manipulator testbed demonstrate the effectiveness of the proposed approach to suppression of vibrations in the macro/micro manipulator system using micro-manipulator-based inertial active damping control.

  14. Manipulator comparative testing program

    SciTech Connect

    Draper, J.V.; Handel, S.J.; Sundstrom, E.; Herndon, J.N.; Fujita, Y.; Maida, M.

    1986-01-01

    The Manipulator Comparative Testing Program compared performance of selected manipulator systems under typical remote handling conditions. The site of testing was the Remote Operations and Maintenance Demonstration Facility operated by the Consolidated Fuel Reprocessing Program of the Oak Ridge National Laboratory. Three experiment examined differences among manipulator systems from the US and Japan. The manipulator systems included the Meidensha BILARM 83A, Central Research Laboratories' (CRL's) Model M-2, and GCA PaR systems Model 6000. Six manipulator and control mode combinations were evaluated: (a) the BILARM in master-slave mode without force reflection; (b) the BILARM in master-slave mode with force reflection; (c) the Model M-2 in master-slave mode without force reflection; (d) the Model M-2 in master-slave mode with force reflection; (e) the BILARM with switchbox controls; and (f) the PaR 6000 with switchbox controls. The experiments also examined differences between master-slave systems with and without force reflections, and differences between master-slave systems and switchbox-controlled systems.

  15. Simulation of robot manipulators

    SciTech Connect

    Kress, R.L.; Babcock, S.M.; Bills, K.C.; Kwon, D.S.; Schoenwald, D.A.

    1995-03-01

    This paper describes Oak Ridge National Laboratory`s development of an environment for the simulation of robotic manipulators. Simulation includes the modeling of kinematics, dynamics, sensors, actuators, control systems, operators, and environments. Models will be used for manipulator design, proposal evaluation, control system design and analysis, graphical preview of proposed motions, safety system development, and training. Of particular interest is the development of models for robotic manipulators having at least one flexible link. As a first application, models have been developed for the Pacific Northwest Laboratories` Flexible Beam Testbed which is a one-Degree-Of-Freedom, flexible arm with a hydraulic base actuator. Initial results show good agreement between model and experiment.

  16. Model based manipulator control

    NASA Technical Reports Server (NTRS)

    Petrosky, Lyman J.; Oppenheim, Irving J.

    1989-01-01

    The feasibility of using model based control (MBC) for robotic manipulators was investigated. A double inverted pendulum system was constructed as the experimental system for a general study of dynamically stable manipulation. The original interest in dynamically stable systems was driven by the objective of high vertical reach (balancing), and the planning of inertially favorable trajectories for force and payload demands. The model-based control approach is described and the results of experimental tests are summarized. Results directly demonstrate that MBC can provide stable control at all speeds of operation and support operations requiring dynamic stability such as balancing. The application of MBC to systems with flexible links is also discussed.

  17. ELECTRONIC MASTER SLAVE MANIPULATOR

    DOEpatents

    Goertz, R.C.; Thompson, Wm.M.; Olsen, R.A.

    1958-08-01

    A remote control manipulator is described in which the master and slave arms are electrically connected to produce the desired motions. A response signal is provided in the master unit in order that the operator may sense a feel of the object and may not thereby exert such pressures that would ordinarily damage delicate objects. This apparatus will permit the manipulation of objects at a great distance, that may be viewed over a closed TV circuit, thereby permitting a remote operator to carry out operations in an extremely dangerous area with complete safety.

  18. Trends in the orthopedic job market and the importance of fellowship subspecialty training.

    PubMed

    Morrell, Nathan T; Mercer, Deana M; Moneim, Moheb S

    2012-04-01

    Previous studies have examined possible incentives for pursuing orthopedic fellowship training, but we are unaware of previously published studies reporting the trends in the orthopedic job market since the acceptance of certain criteria for fellowship programs by the Accreditation Council for Graduate Medical Education (ACGME) in 1985. We hypothesized that, since the initiation of accredited postresidency fellowship programs, job opportunities for fellowship-trained orthopedic surgeons have increased and job opportunities for nonfellowship-trained orthopedic surgeons have decreased. We reviewed the job advertisements printed in the Journal of Bone and Joint Surgery, American Volume, for the years 1984, 1994, 2004, and 2009. We categorized the job opportunities as available for either a general (nonfellowship-trained) orthopedic surgeon or a fellowship-trained orthopedic surgeon. Based on the advertisements posted in the Journal of Bone and Joint Surgery, American Volume, a trend exists in the orthopedic job market toward seeking fellowship-trained orthopedic surgeons. In the years 1984, 1994, 2004, and 2009, the percentage of job opportunities seeking fellowship-trained orthopedic surgeons was 16.7% (95% confidence interval [CI], 13.1%-20.3%), 40.6% (95% CI, 38.1%-43.1%), 52.2% (95% CI, 48.5%-55.9%), and 68.2% (95% CI, 65.0%-71.4%), respectively. These differences were statistically significant (analysis of variance, P<.05). Fellowship training is thus a worthwhile endeavor.

  19. The 50 Most Cited Articles in Orthopedic Cartilage Surgery

    PubMed Central

    Arshi, Armin; Siesener, Nathan J.; McAllister, David R.; Williams, Riley J.; Sherman, Seth L.; Jones, Kristofer J.

    2015-01-01

    Objective To determine the 50 most cited articles in orthopedic cartilage surgery and their characteristics. Design A systematic review of the Science Citation Index Expanded was performed for articles related to cartilage surgery published in the 66 journals under the category “Orthopedics.” The 50 most cited articles were determined, and the following characteristics were analyzed for each article: authors, journal and year of publication, number of citations, geographic origin, article type (basic science or clinical), article subtype by study design, and level of evidence. Citation density (total number of citations/years since publication) was also computed. Results The 50 most cited articles ranged from 989 to 172 citations, with citation density ranging from 71.5 to 4.1. The publication years spanned from 1968 to 2008, with the 2000s accounting for half (25) of the articles and the highest mean citation density (14.6). The 50 most cited articles were published in 11 journals. The majority of the articles (29) were clinical, with level IV representing the most common level of evidence (10). The remaining basic science articles were most commonly animal in vivo studies (14). Stronger level of evidence was correlated with overall number of citations (P = 0.044), citation density (P < 0.001), and year of publication (P = 0.003). Conclusions Articles with stronger levels of evidence are more highly cited, with an increasing trend as evidence-based practice has been emphasized. This article list provides clinicians, researchers, and trainees with a group of “citation classics” in orthopedic cartilage surgery. PMID:27375839

  20. Minocycline-Induced Cutaneous Hyperpigmentation in an Orthopedic Patient Population

    PubMed Central

    Hanada, Yuri; Berbari, Elie F.; Steckelberg, James M.

    2016-01-01

    Background. The objectives of this study were to estimate the incidence and evaluate risk factors for development of minocycline-induced cutaneous hyperpigmentation in patients with orthopedic infections. Methods. Patients with orthopedic infections evaluated at Mayo Clinic (Rochester, MN) and treated with minocycline from 1 January 2002 to 31 December 2011 were retrospectively identified. Long-term minocycline suppression was defined as daily minocycline use for at least 3 months. A proportional hazards model was used to evaluate potential risk factors. Results. Of 291 patients receiving long-term minocycline suppression, 54% (156 of 291) developed hyperpigmentation after a mean follow-up of 4.8 years (range, 0.3–13.2 years); 88% involved blue-gray pigmentation of normal skin that appeared most commonly in the lower (75%) and upper extremities (44%). The mean duration of minocycline therapy before hyperpigmentation was 1.5 years (range, 0.1–9 years) with a mean cumulative dosage of 107.3 g (range, 8.6–657 g). Notable risk factors include a history of vitamin D deficiency (relative risk [RR], 6.29; 95% confidence interval [CI], 1.91–15.27; P = .0052), presence of a shoulder prosthesis (RR, 3.2; 95% CI, 1.23–6.56; P = .0062), noncirrhotic liver pathology (RR, 3.63; 95% CI, 1.11–8.75; P = .0359), and use of a concurrent medication also known to cause hyperpigmentation (RR, 4.75; 95% CI, 1.83–10.1; P = .0029). Conclusions. Hyperpigmentation associated with the use of long-term minocycline suppression in patients with orthopedic infections is common. PMID:26835479

  1. E-learning in orthopedic surgery training: A systematic review.

    PubMed

    Tarpada, Sandip P; Morris, Matthew T; Burton, Denver A

    2016-12-01

    E-learning is the use of internet-based resources in education. In the field of surgical education, this definition includes the use of virtual patient cases, digital modeling, online tutorials, as well as video recordings of surgical procedures and lectures. In recent years, e-learning has increasingly been considered a viable alternative to traditional teaching within a number of surgical fields. Here we present (1) a systematic review of literature assessing the efficacy of e-learning modules for orthopedic education and (2) a discussion of their relevance. A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted according to the guidelines defined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). The search yielded a total of 255 non-duplicate citations that were screened using predetermined inclusion/exclusion criteria. A total of 9 full text articles met inclusion criteria, which included the use of an objective outcome measure to evaluate an orthopedic e-learning module. Six studies assessed knowledge using a multiple-choice test and 4 assessed skills using a clinical exam. All studies showed positive score improvement pre- to post-intervention, and a majority showed greater score improvement than standard teaching methods in both knowledge (4/6 studies) and clinical skills (3/4 studies). E-learning represents an effective supplement or even alternative to standard teaching techniques within orthopedic education for both medical students and residents. Future work should focus on validating specific e-learning programs using standardized outcome measures and assessing long-term knowledge retention using e-learning platforms.

  2. A History of Orthopedics in San Francisco and the West

    PubMed Central

    Mandell, Peter; Raih, Thomas; Taylor, Lloyd W.

    1976-01-01

    The unique development of early medical specialization in the West can be traced to California's geography and economic development. Such early specialization produced men with orthopedic inclinations. Early orthopedists founded the first medical school and the first modern teaching hospital, helped to found Stanford's Lane Medical Library and made the first use of x-rays in the West. In addition many of these orthopedists were prominent in the political and social activities of the time. ImagesFigure 1.Figure 2.Figure 3.Figure 4. PMID:795165

  3. Klebsiella pneumoniae carrying bla NDM-1 gene in orthopedic practice.

    PubMed

    Gupta, Varsha; Bansal, Neha; Gupta, Ravi; Chander, Jagdish

    2014-09-01

    Emergence and spread of carbapenemases in Enterobacteriaceae is a cause of concern worldwide, the latest threat being New Delhi metallo-β-lactamase (NDM-1). This report is of an orthopedic case with fracture femur managed with internal fixation and bone grafting, who subsequently developed secondary infection with Klebsiella pneumoniae harboring bla NDM-1 gene. Minimum inhibitory concentration (MIC) of imipenem was ≥8 μg/ml by E-test, suggestive of carbapenemase production. Phenotypic and further genotypic detection confirmed the presence of bla NDM-1 gene. The isolate remained susceptible only to tigecycline, colistin, and polymyxin B.

  4. Effect of social media in health care and orthopedic surgery.

    PubMed

    Saleh, Jenine; Robinson, Brooke S; Kugler, Nathan W; Illingworth, Kenneth D; Patel, Pranay; Saleh, Khaled J

    2012-04-01

    With the growth of social media platforms, their potential to affect health care, and orthopedics specifically, continues to expand. We reviewed the literature to obtain all pertinent information on social media in health care and examined its strengths and weaknesses from patient and physician perspectives. Health care professionals have slowly begun to use social media to stay connected with patients. The recent use of networking sites aims to improve education, provide a forum to discuss relevant medical topics, and allow for improved patient care. The use of social media, with the understanding of its limitations, may help promote patient happiness and safety and serve as an educational platform.

  5. Surface evaluation of orthopedic hip implants marketed in Brazil

    NASA Astrophysics Data System (ADS)

    Souza, M. M.; Trommer, R. M.; Maru, M. M.; Roesler, C. R. M.; Barros, W. S.; Dutra, M. S.

    2016-07-01

    One of the factors that contribute to the quality of total hip prostheses is the degree of accuracy in the manufacturing of the joint surfaces. The dimensional control of joint components is important because of its direct influence on the durability and, consequently, in the patients’ life quality. This work presents studies on the form and roughness of orthopedic hip prostheses marketed in Brazil. The results provide data for quality control of the surfaces of the femoral heads and acetabular components of hip prostheses and indicate the need of improvement in the procedures used to this control.

  6. Osteopathic Manipulative Treatment

    MedlinePlus

    ... AOA Certification DO Jobs Online Doctors That DO Facebook Twitter LinkedIn YouTube Pinterest What is a DO? How Are DOs Licensed? How Are DOs Certified? Search for a DO Health Library Osteopathic Manipulative Treatment Becoming a DO Video Library ...

  7. Manipulating the Gradient

    ERIC Educational Resources Information Center

    Gaze, Eric C.

    2005-01-01

    We introduce a cooperative learning, group lab for a Calculus III course to facilitate comprehension of the gradient vector and directional derivative concepts. The lab is a hands-on experience allowing students to manipulate a tangent plane and empirically measure the effect of partial derivatives on the direction of optimal ascent. (Contains 7…

  8. Robot Manipulator Control.

    DTIC Science & Technology

    1983-03-07

    This report presents a synthetic approach for calculating the control of robot manipulators. The initial control problem is broken down into linear ... control and modelling problems. The approach allows derivation of numerous schemes (adaptive or not) of control proposed in the literature and suggests

  9. Kinematically redundant robot manipulators

    NASA Technical Reports Server (NTRS)

    Baillieul, J.; Hollerbach, J.; Brockett, R.; Martin, D.; Percy, R.; Thomas, R.

    1987-01-01

    Research on control, design and programming of kinematically redundant robot manipulators (KRRM) is discussed. These are devices in which there are more joint space degrees of freedom than are required to achieve every position and orientation of the end-effector necessary for a given task in a given workspace. The technological developments described here deal with: kinematic programming techniques for automatically generating joint-space trajectories to execute prescribed tasks; control of redundant manipulators to optimize dynamic criteria (e.g., applications of forces and moments at the end-effector that optimally distribute the loading of actuators); and design of KRRMs to optimize functionality in congested work environments or to achieve other goals unattainable with non-redundant manipulators. Kinematic programming techniques are discussed, which show that some pseudo-inverse techniques that have been proposed for redundant manipulator control fail to achieve the goals of avoiding kinematic singularities and also generating closed joint-space paths corresponding to close paths of the end effector in the workspace. The extended Jacobian is proposed as an alternative to pseudo-inverse techniques.

  10. Computer Algebra versus Manipulation

    ERIC Educational Resources Information Center

    Zand, Hossein; Crowe, David

    2004-01-01

    In the UK there is increasing concern about the lack of skill in algebraic manipulation that is evident in students entering mathematics courses at university level. In this note we discuss how the computer can be used to ameliorate some of the problems. We take as an example the calculations needed in three dimensional vector analysis in polar…

  11. Door breaching robotic manipulator

    NASA Astrophysics Data System (ADS)

    Schoenfeld, Erik; Parrington, Lawrence; von Muehlen, Stephan

    2008-04-01

    As unmanned systems become more commonplace in military, police, and other security forces, they are tasked to perform missions that the original hardware was not designed for. Current military robots are built for rough outdoor conditions and have strong inflexible manipulators designed to handle a wide range of operations. However, these manipulators are not well suited for some essential indoor tasks, including opening doors. This is a complicated kinematic task that places prohibitively difficult control challenges on the robot and the operator. Honeybee and iRobot have designed a modular door-breaching manipulator that mechanically simplifies the demands upon operator and robot. The manipulator connects to the existing robotic arm of the iRobot PackBot EOD. The gripper is optimized for grasping a variety of door knobs, levers, and car-door handles. It works in conjunction with a compliant wrist and magnetic lock-out mechanism that allows the wrist to remain rigid until the gripper has a firm grasp of the handle and then bend with its rotation and the swing of the door. Once the door is unlatched, the operator simply drives the robot through the doorway while the wrist compensates for the complex, multiple degree-of-freedom motion of the door. Once in the doorway the operator releases the handle, the wrist pops back into place, and the robot is ready for the next door. The new manipulator dramatically improves a robot's ability to non-destructively breach doors and perform an inspection of a room's content, a capability that was previously out of reach of unmanned systems.

  12. The Early Years of Organized Chiropractic Orthopedics, 1954–1973: A Social History

    PubMed Central

    Green, Bart N.; Johnson, Claire D.

    2009-01-01

    Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954–1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers’ compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession’s early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and

  13. Evidence for extended prophylaxis in the setting of orthopedic surgery.

    PubMed

    Dobesh, Paul P

    2004-07-01

    Patients undergoing orthopedic surgery represent one of the highest risk groups for the development of venous thromboembolism (VTE). Evidence shows that this risk extends beyond the period in which the patient is hospitalized, especially for patients undergoing hip surgery. Clinical trials have shown that extended prophylaxis with the low-molecular-weight heparins is effective in reducing the rate of total VTE, and a meta-analysis demonstrated a reduction in symptomatic VTE with extended prophylaxis after total hip replacement surgery. Based on these results, the American College of Chest Physicians gives a grade 2A recommendation for the use of extended prophylaxis after orthopedic surgery. Until recently, data evaluating the role of prophylaxis in patients undergoing hip fracture surgery were limited. Subsequently, a novel anticoagulant, fondaparinux, demonstrated significant benefit in these patients and has become the first and only agent approved by the United States Food and Drug Administration (FDA) for use in patients undergoing hip fracture surgery Despite the limitations of the older trials, their findings supported the need to evaluate extended prophylaxis in patients undergoing hip fracture surgery. In the first well-conducted trial of extended prophylaxis for hip fracture surgery, fondaparinux provided impressive results in reducing total and symptomatic VTE. The results of this trial have once again led to fondaparinux being the first and only agent to be granted FDA approval for the indication of extended prophylaxis in patients undergoing hip fracture surgery.

  14. Dynamic Patterns of Expertise: The Case of Orthopedic Medical Diagnosis

    PubMed Central

    Marwan, Norbert; Neuman, Yair; Salai, Moshe; Rath, Ehud

    2016-01-01

    The aim of this study was to analyze dynamic patterns for scanning femoroacetabular impingement (FAI) radiographs in orthopedics, in order to better understand the nature of expertise in radiography. Seven orthopedics residents with at least two years of expertise and seven board-certified orthopedists participated in the study. The participants were asked to diagnose 15 anteroposterior (AP) pelvis radiographs of 15 surgical patients, diagnosed with FAI syndrome. Eye tracking data were recorded using the SMI desk-mounted tracker and were analyzed using advanced measures and methodologies, mainly recurrence quantification analysis. The expert orthopedists presented a less predictable pattern of scanning the radiographs although there was no difference between experts and non-experts in the deterministic nature of their scan path. In addition, the experts presented a higher percentage of correct areas of focus and more quickly made their first comparison between symmetric regions of the pelvis. We contribute to the understanding of experts’ process of diagnosis by showing that experts are qualitatively different from residents in their scanning patterns. The dynamic pattern of scanning that characterizes the experts was found to have a more complex and less predictable signature, meaning that experts’ scanning is simultaneously both structured (i.e. deterministic) and unpredictable. PMID:27414794

  15. Dynamic Patterns of Expertise: The Case of Orthopedic Medical Diagnosis.

    PubMed

    Assaf, Dan; Amar, Eyal; Marwan, Norbert; Neuman, Yair; Salai, Moshe; Rath, Ehud

    2016-01-01

    The aim of this study was to analyze dynamic patterns for scanning femoroacetabular impingement (FAI) radiographs in orthopedics, in order to better understand the nature of expertise in radiography. Seven orthopedics residents with at least two years of expertise and seven board-certified orthopedists participated in the study. The participants were asked to diagnose 15 anteroposterior (AP) pelvis radiographs of 15 surgical patients, diagnosed with FAI syndrome. Eye tracking data were recorded using the SMI desk-mounted tracker and were analyzed using advanced measures and methodologies, mainly recurrence quantification analysis. The expert orthopedists presented a less predictable pattern of scanning the radiographs although there was no difference between experts and non-experts in the deterministic nature of their scan path. In addition, the experts presented a higher percentage of correct areas of focus and more quickly made their first comparison between symmetric regions of the pelvis. We contribute to the understanding of experts' process of diagnosis by showing that experts are qualitatively different from residents in their scanning patterns. The dynamic pattern of scanning that characterizes the experts was found to have a more complex and less predictable signature, meaning that experts' scanning is simultaneously both structured (i.e. deterministic) and unpredictable.

  16. Angiogenesis and osteogenesis in an orthopedically expanded suture

    NASA Technical Reports Server (NTRS)

    Chang, H. N.; Garetto, L. P.; Potter, R. H.; Katona, T. R.; Lee, C. H.; Roberts, W. E.

    1997-01-01

    The purpose of this study was to examine the angiogenic and the subsequent osteogenic responses during a 96-hour time-course after sutural expansion. Fifty rats were divided into: (1) a control group that received only angiogenic induction through injection of 5 ng/gm recombinant human endothelial cell growth factor (rhECGF); (2) an experimental group that received orthopedic expansion and rhECGF; (3) a sham group that received expansion and sodium chloride (NaCl) injection; and (4) a baseline group that received no expansion or injection. All rats were injected with 3H-thymidine (1.0 microCi/gm) 1 hour before death to label the DNA of S-phase cells. Demineralized sections (4 microm thick) were stained with hematoxylin and eosin. Angiogenesis and cell migration were analyzed with a previously established cell kinetics model. Analysis of variance was used to test the hypothesis that enhancement of angiogenesis stimulates reestablishment of osteogenic capability. Blood vessel number, area, and endothelial cell-labeled index significantly increased in experimental groups, but no difference was found between control and baseline groups. Labeled-pericyte index and activated pericyte numbers in the experimental group were also higher than in the sham groups. These results show that supplemental rhECGF enhances angiogenesis in expanded sutures but not in nonexpanded sutures. Data also suggest that pericytes are the source of osteoblasts in an orthopedically expanded suture.

  17. Developments in ambulatory surgery in orthopedics in France in 2016.

    PubMed

    Hulet, C; Rochcongar, G; Court, C

    2017-02-01

    Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives. Patient eligibility and psychosocial criteria are crucial determining factors for the success of the AS strategy. The surgeons involved are strongly committed. Feedback from many orthopedic subspecialties (shoulder, foot, knee, spine, hand, large joints, emergency and pediatric surgery) testify to the rise of AS, which now accounts for 41% of all orthopedic procedures. Questions remain, however, concerning the role of the GP in the continuity of care, the role of innovation and teaching, the creation of new jobs, and the attractiveness of AS for surgeons. More than ever, it is the patient who is "ambulatory", within an organized structure in which surgical technique and pain management are well controlled. Not all patients can be eligible, but the AS concept is becoming standard, and overnight stay will become a matter for medical and surgical prescription.

  18. Breed susceptibility for developmental orthopedic diseases in dogs.

    PubMed

    LaFond, Elizabeth; Breur, Gert J; Austin, Connie C

    2002-01-01

    A large-scale epidemiological study was conducted to determine breeds at risk for 12 developmental orthopedic diseases (DODs). Developmental orthopedic diseases investigated included canine hip dysplasia (CHD); craniomandibular osteopathy (CMO); fragmented coronoid process; hypertrophic osteodystrophy; Legg-Calvé-Perthes disease; osteochondrosis of the medial humeral condyle, caudal humeral head, femoral condyles, and talar trochlear ridges; panosteitis; patella luxation; and ununited anconeal process. Dogs that were diagnosed with any one of the diseases of interest at any of 10 veterinary teaching hospitals participating in the Veterinary Medical Database from 1986 to 1995 were included as cases. Odds ratios and corresponding 95% confidence intervals were calculated to determine risk. Frequency of diagnosis during the 10-year period ranged from 35 cases (CMO) to 10,637 cases (CHD). The number of breeds at increased risk for a disease ranged from one (CMO) to 35 (CHD). Breed susceptibility for a DOD may suggest a genetic component in the disease etiology. The results of this study serve to increase veterinarians' awareness of breeds susceptible to DODs and may facilitate the control of such diseases by identifying breeds that might benefit from breeding programs or environmental intervention such as dietary modification.

  19. Basis for spinal manipulative therapy: A physical therapist perspective

    PubMed Central

    Bialosky, Joel E.; Simon, Corey B.; Bishop, Mark D.; George, Steven Z.

    2012-01-01

    Physical therapists internationally provide spinal manipulative therapy (SMT) to patients with musculoskeletal pain complaints. SMT has been a part of physical therapist practice since the profession’s beginning. Early physical therapist clinical decision making for SMT was influenced by the approaches of osteopathic and orthopedic physicians at the time. Currently a segmental clinical decision making approach and a responder clinical decision making approach are two of the more common models through which physical therapist clinical use of SMT is directed. The focus of segmental clinical decision making is upon identifying a dysfunctional vertebral segment with the application of SMT to restore mobility and/or alleviate pain. The responder clinical decision making approach attempts to categorize individuals based on a pattern of signs and symptoms suggesting a likely positive response to SMT. The present manuscript provides an overview of common physical therapist clinical decision making approaches to SMT and presents areas requiring further study in order to optimize patient response. PMID:22197083

  20. Basis for spinal manipulative therapy: a physical therapist perspective.

    PubMed

    Bialosky, Joel E; Simon, Corey B; Bishop, Mark D; George, Steven Z

    2012-10-01

    Physical therapists internationally provide spinal manipulative therapy (SMT) to patients with musculoskeletal pain complaints. SMT has been a part of physical therapist practice since the profession's beginning. Early physical therapist clinical decision making for SMT was influenced by the approaches of osteopathic and orthopedic physicians at the time. Currently a segmental clinical decision making approach and a responder clinical decision making approach are two of the more common models through which physical therapist clinical use of SMT is directed. The focus of segmental clinical decision making is upon identifying a dysfunctional vertebral segment with the application of SMT to restore mobility and/or alleviate pain. The responder clinical decision making approach attempts to categorize individuals based on a pattern of signs and symptoms suggesting a likely positive response to SMT. The present manuscript provides an overview of common physical therapist clinical decision making approaches to SMT and presents areas requiring further study in order to optimize patient response.

  1. The Orthopedically Disabled Child: Psychological Implications with an Individual Basis. July 1984 Revision.

    ERIC Educational Resources Information Center

    Sigmon, Scott B.

    This study describes the implications of the Individual Psychology of Alfred Adler and field theory associated with Kurt Lewin in understanding orthopedically disabled children and points out that orthopedically disabled youngsters have a remarkable range of individual differences both in type of disability as well as level of adjustment.…

  2. Age, Physical Activity, Physical Fitness, Body Composition, and Incidence of Orthopedic Problems.

    ERIC Educational Resources Information Center

    Research Quarterly for Exercise and Sport, 1989

    1989-01-01

    Effects of age, physical activity, physical fitness, and body mass index (BMI) on the occurrence of orthopedic problems were examined. For men, physical fitness, BMI, and physical activity were associated with orthopedic problems; for women, physical activity was the main predictor. Age was not a factor for either gender. (JD)

  3. Guidelines for the Implementation of Programs for Pupils Who Are Orthopedically Handicapped.

    ERIC Educational Resources Information Center

    Black, Robert S.; Fusco, Carol B.

    Guidelines are provided for the development of programs in South Carolina for orthopedically handicapped (OH) pupils. Basic information is given concerning the definition of orthopedic handicap, the legal mandates on the education of OH pupils, funding sources, authorized programs (whether self-contained programs, resource rooms, or itinerant…

  4. Interpretation by radiologists of orthopedic total joint radiographs: Is it necessary or cost-effective?

    PubMed Central

    Nayak, K. Naresh K.; Rorabeck, Cecil H.; Bourne, Robert B.; Mulliken, Brian; Robinson, Eric

    1996-01-01

    Objective To examine the necessity and cost-effectiveness of interpretation by radiologists of orthopedic radiographs obtained for patients who undergo total hip or knee replacement. Design A prospective study. Serial preoperative and postoperative x-ray films of the joint in patients scheduled to undergo total hip or knee joint replacement during one calendar year were interpreted by both radiology and orthopedic department staff and compared. Intraoperative findings were used to confirm the radiologic interpretation. The follow-up was 1 year. Setting A university teaching hospital. Interventions Primary or revision total hip or knee replacement. Main Outcome Measures Differences in interpretation of radiographs by radiologists and orthopedic surgeons for any of the four procedures. A change in orthopedic management. Results For preoperative radiographs, there were no discrepancies between the radiologists and orthopedic surgeons with respect to primary joint replacement. For 100 revision procedures there were 15 discrepancies, but in all cases the orthopedic surgeon’s interpretation proved to be correct. For the postoperative radiographs, there were no discrepancies in the group of revision hip replacements. For the other three groups there were a total of six discrepancies and in all cases the orthopedic surgeon’s interpretation was correct. In two cases conditions were present that were not recognized by staff from either the radiology department or orthopedic department. Conclusion Interpretation by radiologists of total joint radiographs in patients who undergo primary or revision total hip or knee replacement arthroplasty is not necessary or cost-effective. PMID:8857988

  5. Military Curricula for Vocational & Technical Education. Orthopedic Specialist, Classroom Course 10-13.

    ERIC Educational Resources Information Center

    Brooke Army Medical Center, Fort Sam Houston, TX. Health Care Research Div.

    These military-developed curriculum materials for a course for orthopedic specialists are targeted for students from grades 11 through the adult level. The course is designed to provide a working knowledge of the application of casts, traction, and splints to orthopedic patients and the removal of these devices; a working knowledge of assisting in…

  6. A qualitative and quantitative needs assessment of pain management for hospitalized orthopedic patients.

    PubMed

    Cordts, Grace A; Grant, Marian S; Brandt, Lynsey E; Mears, Simon C

    2011-08-08

    Despite advances in pain management, little formal teaching is given to practitioners and nurses in its use for postoperative orthopedic patients. The goal of our study was to determine the educational needs for orthopedic pain management of our residents, nurses, and physical therapists using a quantitative and qualitative assessment. The needs analysis was conducted in a 10-bed orthopedic unit at a teaching hospital and included a survey given to 20 orthopedic residents, 9 nurses, and 6 physical therapists, followed by focus groups addressing barriers to pain control and knowledge of pain management. Key challenges for nurses included not always having breakthrough pain medication orders and the gap in pain management between cessation of patient-controlled analgesia and ordering and administering oral medications. Key challenges for orthopedic residents included treating pain in patients with a history of substance abuse, assessing pain, and determining when to use long-acting vs short-acting opioids. Focus group assessments revealed a lack of training in pain management and the need for better coordination of care between nurses and practitioners and improved education about special needs groups (the elderly and those with substance abuse issues). This needs assessment showed that orthopedic residents and nurses receive little formal education on pain management, despite having to address pain on a daily basis. This information will be used to develop an educational program to improve pain management for postoperative orthopedic patients. An integrated educational program with orthopedic residents, nurses, and physical therapists would promote understanding of issues for each discipline.

  7. Endovascular repair of femoral artery pseudoaneurysm after orthopedic surgery with balloon-expandable covered stents.

    PubMed

    Eslami, Mohammad H; Silvia, Brian A

    2008-01-01

    Arterial injury after orthopedic procedures is an uncommon complication that can present clinically in a variety of forms and has conventionally been repaired by open vascular surgery. The case and discussion in this article highlights the usefulness of endovascular repair following a delayed presentation of vascular injury from an orthopedic procedure.

  8. REMOTELY OPERATED MANIPULATOR

    DOEpatents

    Hutto, E.L.

    1961-08-15

    A manipulator is described for performing, within an entirely enclosed cell containling radioactive materials, various mechanical operations. A rod with flexible fingers is encompassed by a tubular sleeve shorter than the rod. Relative movement between the rod and sleeve causes the fingers to open and close. This relative movement is effected by relative movement of permanent magnets in magnetic coupling relation to magnetic followers affixed to the ends of the rod and sleeve. The rod and its sleeve may be moved as a unit axially or may be rotated by means of the magnetic couplings. The manipulator is enclosed within a tubular member which is flexibly sealed to an opening in the cell. (AEC)

  9. Computer aided manipulator control

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.; Zawacki, R. L.

    1980-01-01

    This paper describes the hardware and software system of a dedicated mini- and microcomputer network developed at the JPL teleoperator project to aid the operator in real-time control of remote manipulators. The operator can be in series or in parallel with the control computer during operation. The purpose of the project is to develop, demonstrate and evaluate advanced supervisory control concepts and techniques for space applications. The paper concludes with a brief outline of future development plans and issues.

  10. Microradiographic microsphere manipulator

    DOEpatents

    Singleton, R.M.

    A method and apparatus is disclosed for radiographic characterization of small hollow spherical members (microspheres), constructed of either optically transparent or opaque materials. The apparatus involves a microsphere manipulator which holds a batch of microspheres between two parallel thin plastic films for contact microradiographic characterization or projection microradiography thereof. One plastic film is translated relative to and parallel to the other to roll the microspheres through any desired angle to allow different views of the microspheres.

  11. Microradiographic microsphere manipulator

    DOEpatents

    Singleton, Russell M.

    1980-01-01

    A method and apparatus for radiographic characterization of small hollow spherical members (microspheres), constructed of either optically transparent or opaque materials. The apparatus involves a microsphere manipulator which holds a batch of microspheres between two parallel thin plastic films for contact microradiographic characterization or projection microradiography thereof. One plastic film is translated to relative to and parallel to the other to roll the microspheres through any desired angle to allow different views of the microspheres.

  12. Manipulation of quantum evolution

    NASA Technical Reports Server (NTRS)

    Cabera, David Jose Fernandez; Mielnik, Bogdan

    1994-01-01

    The free evolution of a non-relativistic charged particle is manipulated using time-dependent magnetic fields. It is shown that the application of a programmed sequence of magnetic pulses can invert the free evolution process, forcing an arbitrary wave packet to 'go back in time' to recover its past shape. The possibility of more general operations upon the Schrodinger wave packet is discussed.

  13. MANIPULATOR FOR SLAVE ROBOT

    DOEpatents

    Goertz, R.C.; Grimson, J.H.; Kohut, F.A.

    1961-04-01

    A remote-control manipulator comprising two stationary master units, two slave units on a movable vehicle, and electrical connections between the master and slave units is reported. The slave units are side by side with a minimum over-all width, which is made feasible by an arrangement of transducers producing most movements of each slave unit to one side of the support of said slave unit.

  14. Endocavity Ultrasound Probe Manipulators

    PubMed Central

    Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop

    2014-01-01

    We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure. PMID:24795525

  15. Endocavity Ultrasound Probe Manipulators.

    PubMed

    Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop

    2013-06-01

    We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure.

  16. Welding nozzle position manipulator

    NASA Technical Reports Server (NTRS)

    Gilbert, Jeffrey L. (Inventor); Gutow, David A. (Inventor)

    1994-01-01

    The present invention is directed to a welding nozzle position manipulator. The manipulator consists of an angle support to which the remaining components of the device are attached either directly or indirectly. A pair of pivotal connections attach a weld nozzle holding link to the angle support and provide a two axis freedom of movement of the holding link with respect to the support angle. The manipulator is actuated by a pair of adjusting screws angularly mounted to the angle support. These screws contact a pair of tapered friction surfaces formed on the upper portion of the welding nozzle holding link. A spring positioned between the upper portions of the support angle and the holding link provides a constant bias engagement between the friction surfaces of the holding link and the adjustment screws, so as to firmly hold the link in position and to eliminate any free play in the adjustment mechanism. The angular relationships between the adjustment screws, the angle support and the tapered friction surfaces of the weld nozzle holding link provide a geometric arrangement which permits precision adjustment of the holding link with respect to the angle support and also provides a solid holding link mount which is resistant to movement from outside forces.

  17. Welding nozzle position manipulator

    NASA Astrophysics Data System (ADS)

    Gilbert, Jeffrey L.; Gutow, David A.

    1994-11-01

    The present invention is directed to a welding nozzle position manipulator. The manipulator consists of an angle support to which the remaining components of the device are attached either directly or indirectly. A pair of pivotal connections attach a weld nozzle holding link to the angle support and provide a two axis freedom of movement of the holding link with respect to the support angle. The manipulator is actuated by a pair of adjusting screws angularly mounted to the angle support. These screws contact a pair of tapered friction surfaces formed on the upper portion of the welding nozzle holding link. A spring positioned between the upper portions of the support angle and the holding link provides a constant bias engagement between the friction surfaces of the holding link and the adjustment screws, so as to firmly hold the link in position and to eliminate any free play in the adjustment mechanism. The angular relationships between the adjustment screws, the angle support and the tapered friction surfaces of the weld nozzle holding link provide a geometric arrangement which permits precision adjustment of the holding link with respect to the angle support and also provides a solid holding link mount which is resistant to movement from outside forces.

  18. Welding nozzle position manipulator

    NASA Astrophysics Data System (ADS)

    Gilbert, Jeffrey L.; Gutow, David A.

    1993-08-01

    The present invention is directed to a welding nozzle position manipulator. The manipulator consists of an angle support to which the remaining components of the device are attached either directly or indirectly. A pair of pivotal connections attach a weld nozzle holding link to the angle support and provide a two axis freedom of movement of the holding link with respect to the support angle. The manipulator is actuated by a pair of adjusting screws angularly mounted to the angle support. These screws contact a pair of tapered friction surfaces formed on the upper portion of the welding nozzle holding link. A spring positioned between the upper portions of the support angle and the holding link provides a constant bias engagement between the friction surfaces of the holding link and the adjustment screws, so as to firmly hold the link in position and to eliminate any free play in the adjustment mechanism. The angular relationships between the adjustment screws, the angle support and the tapered friction surfaces of the weld nozzle holding link provide a geometric arrangement which permits precision adjustment of the holding link with respect to the angle support and also provides a solid holding link mount which is resistant to movement from outside forces.

  19. Factors affecting interest in orthopedics among female medical students: a prospective analysis.

    PubMed

    Baldwin, Keith; Namdari, Surena; Bowers, Andrea; Keenan, Mary Ann; Levin, L Scott; Ahn, Jaimo

    2011-12-06

    The field of orthopedics has a limited ability to recruit high-quality female applicants. The purpose of this study was to determine whether early exposure to the field affects a woman's decision to pursue orthopedics. We performed a prospective, nonrandomized cohort study between academic years 2005 and 2009 and compared interest in orthopedic surgery among female (n=271) and male (n=71) medical students at 2 urban teaching institutions. Elective lectures and orthopedic literature were distributed via e-mail to the study participants. These materials included articles published in the medical literature, materials produced and distributed by the American Academy of Orthopaedic Surgeons, and Web sites providing educational materials. The primary outcome was the likelihood of application for orthopedic residency. We studied the influence of demographics, exposure, and attitudes on interest in pursuing an orthopedic career. Men had a significantly higher baseline level of interest in orthopedic surgery than women (P=.005). Younger age (P<.001) and personal (P<.001), independent (P<.001), and school (P=.023) exposures to orthopedics were significantly related to interest among women. At final follow-up, total personal exposures (P=.003) and total independent exposures (P<.001) in the form of our literature and lectures were correlated with final interest in women. Female interest was decreased by the long hours, physical demands, and predominantly male nature of the field. Early exposure to orthopedic educational resources may be useful in generating female interest. Perceptions and attitudes regarding orthopedic surgery must to be changed to attract the best and brightest minds, regardless of sex.

  20. ADVANCES IN THE USE OF STEM CELLS IN ORTHOPEDICS

    PubMed Central

    Cristante, Alexandre Fogaça; Narazaki, Douglas Kenji

    2015-01-01

    Primordial cells or stem cells are multipotent undifferentiated cells with the capacity to originate any type of cell in the organism. They may have their origins in the blastocyst and thus are classified as embryonic, or tissues developed in fetuses, newborns or adults and thus are known as somatic stem cells. Bone marrow is one of the main locations for isolating primordial cells, and there are two lineages: hematopoietic and mesenchymal progenitor cells. There are several uses for these undifferentiated cells in orthopedics, going from cartilaginous lesions in osteoarthrosis, osteochondritis dissecans and patellar chondromalacia, to bone lesions like in pseudarthrosis or bone losses, or nerve lesions like in spinal cord trauma. Studying stem cells is probably the most promising field of study of all within medicine, and this is shortly going to revolutionize all medical specialties (both clinical and surgical) and thus provide solutions for diseases that today are difficult to deal with. PMID:27027022

  1. Congenital and acquired orthopedic abnormalities in patients with myelomeningocele.

    PubMed

    Westcott, M A; Dynes, M C; Remer, E M; Donaldson, J S; Dias, L S

    1992-11-01

    This article presents a radiologic review of the spectrum of acquired and congenital orthopedic abnormalities found in patients with myelomeningocele. These abnormalities are caused predominantly by muscle imbalance, paralysis, and decreased sensation in the lower extremity. Iatrogenic injury, such as a postoperative tethered cord, may also cause bone abnormalities. Selected images were obtained from more than 800 children. Important entities presented include spinal curvatures such as kyphosis, scoliosis, and lordosis; subluxation and dislocation of the hip, coxa valga, contractures of the hip, and femoral torsion; knee deformities; rotational abnormalities of the lower extremity and external and internal torsion; ankle and foot abnormalities such as ankle valgus, calcaneus foot, congenital vertical talus (rocker-bottom deformity), and talipes equinovarus; and metaphyseal, diaphyseal, and physeal fractures. Familiarity with congenital abnormalities and an understanding of the pathogenesis of acquired disorders in patients with myelomeningocele are essential for proper radiologic interpretation and timely therapy.

  2. Mechanical Properties of Nanotextured Titanium Orthopedic Screws for Clinical Applications.

    PubMed

    Descamps, Stephane; Awitor, Komla O; Raspal, Vincent; Johnson, Matthew B; Bokalawela, Roshan S P; Larson, Preston R; Doiron, Curtis F

    2013-06-01

    In this work, we modified the topography of commercial titanium orthopedic screws using electrochemical anodization in a 0.4 wt% hydrofluoric acid solution to produce titanium dioxide nanotube layers. The morphology of the nanotube layers were characterized using scanning electron microscopy. The mechanical properties of the nanotube layers were investigated by screwing and unscrewing an anodized screw into several different types of human bone while the torsional force applied to the screwdriver was measured using a torque screwdriver. The range of torsional force applied to the screwdriver was between 5 and [Formula: see text]. Independent assessment of the mechanical properties of the same surfaces was performed on simple anodized titanium foils using a triboindenter. Results showed that the fabricated nanotube layers can resist mechanical stresses close to those found in clinical situations.

  3. Barriers to the clinical translation of orthopedic tissue engineering.

    PubMed

    Evans, Christopher H

    2011-12-01

    Tissue engineering and regenerative medicine have been the subject of increasingly intensive research for over 20 years, and there is concern in some quarters over the lack of clinically useful products despite the large sums of money invested. This review provides one perspective on orthopedic applications from a biologist working in academia. It is suggested that the delay in clinical application is not atypical of new, biologically based technologies. Some barriers to progress are acknowledged and discussed, but it is also noted that preclinical studies have identified several promising types of cells, scaffolds, and morphogenetic signals, which, although not optimal, are worth advancing toward human trials to establish a bridgehead in the clinic. Although this transitional technology will be replaced by more sophisticated, subsequent systems, it will perform valuable pioneering functions and facilitate the clinical development of the field. Some strategies for achieving this are suggested.

  4. Orthopedic Correction of Growing Hyperdivergent, Retrognathic, Patients with Miniscrew Implants

    PubMed Central

    Buschang, Peter H.; Carrillo, Roberto; Rossouw, P. Emile

    2010-01-01

    Traditional orthodontic treatments do not adequately address the skeletal problems of retrognathic, hyperdivergent, Class II adolescents; the few approaches that do require long-term patient compliance. This paper introduces a novel approach using miniscrew implants (MSIa) and growth to treat retrognathic hyperdivergent adolescents. Nine consecutive patients were evaluated at the start of treatment (13.2 ±1.1 years of age) and again at the end of the orthopedic phase (after 1.9 ±0.3 years). Each patient had two MSIs placed in either side of the palate. Coil springs (150 g) extended from the MSIs to a RPE, which served as a rigid segment for intruding the maxillary premolar and molars. Two additional MSIs were placed between the first mandibular molars and second premolars; coil spring (150 g) extended from the MSIs to hold or intrude the mandibular molars. Prior to treatment, the patients exhibited substantial and significant mandibular retrusion (Z-score=−1.0), facial convexity (Z-score=0.7), and hyperdivergence (Z-score=1.6). Treatment produced consistent and substantial orthopedic effects. The chin was advanced an average of 2.4 mm, the SNB angle increased by 2.1°, the mandibular plane angle decreased 3.9°, and facial convexity decreased by approximately 3.2°. Questionnaires showed that this treatment approach was not painful or uncomfortable; the majority of the patients indicated that they were very likely to recommend the treatment to others. Treatment was accomplished by titrating the amount of orthodontic intrusion performed based on the individuals’ growth potential. PMID:21236539

  5. Applications of finite element simulation in orthopedic and trauma surgery

    PubMed Central

    Herrera, Antonio; Ibarz, Elena; Cegoñino, José; Lobo-Escolar, Antonio; Puértolas, Sergio; López, Enrique; Mateo, Jesús; Gracia, Luis

    2012-01-01

    Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography (CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element (FE) simulation lets us know the biomechanical changes that take place after hip prostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints

  6. Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein.

