Sample records for open lateral internal

  1. Effect of the Rhinoplasty Technique and Lateral Osteotomy on Periorbital Edema and Ecchymosis.

    PubMed

    Kiliç, Caner; Tuncel, Ümit; Cömert, Ela; Şencan, Ziya

    2015-07-01

    The present study aimed to compare edema and ecchymosis in the early and late postoperative periods following the application of different surgical techniques (open and endonasal) and different types of lateral osteotomy (internal and external). The files and photographs of a total of 120 patients whose records were regularly maintained/updated and who underwent septorhinoplasty operation with the same surgeon were retrospectively evaluated. Sixty-nine (57.5%) patients were women and 51 (43.5%) were men. The patients were divided into 4 different groups according to the operations they underwent as follows--Group I: open technique septorhinoplasty + internal/continuous lateral osteotomy; Group II: endonasal rhinoplasty + internal/continuous lateral osteotomy; Group III: open technique septorhinoplasty + external/perforating lateral osteotomy; and Group IV: endonasal rhinoplasty + external/perforating lateral osteotomy. Postoperative edema and ecchymosis, and lateral nasal wall mucosal damage because of osteotomy were evaluated. Postoperative second day edema and ecchymosis scores were statistically significantly better in patients in Group II compared with the patients in Group I (P = 0.010 and P = 0.004, respectively). Postoperative first day edema and postoperative seventh day ecchymosis scores were statistically significantly better in the patients in Group IV compared with the patients in Group III (P = 0.025 and P = 0.011, respectively). Intraoperative bleeding was similar in all groups. The nasal tip was more flexible in patients who underwent closed technique rhinoplasty. Unilateral mucosal damage occurred in 3 patients (4%) with internal lateral osteotomy, whereas no mucosal damage was present in patients with external osteotomy. The difference in the rate of edema and ecchymosis in the early postoperative period between the closed technique rhinoplasty and the open surgical approach was statistically significant, whereas osteotomy did not cause a significant difference. According to these results, the authors suggest endonasal surgery to prevent the development of edema and ecchymosis, whereas the choice of lateral osteotomy should be dependent on the experience of the surgeon.

  2. Surgical stabilization of shoulder luxation in a pot-bellied pig.

    PubMed

    Rubio-Martínez, Luis M; Rioja, Eva; Shakespeare, A S

    2013-03-15

    Case Description-A 4.6-month-old pot-bellied pig was evaluated because of non-weight-bearing lameness (grade 5/5) in the right forelimb of 4 days' duration. Clinical Findings-Clinical and radiographic examination revealed a closed, lateral luxation of the right shoulder joint. Treatment and Outcome-Initial attempts at closed reduction failed to provide adequate stability of the shoulder joint. Open reduction and internal fixation by placement of 2 lateral tension sutures with a system designed for canine cranial cruciate ligament repair provided adequate joint stability and a successful outcome. Conclusions and Clinical Relevance-Stabilization of the shoulder joint with lateral tension sutures after open reduction should be considered for management of lateral shoulder luxation in pot-bellied pigs.

  3. Outcome of Surgical Fixation of Lateral Column Distal Humerus Fractures.

    PubMed

    Von Keudell, Arvind; Kachooei, Amir R; Moradi, Ali; Jupiter, Jesse B

    2016-05-01

    The purpose of this study was to report the long-term outcome and complications of surgically fixated lateral unicondylar distal humerus fractures. Retrospective Review. Two level 1 Trauma Centers, Massachusetts General Hospital and Brigham and Women's Hospital. Between 2002 and 2014, 24 patients treated with open reduction and internal fixation for lateral unicondylar distal humerus fractures (OTA/AO type B1 fractures) were retrospectively reviewed. Open reduction and internal fixation. Union rates, early complications, functional outcome, and the range of elbow motion were evaluated. Disabilities of the arm, shoulder, and hand, Mayo elbow Performance Index, satisfaction, pain scale, and American Shoulder and Elbow Surgeons. The mean age of patients was 46 ± 23 years at the time of surgery. The average final flexion/extension arc of motion was 108°. Reoperations were performed in 9 of 24 elbows after an average 21 ± 31 months. Twenty of the 24 patients were available for the clinical follow-up at an average of 70 months (range: 16-144 months). Disabilities of the arm, shoulder, and hand averaged at 10.8 ± 11.7 points, satisfaction at 9.5 ± 1.2, American Shoulder and Elbow Surgeons score at 88.5 ± 13.3 points at final follow-up. Based on the functional classification proposed by Jupiter, 16 demonstrated good to excellent results, 2 fair and 2 poor result. Outcome of open reduction and internal fixation of isolated lateral column distal humerus fractures can result in high union rates with acceptable outcome scores and high patient satisfaction despite a high reoperation rate. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  4. Management of complications of open reduction and internal fixation of ankle fractures.

    PubMed

    Ng, Alan; Barnes, Esther S

    2009-01-01

    The management of complications resulting from the open reduction and internal fixation of ankle fractures is discussed in detail. The initial radiographic findings of the most common postsurgical complications of ankle fracture reduction are briefly discussed, namely lateral, medial, and posterior malleolar malunion or nonunion, syndesmotic widening, degenerative changes, and septic arthritis with or without concomitant osteomyelitis. Emphasis is placed on the management of these complications, with a review of the treatment options proposed in the literature, a detailed discussion of the authors' recommendations, and an inclusion of different case presentations.

  5. [Operative treatment and curative effects of the deltoid ligament injuries of the ankle joint].

    PubMed

    Cong, Pei-Jun; Liu, Bai-Hong; Wang, Ji-Ping; Qiao, Yong-Ping

    2009-12-01

    To explore the operative methods and curative effects of the deltoid ligament injuries. From 2002 to 2008, all 61 patients with ankle fractures complicated with deltoid ligament injuries were treated with open reduction and firm internal fixation. Among the patients, 39 patients were male and 22 patients were female, ranging in age from 14 to 71 years, with an average of 41 years. During the operation, the deltoid ligament was reconstructed to restore the medial and lateral stability of ankle joint. All the patients were followed up ranged from 5 to 30 months, with an average of 17 months. Fifty-nine patients had incision healed at the first stage; 2 patients had superficial infections at lateral malleolus, and healed at the 3rd week after changing dressings. The incisions at the internal medial malleolus were all healed at the first stage. According to Qi evaluation criteria, 35 patients got an excellent result, 13 good and 13 fair. The deltoid ligament should be treated properly in the treatment of ankle joint fractures when open reduction and firm internal fixation were emphasized.

  6. Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach.

    PubMed

    Ono, Hiroshi; Furuta, Kazuhiko; Fujitani, Ryotaro; Katayama, Takeshi; Akahane, Manabu

    2010-07-01

    The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopyguided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of > or = 2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after internal fixation.

  7. A nonsurgical endodontic treatment in open-apex and immature teeth affected by dens invaginatus: using a collagen membrane as an apical barrier.

    PubMed

    Gharechahi, Maryam; Ghoddusi, Jamileh

    2012-02-01

    The authors' objective in this case report is to demonstrate an effective nonsurgical endodontic treatment in open-apex teeth affected by dens invaginatus (DI) by using a collagen membrane as an apical barrier and using a mineral trioxide aggregate (MTA) apical plug. . The authors present two cases of DI with open apexes in maxillary lateral incisors. In the first case, an adolescent had bilateral Oehlers type II DI and extensive periradicular radiolucency, internal root resorption and a vestibular fistula in the left maxillary lateral incisor. In the second case, an adult had Oehlers type II DI and an incomplete apex in the left maxillary lateral incisor. For both patients, the clinician placed a collagen membrane through the apexes of the left maxillary incisors to provide a resorbable extraradicular barrier against which MTA cement could be packed. The clinician obturated the adolescent's right lateral incisor. In the adolescent, the vestibular sinus tract was closed after one week. At subsequent follow-up examinations, the periradicular regions were completely healed, and postoperative radiographs revealed good bone healing in the lateral incisors. The teeth were asymptomatic and healing was achieved without any need for further endodontic surgical intervention. In the adult patient, the tooth was symptom free after one week, and radiography performed six months after the procedure showed complete healing. and Despite complex anatomy and diagnoses of DI and open apexes, both patients successfully underwent nonsurgical endodontic treatment involving the use of a collagen membrane and an MTA apical plug. Using an extraradicular barrier clinically can help improve the adaptation of MTA in the apexes of open-apex teeth to achieve a complete seal.

  8. Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture

    PubMed Central

    Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

    2015-01-01

    Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay. PMID:26264942

  9. View of the STS-98 orbiter Atlantis on approach to ISS

    NASA Image and Video Library

    2001-02-09

    ISS001-E-6128 (9 February 2001) --- Atlantis was photographed from the International Space Station (ISS) prior to link-up with international outpost at 10:50 a.m. (CST), Feb. 9, 2001, as the two craft flew over the Western Pacific northeast of New Guinea. About ninety minutes later, hatches were swung open between Atlantis and the ISS, enabling the STS-98 and station crews to greet each other and transfer critical gear before re-closure later in preparation for the first (Feb. 10) of three planned space walks to help in the installation and hookup of Destiny on the station. The photograph was taken with a digital still camera.

  10. Astronauts Cockrell, Shepherd and Polansky during hatch opening

    NASA Image and Video Library

    2001-02-11

    STS98-E-5130 (11 February 2001) --- The crews of Atlantis and the International Space Station open the Destiny laboratory on February 11 in this digital still camera view. From the left are astronauts Kenneth D. Cockrell, STS-98 commander; William M. (Bill) Shepherd, Expedition One commander; and Mark L. Polansky, STS-98 pilot. Later, the astronauts and cosmonauts spent the first full day of what are planned to be years of work ahead inside the orbiting science and command center. After Shepherd opened the Destiny hatch, he and Cockrell ventured inside at 8:38 a.m. (CST). As depicted in subsequent digital images in this series, members of both crews went to work quickly inside the new module, activating air systems, fire extinguishers, alarm systems, computers and internal communications. The crew also continued equipment transfers from the shuttle to the station.

  11. Astronauts Cockrell, Shepherd and Polansky during hatch opening

    NASA Image and Video Library

    2001-02-11

    STS98-E-5131 (11 February 2001) --- The crews of Atlantis and the International Space Station open the Destiny laboratory on February 11 in this digital still camera view. From the left are astronauts Kenneth D. Cockrell, STS-98 commander; William M. (Bill) Shepherd, Expedition One commander; and Mark L. Polansky, STS-98 pilot. Later, the astronauts and cosmonauts spent the first full day of what are planned to be years of work ahead inside the orbiting science and command center. After Shepherd opened the Destiny hatch, he and Cockrell ventured inside at 8:38 a.m. (CST). As depicted in subsequent digital images in this series, members of both crews went to work quickly inside the new module, activating air systems, fire extinguishers, alarm systems, computers and internal communications. The crew also continued equipment transfers from the shuttle to the station.