    PubMed

    Baranowski, Andreas; Klein, Anja; Ritz, Ulrike; Ackermann, Angelika; Anthonissen, Joris; Kaufmann, Kerstin B; Brendel, Christian; Götz, Hermann; Rommens, Pol M; Hofmann, Alexander

    2016-01-01

    Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP) has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES), and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs) and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants. Both

  7. Applications of finite element simulation in orthopedic and trauma surgery.

    PubMed

    Herrera, Antonio; Ibarz, Elena; Cegoñino, José; Lobo-Escolar, Antonio; Puértolas, Sergio; López, Enrique; Mateo, Jesús; Gracia, Luis

    2012-04-18

    Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography (CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element (FE) simulation lets us know the biomechanical changes that take place after hip prostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints

  8. Hydroxyapatite-nanotube composites and coatings for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Lahiri, Debrupa

    Hydroxyapatite (HA) has received wide attention in orthopedics, due to its biocompatibility and osseointegration ability. Despite these advantages, the brittle nature and low fracture toughness of HA often results in rapid wear and premature fracture of implant. Hence, there is a need to improve the fracture toughness and wear resistance of HA without compromising its biocompatibility. The aim of the current research is to explore the potential of nanotubes as reinforcement to HA for orthopedic implants. HA- 4 wt.% carbon nanotube (CNT) composites and coatings are synthesized by spark plasma sintering and plasma spraying respectively, and investigated for their mechanical, tribological and biological behavior. CNT reinforcement improves the fracture toughness (>90%) and wear resistance (>66%) of HA for coating and free standing composites. CNTs have demonstrated a positive influence on the proliferation, differentiation and matrix mineralization activities of osteoblasts, during in-vitro biocompatibility studies. In-vivo exposure of HA-CNT coated titanium implant in animal model (rat) shows excellent histocompatibility and neobone integration on the implant surface. The improved osseointegration due to presence of CNTs in HA is quantified by the adhesion strength measurement of single osteoblast using nano-scratch technique. Considering the ongoing debate about cytotoxicity of CNTs in the literature, the present study also suggests boron nitride nanotube (BNNT) as an alternative reinforcement. BNNT with the similar elastic modulus and strength as CNT, were added to HA. The resulting composite having 4 wt.% BNNTs improved the fracture toughness (˜85%) and wear resistance (˜75%) of HA in the similar range as HA-CNT composites. BNNTs were found to be non-cytotoxic for osteoblasts and macrophages. In-vitro evaluation shows positive role of BNNT in osteoblast proliferation and viability. Apatite formability of BNNT surface in ˜4 days establishes its osseointegration

  9. Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein

    PubMed Central

    Ritz, Ulrike; Ackermann, Angelika; Anthonissen, Joris; Kaufmann, Kerstin B.; Brendel, Christian; Götz, Hermann; Rommens, Pol M.; Hofmann, Alexander

    2016-01-01

    Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP) has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES), and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs) and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants. Both

  10. Performance measurement of mobile manipulators

    NASA Astrophysics Data System (ADS)

    Bostelman, Roger; Hong, Tsai; Marvel, Jeremy

    2015-05-01

    This paper describes a concept for measuring the reproducible performance of mobile manipulators to be used for assembly or other similar tasks. An automatic guided vehicle with an onboard robot arm was programmed to repeatedly move to and stop at a novel, reconfigurable mobile manipulator artifact (RMMA), sense the RMMA, and detect targets on the RMMA. The manipulator moved a laser retroreflective sensor to detect small reflectors that can be reconfigured to measure various manipulator positions and orientations (poses). This paper describes calibration of a multi-camera, motion capture system using a 6 degree-of-freedom metrology bar and then using the camera system as a ground truth measurement device for validation of the reproducible mobile manipulator's experiments and test method. Static performance measurement of a mobile manipulator using the RMMA has proved useful for relatively high tolerance pose estimation and other metrics that support standard test method development for indexed and dynamic mobile manipulator applications.

  11. Parasites and supernormal manipulation.

    PubMed Central

    Holen, Ø. H.; Saetre, G. P.; Slagsvold, T.; Stenseth, N. C.

    2001-01-01

    Social parasites may exploit their hosts by mimicking other organisms that the hosts normally benefit from investing in or responding to in some other way. Some parasites exaggerate key characters of the organisms they mimic, possibly in order to increase the response from the hosts. The huge gape and extreme begging intensity of the parasitic common cuckoo chick (Cuculus canorus) may be an example. In this paper, the evolutionary stability of manipulating hosts through exaggerated signals is analysed using game theory. Our model indicates that a parasite's signal intensity must be below a certain threshold in order to ensure acceptance and that this threshold depends directly on the rate of parasitism. The only evolutionarily stable strategy (ESS) combination is when hosts accept all signallers and parasites signal at their optimal signal intensity, which must be below the threshold. Supernormal manipulation by parasites is only evolutionarily stable under sufficiently low rates of parasitism. If the conditions for the ESS combination are not satisfied, rejector hosts can invade using signal intensity as a cue for identifying parasites. These qualitative predictions are discussed with respect to empirical evidence from parasitic mimicry systems that have been suggested to involve supernormal signalling, including evicting avian brood parasites and insect-mimicking Ophrys orchids. PMID:11749709

  12. Orthopedic Surgery Resident Debt Load and Its Effect on Career Choice.

    PubMed

    Johnson, Joey P; Cassidy, Dale B; Tofte, Josef N; Bariteau, Jason T; Daniels, Alan H

    2016-05-01

    Student loan debt has become a topic of discussion and debate among physicians and legislators. This study seeks to assess the level of debt of orthopedic surgery residents and to determine whether debt burden affects the career choice of orthopedic trainees. A 26-question, anonymous survey was distributed via email to resident trainees enrolled in different medical and surgical specialty training programs across the United States. Orthopedic trainees were compared with trainees in other specialties using comparative statistics. Of the approximately 13,503 residents who were sent the survey, a total of 3076 responded, including 167 of an estimated 580 orthopedic residents, for approximate response rates of 22.8% and 28.8%, respectively. On average, orthopedic surgery residents were at a later post-graduate year than overall respondents (P<.025). When asked if student loan debt would influence the next step in their career, nonorthopedic residents were statistically more likely to respond "yes" compared with orthopedic surgery residents (57.21% vs 49.08%, respectively; P=.041). More than 50% of all respondents agreed that student loan debt would affect their type or location of practice. The majority of orthopedic residents take student loan debt into consideration when determining their final location and type of practice, although less so for orthopedic trainees compared with other specialties. As medical education continues to become more expensive and the threat of dropping physician reimbursement looms on the horizon, student debt may become a primary driving factor for young American physicians' career plans. [Orthopedics. 2016; 39(3):e438-e443.].

  13. Hydraulic manipulator research at ORNL

    SciTech Connect

    Kress, R.L.; Jansen, J.F.; Love, L.J.

    1997-03-01

    Recently, task requirements have dictated that manipulator payload capacity increase to accommodate greater payloads, greater manipulator length, and larger environmental interaction forces. General tasks such as waste storage tank cleanup and facility dismantlement and decommissioning require manipulator life capacities in the range of hundreds of pounds rather than tens of pounds. To meet the increased payload capacities demanded by present-day tasks, manipulator designers have turned once again to hydraulics as a means of actuation. In order to successfully design, build, and deploy a new hydraulic manipulator (or subsystem), sophisticated modeling, analysis, and control experiments are usually needed. Oak Ridge National Laboratory (ORNL) has a history of projects that incorporate hydraulics technology, including mobile robots, teleoperated manipulators, and full-scale construction equipment. In addition, to support the development and deployment of new hydraulic manipulators, ORNL has outfitted a significant experimental laboratory and has developed the software capability for research into hydraulic manipulators, hydraulic actuators, hydraulic systems, modeling of hydraulic systems, and hydraulic controls. The purpose of this article is to describe the past hydraulic manipulator developments and current hydraulic manipulator research capabilities at ORNL. Included are example experimental results from ORNL`s flexible/prismatic test stand.

  14. Pre: Surgical orthopedic pre-maxillary alignment in bilateral cleft lip and palate patient

    PubMed Central

    Ellore, Vijaya Prasad Kamavaram; Ramagoni, Naveen Kumar; Taranatha, Mahantesha; Nara, Asha; Gunjalli, Gururaj; Bhat, Ashwin Devasya

    2012-01-01

    Pre-surgical orthopedic appliances are mainly used to retract and align the protruded and deviated pre-maxilla and to facilitate initial lip repair. This article presents a case report of a five year old male child patient with bilateral cleft lip and palate in whom a special custom made pre-surgical orthopedic appliance was delivered. Use of a special custom made presurgical orthopedic appliance for repositioning pre-maxilla in bilateral cleft lip and palate patient is discussed in this article. PMID:23293501

  15. Usefulness of a metal artifact reduction algorithm for orthopedic implants in abdominal CT: phantom and clinical study results.

    PubMed

    Jeong, Seonji; Kim, Se Hyung; Hwang, Eui Jin; Shin, Cheong-Il; Han, Joon Koo; Choi, Byung Ihn

    2015-02-01

    OBJECTIVE. The purpose of this study was to evaluate the usefulness of a metal artifact reduction (MAR) algorithm for orthopedic prostheses in phantom and clinical CT. MATERIALS AND METHODS. An agar phantom with two sets of spinal screws was scanned at various tube voltage (80-140 kVp) and tube current-time (34-1032 mAs) settings. The orthopedic MAR algorithm was combined with filtered back projection (FBP) or iterative reconstruction. The mean SDs in three ROIs were compared among four datasets (FBP, iterative reconstruction, FBP with orthopedic MAR, and iterative reconstruction with orthopedic MAR). For the clinical study, the mean SDs of three ROIs and 4-point scaled image quality in 52 patients with metallic orthopedic prostheses were compared between CT images acquired with and without orthopedic MAR. The presence and type of image quality improvement with orthopedic MAR and the presence of orthopedic MAR-related new artifacts were also analyzed. RESULTS. In the phantom study, the mean SD with orthopedic MAR was significantly lower than that without orthopedic MAR regardless of dose settings and reconstruction algorithms (FBP versus iterative reconstruction). The mean SD near the metallic prosthesis in 52 patients was significantly lower on CT images with orthopedic MAR (28.04 HU) than those without it (49.21 HU). Image quality regarding metallic artifact was significantly improved with orthopedic MAR (rating of 2.60 versus 1.04). Notable reduction of metallic artifacts and better depiction of abdominal organs were observed in 45 patients. Diagnostic benefit was achieved in six patients, but orthopedic MAR-related new artifacts were seen in 30 patients. CONCLUSION. Use of the orthopedic MAR algorithm significantly reduces metal artifacts in CT of both phantoms and patients and has potential for improving diagnostic performance in patients with severe metallic artifacts.

  16. Vacuum tool manipulator

    SciTech Connect

    Zollinger, W.T.

    1992-12-31

    This invention is comprised of an apparatus for manipulating a vacuum hose in a reactor vessel comprising a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm.

  17. Vacuum tool manipulator

    DOEpatents

    Zollinger, W.T.

    1993-11-23

    Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm. 6 figures.

  18. REMOTE CONTROL MANIPULATOR

    DOEpatents

    Coffman, R.T.

    1962-11-27

    The patent covers a remote-control manipulator in which a tool is carried on a tube at an end thereof angularly related to the main portion of the tube and joined thereto by a curved section. The main portion of the tube is mounted for rotation and axial shifting in a wall separating safe and dangerous areas. The tool is actuated to grasp and release an object in the dangerous area by means of a compound shaft extending through the tube, the shaft having a flexible section extending through the curved section of the tube. The tool is moved about in the dangerous area by rotation and axial movement of the main portion of the tube. Additional movement of the tool is obtained through axial shifting of the shaft with respect to the tube through which it extends. (AEC)

  19. Vacuum tool manipulator

    DOEpatents

    Zollinger, William T.

    1993-01-01

    Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm.

  20. Interactive protein manipulation

    SciTech Connect

    SNCrivelli@lbl.gov

    2003-07-01

    We describe an interactive visualization and modeling program for the creation of protein structures ''from scratch''. The input to our program is an amino acid sequence -decoded from a gene- and a sequence of predicted secondary structure types for each amino acid-provided by external structure prediction programs. Our program can be used in the set-up phase of a protein structure prediction process; the structures created with it serve as input for a subsequent global internal energy minimization, or another method of protein structure prediction. Our program supports basic visualization methods for protein structures, interactive manipulation based on inverse kinematics, and visualization guides to aid a user in creating ''good'' initial structures.

  1. Advanced servo manipulator

    DOEpatents

    Holt, W.E.; Kuban, D.P.; Martin, H.L.

    1988-10-25

    An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member. 41 figs.

  2. Advanced servo manipulator

    DOEpatents

    Holt, William E.; Kuban, Daniel P.; Martin, H. Lee

    1988-01-01

    An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member.

  3. Ion manipulation device

    SciTech Connect

    Anderson, Gordon A; Smith, Richard D; Ibrahim, Yehia M; Baker, Erin M

    2014-09-16

    An ion manipulation method and device is disclosed. The device includes a pair of substantially parallel surfaces. An array of inner electrodes is contained within, and extends substantially along the length of, each parallel surface. The device includes a first outer array of electrodes and a second outer array of electrodes. Each outer array of electrodes is positioned on either side of the inner electrodes, and is contained within and extends substantially along the length of each parallel surface. A DC voltage is applied to the first and second outer array of electrodes. A RF voltage, with a superimposed electric field, is applied to the inner electrodes by applying the DC voltages to each electrode. Ions either move between the parallel surfaces within an ion confinement area or along paths in the direction of the electric field, or can be trapped in the ion confinement area.

  4. A History of Manipulative Therapy

    PubMed Central

    Pettman, Erland

    2007-01-01

    Manipulative therapy has known a parallel development throughout many parts of the world. The earliest historical reference to the practice of manipulative therapy in Europe dates back to 400 BCE. Over the centuries, manipulative interventions have fallen in and out of favor with the medical profession. Manipulative therapy also was initially the mainstay of the two leading alternative health care systems, osteopathy and chiropractic, both founded in the latter part of the 19th century in response to shortcomings in allopathic medicine. With medical and osteopathic physicians initially instrumental in introducing manipulative therapy to the profession of physical therapy, physical therapists have since then provided strong contributions to the field, thereby solidifying the profession's claim to have manipulative therapy within in its legally regulated scope of practice. PMID:19066664

  5. Repeatability in redundant manipulator systems

    NASA Astrophysics Data System (ADS)

    Mukherjee, Ranjan

    1994-02-01

    Terrestrial manipulators with more DOF than the dimension of the workspace and space manipulators with as many manipulator DOF as the dimension of the workspace are both redundant systems. An interesting problem of such redundant systems has been the repeatability problem due to the presence of nonholonomic constraints. We show, contrary to the existing belief, that integrability of the nonholonomic constraints is not a necessary condition for the repeatability of the configuration variables. There exist certain trajectories in the independent configuration variable space that are like 'holonomic loops' along which the redundant manipulators exhibit repeatable motion. We present a simple method based on optimization techniques for designing repeatable trajectories for free-flying space manipulators and terrestrial manipulators under pseudoinverse control.

  6. Digital Control For Remote Manipulators

    NASA Technical Reports Server (NTRS)

    Bejczy, Antal K.; Dotson, Ronald S.

    1987-01-01

    Multiple microprocessors enable large separations between controllers and manipulators. Controller for remote manipulator requires no direct mechanical connection between slave arm and master arm moved by human operator. Employs two-way digital data transmission rather than mechanical linkage between master and slave. Manipulator a considerable distance from operator. Software for controller distributed between master and slave locations. Organized into modules. Hardware and software for system demonstrated in laboratory model.

  7. Manipulation hardware for microgravity research

    SciTech Connect

    Herndon, J.N.; Glassell, R.L.; Butler, P.L.; Williams, D.M. ); Rohn, D.A. . Lewis Research Center); Miller, J.H. )

    1990-01-01

    The establishment of permanent low earth orbit occupation on the Space Station Freedom will present new opportunities for the introduction of productive flexible automation systems into the microgravity environment of space. The need for robust and reliable robotic systems to support experimental activities normally intended by astronauts will assume great importance. Many experimental modules on the space station are expected to require robotic systems for ongoing experimental operations. When implementing these systems, care must be taken not to introduce deleterious effects on the experiments or on the space station itself. It is important to minimize the acceleration effects on the experimental items being handled while also minimizing manipulator base reaction effects on adjacent experiments and on the space station structure. NASA Lewis Research Center has been performing research on these manipulator applications, focusing on improving the basic manipulator hardware, as well as developing improved manipulator control algorithms. By utilizing the modular manipulator concepts developed during the Laboratory Telerobotic Manipulator program, Oak Ridge National Laboratory has developed an experimental testbed system called the Microgravity Manipulator, incorporating two pitch-yaw modular positioners to provide a 4 dof experimental manipulator arm. A key feature in the design for microgravity manipulation research was the use of traction drives for torque transmission in the modular pitch-yaw differentials.

  8. Torque-Limiting Manipulation Device

    NASA Technical Reports Server (NTRS)

    Moetteli, John B. (Inventor)

    1999-01-01

    A device for manipulating a workpiece in space includes a fixture, a stanchion assembly, a manipulation mechanism, an actuation mechanism, and a reaction mechanism. The fixture has an end onto which the workpiece affixes. The stanchion assembly has an upper and a lower end. The manipulation mechanism connects the fixture and the upper end of the stanchion assembly. The lower end of the stanchion assembly mounts, via probe and a socket, to a structure. The actuation mechanism operably connects to the manipulation mechanism, and moves the fixture in space. The reaction mechanism provides a point through which force inputs into the actuation mechanism may react.

  9. Online Bimanual Manipulation Using Surface Electromyography and Incremental Learning.

    PubMed

    Strazzulla, Ilaria; Nowak, Markus; Controzzi, Marco; Cipriani, Christian; Castellini, Claudio

    2017-03-01

    The paradigm of simultaneous and proportional myocontrol of hand prostheses is gaining momentum in the rehabilitation robotics community. As opposed to the traditional surface electromyography classification schema, in simultaneous and proportional control the desired force/torque at each degree of freedom of the hand/wrist is predicted in real-time, giving to the individual a more natural experience, reducing the cognitive effort and improving his dexterity in daily-life activities. In this study we apply such an approach in a realistic manipulation scenario, using 10 non-linear incremental regression machines to predict the desired torques for each motor of two robotic hands. The prediction is enforced using two sets of surface electromyography electrodes and an incremental, non-linear machine learning technique called Incremental Ridge Regression with Random Fourier Features. Nine able-bodied subjects were engaged in a functional test with the aim to evaluate the performance of the system. The robotic hands were mounted on two hand/wrist orthopedic splints worn by healthy subjects and controlled online. An average completion rate of more than 95% was achieved in single-handed tasks and 84% in bimanual tasks. On average, 5 min of retraining were necessary on a total session duration of about 1 h and 40 min. This work sets a beginning in the study of bimanual manipulation with prostheses and will be carried on through experiments in unilateral and bilateral upper limb amputees thus increasing its scientific value.

  10. Rational design of nanofiber scaffolds for orthopedic tissue repair and regeneration

    PubMed Central

    Ma, Bing; Xie, Jingwei; Jiang, Jiang; Shuler, Franklin D; Bartlett, David E

    2013-01-01

    This article reviews recent significant advances in the design of nanofiber scaffolds for orthopedic tissue repair and regeneration. It begins with a brief introduction on the limitations of current approaches for orthopedic tissue repair and regeneration. It then illustrates that rationally designed scaffolds made up of electrospun nanofibers could be a promising solution to overcome the problems that current approaches encounter. The article also discusses the intriguing properties of electrospun nanofibers, including control of composition, structures, orders, alignments and mechanical properties, use as carriers for topical drug and/or gene sustained delivery, and serving as substrates for the regulation of cell behaviors, which could benefit musculoskeletal tissue repair and regeneration. It further highlights a few of the many recent applications of electrospun nanofiber scaffolds in repairing and regenerating various orthopedic tissues. Finally, the article concludes with perspectives on the challenges and future directions for better design, fabrication and utilization of nanofiber scaffolds for orthopedic tissue engineering. PMID:23987110

  11. 78 FR 17940 - Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... COMMISSION Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof..., Software, Implants, and Components Thereof, DN 2945; the Commission is soliciting comments on any public... devices, software, implants, and components thereof. The complaint names as respondents Stanmore...

  12. Rational design of nanofiber scaffolds for orthopedic tissue repair and regeneration.

    PubMed

    Ma, Bing; Xie, Jingwei; Jiang, Jiang; Shuler, Franklin D; Bartlett, David E

    2013-09-01

    This article reviews recent significant advances in the design of nanofiber scaffolds for orthopedic tissue repair and regeneration. It begins with a brief introduction on the limitations of current approaches for orthopedic tissue repair and regeneration. It then illustrates that rationally designed scaffolds made up of electrospun nanofibers could be a promising solution to overcome the problems that current approaches encounter. The article also discusses the intriguing properties of electrospun nanofibers, including control of composition, structures, orders, alignments and mechanical properties, use as carriers for topical drug and/or gene sustained delivery, and serving as substrates for the regulation of cell behaviors, which could benefit musculoskeletal tissue repair and regeneration. It further highlights a few of the many recent applications of electrospun nanofiber scaffolds in repairing and regenerating various orthopedic tissues. Finally, the article concludes with perspectives on the challenges and future directions for better design, fabrication and utilization of nanofiber scaffolds for orthopedic tissue engineering.

  13. Do Astronauts Havbe a Higher Rate of Orthopedic Shoulder Conditions Than a Cohort of Working Professionals

    NASA Technical Reports Server (NTRS)

    Laughlin, M. S.; Murray, J. D.; Young, M.; Wear, M. L.; Van Baalen, M.; Tarver, W. J.

    2016-01-01

    Occupational surveillance of astronaut shoulder injuries began with operational concerns at the Neutral Buoyancy Laboratory (NBL) during Extra Vehicular Activity (EVA) training. Orthopedic shoulder injury and surgery rates were calculated [1], but classifying the rates as normal, high or low was highly dependent on the comparison group. Thus, the purpose of this study was to identify a population of working professionals and compare orthopedic shoulder consultation and surgery rates.

  14. Manipulating and Visualizing Proteins

    SciTech Connect

    Simon, Horst D.

    2003-12-05

    ProteinShop Gives Researchers a Hands-On Tool for Manipulating, Visualizing Protein Structures. The Human Genome Project and other biological research efforts are creating an avalanche of new data about the chemical makeup and genetic codes of living organisms. But in order to make sense of this raw data, researchers need software tools which let them explore and model data in a more intuitive fashion. With this in mind, researchers at Lawrence Berkeley National Laboratory and the University of California, Davis, have developed ProteinShop, a visualization and modeling program which allows researchers to manipulate protein structures with pinpoint control, guided in large part by their own biological and experimental instincts. Biologists have spent the last half century trying to unravel the ''protein folding problem,'' which refers to the way chains of amino acids physically fold themselves into three-dimensional proteins. This final shape, which resembles a crumpled ribbon or piece of origami, is what determines how the protein functions and translates genetic information. Understanding and modeling this geometrically complex formation is no easy matter. ProteinShop takes a given sequence of amino acids and uses visualization guides to help generate predictions about the secondary structures, identifying alpha helices and flat beta strands, and the coil regions that bind them. Once secondary structures are in place, researchers can twist and turn these pre-configurations until they come up with a number of possible tertiary structure conformations. In turn, these are fed into a computationally intensive optimization procedure that tries to find the final, three-dimensional protein structure. Most importantly, ProteinShop allows users to add human knowledge and intuition to the protein structure prediction process, thus bypassing bad configurations that would otherwise be fruitless for optimization. This saves compute cycles and accelerates the entire process, so

  15. Orthopedic disorders of the knee in hemophilia: A current concept review

    PubMed Central

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-01-01

    The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy (HA) in patients with deficiency of coagulation factor VIII or IX and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems. Lifelong factor replacement therapy (FRT) is optimal to prevent HA, however adherence to this regerous treatment is challenging leading to breakthrough bleeding. In patients with chronic hemophilic synovitis, the prelude to HA, radiosynovectomy (RS) is the optimal to ameliorate bleeding. Surgery in people with hemophilia (PWH) is associated with a high risk of bleeding and infection, and must be performed with FRT. A coordinated effort including orthopedic surgeons, hematologists, physical medicine and rehabilitation physicians, physiotherapists and other team members is key to optimal outcomes. Ideally, orthopedic procedures should be performed in specialized hospitals with experienced teams. Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures (arthrocentesis, RS, arthroscopic synovectomy, hamstring release, arthroscopic debridement, alignment osteotomy, and total knee arthroplasty). By using the aforementioned procedures, the quality of life of PWH will be improved. PMID:27335812

  16. Biofilm Disrupting Technology for Orthopedic Implants: What’s on the Horizon?

    PubMed Central

    Connaughton, Alexander; Childs, Abby; Dylewski, Stefan; Sabesan, Vani J.

    2014-01-01

    The use of orthopedic implants in joints has revolutionized the treatment of patients with many debilitating chronic musculoskeletal diseases such as osteoarthritis. However, the introduction of foreign material into the human body predisposes the body to infection. The treatment of these infections has become very complicated since the orthopedic implants serve as a surface for multiple species of bacteria to grow at a time into a resistant biofilm layer. This biofilm layer serves as a protectant for the bacterial colonies on the implant making them more resistant and difficult to eradicate when using standard antibiotic treatment. In some cases, the use of antibiotics alone has even made the bacteria more resistant to treatment. Thus, there has been surge in the creation of non-antibiotic anti-biofilm agents to help disrupt the biofilms on the orthopedic implants to help eliminate the infections. In this study, we discuss infections of orthopedic implants in the shoulder then we review the main categories of anti-biofilm agents that have been used for the treatment of infections on orthopedic implants. Then, we introduce some of the newer biofilm disrupting technology that has been studied in the past few years that may advance the treatment options for orthopedic implants in the future. PMID:25705632

  17. [Prophylaxis of venous thromboembolic disease in high-risk orthopedic surgery].

    PubMed

    Meza Reyes, Gilberto Eduardo; Esquivel Gómez, Ricardo; Martínez del Campo Sánchez, Antonio; Espinosa-Larrañaga, Francisco; Martínez Guzmán, Miguel Ángel Enrique; Torres González, Rubén; de la Fuente Zuno, Juan Carlos; Méndez Huerta, Juan Vicente; Villalobos Garduño, Enrique; Cymet Ramírez, José; Ibarra Hirales, Efrén; Díaz Borjón, Efraín; Aguilera Zepeda, José Manuel; Valles Figueroa, Juan Francisco; Majluf-Cruz, Abraham

    2012-01-01

    Venous thromboembolism (VTE) is a worldwide public health problem, with an annual incidence of 1-2 cases/1,000 individuals in the general population and a 1-5% associated mortality. Orthopedic surgery is a major surgical risk factor for VTE, but the problem is more important for patients with hip and knee joint replacement, multiple traumatisms, severe damage to the spine, or large fractures. Thromboprophylaxis is defined as the strategy and actions necessary to diminish the risk of VTE in high-risk orthopedic surgery. Antithrombotics may prevent VTE. At the end of this paper, we describe a proposal of thromboprophylaxis actions for patients requiring high-risk orthopedic surgery, based on the opinion of specialists in Orthopedics and Traumatology who work with high-risk orthopedic surgery patients. A search for evidence about this kind of surgery was performed and a 100-item inquiring instrument was done in order to know the opinions of the participants. Then, recommendations and considerations were built. In conclusion, this document reviews the problem of VTE in high-risk orthopedic surgery patients and describes the position of the Colegio Mexicano de Ortopedia y Traumatología related to VTE prevention in this setting.

  18. Academic characteristics of orthopedic team physicians affiliated with high school, collegiate, and professional teams.

    PubMed

    Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S

    2015-11-01

    We conducted a study to determine the academic involvement and research productivity of orthopedic team physicians at high school, college, and professional levels of sport. Through Internet and telephone queries, we identified 1054 team physicians from 362 institutions, including 120 randomly selected high schools and colleges and 122 professional teams (baseball, basketball, football, hockey). For all physicians included in the study, we performed a comprehensive search of the Internet and of a citation database to determine academic affiliations, number of publications, and h-index values. Of the 1054 physicians, 678 (64%) were orthopedic surgeons. Percentage of orthopedic team physicians affiliated with an academic medical center was highest in professional sports (64%; 173/270) followed by collegiate sports (36%; 98/275) and high school sports (20%; 27/133). Median number of publications per orthopedic team physician was significantly higher in professional sports (30.6) than in collegiate sports (10.7) or high school sports (6). Median number of publications by orthopedic physicians also varied by sport, with the highest number in Major League Baseball (37.9; range, 0-225) followed by the National Basketball Association (32.0; range, 0-227) and the National Football League (30.4; range, 0-460), with the lowest number within the National Hockey League (20.7; range, 0-144). Academic affiliation and research productivity of orthopedic team physicians vary by competition level and professional sporting league.

  19. Development of an orthopedic surgery trauma patient handover checklist

    PubMed Central

    LeBlanc, Justin; Donnon, Tyrone; Hutchison, Carol; Duffy, Paul

    2014-01-01

    Background In surgery, preoperative handover of surgical trauma patients is a process that must be made as safe as possible. We sought to determine vital clinical information to be transferred between patient care teams and to develop a standardized handover checklist. Methods We conducted standardized small-group interviews about trauma patient handover. Based on this information, we created a questionnaire to gather perspectives from all Canadian Orthopaedic Association (COA) members about which topics they felt would be most important on a handover checklist. We analyzed the responses to develop a standardized handover checklist. Results Of the 1106 COA members, 247 responded to the questionnaire. The top 7 topics felt to be most important for achieving patient safety in the handover were comorbidities, diagnosis, readiness for the operating room, stability, associated injuries, history/mechanism of injury and outstanding issues. The expert recommendations were to have handover completed the same way every day, all appropriate radiographs available, adequate time, all appropriate laboratory work and more time to spend with patients with more severe illness. Conclusion Our main recommendations for safe handover are to use standardized checklists specific to the patient and site needs. We provide an example of a standardized checklist that should be used for preoperative handovers. To our knowledge, this is the first checklist for handover developed by a group of experts in orthopedic surgery, which is both manageable in length and simple to use. PMID:24461220

  20. Snow Catastrophe Conditions: What is its Impact on Orthopedic Injuries?

    PubMed Central

    Mardani-Kivi, Mohsen; Karimi-Mobarakeh, Mahmoud; Kazemnejad, Ehsan; Saheb-Ekhtiari, Khashayar; Hashemi-Motlagh, Keyvan

    2014-01-01

    Background: Iran places sixth amongst high risk natural disaster countries and Guilan province of Iran shoulders a large amount of socio-economic burden due to snow catastrophes. The more knowledge of circumstances we have, the more efficient our future encounters will be. Methods: In this retrospective study, of all of the patients admitted to Poursina Hospital due to snow and ice related trauma in the first two weeks of February 2014, 306 cases were found eligible for entry into the present study. Results: Of the 306 eligible patients (383 injuries), there were 175 men (57.2%) and 131 women (42.8%). Most patients suffered from orthopedic injuries (81%) and the most common fractures were distal radius fractures in the upper extremities and hip fractures in the lower extremities. Slipping was the most common and motor vehicle accidents had the rarest injury mechanisms. It was shown that the frequency of injuries were higher on icy days (67.6%) than snowy days (32.4%). Conclusions: Snow crises may lead to increased risk of slipping and falling situations, especially on icy days. The peak of injury rates is a few days after snowfall with the most common injury being distal radius fracture. Providing essential instructions and supporting resource allocation to better handle such catastrophes may improve outcomes. PMID:25207329

  1. PEEK Biomaterials in Trauma, Orthopedic, and Spinal Implants

    PubMed Central

    Kurtz, S. M.; Devine, J. N.

    2007-01-01

    Since the 1980s, polyaryletherketones (PAEKs) have been increasingly employed as biomaterials for trauma, orthopedic, and spinal implants. We have synthesized the extensive polymer science literature as it relates to structure, mechanical properties, and chemical resistance of PAEK biomaterials. With this foundation, one can more readily appreciate why this family of polymers will be inherently strong, inert, and biocompatible. Due to its relative inertness, PEEK biomaterials are an attractive platform upon which to develop novel bioactive materials, and some steps have already been taken in that direction, with the blending of HA and TCP into sintered PEEK. However, to date, blended HA-PEEK composites have involved a trade-off in mechanical properties in exchange for their increased bioactivity. PEEK has had the greatest clinical impact in the field of spine implant design, and PEEK is now broadly accepted as a radiolucent alternative to metallic biomaterials in the spine community. For mature fields, such as total joint replacements and fracture fixation implants, radiolucency is an attractive but not necessarily critical material feature. PMID:17686513

  2. Amino acid containing glass-ionomer cement for orthopedic applications

    NASA Astrophysics Data System (ADS)

    Wu, Wei

    Amino acid containing glass-ionomer cements were synthesized, formulated, and evaluated for orthopedic application. The formulation of different amino acid containing glass-ionomer bone cements was optimized, and conventional and resin-modified glass-ionomer bone cements were compared. Properties of interest included handling characteristics, physical and chemical properties, and mechanical strength of the bone cement. The study was based on the synthesis of different vinyl containing amino acids, different polyelectrolytes containing these amino acid residues, and different resin-modified polyelectrolytes, as well as formulation and evaluation of conventional and resin-modified glass-ionomer bone cements using these polyelectrolytes. Systematic preparation of polyelectrolytes and formulation of glass-ionomer bone cements were essential features of this work, since we anticipated that the mechanical properties of the glass-ionomer bone cements could be strongly affected by the nature of the polyelectrolytes and formulation. Mechanical properties were evaluated in a screw driven mechanical testing machine, and structure-property relationships were determined by scanning electron microscopic (SEM) observation of the fracture surface of the specimens. How the structure of polyelectrolytes, such as different amino acid residues, molecular weight, different modifying resin, and formulation of glass-ionomer bone cement, affected the mechanical properties was also studied.

  3. The Top 100 Cited Articles in Clinical Orthopedic Sports Medicine.

    PubMed

    Nayar, Suresh K; Dein, Eric J; Spiker, Andrea M; Bernard, Johnathan A; Zikria, Bashir A

    2015-08-01

    Orthopedic sports medicine continues to evolve, owing much of its clinical management and practice to rigorous academic research. In this review, we identify and describe the top 100 cited articles in clinical sports medicine and recognize the authors and institutions driving the research. We collected articles (excluding basic science, animal, and cadaveric studies) from the 25 highest-impact sports medicine journals and analyzed them by number of citations, journal, publication date, institution, country, topic, and author. Mean number of citations was 408 (range, 229-1629). The articles were published in 7 journals, most in the 1980s to 2000s, and represented 15 countries. Thirty topics were addressed, with a heavy emphasis on anterior cruciate ligament injury and reconstruction, knee rating systems, rotator cuff reconstruction, and chondrocyte transplantation. The 3 most cited articles, by Insall and colleagues, Constant and Murley, and Tegner and Lysholm, addressed a knee, a shoulder, and another knee rating system, respectively. Several authors contributed multiple articles. The Hospital for Special Surgery and the University of Bern contributed the most articles (5 each). This study provides a comprehensive list of the past century's major academic contributions to sports medicine. Residents and fellows may use this list to guide their scholarly investigations.

  4. Bioactive, mechanically favorable, and biodegradable copolymer nanocomposites for orthopedic applications.

    PubMed

    Victor, Sunita Prem; Muthu, Jayabalan

    2014-06-01

    We report the synthesis of mechanically favorable, bioactive, and biodegradable copolymer nanocomposites for potential bone applications. The nanocomposites consist of in situ polymerized biodegradable copolyester with hydroxyapatite (HA). Biodegradable copolyesters comprise carboxy terminated poly(propylene fumarate) (CT-PPF) and poly(trimethylol propane fumarate co mannitol sebacate) (TF-Co-MS). Raman spectral imaging clearly reveals a uniform homogenous distribution of HA in the copolymer matrix. The mechanical studies reveal that improved mechanical properties formed when crosslinked with methyl methacrylate (MMA) when compared to N-vinyl pyrrolidone (NVP). The SEM micrographs of the copolymer nanocomposites reveal a serrated structure reflecting higher mechanical strength, good dispersion, and good interfacial bonding of HA in the polymer matrix. In vitro degradation of the copolymer crosslinked with MMA is relatively more than that of NVP and the degradation decreases with an increase in the amount of the HA filler. The mechanically favorable and degradable MMA based nanocomposites also have favorable bioactivity, blood compatibility, cytocompatibility and cell adhesion. The present nanocomposite is a more promising material for orthopedic applications.

  5. Infection Mitigation Efficacy of Photoactive Titania on Orthopedic Implant Materials

    PubMed Central

    Azad, Abdul-Majeed; Hershey, Ryan; Aboelzahab, Asem; Goel, Vijay

    2011-01-01

    In order to impede infection and achieve accelerated wound healing in the postorthopaedic surgery patients, a simple and benign procedure for creating nanotubular or nanofibrillar structure of photoactive TiO2 on the surface of Ti plates and wires is described. The nanoscale TiO2 films on titanium were grown by hydrothermal processing in one case and by anodization in the presence of dilute mineral acids under mild and benign conditions in the other. Confocal microscopy results demonstrated at least 50% reduction in the population of E. coli colonies (concentration 2.15 × 107 cells/mL) on TiO2-coated implants upon an IR exposure of up to 30 s; it required ∼20 min of exposure to UV beam for the same effect. These findings suggest the probability of eliminating wound infection during and after orthopedic surgical procedures by brief illumination of photoactive titania films on the implants with an IR beam. PMID:21994891

  6. Tissue engineering strategies for the regeneration of orthopedic interfaces.

    PubMed

    Lu, Helen H; Subramony, Siddarth D; Boushell, Margaret K; Zhang, Xinzhi

    2010-06-01

    A major focus in the field of orthopedic tissue engineering is the development of tissue engineered bone and soft tissue grafts with biomimetic functionality to allow for their translation to the clinical setting. One of the most significant challenges of this endeavor is promoting the biological fixation of these grafts with each other as well as the implant site. Such fixation requires strategic biomimicry to be incorporated into the scaffold design in order to re-establish the critical structure-function relationship of the native soft tissue-to-bone interface. The integration of distinct tissue types (e.g. bone and soft tissues such as cartilage, ligaments, or tendons), necessitates a multi-phased or stratified scaffold with distinct yet continuous tissue regions accompanied by a gradient of mechanical properties. This review discusses tissue engineering strategies for regenerating common tissue-to-tissue interfaces (ligament-to-bone, tendon-to-bone, or cartilage-to-bone), and the strategic biomimicry implemented in stratified scaffold design for multi-tissue regeneration. Potential challenges and future directions in this emerging field will also be presented. It is anticipated that interface tissue engineering will enable integrative soft tissue repair, and will be instrumental for the development of complex musculoskeletal tissue systems with biomimetic complexity and functionality.

  7. Functional orthopedic magnetic appliance (FOMA) III--modus operandi.

    PubMed

    Vardimon, A D; Graber, T M; Voss, L R; Muller, T P

    1990-02-01

    An intraoral intermaxillary appliance has been developed for the treatment of Class III malocclusions that exhibit midface sagittal deficiency with or without mandibular excess. The functional orthopedic magnetic appliance (FOMA) III consists of upper and lower acrylic plates with a permanent magnet incorporated into each plate. The upper magnet is linked to a retraction screw. The upper magnet is retracted periodically (e.g., monthly) to stimulate maxillary advancement and mandibular retardation. The attractive mode neodymium magnets used in this study produced a horizontal force of 98 gm and a vertical force of 371 gm. Six female Macaca fascicularis monkeys were treated with FOMA IIIs. An additional three animals were treated with sham appliances. After 4 months of treatment, the following results were found: the growth pattern of the cranial base (saddle angle) was not altered; midfacial protraction did occur along a recumbent hyperbolic curve with a horizontal maxillary displacement and an anterosuperior premaxillary rotation; the cumulative protraction of the maxillary complex was initiated at the pterygomaxillary fissure with an additional contribution provided by other circummaxillary sutures (zygomaticomaxillary s., transverse s., premaxillary s.); and inhibition of mandibular length was minimal, but a tendency toward a vertical condylar growth pattern was observed. The interaction between sutural and condylar growth sites appeared biphasic, characterized by an immediate and rapid excitation of the circummaxillary sutures followed by a delayed and slow suppression of the condylar cartilage. Long-term animal and clinical FOMA III studies are recommended.

  8. Presurgical orthopedic premaxillary alignment in cleft lip and palate reconstruction.

    PubMed

    Papay, F A; Morales, L; Motoki, D S; Yamashiro, D K

    1994-11-01

    Premaxillary malposition is a difficult problem in cleft lip and palate repair. Orthopedic palatal devices are excellent in positioning the premaxilla, though they are somewhat cumbersome and require complex techniques in adjusting precisely the position of the premaxilla prior to repair. A new technique has been developed for premaxillary repositioning in conjunction with palatal shelf expansion and obturation. The procedure implements microplate fixation anterior to the premaxillary segment and linked to a palatal splint by adjustable elastics. The microplate is inserted through a nasal floor incision and secured by a tight submucosal tunnel through minimal dissection between the prolabium and premaxilla. The last hole of each microplate protrudes through the mucosa and is attached to a pin-retained palatal splint by an elastic chain. Differential tension is applied to the chains to allow gradual repositioning of the protruding maxilla while the splint expands and maintains positioning of the lateral palatal segments. These elastic retractors can be adjusted by staff in the outpatient office. During the past 2 years, this technique has been used successfully in 21 consecutive patients with unilateral or bilateral cleft lip and palate. Its technical ease and design allows simple adjustments to control premaxillary positioning and growth before definitive surgical closure.

  9. Image Manipulation: Then and Now.

    ERIC Educational Resources Information Center

    Sutton, Ronald E.

    The images of photography have been manipulated almost from the moment of their discovery. The blending together in the studio and darkroom of images not found in actual scenes from life has been a regular feature of modern photography in both art and advertising. Techniques of photograph manipulation include retouching; blocking out figures or…

  10. Modeling Manipulation in Medical Education

    ERIC Educational Resources Information Center

    Dailey, Jason I.

    2010-01-01

    As residents and medical students progress through their medical training, they are presented with multiple instances in which they feel they must manipulate the healthcare system and deceive others in order to efficiently treat their patients. This, however, creates a culture of manipulation resulting in untoward effects on trainees' ethical and…

  11. Thermoelectrical manipulation of nanomagnets

    NASA Astrophysics Data System (ADS)

    Kadigrobov, A. M.; Andersson, S.; Radić, D.; Shekhter, R. I.; Jonson, M.; Korenivski, V.

    2010-06-01

    We investigate the interplay between the thermodynamic properties and spin-dependent transport in a mesoscopic device based on a magnetic multilayer (F/f/F), in which two strongly ferromagnetic layers (F) are exchange-coupled through a weakly ferromagnetic spacer (f) with the Curie temperature in the vicinity of room temperature. We show theoretically that the Joule heating produced by the spin-dependent current allows a spin-thermoelectronic control of the ferromagnetic-to-paramagnetic (f/N) transition in the spacer and, thereby, of the relative orientation of the outer F-layers in the device (spin-thermoelectric manipulation of nanomagnets). Supporting experimental evidence of such thermally-controlled switching from parallel to antiparallel magnetization orientations in F/f(N)/F sandwiches is presented. Furthermore, we show theoretically that local Joule heating due to a high concentration of current in a magnetic point contact or a nanopillar can be used to reversibly drive the weakly ferromagnetic spacer through its Curie point and thereby exchange couple and decouple the two strongly ferromagnetic F-layers. For the devices designed to have an antiparallel ground state above the Curie point of the spacer, the associated spin-thermionic parallel to antiparallel switching causes magnetoresistance oscillations whose frequency can be controlled by proper biasing from essentially dc to GHz. We discuss in detail an experimental realization of a device that can operate as a thermomagnetoresistive switch or oscillator.

  12. Stereoscopically Observing Manipulative Actions

    PubMed Central

    Ferri, S.; Pauwels, K.; Rizzolatti, G.; Orban, G. A.

    2016-01-01

    The purpose of this study was to investigate the contribution of stereopsis to the processing of observed manipulative actions. To this end, we first combined the factors “stimulus type” (action, static control, and dynamic control), “stereopsis” (present, absent) and “viewpoint” (frontal, lateral) into a single design. Four sites in premotor, retro-insular (2) and parietal cortex operated specifically when actions were viewed stereoscopically and frontally. A second experiment clarified that the stereo-action-specific regions were driven by actions moving out of the frontoparallel plane, an effect amplified by frontal viewing in premotor cortex. Analysis of single voxels and their discriminatory power showed that the representation of action in the stereo-action-specific areas was more accurate when stereopsis was active. Further analyses showed that the 4 stereo-action-specific sites form a closed network converging onto the premotor node, which connects to parietal and occipitotemporal regions outside the network. Several of the specific sites are known to process vestibular signals, suggesting that the network combines observed actions in peripersonal space with gravitational signals. These findings have wider implications for the function of premotor cortex and the role of stereopsis in human behavior. PMID:27252350

  13. Genetic Manipulations in Dermatophytes.

    PubMed

    Alshahni, Mohamed Mahdi; Yamada, Tsuyoshi

    2017-02-01

    Dermatophytes are a group of closely related fungi that nourish on keratinized materials for their survival. They infect stratum corneum, nails, and hair of human and animals, accounting the largest portion of fungi causing superficial mycoses. Huge populations are suffering from dermatophytoses, though the biology of these fungi is largely unknown yet. Reasons are partially attributed to the poor amenability of dermatophytes to genetic manipulation. However, advancements in this field over the last decade made it possible to conduct genetic studies to satisfying extents. These included genetic transformation methods, indispensable molecular tools, i.e., dominant selectable markers, inducible promoter, and marker recycling system, along with improving homologous recombination frequency and gene silencing. Furthermore, annotated genome sequences of several dermatophytic species have recently been available, ensuring an optimal recruitment of the molecular tools to expand our knowledge on these fungi. In conclusion, the establishment of basic molecular tools and the availability of genomic data will open a new era that might change our understanding on the biology and pathogenicity of this fungal group.

  14. Manipulability, force, and compliance analysis for planar continuum manipulators.

    PubMed

    Gravagne, Ian A; Walker, Ian D

    2002-06-01

    Continuum manipulators, inspired by the natural capabilities of elephant trunks and octopus tentacles, may find niche applications in areas like human-robot interaction, multiarm manipulation, and unknown environment exploration. However, their true capabilities will remain largely inaccessible without proper analytical tools to evaluate their unique properties. Ellipsoids have long served as one of the foremost analytical tools available to the robotics researcher, and the purpose of this paper is to first formulate, and then to examine, three types of ellipsoids for continuum robots: manipulability, force, and compliance.

  15. Manipulability, force, and compliance analysis for planar continuum manipulators

    NASA Technical Reports Server (NTRS)

    Gravagne, Ian A.; Walker, Ian D.

    2002-01-01

    Continuum manipulators, inspired by the natural capabilities of elephant trunks and octopus tentacles, may find niche applications in areas like human-robot interaction, multiarm manipulation, and unknown environment exploration. However, their true capabilities will remain largely inaccessible without proper analytical tools to evaluate their unique properties. Ellipsoids have long served as one of the foremost analytical tools available to the robotics researcher, and the purpose of this paper is to first formulate, and then to examine, three types of ellipsoids for continuum robots: manipulability, force, and compliance.

  16. [Joint position statement of the Mexican College of Orthopedics and Traumatology: prophylaxis for venous thromboembolic disease in high-risk orthopedic surgery].

    PubMed

    Meza-Reyes, G E; Cymet-Ramírez, J; Esquivel-Gómez, R; del Campo-Sánchez, Martínez A; Martínez-Guzmán, M A E; Espinosa-Larrañaga, F; Majluf-Cruz, A; Torres-González, R; De la Fuente-Zuno, J C; Villalobos-Garduño, E; Méndez-Huerta, J V; Ibarra-Hirales, E; Valles-Figueroa, J F; Aguilera-Zepeda, J M; Díaz-Borjón, E

    2011-01-01

    Venous thromboembolic disease (VTED) is a public health problem worldwide. In the United States it causes 2 million annual cases. Its annual incidence is 1-2 cases per 1,000 individuals in the general population. It is a disease frequently associated with life threatening complications and its mortality rate is 1-5% of cases. Due to its high complication rate, its slow recovery, and the need for prolonged disability, it is considered as a high-cost disease. VTED may occur in both surgical and medical patients; the known associated risk factors include prolonged rest, active cancer, congestive heart failure, atrial fibrillation, and stroke, among the major medical conditions. Orthopedic surgery represents the main surgical risk factor for VTED, including mainly hip and knee replacements, as well as polytraumatized patients with severe spinal lesions, and major fractures. VTED may be prevented with the appropriate use of antithrombotics. The participants in this consensus defined thromboprophylaxis as the strategy and actions undertaken to reduce the risk of VTED in patients undergoing high risk orthopedic surgery. The position of the Mexican College of Orthopedics and Traumatology regarding the prevention of VTED in orthopedic surgery is described herein.

  17. Transmaxillary osteogenesis distraction combined with orthopedics and orthodontics in the correction of a severe retrusion of the upper maxilla.

    PubMed

    Aguirre, Inés Ulfe; Dogliotti, Pedro Luis

    2004-09-01

    A patient having adequate records and diagnosed as having Binder syndrome is presented. Nasomaxillary hypoplasia requires a definitive treatment, use of bone grafts, upper maxillary osteotomies, and advancement or a combination of both. Bone grafts can be reabsorbed, and complete maxillary advance modifies normal occlusion in a certain way, because the posterior sector is not compromised. The aim of this case treatment is to create a new osseous surface that makes the eruption of the permanent dental pieces easier and gives the correct skeletal position to the upper maxilla with distraction osteogenesis combined with an orthopedic appliance, transmaxillary segment osteotomy, and subsequent orthodontics. The absence of the osseous surface in the upper maxilla and the presence of supernumeraries in the anterior region determined the permanence of most of the temporary dental pieces, resulting in the impossibility of making the exchange to permanent dental pieces. The technique and the devices are simple and easy to manipulate. After the treatment, an adequate dental relation is restored as well as effective advance of the upper maxillary bone; thus, an excellent functional and stable esthetic result is achieved, avoiding any complication of velopharingeal incompetence.

  18. Poly(2-methacryloyloxyethyl phosphorylcholine) grafting and vitamin E blending for high wear resistance and oxidative stability of orthopedic bearings.

    PubMed

    Kyomoto, Masayuki; Moro, Toru; Yamane, Shihori; Watanabe, Kenichi; Hashimoto, Masami; Takatori, Yoshio; Tanaka, Sakae; Ishihara, Kazuhiko

    2014-08-01

    The ultimate goal in manipulating the surface and substrate of a cross-linked polyethylene (CLPE) liner is to obtain not only high wear resistance but also high oxidative stability and high-mechanical properties for life-long orthopedic bearings. We have demonstrated the fabrication of highly hydrophilic and lubricious poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) grafting layer onto the antioxidant vitamin E-blended CLPE (HD-CLPE(VE)) surface. The PMPC grafting layer with a thickness of 100 nm was successfully fabricated on the vitamin E-blended CLPE surface by using photoinduced-radical graft polymerization. Since PMPC has a highly hydrophilic nature, the water wettability and lubricity of the PMPC-grafted CLPE and HD-CLPE(VE) surfaces were greater than that of the untreated CLPE surface. The PMPC grafting contributed significantly to wear reduction in a hip-joint simulator wear test. Despite high-dose gamma-ray irradiation for cross-linking and further UV irradiation for PMPC grafting, the substrate modified by vitamin E blending maintained high-oxidative stability because vitamin E is an extremely efficient radical scavenger. Furthermore, the mechanical properties of the substrate remained almost unchanged even after PMPC grafting or vitamin E blending, or both PMPC grafting and vitamin E blending. In conclusion, the PMPC-grafted HD-CLPE(VE) provided simultaneously high-wear resistance, oxidative stability, and mechanical properties.

  19. Direct Manipulation in Virtual Reality

    NASA Technical Reports Server (NTRS)

    Bryson, Steve

    2003-01-01

    Virtual Reality interfaces offer several advantages for scientific visualization such as the ability to perceive three-dimensional data structures in a natural way. The focus of this chapter is direct manipulation, the ability for a user in virtual reality to control objects in the virtual environment in a direct and natural way, much as objects are manipulated in the real world. Direct manipulation provides many advantages for the exploration of complex, multi-dimensional data sets, by allowing the investigator the ability to intuitively explore the data environment. Because direct manipulation is essentially a control interface, it is better suited for the exploration and analysis of a data set than for the publishing or communication of features found in that data set. Thus direct manipulation is most relevant to the analysis of complex data that fills a volume of three-dimensional space, such as a fluid flow data set. Direct manipulation allows the intuitive exploration of that data, which facilitates the discovery of data features that would be difficult to find using more conventional visualization methods. Using a direct manipulation interface in virtual reality, an investigator can, for example, move a data probe about in space, watching the results and getting a sense of how the data varies within its spatial volume.

  20. Chemokines Associated with Pathologic Responses to Orthopedic Implant Debris

    PubMed Central

    Hallab, Nadim J.; Jacobs, Joshua J.

    2017-01-01

    Despite the success in returning people to health saving mobility and high quality of life, the over 1 million total joint replacements implanted in the US each year are expected to eventually fail after approximately 15–25 years of use, due to slow progressive subtle inflammation to implant debris compromising the bone implant interface. This local inflammatory pseudo disease state is primarily caused by implant debris interaction with innate immune cells, i.e., macrophages. This implant debris can also activate an adaptive immune reaction giving rise to the concept of implant-related metal sensitivity. However, a consensus of studies agree the dominant form of this response is due to innate reactivity by macrophages to implant debris danger signaling (danger-associated molecular pattern) eliciting cytokine-based and chemokine inflammatory responses. This review covers implant debris-induced release of the cytokines and chemokines due to activation of the innate (and the adaptive) immune system and how this leads to subsequent implant failure through loosening and osteolysis, i.e., what is known of central chemokines (e.g., IL-8, monocyte chemotactic protein-1, MIP-1, CCL9, CCL10, CCL17, and CCL22) associated with implant debris reactivity as related to the innate immune system activation/cytokine expression, e.g., danger signaling (e.g., IL-1β, IL-18, IL-33, etc.), toll-like receptor activation (e.g., IL-6, tumor necrosis factor α, etc.), bone catabolism (e.g., TRAP5b), and hypoxia responses (HIF-1α). More study is needed, however, to fully understand these interactions to effectively counter cytokine- and chemokine-based orthopedic implant-related inflammation. PMID:28154552

  1. Chitosan for gene delivery and orthopedic tissue engineering applications.

    PubMed

    Raftery, Rosanne; O'Brien, Fergal J; Cryan, Sally-Ann

    2013-05-15

    Gene therapy involves the introduction of foreign genetic material into cells in order exert a therapeutic effect. The application of gene therapy to the field of orthopaedic tissue engineering is extremely promising as the controlled release of therapeutic proteins such as bone morphogenetic proteins have been shown to stimulate bone repair. However, there are a number of drawbacks associated with viral and synthetic non-viral gene delivery approaches. One natural polymer which has generated interest as a gene delivery vector is chitosan. Chitosan is biodegradable, biocompatible and non-toxic. Much of the appeal of chitosan is due to the presence of primary amine groups in its repeating units which become protonated in acidic conditions. This property makes it a promising candidate for non-viral gene delivery. Chitosan-based vectors have been shown to transfect a number of cell types including human embryonic kidney cells (HEK293) and human cervical cancer cells (HeLa). Aside from its use in gene delivery, chitosan possesses a range of properties that show promise in tissue engineering applications; it is biodegradable, biocompatible, has anti-bacterial activity, and, its cationic nature allows for electrostatic interaction with glycosaminoglycans and other proteoglycans. It can be used to make nano- and microparticles, sponges, gels, membranes and porous scaffolds. Chitosan has also been shown to enhance mineral deposition during osteogenic differentiation of MSCs in vitro. The purpose of this review is to critically discuss the use of chitosan as a gene delivery vector with emphasis on its application in orthopedic tissue engineering.

  2. Biocompatibility evaluation of porous ceria foams for orthopedic tissue engineering.

    PubMed

    Ball, Jordan P; Mound, Brittnee A; Monsalve, Adam G; Nino, Juan C; Allen, Josephine B

    2015-01-01

    Ceria ceramics have the unique ability to protect cells from free radical-induced damage, making them materials of interest for biomedical applications. To expand upon the understanding of the potential of ceria as a biomaterial, porous ceria, fabricated via direct foaming, was investigated to assess its biocompatibility and its ability to scavenge free radicals. A mouse osteoblast (7F2) cell line was cultured with the ceria foams to determine the extent of the foams' toxicity. Toxicity assessments indicate that mouse osteoblasts cultured directly on the ceria scaffold for 72 h did not show a significant (p > 0.05) increase in toxicity, but rather show comparable toxicity to cells cultured on porous 45S5 Bioglass. The in vitro inflammatory response elicited from porous ceria foams was measured as a function of tumor necrosis factor alpha (TNF-α) secreted from a human monocytic leukemia cell line. Results indicate that the ceria foams do not cause a significant inflammatory response, eliciting a response of 27.1 ± 7.1 pg mL(-1) of TNF-α compared to 36.3 ± 5.8 pg mL(-1) from cells on Bioglass, and 20.1 ± 2.9 pg mL(-1) from untreated cells. Finally, we report cellular toxicity in response to free radicals from tert-butyl hydroperoxide with and without foamed ceria. Our preliminary results show that the foamed ceria is able to decrease the toxic effect of induced oxidative stress. Collectively, this study demonstrates that foamed ceria scaffolds do not activate an inflammatory response, and show potential free radical scavenging ability, thus they have promise as an orthopedic biomaterial.

  3. Autonomous Object Manipulation Using a Soft Planar Grasping Manipulator

    PubMed Central

    Katzschmann, Robert K.; Marchese, Andrew D.

    2015-01-01

    Abstract This article presents the development of an autonomous motion planning algorithm for a soft planar grasping manipulator capable of grasp-and-place operations by encapsulation with uncertainty in the position and shape of the object. The end effector of the soft manipulator is fabricated in one piece without weakening seams using lost-wax casting instead of the commonly used multilayer lamination process. The soft manipulation system can grasp randomly positioned objects within its reachable envelope and move them to a desired location without human intervention. The autonomous planning system leverages the compliance and continuum bending of the soft grasping manipulator to achieve repeatable grasps in the presence of uncertainty. A suite of experiments is presented that demonstrates the system's capabilities. PMID:27625916

  4. Autonomous Object Manipulation Using a Soft Planar Grasping Manipulator.

    PubMed

    Katzschmann, Robert K; Marchese, Andrew D; Rus, Daniela

    2015-12-01

    This article presents the development of an autonomous motion planning algorithm for a soft planar grasping manipulator capable of grasp-and-place operations by encapsulation with uncertainty in the position and shape of the object. The end effector of the soft manipulator is fabricated in one piece without weakening seams using lost-wax casting instead of the commonly used multilayer lamination process. The soft manipulation system can grasp randomly positioned objects within its reachable envelope and move them to a desired location without human intervention. The autonomous planning system leverages the compliance and continuum bending of the soft grasping manipulator to achieve repeatable grasps in the presence of uncertainty. A suite of experiments is presented that demonstrates the system's capabilities.

  5. Manipulator control by exact linearization

    NASA Technical Reports Server (NTRS)

    Kruetz, K.

    1987-01-01

    Comments on the application to rigid link manipulators of geometric control theory, resolved acceleration control, operational space control, and nonlinear decoupling theory are given, and the essential unity of these techniques for externally linearizing and decoupling end effector dynamics is discussed. Exploiting the fact that the mass matrix of a rigid link manipulator is positive definite, a consequence of rigid link manipulators belonging to the class of natural physical systems, it is shown that a necessary and sufficient condition for a locally externally linearizing and output decoupling feedback law to exist is that the end effector Jacobian matrix be nonsingular. Furthermore, this linearizing feedback is easy to produce.

  6. Dealing with innovation and costs in orthopedics: a conversation with Dane Miller. Interview by Lawton R Burns.

    PubMed

    Miller, Dane

    2006-01-01

    Rob Burns talks with Dane Miller, former CEO of Biomet, about challenges posed by new technology in the orthopedic devices area. One key challenge is the rising cost and use of orthopedic devices at a time when providers are facing decreased profitability and reimbursement for orthopedic services. Another challenge is the long-term time horizon needed to gauge product success that contrasts with payers' and providers' short-term horizon. A third challenge is heightened governmental scrutiny of device makers' relationships with orthopedic surgeons. This interview was conducted before Miller left Biomet in March 2006.

  7. [Dental orthopedic service for retirees from MD RF in medical institutions of state and municipal system of healthcare].

    PubMed

    Malykh, A B; Grebnev, G A; Butsenko, S A; Pastukhov, A G

    2012-04-01

    Financial feasibility study of dental orthopedic service for retirees of Ministry of Defence is analyzed, suggestions about the organization of dental orthopedic service for contingent in medical institution of state and municipal system of healthcare. Information about the number of retirees, index of needs in dental orthopedic service which was 40,29%, information about 2806 prosthodontics oders for retirees in military medical institution, data about the average price of production of dental in different subjects of Russian Federation is the basis of the given research. Algorithm of dental orthopedic service for retirees by stomatologies is suggested.

  8. Building Fractal Models with Manipulatives.

    ERIC Educational Resources Information Center

    Coes, Loring

    1993-01-01

    Uses manipulative materials to build and examine geometric models that simulate the self-similarity properties of fractals. Examples are discussed in two dimensions, three dimensions, and the fractal dimension. Discusses how models can be misleading. (Contains 10 references.) (MDH)

  9. Machine intelligence for autonomous manipulation.

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.

    1973-01-01

    Survey of the present technological development status of machine intelligence for autonomous manipulation in the U.S., Japan, USSR, and England. The extent of task-performance autonomy is examined that machine intelligence gives the manipulator by eliminating the need for a human operator to close continuously the control loop, or to rewrite control programs for each different task. Surveyed research projects show that the development of some advanced automation systems for manipulator control are within the state of the art. Yet, many more realistic breadboard systems and experimental work are needed before further progress can be made in the design of advanced automation systems for manipulator control suitable for new major practical applications. Specific research areas of promise are pointed out.

  10. Biological Strategies for Improved Osseointegration and Osteoinduction of Porous Metal Orthopedic Implants

    PubMed Central

    Riester, Scott M.; Bonin, Carolina A.; Kremers, Hilal Maradit; Dudakovic, Amel; Kakar, Sanjeev; Cohen, Robert C.; Westendorf, Jennifer J.

    2015-01-01

    The biological interface between an orthopedic implant and the surrounding host tissue may have a dramatic effect upon clinical outcome. Desired effects include bony ingrowth (osseointegration), stimulation of osteogenesis (osteoinduction), increased vascularization, and improved mechanical stability. Implant loosening, fibrous encapsulation, corrosion, infection, and inflammation, as well as physical mismatch may have deleterious clinical effects. This is particularly true of implants used in the reconstruction of load-bearing synovial joints such as the knee, hip, and the shoulder. The surfaces of orthopedic implants have evolved from solid-smooth to roughened-coarse and most recently, to porous in an effort to create a three-dimensional architecture for bone apposition and osseointegration. Total joint surgeries are increasingly performed in younger individuals with a longer life expectancy, and therefore, the postimplantation lifespan of devices must increase commensurately. This review discusses advancements in biomaterials science and cell-based therapies that may further improve orthopedic success rates. We focus on material and biological properties of orthopedic implants fabricated from porous metal and highlight some relevant developments in stem-cell research. We posit that the ideal primary and revision orthopedic load-bearing metal implants are highly porous and may be chemically modified to induce stem cell growth and osteogenic differentiation, while minimizing inflammation and infection. We conclude that integration of new biological, chemical, and mechanical methods is likely to yield more effective strategies to control and modify the implant–bone interface and thereby improve long-term clinical outcomes. PMID:25348836

  11. [Hopes for future practice of junior orthopedic surgeons in France: a sociological study].

    PubMed

    Grégory, T; Gaillard, R; Grenier, A

    2007-09-01

    Medical demographics have become a major public health issue in France since the publication of the Berlan report in 2002 which announced an upcoming shortage in the next 20 years. But demographic projections cannot be limited to an accounting of training and retirement figures. Other factors such as demographic distribution, changing societal aspirations (free time), modes and sites of occupational activities, the influence of feminization, and initial training and its effects on professional practice must be taken into consideration. The purpose of this work was to study these parameters in orthopedic and traumatology surgery. This was a sociological study designed to ascertain the aspirations of junior orthopedic surgeons. Forty-seven interns in orthopedic surgery in the Paris area were invited to complete a questionnaire in March 2003. Forty-two responded. The choice of orthopedics was an intellectual choice. The attractiveness of the specialty was particularly important during the final years of medical school. Fewer junior surgeons would rather practice in a university hospital setting, more preferring a mixed setting with a private (fees) and a public (salary) component. The desire for "free time" was particularly important. Fewer juniors wanted to practice in general hospitals. For orthopedic surgeons, private practice and payment by fees are the cornerstones of medical practice.

  12. OrthoEvidence™: A Clinical Resource for Evidence-Based Orthopedics

    PubMed Central

    Sprague, Sheila; Smith, Chris; Bhandari, Mohit

    2015-01-01

    The prevalence of musculoskeletal issues in clinical practice, and the limited focus placed upon musculoskeletal conditions by current electronic summary resources, highlights the need for a resource that provides access to simple and concise summaries of top-quality orthopedic literature for orthopedic surgeons and allied healthcare professionals. OrthoEvidence™ is an online clinical resource that addresses the paucity of adequate evidence-based summary tools in the field of orthopedic surgery. OrthoEvidence™ uses a rigorous, transparent, and unique process to review, evaluate, and summarize high quality research studies and their implications for orthopedic clinical practice. Randomized controlled trials and meta-analyses are identified and reviewed by an expert medical writing team, who prepare Advanced Clinical Evidence (ACETM) reports: one or two detailed pages including critical appraisals and synopses of key research. These timely and targeted reports provide a clear understanding about the quality of evidence associated with each summarized study, and can be organized by users to identify trending information. OrthoEvidence™ allows members to use their time efficiently and to stay current by having access to a breadth of timely, high-quality research output. OrthoEvidence™ is easily accessible through the internet and is available at the point-of-care, which allows treating orthopedic surgeons and allied health professionals to easily practice the principles of evidence-based medicine within their clinical practices.. PMID:26330990

  13. Mobile Device Trends in Orthopedic Surgery: Rapid Change and Future Implications.

    PubMed

    Andrawis, John P; Muzykewicz, David A; Franko, Orrin I

    2016-01-01

    Mobile devices are increasingly becoming integral communication and clinical tools. Monitoring the prevalence and utilization characteristics of surgeons and trainees is critical to understanding how these new technologies can be best used in practice. The authors conducted a prospective Internet-based survey over 7 time points from August 2010 to August 2014 at all nationwide American Council for Graduate Medical Education-accredited orthopedic programs. The survey questionnaire was designed to evaluate the use of devices and mobile applications (apps) among trainees and physicians in the clinical setting. Results were analyzed and summarized for orthopedic surgeons and trainees. During the 48-month period, there were 7 time points with 467, 622, 329, 223, 237, 111, and 134 responses. Mobile device use in the clinical setting increased across all fields and levels of training during the study period. Orthopedic trainees increased their use of Smartphone apps in the clinical setting from 60% to 84%, whereas attending use increased from 41% to 61%. During this time frame, use of Apple/Android platforms increased from 45%/13% to 85%/15%, respectively. At all time points, 70% of orthopedic surgeons believed their institution/hospital should support mobile device use. As measured over a 48-month period, mobile devices have become an ubiquitous tool in the clinical setting among orthopedic surgeons and trainees. The authors expect these trends to continue and encourage providers and trainees to be aware of the limitations and risks inherent with new technology.

  14. Orthopedic Management of Patients with Pompe Disease: A Retrospective Case Series of 8 Patients

    PubMed Central

    Forst, Jürgen; Forst, Raimund

    2014-01-01

    Introduction. Pompe disease (PD), a lysosomal storage disease as well as a neuromuscular disorder, is a rare disease marked by progressive muscle weakness. Enzyme replacement therapy (ERT) in recent years allowed longer survival but brought new problems to the treatment of PD with increasing affection of the musculoskeletal system, particularly with a significantly higher prevalence of scoliosis. The present paper deals with the orthopedic problems in patients with PD and is the first to describe surgical treatment of scoliosis in PD patients. Patients and Methods. The orthopedic problems and treatment of eight patients with PD from orthopedic consultation for neuromuscular disorders are retrospectively presented. We analyzed the problems of scoliosis, hip dysplasia, feet deformities, and contractures and presented the orthopedic treatment options. Results. Six of our eight PD patients had scoliosis and two young patients were treated by operative spine stabilization with benefits for posture and sitting ability. Hip joint surgery, operative contracture release, and feet deformity correction were performed with benefits for independent activity. Conclusion. Orthopedic management gains importance due to extended survival and musculoskeletal involvement under ERT. Surgical treatment is indicated in distinct cases. Further investigation is required to evidence the effect of surgical spine stabilization in PD. PMID:24523658

  15. Parametric study of orthopedic insole of valgus foot on partial foot amputation.

    PubMed

    Guo, Jun-Chao; Wang, Li-Zhen; Chen, Wei; Du, Cheng-Fei; Mo, Zhong-Jun; Fan, Yu-Bo

    2016-01-01

    Orthopedic insole was important for partial foot amputation (PFA) to achieve foot balance and avoid foot deformity. The inapposite insole orthosis was thought to be one of the risk factors of reamputation for foot valgus patient, but biomechanical effects of internal tissues on valgus foot had not been clearly addressed. In this study, plantar pressure on heel and metatarsal regions of PFA was measured using F-Scan. The three-dimensional finite element (FE) model of partial foot evaluated different medial wedge angles (MWAs) (0.0°-10.0°) of orthopedic insole on valgus foot. The effect of orthopedic insole on the internal bone stress, the medial ligament tension of ankle, plantar fascia tension, and plantar pressure was investigated. Plantar pressure on medial heel region was about 2.5 times higher than that of lateral region based on the F-Scan measurements. FE-predicted results showed that the tension of medial ankle ligaments was the lowest, and the plantar pressure was redistributed around the heel, the first metatarsal, and the lateral longitudinal arch regions when MWA of orthopedic insole ranged from 7.5° to 8.0°. The plantar fascias maintained about 3.5% of the total load bearing on foot. However, the internal stresses from foot bones increased. The simulation in this study would provide the suggestion of guiding optimal design of orthopedic insole and therapeutic planning to pedorthist.

  16. Dynamic Scaling of Manipulator Trajectories.

    DTIC Science & Technology

    1983-01-01

    Manipulators Robotics Trajectory Planning Manipulator Dynamics 20. ABSTRACT (Conftnue wn reverse side ID neceeOor Oine Identlfy b? block nuemNer) A...receives a c factor for each b(i). ’lhus both terms change equally with differing movement speeds. This contradicts the normal assumption in the robotics ...as well since they share the same significance as the velocity terms, yet this is not done. In any case, future generations of robots will contain

  17. Manipulation: description, identification and ambiguity.

    PubMed

    Bowers, L

    2003-06-01

    The word manipulation is frequently applied to some of the difficult-to-manage behaviours of the personality-disordered patient. However, the term is rarely defined, and a review of both the clinical and research literature shows that little has been written about its definition and identification, let alone its clinical management in both in- and outpatient settings. Recent empirical work conducted with nurses in forensic settings has demonstrated the range of behaviours that professionals refer to as 'manipulative', thus clarifying the use of the term and allowing the provision of a more precise definition. The scope of manipulation in everyday life, management practice and politics is perhaps relatively small, although manipulation can occur in all areas of human activity. Social behaviour is doubly ambiguous with respect to judgements of manipulation, as such judgements involve a moral evaluation combined with the identification of deception on the basis of little or partial evidence. The implications of this social ambiguity for clinical psychiatric practice are that professionals need to guard themselves from two polar faults: seeing manipulation everywhere; or being blind to its presence. In order to achieve a cautious moderation, staff need to hold both alternatives in mind at all times.

  18. Functional orthopedic magnetic appliance (FOMA) II--modus operandi.

    PubMed

    Vardimon, A D; Stutzmann, J J; Graber, T M; Voss, L R; Petrovic, A G

    1989-05-01

    A new functional appliance (FA) to correct Class II dentoskeletal malocclusions is introduced. The functional orthopedic magnetic appliance (FOMA) II uses upper and lower attracting magnetic means (Nd2Fe14B) to constrain the lower jaw in an advanced sagittal posture. In vitro, a special gauge transducer measured the magnetic attractive path and forces. In vivo, 13 prepubertal female Macaca fascicularis monkeys received facial implants and were treated for 4 months with the following appliances: conventional FA (four subjects), FOMA II (five subjects), a combined FOMA II + FA (two subjects), and sham (control) appliance (two subjects). The in vitro results showed the following: vertico-sagitally displaced upper and lower magnets attracted ultimately along an oblique line with a terminal horizonal slide to become fully superimposed; the functional performance improved when the magnetic interface acted as a magnetic inclined plane; and the magnetic force was able to guide and constrain the mandible toward the constructive protrusive closure position (CPCP) (1.2 mm, F = 570 gm) from levels below the habitual rest position (3 mm, F = 219 gm) and the electromyographic (EMG) relaxed position (8.5 mm, F = 45 gm). The in vivo results demonstrated the following: functional performance increased in FOMA II (22%) and in the combined FOMA II + FA (28%) over the conventional FA; mandibular length increased significantly in the treated animals (means = 2.83 +/- 0.70 mm) over the control animals (means = 0.43 +/- 0.08 mm); incisor proclination was lower in magnetic appliances (means = 4.57 +/- 1.76 degrees) than in the conventional FA (means = 8.75 +/- 1.85 degrees); mandibular elongation and condylar posterior inclination resulted from posterosuperior endochondral growth (increased cell proliferation and/or hyperplasia of functional chondroblasts) and by bony remodeling of the condylar neck (apposition posterior border, resorption anterior border), respectively; virtually no

  19. Hepatitis C virus infection: review and implications for the orthopedic surgeon.

    PubMed

    McGrory, B J; Kilby, A E

    2000-04-01

    Hepatitis C virus (HCV), a single-stranded ribonucleic acid virus identified in 1989, is estimated to have infected 1%-2% of the United States population. The incidence of HCV in patients requiring orthopedic surgery may be as high as 5%. Surgeons and operating room personnel are at risk for blood-borne diseases transmitted during surgery. The orthopedic surgeon must be aware of viral infection with this pathogen for the safety of the entire operating room team. Further, screening for HCV is routinely done when a patient donates autologous blood prior to elective surgery, and the orthopedic surgeon is often the first or only physician informed of a positive result. The surgeon should know how to interpret the result, advise the patient, and incorporate the diagnosis of HCV into the plan for the proposed surgery. We will review the natural history, transmission, evaluation of, and current treatment for infection with this blood-borne virus.

  20. The education, role, distribution, and compensation of physician assistants in orthopedic surgery.

    PubMed

    Chalupa, Robyn L; Hooker, Roderick S

    2016-05-01

    Physician assistants (PAs) have worked alongside surgeons since the 1970s, yet little is known about their postgraduate education, roles, distribution, and compensation. In 2015, an estimated 8,900 PAs were employed in orthopedics (9.4% of all clinically active PAs in the United States). This study analyzed surveys undertaken by Physician Assistants in Orthopaedic Surgery (PAOS) from 2009 to 2015 and found that most PAs working in orthopedics (85%) reported regularly assisting in surgery. Demand for PAs in orthopedics is expected to grow because of population growth, increasing incidence of musculoskeletal conditions, shortages of surgeons, and changing technology. Improved data acquisition and more detailed analyses are needed to better understand the nature of this specialized workforce.

  1. Does Weather Matter? The Effect of Weather Patterns and Temporal Factors on Pediatric Orthopedic Trauma Volume

    PubMed Central

    Livingston, Kristin S.; Miller, Patricia E.; Lierhaus, Anneliese; Matheney, Travis H.; Mahan, Susan T.

    2016-01-01

    Objectives: Orthopaedists often speculate how weather and school schedule may influence pediatric orthopedic trauma volume, but few studies have examined this. This study aims to determine: how do weather patterns, day, month, season and public school schedule influence the daily frequency of pediatric orthopedic trauma consults and admissions? Methods: With IRB approval, orthopedic trauma data from a level 1 pediatric trauma center, including number of daily orthopedic trauma consults and admissions, were collected from July 2009 to March 2012. Historical weather data (high temperatures, precipitation and hours of daylight), along with local public school schedule data were collected for the same time period. Univariate and multivariate regression models were used to show the average number of orthopedic trauma consults and admissions as a function of weather and temporal variables. Results: High temperature, precipitation, month and day of the week significantly affected the number of daily consults and admissions. The number of consults and admissions increased by 1% for each degree increase in temperature (p=0.001 and p<0.001, respectively), and decreased by 21% for each inch of precipitation (p<0.001, p=0.006). Daily consults on snowy days decreased by an additional 16% compared to days with no precipitation. November had the lowest daily consult and admission rate, while September had the highest. Daily consult rate was lowest on Wednesdays and highest on Saturdays. Holiday schedule was not independently significant. Conclusion: Pediatric orthopedic trauma consultations and admissions are highly linked to temperature and precipitation, as well as day of the week and time of year. PMID:27990193

  2. Multi-detector CT imaging in the postoperative orthopedic patient with metal hardware.

    PubMed

    Vande Berg, Bruno; Malghem, Jacques; Maldague, Baudouin; Lecouvet, Frederic

    2006-12-01

    Multi-detector CT imaging (MDCT) becomes routine imaging modality in the assessment of the postoperative orthopedic patients with metallic instrumentation that degrades image quality at MR imaging. This article reviews the physical basis and CT appearance of such metal-related artifacts. It also addresses the clinical value of MDCT in postoperative orthopedic patients with emphasis on fracture healing, spinal fusion or arthrodesis, and joint replacement. MDCT imaging shows limitations in the assessment of the bone marrow cavity and of the soft tissues for which MR imaging remains the imaging modality of choice despite metal-related anatomic distortions and signal alteration.

  3. Temporomandibular joint orthopedics with anterior repositioning appliance therapy and therapeutic injections.

    PubMed

    Simmons, Clifton

    2014-08-01

    TMD orthopedics is the assessment, diagnosis and management of orthopedic disorders of the temporomandibular joint (TMJ). Anterior repositioning appliance (ARA) therapy for TMJ internal derangements is successful in long-term recapturing of disks in reducing and nonreducing joints at a rate of 64 percent and in regenerating degenerated condyles in some cases. ARA therapy for TMJ internal derangements is subjectively successful in relieving symptoms in reducing and nonreducing disk displacement TMJs in this study at an average rate of 94.5 percent.

  4. Do Astronauts have a Higher Rate of Orthopedic Shoulder Conditions than a Cohort of Working Professionals?

    NASA Technical Reports Server (NTRS)

    Laughlin, Mitzi S.; Murray, Jocelyn D.; Young, Millenia; Wear, Mary L.; Tarver, W. J.; Van Baalen, Mary

    2016-01-01

    Occupational surveillance of astronaut shoulder injuries began with operational concerns at the Neutral Buoyancy Laboratory (NBL) during Extra Vehicular Activity (EVA) training. NASA has implemented several occupational health initiatives during the past 20 years to decrease the number and severity of injuries, but the individual success rate is unknown. Orthopedic shoulder injury and surgery rates were calculated, but classifying the rates as normal, high or low was highly dependent on the comparison group. The purpose of this study was to identify a population of working professionals and compare orthopedic shoulder consultation and surgery rates.

  5. High precision redundant robotic manipulator

    DOEpatents

    Young, Kar-Keung David

    1998-01-01

    A high precision redundant robotic manipulator for overcoming contents imposed by obstacles or imposed by a highly congested work space. One embodiment of the manipulator has four degrees of freedom and another embodiment has seven degreed of freedom. Each of the embodiments utilize a first selective compliant assembly robot arm (SCARA) configuration to provide high stiffness in the vertical plane, a second SCARA configuration to provide high stiffness in the horizontal plane. The seven degree of freedom embodiment also utilizes kinematic redundancy to provide the capability of avoiding obstacles that lie between the base of the manipulator and the end effector or link of the manipulator. These additional three degrees of freedom are added at the wrist link of the manipulator to provide pitch, yaw and roll. The seven degrees of freedom embodiment uses one revolute point per degree of freedom. For each of the revolute joints, a harmonic gear coupled to an electric motor is introduced, and together with properly designed based servo controllers provide an end point repeatability of less than 10 microns.

  6. High precision redundant robotic manipulator

    DOEpatents

    Young, K.K.D.

    1998-09-22

    A high precision redundant robotic manipulator for overcoming contents imposed by obstacles or imposed by a highly congested work space is disclosed. One embodiment of the manipulator has four degrees of freedom and another embodiment has seven degrees of freedom. Each of the embodiments utilize a first selective compliant assembly robot arm (SCARA) configuration to provide high stiffness in the vertical plane, a second SCARA configuration to provide high stiffness in the horizontal plane. The seven degree of freedom embodiment also utilizes kinematic redundancy to provide the capability of avoiding obstacles that lie between the base of the manipulator and the end effector or link of the manipulator. These additional three degrees of freedom are added at the wrist link of the manipulator to provide pitch, yaw and roll. The seven degrees of freedom embodiment uses one revolute point per degree of freedom. For each of the revolute joints, a harmonic gear coupled to an electric motor is introduced, and together with properly designed based servo controllers provide an end point repeatability of less than 10 microns. 3 figs.

  7. Mobile camera-space manipulation

    NASA Technical Reports Server (NTRS)

    Seelinger, Michael J. (Inventor); Yoder, John-David S. (Inventor); Skaar, Steven B. (Inventor)

    2001-01-01

    The invention is a method of using computer vision to control systems consisting of a combination of holonomic and nonholonomic degrees of freedom such as a wheeled rover equipped with a robotic arm, a forklift, and earth-moving equipment such as a backhoe or a front-loader. Using vision sensors mounted on the mobile system and the manipulator, the system establishes a relationship between the internal joint configuration of the holonomic degrees of freedom of the manipulator and the appearance of features on the manipulator in the reference frames of the vision sensors. Then, the system, perhaps with the assistance of an operator, identifies the locations of the target object in the reference frames of the vision sensors. Using this target information, along with the relationship described above, the system determines a suitable trajectory for the nonholonomic degrees of freedom of the base to follow towards the target object. The system also determines a suitable pose or series of poses for the holonomic degrees of freedom of the manipulator. With additional visual samples, the system automatically updates the trajectory and final pose of the manipulator so as to allow for greater precision in the overall final position of the system.

  8. Selective Manipulation of Neural Circuits.

    PubMed

    Park, Hong Geun; Carmel, Jason B

    2016-04-01

    Unraveling the complex network of neural circuits that form the nervous system demands tools that can manipulate specific circuits. The recent evolution of genetic tools to target neural circuits allows an unprecedented precision in elucidating their function. Here we describe two general approaches for achieving circuit specificity. The first uses the genetic identity of a cell, such as a transcription factor unique to a circuit, to drive expression of a molecule that can manipulate cell function. The second uses the spatial connectivity of a circuit to achieve specificity: one genetic element is introduced at the origin of a circuit and the other at its termination. When the two genetic elements combine within a neuron, they can alter its function. These two general approaches can be combined to allow manipulation of neurons with a specific genetic identity by introducing a regulatory gene into the origin or termination of the circuit. We consider the advantages and disadvantages of both these general approaches with regard to specificity and efficacy of the manipulations. We also review the genetic techniques that allow gain- and loss-of-function within specific neural circuits. These approaches introduce light-sensitive channels (optogenetic) or drug sensitive channels (chemogenetic) into neurons that form specific circuits. We compare these tools with others developed for circuit-specific manipulation and describe the advantages of each. Finally, we discuss how these tools might be applied for identification of the neural circuits that mediate behavior and for repair of neural connections.

  9. Manipulation strategies for massive space payloads

    NASA Technical Reports Server (NTRS)

    Book, Wayne J.

    1991-01-01

    Motion planning and control for the joints of flexible manipulators are discussed. Specific topics covered include control of a flexible braced manipulator, control of a small working robot on a large flexible manipulator to suppress vibrations, control strategies for ensuring cooperation among disparate manipulators, and motion planning for robots in free-fall.

  10. Learning Area and Perimeter with Virtual Manipulatives

    ERIC Educational Resources Information Center

    Bouck, Emily; Flanagan, Sara; Bouck, Mary

    2015-01-01

    Manipulatives are considered a best practice for educating students with disabilities, but little research exists which examines virtual manipulatives as tool for supporting students in mathematics. This project investigated the use of a virtual manipulative through the National Library of Virtual Manipulatives--polynominoes (i.e., tiles)--as a…

  11. [The construction of a medical discipline and its challenges: Orthopedics in Switzerland during the 19th and 20th centuries].

    PubMed

    Kaba, Mariama

    2015-07-01

    During the 19th century, numerous figures, with different qualifications, claimed to practice orthopedics: doctors, surgeons, inventors of equipment and instruments, and other empiricists. They performed certain types of techniques, massages, surgical operationsand/or fitted prostheses. The polysemous notion of orthopedics had created conflicts of interest that would reach their height at the end of the 19th century. The integration of orthopedics into the training at the university level enhanced its proximity to surgery, a discipline that has dominated the so-called modern medicine. During the 20th century, various medical branches defend the legitimacy of certain orthopedic practices, thereby threating to a degree the title itself of this specialization. By examining the challenges that have shaped the history of orthopedics in Switzerland, this article also seeks to shed light on the strategies that were implemented in adopting a medical and technical discipline within a transforming society.

  12. The biomechanics of spinal manipulation.

    PubMed

    Herzog, Walter

    2010-07-01

    Biomechanics is the science that deals with the external and internal forces acting on biological systems and the effects produced by these forces. Here, we describe the forces exerted by chiropractors on patients during high-speed, low-amplitude manipulations of the spine and the physiological responses produced by the treatments. The external forces were found to vary greatly among clinicians and locations of treatment on the spine. Spinal manipulative treatments produced reflex responses far from the treatment site, caused movements of vertebral bodies in the "para-physiological" zone, and were associated with cavitation of facet joints. Stresses and strains on the vertebral artery during chiropractic spinal manipulation of the neck were always much smaller than those produced during passive range of motion testing and diagnostic procedures.

  13. Employee involvement: motivation or manipulation?

    PubMed

    McConnell, C R

    1998-03-01

    Employee involvement is subject to a great deal of verbal tribute; there is hardly a manager at work today who will not praise the value of employee input. However, many employee involvement efforts leave employees feeling more manipulated than motivated. This occurs because supervisors and managers, while expecting employees to change the way they work, are themselves either unwilling to change or remain unconscious of the need to change. The result is that, although employee input is regularly solicited in a number of forms, it is often discounted, ignored, or altered to fit the manager's preconceptions. Often the employee is left feeling manipulated. Since the opportunity for involvement can be a strong motivator, it becomes the manager's task to learn how to provide involvement opportunity in manipulative fashion. This can be accomplished by providing involvement opportunity accompanied by clear outcome expectations and allowing employees the freedom to pursue those outcomes in their own way.

  14. Manipulating Complex Light with Metamaterials

    PubMed Central

    Zeng, Jinwei; Wang, Xi; Sun, Jingbo; Pandey, Apra; Cartwright, Alexander N.; Litchinitser, Natalia M.

    2013-01-01

    Recent developments in the field of metamaterials have revealed unparalleled opportunities for “engineering” space for light propagation; opening a new paradigm in spin- and quantum-related phenomena in optical physics. Here we show that unique optical properties of metamaterials (MMs) open unlimited prospects to “engineer” light itself. We propose and demonstrate for the first time a novel way of complex light manipulation in few-mode optical fibers using optical MMs. Most importantly, these studies highlight how unique properties of MMs, namely the ability to manipulate both electric and magnetic field components of electromagnetic (EM) waves, open new degrees of freedom in engineering complex polarization states of light at will, while preserving its orbital angular momentum (OAM) state. These results lay the first steps in manipulating complex light in optical fibers, likely providing new opportunities for high capacity communication systems, quantum information, and on-chip signal processing. PMID:24084836

  15. Selective laser sintering of calcium phosphate materials for orthopedic implants

    NASA Astrophysics Data System (ADS)

    Lee, Goonhee

    control of micro and macro pore structure, to maximize bone healing and provide sufficient mechanical strength. It also permits the complete removal of the polymeric binders that are resided in the SLS process. In collaboration with the University of Texas Health Science Center at San Antonio and BioMedical Enterprises, Inc., porous implants based on anatomical geometry have been successfully implanted in rabbits and dogs. These histologic animal studies reveal excellent biocompatibility and show its great potential for commercial custom-fit implant manufacture. The second research effort involves fabrication of fully dense bone for application in dental restoration and load-bearing orthopedic functions. Calcium phosphate glass melts, proven to be biocompatible in the first effort, were cast into carbon molds. Processes were developed for preparing the molds. These carbon molds of anatomic shape can be prepared from either Computer Numerical Control (CNC) milling of slab stock or SLS processing of thermoset-coated graphite powder. The CNC milling method provides accurate dimension of the molds in a short period of time, however, the capable geometries are limited; generally two pieces of molds are required for complex shapes. The SLS method provides very complex shape green molds. However, they need to go through pyrolysis of thermoset binder to provide the high temperature capability reached at calcium phosphate melt temperatures (1100°C) and noticeable shrinkage was observed during pyrolysis. The cast glass was annealed to develop polycrystalline calcium phosphate. This process also exhibits great potential.