  12. Is fibular fracture displacement consistent with tibiotalar displacement?

    PubMed

    van den Bekerom, Michel P J; van Dijk, C Niek

    2010-04-01

    We believed open reduction with internal fixation is required for supination-external rotation ankle fractures located at the level of the distal tibiofibular syndesmosis (Lauge-Hanssen SER II and Weber B) with 2 mm or more fibular fracture displacement. The rationale for surgery for these ankle fractures is based on the notion of elevated intraarticular contact pressures with lateral displacement. To diagnose these injuries, we presumed that in patients with a fibular fracture with at least 2 mm fracture displacement, the lateral malleolus and talus have moved at least 2 mm in a lateral direction without medial displacement of the proximal fibula. We reviewed 55 adult patients treated operatively for a supination-external rotation II ankle fracture (2 mm or more fibular fracture displacement) between 1990 and 1998. On standard radiographs, distance from the tibia to the proximal fibula, distance from the tibia to the distal fibula, and displacement at the level of the fibular fracture were measured. These distances were compared preoperatively and postoperatively. We concluded tibiotalar displacement cannot be reliably assessed at the level of the fracture. Based on this and other studies, we believe there is little evidence to perform open reduction and internal fixation of supination-external rotation II ankle fractures. Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.

  13. Successful treatment of open jaw and jaw deviation dystonia with botulinum toxin using a simple intraoral approach.

    PubMed

    Moscovich, Mariana; Chen, Zhongxing Peng; Rodriguez, Ramon

    2015-03-01

    Oromandibular dystonia (OMD) is a focal dystonia that involves the mouth, jaw, and/or tongue. It can be classified as idiopathic, tardive dystonia or secondary to other neurological disorders and subdivided into jaw opening, jaw closing, jaw deviation and lip pursing. The muscles involved in jaw opening dystonia are usually the digastrics and lateral pterygoids. It is known that the lateral pterygoids may be approached both internally and externally. The external approach is the most common; however neurologists experienced in treating patients with botulinum toxin can safely and with no extra cost perform the intraoral procedure. We report our experience in the treatment of jaw opening and jaw deviation dystonia using the intraoral injection approach. Eight patients were selected from the University of Florida with a clinical diagnosis of open jaw/jaw deviation dystonia. All of them were injected with onabotulinum toxin A using the internal approach and the clinical global impression scale was applied. The mean age of the patients was 67 (standard deviation [SD] 10.2) years, with a disease duration of 10.2 (SD 7.7) years and the mean distance they traveled to our institution was 448 km (278 miles). After treatment, six patients scored as very much improved in the clinical global impression scale and two patients scored as much improved. Only one patient reported an adverse event of nasal speech following one of the injections that improved after 4 weeks. Botulinum toxin injections for open jaw/jaw deviation dystonia can be safely performed with the intraoral approach without the need of special devices other than electromyography. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture.

    PubMed

    Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

    2015-08-11

    Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay. 2015 BMJ Publishing Group Ltd.

  15. Astronauts Cockrell, Shepherd and Polansky during hatch opening

    NASA Image and Video Library

    2001-02-11

    STS98-E-5133 (11 February 2001) --- The crew commanders of Atlantis and the International Space Station shake hands following the opening of the Destiny laboratory on February 11 in this digital still camera view. From the left are astronauts Kenneth D. Cockrell, STS-98 commander; William M. (Bill) Shepherd, Expedition One commander; and Mark L. Polansky, STS-98 pilot. Later, the astronauts and cosmonauts spent the first full day of what are planned to be years of work ahead inside the orbiting science and command center. After Shepherd opened the Destiny hatch, he and Cockrell ventured inside at 8:38 a.m. (CST). As depicted in subsequent digital images in this series, members of both crews went to work quickly inside the new module, activating air systems, fire extinguishers, alarm systems, computers and internal communications. The crew also continued equipment transfers from the shuttle to the station.

  16. Clinics in diagnostic imaging (163). Transient lateral patellar dislocation with trochlear dysplasia

    PubMed Central

    Zhang, Junwei; Lee, Chin Hwee

    2015-01-01

    A 14-year-old girl presented with left knee pain and swelling after an injury. Magnetic resonance (MR) imaging showed a transient lateral patellar dislocation with patellar osteochondral fracture, medial patellofemoral ligament tear and underlying femoral trochlear dysplasia. Open reduction and internal fixation of the osteochondral fracture, plication of the medial patellar retinaculum and lateral release were performed. As lateral patellar dislocation is often clinically unsuspected, an understanding of its characteristic imaging features is important in making the diagnosis. Knowledge of the various predisposing factors for patellar instability may also influence the choice of surgical management. We also discuss signs of acute injury and chronic instability observed on MR imaging, and the imaging features of anatomical variants that predispose an individual to lateral patellar dislocation. Treatment options and postsurgical imaging appearances are also briefly described. PMID:26512145

  17. Unrecognized anterior compartment syndrome following ankle fracture surgery: a case report.

    PubMed

    Seyahi, Aksel; Uludag, Serkan; Akman, Senol; Demirhan, Mehmet

    2009-01-01

    A 35-year-old male sustained a lateral malleolar fracture while playing football. The fracture was treated by open reduction and internal fixation with a tourniquet. The next day, the patient returned with pain and swelling of the ankle and was admitted again to the hospital with a suspected diagnosis of cellulitis. Ten hours later, the patient developed the symptoms of anterior compartment syndrome. Emergency open fasciotomy of the anterior compartment was performed. The retrospective analysis of the patient's history was suggestive of a predisposition to an exercise-induced compartment syndrome. We think that exertional increase of the compartmental pressure before the injury and the tourniquet used during surgery contributed together to the development of compartment syndrome. Physicians should be vigilant in identifying the features of compartment syndrome when managing patients injured during a sporting activity.

  18. Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure.

    PubMed

    Aslam, Muhammad I; Pervaiz, Arif; Figueiredo, Rodrigo

    2014-01-01

    Anal fissure is a common benign condition. An anorectal problem is defined as a split in the anal canal mucosa that extends from the dentate line to the anal verge. Chronic anal fissure is defined by a history of symptoms present for more than 2 months' duration and with a triad of external skin tags, namely, a hypertrophied anal papilla, an ulcer with rolled edges, and a base exposing the internal sphincter. Because complications such as incontinence are associated with surgical treatment, chemical sphincterotomy is currently favored. The objective of this study is to compare the difference in outcome between open partial lateral anal sphincterotomy and application of topical 0.2% nitroglycerin ointment for the treatment of chronic anal fissure. This was a quasi-experimental study carried out between January 16, 2007 and January 15, 2008 in the Surgical Department of Jinnah Hospital, Lahore, Pakistan. Sixty consecutive cases with a clinical diagnosis of chronic anal fissure were recruited in the study. All recruited patients met the study inclusion criteria and were randomly assigned to one of the two groups. Group A was managed conservatively using topical 0.2% nitroglycerin ointment, whereas Group B underwent open partial lateral anal sphincterotomy. Both groups were followed up at 1 week, 2 weeks, 4 weeks, and 6 weeks after the treatment. All the patients complained of pain. A total of 43 (71.7%) patients had pain with constipation, whereas 31 (51.7%) patients had bleeding per rectum. Upon clinically examining the anal area, tenderness was elicited in all 60 (100%) patients. Group A included 30 (11 females and 19 males) cases treated with topical 0.2% nitroglycerin ointment and Group B included 30 (11 females and 19 males) cases who underwent open partial lateral anal sphincterotomy. In Group A, only 15 patients with fissures were successfully treated (50%). By contrast, 28 (93%) patients with fissures in Group B were successfully treated, and only two (7%) remained uncured. These two patients (6.6%) in Group B suffered from incontinence due to flatus and feces as a complication of the procedure. This quasi-experimental study demonstrates that open partial lateral internal sphincterotomy is superior to topical 0.2% nitroglycerin application in the treatment of chronic anal fissure, with good symptomatic relief, high rate of healing, fewer side effects, and a very low rate of early continence disturbances. Copyright © 2013. Published by Elsevier B.V.

  19. FREQUENCY OF POST-OPERATIVE FAECAL INCONTINENCE IN PATIENTS WITH CLOSED AND OPEN INTERNAL ANAL SPHINCTEROTOMY.

    PubMed

    Ghayas, Nighat; Younus, Syed Muneeb; Mirani, Abdul Jabbar; Ghayasuddin, Mohammed; Qazi, Aamna; Suchdev, Sunil Dutt; Bakshi, Saqib Kamran

    2015-01-01

    Fissure in ano is one of the commonest benign and painful proctologic diseases causing considerable morbidity and reduction in quality of life. There are medical as well as surgical treatment options for anal fissure. The study was conducted to compare the frequency of postoperative faecal incontinence in patients with closed lateral internal anal sphincterotomy with von-greaves knife versus standard Park's operation (open method) for chronic anal fissure. This was a randomized controlled trial (RCT) was conducted at the Department of Surgery, KVSS, S.I.T.E. Hospital, Karachi, for a period of six months from 13th February to 12th August 2011. Ninety four consecutive patients having chronic anal fissure were assigned through blocked randomization to groups A & B, with 47 patients in each group. Closed lateral internal anal sphincterotomy (CLIAS) via von-greaves knife was carried out in patients of group-A whereas patients of group-B were subjected to open internal anal sphincterotomy (OIAS) also known as Parks' procedure. Faecal incontinence was noted on the 5th post-operative day. Data was analysed using SPSS 16. There were 81 (86.2%) males and 13 (13.8%) females with male to female ratio being 6:1. Mean age was 38.38 mp ± 14.56 years. Post-operative faecal incontinence in patients undergoing CLIAS was 4.3% while it was 21.3% in those undergoing OIAS with a p-value of 0.027. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to standard OIAS. CLIAS with von-greaves knife is effective in reducing faecal incontinence on 5th postoperative day as compared to OIAS (Park's procedure). Therefore, this technique may be used in future regularly to treat chronic anal fissure for prevention of this morbidity.

  20. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years.

    PubMed

    Cameron, James I; McCauley, Julie C; Kermanshahi, Arash Y; Bugbee, William D

    2015-06-01

    Distal femoral varus osteotomy may be used to treat valgus knee malalignment or to protect a knee compartment in which cartilage restoration surgery (such as osteochondral or meniscus allografting) has been performed. Medial closing-wedge osteotomy has demonstrated good success in treatment of osteoarthritis in published series, but few studies have evaluated distal femoral lateral opening-wedge osteotomy in terms of correction of deformity, pain and function, and survivorship. (1) Does lateral opening-wedge osteotomy lead to accurate correction? (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? Between 2000 and 2010, we performed 40 distal femoral osteotomies. Two knees (two patients) underwent a medial closing-wedge osteotomy and were excluded from the present study. Thirty-eight knees (97%) in 36 patients were lateral opening-wedge varus-producing osteotomies; of those, 31 knees (82%) in 30 patients had followup at a minimum of 2 years (mean, 5 years; SD, 2; range, 2-12 years) and comprised the study population. The indications for osteotomy included symptomatic lateral compartment arthritis with clinical valgus deformity or a cartilage or meniscal defect in the lateral compartment with clinical valgus alignment. The study population was stratified into two groups based on reason for osteotomy: patients with isolated symptomatic lateral compartment arthritis (arthritis group; 19 knees [61%]) and patients who underwent joint preservation procedures including osteochondral allograft transplantation or meniscal allograft transplantation (joint preservation group; 12 knees [39%]). Data collection from our institution's osteotomy database included patient demographics, lower extremity coronal alignment, and operative details. Pain and function were measured preoperatively and postoperatively using the International Knee Documentation Committee (IKDC) score. Time to radiographic union, complications, and reoperations were recorded. Twenty-one of 31 knees had postoperative radiographic data available for review. Of these, seven of 15 knees in the arthritis group and three of six knees in the joint preservation group were within the correction goal of ± 3° from neutral mechanical alignment. In the arthritis group, the mean IKDC total score improved from 47 (SD, 15) preoperatively to 67 (SD, 10) postoperatively. In the joint preservation group, the mean IKDC total score improved from 36 (SD, 12) preoperatively to 62 (SD, 18) postoperatively. One nonunion occurred in the arthritis group. No postoperative complications were experienced. Ten knees in the arthritis group and six knees in the joint preservation group had additional surgery after the osteotomy, consisting primarily of hardware removal, arthroscopy for cartilage-related conditions, or conversion to arthroplasty. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. Lateral opening-wedge distal femoral osteotomy was less accurate in correction of valgus deformity than expected, but the procedure was associated with improved knee pain and function scores. Our clinical and radiographic results are comparable to published series evaluating medial closing-wedge distal femoral osteotomy. Achieving our desired correction of ± 3° from neutral alignment was clinically difficult. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. Future studies with more patients and longer followup will provide clarity on this topic. Level IV, therapeutic study.

  1. News from the Biological Stain Commission No. 11.

    PubMed

    Lyon, H O; Horobin, R W

    2012-01-01

    The 11th issue of News from the Biological Stain Commission (BSC) provides our first impressions of the REACH and ECHA programs. We intend to give a more thorough account of what these important programs actually mean in later editions of News from the Biological Stain Commission. Under the heading of Regulatory Affairs, the Biological Stain Commission's International Affairs Committee presents information from the opening session of the meeting of the International Standards Organization ISO/TC 212 Clinical laboratory testing and in vitro diagnostic test systems held on 2-4 June 2010 in Seoul, Republic of Korea.

  2. Self-designed posterior atlas polyaxial lateral mass screw-plate fixation for unstable atlas fracture.

    PubMed

    He, Baorong; Yan, Liang; Zhao, Qinpeng; Chang, Zhen; Hao, Dingjun

    2014-12-01

    Most atlas fractures can be effectively treated nonoperatively with external immobilization unless there is an injury to the transverse atlantal ligament. Surgical stabilization is most commonly achieved using a posterior approach with fixation of C1-C2 or C0-C2, but these treatments usually result in loss of the normal motion of the C1-C2 and C0-C1 joints. To clinically validate feasibility, safety, and value of open reduction and fixation using an atlas polyaxial lateral mass screw-plate construct in unstable atlas fractures. Retrospective review of patients who sustained unstable atlas fractures treated with polyaxial lateral mass screw-plate construct. Twenty-two patients with unstable atlas fractures who underwent posterior atlas polyaxial lateral mass screw-plate fixation were analyzed. Visual analog scale, neurologic status, and radiographs for fusion. From January 2011 to September 2012, 22 patients with unstable atlas fractures were treated with this technique. Patients' charts and radiographs were reviewed. Bone fusion, internal fixation placement, and integrity of spinal cord and vertebral arteries were assessed via intraoperative and follow-up imaging. Neurologic function, range of motion, and pain levels were assessed clinically on follow-up. All patients were followed up from 12 to 32 months, with an average of 22.5±18.0 months. A total of 22 plates were placed, and all 44 screws were inserted into the atlas lateral masses. The mean duration of the procedure was 86 minutes, and the average estimated blood loss was 120 mL. Computed tomography scans 9 months after surgery confirmed that fusion was achieved in all cases. There was no screw or plate loosening or breakage in any patient. All patients had well-preserved range of motion. No vascular or neurologic complication was noted, and all patients had a good clinical outcome. An open reduction and posterior internal fixation with atlas polyaxial lateral mass screw-plate is a safe and effective surgical option in the treatment of unstable atlas fractures. This technique can provide immediate reduction and preserve C1-C2 motion. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Treatment of Peripheral Talus Fractures.

    PubMed

    Shank, John R; Benirschke, Stephen K; Swords, Michael P

    2017-03-01

    Peripheral talus fractures include injuries to the lateral process, posteromedial talar body, and talar head. These injuries are rare and are often missed. Nonunion with conservative treatment is high and excision can lead to joint instability, rapid arthrosis, and earlier need for arthrodesis. Open reduction internal fixation of most peripheral talus fractures is critical to achieving a good outcome. Open reduction leads to more rapid union and ability to mobilize the ankle and subtalar joints, quicker revascularization of the talus, and lower rates of arthrosis. Surgical treatment can lead to substantial functional improvement and a slowing of the degenerative process. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Valve assembly for internal combustion engine

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

    Wakeman, R.J.; Shea, S.F.

    1989-09-05

    This patent describes an improvement in a valve assembly for an internal combustion engine of the type including a valve having a valve stem, a valve guideway for mounting this valve for reciprocal strokes between opened and seated position, and spring means for biasing the valve into the seated position. The improvement comprising a valve spool of greater cross-sectional diameter as compared to the valve stem, and a valve spool guideway within which the valve spool is movable during the strokes of the valve, an upper surface of the valve spool and a portion of the spool guideway collectively establishingmore » a damper chamber which varies in volume during the valve strokes. a feed passage for introducing oil into the damper chamber, and a bleed passage for discharging oil from the damper chamber. The bleed passages each laterally opening into the valve spool guideway.« less

  5. Clavicle fractures.

    PubMed

    Ropars, M; Thomazeau, H; Huten, D

    2017-02-01

    Management of clavicle fracture has progressed over the last decade, notably with wider use of surgery in midshaft fracture, and new techniques for lateral fracture. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patient's activity level. Whichever the segment involved, treatment for non-displaced fracture is functional; elbow-to-body sling immobilization seems the best tolerated. Apart from regular surgical indications (shoulder impaction, floating shoulder, open fracture or fracture with neurovascular complications), surgery is recommended in case of bone shortening exceeding 1.5cm in young active patients. The technique needs to take account of clavicle anatomy: notably periosteal vascularization in midshaft fracture and acromioclavicular ligament integrity and location in case of lateral fracture. Plate osteosynthesis should take account of bone diameter and 3D curvature; intramedullary fixation should take account of intramedullary canal morphology. Although iatrogenic vascular complications are rare, vessel relations and variants need to be known, especially in the medial end of the clavicle and midshaft. Lateral segment fractures are a particular entity. Large-scale randomized studies are needed to assess indications and results for the various possible internal fixation techniques: isolated or associated to ligament reconstruction, rigid or flexible, and open or arthroscopic. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Surgical treatment of displaced intra-articular calcaneal fracture using a single small lateral approach

    PubMed Central

    El-Adl, Gamal; Hassanin, Ehab Y.; Abdellatif, M-Serry

    2010-01-01

    The objective of this study was to evaluate the outcome of semi-open reduction and minimal internal fixation through a single small lateral approach as a minimally invasive technique for treatment of displaced intra-articular calcaneal fractures. This prospective study was conducted on eighteen patients (16 men and 2 women). The average age was 37.7 (22–55). The most common cause of injury was a fall from height in fourteen patients. Patients were operated on within a mean time of 4.8 days of admission (1–11 days) and were followed up for an average period of 24.1 months (6–39 months). Patients were evaluated clinically using the Creighton-Nebraska Heath Foundation Assessment score of Crosby and Fitzgibbons (J Bone Joint Surg (Am) 72-A:852–859, 1990). The scoring system proposed by Knirk and Jupiter was used for radiological assessment of the posterior subtalar joint (Knirk and Jupiter in J Bone Joint Surg (Am) 68-A: 647–659, 1986). The skin incision healed in all cases without necrosis, infection, or sural nerve injury. All fractures healed after an average of 8 weeks (7–10 weeks), and patients returned to the routine daily activities after an average time of 4.3 months (3–7 months). In conclusion, semi-open reduction and minimal internal fixation through a small lateral approach is an effective treatment for carefully selected cases of displaced intra-articular calcaneal fractures. PMID:21811904

  7. Small flake, big problem: an unreported cause of extensor pollicis longus tendon rupture.

    PubMed

    Durrant, C A T; Bantick, G

    2010-01-01

    Fracture of the base of the third metacarpal with associated avulsion of the extensor carpi radialis brevis tendon is a rare injury. We report such a fracture and the unusual resulting complication of division of the extensor pollicis longus tendon by the avulsed bony fragment. Careful monitoring using lateral radiographs is needed to make the diagnosis and displacement of the avulsed fragment warrants open reduction and internal fixation.

  8. Chad: World Oil Report 1991

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

    Not Available

    1991-08-01

    This paper reports on Mango 1, which is an exploration well started in September 1990 on a block adjacent to Lake Chad by Esso, Chevron and Shell was suspended after the coup in that nation's capital later in the year. The small Sedigi oil field, discovered in the 70s, will be developed with a pipeline to a 3,000-bpd refinery. Improved relations with Libya and future internal stability may further open the door to exploration.

  9. Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures.

    PubMed

    Zhou, Hai-Chao; Yu, Tao; Ren, Hao-Yang; Li, Bing; Chen, Kai; Zhao, You-Guang; Yang, Yun-Feng

    2017-02-01

    To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra-articular calcaneal fractures. We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group. All patients were asked to return for a research visit that included radiography and clinical evaluation. The postoperative function was evaluated using the ankle and hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and the visual analogue scale (VAS). No significant difference was found in demographics between the two groups. The corrected value of the calcaneal varus angle between the two groups is statistically significant (P < 0.05). The overall wound complication rate was 3.6% in the minimally invasive group versus 13.5% in the extensile group. Four patients in the extensile lateral approach group had developed hindfoot varus deformity at last follow-up. At the last follow-up, the average AOFAS ankle and the hindfoot score of the minimal group was 88.4 ± 6.6, and the VAS score was 1.9 ± 0.7, while that of the extensile lateral approach group was 83.2 ± 5.6 and 2.3 ± 1.0, respectively. Limited open reduction via the sinus tarsi approach for intra-articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful for correcting the calcaneus varus deformity. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  10. Effect of open wedge high tibial osteotomy on the lateral tibiofemoral compartment in sheep. Part II: standard and overcorrection do not cause articular cartilage degeneration.

    PubMed

    Ziegler, Raphaela; Goebel, Lars; Cucchiarini, Magali; Pape, Dietrich; Madry, Henning

    2014-07-01

    To evaluate whether medial open wedge high tibial osteotomy (HTO) results in structural changes in the articular cartilage in the lateral tibiofemoral compartment of adult sheep. Three experimental groups received biplanar osteotomies of the right proximal tibiae: (a) closing wedge HTO (4.5° of tibial varus), (b) opening wedge HTO (4.5° tibial valgus; standard correction), and (c) opening wedge HTO (9.5° of valgus; overcorrection), each of which was compared to the contralateral knees that only received an arthrotomy. After 6 months, the macroscopic and microscopic characteristics of the articular cartilage of the lateral tibiofemoral compartment were assessed. The articular cartilage in the central region of the lateral tibial plateau in sheep had a higher safranin O staining intensity and was 4.6-fold thicker than in the periphery (covered by the lateral meniscus). No topographical variation in the type-II collagen immunoreactivity was seen. All lateral tibial plateaus showed osteoarthritic changes in regions not covered by the lateral meniscus. No osteoarthritis was seen in the peripheral submeniscal regions of the lateral tibial plateau and the lateral femoral condyle. Opening wedge HTO resulting in both standard and overcorrection was not associated with significant macroscopic and microscopic structural changes between groups in the articular cartilage of the lateral tibial plateau and femoral condyle after 6 months in vivo. Opening wedge HTO resulting in both standard and overcorrection is a safe procedure for the articular cartilage in an intact lateral tibiofemoral compartment of adult sheep at 6 months postoperatively.