  16. A novel manipulator technology for space applications

    NASA Technical Reports Server (NTRS)

    Schmitz, Donald; Khosia, Pradeep; Kanade, Takeo

    1988-01-01

    Modular manipulator designs have long been considered for use as research tools, and as the basis for easily modified industrial manipulators. In these manipulators the links and joints are discrete and modular components that can be assembled into a desired manipulator configuration. As hardware advances have made actual modular manipulators practical, various capabilities of such manipulators have gained interest. Particularly desirable is the ability to rapidly reconfigure such a manipulator, in order to custom tailor it to specific tasks. The reconfiguration greatly enhances the capability of a given amount of manipulator hardware. The development of a prototype modular manipulator is discussed as well as the implementation of a configuration independent manipulator kinematics algorithm used for path planning in the prototype.

  17. Understanding pharmaceutical research manipulation in the context of accounting manipulation.

    PubMed

    Brown, Abigail

    2013-01-01

    The problem of the manipulation of data that arises when there is both opportunity and incentive to mislead is better accepted and studied - though by no means solved - in financial accounting than in medicine. This article analyzes pharmaceutical company manipulation of medical research as part of a broader problem of corporate manipulation of data in the creation of accounting profits. The article explores how our understanding of accounting fraud and misinformation helps us understand the risk of similar information manipulation in the medical sciences. This understanding provides a framework for considering how best to improve the quality of medical research and analysis in light of the current system of medical information production. I offer three possible responses: (1) use of the Dodd-Frank whistleblower provisions to encourage reporting of medical research fraud; (2) a two-step academic journal review process for clinical trials; and (3) publicly subsidized trial-failure insurance. These would improve the release of negative information about drugs, thereby increasing the reliability of positive information.

  18. Precision Manipulation with Cooperative Robots

    NASA Technical Reports Server (NTRS)

    Stroupe, Ashley; Huntsberger, Terry; Okon, Avi; Aghzarian, Hrand

    2005-01-01

    This work addresses several challenges of cooperative transportThis work addresses several challenges of cooperative transport and precision manipulation. Precision manipulation requires a rigid grasp, which places a hard constraint on the relative rover formation that must be accommodated, even though the rovers cannot directly observe their relative poses. Additionally, rovers must jointly select appropriate actions based on all available sensor information. Lastly, rovers cannot act on independent sensor information, but must fuse information to move jointly; the methods for fusing information must be determined.

  19. Enhanced osteoblast adhesion on nanostructured selenium compacts for anti-cancer orthopedic applications.

    PubMed

    Tran, Phong; Webster, Thomas J

    2008-01-01

    Metallic bone implants possess numerous problems limiting their long-term efficacy, such as poor prolonged osseointegration, stress shielding, and corrosion under in vivo environments. Such problems are compounded for bone cancer patients since numerous patients receive orthopedic implants after cancerous bone resection. Unfortunately, current orthopedic materials were not originally developed to simultaneously increase healthy bone growth (as in traditional orthopedic implant applications) while inhibiting cancerous bone growth. The long-term objective of the present research is to investigate the use of nano-rough selenium to prevent bone cancer from re-occurring while promoting healthy bone growth for this select group of cancer patients. Selenium is a well known anti-cancer chemical. However, what is not known is how healthy bone cells interact with selenium. To determine this, selenium, spherical or semispherical shots, were pressed into cylindrical compacts and these compacts were then etched using 1N NaOH to obtain various surface structures ranging from the micron, submicron to nano scales. Changes in surface chemistry were also analyzed. Through these etching techniques, results of this study showed that biologically inspired surface roughness values were created on selenium compacts to match that of natural bone roughness. Moreover, results showed that healthy bone cell adhesion increased with greater nanometer selenium roughness (more closely matching that of titanium). In this manner, this study suggests that nano-rough selenium should be further tested for orthopedic applications involving bone cancer treatment.

  20. The Effectiveness of Active and Traditional Teaching Techniques in the Orthopedic Assessment Laboratory

    ERIC Educational Resources Information Center

    Nottingham, Sara; Verscheure, Susan

    2010-01-01

    Active learning is a teaching methodology with a focus on student-centered learning that engages students in the educational process. This study implemented active learning techniques in an orthopedic assessment laboratory, and the effects of these teaching techniques. Mean scores from written exams, practical exams, and final course evaluations…

  1. Social Networking as a Tool for Lifelong Learning with Orthopedically Impaired Learners

    ERIC Educational Resources Information Center

    Ersoy, Metin; Güneyli, Ahmet

    2016-01-01

    This paper discusses how Turkish Cypriot orthopedically impaired learners who are living in North Cyprus use social networking as a tool for leisure and education, and to what extent they satisfy their personal development needs by means of these digital platforms. The case study described, conducted in North Cyprus in 2015 followed a qualitative…

  2. A Review of the Design Process for Implantable Orthopedic Medical Devices

    PubMed Central

    Aitchison, G.A; Hukins, D.W.L; Parry, J.J; Shepherd, D.E.T; Trotman, S.G

    2009-01-01

    The design process for medical devices is highly regulated to ensure the safety of patients. This paper will present a review of the design process for implantable orthopedic medical devices. It will cover the main stages of feasibility, design reviews, design, design verification, manufacture, design validation, design transfer and design changes. PMID:19662153

  3. Failure Analysis of Some Orthopedic Implants (Analyse de Rupture de Quelques Protheses Orthopediques)

    DTIC Science & Technology

    1980-05-01

    Osteosynthesefragen (AO) plate, used to correct a subtrochanteric fracture of the femur. The part was removed because it fractured in service only 4...Failures in Orthopedic Surgery, Biomat. Med. Devices Art. Org., 1979, 7 (2), 243-255. -48- 217 Hemminger, W. and Lange, G. - Osteotomy Plates which

  4. High energy devices versus low energy devices in orthopedics treatment modalities

    NASA Astrophysics Data System (ADS)

    Schultheiss, Reiner

    2003-10-01

    The orthopedic consensus group defined in 1997 the 42 most likely relevant parameters of orthopedic shock wave devices. The idea of this approach was to correlate the different clinical outcomes with the physical properties of the different devices with respect to their acoustical waves. Several changes in the hypothesis of the dose effect relationship have been noticed since the first orthopedic treatments. The relation started with the maximum pressure p+, followed by the total energy, the energy density; and finally the single treatment approach using high, and then the multiple treatment method using low energy. Motivated by the reimbursement situation in Germany some manufacturers began to redefine high and low energy devices independent of the treatment modality. The OssaTron as a high energy, single treatment electro hydraulic device gained FDA approval as the first orthopedic ESWT device for plantar fasciitis and, more recently, for lateral epicondylitis. Two low energy devices have now also gained FDA approval based upon a single treatment. Comparing the acoustic data, differences between the OssaTron and the other devices are obvious and will be elaborated upon. Cluster analysis of the outcomes and the acoustical data are presented and new concepts will be suggested.

  5. An Evaluation Design for the Educational Programs for Pupils Who Are Orthopedically Handicapped.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Programs for the Handicapped.

    The booklet provides forms for the teacher of the orthopedically handicapped to use in systematically collecting data and designing an appropriate educational blueprint for each student. Pupil development assessment sheets include columns for recording assessment date, date of mastery, level of achievement, and comments for each behavioral…

  6. Aging and orthopedics: how a lifespan development model can inform practice and research

    PubMed Central

    Gautreau, Sylvia; Gould, Odette N.; Forsythe, Michael E.

    2016-01-01

    Orthopedic surgical care, like all health care today, is in flux owing to an aging population and to chronic medical conditions leading to an increased number of people with illnesses that need to be managed over the lifespan. The result is an ongoing shift from curing acute illnesses to the management and care of chronic illness and conditions. Theoretical models that provide a useful and feasible vision for the future of health care and health care research are needed. This review discusses how the lifespan development model used in some disciplines within the behavioural sciences can be seen as an extension of the biopsychosocial model. We posit that the lifespan development model provides useful perspectives for both orthopedic care and research. We present key concepts and recommendations, and we discuss how the lifespan development model can contribute to new and evolving perspectives on orthopedic outcomes and to new directions for research. We also offer practical guidelines on how to implement the model in orthopedic practice. PMID:27240129

  7. Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist.

    PubMed

    Saltzman, Bryan M; Kuhns, Benjamin D; Weber, Alexander E; Yanke, Adam; Nho, Shane J

    2016-01-01

    The use of biologic adjuvants in the treatment of operative and nonoperative orthopedic injuries continues to expand in concert with our understanding of the acute and chronic healing process of musculoskeletal injuries. Stem cell treatments in orthopedics are among the most commonly explored options, and have found varying levels of success in promoting osseous and soft tissue healing. Basic science and translational studies have demonstrated the potential for broad application of stem cells in the treatment of a growing number of musculoskeletal injuries. Emerging clinical studies have also provided promising results, although the vast majority of studies have featured small sample sizes and limited duration of follow-up. In addition, a number of important questions remain regarding the clinical safety, treatment delivery, and overall efficacy of stem cell augmentation of injured tissue in orthopedics. The objective of the current review is to present a broad overview of the current state of stem cell treatments in orthopedic surgery, with an emphasis on soft tissue healing. This review of stem cell treatment covers the basic science behind biologic augmentation, advantages of the various stem cell sources, preclinical results, and current and future clinical applications.

  8. The Effect of Orthopedic Advertising and Self-Promotion on a Naïve Population.

    PubMed

    Mohney, Stephen; Lee, Daniel J; Elfar, John C

    2016-01-01

    There has been a marked increase in the number of physicians marketing themselves directly to patients and consumers. However, it is unclear how different promotional styles affect patients' perceptions of their physicians. We hypothesized that self-promoting orthopedic surgeons enjoy a more positive impact on nonphysician patients as compared to non-self-promoting surgeons, as well as a corresponding negative impact on their peer-surgeons. Surgeon websites were selected from the 5 largest population centers in the United States. Subjects with varying degrees of familiarity with orthopedic surgery evaluated Internet profiles of surgeons on a forced choice Likert scale to measure the amount of self-promotion. The naïve subjects judged self-promoting surgeons more favorably than the orthopedic surgeons. In contrast, board-certified orthopedic surgeons viewed self-promoting surgeons more negatively than did their nonphysician counterparts. In summary, the present study revealed that the potential for self-promotion to unduly influence potential patients is real and should be a considerable concern to surgeons, patients, and the profession.

  9. Late orthopedic effects in children with Wilms' tumor treated with abdominal irradiation

    SciTech Connect

    Rate, W.R.; Butler, M.S.; Robertson, W.W. Jr.; D'Angio, G.J. )

    1991-01-01

    Between 1970 and 1984, 31 children with biopsy-proven Wilms' tumor received nephrectomy, chemotherapy, and abdominal irradiation and were followed beyond skeletal maturity. Three patients (10%) developed late orthopedic abnormalities requiring intervention. Ten children received orthovoltage irradiation, and all cases requiring orthopedic intervention or developing a scoliotic curve of greater than 20 degrees were confined to this group, for a complication frequency of 50%. Those children who developed a significant late orthopedic abnormality (SLOA) as defined were treated to a higher median dose (2,890 cGy) and a larger field size (150 cm2) than those who did not (2,580 cGy and 120 cm2). Age at irradiation, sex, and initial stage of disease did not appear to influence the risk of developing an SLOA. No child who received megavoltage irradiation developed an SLOA despite treatment up to 4,000 cGy or to field sizes of 400 cm2. We conclude that modern radiotherapy techniques rarely lead to significant late orthopedic abnormalities previously associated with abdominal irradiation in children with Wilms' tumor.

  10. Value of 3-D CT in classifying acetabular fractures during orthopedic residency training.

    PubMed

    Garrett, Jeffrey; Halvorson, Jason; Carroll, Eben; Webb, Lawrence X

    2012-05-01

    The complex anatomy of the pelvis and acetabulum have historically made classification and interpretation of acetabular fractures difficult for orthopedic trainees. The addition of 3-dimensional (3-D) computed tomography (CT) scan has gained popularity in preoperative planning, identification, and education of acetabular fractures given their complexity. Therefore, the authors examined the value of 3-D CT compared with conventional radiography in classifying acetabular fractures at different levels of orthopedic training. Their hypothesis was that 3-D CT would improve correct identification of acetabular fractures compared with conventional radiography.The classic Letournel fracture pattern classification system was presented in quiz format to 57 orthopedic residents and 20 fellowship-trained orthopedic traumatologists. A case consisted of (1) plain radiographs and 2-dimensional axial CT scans or (2) 3-D CT scans. All levels of training showed significant improvement in classifying acetabular fractures with 3-D vs 2-D CT, with the greatest benefit from 3-D CT found in junior residents (postgraduate years 1-3).Three-dimensional CT scans can be an effective educational tool for understanding the complex spatial anatomy of the pelvis, learning acetabular fracture patterns, and correctly applying a widely accepted fracture classification system.

  11. Orthopedic Surgery in Rural American Hospitals: A Survey of Rural Hospital Administrators

    ERIC Educational Resources Information Center

    Weichel, Derek

    2012-01-01

    Rural American residents prefer to receive their medical care locally. Lack of specific medical services in the local community necessitates travel to a larger center which is less favorable. This study was done to identify how rural hospitals choose to provide orthopedic surgical services to their communities. Methods: All hospitals in 5 states…

  12. A Prototype Robotic Arm for Use by Severely Orthopedically Handicapped Students. Final Report.

    ERIC Educational Resources Information Center

    Howell, Richard

    This 18-month pilot project, which ran from October 1, 1987 to March 31, 1989, developed a prototype robotic arm for educational use by students with severe orthopedic disabilities in the Columbus (Ohio) Public Schools. The developmental effort was intended first, to provide direct access to currently available instructional materials and, second,…

  13. [Lack of new trainees in trauma surgery and orthopedics. An approach to a solution].

    PubMed

    Thiele, K; Matziolis, D; Perka, C

    2010-12-01

    The reasons for a shortage of young people in trauma surgery and orthopedics have often been discussed. Atypical progression of medical operating levels, antisocial working hours and an inadequate financial compensation for on-call duties have been given as the reasons for a lack of interest in the discipline. Additionally a progressive feminization of the medical profession and rejection of surgical disciplines because of a mismatch with family interests and the demands of advanced surgical training have also been named. Surveys on the choice of medical specialization reveal that experiences during the course of studying have a great influence on future prospects and are immensely important for the further focusing on the future as a medical doctor. In order to increase the attractiveness of the specialization, programs for students were initiated by the heads of the Conventions of Higher Education Lecturers for Orthopedics and Trauma Surgery and the management of the German Society for Orthopedics and Trauma Surgery. Due to the enormous popularity auxiliary projects were demanded. Consequently a "Trauma Surgery and Orthopedic Day for Students" was organized on 16th February 2010 in the Musculoskeletal Centre of the Charité in Berlin. The aim was to convey practical skills and to inspire the choice of this specialization in the future.

  14. Master/slave manipulator system

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.; King, R. F.; Vallotton, W. C.

    1973-01-01

    System capabilities are equivalent to mobility, dexterity, and strength of human arm. Arrangement of torque motor, harmonic drive, and potentiometer combination allows all power and control leads to pass through center of slave with position-transducer arrangement of master, and "stovepipe joint" is incorporated for manipulator applications.

  15. Manipulating Genetic Material in Bacteria

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Lisa Crawford, a graduate research assistant from the University of Toledo, works with Laurel Karr of Marshall Space Flight Center (MSFC) in the molecular biology laboratory. They are donducting genetic manipulation of bacteria and yeast for the production of large amount of desired protein. Photo credit: NASA/Marshall Space Flight Center (MSFC)

  16. Optical manipulation of valley pseudospin

    NASA Astrophysics Data System (ADS)

    Ye, Ziliang; Sun, Dezheng; Heinz, Tony F.

    2017-01-01

    The coherent manipulation of spin and pseudospin underlies existing and emerging quantum technologies, including quantum communication and quantum computation. Valley polarization, associated with the occupancy of degenerate, but quantum mechanically distinct valleys in momentum space, closely resembles spin polarization and has been proposed as a pseudospin carrier for the future quantum electronics. Valley exciton polarization has been created in the transition metal dichalcogenide monolayers using excitation by circularly polarized light and has been detected both optically and electrically. In addition, the existence of coherence in the valley pseudospin has been identified experimentally. The manipulation of such valley coherence has, however, remained out of reach. Here we demonstrate all-optical control of the valley coherence by means of the pseudomagnetic field associated with the optical Stark effect. Using below-bandgap circularly polarized light, we rotate the valley exciton pseudospin in monolayer WSe2 on the femtosecond timescale. Both the direction and speed of the rotation can be manipulated optically by tuning the dynamic phase of excitons in opposite valleys. This study unveils the possibility of generation, manipulation, and detection of the valley pseudospin by coupling to photons.

  17. Data manipulation in heterogeneous databases

    SciTech Connect

    Chatterjee, A.; Segev, A.

    1991-10-01

    Many important information systems applications require access to data stored in multiple heterogeneous databases. This paper examines a problem in inter-database data manipulation within a heterogeneous environment, where conventional techniques are no longer useful. To solve the problem, a broader definition for join operator is proposed. Also, a method to probabilistically estimate the accuracy of the join is discussed.

  18. Mapping and Manipulating Facial Expression

    ERIC Educational Resources Information Center

    Theobald, Barry-John; Matthews, Iain; Mangini, Michael; Spies, Jeffrey R.; Brick, Timothy R.; Cohn, Jeffrey F.; Boker, Steven M.

    2009-01-01

    Nonverbal visual cues accompany speech to supplement the meaning of spoken words, signify emotional state, indicate position in discourse, and provide back-channel feedback. This visual information includes head movements, facial expressions and body gestures. In this article we describe techniques for manipulating both verbal and nonverbal facial…

  19. Ants: the supreme soil manipulators

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This review focuses on the semiochemical interactions between ants and their soil environment. Ants occupy virtually every ecological niche and have evolved mechanisms to not just cope with, but also manipulate soil organisms. The metapleural gland, specific to ants was thought to be the major sourc...

  20. COGNITION, ACTION, AND OBJECT MANIPULATION

    PubMed Central

    Rosenbaum, David A.; Chapman, Kate M.; Weigelt, Matthias; Weiss, Daniel J.; van der Wel, Robrecht

    2012-01-01

    Although psychology is the science of mental life and behavior, it has paid little attention to the means by which mental life is translated into behavior. One domain where links between cognition and action have been explored is the manipulation of objects. This article reviews psychological research on this topic, with special emphasis on the tendency to grasp objects differently depending on what one plans to do with the objects. Such differential grasping has been demonstrated in a wide range of object manipulation tasks, including grasping an object in a way that reveals anticipation of the object's future orientation, height, and required placement precision. Differential grasping has also been demonstrated in a wide range of behaviors, including one-hand grasps, two-hand grasps, walking, and transferring objects from place to place as well as from person to person. The populations in whom the tendency has been shown are also diverse, including nonhuman primates as well as human adults, children, and babies. Meanwhile, the tendency is compromised in a variety of clinical populations and in children of a surprisingly advanced age. Verbal working memory is compromised as well if words are memorized while object manipulation tasks are performed; the recency portion of the serial position curve is reduced in this circumstance. In general, the research reviewed here points to rich connections between cognition and action as revealed through the study of object manipulation. Other implications concern affordances, Donders' Law, and naturalistic observation and the teaching of psychology. PMID:22448912

  1. DYMAFLEX: DYnamic Manipulation FLight EXperiment

    DTIC Science & Technology

    2013-09-03

    Moosavian. Learning- based Modified Transpose Jacobian control of robotic manipulators. In Proc. IEEE Conf. on Advanced Intelligent Mechatronics , pages...34Path planning for minimizing base reaction of space robot and its ground experimental study," in IEEE International Conference on Mechatronics

  2. Teaching Integration Applications Using Manipulatives

    ERIC Educational Resources Information Center

    Bhatia, Kavita; Premadasa, Kirthi; Martin, Paul

    2014-01-01

    Calculus students' difficulties in understanding integration have been extensively studied. Research shows that the difficulty lies with students understanding of the definition of the definite integral as a limit of a Riemann sum and with the idea of accumulation inherent in integration. We have created a set of manipulatives and activities…

  3. MODULAR MANIPULATOR FOR ROBOTICS APPLICATIONS

    SciTech Connect

    Joseph W. Geisinger, Ph.D.

    2001-07-31

    ARM Automation, Inc. is developing a framework of modular actuators that can address the DOE's wide range of robotics needs. The objective of this effort is to demonstrate the effectiveness of this technology by constructing a manipulator from these actuators within a glovebox for Automated Plutonium Processing (APP). At the end of the project, the system of actuators was used to construct several different manipulator configurations, which accommodate common glovebox tasks such as repackaging. The modular nature and quickconnects of this system simplify installation into ''hot'' boxes and any potential modifications or repair therein. This work focused on the development of self-contained robotic actuator modules including the embedded electronic controls for the purpose of building a manipulator system. Both of the actuators developed under this project contain the control electronics, sensors, motor, gear train, wiring, system communications and mechanical interfaces of a complete robotics servo device. Test actuators and accompanying DISC{trademark}s underwent validation testing at The University of Texas at Austin and ARM Automation, Inc. following final design and fabrication. The system also included custom links, an umbilical cord, an open architecture PC-based system controller, and operational software that permitted integration into a completely functional robotic manipulator system. The open architecture on which this system is based avoids proprietary interfaces and communication protocols which only serve to limit the capabilities and flexibility of automation equipment. The system was integrated and tested in the contractor's facility for intended performance and operations. The manipulator was tested using the full-scale equipment and process mock-ups. The project produced a practical and operational system including a quantitative evaluation of its performance and cost.

  4. Factors influencing the number of applications submitted per applicant to orthopedic residency programs

    PubMed Central

    Finkler, Elissa S.; Fogel, Harold A.; Kroin, Ellen; Kliethermes, Stephanie; Wu, Karen; Nystrom, Lukas M.; Schiff, Adam P.

    2016-01-01

    Background From 2002 to 2014, the orthopedic surgery residency applicant pool increased by 25% while the number of applications submitted per applicant rose by 69%, resulting in an increase of 109% in the number of applications received per program. Objective This study aimed to identify applicant factors associated with an increased number of applications to orthopedic surgery residency programs. Design An anonymous survey was sent to all applicants applying to the orthopedic surgery residency program at Loyola University. Questions were designed to define the number of applications submitted per respondent as well as the strength of their application. Of 733 surveys sent, 140 (19.1%) responses were received. Setting An academic institution in Maywood, IL. Participants Fourth-year medical students applying to the orthopedic surgery residency program at Loyola University. Results An applicant's perception of how competitive he or she was (applicants who rated themselves as ‘average’ submitted more applications than those who rated themselves as either ‘good’ or ‘outstanding’, p=0.001) and the number of away rotations (those who completed >2 away rotations submitted more applications, p=0.03) were significantly associated with an increased number of applications submitted. No other responses were found to be associated with an increased number of applications submitted. Conclusion Less qualified candidates are not applying to significantly more programs than their more qualified counterparts. The increasing number of applications represents a financial strain on the applicant, given the costs required to apply to more programs, and a time burden on individual programs to screen increasing numbers of applicants. In order to stabilize or reverse this alarming trend, orthopedic surgery residency programs should openly disclose admission criteria to prospective candidates, and medical schools should provide additional guidance for candidates in this process

  5. Better osteoblast adhesion on nanoparticulate selenium- A promising orthopedic implant material.

    PubMed

    Perla, Venu; Webster, Thomas J

    2005-11-01

    Apart from problems such as poor osseointegration, stress shielding, and wear debris-associated bone cell death, a major concern of metallic orthopedic implants is that they slowly corrode under in vivo environments. It is possible that continuous tissue exposure to metallic corrosion products limits orthopedic implant efficacy; this is especially true for patients receiving implants due to bone cancer. To date, there is no metallic orthopedic implant available in the market that specifically deals with the prevention and/or recurring cancer that may happen in these patients. The objective of this study was to deal with these problems in an integrated way by introducing a new biomaterial to the orthopedic community with anticancer chemistry: selenium (Se). In this study, six types of Se compacts were tested for bone cell (osteoblast) adhesion under in vitro conditions. Two types of cylindrical compacts were made with conventional Se metal particles in the micron (6.539 +/- 1.364-microm diameter) and submicron (0.963 +/- 0.139-microm diameter) range. These two types of compacts were chemically etched with different concentrations of NaOH to create two additional types of Se particles in each category: conventional size particles with nanosurface roughness and nanometer particles (0.204- to 0.264-microm diameter). Results showed for the first time, enhanced osteoblast adhesion on particulate surfaces of the compacts made from conventional Se compared with reference nonparticulate wrought titanium sheets. More importantly, this study provided the first evidence that osteoblast density was further increased on the surfaces of the Se compacts with nanometer particles. These initial findings indicate that there may be a promising future for nanoparticulate Se as an anticancer biocompatible orthopedic material.

  6. Developing a Minimum Data Set of the Information Management System for Orthopedic Injuries in Iran

    PubMed Central

    Ahmadi, Maryam; Mohammadi, Ali; Chraghbaigi, Ramin; Fathi, Taimur; Shojaee Baghini, Mahdieh

    2014-01-01

    Background: Orthopedic injuries are the most common types of injuries. To identify the main causes of injuries, collecting data in a standard manner at the national level are needed, which justifies necessity of making a minimum data set (MDS). Objectives: The aim of this study was to develop an MDS of the information management system for orthopedic injuries in Iran. Materials and Methods: This descriptive cross-sectional study was performed in 2013. Data were collected from hospitals affiliated with Tehran University of Medical Sciences that had orthopedic department, medical documents centers, legal medicine centers, emergency centers, internet access, and library. Investigated documents were orthopedic injury records in 2012, documents that retrieved from the internet, and printed materials. Records with Random sampling by S22-S99 categories from ICD-10 were selected and the related internet-sourced data were evaluated entirely. Data were collected using a checklist. In order to make a consensus about the data elements, the decision Delphi technique was applied by a questionnaire. The content validity and reliability of the questionnaire were assessed by expert’s opinions and test-retest method, respectively. Results: An MDS of orthopedic injuries were assigned to two categories: administrative category with six classes including 142 data elements, and clinical category with 17 classes including 250 data elements. Conclusions: This study showed that some of the essential data elements included in other country’s MDS or required for organizations and healthcare providers were not included. Therefore, a complete list of an MDS elements was created. Existence of comprehensive data concerning the causes and mechanisms of injuries informs public health policy-makers about injuries occurrence and enables them to take rationale measures to deal with these problems. PMID:25237576

  7. Diversity and evolution of bodyguard manipulation.

    PubMed

    Maure, Fanny; Daoust, Simon Payette; Brodeur, Jacques; Mitta, Guillaume; Thomas, Frédéric

    2013-01-01

    Among the different strategies used by parasites to usurp the behaviour of their host, one of the most fascinating is bodyguard manipulation. While all classic examples of bodyguard manipulation involve insect parasitoids, induced protective behaviours have also evolved in other parasite-host systems, typically as specific dimensions of the total manipulation. For instance, parasites may manipulate the host to reduce host mortality during their development or to avoid predation by non-host predators. This type of host manipulation behaviour is rarely described, probably due to the fact that studies have mainly focused on predation enhancement rather than studying all the dimensions of the manipulation. Here, in addition to the classic cases of bodyguard manipulation, we also review these 'bodyguard dimensions' and propose extending the current definition of bodyguard manipulation to include the latter. We also discuss different evolutionary scenarios under which such manipulations could have evolved.

  8. Effect of the Mandibular Orthopedic Repositioning Appliance on Trunk and Upper Limb Muscle Activation during Maximum Isometric Contraction.

    PubMed

    Lee, Sang-Yeol; Hong, Min-Ho; Park, Min-Chull; Choi, Sung-Min

    2013-11-01

    [Purpose] The purpose of this study was to measure the muscle activities of the trunk muscles and upper limb muscles during maximum isometric contraction when temporomandibular joint alignment was achieved with a mandibular orthopedic repositioning appliance in order provide basic data on the effects of mandibular orthopedic repositioning appliance on the entire body. [Subjects] The present study was conducted with healthy Korean adults in their 20s (males=10, females=10). [Methods] An 8 channel surface electromyography system was used to measure the muscle activities of the upper limb muscles and neck muscles of the subjects during maximum isometric contraction with and without use of a mandibular orthopedic repositioning appliance. [Results] The maximum isometric contractions of the trunk and upper limb muscles when mandibular orthopedic repositioning appliance were used were compared with those when no mandibular orthopedic repositioning appliance was used. The results showed that the sternocleidomastoid muscle, cervical and lumbar erector spinae, upper trapezius, biceps, triceps, rectus abdominis and internal oblique and external oblique muscles all showed significant increases in maximum isometric contractions with a mandibular orthopedic repositioning appliance. [Conclusion] The use of a mandibular orthopedic repositioning appliance is considered to be a method for normal adults to improve the stability of the entire body with the improvement of the stability of the TMJ. The proximal improvement in stability improves of the proximal thereby improving not only muscle strength with increased muscle activation but also stability during exercises.

  9. The Highest-Impact Combat Orthopedic and Extremity Injury Articles in the Past 70 Years: A Citation Analysis.

    PubMed

    Nam, Jason; Do, Woo S; Stinner, Daniel J; Wenke, Joseph C; Orman, Jean A; Kragh, John F

    2017-01-01

    The objective of this study was to identify the most-cited peer-reviewed combat orthopedic and extremity injury articles published during the past 70 years. Orthopedic trauma presents ongoing challenges to both US civilian and military healthcare personnel. Improvements in combat trauma and extremity injury survival and quality of life are the result of advances in orthopedic trauma research. The Web of Science (including Science Citation Index) was searched for the most cited articles related to combat orthopedic trauma, published from 1940 to 2013. The most-cited article was by Owens et al. (Journal of Orthopaedic Trauma, 2007; 137 citations). Between the 1990s and 2000s, there was a 256% increase in the number of highly cited publications. A total of 69% of the articles were on the topics of comorbid vascular trauma (25%), epidemiology (23%), or orthopedic trauma (21%). This study identifies some of the most important contributions to combat orthopedic trauma and research and the areas of greatest scientific interest to the specialty during the past seven decades and highlights key research that has contributed to the evolution of modern combat orthopedic traumatology.

  10. Position control of robot manipulators manipulating a flexible payload

    SciTech Connect

    Sun, D.; Mills, J.K.; Liu, Y.

    1999-03-01

    Robotic manipulation of a flexible payload is a complex and challenging control problem. This paper demonstrates from both theoretical and experimental perspectives that through proper design of the control gains, the simple scheme of PD plus gravity compensation can control a flexible payload manipulated by multiple robots to a desired position/orientation while damping the vibrations of the payload at each contact. The suppression of the vibration at each contact is helpful to suppress all vibrations of the flexible body. If the payload has a large stiffness or small mass, the proposed scheme can regulate the deformations at the contacts to zero, and also, the offsets of all static deformations of the payload with reference to the original positions decay to zero. A clamped-free model is used to decompose the dynamics of the payload into two distinct dynamic subsystems. This allows them to treat these dynamic subsystems separately and prove that desired motion trajectories can be achieved with the proposed scheme. As an example, the experiment of manipulating a flexible sheet using two CRS A460 robots is further described.

  11. The laboratory telerobotic manipulator program

    NASA Technical Reports Server (NTRS)

    Herndon, J. N.; Babcock, S. M.; Butler, P. L.; Costello, H. M.; Glassell, R. L.; Kress, R. L.; Kuban, D. P.; Rowe, J. C.; Williams, D. M.

    1989-01-01

    New opportunities for the application of telerobotic systems to enhance human intelligence and dexterity in the hazardous environment of space are presented by the NASA Space Station Program. Because of the need for significant increases in extravehicular activity and the potential increase in hazards associated with space programs, emphasis is being heightened on telerobotic systems research and development. The Laboratory Telerobotic Manipulator (LTM) program is performed to develop and demonstrate ground-based telerobotic manipulator system hardware for research and demonstrations aimed at future NASA applications. The LTM incorporates traction drives, modularity, redundant kinematics, and state-of-the-art hierarchical control techniques to form a basis for merging the diverse technological domains of robust, high-dexterity teleoperations and autonomous robotic operation into common hardware to further NASA's research.

  12. Adaptive hybrid control of manipulators

    NASA Technical Reports Server (NTRS)

    Seraji, H.

    1987-01-01

    Simple methods for the design of adaptive force and position controllers for robot manipulators within the hybrid control architecuture is presented. The force controller is composed of an adaptive PID feedback controller, an auxiliary signal and a force feedforward term, and it achieves tracking of desired force setpoints in the constraint directions. The position controller consists of adaptive feedback and feedforward controllers and an auxiliary signal, and it accomplishes tracking of desired position trajectories in the free directions. The controllers are capable of compensating for dynamic cross-couplings that exist between the position and force control loops in the hybrid control architecture. The adaptive controllers do not require knowledge of the complex dynamic model or parameter values of the manipulator or the environment. The proposed control schemes are computationally fast and suitable for implementation in on-line control with high sampling rates.

  13. Nanoparticle manipulation by thermal gradient

    PubMed Central

    2012-01-01

    A method was proposed to manipulate nanoparticles through a thermal gradient. The motion of a fullerene molecule enclosed inside a (10, 10) carbon nanotube with a thermal gradient was studied by molecular dynamics simulations. We created a one-dimensional potential valley by imposing a symmetrical thermal gradient inside the nanotube. When the temperature gradient was large enough, the fullerene sank into the valley and became trapped. The escaping velocities of the fullerene were evaluated based on the relationship between thermal gradient and thermophoretic force. We then introduced a new way to manipulate the position of nanoparticles by translating the position of thermostats with desirable thermal gradients. Compared to nanomanipulation using a scanning tunneling microscope or an atomic force microscope, our method for nanomanipulation has a great advantage by not requiring a direct contact between the probe and the object. PMID:22364240

  14. Manipulating the edge of instability

    PubMed Central

    Venkadesan, Madhusudhan; Guckenheimer, John; Valero-Cuevas, Francisco J.

    2009-01-01

    We investigate the integration of visual and tactile sensory input for dynamic manipulation. Our experimental data and computational modeling reveal that time-delays are as critical to task-optimal multisensory integration as sensorimotor noise. Our focus is a dynamic manipulation task “at the edge of instability.” Mathematical bifurcation theory predicts that this system will exhibit well-classified low-dimensional dynamics in this regime. The task was using the thumbpad to compress a slender spring prone to buckling as far as possible, just shy of slipping. As expected from bifurcation theory, principal components analysis gives a projection of the data onto a low dimensional subspace that captures 91-97% of its variance. In this subspace, we formulate a low-order model for the brain+hand+spring dynamics based on known mechanical and neurophysiological properties of the system. By systematically occluding vision and anesthetically blocking thumbpad sensation in 12 consenting subjects, we found that vision contributed to dynamic manipulation only when thumbpad sensation was absent. The reduced ability of the model system to compress the spring with absent sensory channels closely resembled the experimental results. Moreover, we found that the model reproduced the contextual usefulness of vision only if we took account of time-delays. Our results shed light on critical features of dynamic manipulation distinct from those of static pinch, as well as the mechanism likely responsible for loss of manual dexterity and increased reliance on vision when age or neuromuscular disease increase noisiness and/or time-delays during sensorimotor integration. PMID:17400231

  15. Towards Manipulation-Driven Vision

    DTIC Science & Technology

    2001-01-01

    perience through experimental manipulation, using The human ability to segment objects is not general - tight correlations between arm motion and...required for action, rule) generates informative percepts. while the ventral is important for more cognitive tasks such as maintaining an object’s...identity and Neurons in area F4 are thought to provide a body constancy. Although the dorsal/ventral segregation map useful for generating arm, head, and

  16. Fluid Manipulation Utilizing Electrowetting Techniques

    NASA Astrophysics Data System (ADS)

    Kaiser, Laura; Pyrak-Nolte, Laura

    2014-03-01

    The fraction of the pore space in rock occupied by a given fluid is called saturation. The relationship between saturation and capillary pressure for porous media is hysteretic between imbibition and drainage cycles. If the wetting phase saturation increases, the capillary pressure follows an imbibition curve, and, if the wetting phase saturation decreases, the capillary pressure follows the drainage curve. Due to this hysteresis, researchers have suggested that there is a third variable that should be considered called interfacial area per volume that removes the ambiguity in the capillary pressure - saturation relationship. Before the relationship can be explored in more detail, we first must be able to manipulate the saturation internally rather than externally. We used electrowetting techniques to manipulate the contact angle of a salt water drop. This technique affects the interfacial energy and, therefore, enables manipulation of the contact angles and saturation. Once mastered, the technique could be used to explore the effect of interfacial area per volume on micromodel systems. NSF REU

  17. Model reduction of flexible manipulators

    NASA Astrophysics Data System (ADS)

    Yang, Jie; Xu, Yangsheng; Chen, C. S.

    1992-06-01

    Flexible manipulators can be characterized by a dynamic model with a large number of vibration modes, and the use of the model in the model-based control schemes requires reduction of model order. Balanced truncation is an effective method for model reduction of asymptotically stable systems by transforming the states to a coordinate system in which the controllability and observability Gramians are equal and diagonal, and eliminating the states which contribute weakly to the input-output map. An elastic flexible manipulator, however, is a marginally stable system and thus the balanced truncation method can not be directly applied. Herein, a method is presented of reducing the order of a marginally stable system based on the fact that translation transformations in the frequency domain preserve input-output properties of the system. The successful application is addressed of the method to model reduction of flexible manipulators with infinite-dimensional for finite-dimensional model. The method is also applicable for any other marginally stable model, such as elastic space trusswork and multi-dimensional space vehicle structure.

  18. What is 'manipulation'? A reappraisal.

    PubMed

    Evans, David W; Lucas, Nicholas

    2010-06-01

    Due primarily to its colloquial function, 'manipulation' is a poor term for distinguishing one healthcare intervention from another. With reports continuing to associate serious adverse events with manipulation, particularly relating to its use in the cervical spine, it is essential that the term be used appropriately and in accordance with a valid definition. The purpose of this paper is to identify empirically-derived features that we propose to be necessary and collectively sufficient for the formation of a valid definition for manipulation. A final definition is not offered. However, arguments for and against the inclusion of features are presented. Importantly, these features are explicitly divided into two categories: the 'action' (that which the practitioner does to the recipient) and the 'mechanical response' (that which occurs within the recipient). The proposed features are: 1) A force is applied to the recipient; 2) The line of action of this force is perpendicular to the articular surface of the affected joint; 3) The applied force creates motion at a joint; 4) This joint motion includes articular surface separation; 5) Cavitation occurs within the affected joint.

  19. Manipulation of Biofilm Microbial Ecology

    SciTech Connect

    White, D.C.; Palmer, R.J., Jr.; Zinn, M.; Smith, C.A.; Burkhalter, R.; Macnaughton, S.J.; Whitaker, K.W.; Kirkegaard, R.D.

    1998-08-15

    The biofilm mode of growth provides such significant advantages to the members of the consortium that most organisms in important habitats are found in biofilms. The study of factors that allow manipulation of biofilm microbes in the biofilm growth state requires that reproducible biofilms be generated. The most effective monitoring of biofilm formation, succession and desaturation is with on-line monitoring of microbial biofilms with flowcell for direct observation. The biofilm growth state incorporates a second important factor, the heterogeneity in distribution in time and space of the component members of the biofilm consortium. This heterogeneity is reflected not only in the cellular distribution but in the metabolic activity within a population of cells. Activity and cellular distribution can be mapped in four dimensions with confocal microscopy, and function can be ascertained by genetically manipulated reporter functions for specific genes or by vital stains. The methodology for understanding the microbial ecology of biofilms is now much more readily available and the capacity to manipulate biofilms is becoming an important feature of biotechnology.

  20. Visualizing Motion Patterns in Acupuncture Manipulation.

    PubMed

    Lee, Ye-Seul; Jung, Won-Mo; Lee, In-Seon; Lee, Hyangsook; Park, Hi-Joon; Chae, Younbyoung

    2016-07-16

    Acupuncture manipulation varies widely among practitioners in clinical settings, and it is difficult to teach novice students how to perform acupuncture manipulation techniques skillfully. The Acupuncture Manipulation Education System (AMES) is an open source software system designed to enhance acupuncture manipulation skills using visual feedback. Using a phantom acupoint and motion sensor, our method for acupuncture manipulation training provides visual feedback regarding the actual movement of the student's acupuncture manipulation in addition to the optimal or intended movement, regardless of whether the manipulation skill is lifting, thrusting, or rotating. Our results show that students could enhance their manipulation skills by training using this method. This video shows the process of manufacturing phantom acupoints and discusses several issues that may require the attention of individuals interested in creating phantom acupoints or operating this system.

  1. Rising incidence of Enterococcus species in microbiological specimens from orthopedic patients correlates to increased use of cefuroxime

    PubMed Central

    2013-01-01

    Background and purpose Enterococci are emerging causes of severe infections, including wound and bone infections in orthopedic patients. The main purpose of this study was to determine whether there was a correlation between the incidence of enterococci in tissue samples (biopsies) from orthopedic patients and consumption of cefuroxime in the orthopedic department. Methods and results Data were obtained from the department of clinical microbiology and the hospital pharmacy. The consumption of cefuroxime successively increased from 40 defined daily doses (DDD)/103 bed days in 2002 to 212 DDD/103 bed days in 2009. The incidence of patients with enterococci in tissue samples increased steadily from 1.03/103 bed days in 2002 to 5.90/103 bed days in 2009. Regression analysis revealed a significant correlation between the consumption of cefuroxime and the incidence of enterococci. Interpretation Continuous surveillance of species distribution, resistance rates, and antibiotic consumption is of utmost importance for optimal antibiotic strategy in orthopedic patients. PMID:23594224

  2. The Medical Education and Best Practice in Orthopedic Patient Care in Poland.

    NASA Astrophysics Data System (ADS)

    Rosiek, Anna; Leksowski, Krzysztof

    2012-07-01

    The leadership organization focuses on education, teamwork, customer relationship and developing strategy which help in building added value, in managing activities, time and quality. Everyday orthopedic experience shows that medical education is a mixture of: specific knowledge, skills and attitudes of people working together, and that creates effective teamwork in a hospital environment. Apart from the main reason of medical education, teaching about disease treatment and health problem solving, medical education should also concentrate on human factors and behavioral aspects of patient treatment in hospital.Assessment of an organization and medical education process by cultural and teamwork criteria, offers a powerful new way to think about performance at the frontlines of healthcare and in the future it could be gold standard for assessing the success of an organization, and standards in medical education, not only in orthopedics.

  3. Hope versus hype: what can additive manufacturing realistically offer trauma and orthopedic surgery?

    PubMed

    Gibbs, David M R; Vaezi, Mohammad; Yang, Shoufeng; Oreffo, Richard O C

    2014-01-01

    Additive manufacturing (AM) is a broad term encompassing 3D printing and several other varieties of material processing, which involve computer-directed layer-by-layer synthesis of materials. As the popularity of AM increases, so to do expectations of the medical therapies this process may offer. Clinical requirements and limitations of current treatment strategies in bone grafting, spinal arthrodesis, osteochondral injury and treatment of periprosthetic joint infection are discussed. The various approaches to AM are described, and the current state of clinical translation of AM across these orthopedic clinical scenarios is assessed. Finally, we attempt to distinguish between what AM may offer orthopedic surgery from the hype of what has been promised by AM.

  4. Energy-triggered drug release from polymer nanoparticles for orthopedic applications.

    PubMed

    Pullan, Jessica E; Pullan, Austin T; Taylor, V Bryce; Brooks, Benjamin D; Ewert, Daniel; Brooks, Amanda E

    2017-01-01

    Sequestra, present in many cancers and orthopedic infections, provide a safe harbor for the development of drug resistance. In the face of burgeoning drug resistance, the importance of nanoscale, microenvironment-triggered drug delivery cannot be overestimated. Such strategies may preserve pharmaceutical efficacy and significantly alter the etiology of many orthopedic diseases. Although temperature-, pH- and redox-responsive nanoparticle-based systems have been extensively studied, local drug delivery from polymeric nanoparticles can be triggered by a variety of energy forms. This review offers an overview of the state of the field as well as a perspective on the safety and efficacy of ultrasound, hyperthermia and radio frequency-triggered internal delivery systems in a variety of applications.