  11. Total knee arthroplasty after failed high tibial osteotomy: a systematic review of open versus closed wedge osteotomy.

    PubMed

    Han, Jae Hwi; Yang, Jae-Hyuk; Bhandare, Nikhl N; Suh, Dong Won; Lee, Jong Seong; Chang, Yong Suk; Yeom, Ji Woong; Nha, Kyung Wook

    2016-08-01

    Medial opening wedge high tibial osteotomy (HTO) has become increasingly popular as an alternative to lateral closing wedge osteotomy for the treatment of medial compartment knee osteoarthritis with varus deformity. The present systematic review was conducted to provide an objective analysis of total knee arthroplasty (TKA) outcomes following previous knee osteotomy (medial opening wedge vs. lateral closing wedge). A literature search of online databases (MEDLINE, EMBASE, Cochrane Library database) was made, in addition to manual search of major orthopaedic journals. The methodological quality of each of the studies was assessed on the Newcastle-Ottawa Scale and Effective Practice and Organization of Care. A total of ten studies were included in the review. There were eight studies with Level IV and two studies with Level III evidence. Eight studies reported clinical and radiologic scores. Comparative studies between TKA following medial opening and lateral closing wedge HTO did not demonstrate statistically significant clinical and radiologic differences. The revision rates were similar. However, more technical issues during TKA surgery after lateral closing wedge HTO were mentioned than the medial open wedge group. The quadriceps snip, tibial tubercle osteotomy, and lateral soft tissue release were more frequently needed in the lateral closing wedge HTO group. In addition, because of loss of proximal tibia bone geometry in the lateral closing wedge HTO group, concerns such as tibia stem impingement in the lateral tibial cortex was noted. The present systematic review suggests that TKA after medial opening and lateral closing wedge HTO showed similar performance. Clinical and radiologic outcome including revision rates did not statistically differ from included studies. However, there are more surgical technical concerns in TKA conversion from lateral closing wedge HTO than from the medial opening wedge HTO group. IV.

  12. Medical tourism: a review of the literature and analysis of a role for bi-lateral trade.

    PubMed

    Smith, Richard; Martínez Álvarez, Melisa; Chanda, Rupa

    2011-12-01

    With increasing globalization, many countries are considering opening their health systems to greater cross-border movement of patients. This is usually done from the viewpoint of a multi-lateral trade relationship. This paper considers the issues that arise from this debate from a bi-lateral perspective. A systematic literature review was carried out on 'Medical Tourism' from the perspective of a bi-lateral trade relationship, using the UK and India as a case study. There is a dearth of data and discussion on such bi-lateral trade. This limited evidence offers some suggestions. Exporting countries may benefit from medical tourism by generating foreign exchange and reversing the brain drain, but run the risk of creating a dual system, where the local population is crowded out. Importing countries can benefit from alleviating waiting lists and lowering healthcare costs, but may risk quality of care and legal liability. However, evidence from a bi-lateral perspective suggests that the positive aspects can be capitalised, and the negative ones reduced. The key recommendations from this paper are for more evidence to be collected at the country and international level, and for countries to consider trade in health services from a bi-lateral rather than multi-lateral perspective. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture.

    PubMed

    Wang, Chien-Shun; Tzeng, Yun-Hsuan; Lin, Chun-Cheng; Huang, Ching-Kuei; Chang, Ming-Chau; Chiang, Chao-Ching

    2016-09-01

    The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability. Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively. The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively). The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures. Level II, comparative study. © The Author(s) 2016.

  14. [Surgical treatment of pronation and supination external rotation trimalleolar fractures].

    PubMed

    Xu, Ye-qing; Zhan, Bei-lei; He, Fei-xiong; Wei, Hong-da

    2008-04-01

    To explore the operative method and its clinical effects of pronation and supination external rotation trimalleolar fractures. From March 2000 to July 2006,42 patients of the pronation and supination external rotation trimalleolar fractures treated with open reduction and internal fixation. Thirty-one were males and 11 were females,with an average age of 40.5 years (from 19 to 76 years). Four cases were open fractures and 38 cases close fractures. The fractures were classified as pronation-external rotation (grade IV) injury in 18 cases and supination-external rotation (grade IV)in 24 cases according to the system of Lauge-Hansen. The time of injury to operation was 2 hours to 27 days. The medial, lateral and posterior malleolus were exposed by standard anteromedial and Gatellier-Chastang approaches. The reduction and internal fixation started with the posterior,then the medial and the lateral malleolus and distal tibiofibular syndesmosis in sequence. The anteroposterior, lateral and mostise X-ray films were taken after operation. All the patients were followed up for an average time of 13.5 months(from 6 to 24 months). The time of union was from 12 to 16 weeks. The results were excellent in 20,good in 16, fair in 4 and poor in 2 cases according to Baird-Jackson ankle scoring system based on pain, stability, walking ability,range of motion and radiological manifestations. The excellent and good rate was 85.7%. There were no infection,malunion and nonunion of the fractures except that the inserted screw to distal tibiofibular syndesmosis was broken in 1 case. The key of operative treatment is to restore the anatomy of ankle and to regain the ankle function maximally.

  15. Transconjunctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticomaxillary complex fractures: a randomized feasibility study.

    PubMed

    El-Anwar, Mohammad Waheed; Elsheikh, Ezzeddin; Hussein, Atef M; Tantawy, Adly A; Abdelbaki, Youssef Mansour

    2017-06-01

    Although some studies addressed the differences between subciliary and transconjunctival approaches, no previous prospective comparative study on displaced zygomaticomaxillary complex (ZMC) fracture that repaired by three-point internal fixation using also upper gingivolabial incision and upper eye lid incision. So, the effect of these incisions on the comparison was not investigated. The purpose of this study was to compare transconjunctival and subciliary approaches for open reduction and internal rigid fixation (OR/IF) of ZMC fractures. This prospective study was carried out on 40 patients had displaced ZMC fractures repaired by OR/IF. Patients were randomly assigned into two equal groups (20 patients for each); subciliary group subjected to subciliary approach and transconjunctival group subjected to transconjunctival approach for inferior orbital rim repair. In both groups, frontozygomatic and zygomaticomaxillary buttresses were also approached by lateral eye brow and superior gingivolabial incision, respectively. Primary outcome measures include accessibility (need for lateral canthotomy), the exposure duration, postoperative pain, early postoperative edema, and operative complications. Secondary outcome measures include dental occlusion, average intrinsic vertical mouth opening, post subciliary scar assessment, late postoperative complication, and opthalmological assessment concerning ectropion, entropion, scleral show, and eye globe affection (enophthalmos or diplopia). The mean duration from incisions to fracture exposure was 13.7 ± 2.17 min in subciliary approach and 14.6 ± 2.31 min in transconjunctival approach with nonsignificant difference (p = 0.1284). Lateral canthotomy was required for proper exposure of the fracture and OR/IF using transconjunctival approach while not needed with subciliary approach. Ectropion and scleral show occurred in 10 and 15% respectively in subciliary group and were not encountered in transconjunctival group. Although postoperative periorbital edema was significantly more sever in transconjunctival group within the first postoperative week (p = 0.028), no persistent periorbital edema was reported. Infection, hematoma, and globe complication were not detected in any patient. All authors characterized all scars of the subciliary group as unnoticeable. Transconjunctival approach mostly needs lateral canthotomy that was not needed with subciliary approach. Transient postoperative edema is more in transconjunctival approach while postoperative ectropion and sclera show was detected only with subciliary approach. So, building up of experience in transconjunctival approach will be beneficial for maxillofacial surgeons and more measures to avoid ectropion are needed with subciliary approach.

  16. The limited anterior approach of the elbow for open reduction and internal fixation of capitellum fractures. Surgical technique and clinical experience in 2 cases with more than 2 years follow-up.

    PubMed

    Ballesteros-Betancourt, J R; Fernández-Valencia, J A; García-Tarriño, R; Domingo-Trepat, A; Sastre-Solsona, S; Combalia-Aleu, A; Llusá-Pérez, M

    Fractures involving the capitellum can be treated surgically by excision of the fragment, or by reduction and internal fixation with screws, with or without heads. The lateral Kocher approach is the most common approach for open reduction. We believe that the limited anterior approach of the elbow, could be a valid technique for treating these fractures, as it does not involve the detachment of any muscle group or ligament, facilitating the recovery process. A description is presented of the surgical technique, as well as of 2cases with a Bryan-Morrey type 1 fracture (Dubberley type 1A). Two different final quality of life evaluation questionnaires were completed by telephone: the EuroQol Five Dimensions Questionnaire (EQ-5D), and the patient part of the Liverpool Elbow Score (PAQ-LES) questionnaire. The 2patients showed favourable clinical progress at 36 and 24 months, respectively, with an extension/flexion movement arc of -5°/145° and -10°/145°, as well as a pronosupination of 85°/80° and 90°/90°. The 2patients showed radiological consolidation with no signs of osteonecrosis. The EQ-5D score was 0.857 and 0.910 (range: 0.36-1), and a PAQ-SLE of 35 and 35 (range: 17-36), respectively. We believe that the limited anterior approach of the elbow is a technical option to consider for the open surgical treatment of a capitellum fracture, although further studies are needed to demonstrate its superiority and clinical safety compared to the classical lateral Kocher approach. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Resident learning across the full range of core competencies through a transitions of care curriculum.

    PubMed

    Pavon, Juliessa M; Pinheiro, Sandro O; Buhr, Gwendolen T

    2018-01-01

    The authors developed a Transitions of Care (TOC) curriculum to teach and measure learner competence in performing TOC tasks for older adults. Internal medicine interns at an academic residency program received the curriculum, which consisted of experiential learning, self-study, and small group discussion. Interns completed retrospective pre/post surveys rating their confidence in performing five TOC tasks, qualitative open-ended survey questions, and a self-reflection essay. A subset of interns also completed follow-up assessments. For all five TOC tasks, the interns' confidence improved following completion of the TOC curriculum. Self-confidence persisted for up to 3 months later for some but not all tasks. According to the qualitative responses, the TOC curriculum provided interns with learning experiences and skills integral to performing safe care transitions. The TOC curriculum and a mixed-method assessment approach effectively teaches and measures learner competency in TOC across all six Accreditation Council for Graduate Medical Education competency domains.

  18. Plantar Pressure Anomalies After Open Reduction With Internal Fixation of High-Grade Calcaneal Fractures.

    PubMed

    Hetsroni, Iftach; Ben-Sira, David; Nyska, Meir; Ayalon, Moshe

    2014-07-01

    Plantar pressure abnormalities after open reduction with internal fixation (ORIF) of intra-articular calcaneal fractures have been observed previously, but high-grade fractures were not selectively investigated and follow-up times were shorter than 2 years. The purpose of this study was to characterize plantar pressure anomalies in patients with exclusively high-grade calcaneal fractures after ORIF with a minimum 2 years of follow-up, and to test the association between plantar pressure distribution and the clinical outcome. The orthopaedic registry was reviewed to identify patients with isolated high-grade calcaneal fractures (Sanders types III-IV) who were operated on and had a minimum 2 years of follow-up. Sixteen patients were evaluated. Mean age was 47 years and follow-up was between 2 and 6 years. The Pedar-Mobile system was used to measure 3 loading and 3 temporal variables and compare these between the operated and the uninjured limbs. Mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 76 ± 7 at latest follow-up. Bohler's angle was 5 ± 8 degrees before surgery and 25 ± 7 degrees at latest follow-up. Stance was shorter in operated limbs (P = .001). Timing of the peak of pressure was delayed in operated limbs under the hallux and the second toe (P ≤ .03). Peak pressure, force time integral, and pressure time integral were increased under the lateral midfoot (P ≤ .03) and decreased under the second metatarsal (P ≤ .03). Force time integral was decreased under the first metatarsal (P = .02) and under the hallux and the lateral toes (P ≤ .05). Increased loading under the lateral midfoot and decreased loading under the lateral toes were correlated with poorer clinical outcome (r = -.53, P < .05, and r = .63, P < .01, respectively). Side-to-side plantar pressure mismatch persisted at more than 2 years after ORIF of high-grade calcaneal fractures performed via lateral approach, despite improvement of Bohler's angle. This was characterized by shortened stance phase, delayed timing of peak of pressure under the hallux and second toe, lateral load shift at the midfoot, and decreased toe pressures in operated limbs. Since loading abnormalities were correlated with the clinical outcome, modifications in treatment strategy that can improve foot loading may be desirable in these cases. Level III, case control. © The Author(s) 2014.