  5. Priming the Surface of Orthopedic Implants for Osteoblast Attachment in Bone Tissue Engineering

    PubMed Central

    Chan, Kiat Hwa; Zhuo, Shuangmu; Ni, Ming

    2015-01-01

    The development of better orthopedic implants is incessant. While current implants can function reliably in the human body for a long period of time, there are still a significant number of cases for which the implants can fail prematurely due to poor osseointegration of the implant with native bone. Increasingly, it is recognized that it is extremely important to facilitate the attachment of osteoblasts on the implant so that a proper foundation of extracellular matrix (ECM) can be laid down for the growth of new bone tissue. In order to facilitate the osseointegration of the implant, both the physical nanotopography and chemical functionalization of the implant surface have to be optimized. In this short review, however, we explore how simple chemistry procedures can be used to functionalize the surfaces of three major classes of orthopedic implants, i.e. ceramics, metals, and polymers, so that the attachment of osteoblasts on implants can be facilitated in order to promote implant osseointegration. PMID:26392807

  6. Special Measurement Clothing and Footwear, Orthopedic Footwear, Guidons, Streamers, and Flags (Supplementation is Permitted at all Levels)

    DTIC Science & Technology

    2007-11-02

    GUIDONS , STREAMERS, AND FLAGS (Supplementation is permitted at all levels.) Headquarters Departments of the Army, Defense Logistic AgencyDepartment of...Special Measurement Clothing and Footwear, Orthopedic Footwear, Guidons , Streamers, and Flags Unclassified 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...NAVSUPINST 4400.70C/MCO 4400.137A SPECIAL MEASUREMENT CLOTHING AND FOOTWEAR, ORTHOPEDIC FOOTWEAR, GUIDONS , STREAMERS, AND FLAGS (Supplementation is

  7. Design and implementation of a visual and haptic simulator in a platform for a TEL system in percutaneuos orthopedic surgery.

    PubMed

    Luengo, Vanda; Larcher, Aurelie; Tonetti, Jérôme

    2011-01-01

    Within a research project whose aim is to promote the learning of percutaneous operation in orthopedic surgery we design a Technological Enhanced Learning (TEL) system. This project belongs to a multidisciplinary field including computer, orthopedic surgery, medical imaging, didactic and cognitive sciences. The article presents the design principles of TEL with a particular interest in the development of a simulator. This simulator allows a virtual exercise interacting with the learner in visual, temporal and haptic dimension.

  8. Brandon Research, Inc. Orthopedic Implant Cooperative Research and Development Agreement (CRADA) Final Report

    SciTech Connect

    Freeman, W.R.

    1999-04-22

    The project was a joint research effort between the U. S. Department of Energy's (DOE) Kansas City Plant (KCP) and Brandon Research, Inc. to develop ways to improve implants used for orthopedic surgery for joint replacement. The primary product produced by this study is design information, which may be used to develop implants that will improve long-term fixation and durability in the host bone environment.

  9. In-vivo orthopedic implant diagnostic device for sensing load, wear, and infection

    DOEpatents

    Evans, III, Boyd McCutchen; Thundat, Thomas G.; Komistek, Richard D.; Dennis, Douglas A.; Mahfouz, Mohamed

    2006-08-29

    A device for providing in vivo diagnostics of loads, wear, and infection in orthopedic implants having at least one load sensor associated with the implant, at least one temperature sensor associated with the implant, at least one vibration sensor associated with the implant, and at least one signal processing device operatively coupled with the sensors. The signal processing device is operable to receive the output signal from the sensors and transmit a signal corresponding with the output signal.

  10. Rapid Extremity Pain Relief by Battlefield Acupuncture after Orthopedic Surgery: A Randomized Clinical Trial

    DTIC Science & Technology

    2017-03-21

    FINAL REPORT Project Title: Rapid Extremity Pain Relief by Battlefield Acupuncture after Orthopedic Surgery: A Randomized Clinical Trial...surgeries. These invasive procedures result in swelling and pain . The side effects of the pain medications are well known and a decrease in their use could...relieving acute extremity pain , reducing medication use, decreasing time to full ambulation and improving quality of life than placebo acupuncture or

  11. [Clinical observation of traumatic ankle arthritis with orthopedics lotion on 60 cases].

    PubMed

    Zhang, Hui; Yu, Jie

    2014-02-01

    Observing the clinical curative effect of orthopedics lotion to treat traumatic ankle arthritis, the outpatient department of orthopedics in Guang'anmen Hospital collected 60 cases who were diagnosed as traumatic ankle arthritis. The cases who already met the inclusion criteria, were randomly divided into the treatment group (30 cases) and control group (30 cases). Thirty patients in treatment group were received fumigation treatment with orthopedics lotion; 30 patients in control group were treated by intra-articular injection of sodium hyaluronate. After 5 weeks treatment, the effects on the both groups would be observed and analysed. Baird-Jackson scoring system was used to assess the overall curative effect. Visual analogue scales (VAS) was used to assess analgesic effect. BJ scores of pre-treatment and post-treatment in both the treatment group and the control group were compared, P <0O. 01, significantly different; and the BJ scores after treatment of two groups were compared by paired t-test, the t value is 1. 76, there was no significant difference between two groups. Both of the treatments were effective, but there was no significant difference in overall curative effect between the two kinds of treatment. The VAS scores after treatment of two groups were compared by paired t-test, the t value was 2. 282, and there was a significant difference between two groups (P <0. 05). The analgesic effect shown in treatment group was better than the control group. The results suggest that: orthopedics lotion is a effective way to treat traumatic ankle arthritis, and it has significant effect on analgesic.

  12. Differences in the Clinical Outcome of Osteomyelitis by Treating Specialty: Orthopedics or Infectology.

    PubMed

    Arias Arias, Carolina; Tamayo Betancur, Maria Carolina; Pinzón, Miguel Alejandro; Cardona Arango, Doris; Capataz Taffur, Cesar Antonio; Correa Prada, Edgar

    2015-01-01

    Osteomyelitis is a heterogeneous infection with regard to etiology and treatment, and currently no single management protocol exists. Management of the condition is typically an interdisciplinary approach between orthopedics and infectious disease; however, the orthopedist is often the person who manages treatment. The aim of the study was to determine differences in the outcome of osteomyelitis according to its treating specialty and to identify factors associated with the recurrence of the disease. An ambispective cohort study of 129 patients with osteomyelitis was conducted and the proportions for qualitative variables and central tendency and dispersion measures for quantitative variables were calculated; the latter were tested for normality using the Shapiro-Wilk test. A bivariate analysis was conducted with measures of association based on the chi square test and crude relative risk. A logistic regression model was applied and statistical significance was set at p < 0.05, including the model of relevant clinical variables that fit the Hosmer-Lemeshow test. We found that 70% of patients were treated either by orthopedics or infectious disease. Patients who were treated by an orthopedist alone presented a greater risk of relapse or reinfection (RR = 4.6; 95% CI 2.3;8.9). Risk factors of osteomyelitis recurrence as determined in the regression model included the following: age of 57 years or older (RR = 1.3; 95% 0.3;5.2), long bones (RR = 1.9; 95% CI 0.5;7.1), fracture (RR = 5.0; 95% CI 0.4;51.4), monotherapy (RR = 3.0; 95% CI 0.6;14.5), receiving less than 4 weeks of antibiotics (RR = 1.5; 95% CI 0.2;10.1), inadequate treatment (RR = 3.1; 95% CI 0.4;20.1), and receiving orthopedics treatment (RR = 5.5; 95% CI 1.6;18.2). Most patients evaluated jointly by orthopedics and infectious disease received adequate treatment for osteomyelitis and had fewer relapses.

  13. Orthopedic emergencies: a practical emergency department classification (US-VAGON) in pelvic fractures.

    PubMed

    Wang, Hao; Coppola, Paolo T; Coppola, Marco

    2015-05-01

    Trauma is one of the leading causes of death before the age of 40 years and approximately 5% of patients with trauma who require hospital admission have pelvic fractures. This article updates the emergency department classification of pelvic fractures first described in 2000. This information is of practical value to emergency physicians in identifying the potential vascular, genitourinary, gastrointestinal, orthopedic, and neurologic complications and further assists them in the initial evaluation and treatment of patients with pelvic fractures.

  14. Accessibility and Availability of Online Information for Orthopedic Surgery Residency Programs

    PubMed Central

    Davidson, Austin R.; Loftis, Christopher M.; Throckmorton, Thomas W.

    2016-01-01

    Abstract Background Prospective orthopedic residency applicants commonly use one of three databases to identify potential programs: Accreditation Council of Graduate Medical Education (ACGME), American Medical Association (FREIDA), or Orthogate. org. In addition, institutional websites are typically the primary source of information once programs are identified. We sought to evaluate the databases and websites used by prospective orthopedic surgery applicants for content and accessibility. We hypothesized that information would be more available in comparison to previous studies but would still fail to provide complete, up to date program information for the prospective applicant. Methods Three online databases were queried in December 2014 to compile a list of orthopedic residency programs in the United States. This combined list was used as a basis for evaluating individual institution websites. Previously described criteria were used to evaluate the availability of information contained within orthopedic surgery residency websites. Results At the time of online review, 157 programs were identified. Depending on the database in question, up to 33% of programs either did not provide a link or listed a non-functioning link. Among the variety of evaluated criteria, inclusion of the information varied between 12% and 97% for the individual program websites. Conclusions Online databases are useful in listing programs, but individual program details and direct functional links are lacking. Most program websites contain varying degrees of desired information; however, not all programs maintain websites which consistently provide information to satisfy the evaluated criteria in this study. Improved online accessibility and availability of information for residency programs would increase their visibility and utility for prospective applicants. PMID:27528832

  15. Evaluation of Orthopedic Trauma Surgery Follow-up and Impact of a Routine Callback Program.

    PubMed

    Casp, Aaron J; Wells, Jodi; Holzgrefe, Russell; Weiss, David; Kahler, David; Yarboro, Seth R

    2017-01-05

    A high rate of patients lost to follow-up is a common problem in orthopedic trauma surgery. This adversely affects the ability to produce accurate clinical outcomes research. The purpose of this project was to (1) evaluate the rate of loss to follow-up at an academic level I trauma center; (2) identify the patient-reported reasons for loss to follow-up; and (3) evaluate the efficacy of a routine patient callback program. All patients who underwent surgery in the orthopedic trauma division of the University of Virginia Medical Center from April 1, 2014, to September 30, 2014, and did not complete their postoperative clinic follow-up were analyzed. The characteristics of these patients were evaluated, and the primary reason for not completing the recommended follow-up was identified. All patients were then offered additional orthopedic follow-up at the time of contact. Of the 480 patients who met the inclusion criteria, 41 (8.5%) failed to complete the recommended postoperative follow-up course. The most common reason for being lost to follow-up was feeling well and not having the need to be seen (46.3%). Only 6 (14.6%) of the 41 patients requested follow-up care at the time of contact. The lost to follow-up rate in this study, 8.5%, was considerably lower than that previously reported, but patient characteristics were consistent with those of prior studies on this subject. The low lost to follow-up rate may reflect a difference in geographic location or patient population. The patient callback program had a low yield of patients requesting additional follow-up after being contacted. [Orthopedics. 201x; xx(x):xx-xx.].

  16. Optical manipulation for optogenetics: otoliths manipulation in zebrafish (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Favre-Bulle, Itia A.; Scott, Ethan; Rubinsztein-Dunlop, Halina

    2016-03-01

    Otoliths play an important role in Zebrafish in terms of hearing and sense of balance. Many studies have been conducted to understand its structure and function, however the encoding of its movement in the brain remains unknown. Here we developed a noninvasive system capable of manipulating the otolith using optical trapping while we image its behavioral response and brain activity. We'll also present our tools for behavioral response detection and brain activity mapping. Acceleration is sensed through movements of the otoliths in the inner ear. Because experimental manipulations involve movements, electrophysiology and fluorescence microscopy are difficult. As a result, the neural codes underlying acceleration sensation are poorly understood. We have developed a technique for optically trapping otoliths, allowing us to simulate acceleration in stationary larval zebrafish. By applying forces to the otoliths, we can elicit behavioral responses consistent with compensation for perceived acceleration. Since the animal is stationary, we can use calcium imaging in these animals' brains to identify the functional circuits responsible for mediating responses to acceleration in natural settings.

  17. Models of remote manipulation in space

    NASA Technical Reports Server (NTRS)

    Hannaford, Blake

    1991-01-01

    Robots involved in high value manipulation must be effectively coupled to a human operator either at the work-site or remotely connected via communication links. In order to make use of experimental performance evaluation data, models must be developed. Powerful models of remote manipulation by humans can be used to predict manipulation performance in future systems based on today's laboratory systems. In this paradigm, the models are developed from experimental data, and then used to predict performance in slightly different situations. Second, accurate telemanipulation will allow design of manipulation systems which extend manipulation capability beyond its current bounds.

  18. Earth orbital teleoperator manipulator system evaluation program

    NASA Technical Reports Server (NTRS)

    Brye, R. G.; Frederick, P. N.; Kirkpatrick, M., III; Shields, N. L., Jr.

    1977-01-01

    The operator's ability to perform five manipulator tip movements while using monoptic and stereoptic video systems was assessed. Test data obtained were compared with previous results to determine the impact of camera placement and stereoptic viewing on manipulator system performance. The tests were performed using the NASA MSFC extendible stiff arm Manipulator and an analog joystick controller. Two basic manipulator tasks were utilized. The minimum position change test required the operator to move the manipulator arm to touch a target contract. The dexterity test required removal and replacement of pegs.

  19. Knee Laxity Variations in the Menstrual Cycle in Female Athletes Referred to the Orthopedic Clinic

    PubMed Central

    Shafiei, Seyed Esmaeel; Peyvandi, Sepideh; Kariminasab, Mohamad Hosein; Shayesteh Azar, Masoud; Daneshpoor, Seyed Mohamad Mehdi; Khalilian, Alireza; Aghajantabar, Zeinab

    2016-01-01

    Background Anterior cruciate ligament (ACL) rupture is the biggest concern for orthopedic surgeons who are involved in sports injuries, so most of ACL reconstruction surgeries are sports related. ACL injuries in female athletes are 2 - 8 times more common than male athletes in similar sport injuries. Objectives The aim of this study was to compare knee laxity changes in the menstrual cycle in female athletes referred to the orthopedic clinic of Imam Khomeini hospital in the north of Iran, Sari, 2013. Patients and Methods The present descriptive study was conducted on 40 female athletes that were referred to the orthopedic clinic. Hormone levels, such as estrogen and progesterone were assessed by one laboratory in 3 phases of the menstrual cycle. We used Lachman test and anterior drawer test for knee laxity rate. The descriptive statistics were calculated as indices of central distribution of bonds (x ± SD) and relative frequency distribution was used for qualitative variables. Results The results of the current study showed that there is no significant difference in ACL laxity in female athletes in three phases of menstrual cycle; namely menstruation time, ovulation time and mid-luteal phase. Conclusions Despite numerous studies and research in the field of knee laxity and effects of female hormones, many researchers do not agree about the effect of female hormones on knee laxity. The current study also reported no relationship between female hormones and knee laxity, while statistics show fundamental difference between male and female athletes. PMID:28144404

  20. Extended scope physiotherapy roles for orthopedic outpatients: an update systematic review of the literature

    PubMed Central

    Stanhope, Jessica; Grimmer-Somers, Karen; Milanese, Steve; Kumar, Saravana; Morris, Joanne

    2012-01-01

    Purpose This systematic review updates one conducted in 2008 into extended scope practice (ESP) in physiotherapy in orthopedics. Methods A comprehensive open-ended search was conducted using electronic library data-bases and Google Scholar to identify any primary study design reporting on physiotherapists working in ESP roles within orthopedic settings. Studies were allocated to the National Health and Medical Research Council hierarchy of evidence, although only studies in levels I, II, or III_1 were critically appraised using a purpose-built critical appraisal tool. Information was extracted on the country of origin, ESP tasks, relevant training, patient types, health, process, and cost measures. Results 1071 studies were identified, and twelve were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from II to IV, from which only two diagnostic studies met the criteria for critical appraisal. ESP tasks included injection therapy, removing k-wires, and requesting investigations. The education of ESP physiotherapists varied widely, and included formal and informal training. The positive outcomes of ESP initiatives were reported, in diagnostic ability, reduced costs and waiting times, and improved health outcomes. Conclusion Despite the positive results, the generally low level of evidence and the range of outcome measures reported, constrained clear conclusions regarding the health, process, and cost implications of ESP physiotherapy roles in orthopedic settings. The need for formalized, widely recognized training was highlighted, to give ESP physiotherapy roles credibility. PMID:22359462

  1. A touch probe method of operating an implantable RFID tag for orthopedic implant identification.

    PubMed

    Liu, Xiaoyu; Berger, J Lee; Ogirala, Ajay; Mickle, Marlin H

    2013-06-01

    The major problem in operating an implantable radio-frequency identification (RFID) tag embedded on an orthopedic implant is low efficiency because of metallic interference. To improve the efficiency, this paper proposes a method of operating an implantable passive RFID tag using a touch probe at 13.56 MHz. This technology relies on the electric field interaction between two pairs of electrodes, one being a part of the touch probe placed on the surface of tissue and the other being a part of the tag installed under the tissue. Compared with using a conventional RFID antenna such as a loop antenna, this method has a better performance in the near field operation range to reduce interference with the orthopedic implant. Properly matching the touch probe and the tag to the tissue and the implant reduces signal attenuation and increases the overall system efficiency. The experiments have shown that this method has a great performance in the near field transcutaneous operation and can be used for orthopedic implant identification.

  2. Orthopedic Lesions in Tethered Cord Syndrome: The Importance of Early Diagnosis and Treatment on Patient Outcome

    PubMed Central

    Gharedaghi, Mohammad; Samini, Fariborz; Mashhadinejad, Hosein; Khajavi, Mahdi; Samini, Mohammad

    2014-01-01

    Background: Many of the patients with tethered cord syndrome (TCS) are admitted because of neurological symptoms, while some are admitted because of their orthopedic, urologic, anorectal, and dermatologic manifestations. Consequently, this study aimed to evaluate the importance of early diagnosis and treatment of tethered cord syndrome on patient outcome. Methods: Fourty-three patients who underwent surgery because of tethered cord syndrome from 2006 to 2010 were studied. Many of these cases were referred by orthopedic surgeons. All of the findings were recorded and follow up was done twice (1 and 3 years after surgery). Results: Thirty-seven patients were less than 7 years old and 6 were between 17 to 33 years old. According to clinical and neurological exams, satisfactory results were achieved in both groups. Those with early surgical intervention, especially in their early follow up assessment, had the best results. Seventeen cases were referred by an orthopedic surgeon because of manifestations such as leg weakness and numbness, leg pain and spasticity, pes cavus, claw toes, and leg or foot length discrepancy. Cerebrospinal fluid leakage occurred in 3 cases after surgery and 1 showed pseudomeningocele formation. Conclusions: After one year of follow up, initially the results of the treatment were better in early operated cases, but in later follow up assessment (after 3 years) the results were almost the same in both of the groups. PMID:25207325

  3. Nanomaterials and synergistic low-intensity direct current (LIDC) stimulation technology for orthopedic implantable medical devices.

    PubMed

    Shirwaiker, Rohan A; Samberg, Meghan E; Cohen, Paul H; Wysk, Richard A; Monteiro-Riviere, Nancy A

    2013-01-01

    Nanomaterials play a significant role in biomedical research and applications because of their unique biological, mechanical, and electrical properties. In recent years, they have been utilized to improve the functionality and reliability of a wide range of implantable medical devices ranging from well-established orthopedic residual hardware devices (e.g., hip implants) that can repair defects in skeletal systems to emerging tissue engineering scaffolds that can repair or replace organ functions. This review summarizes the applications and efficacies of these nanomaterials that include synthetic or naturally occurring metals, polymers, ceramics, and composites in orthopedic implants, the largest market segment of implantable medical devices. The importance of synergistic engineering techniques that can augment or enhance the performance of nanomaterial applications in orthopedic implants is also discussed, the focus being on a low-intensity direct electric current (LIDC) stimulation technology to promote the long-term antibacterial efficacy of oligodynamic metal-based surfaces by ionization, while potentially accelerating tissue growth and osseointegration. While many nanomaterials have clearly demonstrated their ability to provide more effective implantable medical surfaces, further decisive investigations are necessary before they can translate into medically safe and commercially viable clinical applications. The article concludes with a discussion about some of the critical impending issues with the application of nanomaterials-based technologies in implantable medical devices, and potential directions to address these.

  4. Prevalence of musculoskeletal disorders among orthopedic trauma surgeons: an OTA survey

    PubMed Central

    AlQahtani, Saad M.; Alzahrani, Mohammad M.; Harvey, Edward J.

    2016-01-01

    Background Occupational injuries and hazards have gained increased attention in the surgical community in general and in the orthopedic literature specifically. The aim of this study was to assess prevalence and characteristics of musculoskeletal disorders among orthopedic trauma surgeons and the impact of these injuries on the surgeons’ practices. Methods We sent a modified version of the physical discomfort survey to surgeon members of the Orthopaedic Trauma Association (OTA) via email. Data were collected and descriptive statistics were analyzed. Results A total of 86 surgeons completed the survey during the period of data collection; 84.9% were men, more than half were 45 years or older and 40.6% were in practice for 10 years or more. More than 66% of respondents reported a musculoskeletal disorder that was related to work; the most common was low back pain (29.3%). The number of body regions involved and disorders diagnosed was associated with increasing age and number of years in practice (p = 0.033). Time off work owing to these disorders was associated with working in a private setting (p = 0.045) and working in more than 1 institute (p = 0.009). Conclusion To our knowledge, our study is the first to report a high percentage of orthopedic trauma surgeons sustaining occupational injuries some time in their careers. The high cost of management and rehabilitation of these injuries in addition to the related number of missed work days indicate the need for increased awareness and implementation of preventive measures. PMID:26812408

  5. The roles of funding source, clinical trial outcome, and quality of reporting in orthopedic surgery literature.

    PubMed

    Khan, Safdar N; Mermer, Matthew J; Myers, Elizabeth; Sandhu, Harvinder S

    2008-12-01

    Compared with nonfunded or peer-reviewed funded projects, industry-sponsored clinical trials have traditionally been associated with more positive results. This relationship has been extensively studied in the nonsurgical literature. Although a few authors have addressed specialties, little has been reported on orthopedic clinical trials and their association with funding, study outcome, and efforts to reduce bias after randomization across journals of multiple subspecialties. For the study reported here, we selected 5 major orthopedic subspecialty journals: Journal of Bone and Joint Surgery (American Volume), Spine, Journal of Arthroplasty, Journal of Orthopaedic Trauma, and American Journal of Sports Medicine. We chose a 2-year limit for investigation (2002-2004); included all original randomized clinical trials reported in these 5 journals; and examined these trials for their study design, funding source, outcome, bias potential, and conclusion reached. Support for the 100 eligible orthopedic clinical trials was stated as coming from industry (26 trials, 26%), nonprofit sources (19 trials, 19%), and mixed sources (5 trials, 5%); no support was stated in 46 trials (46%), and support was not reported in 4 trials (4%). Of the 26 trials reporting industry support, 22 (85%) were graded as indicating an outcome favorable to the new treatment. The association between industry funding and favorable outcome was strong and significant (P<.001). In almost half of the studies reported in Journal of Bone and Joint Surgery and Spine, measures taken to reduce bias were not documented.

  6. The Use of Carbon-Fiber-Reinforced (CFR) PEEK Material in Orthopedic Implants: A Systematic Review

    PubMed Central

    Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

    2015-01-01

    Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) has been successfully used in orthopedic implants. The aim of this systematic review is to investigate the properties, technical data, and safety of CFR-PEEK biomaterial and to evaluate its potential for new innovation in the design of articulating medical devices. A comprehensive search in PubMed and EMBASE was conducted to identify articles relevant to the outcomes of CFR-PEEK orthopedic implants. The search was also expanded by reviewing the reference sections of selected papers and references and benchmark reports provided by content experts. A total of 23 articles were included in this review. There is limited literature available assessing the performance of CFR-PEEK, specifically as an implant material for arthroplasty systems. Nevertheless, available studies strongly support CFR-PEEK as a promising and suitable material for orthopedic implants because of its biocompatibility, material characteristics, and mechanical durability. Future studies should continue to investigate CFR-PEEK’s potential benefits. PMID:25780341

  7. Peripheral neuropathy of the upper extremity: medical comorbidity that confounds common orthopedic pathology.

    PubMed

    Bales, Joshua G; Meals, Roy

    2009-10-01

    In the orthopedic patient, the diagnosis of a compression neuropathy may be straightforward. However, various medical comorbidities can obscure this diagnosis. It is paramount for the practicing orthopedic surgeon to have an appreciation for the medical pathology of common axonal neuropathies to properly diagnose, treat, and refer a patient with altered sensation in the upper extremity. The prevalence of diabetes in the United States is 10%, and roughly 20% of diabetic patients have peripheral neuropathy. In addition to diabetes, 32% of heavy alcohol users present with polyneuropathy. With advancements in the treatment of human immunodeficiency virus/acquired immunodeficiency syndrome clinicians may see the long-term effects of the virus manifested as axonal neuropathies and extreme allodynia. In some regions of the world, Hansen's disease usurps diabetes as the most common cause of polyneuropathy. Based on patient demographics and social habits, Lyme disease, multiple sclerosis, and syphilis can all manifest as polyneuropathies. Understanding the common medical causes of neuropathy will aid the orthopedic surgeon in differentiating simple compression neuropathies from diseases mimicking or confounding them.

  8. Orthopedic Injuries and Their Treatment in Children During Earthquakes: A Systematic Review.

    PubMed

    Morelli, Ilaria; Sabbadini, Maria Grazia; Bortolin, Michelangelo

    2015-10-01

    Orthopedic injuries commonly affect children during earthquakes, but reports about them are rare. This setting may lead to different standards of care, but guidelines are still missing in this field. A systematic review was performed to: (1) assess type and body distribution of pediatric earthquake-related injuries, treatment performed, length of stay, and complications; and (2) identify starting points to define standards of care. PubMed database was researched for papers (1999-2014 period) in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Inclusion criteria were: English, French, Spanish, or Italian language and data reported about orthopedic lesions in children (≤18 years old). Reviews, letters, commentaries, editorials, and single case reports were excluded. Two independent reviewers selected articles after abstract and full-text reading. Traumatic injuries caused child hospital admissions ranging from 46.9% to 100.0%; 16% to 53% suffered fractures. Lower limbs mostly were involved. Soft-tissue injuries affected 55% of patients. Debridement and external fixation (EF) were the most frequent surgical treatments. Amputation rates varied from 5% to 11%. This study revealed that field hospitals should be prepared to: (1) treat mainly lower extremities fractures in children; and (2) use especially EF techniques. The presence of orthopedic surgeons familiar with pediatric traumatology should be considered.

  9. The creation and evaluation of an ambulatory orthopedic surgical patient education web site to support empowerment.

    PubMed

    Heikkinen, Katja; Suomi, Reima; Jääskeläinen, Miika; Kaljonen, Anne; Leino-Kilpi, Helena; Salanterä, Sanna

    2010-01-01

    The use and evaluation of Web sites in ambulatory surgery patients' education are rare; hence, innovative approaches to educate these patients should be adopted and evaluated. The aim of this study was to describe the creation of and evaluate the utility and usability of an ambulatory orthopedic surgical patient education Web site. A descriptive study design was used. The evaluators were 72 ambulatory orthopedic surgery patients receiving education through a Web site. The data were collected after education preoperatively and 2 weeks postoperatively. Two instruments were used: "Patients' Evaluation of Education" and "Diary of the Use of the Website." Web site evaluators' scores for utility of the Web site ranged from 57.56 to 87.87 of 100. Utility of the Web site evaluations was significantly higher (P < .05) 2 weeks postoperatively than immediately after the operation. Web site evaluators' scores for usability of the Web site ranged from 85.69 to 88.32. The use of this program as educational material for orthopedic surgery patients was supported by the patients' opinions of the usability and utility of the Web site.

  10. Incidence and costs of defensive medicine among orthopedic surgeons in the United States: a national survey study.

    PubMed

    Sethi, Manish K; Obremskey, William T; Natividad, Hazel; Mir, Hassan R; Jahangir, A Alex

    2012-02-01

    Defensive medicine is defined as medical practices that may exonerate physicians from liability without significant benefit to patients. No study has evaluated the United States national incidence of defensive medicine in the field of orthopedic surgery. In the study reported here, we investigated the practice of defensive medicine and the resultant financial implications of such behavior by orthopedic surgeons in the US. A Web-based survey was sent to 2000 orthopedic surgeons in the US. Of the 1214 respondents, 1168 (96%) reported having practiced defensive medicine by ordering imaging, laboratory tests, specialist referrals, or hospital admissions mainly to avoid possible malpractice liability. On average, 24% of all ordered tests were for defensive reasons. Mean national Medicare payment information was used to calculate the cost of defensive medicine per respondent: approximately $100,000 per year. With there being 20,400 practicing orthopedic surgeons in the US, we estimated that the national cost of defensive medicine for the specialty of orthopedic surgery is $2 billion annually. Orthopedic surgeons' defensive medicine is a significant factor in health care costs and is of marginal benefit to patients. Policies aimed at managing liability risk may be useful in containing such practices.

  11. Educational impact of a clinical anatomy workshop on 1st-year orthopedic and rheumatology fellows in Mexico City.

    PubMed

    Saavedra, M A; Villaseñor-Ovies, P; Harfush, L A; Navarro-Zarza, J E; Canoso, J J; Cruz-Domínguez, P; Vargas, A; Hernández-Díaz, C; Chiapas-Gasca, K; Camacho-Galindo, J; Alvarez-Nemegyei, J; Kalish, R A

    2016-05-01

    We aim to study the educational impact of a clinical anatomy workshop in 1st-year orthopedic and rheumatology fellows. First-year rheumatology fellows (N = 17) and a convenience sample of 1st-year orthopedic fellows (N = 14) from Mexico City in the 9th month of training participated in the study. The pre- and the post- workshop tests included the same 20 questions that had to be answered by identification or demonstration of relevant anatomical items. The questions, arranged by anatomical regions, were asked in five dynamic stations. Overall, the 31 participants showed an increase of correct answers, from a median of 6 (range 1 to 12) in the pre-workshop test, to a median of 14 (range 7 to 19) in the post-workshop test. In the pre-workshop test, the correct median answers were 7 (range 2 to 12) in the orthopedic fellows and 5 (range 1 to 10) in the rheumatology fellows (p = 0.297). Corresponding scores in the post-workshop were 15 (range 10 to 19) and 12 (range 7 to 18) (p = 0.026) showing a significant difference favoring the orthopedic group. Our clinical anatomy workshop was efficacious, in the short term, as a teaching instrument for 1st-year orthopedic and rheumatology fellows. The post-workshop scores, although significantly improved in both groups, particularly in the orthopedic fellows, were still suboptimal. Further refinements of our workshop might yield better results.

  12. Spin-manipulating polarized deuterons

    SciTech Connect

    Morozov, V S; Krisch, A D; Leonova, M A; Raymond, R S; Sivers, D W; Wong, V K; Hinterberger, F; Kondratenko, A M; Stephenson, E J

    2011-03-01

    Spin dynamics of polarized deuteron beams near depolarization resonances, including a new polarization preservation concept based on specially-designed multiple resonance crossings, has been tested in a series of experiments in the COSY synchrotron. Intricate spin dynamics with sophisticated pre-programmed patterns as well as effects of multiple crossings of a resonance were studied both theoretically and experimentally with excellent agreement. Possible applications of these results to preserve, manipulate and spin-flip polarized beams in synchrotrons and storage rings are discussed.

  13. From Micro- to Nanoparticle Manipulation

    NASA Astrophysics Data System (ADS)

    Baechi, D.; Buser, R.; Dual, J.

    2000-12-01

    The precise manipulation of small particles is not a trivial task. In a first effort, a nanorobot system was built based on a robot with vision feedback and a micromachined gripper. It was suitable for handling particles down to 100 μ with submicron accuracy in a normal environment. For smaller particles stiction effects prohibit the release of the particles in a controlled way. Stiction effects are avoided in a fluid environment. As an example, a system of channels is described in detail that is able to feed micron sized particles in a fluid environment to the desired places.

  14. Covariance Manipulation for Conjunction Assessment

    NASA Technical Reports Server (NTRS)

    Hejduk, M. D.

    2016-01-01

    Use of probability of collision (Pc) has brought sophistication to CA. Made possible by JSpOC precision catalogue because provides covariance. Has essentially replaced miss distance as basic CA parameter. Embrace of Pc has elevated methods to 'manipulate' covariance to enable/improve CA calculations. Two such methods to be examined here; compensation for absent or unreliable covariances through 'Maximum Pc' calculation constructs, projection (not propagation) of epoch covariances forward in time to try to enable better risk assessments. Two questions to be answered about each; situations to which such approaches are properly applicable, amount of utility that such methods offer.

  15. Primary Payer Status is Associated with the Use of Nerve Block Placement for Ambulatory Orthopedic Surgery

    PubMed Central

    Tighe, Patrick J.; Brennan, Meghan; Moser, M.; Boezaart, Andre P.; Bihorac, Azra

    2012-01-01

    Introduction Although more than 30 million patients in the United States undergo ambulatory surgery each year, it remains unclear what percentage of these patients receive a perioperative nerve block. We reviewed data from the 2006 National Survey of Ambulatory Surgery (NSAS) to determine the demographic, socioeconomic, geographic, and clinical factors associated with the likelihood of nerve block placement for ambulatory orthopedic surgery. The primary outcome of interest was the association between primary method of payment and likelihood of nerve block placement. Additionally, we examined the association between type of surgical procedures, patient demographics, and hospital characteristics with the likelihood of receiving a nerve block. Methods This cross-sectional study reviewed 6,000 orthopedic anesthetics from the 2006 NSAS dataset, which accounted for over 3.9 million orthopedic anesthetics when weighted. The primary outcome of this study addressed the likelihood of receiving a nerve block for orthopedic ambulatory surgery according to the patient’s primary method of payment. Secondary endpoints included differences in demographics, surgical procedures, side effects, complications, recovery profile, anesthesia staffing model, and total perioperative charges in those with and without nerve block. Results Overall, 14.9% of anesthetics in this sample involved a peripheral nerve block. Length of time in postoperative recovery, total perioperative time, and total charges were less for those receiving nerve blocks. Patients were more likely to receive a nerve block if their procedures were performed in metropolitan service areas (OR 1.86, 95% CI 1.19-2.91, p=0.007) or freestanding surgical facilities (OR 2.27, 95% CI 1.74-2.96, p<0.0001), and if payment for their surgery was supported by government programs (OR 2.5, 95% CI 1.01-6.21, p=0.048) or private insurance (OR 2.62, 95% CI 1.12-6.13, p=0.03) versus self-pay or charity care. Conclusion For patients

  16. Manipulating expression of tonoplast transporters.

    PubMed

    Li, Zhigang; Zhou, Man; Hu, Qian; Reighard, Shane; Yuan, Shuangrong; Yuan, Ning; San, Bekir; Li, Dayong; Jia, Haiyan; Luo, Hong

    2012-01-01

    Plant vacuoles have multifaceted roles including turgor maintenance, cytosolic pH and ionic homeostasis, plant protection against environmental stress, detoxification, pigmentation, and cellular signaling. These roles are achieved through the coordinated activities of many proteins in the tonoplast (vacuolar membrane), of which the proton pumps and ion transporters have been modified for improved abiotic stress tolerance in transgenic plants. Here we describe a method to manipulate vacuolar H(+)-pyrophosphatase in turfgrass and evaluate the impact of the modified tonoplast on the phenotype, biochemistry, and physiology of the transgenics. Creeping bentgrass (Agrostis stolonifera L.) plants overexpressing an Arabidopsis vacuolar H(+)-pyrophosphatase AVP1 exhibited improved growth and enhanced salt tolerance, likely associated with increased photosynthesis, relative water content, proline production, and Na(+) uptake. These transgenic plants also had decreased solute leakage in the leaf tissues and increased concentrations of Na(+), K(+), Cl(-), and total phosphorus in the root tissues. Similar strategies can be employed to manipulate other tonoplast transporters and in other plant species to produce transgenic plants with improved performance under various abiotic stresses.

  17. Mobile remote manipulator vehicle system

    NASA Technical Reports Server (NTRS)

    Bush, Harold G. (Inventor); Mikulas, Martin M., Jr. (Inventor); Wallsom, Richard E. (Inventor); Jensen, J. Kermit (Inventor)

    1987-01-01

    A mobile remote manipulator system is disclosed for assembly, repair and logistics transport on, around and about a space station square bay truss structure. The vehicle is supported by a square track arrangement supported by guide pins integral with the space station truss structure and located at each truss node. Propulsion is provided by a central push-pull drive mechanism that extends out from the vehicle one full structural bay over the truss and locks drive rods into the guide pins. The draw bar is now retracted and the mobile remote manipulator system is pulled onto the next adjacent structural bay. Thus, translation of the vehicle is inchworm style. The drive bar can be locked onto two guide pins while the extendable draw bar is within the vehicle and then push the vehicle away one bay providing bidirectional push-pull drive. The track switches allow the vehicle to travel in two orthogonal directions over the truss structure which coupled with the bidirectional drive, allow movement in four directions on one plane. The top layer of this trilayered vehicle is a logistics platform. This platform is capable of 369 degees of rotation and will have two astronaut foot restraint platforms and a space crane integral.

  18. Actuators for a space manipulator

    NASA Technical Reports Server (NTRS)

    Chun, W.; Brunson, P.

    1987-01-01

    The robotic manipulator can be decomposed into distinct subsytems. One particular area of interest of mechanical subsystems is electromechanical actuators (or drives). A drive is defined as a motor with an appropriate transmission. An overview is given of existing, as well as state-of-the-art drive systems. The scope is limited to space applications. A design philosophy and adequate requirements are the initial steps in designing a space-qualified actuator. The focus is on the d-c motor in conjunction with several types of transmissions (harmonic, tendon, traction, and gear systems). The various transmissions will be evaluated and key performance parameters will be addressed in detail. Included in the assessment is a shuttle RMS joint and a MSFC drive of the Prototype Manipulator Arm. Compound joints are also investigated. Space imposes a set of requirements for designing a high-performance drive assembly. Its inaccessibility and cryogenic conditions warrant special considerations. Some guidelines concerning these conditions are present. The goal is to gain a better understanding in designing a space actuator.

  19. Covariance Manipulation for Conjunction Assessment

    NASA Technical Reports Server (NTRS)

    Hejduk, M. D.

    2016-01-01

    The manipulation of space object covariances to try to provide additional or improved information to conjunction risk assessment is not an uncommon practice. Types of manipulation include fabricating a covariance when it is missing or unreliable to force the probability of collision (Pc) to a maximum value ('PcMax'), scaling a covariance to try to improve its realism or see the effect of covariance volatility on the calculated Pc, and constructing the equivalent of an epoch covariance at a convenient future point in the event ('covariance forecasting'). In bringing these methods to bear for Conjunction Assessment (CA) operations, however, some do not remain fully consistent with best practices for conducting risk management, some seem to be of relatively low utility, and some require additional information before they can contribute fully to risk analysis. This study describes some basic principles of modern risk management (following the Kaplan construct) and then examines the PcMax and covariance forecasting paradigms for alignment with these principles; it then further examines the expected utility of these methods in the modern CA framework. Both paradigms are found to be not without utility, but only in situations that are somewhat carefully circumscribed.

  20. Semantics of directly manipulating spatializations.

    PubMed

    Hu, Xinran; Bradel, Lauren; Maiti, Dipayan; House, Leanna; North, Chris; Leman, Scotland

    2013-12-01

    When high-dimensional data is visualized in a 2D plane by using parametric projection algorithms, users may wish to manipulate the layout of the data points to better reflect their domain knowledge or to explore alternative structures. However, few users are well-versed in the algorithms behind the visualizations, making parameter tweaking more of a guessing game than a series of decisive interactions. Translating user interactions into algorithmic input is a key component of Visual to Parametric Interaction (V2PI) [13]. Instead of adjusting parameters, users directly move data points on the screen, which then updates the underlying statistical model. However, we have found that some data points that are not moved by the user are just as important in the interactions as the data points that are moved. Users frequently move some data points with respect to some other 'unmoved' data points that they consider as spatially contextual. However, in current V2PI interactions, these points are not explicitly identified when directly manipulating the moved points. We design a richer set of interactions that makes this context more explicit, and a new algorithm and sophisticated weighting scheme that incorporates the importance of these unmoved data points into V2PI.

  1. Self mobile space manipulator project

    NASA Technical Reports Server (NTRS)

    Brown, H. Ben; Friedman, Mark; Xu, Yangsheng; Kanade, Takeo

    1992-01-01

    A relatively simple, modular, low mass, low cost robot is being developed for space EVA that is large enough to be independently mobile on a space station or platform exterior, yet versatile enough to accomplish many vital tasks. The robot comprises two long flexible links connected by a rotary joint, with 2-DOF 'wrist' joints and grippers at each end. It walks by gripping pre-positioned attachment points, such as trusswork nodes, and alternately shifting its base of support from one foot (gripper) to the other. The robot can perform useful tasks such as visual inspection, material transport, and light assembly by manipulating objects with one gripper, while stabilizing itself with the other. At SOAR '90, we reported development of 1/3 scale robot hardware, modular trusswork to serve as a locomotion substrate, and a gravity compensation system to allow laboratory tests of locomotion strategies on the horizontal face of the trusswork. In this paper, we report on project progress including the development of: (1) adaptive control for automatic adjustment to loads; (2) enhanced manipulation capabilities; (3) machine vision, including the use of neural nets, to guide autonomous locomotion; (4) locomotion between orthogonal trusswork faces; and (5) improved facilities for gravity compensation and telerobotic control.

  2. Autonomous manipulation on a robot: Summary of manipulator software functions

    NASA Technical Reports Server (NTRS)

    Lewis, R. A.

    1974-01-01

    A six degree-of-freedom computer-controlled manipulator is examined, and the relationships between the arm's joint variables and 3-space are derived. Arm trajectories using sequences of third-degree polynomials to describe the time history of each joint variable are presented and two approaches to the avoidance of obstacles are given. The equations of motion for the arm are derived and then decomposed into time-dependent factors and time-independent coefficients. Several new and simplifying relationships among the coefficients are proven. Two sample trajectories are analyzed in detail for purposes of determining the most important contributions to total force in order that relatively simple approximations to the equations of motion can be used.

  3. Sperm cells manipulation employing dielectrophoresis.

    PubMed

    Rosales-Cruzaley, E; Cota-Elizondo, P A; Sánchez, D; Lapizco-Encinas, Blanca H

    2013-10-01

    Infertility studies are an important growing field, where new methods for the manipulation, enrichment and selection of sperm cells are required. Microfluidic techniques offer attractive advantages such as requirement of low sample volume and short processing times in the range of second or minutes. Presented here is the application of insulator-based dielectrophoresis (iDEP) for the enrichment and separation of mature and spermatogenic cells by employing a microchannel with cylindrical insulating structures with DC electric potentials in the range of 200-1500 V. The results demonstrated that iDEP has the potential to concentrate sperm cells and distinguish between mature and spermatogenic cells by exploiting the differences in shape which lead to differences in electric polarization. Viability assessments revealed that a significant percentage of the cells are viable after the dielectrophoretic treatment, opening the possibility for iDEP to be developed as a tool in infertility studies.

  4. Controlling multiple manipulators using RIPS

    NASA Technical Reports Server (NTRS)

    Wang, Yulun; Jordan, Steve; Mangaser, Amante; Butner, Steve

    1989-01-01

    A prototype of the RIPS architecture (Robotic Instruction Processing System) was developed. A two arm robot control experiment is underway to characterize the architecture as well as research multi-arm control. This experiment uses two manipulators to cooperatively position an object. The location of the object is specified by the host computer's mouse. Consequently, real time kinematics and dynamics are necessary. The RIPS architecture is specialized so that it can satisfy these real time constraints. The two arm experimental set-up is discussed. A major part of this work is the continued development of a good programming environment for RIPS. The C++ language is employed and favorable results exist in the targeting of this language to the RIPS hardware.

  5. Research on a Reconfigurable Modular Manipulator System

    SciTech Connect

    Khosla, P.K.; Kanade, T.