  19. Endoscopic versus open bursectomy of lateral malleolar bursitis.

    PubMed

    Choi, Jae Hyuck; Lee, Kyung Tai; Lee, Young Koo; Kim, Dong Hyun; Kim, Jeong Ryoul; Chung, Woo Chull; Cha, Seung Do

    2012-06-01

    Compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis. Prospective evaluation of 21 patients (22 ankles) undergoing either open or endoscopic excision of lateral malleolar bursitis. The median age was 64 (38-79) years old. The median postoperative follow-up was 15 (12-18) months. Those patients undergoing endoscopic excision showed a higher satisfaction rate (excellent 9, good 2) than open excision (excellent 4, good 3, fair 1). The wounds also healed earlier in the endoscopic group although the operation time was slightly longer. One patient in the endoscopic group had recurrence of symptoms but complications in the open group included one patient with skin necrosis, one patient with wound dehiscence, and two patients of with superficial peroneal nerve injury. Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favorable results compared to the open resection. Therapeutic studies-Investigating the result of treatment, Level II.

  20. GHGfrack: An Open-Source Model for Estimating Greenhouse Gas Emissions from Combustion of Fuel during Drilling and Hydraulic Fracturing.

    PubMed

    Vafi, Kourosh; Brandt, Adam

    2016-07-19

    This paper introduces GHGfrack, an open-source engineering-based model that estimates energy consumption and associated GHG emissions from drilling and hydraulic fracturing operations. We describe verification and calibration of GHGfrack against field data for energy and fuel consumption. We run GHGfrack using data from 6927 wells in Eagle Ford and 4431 wells in Bakken oil fields. The average estimated energy consumption in Eagle Ford wells using lateral hole diameters of 8 (3)/4 and 6 (1)/8 in. are 2.25 and 2.73 TJ/well, respectively. The average estimated energy consumption in Bakken wells using hole diameters of 6 in. for horizontal section is 2.16 TJ/well. We estimate average greenhouse gas (GHG) emissions of 419 and 510 tonne of equivalent CO2 per well (tonne of CO2 eq/well) for the two aforementioned assumed geometries in Eagle Ford, respectively, and 417 tonne of CO2 eq/well for the case of Bakken. These estimates are limited only to GHG emissions from combustion of diesel fuel to supply energy only for rotation of drill string, drilling mud circulation, and fracturing pumps. Sensitivity analysis of the model shows that the top three key variables in driving energy intensity in drilling are the lateral hole diameter, drill pipe internal diameter, and mud flow rate. In hydraulic fracturing, the top three are lateral casing diameter, fracturing fluid volume, and length of the lateral.

  1. Lateral unicompartmental knee arthroplasty through a lateral parapatellar approach has high early survivorship.

    PubMed

    Berend, Keith R; Kolczun, Michael C; George, Joseph W; Lombardi, Adolph V

    2012-01-01

    The literature suggests lateral unicompartmental knee arthroplasties are associated with low revision rates. However, there are fewer reports describing techniques for lateral unicompartmental arthroplasty and whether technique influences ROM and function compared to reports for medial unicompartmental arthroplasty. We report our indications for lateral unicompartmental arthroplasty, how we perform this procedure, and the subsequent Knee Society scores, ROM, and revision and reoperation rates. From a retrospective review of electronic records from 2004 through 2008, we identified 93 patients who had 100 lateral unicompartmental arthroplasties. Indications were complete lateral bone-on-bone arthrosis with a correctible deformity and maintenance of the medial joint space on varus stress radiographs or isolated lateral disease by diagnostic arthroscopy. Average age was 68 years. Seventy percent of patients were women. At followup, we obtained Knee Society scores and ROM. Minimum followup was 24 months (average, 39 months; range, 24-81 months). At followup, Knee Society scores averaged 46 for pain, 94 for clinical, and 89 for function, and ROM averaged 124°. Three patients had reoperations: one an open reduction and internal fixation for fracture at 2 years postoperatively, one an arthroscopy for a medial meniscal tear, and one a revision for pain. Based on our observations, we believe complete cartilage loss laterally and correctible deformity with maintenance of the medial joint on varus stress radiographs are reasonable indications for lateral unicompartmental arthroplasty. We recommend a lateral parapatellar approach can be utilized. The early reoperation and revision rates were low.

  2. Vascular risk reduction during anterior surgical approach sacroiliac joint plating.

    PubMed

    Alla, Sreenivasa R; Roberts, Craig S; Ojike, Nwakile I

    2013-02-01

    Open reduction and internal fixation of sacroiliac (SI) joint is often performed through an anterior approach. However, there were no studies to our knowledge which described the "at risk area" for injury to the nutrient artery as it relates to open reduction and internal fixation of the SI joint. The purpose of this study was to determine the "at risk area" for the nutrient artery during anterior surgical approaches to the SI joint and to define the safe location of the plate for SI joint fixation. Six right and five left hemipelvises (three male and three female cadavers) were dissected with a mean age of 72 years (range, 51-90 years). Three bony landmarks including the pelvic brim, anterior SI joint line, and the anterior superior iliac spine (ASIS) were identified to quantify the measurements. Three different measurements were taken: from the nutrient foramen to the anterior SI joint line; from the nutrient foramen to the nearest point on the pelvic brim; from the nutrient foramen to ASIS using a flexible ruler with a 1mm base. The nutrient artery courses across the SI joint to enter into the nutrient foramen. Whilst exposing the internal surface of the SI joint, the nutrient foramen was identified at a mean distance of 88.1mm medial to ASIS, 20.1mm above the pelvic brim, and 20.1mm lateral to SI joint. The variability of the location of the nutrient foramen was identified and was located from 80mm to 95mm medial to the ASIS, 12mm to 25mm lateral to the SI joint, and 16mm to 30mm above the pelvic brim. Familiarity of the vasculature of the internal pelvis is of utmost importance for the surgeon when considering operative fixation of the anterior SI joint. We were able to identify the relation of the nutrient artery to the anatomic landmarks of the internal pelvis and to define the "at risk area" for the nutrient artery. We believe increased understanding of the anatomy of the nutrient artery will aid in the avoidance of vascular complications during internal fixation of the anterior SI joint. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Determinants of complete resection of thymoma by minimally invasive and open thymectomy: analysis of an international registry

    PubMed Central

    Burt, Bryan M.; Yao, Xiaopan; Shrager, Joseph; Antonicelli, Alberto; Padda, Sukhmani; Reiss, Jonathan; Wakelee, Heather; Su, Stacey; Huang, James; Scott, Walter

    2017-01-01

    INTRODUCTION Minimally invasive thymectomy (MIT) is a surgical approach to thymectomy that has more favorable short-term outcomes than open thymectomy (OT) for myasthenia gravis. When performed for thymoma, the oncologic outcomes of MIT have not been rigorously evaluated. We analyzed determinants of complete (R0) resection among patients undergoing MIT and open thymectomy in a large international database. METHODS The retrospective database of the International Thymic Malignancy Interest Group (ITMIG) was queried. Chi-Square and Wilcoxon rank-sum tests, multivariate logistic regression models, and propensity matching were performed. RESULTS A total of 2514 patients underwent thymectomy for thymoma between 1997 and 2012. 2053 (82%) patients underwent OT, 461 (18%) patients underwent MIT, and the use of MIT increased significantly in recent years. The rate of R0 resection among patients undergoing OT was 86%, and among those undergoing MIT was 94%, respectively (p<0.0001). In propensity matched MIT and OT groups (n=266 each group), however, the rate of R0 resection did not differ significantly (MIT 96%, OT 96%, p=0.7). Multivariate analyses were performed to identify determinants of complete resection. Factors independently associated with R0 resection were geographical region, later time period, less advanced Masaoka stage, total thymectomy, and the absence of radiotherapy. Surgical approach, whether minimally invasive or open, was not associated with completeness of resection. CONCLUSIONS The use of MIT for resection of thymoma is increasing substantially over time, and MIT can achieve similar rates of R0 resection for thymoma as OT. PMID:27566187

  4. Factors Associated With Narcotic Use After Clavicle Fractures.

    PubMed

    Weinberg, Douglas S; Napora, Joshua K; West, William H; Grimberg, Dominic C; Vallier, Heather A

    2016-09-01

    Clavicle fractures are common in adults. Recent studies have shown that operative treatment of clavicle fractures has benefits in many situations. However, there is controversy about the indications. Data on social outcomes are limited. A total of 434 patients with 436 clavicle fractures treated both operatively and nonoperatively at a level 1 trauma center were identified. Narcotic use was recorded 2, 4, 6, 8, 10, 12, 14, and 16 weeks after injury for both treatment groups. Other descriptive data included age, sex, laterality, hand dominance, rib fractures, smoking, alcohol use, employment, long bone or spine fracture, open clavicle fracture, and mechanism of injury. Logistic regression analysis was performed to determine the independent predictors of narcotic use after clavicle fracture. Open reduction and internal fixation was performed in 105 fractures (24%), and 329 fractures were managed nonoperatively. A total of 154 patients (35%) reported some narcotic use 2 weeks after injury, and 15% were still using narcotics 16 weeks after injury. Narcotic use decreased over time in patients treated with open reduction and internal fixation (10% vs 15% after nonoperative management). Patients treated with open reduction and internal fixation reported reduced narcotic use at 16 weeks (odds ratio [OR], 0.454; P=.070). Concurrent rib fracture (OR, 5.668; P<.001), smoking (OR, 3.095; P=.013), unemployment (OR, 5.429; P<.0005), and long bone or spine fracture (OR, 6.761; P<.001) were predictors of narcotic use. Further studies of the social, economic, and financial outcomes of clavicle fracture and osteosynthesis are warranted. [Orthopedics. 2016; 39(5):e917-e923.]. Copyright 2016, SLACK Incorporated.

  5. Internal fixation in pelvic fractures and primary repairs of associated genitourinary disruptions: a team approach.

    PubMed

    Routt, M L; Simonian, P T; Defalco, A J; Miller, J; Clarke, T

    1996-05-01

    Associated urological and orthopedic injuries of the pelvic ring are complex with numerous potential complications. These patients are treated optimally using a team approach. The combined expertise is not only helpful initially when managing these difficult patients, but also later as problems develop. This study describes a treatment protocol and reports the early results of 23 patients with unstable pelvic fractures and associated bladder or urethral disruptions, or both, treated surgically with open reduction and internal fixation of the anterior pelvic ring injuries at the same anesthetic and using the same surgical exposure as the urethral realignments or bladder repairs or both. Early complications occurred in four patients (17%): one patient sustained a fifth lumbar nerve injury caused by the pelvic reduction procedure, and three patients had anterior pelvic internal fixation failures. Late complications occurred in eight patients (35%). There was one deep wound infection (4.3%) that presented 6 weeks after injury. Late urological complications occurred in seven patients (30%). Four of the nine male patients with urethral disruptions had urethral stricture after their primary urethral realignments (44%). Three of the 18 male patients admitted to impotence (16.7%). One of the three had a residual thoracic paraplegia caused by a burst fracture. One of the five female patients had urinary incontinence and required a bladder suspension operation to restore normal function (20%). A low infection rate can be expected despite the use of internal fixation. Early urethral "indirect" realignments avoid more difficult delayed open repairs; however, late urological complication rates are still high. Early "direct" bladder repairs are easily performed at the time of anterior pelvic open reduction and internal fixation. Suprapubic tubes are not necessary to adequately divert the urine when large diameter urethral catheters are used in these patients.

  6. Surgical Approaches to the Proximal Interphalangeal Joint.

    PubMed

    Cheah, Andre Eu-Jin; Yao, Jeffrey

    2016-02-01

    The proximal interphalangeal (PIP) joint may be affected by many conditions such as arthropathy, fractures, dislocations, and malunions. Whereas some of these conditions may be treated nonsurgically, many require open surgical intervention. Open interventions include implant arthroplasty or arthrodesis for arthropathy, open reduction internal fixation, or hemi-hamate arthroplasty for dorsal fracture-dislocations. Volar plate arthroplasty and corrective osteotomy for malunion about the PIP joint are also surgeries that may be required. The traditional approach to the PIP joint has been dorsal, which damages the delicate extensor apparatus with subsequent development of an extensor lag. This has led surgeons to explore volar and lateral approaches to the PIP joint. In this article, we describe each of these surgical approaches, discuss their advantages and disadvantages, and provide some guidance on which approach to choose based on the surgery that is to be performed. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  7. Variations in medial-lateral hamstring force and force ratio influence tibiofemoral kinematics.

    PubMed

    Shalhoub, Sami; Fitzwater, Fallon G; Cyr, Adam J; Maletsky, Lorin P

    2016-10-01

    A change in hamstring strength and activation is typically seen after injuries or invasive surgeries such as anterior cruciate reconstruction or total knee replacement. While many studies have investigated the influence of isometric increases in hamstring load on knee joint kinematics, few have quantified the change in kinematics due to a variation in medial to lateral hamstring force ratio. This study examined the changes in knee joint kinematics on eight cadaveric knees during an open-chain deep knee bend for six different loading configurations: five loaded hamstring configurations that varied the ratio of a total load of 175 N between the semimembranosus and biceps femoris and one with no loads on the hamstring. The anterior-posterior translation of the medial and lateral femoral condyles' lowest points along proximal-distal axis of the tibia, the axial rotation of the tibia, and the quadriceps load were measured at each flexion angle. Unloading the hamstring shifted the medial and lateral lowest points posteriorly and increased tibial internal rotation. The influence of unloading hamstrings on quadriceps load was small in early flexion and increased with knee flexion. The loading configuration with the highest lateral hamstrings force resulted in the most posterior translation of the medial lowest point, most anterior translation of the lateral lowest point, and the highest tibial external rotation of the five loading configurations. As the medial hamstring force ratio increased, the medial lowest point shifted anteriorly, the lateral lowest point shifted posteriorly, and the tibia rotated more internally. The results of this study, demonstrate that variation in medial-lateral hamstrings force and force ratio influence tibiofemoral transverse kinematics and quadriceps loads required to extend the knee. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1707-1715, 2016. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  8. Agency and Social Forces in the Life Course: The Case of Gender Transitions in Later Life

    PubMed Central

    2017-01-01

    Abstract Objectives: In order to bolster gerontology’s knowledge base about transgender issues and advance conceptualizations of agency and social forces in life course scholarship, this study explores the conditions under which people contemplate or pursue a gender transition in later life. Methods: In-depth interviews were conducted with male-to-female identified persons (N = 22) who have seriously contemplated or pursued a gender transition after the age of 50 years. Participant observation was also carried out at three national transgender conferences (N = 170 hours). Interpretive analyses utilized open and focused coding, analytical memo writing, and an iterative process of theory development. Results: Participants in this study faced unrelenting social pressures to conform to normative gender expectations throughout their lives, which were often internalized and experienced as part of themselves. Confronting these internalized forces often took the form of a “dam bursting,” an intense emotional process through which participants asserted agency in the face of constraining social forces in order to pursue a gender transition in later life. Discussion: The findings in this paper are used to extend the life course concept of agency within structure, which has implications for future life course research in aging, especially with respect to socially marginalized and oppressed minority groups. PMID:27582504

  9. Open Approaches to the Anterior Skull Base in Children: Review of the Literature.

    PubMed

    Wasserzug, Oshri; DeRowe, Ari; Ringel, Barak; Fishman, Gadi; Fliss, Dan M

    2018-02-01

    Introduction  Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the "gold standard" for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective  This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods  Comprehensive literature review. Results  Extensive intracranial-intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion  Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a specific lesion in regard to its nature, location, and extent is of utmost importance.

  10. A bioassay experience and lessons learned on the internal contamination of (131)I during a maintenance period in a Korean nuclear power plant.

    PubMed

    Kim, Hee Geun; Kong, Tae Young

    2012-08-01

    During a maintenance period at a Korean nuclear power plant, internal exposure of radiation workers occurred by the inhalation of (131)I that was released into the reactor building from a primary system opening due to defective fuels. The internal activity in radiation workers contaminated by (131)I was immediately measured using a whole body counter (WBC). A whole body counting was performed again a few days later, considering the factors of equilibrium in the body. The intake and the committed effective dose were estimated based on the WBC results. The intake was also calculated by hand, based on both the entrance records to the reactor building, and the counted results of the air concentration for (131)I were compared with the whole body counting results.

  11. Contrasting catastrophic eruptions predicted by different intrusion and collapse scenarios.

    PubMed

    Rincón, M; Márquez, A; Herrera, R; Alonso-Torres, A; Granja-Bruña, J L; van Wyk de Vries, B

    2018-04-18

    Catastrophic volcanic eruptions triggered by landslide collapses can jet upwards or blast sideways. Magma intrusion is related to both landslide-triggered eruptive scenarios (lateral or vertical), but it is not clear how such different responses are produced, nor if any precursor can be used for forecasting them. We approach this problem with physical analogue modelling enhanced with X-ray Multiple Detector Computed Tomography scanning, used to track evolution of internal intrusion, and its related faulting and surface deformation. We find that intrusions produce three different volcano deformation patterns, one of them involving asymmetric intrusion and deformation, with the early development of a listric slump fault producing pronounced slippage of one sector. This previously undescribed early deep potential slip surface provides a unified explanation for the two different eruptive scenarios (lateral vs. vertical). Lateral blast only occurs in flank collapse when the intrusion has risen into the sliding block. Otherwise, vertical rather than lateral expansion of magma is promoted by summit dilatation and flank buttressing. The distinctive surface deformation evolution detected opens the possibility to forecast the possible eruptive scenarios: laterally directed blast should only be expected when surface deformation begins to develop oblique to the first major fault.

  12. Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts.

    PubMed

    Wu, Zhanpo; Su, Yanling; Chen, Wei; Zhang, Qi; Liu, Yueju; Li, Ming; Wang, Haili; Zhang, Yingze

    2012-09-01

    The purpose of this study is to assess the clinical results of a minimally invasive treatment featured the concept of internal compression, including an anatomic plate and multiple compression bolts compared with open reduction and internal fixation for displaced intra-articular calcaneal fractures (DIACFs). We retrospectively analyzed 329 patients (383 feet) who were identified from trauma inpatient database in our hospital for DIACFs from January 2004 to December 2009. Of them, 148 patients (170 feet) were treated with open reduction and internal fixation (OR group), which involved using a traditional L-shaped extended lateral approach, and fractures were fixed by plate and screws from January 2004 to December 2006; 181 patients (213 feet) were treated with a minimally invasive approach featured the concept of calcaneal internal compression (CIC group), which was achieved by an anatomic plate and multiple compression bolts through a small lateral incision from January 2007 to December 2009. Postoperative complications were recorded. During follow-up, pain and functional outcome were evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) scores and compared between the two groups. Subsequent subtalar arthrodesis and early implant removal were performed when indicated. Routine hardware removal was scheduled for all patients at 1-year follow-up. There were no significant differences in sex, age, and fracture classification (Sanders classification) between the two groups. Wound healing complications were 4 of 213 (1.88%) in CIC group and 20 of 170 (11.76%) in OR group. Subtalar arthrodesis had to be performed in one case in OR group. Four cases in CIC group and four cases in OR group had the hardware removed earlier due to complications. The average time after surgery to start weight-bearing exercise is 5.64 weeks in CIC group and 9.38 weeks in OR group (p < 0.001). The mean AOFAS score is higher in CIC group than in OR group, although the difference is not statistically significant (87.53 vs. 84.95; p = 0.191). The overall results according to the AOFAS scoring system were good or excellent in 185 of 213 (86.85%) in CIC group and 144 of 170 (84.71%) in OR group. The subjective portion of the AOFAS survey answered by patients showed statistically significant difference in activity limitation and walking surface score (7.31 vs. 7.02 and 3.72 vs. 3.42; p < 0.05) but not in pain and walking distance between the two groups (32.72 vs. 32.29 and 4.37 vs. 4.42; p > 0.05). The study results suggest that this minimally invasive approach featured the concept of the calcaneal internal compression can achieve functional outcome as good as, if not better than the open techniques. It is proved to be an effective alternative treatment for DIACFs. Therapeutic study, level IV.

  13. Indication for and frequency of early orthodontic therapy or interceptive measures.

    PubMed

    Schopf, Peter

    2003-05-01

    The early treatment of nonskeletal and skeletal orthodontic anomalies in the deciduous and early mixed dentition is intended to prevent the development of pronounced anomalies in the late mixed and permanent dentition with the ultimate aim of reducing or even eliminating the need for later orthodontic treatment. There is a general consensus in the international literature that early therapy is indicated in cases of anterior and lateral crossbite and Class III malocclusion, and possibly for extreme forms of mandibular retrognathism (overjet > or =10 mm) and of open bite. However, evidence of the efficiency of early orthodontic measures is just as rare as studies providing serviceable information on the incidence of tooth malalignments and malocclusions in the deciduous and early mixed dentition, some of whose findings are in any case highly divergent. This makes it substantially more difficult to draw conclusions on the extent to which early orthodontic therapy may be indicated. In order to obtain information on the incidence of nonskeletal and skeletal orthodontic problems constituting a treatment need, 2326 first-year schoolchildren aged between 6 and 7 years were examined in Frankfurt am Main and in the Rural District of Offenbach. In only 14.7% of the children were no relevant orthodontic findings recorded. 77.2% displayed mild to severe dysgnathic symptoms, though without early orthodontic therapy being considered indicated. Treatment with orthodontic appliances was considered urgent for 187 of the children (8.04%). With 8.3% and 7.9% respectively, lateral and anterior crossbite were top of the list of anomalies with an urgent treatment need. Among the patients with lateral crossbite, the prognostically less favorable unilateral form was recorded approximately four times more often than the bilateral form. Markedly increased sagittal overjet > or =10 mm) was registered in only 1.4% of the children, and negative overjet (Class III) (with the exception of edge-to-edge bite) in 1.9%. Extreme anterior open bite > or =6 mm) was recorded in only two children (0.09%). In 19.6% of the children, a supporting zone was reduced in at least one quadrant, necessitating interceptive measures such as the insertion of a space maintainer or later orthodontic treatment (space opening or extraction therapy).