    1992-01-01

    Research has been conducted on developing the theoretical basis and the technology for a Reconfigurable Modular Manipulation System (RMMS). Unlike a conventional manipulator which has a fixed configuration, the RMMS consists of a set of interchangeable modules that can be rapidly assembled into a system of manipulators with appropriate configurations depending on the specific task requirement. For effective development and use of such a versatile and flexible system a program of theoretical and experimental research has been pursued aimed at developing the basis for next generation of autonomous manipulator systems. The RMMS concept extends the idea of autonomy from sensor-based to configuration based autonomy. One of the important components is the development of design methodologies for mapping tasks into manipulator configurations and for automatic generation of manipulator specific algorithms (e.g., kinematics and dynamics) in order to make the hardware transparent to the user.(JDB)

  6. Virus manipulation of cell cycle.

    PubMed

    Nascimento, R; Costa, H; Parkhouse, R M E

    2012-07-01

    Viruses depend on host cell resources for replication and access to those resources may be limited to a particular phase of the cell cycle. Thus manipulation of cell cycle is a commonly employed strategy of viruses for achieving a favorable cellular environment. For example, viruses capable of infecting nondividing cells induce S phase in order to activate the host DNA replication machinery and provide the nucleotide triphosphates necessary for viral DNA replication (Flemington in J Virol 75:4475-4481, 2001; Sullivan and Pipas in Microbiol Mol Biol Rev 66:179-202, 2002). Viruses have developed several strategies to subvert the cell cycle by association with cyclin and cyclin-dependent kinase complexes and molecules that regulate their activity. Viruses tend to act on cellular proteins involved in a network of interactions in a way that minimal protein-protein interactions lead to a major effect. The complex and interactive nature of intracellular signaling pathways controlling cell division affords many opportunities for virus manipulation strategies. Taking the maxim "Set a thief to catch a thief" as a counter strategy, however, provides us with the very same virus evasion strategies as "ready-made tools" for the development of novel antivirus therapeutics. The most obvious are attenuated virus vaccines with critical evasion genes deleted. Similarly, vaccines against viruses causing cancer are now being successfully developed. Finally, as viruses have been playing chess with our cell biology and immune responses for millions of years, the study of their evasion strategies will also undoubtedly reveal new control mechanisms and their corresponding cellular intracellular signaling pathways.

  7. Spatial-Operator Algebra For Robotic Manipulators

    NASA Technical Reports Server (NTRS)

    Rodriguez, Guillermo; Kreutz, Kenneth K.; Milman, Mark H.

    1991-01-01

    Report discusses spatial-operator algebra developed in recent studies of mathematical modeling, control, and design of trajectories of robotic manipulators. Provides succinct representation of mathematically complicated interactions among multiple joints and links of manipulator, thereby relieving analyst of most of tedium of detailed algebraic manipulations. Presents analytical formulation of spatial-operator algebra, describes some specific applications, summarizes current research, and discusses implementation of spatial-operator algebra in the Ada programming language.

  8. Bracing micro/macro manipulators control

    SciTech Connect

    Lew, J.Y.; Book, W.J.

    1994-05-01

    This paper proposes a bracing strategy for micro/macro manipulators. The bracing micro/macro manipulator can provide advantages in accurate positioning, large work-space, and contact-task capability however, in exchange for improvement in performance one must accept the complex control problem along wit the complex dynamics. This research develops a control scheme for a bracing manipulator which makes multiple contacts with the environment. Experimental results show the feasibility of the proposed ideas for real world applications.

  9. Compliant Gripper for a Robotic Manipulator

    NASA Technical Reports Server (NTRS)

    Cipra, Raymond; Das, Hari

    2003-01-01

    A figure depicts a prototype of a robotic-manipulator gripping device that includes two passive compliant fingers, suitable for picking up and manipulating objects that have irregular shapes and/or that are, themselves, compliant. The main advantage offered by this device over other robotic-manipulator gripping devices is simplicity: Because of the compliance of the fingers, force-feedback control of the fingers is not necessary for gripping objects of a variety of sizes, shapes, textures, and degrees of compliance. Examples of objects that can be manipulated include small stones, articles of clothing, and parts of plants.

  10. Culture and Manipulation of Embryonic Cells

    PubMed Central

    Edgar, Lois G.; Goldstein, Bob

    2012-01-01

    The direct manipulation of embryonic cells is an important tool for addressing key questions in cell and developmental biology. C. elegans is relatively unique among genetic model systems in being amenable to manipulation of embryonic cells. Embryonic cell manipulation has allowed the identification of cell interactions by direct means, and it has been an important technique for dissecting mechanisms by which cell fates are specified, cell divisions are oriented, and morphogenesis is accomplished. Here, we present detailed methods for isolating, manipulating and culturing embryonic cells of C. elegans. PMID:22226523

  11. Earth orbital teleoperator manipulator system evaluation program

    NASA Technical Reports Server (NTRS)

    Kirkpatrick, M., III; Shields, N. L., Jr.; Frederick, P. N.; Brye, R.; Malone, T. B.

    1975-01-01

    The performance of an orbital teleoperator system which includes small dextrous servicing manipulators to be used in satellite servicing was examined. System/operator performance testing was implemented and the results of a fine positioning control test using two different manipulator systems varying widely in manipulator configuration and control systems are presented. Fine position control is viewed as representing a fundamental requirement placed on manipulator control. The relationship of position control to more complex tasks which directly represent on-orbit servicing operations are also presented.

  12. Orthopedic Practice Patterns Relating to Anterior Cruciate Ligament Reconstruction in Elite Athletes.

    PubMed

    Erickson, Brandon J; Harris, Joshua D; Fillingham, Yale A; Cvetanovich, Gregory L; Bush-Joseph, Charles; Cole, Brian J; Bach, Bernard R; Verma, Nikhil N

    2015-12-01

    We conducted an online survey of National Hockey League (NHL), Major League Soccer (MLS), and US Olympic/World Cup Ski/Snowboard (Olympic) team orthopedic surgeons to determine practice patterns relating to anterior cruciate ligament (ACL) reconstruction in elite athletes. Of the 94 team orthopedic surgeons surveyed, 47 (50%) responded. Mean (SD) experience as a team physician was 7.73 (5.33) years for NHL, 6.77 (6.64) years for MLS, and 1.14 (0.36) years for Olympic. Mean (SD) number of ACL reconstructions performed in 2012 was 101 (51) for NHL, 78 (38) for MLS, and 110 (105) for Olympic. Overall, 33 surgeons (70.2%) indicated they would use bone-patellar tendon-bone (BPTB) autograft to treat their starting athletes. Twenty-one (44.7%) drilled the femoral tunnel through a transtibial portal, 36.2% through an anteromedial portal, and 12.8% by a 2-incision technique. All the surgeons used a single-bundle technique. Thirty-three (70.2%) did not recommend a brace for their elite athletes during play on return to sport (RTS). Twenty-seven NHL and MLS surgeons (81.8%) recommended RTS only after an athlete has passed a series of RTS tests (eg, Vail, single-leg hop). Most of the NHL, MLS, and Olympic team orthopedic surgeons who were surveyed perform their ACL reconstructions using BPTB autograft, using a single-bundle technique, and through a transtibial portal, and do not require bracing for their athletes returning to sport. Most required their athletes to complete a series of RTS tests before resuming competitive play.

  13. Orthopedic Management of Scoliosis by Garches Brace and Spinal Fusion in SMA Type 2 Children

    PubMed Central

    Catteruccia, Michela; Vuillerot, Carole; Vaugier, Isabelle; Leclair, Danielle; Azzi, Viviane; Viollet, Louis; Estournet, Brigitte; Bertini, Enrico; Quijano-Roy, Susana

    2015-01-01

    Background: Scoliosis is the most debilitating issue in SMA type 2 patients. No evidence confirms the efficacy of Garches braces (GB) to delay definitive spinal fusion. Objective: Compare orthopedic and pulmonary outcomes in children with SMA type 2 function to management. Method: We carried out a monocentric retrospective study on 29 SMA type 2 children who had spinal fusion between 1999 and 2009. Patients were divided in 3 groups: group 1-French patients (12 children) with a preventive use of GB; group 2-French patients (10 children) with use of GB after the beginning of the scoliosis curve; and group 3-Italian patients (7 children) with use of GB after the beginning of the scoliosis curve referred to our centre to perform orthopedic preoperative management. Results: Mean preoperative and postoperative Cobb angle were significantly lower in the group 1 of proactively braced than in group 2 or 3 (Anova p = 0.03; Kruskal Wallis test p = 0.05). Better surgical results were observed in patients with a minor preoperative Cobb angle (r = 0.92 p <  0.0001). Fewer patients in the group 1 proactively braced required trunk casts and/or halo traction and an additional anterior fusion in comparison with patients in the group 2 and 3. Moreover, major complications tend to be less in the group 1 proactively braced. No significant differences were found between groups in pulmonary outcome measures. Conclusions: A proactive orthotic management may improve orthopedic outcome in SMA type 2. Further prospective studies comparing SMA management are needed to confirm these results. Level of Evidence: Therapeutic Level III. See Instructions to Authors on jbjs.org for a complete description of levels of evidence (Retrospective comparative study). PMID:27858747

  14. Low-power circuits for the bidirectional wireless monitoring system of the orthopedic implants.

    PubMed

    Hong Chen; Ming Liu; Wenhan Hao; Yi Chen; Chen Jia; Chun Zhang; Zihua Wang

    2009-12-01

    This paper proposes an architecture of the wireless monitoring system for the real-time monitoring of the orthopedic implants, which monitors the implant duty cycle, detects abnormal asymmetry, high amounts of force, and other conditions of the orthopedic implants. Data for diagnosis are communicated wirelessly by the radio-frequency (RF) signal between the embedded chip and the remote circuit. In different working modes, the system can be powered by the RF signal or stiff lead zirconate-titanate (PZT) ceramics which are able to convert mechanical energy inside the orthopedic implant into electrical energy. The power circuits with a variable ratio switched-capacitor (SC) dc-dc converter have been taped out with 0.35-mum complementary metal-oxide semiconductor (CMOS) technology. The test results show that the SC converter can transfer the input voltage that ranges from 5 V to 14 V from the PZT ceramics into the voltage ranging from 2 V to 2.5 V which will be dealt with by a low drop-out circuit in the future work. The total efficiency of the SC converter is from 28% to 42% at full-time working mode. The analog-to-digital converter (ADC) circuits have been fabricated in a 0.18-mum 1P6M CMOS process. The test results show that the ADC chip consumes only 12.5 muW in working mode and 150 nW in the sleep mode. The circuits, including RF circuits, ADC, and the microcontrol unit, have been implemented in a 0.18-mu m CMOS process. Future work includes some clinical experiments test in the application where PZT elements are used for power generation in total knee-replacement implants.

  15. Functionally graded materials for orthopedic applications - an update on design and manufacturing.

    PubMed

    Sola, Antonella; Bellucci, Devis; Cannillo, Valeria

    2016-01-01

    Functionally graded materials (FGMs) are innovative materials whose composition and/or microstructure gradually vary in space according to a designed law. As a result, also the properties gradually vary in space, so as to meet specific non-homogeneous service requirements without any abrupt interface at the macroscale. FGMs are emerging materials for orthopedic prostheses, since the functional gradient can be adapted to reproduce the local properties of the original bone, which helps to minimize the stress shielding effect and, at the same time, to reduce the shear stress between the implant and the surrounding bone tissue, two critical prerequisites for a longer lifespan of the graft. After a brief introduction to the origin of the FGM concept, the review surveys some representative examples of graded systems which are present in nature and, in particular, in the human body, with a focus on bone tissue. Then the rationale for using FGMs in orthopedic devices is discussed more in detail, taking into account both biological and biomechanical requirements. The core of the paper is dedicated to two fundamental topics, which are essential to benefit from the use of FGMs for orthopedic applications, namely (1) the computational tools for materials design and geometry optimization, and (2) the manufacturing techniques currently available to produce FGM-based grafts. This second part, in its turn, is structured to consider the production of functionally graded coatings (FGCs), of functionally graded 3D parts, and of special devices with a gradient in porosity (functionally graded scaffolds). The inspection of the literature on the argument clearly shows that the integration of design and manufacturing remains a critical step to overpass in order to achieve effective FGM-based implants.

  16. Locus of pain control associated with medication adherence behaviors among patients after an orthopedic procedure

    PubMed Central

    Porto, Thaisy Mendes; Machado, Daniele Caferatti; Martins, Rafael Olívio; Galato, Dayani; Piovezan, Anna Paula

    2014-01-01

    Background Locus of pain control (LPC) is characterized by the behavior of people coping with their health problems, as a result of their own actions (internal control) or external factors or other people (external control). This parameter can be associated with medication adherence, in addition to other psychosocial factors that may also influence this behavior. This study was performed to investigate the influence of the LPC on medication adherence in patients undergoing an orthopedic procedure. Subjects and methods We conducted a prospective cohort study on patients who attended an orthopedic clinic for arthroscopy treatment. The patients’ LPC and pain intensity data were obtained on the day of admission through the use of the LPC scale and the visual analog scale (VAS), respectively, both being validated tools. After arthroscopic surgery, the patients received drug prescriptions and were reassessed after 15 days regarding treatment adherence, using the Morisky test. A P-value <0.05 was considered statistically significant. Results We assessed 79 individuals from both the internal LPC group (n=35) and external LPC group (n=44) and found that there were no group differences in sex, affected limb, cause of injury, repetitive strain injury, duration of pain, or pain intensity. However, there was a higher proportion of patients in the external LPC group that adhered to the prescribed medication compared with the internal LPC group (P<0.01). Conclusion The results showed that among patients who underwent an orthopedic procedure, there was a higher adherence rate to prescribed medication in the external LPC group compared with the internal LPC group. PMID:25075178

  17. The Use of Finite Element Analysis to Enhance Research and Clinical Practice in Orthopedics.

    PubMed

    Pfeiffer, Ferris M

    2016-02-01

    Finite element analysis (FEA) is a very powerful tool for the evaluation of biomechanics in orthopedics. Finite element (FE) simulations can effectively and efficiently evaluate thousands of variables (such as implant variation, surgical techniques, and various pathologies) to optimize design, screening, prediction, and treatment in orthopedics. Additionally, FEA can be used to retrospectively evaluate and troubleshoot complications or failures to prevent similar future occurrences. Finally, FE simulations are used to evaluate implants, procedures, and techniques in a time- and cost-effective manner. In this work, an overview of the development of FE models is provided and an example application is presented to simulate knee biomechanics for a specimen with medial meniscus insufficiency. FE models require the development of the geometry of interest, determination of the material properties of the tissues simulated, and an accurate application of a numerical solver to produce an accurate solution and representation of the field variables. The objectives of this work are to introduce the reader to the application of FEA in orthopedic analysis of the knee joint. A brief description of the model development process as well as a specific application to the investigation of knee joint stability in geometries with normal or compromised medial meniscal attachment is included. Significant increases in stretch of the anterior cruciate ligament were predicted in specimens with medial meniscus insufficiency (such behavior was confirmed in corresponding biomechanical testing). It can be concluded from this work that FE analysis of the knee can provide significant new information with which more effective clinical decisions can be made.

  18. Utilizing the physician assistant role: case study in an upper-extremity orthopedic surgical program

    PubMed Central

    Hepp, Shelanne L.; Suter, Esther; Nagy, Dwayne; Knorren, Tanya; Bergman, Joseph W.

    2017-01-01

    Background Shortages with resources and inefficiencies with orthopedic services in Canada create opportunities for alternative staffing models and ways to use existing resources. Physician assistants (PAs) are a common provider used in specialty orthopedic services in the United States; however, Canada has limited experience with PAs. As part of a larger demonstration project, Alberta Health Services (AHS) implemented 1 PA position in an upper-extremity surgical program in Alberta, Canada, to demonstrate the role in 4 areas: preoperative, operative, postoperative and follow-up care. Methods A mixed-methods evaluation was conducted using semi-structured interviews (n = 38), health care provider (n = 28) and patient surveys (n = 47), and 2 years of clinic data on new patients. Data from a double operating room experiment detailed expected versus actual times for 3 phases of surgery (pre, during, post). Results Preoperatively, the PA prioritizes patient referrals for surgery and redirects patients to alternative care. In the second year with the PA in place, there was an increase in total new patients seen (113%). Postoperatively, the PA attended rounds on 5 surgeons’ patients and handled follow-up care activities. Health care providers and patients reported that the PA provided excellent care. Findings from the operating room showed that the preparation time was greater than expected (38.6%), whereas the surgeon time (20.6%) and postsurgery time (37.2%) was less than expected. Conclusion After 24 months the PA has become a valuable member of the health care team and works across the continuum of orthopedic care. The PA delivers quality care and improves system efficiencies. PMID:28234216

  19. Active Ankle Movements Prevent Formation of Lower-Extremity Deep Venous Thrombosis After Orthopedic Surgery

    PubMed Central

    Li, Ye; Guan, Xiang-Hong; Wang, Rui; Li, Bin; Ning, Bo; Su, Wei; Sun, Tao; Li, Hong-Yan

    2016-01-01

    Background The aim of this study was to assess the preventive value of active ankle movements in the formation of lower-extremity deep venous thrombosis (DVT), attempting to develop a new method for rehabilitation nursing after orthopedic surgery. Material/Methods We randomly assigned 193 patients undergoing orthopedic surgery in the lower limbs into a case group (n=96) and a control group (n=97). The control group received routine nursing while the case group performed active ankle movements in addition to receiving routine nursing. Maximum venous outflow (MVO), maximum venous capacity (MVC), and blood rheology were measured and the incidence of DVT was recorded. Results On the 11th and 14th days of the experiment, the case group had significantly higher MVO and MVC than the control group (all P<0.05). The whole-blood viscosity at high shear rate and the plasma viscosity were significantly lower in the case group than in the control group on the 14th day (both P<0.05). During the experiment, a significantly higher overall DVT incidence was recorded in the control group (8 with asymptomatic DVT) compared with the case group (1 with asymptomatic DVT) (P=0.034). During follow-up, the case group presented a significantly lower DVT incidence (1 with symptomatic DVT and 4 with asymptomatic DVT) than in the control group (5 with symptomatic DVT and 10 with asymptomatic DVT) (P=0.031). Conclusions Through increasing MVO and MVC and reducing blood rheology, active ankle movements may prevent the formation of lower-extremity DVT after orthopedic surgery. PMID:27600467

  20. Factors Contributing to Satisfaction with Changes in Physical Function after Orthopedic Surgery for Musculoskeletal Dysfunction in Patients with Cerebral Palsy

    PubMed Central

    Kusumoto, Yasuaki; Nitta, Osamu; Matsuo, Atsushi; Takaki, Kenji; Matsuda, Tadamitsu

    2016-01-01

    Background The recognition of required treatments for cerebral palsy (CP) patients, including orthopedic surgery, differs according to region. This study was performed to identify factors associated with satisfactory changes in physical function after orthopedic surgery. Methods 358 patients were selected for the questionnaire survey. The following information was collected: gender, primary disease, age of initial surgery, total procedural count, operated sites, satisfaction of postoperative rehabilitation frequency, ideal amount of postoperative rehabilitation sessions per week, frequency of voluntary home training per week, satisfaction of the timing of surgery and the current satisfaction with the changes in physical function after the orthopedic surgery. We classified the patients into the satisfied and dissatisfied group according to satisfactory changes in physical function after the surgery. We performed unpaired t-tests and chi-square tests to determine the variables that differed significantly between the groups. Variables with a p value of <0.2 were included in the multivariate logistic regression analysis. Results The logistic model was revised and summed up to two potential predictors of postsurgical satisfaction with physical function: satisfaction with the frequency of postoperative rehabilitation sessions and the orthopedic surgery of the hip (distinction hit ratio, 75.4%). Conclusions This study demonstrated that the frequency of postoperative rehabilitation and history of hip surgery seemed to be related to the satisfaction with the changes in physical function after orthopedic surgery. PMID:27135609

  1. Kinematics and Control of Robot Manipulators

    NASA Astrophysics Data System (ADS)

    Paden, Bradley Evan

    This dissertation focuses on the kinematics and control of robot manipulators. The contribution to kinematics is a fundamental theorem on the design of manipulators with six revolute joints. The theorem states, roughly speaking, that manipulators which have six revolute joints and are modeled after the human arm are optimal and essentially unique. In developing the mathematical framework to prove this theorem, we define precisely the notions of length of a manipulator, well-connected-workspace, and work-volume. We contribute to control a set of analysis techniques for the design of variable structure (sliding mode) controllers for manipulators. The organization of the dissertation is the following. After introductory remarks in chapter one, the group of proper rigid motions, G, is introduced in chapter two. The tangent bundle of G is introduced and it is shown that the velocity of a rigid body can be represented by an element in the Lie algebra of G (commonly called a twist). Further, rigid motions which are exponentials of twists are used to describe four commonly occurring subproblems in robot kinematics. In chapter three, the exponentials of twists are used to write the forward kinematic map of robot manipulators and the subproblems of chapter two are used to solve the Stanford manipulator and an elbow manipulator. Chapter four focuses on manipulator singularities. Twist coordinates are used to find critical points of the forward kinematic map. The contribution to kinematics is contained in chapter five where a mathematical framework for studying the relationship between the design of 6R manipulators and their performance is developed. Chapter seven contains the contribution to control. The work of A. F. Filippov on differential equations with discontinuous right-hand-side and the work of F. H. Clarke on generalized gradients are combined to obtain a calculus for analyzing nonsmooth gradient systems. The techniques developed are applied to design a simple

  2. The Evidence-Based Principles of Negative Pressure Wound Therapy in Trauma & Orthopedics

    PubMed Central

    A, Novak; Khan, Wasim S; J, Palmer

    2014-01-01

    Negative pressure wound therapy is a popular treatment for the management of both acute and chronic wounds. Its use in trauma and orthopedics is diverse and includes the acute traumatic setting as well as chronic troublesome wounds associated with pressure sores and diabetic foot surgery. Efforts have been made to provide an evidence base to guide its use however this has been limited by a lack of good quality evidence. The following review article explores the available evidence and describes future developments for its use in trauma and orthopaedic practice. PMID:25067971

  3. Solutions for reducing lawsuits in orthopedic surgery by using psychology and IT technology.

    PubMed

    Purcarea, V L; Cazac, C

    2015-01-01

    Orthopedic surgery is among the top 5 medical specialties with an increased risk of facing a lawsuit. A large part of medical malpractice claims are due to poor communication between physician and patient; therefore, by addressing this issue and implementing psychological methods as well as IT solutions, a reduction in the incidence of medical lawsuits can be achieved. Some of these solutions include implementing and applying psychometric tools such as the SF-36 and SCL-90R tests, creating virtual information hubs for the patient, and establishing efficient communication methods by using IT technology between physician and patient.

  4. Orthopedic complications related to growth hormone therapy in a pediatric population.

    PubMed

    Haidar, Rachid K; Nasrallah, Mona P; Der-Boghossian, Asdghig H; Ghanem, Ismat B

    2011-01-01

    Since the introduction of recombinant growth hormone, its use has diversified and multiplied. Growth hormone is now the recommended therapy for a growing indication to all forms of short stature because of its direct and indirect role on bone growth. Hereby, we discuss the orthopedic complications associated with growth hormone treatment in pediatric patients. These complications include carpal tunnel syndrome, Legg-Calve-Perthes' disease, scoliosis, and slipped capital femoral epiphysis. Their incidence rates recorded in several growth hormone therapy-related pharmacovigilance studies will be summarized in this study with focused discussion on their occurrence in the pediatric and adolescent age groups. The pathogenesis of these complications is also reviewed.

  5. Adaptation of NASA technology for the optimization of orthopedic knee implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Hopkins, D. A.

    1991-01-01

    The NASA technology originally developed for the optimization of composite structures (engine blades) is adapted and applied to the optimization of orthopedic knee implants. A method is developed enabling the tailoring of the implant for optimal interaction with the environment of the tibia. The shape of the implant components are optimized, such that the stresses in the bone are favorably controlled to minimize bone degradation and prevent failures. A pilot tailoring system is developed and the feasibility of the concept is elevated. The optimization system is expected to provide the means for improving knee prosthesis and individual implant tailoring for each patient.

  6. iPhone and iPad Use in Orthopedic Surgery

    PubMed Central

    Duncan, Scott F. M.; Hendawi, Tariq K.; Sperling, John; Kakinoki, Ryosuke; Hartsock, Landon

    2015-01-01

    Background Thousands of healthcare mobile applications (apps) are available, and physicians are increasingly recognizing that mobile technology can improve their workflow and allow them to practice medicine in a better and/or more efficient manner. Methods This article highlights apps compatible with the iPhone and iPad and their utility to the busy orthopedic surgeon. Results Currently available apps address every aspect of healthcare: patient management, reference, education, and research. Conclusion Key aspects of helpful apps include low cost (preferably free), a user-friendly interface, and simplicity. PMID:25829881

  7. Differences in the Clinical Outcome of Osteomyelitis by Treating Specialty: Orthopedics or Infectology

    PubMed Central

    Cardona Arango, Doris; Capataz Taffur, Cesar Antonio; Correa Prada, Edgar

    2015-01-01

    Osteomyelitis is a heterogeneous infection with regard to etiology and treatment, and currently no single management protocol exists. Management of the condition is typically an interdisciplinary approach between orthopedics and infectious disease; however, the orthopedist is often the person who manages treatment. The aim of the study was to determine differences in the outcome of osteomyelitis according to its treating specialty and to identify factors associated with the recurrence of the disease. An ambispective cohort study of 129 patients with osteomyelitis was conducted and the proportions for qualitative variables and central tendency and dispersion measures for quantitative variables were calculated; the latter were tested for normality using the Shapiro-Wilk test. A bivariate analysis was conducted with measures of association based on the chi square test and crude relative risk. A logistic regression model was applied and statistical significance was set at p < 0.05, including the model of relevant clinical variables that fit the Hosmer-Lemeshow test. We found that 70% of patients were treated either by orthopedics or infectious disease. Patients who were treated by an orthopedist alone presented a greater risk of relapse or reinfection (RR = 4.6; 95% CI 2.3;8.9). Risk factors of osteomyelitis recurrence as determined in the regression model included the following: age of 57 years or older (RR = 1.3; 95% 0.3;5.2), long bones (RR = 1.9; 95% CI 0.5;7.1), fracture (RR = 5.0; 95% CI 0.4;51.4), monotherapy (RR = 3.0; 95% CI 0.6;14.5), receiving less than 4 weeks of antibiotics (RR = 1.5; 95% CI 0.2;10.1), inadequate treatment (RR = 3.1; 95% CI 0.4;20.1), and receiving orthopedics treatment (RR = 5.5; 95% CI 1.6;18.2). Most patients evaluated jointly by orthopedics and infectious disease received adequate treatment for osteomyelitis and had fewer relapses. PMID:26678551

  8. Sudden Sensorineural Hearing Loss after Orthopedic Surgery under Combined Spinal and Epidural Anesthesia

    PubMed Central

    Vilhena, Ditza; Pereira, Luís; Duarte, Delfim; Oliveira, Nuno

    2016-01-01

    Postoperative hearing loss following nonotologic surgery is rare. For patients undergoing subarachnoid anesthesia, the loss of cerebral spinal fluid and hence the drop in intracranial pressure can result in hearing loss and cranial nerve palsy. We report a case in which a patient sustained orthopedic surgery under combined spinal and epidural anesthesia complicated by severe and persistent sensorineural hearing loss. This report is a reminder that postoperative sudden sensorineural hearing loss is a poorly understood complication. A high index of suspicion is required for early diagnosis of this complication, although prompt treatment does not guarantee a good outcome. PMID:26904339

  9. Spinal manipulative therapy in sports medicine.

    PubMed

    Haldeman, S

    1986-04-01

    Spinal manipulation or manual therapy is becoming an increasingly popular method of treating athletes with spinal problems. The primary theoretic basis for the claimed beneficial results of manipulation is the restoration of motion with subsequent effect on ligamentous adhesions, muscle spasm, disk nutrition, and central nervous system endorphin systems. The concept of joint barriers has been developed to differentiate among exercise therapy, mobilization, and manipulation. Research trials suggest that spinal manipulation is beneficial in relieving or reducing the duration of acute low back pain and acute neck pain but has much less effect on chronic low back pain and neck pain. There is evidence that manipulation increases certain parameters of motion of the spine but this evidence is not yet conclusive. There are a wide variety of manipulative procedures that are utilized to manipulate the spine to increase range of motion, and the selection of the procedures is based on manual diagnostic skills. Manipulation, however, is not a benign procedure and has been implicated in the aggravation of disk herniation or bony fractures as well as the precipitation of vertebrobasilar artery occlusion.

  10. Teachers' Beliefs and Teaching Mathematics with Manipulatives

    ERIC Educational Resources Information Center

    Golafshani, Nahid

    2013-01-01

    To promote the implementation of manipulatives into mathematics instruction, this research project examined how the instructional practices of four Grade 9 applied mathematics teachers related to their beliefs about the use of manipulatives in teaching mathematics, its effects on students' learning, and enabling and disabling factors. Teacher…

  11. Manipulating Language: A Strategy for Teaching Literature.

    ERIC Educational Resources Information Center

    Byers, Prudence P.

    Literary artists manipulate language. If educators could develop in their students the same sense that language is manipulable, they could help them to better appreciate literature. Emily Dickinson's poem "I Like to See It Lap the Miles" could be approached by changing it on several levels--graphics, phonics, syntax, and semantics--and…

  12. Cervical epidural hematoma after chiropractic spinal manipulation.

    PubMed

    Heiner, Jason D

    2009-10-01

    Spinal epidural hematoma is a rare but potentially devastating complication of spinal manipulation therapy. This is a case report of a healthy pregnant female who presented to the emergency department with a cervical epidural hematoma resulting from chiropractic spinal manipulation therapy that responded to conservative treatment rather than the more common route of surgical management.

  13. Count on It: Congruent Manipulative Displays

    ERIC Educational Resources Information Center

    Morin, Joe; Samelson, Vicki M.

    2015-01-01

    Representations that create informative visual displays are powerful tools for communicating mathematical concepts. The National Council of Teachers of Mathematics encourages the use of manipulatives (NCTM 2000). Manipulative materials are often used to present initial representations of basic numerical principles to young children, and it is…

  14. Welding torch and wire feed manipulator

    NASA Technical Reports Server (NTRS)

    Williams, R. T.

    1967-01-01

    Welding torch and wire feed manipulator increase capability for performing automatic welding operations. The manipulator rotates on its horizontal axis to avoid obstacles as they approach the torch. The initial individual attitudes of the torch and wire guide are set with respect to the general configuration of the part.

  15. On stiffening cables of a long reach manipulator

    SciTech Connect

    Wang, S.L.; Santiago, P.

    1996-02-01

    A long reach manipulator will be used for waste remediation in large underground storage tanks. The manipulator`s slenderness makes it flexible and difficult to control. A low-cost and effective method to enhance the manipulator`s stiffness is proposed in this research by using suspension cables. These cables can also be used to accurately measure the position of the manipulator`s wrist.

  16. Use of commercial manipulator to handle a nuclear weapon component

    SciTech Connect

    Baker, C.P.

    1994-08-01

    Pacific Northwest Laboratory (PNL) has developed a manipulator workcell to load and unload nuclear weapon pit assemblies from a cart. To develop this workcell, PNL procured a commercially available manipulator, equipped it with force-sensing and vision equipment, and developed manipulator control software. Manipulator workcell development demonstrated that commercially available manipulator systems can successfully perform this task if the appropriate manipulator is selected and the manipulator workcell tooling and software are carefully designed.

  17. Genetic manipulation of Giardia lamblia.

    PubMed

    Davis-Hayman, Sara R; Nash, Theodore E

    2002-06-01

    Giardia lamblia is a flagellated protozoan that infects several species including humans and is a major agent of waterborne outbreaks of diarrhea. G. lamblia is also important in the study of basic eukaryotic molecular biology and evolution; however, it has been difficult to employ standard genetic methods in the study of Giardia. Over the past 6 years, two transfection systems were developed and used for the genetic manipulation of G. lamblia. Both systems allow transient or stable transfection of Giardia and/or foreign genes. The DNA-based transfection system allows electroporation of circular or linear plasmid DNA into trophozoites. The RNA virus-based transfection system requires electroporation of in vitro transcribed RNA into GLV-infected trophozoites. Because G. lamblia is one of the most rudimentary eukaryotes, its processes of transcription, translation and protein transport, as well as its metabolic and biochemical pathways, are of interest. Study of these areas will continue to be advanced using transfection in combination with cellular and molecular tools. Several groups have combined these technologies with other techniques to study protein transport and the transcriptional and post-transcriptional regulation of Giardia genes, including encystation-specific and variant surface protein genes. In addition, coupling antisense techniques with transfection has permitted functional knockout of Giardia metabolic genes, allowing Giardia metabolic pathways to be studied. In the near future, both transfection systems will be potent tools in our investigations of the perplexing questions in Giardia biology.

  18. Coanda-assisted Spray Manipulation

    NASA Astrophysics Data System (ADS)

    Mabey, Katie; Smith, Barton; Archibald, Reid; West, Brian

    2009-11-01

    An overview of research on a flow control technique called Coanda-assisted Spray Manipulation (CSM) is presented. CSM uses a high-momentum control jet under the influence of the Coanda effect to vector a high volume-flow jet or spray. Actuators provide the capability of moving the location of applied control flow making rotary or arbitrary motion of the vectored flow possible. The presented work includes a fundamental isothermal study on the effects of rotation speed and Reynolds number on a vectored jet using a belt-driven CSM actuator. Three-component velocity data were acquired for three Reynolds numbers and three rotation speeds using timed resolved high-speed stereo Particle Image Velocimetry. A second CSM system with 16 pneumatically-driven control ports has been retrofitted to a flame spray gun. This combination provides the capability to rapidly alter the direction of applied metal powders. High speed video of this process will also be presented. Finally, a fundamental study on the pneumatic system's response to minor losses and connection lines of varying lengths is presented.

  19. Light Manipulation in Organic Photovoltaics.

    PubMed

    Ou, Qing-Dong; Li, Yan-Qing; Tang, Jian-Xin

    2016-07-01

    Organic photovoltaics (OPVs) hold great promise for next-generation photovoltaics in renewable energy because of the potential to realize low-cost mass production via large-area roll-to-roll printing technologies on flexible substrates. To achieve high-efficiency OPVs, one key issue is to overcome the insufficient photon absorption in organic photoactive layers, since their low carrier mobility limits the film thickness for minimized charge recombination loss. To solve the inherent trade-off between photon absorption and charge transport in OPVs, the optical manipulation of light with novel micro/nano-structures has become an increasingly popular strategy to boost the light harvesting efficiency. In this Review, we make an attempt to capture the recent advances in this area. A survey of light trapping schemes implemented to various functional components and interfaces in OPVs is given and discussed from the viewpoint of plasmonic and photonic resonances, addressing the external antireflection coatings, substrate geometry-induced trapping, the role of electrode design in optical enhancement, as well as optically modifying charge extraction and photoactive layers.

  20. Light Manipulation in Organic Photovoltaics

    PubMed Central

    Ou, Qing‐Dong

    2016-01-01

    Organic photovoltaics (OPVs) hold great promise for next‐generation photovoltaics in renewable energy because of the potential to realize low‐cost mass production via large‐area roll‐to‐roll printing technologies on flexible substrates. To achieve high‐efficiency OPVs, one key issue is to overcome the insufficient photon absorption in organic photoactive layers, since their low carrier mobility limits the film thickness for minimized charge recombination loss. To solve the inherent trade‐off between photon absorption and charge transport in OPVs, the optical manipulation of light with novel micro/nano‐structures has become an increasingly popular strategy to boost the light harvesting efficiency. In this Review, we make an attempt to capture the recent advances in this area. A survey of light trapping schemes implemented to various functional components and interfaces in OPVs is given and discussed from the viewpoint of plasmonic and photonic resonances, addressing the external antireflection coatings, substrate geometry‐induced trapping, the role of electrode design in optical enhancement, as well as optically modifying charge extraction and photoactive layers. PMID:27840805

  1. Genetic manipulation of Coxiella burnetii.

    PubMed

    Beare, Paul A

    2012-01-01

    Until very recently, Coxiella burnetii was viewed and studied as an obligate intracellular bacterium that relied exclusively on a eucaryotic host cell for growth. Other medically relevant obligate intracellular bacteria reside in the genera Anaplasma, Chlamydia, Ehrlichia, Orientia, and Rickettsia. An obligate intracellular lifestyle presents a significant obstacle to genetic transformation. Procedures that are straightforward with free-living bacteria, such as antibiotic selection and cloning, can be very difficult when growth of transformants is restricted to a host cell. Long-term passage in host cells to expand small transformant populations can further complicate the procedure. Despite these and other obstacles, at least rudimentary systems are currently available for genetic transformation of most obligate intracellular bacterial pathogens. Dramatically aiding the development of new genetic methods for C. burnetii is the recent discovery of a medium that supports host cell-free growth of the organism in liquid, and importantly, on solid media as clonal colonies. The expanded C. burnetii genetics toolbox now includes transposon systems for random mutagenesis and single-copy, site-specific chromosomal gene knock-ins, as well as a shuttle vector for heterologous gene expression and in trans complementation. A reliable method of targeted gene inactivation remains a challenge. Advances in C. burnetii genetic manipulation will allow identification of genes essential for intracellular parasitism and disease pathogenesis, and undoubtedly fuel new interest in this minimally studied bacterial pathogen.

  2. Interactive digital image manipulation system

    NASA Technical Reports Server (NTRS)

    Henze, J.; Dezur, R.

    1975-01-01

    The system is designed for manipulation, analysis, interpretation, and processing of a wide variety of image data. LANDSAT (ERTS) and other data in digital form can be input directly into the system. Photographic prints and transparencies are first converted to digital form with an on-line high-resolution microdensitometer. The system is implemented on a Hewlett-Packard 3000 computer with 128 K bytes of core memory and a 47.5 megabyte disk. It includes a true color display monitor, with processing memories, graphics overlays, and a movable cursor. Image data formats are flexible so that there is no restriction to a given set of remote sensors. Conversion between data types is available to provide a basis for comparison of the various data. Multispectral data is fully supported, and there is no restriction on the number of dimensions. In this way multispectral data collected at more than one point in time may simply be treated as a data collected with twice (three times, etc.) the number of sensors. There are various libraries of functions available to the user: processing functions, display functions, system functions, and earth resources applications functions.

  3. Microcrystal manipulation with laser tweezers

    SciTech Connect

    Wagner, Armin Duman, Ramona; Stevens, Bob; Ward, Andy

    2013-07-01

    Optical trapping has successfully been applied to select and mount microcrystals for subsequent X-ray diffraction experiments. X-ray crystallography is the method of choice to deduce atomic resolution structural information from macromolecules. In recent years, significant investments in structural genomics initiatives have been undertaken to automate all steps in X-ray crystallography from protein expression to structure solution. Robotic systems are widely used to prepare crystallization screens and change samples on synchrotron beamlines for macromolecular crystallography. The only remaining manual handling step is the transfer of the crystal from the mother liquor onto the crystal holder. Manual mounting is relatively straightforward for crystals with dimensions of >25 µm; however, this step is nontrivial for smaller crystals. The mounting of microcrystals is becoming increasingly important as advances in microfocus synchrotron beamlines now allow data collection from crystals with dimensions of only a few micrometres. To make optimal usage of these beamlines, new approaches have to be taken to facilitate and automate this last manual handling step. Optical tweezers, which are routinely used for the manipulation of micrometre-sized objects, have successfully been applied to sort and mount macromolecular crystals on newly designed crystal holders. Diffraction data from CPV type 1 polyhedrin microcrystals mounted with laser tweezers are presented.

  4. Simulation and analysis of flexibly jointed manipulators

    NASA Technical Reports Server (NTRS)

    Murphy, Steve H.; Wen, John T.; Saridis, George M.

    1990-01-01

    Modeling, simulation, and analysis of robot manipulators with non-negligible joint flexibility are studied. A recursive Newton-Euler model of the flexibly jointed manipulator is developed with many advantages over the traditional Lagrange-Euler methods. The Newton-Euler approach leads to a method for the simulation of a flexibly jointed manipulator in which the number of computations grows linearly with the number of links. Additionally, any function for the flexibility between the motor and link may be used permitting the simulation of nonlinear effects, such as backlash, in a uniform manner for all joints. An analysis of the control problems for flexibly jointed manipulators is presented by converting the Newton-Euler model to a Lagrange-Euler form. The detailed structure available in the model is used to examine linearizing controllers and shows the dependency of the control on the choice of flexible model and structure of the manipulator.

  5. [Child orthopedics].

    PubMed

    Hvid, Ivan

    2002-05-13

    Children's fractures are a challenge to the treatment system, in that 17,000 children are treated in Denmark each year. The true burden on patients and society is unknown. It is estimated that 1000 new-born infants are treated for hip instability in Denmark per year, and 30 are diagnosed late. Ultrasound scanning is recommended for secondary screening and selective screening of children at risk. Identification of acetabular dysplasia followed by surgical correction could be an important prophylactic measure, with a potential reduction in expenses to society. To some extent, congenital clubfoot is hereditary. Environmental factors are important, maternal smoking being one. Early operative treatment yields good results. There is a need for prospective registration. Perthes' disease is an idiopathic necrosis of the capital femoral epiphysis. Passive smoking is a significant factor. A young age (< 7 years) and limited necrosis carry a good prognosis, and active treatment can improve the prognosis for the other patients.

  6. No evidence for race and socioeconomic status as independent predictors of 30-day readmission rates following orthopedic surgery.

    PubMed

    Hunter, Tracey; Yoon, Richard S; Hutzler, Lorraine; Band, Philip; Liublinksa, Victoria; Slover, James; Bosco, Joseph A

    2015-01-01

    The Centers for Medicare & Medicaid Services considers readmissions within 30 days of discharge to be a quality indicator. Hospitals' and eventually physicians' readmission rates will be used to determine payment for services. It is imperative that health care providers understand which patients are at risk for readmission so that they can apply the appropriate preventive interventions. The research team analyzed all orthopedic admissions and readmissions at their institution from September 2008 to April 2011 in this study. Preparing for the next stage in health care reform, identifying any preoperative factors that may place certain patients into a "high-risk" category for readmission following an orthopedic procedure is of paramount importance. This data analysis of more than 13 000 patients noted that race-based and income-based risk factors did not translate into significant risk factors or predictors of 30-day readmission following orthopedic admission.

  7. History of computer-assisted orthopedic surgery (CAOS) in sports medicine.

    PubMed

    Jackson, Douglas W; Simon, Timothy M

    2008-06-01

    Computer-assisted orthopedic surgery and navigation applications have a history rooted in the desire to link imaging technology with real-time anatomic landmarks. Although applications are still evolving in the clinical and research setting, computer-assisted orthopedic surgery has already demonstrated in certain procedures its potential for improving the surgeon's accuracy, reproducibility (once past the learning curve), and in reducing outlier outcomes. It is also being used as an educational tool to assist less experienced surgeons in interpreting measurements and precision placements related to well defined anatomic landmarks. It also can assist experienced surgeons, in real-time, plan their bony cuts, tunnel placement, and with ligament balancing. Presently, the additional time, the expense to acquire the needed software and hardware, and restricted reimbursement have slowed the widespread use of navigation. Its current applications have been primarily in joint replacement surgery, spine surgery, and trauma. It has not been widely used in the clinical setting for sports medicine procedures. Sports medicine applications such as individualizing tunnel placement in ligament surgery, opening wedge osteotomy with and without accompanying ligament reconstruction, and balancing and tensioning of the ligaments during the procedure (allowing real-time corrections if necessary) are currently being evaluated and being used on a limited clinical basis.

  8. Anodization: a promising nano-modification technique of titanium implants for orthopedic applications.

    PubMed

    Yao, Chang; Webster, Thomas J

    2006-01-01

    Anodization is a well-established surface modification technique that produces protective oxide layers on valve metals such as titanium. Many studies have used anodization to produce micro-porous titanium oxide films on implant surfaces for orthopedic applications. An additional hydrothermal treatment has also been used in conjunction with anodization to deposit hydroxyapatite on titanium surfaces; this is in contrast to using traditional plasma spray deposition techniques. Recently, the ability to create nanometer surface structures (e.g., nano-tubular) via anodization of titanium implants in fluorine solutions have intrigued investigators to fabricate nano-scale surface features that mimic the natural bone environment. This paper will present an overview of anodization techniques used to produce micro-porous titanium oxide structures and nano-tubular oxide structures, subsequent properties of these anodized titanium surfaces, and ultimately their in vitro as well as in vivo biological responses pertinent for orthopedic applications. Lastly, this review will emphasize why anodized titanium structures that have nanometer surface features enhance bone forming cell functions.

  9. Massive subacromial-subdeltoid bursitis with rice bodies secondary to an orthopedic implant.

    PubMed

    Urruela, Adriana M; Rapp, Timothy B; Egol, Kenneth A

    2012-09-01

    Both early and late complications following open reduction and internal fixation of proximal humerus fractures have been reported extensively in the literature. Although orthopedic implants are known to cause irritation and inflammation, to our knowledge, this is the first case report to describe a patient with rice bodies secondary to an orthopedic implant. Although the etiology of rice bodies is unclear, histological studies reveal that they are composed of an inner amorphous core surrounded by collagen and fibrin. The differential diagnosis in this case included synovial chondromatosis, infection, and the formation of a malignant tumor. Additional imaging studies, such as magnetic resonance imaging, and more specific tests were necessary to differentiate the rice bodies due to bursitis versus neoplasm, prior to excision. The patient presented 5 years following open reduction and internal fixation of a displaced proximal humerus fracture, with swelling in the area of the previous surgical site. Examination revealed a large, painless tumor-like mass on the anterior aspect of the shoulder. The patient's chief concern was the unpleasant aesthetic of the mass; no pain was reported. Upon excision of the mass, the patient's full, painless range of motion returned.

  10. Cell-Derived Extracellular Matrix: Basic Characteristics and Current Applications in Orthopedic Tissue Engineering.

    PubMed

    Zhang, Weixiang; Zhu, Yun; Li, Jia; Guo, Quanyi; Peng, Jiang; Liu, Shichen; Yang, Jianhua; Wang, Yu

    2016-06-01

    The extracellular matrix (ECM) is a dynamic and intricate microenvironment with excellent biophysical, biomechanical, and biochemical properties, which can directly or indirectly regulate cell proliferation, adhesion, migration, and differentiation, as well as plays key roles in homeostasis and regeneration of tissues and organs. The ECM has attracted a great deal of attention with the rapid development of tissue engineering in the field of regenerative medicine. Tissue-derived ECM scaffolds (also referred to as decellularized tissues and whole organs) are considered a promising therapy for the repair of musculoskeletal defects, including those that are widely used in orthopedics, although there are a few shortcomings. Similar to tissue-derived ECM scaffolds, cell-derived ECM scaffolds also have highly advantageous biophysical and biochemical properties, in particular their ability to be produced in vitro from a number of different cell types. Furthermore, cell-derived ECM scaffolds more closely resemble native ECM microenvironments. The products of cell-derived ECM have a wide range of biomedical applications; these include reagents for cell culture substrates and biomaterials for scaffolds, hybrid scaffolds, and living cell sheet coculture systems. Although cell-derived ECM has only just begun to be investigated, it has great potential as a novel approach for cell-based tissue repair in orthopedic tissue engineering. This review summarizes and analyzes the various types of cell-derived ECM products applied in cartilage, bone, and nerve tissue engineering in vitro or in vivo and discusses future directions for investigation of cell-derived ECM.

  11. Osteoconductivity and growth factor production by MG63 osteoblastic cells on bioglass-coated orthopedic implants.

    PubMed

    Tan, Fei; Naciri, Mariam; Al-Rubeai, Mohamed

    2011-02-01

    We have produced Bioglass coatings for Orthopedic implants by using a novel coating technique, CoBlast. The two resultant surfaces, designated BG and hydroxyapatite (HA)/BG, were compared with their HA counterpart, OsteoZip in terms of osteoblastic cell attachment, adhesion, proliferation, differentiation, and growth factor production. BG and HA/BG were demonstrated by goniometry to be more hydrophilic than OsteoZip. This corresponded to enhanced protein adsorption, cell attachment, and cell adhesion documented by both quantitative and qualitative assessments. BG and HA/BG surfaces had a significant initial release of Si and Ca ions, and this was consistent with elevated cell proliferation and basic fibroblast growth factor levels. However, OsteoZip, being similar to HA/BG, exhibited better osteogenic differentiation than BG did, shown by augmented differentiation marker activity at both protein and mRNA levels. Sandwich ELISA was used to quantify angiopoietin and inducible nitric oxide synthase which are involved in peri-prosthetic angiogenesis and aseptic loosening of total hip replacement, respectively. Both Bioglass-derived coatings provide superior initial osteoconductivity to OsteoZip, and HA/Bioglass composite coating outruns in long-term osteogenic differentiation and prognostic bioprocesses. The novel coatings discovered in this study have significant potential in providing both orthopedic and therapeutic functions.

  12. Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants

    PubMed Central

    Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

    2012-01-01

    Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

  13. Venous thromboembolism prophylaxis after total hip or knee arthroplasty: a survey of Canadian orthopedic surgeons

    PubMed Central

    Gross, Michael; Anderson, David R.; Nagpal, Seema; O’Brien, Bernie

    1999-01-01

    Objective To determine the pharmacologic and physical modalities used by orthopedic surgeons in Canada to prevent venous thromboembolism (deep venous thrombosis and pulmonary embolism) after total hip or knee arthroplasty. Design Mail survey sent to all members of the Canadian Orthopaedic Association. Setting A nation-wide study. Methods A total of 828 questionnaires, designed to identify the type and frequency of prophylaxis against venous thromboembolism that were used after hip and knee arthroplasty were mailed to orthopedic surgeons. Outcome measures Demographic data and the frequency and type of thromboprophylaxis. Results Of the 828 surveys mailed 445 (54%) were returned, and 397 were included in this analysis. Of the respondents, 97% used prophylaxis routinely for patients who undergo total hip or knee arthroplasty. Three of the 397 (0.8%) did not use any method of prophylaxis. Warfarin was the most common agent used (46%), followed by low-molecular-weight heparin (LMWH) (36%). Combination therapy with both mechanical and pharmacologic methods were used in 39% of patients. Objective screening tests were not frequently performed before discharge. Extended prophylaxis beyond the duration of hospitalization was used by 36% of physicians. Conclusion Prophylaxis for venous thromboembolism with warfarin or LMWH has become standard care after total hip or knee arthroplasty in Canada. PMID:10593248

  14. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery

    PubMed Central

    Robleda, Gemma; Sillero-Sillero, Amalia; Puig, Teresa; Gich, Ignasi; Baños, Josep-E

    2014-01-01

    OBJECTIVES: to analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: the prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery. PMID:25493674

  15. [Interpersonal competence in orthopedics and traumatology : Why technical and procedural skills alone are not sufficient].

    PubMed

    Seemann, R; Münzberg, M; Stange, R; Rüsseler, M; Egerth, M; Bouillon, B; Hoffmann, R; Mutschler, M

    2016-10-01

    Patient safety has increasingly gained significance as criterion which clinics and doctors will be measured against in terms of ethics and finances. The "human factor" moved into focus regarding the question of how to reduce treatment errors in clinical daily routine. Nevertheless, systematic mediation of interpersonal competences only plays a minor role in the catalogue of requirements for medical specialization and professional training. This is the case not only in orthopedics and traumatology, but in other medical fields as well. At the insistence of DGOU and in cooperation with Lufthansa Flight Training, a training model was initiated, comparable to training models used in aviation. In aviation, apart from the training of procedural and technical abilities, regular soft skills training has become standard in the training of all Lufthansa staff. Several studies confirm that by improving communication, interaction, and teamwork skills not only a reduction of intolerable incidents is observed, but also a positive economic effect. Interpersonal competences should be firmly anchored in orthopedics and traumatology and thus be implemented as third post in specialist training.

  16. Open access of evidence-based publications: the case of the orthopedic and musculoskeletal literature.

    PubMed

    Yammine, Kaissar

    2015-11-01

    The open access model, where researchers can publish their work and make it freely available to the whole medical community, is gaining ground over the traditional type of publication. However, fees are to be paid by either the authors or their institutions. The purpose of this paper is to assess the proportion and type of open access evidence-based articles in the form of systematic reviews and meta-analyses in the field of musculoskeletal disorders and orthopedic surgery. PubMed database was searched and the results showed a maximal number of hits for low back pain and total hip arthroplasty. We demonstrated that despite a 10-fold increase in the number of evidence-based publications in the past 10 years, the rate of free systematic reviews in the general biomedical literature did not change for the last two decades. In addition, the average percentage of free open access systematic reviews and meta-analyses for the commonest painful musculoskeletal conditions and orthopedic procedures was 20% and 18%, respectively. Those results were significantly lower than those of the systematic reviews and meta-analyses in the remaining biomedical research. Such findings could indicate a divergence between the efforts engaged at promoting evidence-based principles and those at disseminating evidence-based findings in the field of musculoskeletal disease and trauma. The high processing fee is thought to be a major limitation when considering open access model for publication.

  17. Predicting postoperative vomiting among orthopedic patients receiving patient-controlled epidural analgesia using SVM and LR.

    PubMed

    Wu, Hsin-Yun; Gong, Cihun-Siyong Alex; Lin, Shih-Pin; Chang, Kuang-Yi; Tsou, Mei-Yung; Ting, Chien-Kun

    2016-06-01

    Patient-controlled epidural analgesia (PCEA) has been applied to reduce postoperative pain in orthopedic surgical patients. Unfortunately, PCEA is occasionally accompanied by nausea and vomiting. The logistic regression (LR) model is widely used to predict vomiting, and recently support vector machines (SVM), a supervised machine learning method, has been used for classification and prediction. Unlike our previous work which compared Artificial Neural Networks (ANNs) with LR, this study uses a SVM-based predictive model to identify patients with high risk of vomiting during PCEA and comparing results with those derived from the LR-based model. From January to March 2007, data from 195 patients undergoing PCEA following orthopedic surgery were applied to develop two predictive models. 75% of the data were randomly selected for training, while the remainder was used for testing to validate predictive performance. The area under curve (AUC) was measured using the Receiver Operating Characteristic curve (ROC). The area under ROC curves of LR and SVM models were 0.734 and 0.929, respectively. A computer-based predictive model can be used to identify those who are at high risk for vomiting after PCEA, allowing for patient-specific therapeutic intervention or the use of alternative analgesic methods.

  18. Biomimetic helical rosette nanotubes and nanocrystalline hydroxyapatite coatings on titanium for improving orthopedic implants.

    PubMed

    Zhang, Lijie; Chen, Yupeng; Rodriguez, Jose; Fenniri, Hicham; Webster, Thomas J

    2008-01-01

    Natural bone consists of hard nanostructured hydroxyapatite (HA) in a nanostructured protein-based soft hydrogel template (ie, mostly collagen). For this reason, nanostructured HA has been an intriguing coating material on traditionally used titanium for improving orthopedic applications. In addition, helical rosette nanotubes (HRNs), newly developed materials which form through the self-assembly process of DNA base pair building blocks in body solutions, are soft nanotubes with a helical architecture that mimics natural collagen. Thus, the objective of this in vitro study was for the first time to combine the promising attributes of HRNs and nanocrystalline HA on titanium and assess osteoblast (bone-forming cell) functions. Different sizes of nanocrystalline HA were synthesized in this study through a wet chemical precipitation process following either hydrothermal treatment or sintering. Transmission electron microscopy images showed that HRNs aligned with nanocrystalline HA, which indicates a high affinity between both components. Some of the nanocrystalline HA formed dense coatings with HRNs on titanium. More importantly, results demonstrated enhanced osteoblast adhesion on the HRN/nanocrystalline HA-coated titanium compared with conventional uncoated titanium. Among all the HRN/nanocrystalline HA coatings tested, osteoblast adhesion was the greatest when HA nanometer particle size was the smallest. In this manner, this study demonstrated for the first time that biomimetic HRN/nanocrystalline HA coatings on titanium were cytocompatible for osteoblasts and, thus, should be further studied for improving orthopedic implants.

  19. Damping control of a large flexible manipulator through inertial forces of a small manipulator

    SciTech Connect

    Trudnowski, D.J.; Baker, C.P.; Evans, M.S.

    1993-06-01

    Damping control is applied to a detailed computer model of a long- reach flexible manipulator test bed. The test bed consists of a long slender link with a dexterous manipulator mounted at its tip. The movement of the dexterous manipulator is controlled to create inertial damping forces on the long link. Parameter identification and sequential loop-closure are used to design a controller that feeds back relative tip position and velocity of the long link to control the azimuth angle of the dexterous manipulator. The controller is designed to be robust to varying manipulator loading conditions and reliable under sensor failures.

  20. Interceptive orthopedics for the correction of maxillary transverse and sagittal deficiency in the early mixed dentition period

    PubMed Central

    Talapaneni, Ashok Kumar; Kumar, Karnati Praveen; Kommi, Pradeep Babu; Nuvvula, Sivakumar

    2011-01-01

    Dentofacial Orthopedics directed to a hypoplastic maxilla in the prepubertal period redirects growth of the maxilla in the vertical, transverse and sagittal planes of space. The orthopedic correction of maxillary hypoplasia in the early mixed dentition period thus intercepts the establishment of permanent structural asymmetry in the mandible and helps in the achievement of optimal dentofacial esthetics. This paper presents the growth redirection in a hypoplastic maxilla of an 8-year-old girl with simultaneous rapid maxillary expansion and protraction headgear therapy for a period of 11 months which corrected the posterior unilateral cross-bite, the positional asymmetry of the mandible and established an orthognathic profile in the individual. PMID:22346162

  1. Dynamics and Manipulation of Nanomagnets

    NASA Astrophysics Data System (ADS)

    Cai, Liufei

    This thesis presents my work on the spin dynamics of nanomagnets and investigates the possibility of manipulating nanomagnets by various means. Most of the work has been published. Some has been submitted for publication. The structure of this thesis is as follows. In Chapter 1, I present the theory of manipulation of a nanomagnet by rotating ac fields whose frequency is time dependent. Theory has been developed that maps the problem onto Landau-Zener problem. For the linear frequency sweep the switching phase diagrams are obtained on the amplitude of the ac field and the frequency sweep rate. Switching conditions have been obtained numerically and analytically. For the nonlinear frequency sweep, the optimal time dependence of the frequency is obtained analytically with account of damping that gives the fastest controllable switching of the magnetization. In Chapter 2, interaction between a nanomagnet and a Josephson junction has been studied. The I-V curve of the Josephson junction in the proximity of a nanomagnet shows Shapiro-like steps due to the ac field generated by the precessing magnetic moment. Possibility of switching of the magnetic moment by a time-linear voltage in the Josephson junction is demonstrated. Realization of the optimal switching is suggested that employs two perpendicular Josephson junctions with time-dependent voltage signals. The result is shown to be robust against voltage noises. Quantum-mechanical coupling between the nanomagnet considered as a two-level system and a Josephson junction has been studied and quantum oscillations of the populations of the spin states have been computed. In Chapter 3, the switching dynamics of a nanomagnet embedded in a torsional oscillator that serves as a conducting wire for a spin current has been investigated. Generalized Slonczewski's equation is derived. The coupling of the nanomagnet, the torsional oscillator and the spin current generates a number of interesting phenomena. The mechanically

  2. Task based synthesis of serial manipulators

    PubMed Central

    Patel, Sarosh; Sobh, Tarek

    2015-01-01

    Computing the optimal geometric structure of manipulators is one of the most intricate problems in contemporary robot kinematics. Robotic manipulators are designed and built to perform certain predetermined tasks. There is a very close relationship between the structure of the manipulator and its kinematic performance. It is therefore important to incorporate such task requirements during the design and synthesis of the robotic manipulators. Such task requirements and performance constraints can be specified in terms of the required end-effector positions, orientations and velocities along the task trajectory. In this work, we present a comprehensive method to develop the optimal geometric structure (DH parameters) of a non-redundant six degree of freedom serial manipulator from task descriptions. In this work we define, develop and test a methodology to design optimal manipulator configurations based on task descriptions. This methodology is devised to investigate all possible manipulator configurations that can satisfy the task performance requirements under imposed joint constraints. Out of all the possible structures, the structures that can reach all the task points with the required orientations are selected. Next, these candidate structures are tested to see whether they can attain end-effector velocities in arbitrary directions within the user defined joint constraints, so that they can deliver the best kinematic performance. Additionally least power consuming configurations are also identified. PMID:26257946

  3. Dynamic control of kinematically redundant manipulators

    NASA Astrophysics Data System (ADS)

    Lin, Zhengcheng

    1993-03-01

    A robot manipulator is said to be kinematically redundant when it has more degrees of freedom than are necessary to accomplish a particular task. Useful control strategies are designed for kinematically redundant manipulators in order to enhance their performance. Following the impedance control approach, the problem of minimizing redundant manipulator collision impacts is addressed. The configuration control approach is used to reduce impulsive forces, while a simplified impedance control scheme is formulated to minimize rebound effects. A new Cartesian control strategy for redundant flexible-joint manipulators is proposed. The main idea in this hybrid scheme is to control not only the manipulator's end-effector but also its links, so as to achieve specified positions and velocities for the end-effector and the links. Finally, a new application of kinematically redundant manipulators is proposed: using redundancy resolution to compensate for joint flexibility. This redundancy resolution scheme is incorporated in a control strategy for redundant flexible-joint manipulators. The problem of possible algorithmic singularities is considered, and a scheme is suggested which makes the controller robust with respect to such singularities.

  4. Fuzzy logic control of telerobot manipulators

    NASA Technical Reports Server (NTRS)

    Franke, Ernest A.; Nedungadi, Ashok

    1992-01-01

    Telerobot systems for advanced applications will require manipulators with redundant 'degrees of freedom' (DOF) that are capable of adapting manipulator configurations to avoid obstacles while achieving the user specified goal. Conventional methods for control of manipulators (based on solution of the inverse kinematics) cannot be easily extended to these situations. Fuzzy logic control offers a possible solution to these needs. A current research program at SRI developed a fuzzy logic controller for a redundant, 4 DOF, planar manipulator. The manipulator end point trajectory can be specified by either a computer program (robot mode) or by manual input (teleoperator). The approach used expresses end-point error and the location of manipulator joints as fuzzy variables. Joint motions are determined by a fuzzy rule set without requiring solution of the inverse kinematics. Additional rules for sensor data, obstacle avoidance and preferred manipulator configuration, e.g., 'righty' or 'lefty', are easily accommodated. The procedure used to generate the fuzzy rules can be extended to higher DOF systems.

  5. W-026, acceptance test report manipulator system

    SciTech Connect

    Watson, T.L.

    1997-04-15

    The purpose of the WRAP Manipulator System Acceptance Test Plan (ATP) is to verify that the 4 glovebox sets of WRAP manipulator components, including rail/carriage, slave arm, master controller and auxiliary equipment, meets the requirements of the functional segments of 14590 specification. The demonstration of performance elements of the ATP are performed as a part of the Assembly specifications. Manipulator integration is integrated in the performance testing of the gloveboxes. Each requirement of the Assembly specification will be carried out in conjunction with glovebox performance tests.

  6. Mobile manipulation: a challenge in integration

    NASA Astrophysics Data System (ADS)

    Anderson, Cressel; Axelrod, Ben; Case, J. Philip; Choi, Jaeil; Engel, Martin; Gupta, Gaurav; Hecht, Florian; Hutchinson, John; Krishnamurthi, Niyant; Lee, Jinhan; Nguyen, Hai Dai; Roberts, Richard; Rogers, John G.; Trevor, Alexander J. B.; Christensen, Henrik I.; Kemp, Charles

    2008-04-01

    Mobile manipulation in many respects represents the next generation of robot applications. An important part of design of such systems is the integration of techniques for navigation, recognition, control, and planning to achieve a robust solution. To study this problem three different approaches to mobile manipulation have been designed and implemented. A prototypical application that requires navigation and manipulation has been chosen as a target for the systems. In this paper we present the basic design of the three systems and draw some general lessons on design and implementation.

  7. Osteopathic manipulative medicine for carpal tunnel syndrome.

    PubMed

    Siu, Gilbert; Jaffe, J Douglas; Rafique, Maryum; Weinik, Michael M

    2012-03-01

    Carpal tunnel syndrome (CTS) is 1 of the most common peripheral nerve entrapment disorders. Osteopathic manipulative medicine can be invaluable in diagnosing and managing CTS. Combined with a patient's history and a standard physical examination, an osteopathic structural examination can facilitate localizing the nerve entrapment, diagnosing CTS, and monitoring the disease process. Osteopathic manipulative treatment is noninvasive and can be used to supplement traditional CTS treatment methods. The authors also review the relevant anatomy involving CTS and the clinical efficacy of osteopathic manipulative medicine in the management of this disorder.

  8. Dynamically consistent Jacobian inverse for mobile manipulators

    NASA Astrophysics Data System (ADS)

    Ratajczak, Joanna; Tchoń, Krzysztof

    2016-06-01

    By analogy to the definition of the dynamically consistent Jacobian inverse for robotic manipulators, we have designed a dynamically consistent Jacobian inverse for mobile manipulators built of a non-holonomic mobile platform and a holonomic on-board manipulator. The endogenous configuration space approach has been exploited as a source of conceptual guidelines. The new inverse guarantees a decoupling of the motion in the operational space from the forces exerted in the endogenous configuration space and annihilated by the dual Jacobian inverse. A performance study of the new Jacobian inverse as a tool for motion planning is presented.

  9. Large planar maneuvers for articulated flexible manipulators

    NASA Technical Reports Server (NTRS)

    Huang, Jen-Kuang; Yang, Li-Farn; Juang, Jer-Nan

    1988-01-01

    An articulated flexible manipulator carried on a translational cart is maneuvered by an active controller to perform certain position control tasks. The nonlinear dynamics of the articulated flexible manipulator are derived and a transformation matrix is formulated to localize the nonlinearities in the inertia matrix. Then a feeback linearization scheme is introduced to linearize the dynamic equations for controller design. Through a pole placement technique, a robust controller design is obtained by properly assigning a set of closed-loop desired eigenvalues to meet performance requirements. Numerical simulations for the articulated flexible manipulators are given to demonstrate the feasibility and effectiveness of the proposed position control algorithms.

  10. Large planar maneuvers for articulated flexible manipulators

    NASA Technical Reports Server (NTRS)

    Huang, Jen-Kuang; Yang, Li-Farn

    1988-01-01

    An articulated flexible manipulator carried on a translational cart is maneuvered by an active controller to perform certain position control tasks. The nonlinear dynamics of the articulated flexible manipulator are derived and a transformation matrix is formulated to localize the nonlinearities within the inertia matrix. Then a feedback linearization scheme is introduced to linearize the dynamic equations for controller design. Through a pole placement technique, a robust controller design is obtained by properly assigning a set of closed-loop desired eigenvalues to meet performance requirements. Numerical simulations for the articulated flexible manipulators are given to demonstrate the feasibility and effectiveness of the proposed position control algorithms.

  11. Optoelectronic tweezers for microparticle and cell manipulation

    NASA Technical Reports Server (NTRS)

    Wu, Ming Chiang (Inventor); Chiou, Pei Yu (Inventor); Ohta, Aaron T. (Inventor)

    2009-01-01

    An optical image-driven light induced dielectrophoresis (DEP) apparatus and method are described which provide for the manipulation of particles or cells with a diameter on the order of 100 .mu.m or less. The apparatus is referred to as optoelectric tweezers (OET) and provides a number of advantages over conventional optical tweezers, in particular the ability to perform operations in parallel and over a large area without damage to living cells. The OET device generally comprises a planar liquid-filled structure having one or more portions which are photoconductive to convert incoming light to a change in the electric field pattern. The light patterns are dynamically generated to provide a number of manipulation structures that can manipulate single particles and cells or groups of particles/cells. The OET preferably includes a microscopic imaging means to provide feedback for the optical manipulation, such as detecting position and characteristics wherein the light patterns are modulated accordingly.

  12. Which Colles' fractures should be manipulated?

    PubMed

    Dixon, Sean; Allen, Patricia; Bannister, Gordon

    2005-01-01

    Ninety-two patients with displaced Colles' fractures were followed prospectively after manipulation under regional anaesthesia. Radiographs were taken before and after manipulation and after 3 months when a functional assessment was also made. A correlation was sought between outcome and radiological measurements. Final radial shortening of 3mm or more was associated with a significantly worse functional outcome after 3 months (P < 0.001). Where the initial radial shortening was 3 mm or more, the probability of malunion was 65% whereas with less than 3mm, the probability of malunion was 28% (P < 0.001). With 5 mm or more of radial shortening at presentation, the probability of malunion was 73% (P < 0.01). The decision to manipulate remains a matter of judgement but a high failure rate renders simple manipulation and plaster cast fixation a poor treatment option in fractures with 5mm or more of radial shortening at presentation.

  13. What is morally new in genetic manipulation?

    PubMed

    Keenan, J F

    1990-01-01

    The investigation into the specific moral issues of genetic manipulation requires us to determine exactly the new moral issues of genetic manipulation. But even that determination requires us to consider whether the context in which we live and the method of moral reflection which we use is adequate enough to address genetic manipulation. Given the liberalist context in which we live, this paper argues that an act-oriented ethics is inadequate and that only a virtue-oriented ethics enables us to recognize and resolve the new problems ahead of us in genetic manipulation. Moreover, those problems have a common root, that is, that through genetics we will be in danger of objectifying the human subject.

  14. Brachioradial pruritus and cervical spine manipulation.

    PubMed

    Tait, C P; Grigg, E; Quirk, C J

    1998-08-01

    Brachioradial pruritus (BRP) causes significant morbidity in the majority of patients for whom no effective treatment is found. Chronic ultraviolet radiation exposure has usually been cited as the cause, but nerve damage from cervical spine disease has also been implicated. We report on a small retrospective exploratory study, conducted by questionnaire, of a group of patients who were treated with a specific cervical spine manipulation. Ten of 14 patients reported resolution of symptoms following manipulative treatment. All six patients who had had previous cervical spine disease responded to manipulation, as did half the remaining eight patients who had no previous history of neck symptoms. Although patients with BRP, by definition, share similar symptoms, the aetiology is almost certainly multifactorial. Prospective studies looking for cervical spine disease, as well as assessment of this particular method of cervical spine manipulation as a treatment modality for BRP, should be considered.

  15. Reconfigurable mobile manipulation for accident response

    SciTech Connect

    ANDERSON,ROBERT J.; MORSE,WILLIAM D.; SHIREY,DAVID L.; CDEBACA,DANIEL M.; HOFFMAN JR.,JOHN P.; LUCY,WILLIAM E.

    2000-06-06

    The need for a telerobotic vehicle with hazard sensing and integral manipulation capabilities has been identified for use in transportation accidents where nuclear weapons are involved. The Accident Response Mobile Manipulation System (ARMMS) platform has been developed to provide remote dexterous manipulation and hazard sensing for the Accident Response Group (ARG) at Sandia National Laboratories. The ARMMS' mobility platform is a military HMMWV [High Mobility Multipurpose Wheeled Vehicle] that is teleoperated over RF or Fiber Optic communication channels. ARMMS is equipped with two high strength Schilling Titan II manipulators and a suite of hazardous gas and radiation sensors. Recently, a modular telerobotic control architecture call SMART (Sandia Modular Architecture for Robotic and Teleoperation) has been applied to ARMMS. SMART enables input devices and many system behaviors to be rapidly configured in the field for specific mission needs. This paper summarizes current SMART developments applied to ARMMS.

  16. The Frankfurt School's Theory of Manipulation

    ERIC Educational Resources Information Center

    Petryszak, Nicholas

    1977-01-01

    Discusses the critical sociology of communication of the Frankfurt School suggesting that theorists such as Lowenthal, Adorno, and Habermas have outlined both the political economics of manipulation and the social psychological interaction between the audience and the media. (MH)

  17. Tension Stiffened and Tendon Actuated Manipulator

    NASA Technical Reports Server (NTRS)

    Doggett, William R. (Inventor); Dorsey, John T. (Inventor); Ganoe, George G. (Inventor); King, Bruce D. (Inventor); Jones, Thomas C. (Inventor); Mercer, Charles D. (Inventor); Corbin, Cole K. (Inventor)

    2015-01-01

    A tension stiffened and tendon actuated manipulator is provided performing robotic-like movements when acquiring a payload. The manipulator design can be adapted for use in-space, lunar or other planetary installations as it is readily configurable for acquiring and precisely manipulating a payload in both a zero-g environment and in an environment with a gravity field. The manipulator includes a plurality of link arms, a hinge connecting adjacent link arms together to allow the adjacent link arms to rotate relative to each other and a cable actuation and tensioning system provided between adjacent link arms. The cable actuation and tensioning system includes a spreader arm and a plurality of driven and non-driven elements attached to the link arms and the spreader arm. At least one cable is routed around the driven and non-driven elements for actuating the hinge.

  18. Optoelectronic Tweezers for Microparticle and Cell Manipulation

    NASA Technical Reports Server (NTRS)

    Wu, Ming Chiang (Inventor); Chiou, Pei-Yu (Inventor); Ohta, Aaron T. (Inventor)

    2014-01-01

    An optical image-driven light induced dielectrophoresis (DEP) apparatus and method are described which provide for the manipulation of particles or cells with a diameter on the order of 100 micromillimeters or less. The apparatus is referred to as optoelectric tweezers (OET) and provides a number of advantages over conventional optical tweezers, in particular the ability to perform operations in parallel and over a large area without damage to living cells. The OET device generally comprises a planar liquid-filled structure having one or more portions which are photoconductive to convert incoming light to a change in the electric field pattern. The light patterns are dynamically generated to provide a number of manipulation structures that can manipulate single particles and cells or group of particles/cells. The OET preferably includes a microscopic imaging means to provide feedback for the optical manipulation, such as detecting position and characteristics wherein the light patterns are modulated accordingly.

  19. Manipulatives Make Math Meaningful for Middle Schoolers.

    ERIC Educational Resources Information Center

    Scheer, Janet K.

    1985-01-01

    Narrates an account of teaching mathematical concepts to junior high school students using manipulative materials and small and large group games. The following concepts are explained through game descriptions using numeration or Dienes blocks: regrouping decimals, and place value. (DST)

  20. The use of computer-assisted surgery as an educational tool for the training of orthopedic surgery residents in pedicle screw placement: a pilot study and survey among orthopedic residents

    PubMed Central

    Aoude, Ahmed; Alhamzah, Hamzah; Fortin, Maryse; Jarzem, Peter; Ouellet, Jean; Weber, Michael H.

    2016-01-01

    Background The training of orthopedic residents in adequate pedicle screw placement is very important. We sought to investigate orthopedic residents’ perspectives on the use of computer-assisted surgery (CAS) in a training trial. Methods Orthopedic residents were randomly assigned to independently place a screw using the free-hand technique and the CAS technique on 1 of 3 cadavers (Cobb angles 5º, 15º and 67º) at randomly selected thoracolumbar vertebral levels. All residents were blinded to their colleagues’ pedicle screw placements and were asked to complete a short questionnaire at the end of the session to evaluate their experience with CAS. We obtained CT images for each cadaver to assess pedicle screw placement accuracy and classified placement as A) screw completely in pedicle, B) screw < 2 mm outside pedicle, C) screw 2–4 mm outside pedicle, or D) screw > 4 mm outside pedicle. Results Twenty-four orthopedic residents participated in this trial study. In total, 65% preferred using the free-hand technique in an educational setting even though most (60%) said that CAS is safer. The main reason for free-hand technique preference was the difficult technical aspects encountered with CAS. In addition, accuracy of pedicle screw placement in this trial showed that 5 screws were classified as A or B (safe zone) and 19 as grade C or D (unsafe zone) using the free-hand technique compared with 15 and 9, respectively, using CAS (p = 0.008). Conclusion Orthopedic residents perceived CAS as safe and demonstrated improved accuracy in pedicle screw placement in a single setting. However, the residents preferred the free-hand technique in an educational stetting owing to the difficult technical aspects of CAS. PMID:28234614

  1. Hybrid Image-Plane/Stereo Manipulation

    NASA Technical Reports Server (NTRS)

    Baumgartner, Eric; Robinson, Matthew

    2004-01-01

    Hybrid Image-Plane/Stereo (HIPS) manipulation is a method of processing image data, and of controlling a robotic manipulator arm in response to the data, that enables the manipulator arm to place an end-effector (an instrument or tool) precisely with respect to a target (see figure). Unlike other stereoscopic machine-vision-based methods of controlling robots, this method is robust in the face of calibration errors and changes in calibration during operation. In this method, a stereoscopic pair of cameras on the robot first acquires images of the manipulator at a set of predefined poses. The image data are processed to obtain image-plane coordinates of known visible features of the end-effector. Next, there is computed an initial calibration in the form of a mapping between (1) the image-plane coordinates and (2) the nominal three-dimensional coordinates of the noted end-effector features in a reference frame fixed to the main robot body at the base of the manipulator. The nominal three-dimensional coordinates are obtained by use of the nominal forward kinematics of the manipulator arm that is, calculated by use of the currently measured manipulator joint angles and previously measured lengths of manipulator arm segments under the assumption that the arm segments are rigid, that the arm lengths are constant, and that there is no backlash. It is understood from the outset that these nominal three-dimensional coordinates are likely to contain possibly significant calibration errors, but the effects of the errors are progressively reduced, as described next. As the end-effector is moved toward the target, the calibration is updated repeatedly by use of data from newly acquired images of the end-effector and of the corresponding nominal coordinates in the manipulator reference frame. By use of the updated calibration, the coordinates of the target are computed in manipulator-reference-frame coordinates and then used to the necessary manipulator joint angles to position

  2. Efficient Kinematic Computations For 7-DOF Manipulators

    NASA Technical Reports Server (NTRS)

    Seraji, Homayoun; Long, Mark K.; Kreutz-Delgado, Kenneth

    1994-01-01

    Efficient algorithms for forward kinematic mappings of seven-degree-of-freedom (7-DOF) robotic manipulator having revolute joints developed on basis of representation of redundant DOF in terms of parameter called "arm angle." Continuing effort to exploit redundancy in manipulator according to concept of basic and additional tasks. Concept also discussed in "Configuration-Control Scheme Copes With Singularities" (NPO-18556) and "Increasing the Dexterity of Redundant Robots" (NPO-17801).

  3. Ecological consequences of manipulative parasites: chapter 9

    USGS Publications Warehouse

    Lafferty, Kevin D.; Kuris, A. M.

    2012-01-01

    Parasitic "puppet masters", with their twisted, self-serving life history strategies and impressive evolutionary takeovers of host minds, capture the imagination of listeners—even those that might not normally fi nd the topic of parasitism appealing (which includes most everyone). A favorite anecdote concerns the trematode Leucochloridium paradoxum migrating to the eyestalks of its intermediate host snail and pulsating its colored body, presumably to attract the predatory birds that are the final hosts for the worm. Identifying a parasite as “manipulative” infers that a change in host behavior or appearance is a direct consequence of the parasite’s adaptive actions that, on average, will increase the fi tness of the parasite. The list of parasites that manipulate their hosts is long and growing. Holmes and Bethel (1972) presented the earliest comprehensive review and brought the subject to mainstream ecologists. Over two decades ago, Andy Dobson (1988) listed seven cestodes, seven trematodes, ten acanthocephalans, and three nematodes that manipulated host behavior. Fifteen years later, Janice Moore (2002) filled a book with examples. The five infectious trophic strategies, typical parasites (macroparasites), pathogens, trophically transmitted parasites, parasitic castrators, and parasitoids (Kuris and Lafferty 2000; Lafferty and Kuris 2002, 2009) can modify host behavior, but the likelihood that a parasite manipulates behavior differs among strategies. The most studied infectious agents, non-trophically transmitted pathogens and macroparasites, have enormous public health, veterinary, and wildlife disease importance, yet few manipulate host behavior. The beststudied manipulative infectious agents are trophically transmitted parasites in their prey intermediate hosts. Parasitoids and parasitic castrators can also manipulate host behavior, but for different purposes and with different implications. Several studies of manipulative parasites conclude with

  4. On the manipulability of dual cooperative robots

    NASA Technical Reports Server (NTRS)

    Chiacchio, P.; Chiaverini, S.; Sciavicco, L.; Siciliano, B.

    1989-01-01

    The definition of manipulability ellipsoids for dual robot systems is given. A suitable kineto-static formulation for dual cooperative robots is adopted which allows for a global task space description of external and internal forces, and relative velocities. The well known concepts of force and velocity manipulability ellipsoids for a single robot are formally extended and the contributions of the two single robots to the cooperative system ellipsoids are illustrated. Duality properties are discussed. A practical case study is developed.

  5. Intrarenal stone manipulation: summary of recent experience.

    PubMed

    Ball, T P

    1978-01-01

    Since first described in 1975, non-operative external manipulation of small intrarenal calculi has been done on 30 individuals. This procedure has facilitated stone passage successfully in 80 per cent of the cases and, thus far, has been free of significant complication. Fluoroscopic control and materials available in most radiology departments allow for intrarenal manipulation to dislodge small calculi in virtually any calix, permitting spontaneous and usually asymptomatic passage. The procedure and subsequent management are described in detail.

  6. An Intelligibility Assessment of Toddlers with Cleft Lip and Palate Who Received and Did Not Receive Presurgical Infant Orthopedic Treatment.

    ERIC Educational Resources Information Center

    Konst, Emmy M.; Weersink-Braks, Hanny; Rietveld, Toni; Peters, Herman

    2000-01-01

    The influence of presurgical infant orthopedic treatment (PIO) on speech intelligibility was evaluated with 10 toddlers who used PIO during the first year of life and 10 who did not. Treated children were rated as exhibiting greater intelligibility, however, transcription data indicated there were not group differences in actual intelligibility.…

  7. Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department

    PubMed Central

    Kittipittayakorn, Cholada

    2016-01-01

    Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries' healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES) and agent-based simulation (ABS) to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department. PMID:27195606

  8. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

    PubMed Central

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. Material and Methods: A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Results: Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. Conclusion: This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information. PMID:27006550

  9. The Living Stage Improvisational Theatre Demonstration Project for Orthopedically Handicapped Children, Ages 4-8. Overview, 1978-1981.

    ERIC Educational Resources Information Center

    Alexander, Robert; Haynes, Wendy

    The Living Stage Improvisational Theatre Demonstration Project (Washington, D.C.) conducts weekly workshops to enhance the creative expression and self esteem of orthopedically handicapped children, aged 4 to 8 years. The Living Stage program is designed to demonstrate that methods of improvisational theatre can have a positive impact on parental…

  10. Concentration of Sonication Fluid through Centrifugation Is Superior to Membrane Filtration for Microbial Diagnosis of Orthopedic Implant-Associated Infection.

    PubMed

    Zitron, Renato; Wajsfeld, Tali; Klautau, Giselle Burlamaqui; da Silva, Cely Barreto; Nigro, Stanley; Mercadante, Marcelo Tomanik; Polesello, Giancarlo Cavalli; Cury, Ricardo de Paula Leite; Salles, Mauro Jose Costa

    2016-03-01

    Microbial identification of orthopedic implant-associated infections using sonication fluid (SF) submitted to a concentration step by membrane filtration (SMF) was compared with the standard centrifugation (SC) method. Among 33 retrieved infected implants, sonication identified microorganisms in 26 (78.8%). The sensitivity of SC was higher than that of SMF (78.8% versus 30.3%; P < 0.001).

  11. Intelligent modular manipulation for mobile robots

    NASA Astrophysics Data System (ADS)

    Culbertson, John

    2008-04-01

    As mobile robots continue to gain acceptance across a variety of applications within the defense and civilian markets, the number of tasks that these robot platforms are expected to accomplish are expanding. Robot operators are asked to do more with the same platforms - from EOD missions to reconnaissance and inspection operations. Due to the fact that a majority of missions are dangerous in nature, it is critical that users are able to make remote adjustments to the systems to ensure that they are kept out of harm's way. An efficient way to expand the capabilities of existing robot platforms, improve the efficiency of robot missions, and to ultimately improve the operator's safety is to integrate JAUS-enabled Intelligent Modular Manipulation payloads. Intelligent Modular Manipulation payloads include both simple and dexterous manipulator arms with plug-and-play end-effector tools that can be changed based on the specific mission. End-effectors that can be swapped down-range provide an added benefit of decreased time-on-target. The intelligence in these systems comes from semi-autonomous mobile manipulation actions that enable the robot operator to perform manipulation task with the touch of a button on the OCU. RE2 is supporting Unmanned Systems Interoperability by utilizing the JAUS standard as the messaging protocol for all of its manipulation systems. Therefore, they can be easily adapted and integrated onto existing JAUS-enabled robot platforms.

  12. Manipulator control for rover planetary exploration

    NASA Astrophysics Data System (ADS)

    Cameron, Jonathan M.; Tunstel, Edward; Nguyen, Tam; Cooper, Brian K.

    1992-11-01

    An anticipated goal of Mars surface exploration missions will be to survey and sample surface rock formations which appear scientifically interesting. In such a mission, a planetary rover would navigate close to a selected sampling site and the remote operator would use a manipulator mounted on the rover to perform a sampling operation. Techniques for accomplishing the necessary manipulation for the sampling components of such a mission have been developed and are presented. We discuss the implementation of a system for controlling a seven (7) degree of freedom Puma manipulator, equipped with a special rock gripper mounted on a planetary rover prototype, intended for the purpose of performing the sampling operation. Control is achieved by remote teleoperation. This paper discusses the real-time force control and supervisory control aspects of the rover manipulation system. Integration of the Puma manipulator with the existing distributed computer architecture is also discussed. The work described is a contribution toward achieving the coordinated manipulation and mobility necessary for a Mars sample acquisition and return scenario.

  13. Direct manipulation of virtual objects

    NASA Astrophysics Data System (ADS)

    Nguyen, Long K.

    Interacting with a Virtual Environment (VE) generally requires the user to correctly perceive the relative position and orientation of virtual objects. For applications requiring interaction in personal space, the user may also need to accurately judge the position of the virtual object relative to that of a real object, for example, a virtual button and the user's real hand. This is difficult since VEs generally only provide a subset of the cues experienced in the real world. Complicating matters further, VEs presented by currently available visual displays may be inaccurate or distorted due to technological limitations. Fundamental physiological and psychological aspects of vision as they pertain to the task of object manipulation were thoroughly reviewed. Other sensory modalities -- proprioception, haptics, and audition -- and their cross-interactions with each other and with vision are briefly discussed. Visual display technologies, the primary component of any VE, were canvassed and compared. Current applications and research were gathered and categorized by different VE types and object interaction techniques. While object interaction research abounds in the literature, pockets of research gaps remain. Direct, dexterous, manual interaction with virtual objects in Mixed Reality (MR), where the real, seen hand accurately and effectively interacts with virtual objects, has not yet been fully quantified. An experimental test bed was designed to provide the highest accuracy attainable for salient visual cues in personal space. Optical alignment and user calibration were carefully performed. The test bed accommodated the full continuum of VE types and sensory modalities for comprehensive comparison studies. Experimental designs included two sets, each measuring depth perception and object interaction. The first set addressed the extreme end points of the Reality-Virtuality (R-V) continuum -- Immersive Virtual Environment (IVE) and Reality Environment (RE). This

  14. Control of a flexible bracing manipulator: Integration of current research work to realize the bracing manipulator

    NASA Technical Reports Server (NTRS)

    Kwon, Dong-Soo

    1991-01-01

    All research results about flexible manipulator control were integrated to show a control scenario of a bracing manipulator. First, dynamic analysis of a flexible manipulator was done for modeling. Second, from the dynamic model, the inverse dynamic equation was derived, and the time domain inverse dynamic method was proposed for the calculation of the feedforward torque and the desired flexible coordinate trajectories. Third, a tracking controller was designed by combining the inverse dynamic feedforward control with the joint feedback control. The control scheme was applied to the tip position control of a single link flexible manipulator for zero and non-zero initial condition cases. Finally, the contact control scheme was added to the position tracking control. A control scenario of a bracing manipulator is provided and evaluated through simulation and experiment on a single link flexible manipulator.

  15. Therapeutic approach to Class II, Division 1 malocclusion with maxillary functional orthopedics

    PubMed Central

    de Bittencourt, Aristeu Corrêa; Saga, Armando Yukio; Pacheco, Ariel Adriano Reyes; Tanaka, Orlando

    2015-01-01

    INTRODUCTION: Interceptive treatment of Class II, Division 1 malocclusion is a challenge orthodontists commonly face due to the different growth patterns they come across and the different treatment strategies they have available. OBJECTIVE: To report five cases of interceptive orthodontics performed with the aid of Klammt's elastic open activator (KEOA) to treat Class II, Division 1 malocclusion. METHODS: Treatment comprehends one or two phases; and the use of functional orthopedic appliances, whenever properly recommended, is able to minimize dentoskeletal discrepancies with consequent improvement in facial esthetics during the first stage of mixed dentition. The triad of diagnosis, correct appliance manufacture and patient's compliance is imperative to allow KEOA to contribute to Class II malocclusion treatment. RESULTS: Cases reported herein showed significant improvement in skeletal, dental and profile aspects, as evinced by cephalometric analysis and clinical photographs taken before, during and after interceptive orthodontics. PMID:26352852

  16. Dominance of foreign citations in Brazilian orthopedics journals☆☆☆

    PubMed Central

    Teixeira, Renan Kleber Costa; Yamaki, Vitor Nagai; Rosa, Rita de Cássia Rodrigues; de Barros, Rui Sergio Monteiro; Botelho, Nara Macedo

    2014-01-01

    Objective To evaluate whether there is any preference for citing journals from other countries to the detriment of Brazilian journals, in three Brazilian orthopedics journals. Methods All the references of articles published in 2011 by the journals Acta Ortopédica Brasileira, Coluna/Columna and Revista Brasileira de Ortopedia were evaluated to as certain how many of these came from Brazilian journals and how many from foreign journals. Results 3813 references distributed among 187 articles were analyzed. Out of this total, 306 (8.02%) were from Brazilian journals. There was no difference between the three journals analyzed. There were 76 articles (40.64%) without any citations of articles in Brazilian journals and only two articles (1%) cited more Brazilian articles than articles published elsewhere. Conclusion There is a need for Brazilian researchers to cite articles from Brazilian journals more often. PMID:26229879

  17. Preparation Methods for Improving PEEK's Bioactivity for Orthopedic and Dental Application: A Review

    PubMed Central

    Almasi, Davood; Iqbal, Nida; Sadeghi, Maliheh; Sudin, Izman; Abdul Kadir, Mohammed Rafiq; Kamarul, Tunku

    2016-01-01

    There is an increased interest in the use of polyether ether ketone (PEEK) for orthopedic and dental implant applications due to its elastic modulus close to that of bone, biocompatibility, and its radiolucent properties. However, PEEK is still categorized as bioinert due to its low integration with surrounding tissues. Many studies have reported on methods to increase the bioactivity of PEEK, but there is still one-preparation method for preparing bioactive PEEK implant where the produced implant with desirable mechanical and bioactivity properties is required. The aim of this review is to present the progress of the preparation methods for improvement of the bioactivity of PEEK and to discuss the strengths and weaknesses of the existing methods. PMID:27127513

  18. Segmentation of multiple knee bones from CT for orthopedic knee surgery planning.

    PubMed

    Wu, Dijia; Sofka, Michal; Birkbeck, Neil; Zhou, S Kevin

    2014-01-01

    Patient-specific orthopedic knee surgery planning requires precisely segmenting from 3D CT images multiple knee bones, namely femur, tibia, fibula, and patella, around the knee joint with severe pathologies. In this work, we propose a fully automated, highly precise, and computationally efficient segmentation approach for multiple bones. First, each bone is initially segmented using a model-based marginal space learning framework for pose estimation followed by non-rigid boundary deformation. To recover shape details, we then refine the bone segmentation using graph cut that incorporates the shape priors derived from the initial segmentation. Finally we remove overlap between neighboring bones using multi-layer graph partition. In experiments, we achieve simultaneous segmentation of femur, tibia, patella, and fibula with an overall accuracy of less than 1mm surface-to-surface error in less than 90s on hundreds of 3D CT scans with pathological knee joints.