  14. Sidewall tensiometer and method of determining soil moisture potential in below-grade earthen soil

    DOEpatents

    Hubbell, Joel M.; Sisson, James B.

    2001-01-01

    A sidewall tensiometer to in situ determine below-grade soil moisture potential of earthen soil includes, a) a body adapted for insertion into an opening in earthen soil below grade, the body having lateral sidewalls; b) a laterally oriented porous material provided relative to the body lateral sidewalls, the laterally oriented porous material at least in part defining a fluid chamber within the body; c) a pressure a sensor in fluid communication with the fluid chamber; and d) sidewall engaging means for engaging a portion of a sidewall of an earth opening to laterally urge the porous material into hydraulic communication with earthen soil of another portion of the opening sidewall. Methods of taking tensiometric measurements are also disclosed.

  15. Minimally invasive reduction and fixation of displaced calcaneal fractures: surgical technique and radiographic analysis.

    PubMed

    Arastu, Mateen; Sheehan, Brendan; Buckley, Richard

    2014-03-01

    The optimal treatment of calcaneal fractures is controversial. A specific subgroup of healthy patients has good outcomes with open reduction and internal fixation using an extensile lateral approach. However, there are many patients who do not fit into this category. Consequently, they are either denied surgical intervention or put at significant risk of developing complications as a result of open surgical intervention. Minimally invasive reduction and fixation (MIRF) of calcaneal fractures can restore the height, width, length and shape of the hindfoot in addition to restoring the orientation of the posterior facet of the calcaneus (Böhler's angle). We present a series of 31 patients treated with minimally invasive reduction and fixation technique using threaded K wires and Steinmann pins as an alternative treatment method in patients who are not suitable for open reduction and internal fixation. The mean time to surgery from injury was six days (range one to ten days). The mean duration of surgery was 35 minutes (range 11-52 minutes). The mean followup was 14.9 months (range of seven to 30 months). The mean change in Böhler's angle and length of the calcaneus from intra-operative fixation to final followup were 18.7° and 4.7 mm, respectively. The complication rate was low and there was one case of a superficial wound infection and no cases of deep infection or peroneal impingement in this series. The MIRF technique with the use of threaded K wires has not been previously described in the literature. In our experience, the operative time is short and can be safely performed even in the presence of extensive soft tissue swelling in the immediate period following injury. The infection risk is low and calcaneal morphology was improved and maintained in terms of Böhler's angle. This technique is suitable to be considered in patients who have significant medical co-morbidities (smokers, diabetics, peripheral vascular disease) and in those patients who are not suitable for an extensile lateral approach and internal fixation.

  16. Patient satisfaction after open reduction and internal fixation through lateral extensile approach in displaced intraarticular calcaneal fractures (Sander's type II and III).

    PubMed

    Kavin, Khatri; Vijay, Sharma; Devendra, Lakhotia; Kamran, Farooque

    2016-01-01

    To determine patient satisfaction in the patients of displaced intraarticular calcaneal fractures treated with standard lateral approach. The patients of displaced calcaneal fractures (Sander's type II and III) treated between March 2009 and March 2012 were included in the retrospective review and functional outcome was evaluated using American Orthopaedic Foot and Ankle Society (AOFAS) hind foot score, Creighton Nebraska Health Foundation Assessment (CNHFA) scale and foot function index (FFI). The cohort included 26 patients (19 males: seven were females) with a mean age of 38.16 ± 13.53 years (range 18-64 years). The mean period of follow-up was 24.42 ± 6.68 months. The patients achieved good functional scores after anatomical reduction of the fracture. The complication rate was low following strict inclusion criteria. Careful patient selection in displaced intraarticular calcaneal fractures treated through lateral extensile approach achieves good patient satisfaction.

  17. Three-part head-splitting proximal humerus fracture through a unicameral bone cyst.

    PubMed

    Younghein, John A; Eskander, Mark S; DeAngelis, Nicola A; Wixted, John J

    2012-06-01

    Unicameral bone cysts are rare in adults and are most often found incidentally on radiographs. However, they can persist from the adolescent period and may be present in locations that predispose to or exacerbate fractures.This article describes a case of a healthy 40-year-old woman who sustained a proximal humerus trauma that involved a large unicameral bone cyst, resulting in a 3-part head-splitting fracture. The epiphyseal location of the cyst contributed to the severity and extent of the fracture that resulted from a simple fall. Given the age of the patient, open reduction and internal fixation with a locking plate and lag screws was performed. The patient chose open reduction and internal fixation to preserve a hemiarthroplasty procedure in case of future revision. Successful humeral head reconstruction was achieved, and the patient fully recovered. One year postoperatively, the patient underwent arthroscopic debridement to alleviate subjective stiffness and decreased range of motion.Multipart head-splitting fractures require complex repair strategies. The gold standard for the treatment of these injuries is hemiarthroplasty. However, the decision process is difficult in a young patient given the average survival of autoplastic prostheses and the added difficulty of later revision. The current case demonstrates the complexity of decision making resulting from a rare injury in a young, healthy patient and shows that open reduction and internal fixation can provide acceptable reconstruction in such situations. Copyright 2012, SLACK Incorporated.

  18. A study on single lane-change manoeuvres for determining rearward amplification of multi-trailer articulated heavy vehicles with active trailer steering systems

    NASA Astrophysics Data System (ADS)

    Wang, Qiushi; He, Yuping

    2016-01-01

    The Society of Automotive Engineers issued a test procedure, SAE-J2179, to determine the rearward amplification (RA) of multi-trailer articulated heavy vehicles (MTAHVs). Built upon the procedure, the International Organization for Standardization released the test manoeuvres, ISO-14791, for evaluating directional performance of MTAHVs. For the RA measures, ISO-14791 recommends two single lane-change manoeuvres: (1) an open-loop procedure with a single sine-wave steering input; and (2) a closed-loop manoeuvre with a single sine-wave lateral acceleration input. For an articulated vehicle with active trailer steering (ATS), the RA measure in lateral acceleration under the open-loop manoeuvre was not in good agreement with that under the closed-loop manoeuvre. This observation motivates the research on the applicability of the two manoeuvres for the RA measures of MTAHVs with ATS. It is reported that transient response under the open-loop manoeuvre often leads to asymmetric curve of tractor lateral acceleration [Winkler CB, Fancher PS, Bareket Z, Bogard S, Johnson G, Karamihas S, Mink C. Heavy vehicle size and weight - test procedures for minimum safety performance standards. Final technical report, NHTSA, US DOT, contract DTNH22-87-D-17174, University of Michigan Transportation Research Institute, Report No. UMTRI-92-13; 1992]. To explore the effect of the transient response, a multiple cycle sine-wave steering input (MCSSI) manoeuvre is proposed. Simulation demonstrates that the steady-state RA measures of an MTAHV with and without ATS under the MCSSI manoeuvre are in excellent agreement with those under the closed-loop manoeuvre. It is indicated that between the two manoeuvres by ISO-14791, the closed-loop manoeuvre is more applicable for determining the RA measures of MTAHVs with ATS.

  19. [Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures].

    PubMed

    Encinas-Ullán, C A; Fernandez-Fernandez, R; Rubio-Suárez, J C; Gil-Garay, E

    2013-01-01

    Tibial plafond fractures are one of the most challenging injuries in orthopaedic surgery. Their results could be improved by following the new guidelines for the management, and modern plating techniques. The results and complication rate between anteromedial and anterolateral approach for open reduction and internal fixation of these fractures were compared. A study was conducted on 40 patients treated by open reduction an internal fixation between 2007 and 2008. The surgical approach was selected by the surgeon in charge, depending on fracture pattern and skin situation. Patients were evaluated clinically and radiographically by an independent orthopaedic surgeon, not involved in the surgical procedure, using clinical (American Orthopaedic Foot and Ankle Society score) and radiological criteria at a minimum of two years. The appearance of complications after both approaches was recorded. Forty patients were included. The mean age was 53 years, with 24 males and 16 females. Seventeen of the injuries were of high energy, and there were 8 open fractures (3 of type i, 4 type ii and one type iii), and 12 of the closed injuries were grade ii or iii in the Tscherne classification. Six patients (15%) had associated injuries. At final follow-up there were 33 (82%) excellent or good results. No statistical differences were found between either surgical approach regarding time to bone union, rate of delayed union and infection rate. Three plates of the anteromedial group and none of the anterolateral group needed to be removed. Open reduction and internal fixation of distal tibia fractures produced reliable results, with no statistical differences found between anteromedial and anterolateral surgical approaches. Clinical and radiological results and complication rate were mainly related to the fracture type. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  20. Cellular entry of G3.5 poly (amido amine) dendrimers by clathrin- and dynamin-dependent endocytosis promotes tight junctional opening in intestinal epithelia.

    PubMed

    Goldberg, Deborah S; Ghandehari, Hamidreza; Swaan, Peter W

    2010-08-01

    This study investigates the mechanisms of G3.5 poly (amido amine) dendrimer cellular uptake, intracellular trafficking, transepithelial transport and tight junction modulation in Caco-2 cells in the context of oral drug delivery. Chemical inhibitors blocking clathrin-, caveolin- and dynamin-dependent endocytosis pathways were used to investigate the mechanisms of dendrimer cellular uptake and transport across Caco-2 cells using flow cytometry and confocal microscopy. Dendrimer cellular uptake was found to be dynamin-dependent and was reduced by both clathrin and caveolin endocytosis inhibitors, while transepithelial transport was only dependent on dynamin- and clathrin-mediated endocytosis. Dendrimers were quickly trafficked to the lysosomes after 15 min of incubation and showed increased endosomal accumulation at later time points, suggesting saturation of this pathway. Dendrimers were unable to open tight junctions in cell monolayers treated with dynasore, a selective inhibitor of dynamin, confirming that dendrimer internalization promotes tight junction modulation. G3.5 PAMAM dendrimers take advantage of several receptor-mediated endocytosis pathways for cellular entry in Caco-2 cells. Dendrimer internalization by dynamin-dependent mechanisms promotes tight junction opening, suggesting that dendrimers act on intracellular cytoskeletal proteins to modulate tight junctions, thus catalyzing their own transport via the paracellular route.

  1. Between Nationalism and Internationalism: The German Chemical Society In Comparative Perspective, 1867-1945.

    PubMed

    Johnson, Jeffrey Allan

    2017-09-04

    One-hundred fifty years ago, on the eve of German unification, about one-hundred people gathered in Berlin to found the German Chemical Society (DChG) under the charismatic leadership of August Wilhelm von Hofmann, who attracted a large international membership by promoting modern organic chemistry. By 1892, when Emil Fischer succeeded Hofmann, the DChG was the world's largest chemical society. Under Fischer the Society promoted international collaboration with foreign societies, and in 1900 it opened an impressive headquarters, the Hofmann House, where it centralized its greatly expanded literary activity including abstracts and reference publications. Yet a half-century later, after war and racial-national extremism, the house lay in ruins and the Society had ceased to exist. In remembering the Society, one may well ask why its auspicious beginning should have led to this ignominious end. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Cerclage wire and lag screw fixation of the lateral malleolus in supination and external rotation fractures of the ankle.