  19. 3D Bioprinting of Cartilage for Orthopedic Surgeons: Reading between the Lines

    PubMed Central

    Di Bella, Claudia; Fosang, Amanda; Donati, Davide M.; Wallace, Gordon G.; Choong, Peter F. M.

    2015-01-01

    Chondral and osteochondral lesions represent one of the most challenging and frustrating scenarios for the orthopedic surgeon and for the patient. The lack of therapeutic strategies capable to reconstitute the function and structure of hyaline cartilage and to halt the progression toward osteoarthritis has brought clinicians and scientists together, to investigate the potential role of tissue engineering as a viable alternative to current treatment modalities. In particular, the role of bioprinting is emerging as an innovative technology that allows for the creation of organized 3D tissue constructs via a “layer-by-layer” deposition process. This process also has the capability to combine cells and biomaterials in an ordered and predetermined way. Here, we review the recent advances in cartilage bioprinting and we identify the current challenges and the directions for future developments in cartilage regeneration. PMID:26322314

  20. A controlled antibiotic release system to prevent orthopedic-implant associated infections: An in vitro study

    PubMed Central

    Gimeno, Marina; Pinczowski, Pedro; Pérez, Marta; Giorello, Antonella; Martínez, Miguel Ángel; Santamaría, Jesús; Arruebo, Manuel; Luján, Lluís

    2015-01-01

    A new device for local delivery of antibiotics is presented, with potential use as a drug-eluting fixation pin for orthopedic applications. The implant consists of a stainless steel hollow tubular reservoir packed with the desired antibiotic. Release takes place through several orifices previously drilled in the reservoir wall, a process that does not compromise the mechanical properties required for the implant. Depending on the antibiotic chosen and the number of orifices, the release profile can be tailored from a rapid release of the load (ca. 20 h) to a combination of rapid initial release and slower, sustained release for a longer period of time (ca. 200 h). An excellent bactericidal action is obtained, with 4-log reductions achieved in as little as 2 h, and total bacterial eradication in 8 h using 6-pinholed implants filled with cefazolin. PMID:26297104

  1. In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities

    SciTech Connect

    Magnuson, J.E.; Brown, M.L.; Hauser, M.F.; Berquist, T.H.; Fitzgerald, R.H. Jr.; Klee, G.G.

    1988-07-01

    When infection of prosthetic orthopedic implants is suspected, optimal management requires accurate confirmation or exclusion of infection. The authors retrospectively studied 98 patients with possible infection who underwent scanning with indium-111-labeled white blood cells (WBCs) and subsequently underwent surgery within 14 days. At surgery, 50 patients had infections, as determined by means of culture or histologic results. The diagnostic accuracy of In-111 scanning was compared with that of plain radiography, arthrography, three-phase bone scanning, and various clinical and laboratory findings classically associated with infection. Positive findings on In-111 WBC scans and elevated erythrocyte sedimentation rates were found to be the most predictive variables in the diagnosis of septic prostheses (P less than or equal to .001 and P less than or equal to .002, respectively). Likelihood ratio analysis more clearly demonstrated the superiority of In-111 WBC scanning, with positive and negative scans yielding likelihood ratios of 5.0 and 0.16, respectively.

  2. Quaternized Chitosan as an Antimicrobial Agent: Antimicrobial Activity, Mechanism of Action and Biomedical Applications in Orthopedics

    PubMed Central

    Tan, Honglue; Ma, Rui; Lin, Chucheng; Liu, Ziwei; Tang, Tingting

    2013-01-01

    Chitosan (CS) is a linear polysaccharide with good biodegradability, biocompatibility and antimicrobial activity, which makes it potentially useful for biomedical applications, including an antimicrobial agent either alone or blended with other polymers. However, the poor solubility of CS in most solvents at neutral or high pH substantially limits its use. Quaternary ammonium CS, which was prepared by introducing a quaternary ammonium group on a dissociative hydroxyl group or amino group of the CS, exhibited improved water solubility and stronger antibacterial activity relative to CS over an entire range of pH values; thus, this quaternary modification increases the potential biomedical applications of CS in the field of anti-infection. This review discusses the current findings on the antimicrobial properties of quaternized CS synthesized using different methods and the mechanisms of its antimicrobial actions. The potential antimicrobial applications in the orthopedic field and perspectives regarding future studies in this field are also considered. PMID:23325051

  3. A controlled antibiotic release system to prevent orthopedic-implant associated infections: An in vitro study.

    PubMed

    Gimeno, Marina; Pinczowski, Pedro; Pérez, Marta; Giorello, Antonella; Martínez, Miguel Ángel; Santamaría, Jesús; Arruebo, Manuel; Luján, Lluís

    2015-10-01

    A new device for local delivery of antibiotics is presented, with potential use as a drug-eluting fixation pin for orthopedic applications. The implant consists of a stainless steel hollow tubular reservoir packed with the desired antibiotic. Release takes place through several orifices previously drilled in the reservoir wall, a process that does not compromise the mechanical properties required for the implant. Depending on the antibiotic chosen and the number of orifices, the release profile can be tailored from a rapid release of the load (ca. 20h) to a combination of rapid initial release and slower, sustained release for a longer period of time (ca. 200h). An excellent bactericidal action is obtained, with 4-log reductions achieved in as little as 2h, and total bacterial eradication in 8h using 6-pinholed implants filled with cefazolin.

  4. Surface modification of magnesium alloys developed for bioabsorbable orthopedic implants: a general review.

    PubMed

    Wang, Jiali; Tang, Jian; Zhang, Peng; Li, Yangde; Wang, Jue; Lai, Yuxiao; Qin, Ling

    2012-08-01

    As a bioabsorbable metal with mechanical properties close to bone, pure magnesium or its alloys have great potential to be developed as medical implants for clinical applications. However, great efforts should be made to avoid its fast degradation in vivo for orthopedic applications when used for fracture fixation. Therefore, how to decease degradation rate of pure magnesium or its alloys is one of the focuses in Research and Development (R&D) of medical implants. It has been recognized that surface modification is an effective method to prevent its initial degradation in vivo to maintain its desired mechanical strength. This article reviews the recent progress in surface modifications for prevention of fast degradation of magnesium or its alloys using in vitro testing model, a fast yet relevant model before moving towards time-consuming and expensive in vivo testing. Pros and cons of various surface modifications are also discussed for the goal to design available products to be applied in clinical trials.

  5. [Importance of computer-based procedures. Planning and documentation in orthopedic surgery].

    PubMed

    Basad, E

    1999-03-01

    The demand for efficiency in OR management and increase in the necessity of surgical documentation require the use of software applications in hospitals. A client-server based OP-planning and documentation system has been in use in the department of orthopedic surgery in Giessen University since 1992 and is being continuously further developed. Aside from the lawful requirements, the demands of clinical doctors have been especially considered. The main functions are management of non medical patient data, scheduling and documentation of operations with coding of diagnoses and therapy, tissue banking, implant inventory, on call scheduling, storage of medical video images, clinical word processing and e-mail. With an integrated web-server, MedXS has the capabilities to offer functions accessible over any webbrowser (Netscape, Internet-Explorer) in the internet or intranet. Through the usage of this application clinical procedures could be more efficiently realized and better agreeing positions with the insurance companies could be reached.

  6. Evaluation of low-level controllers for an orthopedic surgery robotic system.

    PubMed

    Barkana, Duygun Erol

    2010-07-01

    In this paper, a computed-torque control and disturbance-observer-based control were evaluated for an orthopedic surgery robotic system called OrthoRoby, to track bone-cutting trajectory. Robust motion control is required to control a medical robotic system in an environment where model uncertainty and disturbances exist. Experiments were performed to demonstrate the performance of the tracking of the desired cutting trajectory when a computed-torque controller and disturbance-observer-based controller were used for OrthoRoby. It was observed that a computed-torque controller can become unstable with inexact cancellation due to parameter uncertainties and unmodeled dynamics. A disturbance-observer-based control was shown to ensure stability with inexact cancellation due to parameter uncertainties and unmodeled dynamics.

  7. Orthopedic surgical site infections: analysis of causative bacteria and implications for antibiotic stewardship.

    PubMed

    Norton, Thomas D; Skeete, Faith; Dubrovskaya, Yanina; Phillips, Michael S; Bosco, Joseph D; Mehta, Sapna A

    2014-05-01

    Data that can be used to guide perioperative antibiotic prophylaxis in our era of emerging antibiotic resistance are limited. We reviewed orthopedic surgeries complicated by surgical site infections (SSIs). Eighty percent of 69 arthroplasty and 80 spine fusion SSIs were infected with Gram-positive bacteria; most were staphylococcal species; and more than 25% of Staphylococcus aureus and more than 65% of coagulase-negative staphylococci were methicillin-resistant. Gram-negative bacteria were isolated from 30% of arthroplasty SSIs and 25% of spine fusion SSIs. Resistance to cefazolin was higher than 40%. A significant proportion of SSIs were caused by resistant organisms, and antibiotic guidelines were altered to provide more adequate surgical prophylaxis.

  8. Patient satisfaction with perioperative care among patients having orthopedic surgery in a university hospital

    PubMed Central

    Jlala, Hatem A; Caljouw, Monique A; Bedforth, Nigel M; Hardman, Jonathan G

    2010-01-01

    This survey aimed to validate the English version of the multidimensional Leiden Perioperative Patient Satisfaction questionnaire (LPPSq) and use it to assess patient satisfaction with perioperative care and the influence of type of anesthesia. One hundred patients having orthopedic surgery under regional and general anesthesia verbally consented to participate. Different aspects of satisfaction were assessed (eg, provision of information, and staff-patient relationship). The reliability estimate of the LPPSq (Cronbach’s-α) was good (0.94). Overall, patient satisfaction score was 86.7%, lowest was for information (80.8%) and highest for staff-patient relationships (90.3%). Patients were more satisfied with the provision of information regarding regional anesthesia. PMID:22915869

  9. Biocompatibility Study of Zirconium-Based Bulk Metallic Glasses for Orthopedic Applications

    NASA Astrophysics Data System (ADS)

    He, Wei; Chuang, Andrew; Cao, Zheng; Liaw, Peter K.

    2010-07-01

    Bulk metallic glasses (BMGs) represent an emerging class of materials that offer an attractive combination of properties, such as high strength, low modulus, good fatigue limit, and near-net-shape formability. The BMGs have been explored in mechanical, chemical, and magnetic applications. However, little research has been attracted in the biomedical field. In this work, we study the potential of BMGs for the orthopedic repair and replacement. We report the biocompatibility study of zirconium (Zr)-based solid BMGs using mouse osteoblast cells. Cell attachment, proliferation, and differentiation are compared to Ti-6Al-4V, a well-studied alloy biomaterial. Our in-vitro study has demonstrated that cells cultured on the Zr-based BMG substrate showed higher attachment, alkaline phosphatase activity, and bone matrix deposition compared to those grown on the control Ti alloy substrate. Cytotoxicity staining also revealed the remarkable viability of cells growing on the BMG substrates.

  10. Ion beam sputter etching of orthopedic implanted alloy MP35N and resulting effects on fatigue

    NASA Technical Reports Server (NTRS)

    Wintucky, E. G.; Christopher, M.; Bahnuik, E.; Wang, S.

    1981-01-01

    The effects of two types of argon ion sputter etched surface structures on the tensile stress fatigue properties of orthopedic implant alloy MP35N were investigated. One surface structure was a natural texture resulting from direct bombardment by 1 keV argon ions. The other structure was a pattern of square holes milled into the surface by a 1 keV argon ion beam through a Ni screen mask. The etched surfaces were subjected to tensile stress only in fatigue tests designed to simulate the cyclic load conditions experienced by the stems of artificial hip joint implants. Both types of sputter etched surface structures were found to reduce the fatigue strength below that of smooth surface MP35N.

  11. Effects of intrathecal hyperbaric ropivacaine versus hyperbaric bupivacaine for lower limb orthopedic surgery

    PubMed Central

    Chatterjee, Somjit; Bisui, Bikash; Mandal, Anamitra; Sheet, Jagabandhu; Sengupta, Swapnadeep; Majumdar, Shakya; Swaika, Sarbari

    2014-01-01

    Background: Regional anesthesia, increasingly used for infraumbilical surgery, has advantages of decreased stress response to surgery, nausea, vomiting, and cardio-respiratory depression with improved postoperative analgesia, in comparison to general anesthesia. Intrathecal isobaric ropivacaine (RP) had been found, in various clinical studies, to be shorter acting in comparison to bupivacaine (BP). Our present study was, hence, aimed to compare the anesthetic and analgesic efficacy of intrathecal hyperbaric RP relative to hyperbaric BP in lower limb orthopedic surgery. Materials and Methods: A total of 100 patients aged ranges between 18 and 60 years of either sex, ASAPS 1 and 2, undergoing elective lower limb orthopedic surgeries were divided into two groups, RP group and BP group receiving intrathecal 0.75% RP 3 ml and glucose 50%, 0.5 ml and 0.5% hyperbaric BP 3 ml and 0.9% normal saline 0.5 ml, respectively. The efficacy in terms of onset and duration of anesthesia and analgesia were assessed along with the heart rate, blood pressure at regular intervals throughout the perioperative period. Result: The two study groups were comparable in terms of demography and duration of surgery. Patients in group RP experienced significantly late onset and shorter duration of sensory and motor block in comparison to patients in group BP. There were clinically insignificant differences in perioperative hemodynamics and side-effects noted in each group. Hence, it was observed in this study that equipotent dose of hyperbaric RP had shorter duration of analgesia and anesthesia than with equipotent dose of hyperbaric BP. PMID:25886334

  12. Physical characteristics of a low-dose gas microstrip detector for orthopedic x-ray imaging

    SciTech Connect

    Despres, Philippe; Beaudoin, Gilles; Gravel, Pierre; Guise, Jacques A. de

    2005-04-01

    A new scanning slit gas detector dedicated to orthopedic x-ray imaging is presented and evaluated in terms of its fundamental imaging characteristics. The system is based on the micromesh gaseous structure detector and achieves primary signal amplification through electronic avalanche in the gas. This feature, together with high quantum detection efficiency and fan-beam geometry, allows for imaging at low radiation levels. The system is composed of 1764 channels spanning a width of 44.8 cm and is capable of imaging an entire patient at speeds of up to 15 cm/s. The resolution was found to be anisotropic and significantly affected by the beam quality in the horizontal direction, but otherwise sufficient for orthopedic studies. As a consequence of line-by-line acquisition, the images contain some ripple components due to mechanical vibrations combined with variations in the x-ray tube output power. The reported detective quantum efficiency (DQE) values are relatively low (0.14 to 0.20 at 0.5 mm{sup -1}) as a consequence of a suboptimal collimation geometry. The DQE values were found to be unaffected by the exposure down to 7 {mu}Gy, suggesting that the system is quantum limited even for low radiation levels. A system composed of two orthogonal detectors is already in use and can produce dual-view full body scans at low doses. This device could contribute to reduce the risk of radiation induced cancer in sensitive clientele undergoing intensive x-ray procedures, like young scoliotic women.

  13. Physical characteristics of a low-dose gas microstrip detector for orthopedic x-ray imaging.

    PubMed

    Després, Philippe; Beaudoin, Gilles; Gravel, Pierre; de Guise, Jacques A

    2005-04-01

    A new scanning slit gas detector dedicated to orthopedic x-ray imaging is presented and evaluated in terms of its fundamental imaging characteristics. The system is based on the micromesh gaseous structure detector and achieves primary signal amplification through electronic avalanche in the gas. This feature, together with high quantum detection efficiency and fan-beam geometry, allows for imaging at low radiation levels. The system is composed of 1764 channels spanning a width of 44.8 cm and is capable of imaging an entire patient at speeds of up to 15 cm/s. The resolution was found to be anisotropic and significantly affected by the beam quality in the horizontal direction, but otherwise sufficient for orthopedic studies. As a consequence of line-by-line acquisition, the images contain some ripple components due to mechanical vibrations combined with variations in the x-ray tube output power. The reported detective quantum efficiency (DQE) values are relatively low (0.14 to 0.20 at 0.5 mm(-1)) as a consequence of a suboptimal collimation geometry. The DQE values were found to be unaffected by the exposure down to 7 microGy, suggesting that the system is quantum limited even for low radiation levels. A system composed of two orthogonal detectors is already in use and can produce dual-view full body scans at low doses. This device could contribute to reduce the risk of radiation induced cancer in sensitive clientele undergoing intensive x-ray procedures, like young scoliotic women.

  14. Limiting loss to follow-up in a multicenter randomized trial in orthopedic surgery.

    PubMed

    Sprague, Sheila; Leece, Pamela; Bhandari, Mohit; Tornetta, Paul; Schemitsch, Emil; Swiontkowski, Marc F

    2003-12-01

    Even the best-designed, randomized controlled trials suffer when patients are lost to follow-up. Incomplete follow-up biases the results of a trial when patients who drop out are different from those who complete follow-up. This is exaggerated further when there are differential dropout rates between study groups. Previous randomized controlled trials in orthopedic trauma have reported up to 28% loss to follow-up. Only by striving to achieve a 0% loss to follow-up rate can we be certain that this type of bias does not affect our results. In our ongoing multicenter, randomized controlled trial comparing reamed and nonreamed intramedullary nailing of tibial shaft fractures, we have implemented several innovative strategies to minimize loss to follow-up. The exclusion criteria and consent process are designed to minimize losses. Study staff are carefully trained in communication and negotiation with patients. Additionally, a central methods center monitors all patient follow-up and aids in finding lost patients. Through these primary, secondary, and tertiary interventions, we have achieved 94% complete 1-year follow-up for the first 440 patients enrolled in the trial. Eleven patients withdrew consent, and we are unable to locate 17 patients. We have successfully minimized the loss to follow-up rate in our trial by incorporating innovative prevention and retention strategies into its design and conduct. Through planning, organization, and committing time and resources to minimizing loss to follow-up, other orthopedic trauma trials can hope to achieve the same high rates of follow-up.

  15. Clinics in Orthopedic Surgery's Evolution into an International Journal Based on Journal Metrics

    PubMed Central

    2016-01-01

    This article is aimed at providing evidence of increased international recognition of Clinics in Orthopedic Surgery (CiOS) based on journal metrics. Since 7 years have passed since its launch in 2009, it is time to reflect on the journal's efforts to be recognized as a top-notch journal. The following journal metrics were analyzed from the journal's homepage and Web of Science Core Collection database: number of citable and noncitable articles; number of original articles supported by grants; editorial board members' countries; authors' countries; citing authors' countries; source titles of citing articles; impact factor; total citations; comparison of impact factor with 3 Science Citation Index Expanded journals; and Hirsch index (H-index). Of the total 392 articles, 378 were citable articles (96.4%). Of the total 282 original articles, 52 (18.4%) were supported by research grants. The editorial board members were from 13 countries. Authors were from 20 countries. The number of countries of citing authors was 66. The number of source titles of citing articles was more than 100. The total citations of CiOS have increased from 0 in 2009 to 374 in 2015. The impact factors without self-citations of CiOS were the greatest among 4 Asian journals in 2013 and 2014. The 2015 impact factor was calculated as 0.79 in January 2016. The H-index was 13. CiOS can be considered to have reached the level of top-notch journal in the orthopedic field based on journal metrics. The inclusion of the journal in PubMed Central appears to have increased international relevance of the journal. PMID:27247735

  16. Mechanical properties of dispersed ceramic nanoparticles in polymer composites for orthopedic applications

    PubMed Central

    Liu, Huinan; Webster, Thomas J

    2010-01-01

    Ceramic/polymer composites have been considered as third-generation orthopedic biomaterials due to their ability to closely match properties (such as surface, chemistry, biological, and mechanical) of natural bone. It has already been shown that the addition of nanophase compared with conventional (or micron-scale) ceramics to polymers enhances bone cell functions. However, in order to fully take advantage of the promising nanometer size effects that nanoceramics can provide when added to polymers, it is critical to uniformly disperse them in a polymer matrix. This is critical since ceramic nanoparticles inherently have a strong tendency to form larger agglomerates in a polymer matrix which may compromise their properties. Therefore, in this study, model ceramic nanoparticles, specifically titania and hydroxyapatite (HA), were dispersed in a model polymer (PLGA, poly-lactic-co-glycolic acid) using high-power ultrasonic energy. The mechanical properties of the resulting PLGA composites with well-dispersed ceramic (either titania or HA) nanoparticles were investigated and compared with composites with agglomerated ceramic nanoparticles. Results demonstrated that well-dispersed ceramic nanoparticles (titania or HA) in PLGA improved mechanical properties compared with agglomerated ceramic nanoparticles even though the weight percentage of the ceramics was the same. Specifically, well-dispersed nanoceramics in PLGA enhanced the tensile modulus, tensile strength at yield, ultimate tensile strength, and compressive modulus compared with the more agglomerated nanoceramics in PLGA. In summary, supplemented by previous studies that demonstrated greater osteoblast (bone-forming cell) functions on well-dispersed nanophase ceramics in polymers, the present study demonstrated that the combination of PLGA with well-dispersed nanoceramics enhanced mechanical properties necessary for load-bearing orthopedic/dental applications. PMID:20463945

  17. Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats

    PubMed Central

    2012-01-01

    Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Results Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%), and thickening, 0-59% (specificity, 74-99%). Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5); the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral). Conclusions Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD. PMID:22281125

  18. Clinics in Orthopedic Surgery's Evolution into an International Journal Based on Journal Metrics.

    PubMed

    Huh, Sun

    2016-06-01

    This article is aimed at providing evidence of increased international recognition of Clinics in Orthopedic Surgery (CiOS) based on journal metrics. Since 7 years have passed since its launch in 2009, it is time to reflect on the journal's efforts to be recognized as a top-notch journal. The following journal metrics were analyzed from the journal's homepage and Web of Science Core Collection database: number of citable and noncitable articles; number of original articles supported by grants; editorial board members' countries; authors' countries; citing authors' countries; source titles of citing articles; impact factor; total citations; comparison of impact factor with 3 Science Citation Index Expanded journals; and Hirsch index (H-index). Of the total 392 articles, 378 were citable articles (96.4%). Of the total 282 original articles, 52 (18.4%) were supported by research grants. The editorial board members were from 13 countries. Authors were from 20 countries. The number of countries of citing authors was 66. The number of source titles of citing articles was more than 100. The total citations of CiOS have increased from 0 in 2009 to 374 in 2015. The impact factors without self-citations of CiOS were the greatest among 4 Asian journals in 2013 and 2014. The 2015 impact factor was calculated as 0.79 in January 2016. The H-index was 13. CiOS can be considered to have reached the level of top-notch journal in the orthopedic field based on journal metrics. The inclusion of the journal in PubMed Central appears to have increased international relevance of the journal.

  19. Orthopedic intrusion of premaxilla with distraction devices before alveolar bone grafting in patients with bilateral cleft lip and palate.

    PubMed

    Liou, Eric Jein-Wein; Chen, Philip K T; Huang, C Shing; Chen, Y Ray

    2004-03-01

    Surgical repositioning of the downward displaced premaxilla in bilateral cleft lip and palate patients remains a controversial and perplexing issue because of its detrimental effects on the growth of the premaxilla. The purpose of this prospective clinical study was to introduce and evaluate the treatment results of an innovative technique for nonsurgically intruding the downward displaced premaxilla. Eight consecutive cases of bilateral cleft lip and palate at the age of mixed dentition were included for the correction of their premaxillary deformities. A pair of intraoral tooth-borne distraction devices was used for the orthopedic intrusion. Serial lateral and posteroanterior cephalometric radiographs were taken periodically for evaluating the growth of the premaxilla 1 year before the intrusion, changes during the intrusion, and growth/relapse up to 1 year after the intrusion. There was no overgrowth of the premaxilla or overeruption of the maxillary incisors during the 1-year observing period before the orthopedic intrusion. The treatment results revealed that the downward displaced premaxillae were all corrected within 1 month. Cephalometrically, 46 percent of the correction resulted from a true orthopedic intrusion and another 54 percent from a dentoalveolar effect in which the maxillary incisors were intruded and the premaxillary dentoalveolus was shortened. The cephalometric evaluations also implied that what occurred during the orthopedic intrusion was mostly the sutural contraction osteogenesis/osteolysis in the vomeropremaxillary suture combined with slightly mechanical upward displacement of the vomeronasal septum complex and nasal bones. The orthopedic intrusion of the premaxilla with distraction devices is an effective nonsurgical method for correcting the downward displaced premaxilla before alveolar bone grafting in patients with bilateral cleft lip and palate, and the results remained stable after 1 year.

  20. Precision manipulation with a dextrous robot hand

    NASA Astrophysics Data System (ADS)

    Michelman, Paul

    1994-01-01

    In this thesis, we discuss a framework for describing and synthesizing precision manipulation tasks with a robot hand. Precision manipulations are those in which the motions of grasped objects are caused by finger motions alone (as distinct from arm or wrist motion). Experiments demonstrating the capabilities of the Utah-MIT hand are presented. This work begins by examining current research on biological motor control to raise a number of questions. For example, is the control centralized and organized by a central processor? Or is the control distributed throughout the nervous system? Motor control research on manipulation has focused on developing classifications of hand motions, concentrating solely on finger motions, while neglecting grasp stability and interaction forces that occur in manipulation. In addition, these taxonomies have not been explicitly functional. This thesis defines and analyzes a basic set of manipulation strategies that includes both position and force trajectories. The fundamental purposes of the manipulations are: (1) rectilinear and rotational motion of grasped objects of different geometries; and (2) the application of forces and moments against the environment by the grasped objects. First, task partitioning is described to allocate the fingers their roles in the task. Second, for each strategy, the mechanics and workspace of the tasks are analyzed geometrically to determine the gross finger trajectories required to achieve the tasks. Techniques illustrating the combination of simple manipulations into complex, multiple degree-of-freedom tasks are presented. There is a discussion of several tasks that use multiple elementary strategies. The tasks described are removing the top of a childproof medicine bottle, putting the top back on, rotating and regrasping a block and a cylinder within the grasp. Finally, experimental results are presented. The experimental setup at Columbia University's Center for Research in Intelligent Systems and

  1. Distinguishing manipulated stocks via trading network analysis

    NASA Astrophysics Data System (ADS)

    Sun, Xiao-Qian; Cheng, Xue-Qi; Shen, Hua-Wei; Wang, Zhao-Yang

    2011-10-01

    Manipulation is an important issue for both developed and emerging stock markets. For the study of manipulation, it is critical to analyze investor behavior in the stock market. In this paper, an analysis of the full transaction records of over a hundred stocks in a one-year period is conducted. For each stock, a trading network is constructed to characterize the relations among its investors. In trading networks, nodes represent investors and a directed link connects a stock seller to a buyer with the total trade size as the weight of the link, and the node strength is the sum of all edge weights of a node. For all these trading networks, we find that the node degree and node strength both have tails following a power-law distribution. Compared with non-manipulated stocks, manipulated stocks have a high lower bound of the power-law tail, a high average degree of the trading network and a low correlation between the price return and the seller-buyer ratio. These findings may help us to detect manipulated stocks.

  2. Better with Byzantine: Manipulation-Optimal Mechanisms

    NASA Astrophysics Data System (ADS)

    Othman, Abraham; Sandholm, Tuomas

    A mechanism is manipulable if it is in some agents’ best interest to misrepresent their private information. The revelation principle establishes that, roughly, anything that can be accomplished by a manipulable mechanism can also be accomplished with a truthful mechanism. Yet agents often fail to play their optimal manipulations due to computational limitations or various flavors of incompetence and cognitive biases. Thus, manipulable mechanisms in particular should anticipate byzantine play. We study manipulation-optimal mechanisms: mechanisms that are undominated by truthful mechanisms when agents act fully rationally, and do better than any truthful mechanism if any agent fails to act rationally in any way. This enables the mechanism designer to do better than the revelation principle would suggest, and obviates the need to predict byzantine agents’ irrational behavior. We prove a host of possibility and impossibility results for the concept which have the impression of broadly limiting possibility. These results are largely in line with the revelation principle, although the considerations are more subtle and the impossibility not universal.

  3. A Modular Approach to Video Designation of Manipulation Targets for Manipulators

    DTIC Science & Technology

    2014-05-12

    taxing to manipulate (i.e. rotate and zoom) and visualize point cloud data dur- ing an EOD operation, 2) 3D sensors that create data which is easy to...The light blue sphere represents the estimated workspace of the manipulator, the coordinate frame at the top left is the camera’s frame, the pink line

  4. A Molecular Analysis of Training Multiple versus Single Manipulations to Establish a Generalized Manipulative Imitation Repertoire

    ERIC Educational Resources Information Center

    Hartley, Breanne K.

    2009-01-01

    This study evaluates the necessity of training multiple versus single manipulative-imitations per object in order to establish generalized manipulative-imitation. Training took place in Croyden Avenue School's Early Childhood Developmental Delay preschool classroom in Kalamazoo, MI. Two groups of 3 children each were trained to imitate in order to…

  5. Manipulators live better, but are they always parasites?

    PubMed

    Heil, Martin

    2015-09-01

    A recent study reports partner manipulation for an interaction that was considered a reward-for-defence mutualism. Secretions of lycaenid caterpillars altered ant locomotion and aggressiveness, likely by manipulating dopaminergic signalling. This study opens the question whether such manipulation is common and whether manipulation necessarily characterises an interaction as parasitism.

  6. Ultrasonic resonator for manipulation of bacteria

    NASA Astrophysics Data System (ADS)

    Schwarz, T.; Dual, J.

    2012-05-01

    Ultrasonic manipulation is a contactless and gentle method to manipulate a large number of particles. The method presented here exploits the advantage to simultaneously move bacteria away from a surface by means of acoustic radiation forces. The device for the manipulation consists of five layers (transducer, epoxy adhesive layer, carrier, fluid, reflector), stacked like a conventional planar resonator. The resonator behavior was simulated using the transfer matrix method (TMM). Validation of the model was realized with admittance measurements performed over a wide frequency range (100 kHz - 16 MHz). The TMM-model was used to optimize frequency, layer thickness and material of the resonator in order to find a combination with a high force potential gradient pointing away from the reflector surface into the fluid. The resonator has been experimentally tested with polystyrene particles (1 μm in diameter) which revealed a good matching with the TMM-model. First preliminary tests with Salmonella Thyphimurium have been done.

  7. Design of multivariable controllers for robot manipulators

    NASA Technical Reports Server (NTRS)

    Seraji, H.

    1986-01-01

    The paper presents a simple method for the design of linear multivariable controllers for multi-link robot manipulators. The control scheme consists of multivariable feedforward and feedback controllers. The feedforward controller is the minimal inverse of the linearized model of robot dynamics and contains only proportional-double-derivative (PD2) terms. This controller ensures that the manipulator joint angles track any reference trajectories. The feedback controller is of proportional-integral-derivative (PID) type and achieves pole placement. This controller reduces any initial tracking error to zero as desired and also ensures that robust steady-state tracking of step-plus-exponential trajectories is achieved by the joint angles. The two controllers are independent of each other and are designed separately based on the linearized robot model and then integrated in the overall control scheme. The proposed scheme is simple and can be implemented for real-time control of robot manipulators.

  8. Force reflecting hand controller for manipulator teleoperation

    NASA Technical Reports Server (NTRS)

    Bryfogle, Mark D.

    1991-01-01

    A force reflecting hand controller based upon a six degree of freedom fully parallel mechanism, often termed a Stewart Platform, has been designed, constructed, and tested as an integrated system with a slave robot manipulator test bed. A force reflecting hand controller comprises a kinesthetic device capable of transmitting position and orientation commands to a slave robot manipulator while simultaneously representing the environmental interaction forces of the slave manipulator back to the operator through actuators driving the hand controller mechanism. The Stewart Platform was chosen as a novel approach to improve force reflecting teleoperation because of its inherently high ratio of load generation capability to system mass content and the correspondingly high dynamic bandwidth. An additional novelty of the program was to implement closed loop force and torque control about the hand controller mechanism by equipping the handgrip with a six degree of freedom force and torque measuring cell. The mechanical, electrical, computer, and control systems are discussed and system tests are presented.

  9. Manipulating cyanobacteria: Spirulina for potential CELSS diet

    NASA Technical Reports Server (NTRS)

    Tadros, Mahasin G.; Smith, Woodrow; Mbuthia, Peter; Joseph, Beverly

    1989-01-01

    Spirulina sp. as a bioregenerative photosynthetic and an edible alga for spacecraft crew in a CELSS, was characterized for the biomass yield in batch cultures, under various environmental conditions. The partitioning of the assimalitory products (proteins, carbohydrates, lipids) were manipulated by varying the environmental growth conditions. Experiments with Spirulina have shown that under stress conditions (i.e., high light 160 uE/sq m/s, temperature 38 C, nitrogen or phosphate limitation; 0.1 M sodium chloride) carbohydrates increased at the expense of proteins. In other experiments, where the growth media were sufficient in nutrients and incubated under optimum growth conditions, the total of the algal could be manipulated by growth conditions. These results support the feasibility of considering Spirulina as a subsystem in CELSS because of the ease with which its nutrient content can be manipulated.

  10. Sensing Temperatures Via Prostheses And Manipulators

    NASA Technical Reports Server (NTRS)

    Zerkus, Mike

    1991-01-01

    Proposed temperature-sensing system applies heat to (or removes heat from) human user's skin according to temperature of remote object. Used in artificial limbs and in telerobotic manipulators. In prosthetic arm and hand, sensors on tips of artificial fingers send signals to electronic control network that drives small, lightweight thermoelectric heat pump worn on back of user's shoulder. Heat pump heats or cools skin according to signals from sensors. Heat pump and control network worn like article of clothing. In manual control of remote robot, sensors placed in fingers of remote manipulator. Sensors drive, via similar electronic control network, thermoelectric heat pumps in fingers of glove worn by operator, who then has benefit of information about temperatures on manipulated object.

  11. Space station erectable manipulator placement system

    NASA Technical Reports Server (NTRS)

    Grimaldi, Margaret E. (Inventor)

    1988-01-01

    A habitable space station was proposed for low earth orbit, to be constructed from components which will be separately carried up from the earth and thereafter assembled. A suitable manipulating system having extraordinary manipulative capability is required. The invention is an erectable manipulator placement system for use on a space station and comprises an elongate, lattice-like boom having guide tracks attached thereto, a carriage-like assembly pivotally mounted on and extending from said dolly. The system further includes a turntable base pivotally interconnected with the proximal end of the boom and positioned either on a part of a transferring vehicle, or on another payload component being carried by the said transferring vehicle, or on the space station. Novelty resides in the use of a turntable base having a hinged boom with a dolly translatable therealong to carry the arm-like assembly, thus providing an additional 3 degrees of freedom to the arm.

  12. Television systems for remote manipulation. [in space

    NASA Technical Reports Server (NTRS)

    Crooks, W. H.; Freedman, L. A.; Coan, P. P.

    1975-01-01

    An analytical and experimental study was conducted to specify a video system for remote manipulation in space. An operator function analysis identified two basic characteristics, work volume and element relationship, which define four manipulation tasks chosen for examination. A visual function analysis developed a set of elemental scene parameters which grouped the visual dimensions into major areas of influence. Simulation testing was conducted with a four degree-of-freedom motion frame which allowed an operator to perform the manipulation tasks. Four video systems were included in the simulation testing: a black and white and a color monoscopic system, a stereoscopic system, and a black and white two-view system. A sequential experimental plan first provided an overall analysis of the effects of tasks, scene parameters, and video systems. This was followed by a detailed experimental examination of the critical dimensions identified in the first experiment. Results are discussed in terms of a recommended TV system.

  13. Manipulator system for constructing overhead distribution lines

    SciTech Connect

    Ohnishi, H.; Tsuchihashi, H.; Waki, S.; Mochizuki, K. ); Yamamoto, T.; Watanabe, H. ); Furukawa, H. )

    1993-04-01

    This paper describes the manipulator for live-line construction of high-voltage overhead power transmission lines (line voltage 6.6 kV) that is being jointly developed by Tokyo Electric Power and other companies. It describes this system's development concept, makeup, functions, and design, as well as operability tests using actual-scale transmission line poles. In this research, development began in 1984. As the first step, a prototype model of a ground-mounted twin-arm manipulator was trial-manufactured in 1985. As the second step, in 1988 a truck-mounted system was developed in which the twin-arm manipulator was mounted on a cherrypicker vehicle. As the third step, a practical system was developed based on these results.

  14. Cooperative control of multiple space manipulators

    NASA Astrophysics Data System (ADS)

    Nahon, M.; Angeles, J.

    The control of multi-armed robotic systems is inherently more complex than that of single-arm systems. Whereas a single manipulator can be controlled purely through positions or velocities, multiple manipulators handling a common payload must also be controlled in terms of forces. In this paper, the problem of finding force setpoints for the controller is formulated as a constrained optimization problem where the constraints are provided by the dynamics equations and the actuator capabilities. A number of potential objective functions which may be minimized are reviewed including the internal force, a norm of the vector of actuator torques and power losses in the system. These are then compared for a task in which the Special Purpose Dextrous Manipulator (SPDM) moves a payload in the absence of gravity. It is concluded that the actuator torque criterion appears to offer the worst compromise in performance, while the minimum internal force and minimum power loss criteria each have their advantages.

  15. Manipulation of microfluidic droplets by electrorheological fluid.

    PubMed

    Zhang, Menying; Gong, Xiuqing; Wen, Weijia

    2009-09-01

    Microfluidics, especially droplet microfluidics, attracts more and more researchers from diverse fields, because it requires fewer materials and less time, produces less waste and has the potential of highly integrated and computer-controlled reaction processes for chemistry and biology. Electrorheological fluid, especially giant electrorheological fluid (GERF), which is considered as a kind of smart material, has been applied to the microfluidic systems to achieve active and precise control of fluid by electrical signal. In this review article, we will introduce recent results of microfluidic droplet manipulation, GERF and some pertinent achievements by introducing GERF into microfluidic system: digital generation, manipulation of "smart droplets" and droplet manipulation by GERF. Once it is combined with real-time detection, integrated chip with multiple functions can be realized.

  16. Coordinated Control Of Mobile Robotic Manipulators

    NASA Technical Reports Server (NTRS)

    Seraji, Homayoun

    1995-01-01

    Computationally efficient scheme developed for on-line coordinated control of both manipulation and mobility of robots that include manipulator arms mounted on mobile bases. Applicable to variety of mobile robotic manipulators, including robots that move along tracks (typically, painting and welding robots), robots mounted on gantries and capable of moving in all three dimensions, wheeled robots, and compound robots (consisting of robots mounted on other robots). Theoretical basis discussed in several prior articles in NASA Tech Briefs, including "Increasing the Dexterity of Redundant Robots" (NPO-17801), "Redundant Robot Can Avoid Obstacles" (NPO-17852), "Configuration-Control Scheme Copes With Singularities" (NPO-18556), "More Uses for Configuration Control of Robots" (NPO-18607/NPO-18608).

  17. Electrochemical Processes Enhanced by Acoustic Liquid Manipulation

    NASA Technical Reports Server (NTRS)

    Oeftering, Richard C.

    2004-01-01

    Acoustic liquid manipulation is a family of techniques that employ the nonlinear acoustic effects of acoustic radiation pressure and acoustic streaming to manipulate the behavior of liquids. Researchers at the NASA Glenn Research Center are exploring new methods of manipulating liquids for a variety of space applications, and we have found that acoustic techniques may also be used in the normal Earth gravity environment to enhance the performance of existing fluid processes. Working in concert with the NASA Commercial Technology Office, the Great Lakes Industrial Technology Center, and Alchemitron Corporation (Elgin, IL), researchers at Glenn have applied nonlinear acoustic principles to industrial applications. Collaborating with Alchemitron Corporation, we have adapted the devices to create acoustic streaming in a conventional electroplating process.

  18. Intra-operative 3D imaging system for robot-assisted fracture manipulation.

    PubMed

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

    2015-01-01

    Reduction is a crucial step in the treatment of broken bones. Achieving precise anatomical alignment of bone fragments is essential for a good fast healing process. Percutaneous techniques are associated with faster recovery time and lower infection risk. However, deducing intra-operatively the desired reduction position is quite challenging due to the currently available technology. The 2D nature of this technology (i.e. the image intensifier) doesn't provide enough information to the surgeon regarding the fracture alignment and rotation, which is actually a three-dimensional problem. This paper describes the design and development of a 3D imaging system for the intra-operative virtual reduction of joint fractures. The proposed imaging system is able to receive and segment CT scan data of the fracture, to generate the 3D models of the bone fragments, and display them on a GUI. A commercial optical tracker was included into the system to track the actual pose of the bone fragments in the physical space, and generate the corresponding pose relations in the virtual environment of the imaging system. The surgeon virtually reduces the fracture in the 3D virtual environment, and a robotic manipulator connected to the fracture through an orthopedic pin executes the physical reductions accordingly. The system is here evaluated through fracture reduction experiments, demonstrating a reduction accuracy of 1.04 ± 0.69 mm (translational RMSE) and 0.89 ± 0.71 ° (rotational RMSE).

  19. Design of a reconfigurable modular manipulator system

    NASA Technical Reports Server (NTRS)

    Schmitz, D.; Kanade, T.

    1987-01-01

    Using manipulators with a fixed configuration for specific tasks is appropriate when the task requirements are known beforehand. However, in less predictable situations, such as an outdoor construction site or aboard a space station, a manipulator system requires a wide range of capabilities, probably beyond the limitations of a single, fixed-configuration manipulator. To fulfill this need, researchers have been working on a Reconfigurable Modular Manipulator System (RMMS). Researchers have designed and are constructing a prototype RMMS. The prototype currently consists of two joint modules and four link modules. The joints utilize a conventional harmonic drive and torque motor actuator, with a small servo amplifier included in the assembly. A brushless resolver is used to sense the joint position and velocity. For coupling the modules together, a standard electrical connector and V-band clamps for mechanical connection are used, although more sophisticated designs are under way for future versions. The joint design yields an output torque to 50 ft-lbf at joint speeds up to 1 radian/second. The resolver and associated electronics have resolutions of 0.0001 radians, and absolute accuracies of plus or minus 0.001 radians. Manipulators configured from these prototype modules will have maximum reaches in the 0.5 to 2 meter range. The real-time RMMS controller consists of a Motorola 68020 single-board computer which will perform real time servo control and path planning of the manipulator. This single board computer communicates via shared memory with a SUN3 workstation, which serves as a software development system and robot programming environment. Researchers have designed a bus communication network to provide multiplexed communication between the joint modules and the computer controller. The bus supports identification of modules, sensing of joint states, and commands to the joint actuator. This network has sufficient bandwidth to allow servo sampling rates in

  20. Holographic assembly workstation for optical manipulation

    NASA Astrophysics Data System (ADS)

    Gibson, Graham; Carberry, David M.; Whyte, Graeme; Leach, Jonathan; Courtial, Johannes; Jackson, Joseph C.; Robert, Daniel; Miles, Mervyn; Padgett, Miles

    2008-04-01

    We report a holographic assembler workstation for optical trapping and micro-manipulation. The workstation is based on a titanium sapphire laser, making it particularly suited for biomaterials and incorporates a choice of user interfaces for different applications. The system is designed around a commercial inverted microscope and is configured such that it can be easily used by the non-specialist. We demonstrate the bio-capabilities of our system by manipulating a group of yeast cells, a single red blood cell and a single cell of the green algae colony Volvox.