    PubMed

    Bajwa, Amarjit S; Gantz, D E

    2005-01-01

    Wound dehiscence and exposed lateral hardware can occur after open reduction internal fixation of lateral malleolus. The bulk of a lateral plate and the minimum soft tissue over the lateral malleolus may contribute to this situation. The objective of this study was to evaluate a series of patients with lateral malleolar fractures treated with operative reduction using minimal hardware. We wanted to observe whether there was any loss of reduction and whether there were any incidences of soft tissue disruption. Fifty-two patients with long spiral fracture of the lateral malleolus in a supination-external rotation injury were treated with two or three 3.5-mm lag screws inserted 1 cm apart and 1 or 2 circlage wires. Less rigid fixation was supplemented with a below-the-knee plaster cast. All patients were followed up until clinical and radiological evidence of fracture healing at 6, 10, and 14 weeks postoperatively. By 10 weeks, all patients were full weight bearing, although most patients still limped. At 14 weeks' follow-up, there were no infections or wound dehiscences. All patients were able to return to their activities of daily living. All the fractures had united without loss of original position. Two fractures of the posterior bone spikes seen during surgery united uneventfully. Long spiral fractures of the lateral malleolus of the ankle can be treated successfully with 2 or 3 lag screws and circlage wires without compromising the outcome of the fracture healing.

  3. Determinants of Complete Resection of Thymoma by Minimally Invasive and Open Thymectomy: Analysis of an International Registry.

    PubMed

    Burt, Bryan M; Yao, Xiaopan; Shrager, Joseph; Antonicelli, Alberto; Padda, Sukhmani; Reiss, Jonathan; Wakelee, Heather; Su, Stacey; Huang, James; Scott, Walter

    2017-01-01

    Minimally invasive thymectomy (MIT) is a surgical approach to thymectomy that has more favorable short-term outcomes for myasthenia gravis than open thymectomy (OT). The oncologic outcomes of MIT performed for thymoma have not been rigorously evaluated. We analyzed determinants of complete (R0) resection among patients undergoing MIT and OT in a large international database. The retrospective database of the International Thymic Malignancy Interest Group was queried. Chi-square and Wilcoxon rank sum tests, multivariate logistic regression models, and propensity matching were performed. A total of 2514 patients underwent thymectomy for thymoma between 1997 and 2012; 2053 of them (82%) underwent OT and 461 (18%) underwent MIT, with the use of MIT increasing significantly in recent years. The rate of R0 resection among patients undergoing OT was 86%, and among those undergoing MIT it was 94% (p < 0.0001). In propensity-matched MIT and OT groups (n = 266 in each group); however, the rate of R0 resection did not differ significantly (96% in both the MIT and OT groups, p = 0.7). Multivariate analyses were performed to identify determinants of R0 resection. Factors independently associated with R0 resection were geographical region, later time period, less advanced Masaoka stage, total thymectomy, and the absence of radiotherapy. Surgical approach, whether minimally invasive or open, was not associated with completeness of resection. The use of MIT for resection of thymoma has been increasing substantially over time, and MIT can achieve rates of R0 resection for thymoma similar to those achieved with OT. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  4. Development of prenatal lateralization: evidence from fetal mouth movements.

    PubMed

    Reissland, N; Francis, B; Aydin, E; Mason, J; Exley, K

    2014-05-28

    Human lateralized behaviors relate to the asymmetric development of the brain. Research of the prenatal origins of laterality is equivocal with some studies suggesting that fetuses exhibit lateralized behavior and other not finding such laterality. Given that by around 22weeks of gestation the left cerebral hemisphere compared to the right is significantly larger in both male and female fetuses we expected that the right side of the fetal face would show more movement with increased gestation. This longitudinal study investigated whether fetuses from 24 to 36weeks of gestation showed increasing lateralized behaviors during mouth opening and whether lateralized mouth movements are related to fetal age, gender and maternal self-reported prenatal stress. Following ethical approval, fifteen healthy fetuses (8 girls) of primagravid mothers were scanned four times from 24 to 36-gestation. Two types of mouth opening movements - upper lip raiser and mouth stretch - were coded in 60 scans for 10min. We modeled the proportion of right mouth opening for each fetal scan using a generalized linear mixed model, which takes account of the repeated measures design. There was a significant increase in the proportion of lateralized mouth openings over the period increasing by 11% for each week of gestational age (LRT change in deviance=10.92, 1df; p<0.001). No gender differences were found nor was there any effect of maternally reported stress on fetal lateralized mouth movements. There was also evidence of left lateralization preference in mouth movement, although no evidence of changes in lateralization bias over time. This longitudinal study provides important new insights into the development of lateralized mouth movements from 24 to 36 weeks of gestation. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. [Distal femoral osteotomy using a lateral opening wedge technique].

    PubMed

    Feucht, M J; Mehl, J; Forkel, P; Imhoff, A B; Hinterwimmer, S

    2017-08-01

    To shift the weight-bearing axis of the lower limb medially by opening a lateral-based metaphyseal osteotomy at the distal femur. Femoral-based valgus malalignment and symptomatic lateral unicompartimental osteoarthritis, lateral hyperpression syndrome, cartilage therapy of the lateral compartment, lateral meniscal replacement/transplantation, medial instability with valgus thrust, reconstruction of the medial collateral ligament, patellar instability and/or maltracking. Advanced cartilage damage (>grade 2) or subtotal meniscal loss of the medial compartment, age >65 years (relative), nicotine abuse, body mass index >30, flexion contracture >25°, corrections with a wedge base >10 mm in case of congenital deformities, inflammatory or septic arthritis, severe osteoporosis. Lateral approach to the distal femur; biplanar osteotomy (frontal + axial osteotomy), gradual opening of the osteotomy, osteotomy fixation with a locking plate. Free range of motion. Partial weight bearing with 20 kg for 2 weeks, followed by progressive weight bearing thereafter. Mean improvement of knee scores from 20-30 points and mean 10-year survival rate of 80% in patients with lateral unicompartimental osteoarthritis. Mean complication rate of 9%.

  6. Agency and Social Forces in the Life Course: The Case of Gender Transitions in Later Life.

    PubMed

    Fabbre, Vanessa D

    2017-05-01

    In order to bolster gerontology's knowledge base about transgender issues and advance conceptualizations of agency and social forces in life course scholarship, this study explores the conditions under which people contemplate or pursue a gender transition in later life. In-depth interviews were conducted with male-to-female identified persons (N = 22) who have seriously contemplated or pursued a gender transition after the age of 50 years. Participant observation was also carried out at three national transgender conferences (N = 170 hours). Interpretive analyses utilized open and focused coding, analytical memo writing, and an iterative process of theory development. Participants in this study faced unrelenting social pressures to conform to normative gender expectations throughout their lives, which were often internalized and experienced as part of themselves. Confronting these internalized forces often took the form of a "dam bursting," an intense emotional process through which participants asserted agency in the face of constraining social forces in order to pursue a gender transition in later life. The findings in this paper are used to extend the life course concept of agency within structure, which has implications for future life course research in aging, especially with respect to socially marginalized and oppressed minority groups. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Lateral Transorbital Endoscopic Access to the Hippocampus, Amygdala, and Entorhinal Cortex: Initial Clinical Experience.

    PubMed

    Chen, H Isaac; Bohman, Leif-Erik; Emery, Lyndsey; Martinez-Lage, Maria; Richardson, Andrew G; Davis, Kathryn A; Pollard, John R; Litt, Brian; Gausas, Roberta E; Lucas, Timothy H

    2015-01-01

    Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe. Two patients with mesial temporal lobe pathology presenting with seizures underwent surgery. The use of a transpalpebral or Stallard-Wright eyebrow incision enabled access to the intraorbital compartment, and a lateral orbital wall 'keyhole' opening permitted visualization of the anterior temporal pole. This approach afforded adequate access to the surgical target and surrounding structures and was well tolerated by the patients. To the best of our knowledge, this report constitutes the first case series describing the endoscope-assisted lateral transorbital approach to the temporal lobe. We discuss the limits of exposure, the nuances of opening and closing, and comparisons to open craniotomy. Further prospective investigation of this approach is warranted for comparison to traditional approaches to the mesial temporal lobe. © 2015 S. Karger AG, Basel.

  8. Concomitant intra-articular glenohumeral injuries in displaced fractures of the lateral clavicle.

    PubMed

    Beirer, Marc; Zyskowski, Michael; Crönlein, Moritz; Pförringer, Dominik; Schmitt-Sody, Marcus; Sandmann, Gunther; Huber-Wagner, Stefan; Biberthaler, Peter; Kirchhoff, Chlodwig

    2017-10-01

    To detect concomitant intra-articular glenohumeral injuries, in acute displaced fractures of the lateral clavicle, initially missed due to unfeasible clinical evaluation of the acutely injured shoulder. All patients suffering from an acute displaced lateral clavicle fracture with indication to surgical treatment underwent diagnostic shoulder arthroscopy prior to open reduction and internal fixation. In case of therapy-relevant intra-articular glenohumeral injuries, subsequent surgical treatment was performed. Intra-articular injuries were found in 13 of 28 patients (46.4 %) with initially suspected isolated lateral clavicle fracture. Additional surgical treatment was performed in 8 of 28 cases (28.6 %). Superior labral anterior-posterior (SLAP) lesions were observed in 4 of 28 patients (14.3 %; SLAP II a: 1; II b: 1; III: 1; and IV: 1). Lesions of the pulley system were found in 3 of 28 patients (10.7 %; Habermeyer III°). One partial articular supraspinatus tendon avulsion lesion (3.6 %) and one lesion of the subscapularis tendon (3.6 %; Fox and Romeo II°) were observed. Traumatic concomitant glenohumeral injuries in lateral clavicle fractures seem to be more frequent than expected in general. Subsequent surgical treatment of these formerly missed but therapy-relevant injuries may increase functional outcome and reduce complication rate. IV.

  9. Associated lateral/medial knee instability and its relevant factors in anterior cruciate ligament-injured knees.

    PubMed

    Yuuki, Arata; Muneta, Takeshi; Ohara, Toshiyuki; Sekiya, Ichiro; Koga, Hideyuki

    2017-03-01

    Associations of lateral/medial knee instability with anterior cruciate ligament (ACL) injury have not been thoroughly investigated. The purposes of this study were to investigate whether lateral/medial knee instability is associated with ACL injury, and to clarify relevant factors for lateral/medial knee instability in ACL-injured knees. One hundred and nineteen patients with unilateral ACL-injured knees were included. Lateral/medial knee instability was assessed with varus/valgus stress X-ray examination for both injured and uninjured knees by measuring varus/valgus angle, lateral/medial joint opening, and lateral/medial joint opening index. Manual knee instability tests for ACL were evaluated to investigate associations between lateral/medial knee instability and anterior and/or rotational instabilities. Patients' backgrounds were evaluated to identify relevant factors for lateral/medial knee instability. Damage on the lateral collateral ligament (LCL) on MRI was also evaluated. All parameters regarding lateral knee instability in injured knees were significantly greater than in uninjured knees. There were significant correlations between lateral knee instability and the Lachman test as well as the pivot shift test. Patients with LCL damage had significantly greater lateral joint opening than those without LCL damage on MRI. Sensitivity of LCL damage on MRI to lateral joint opening was 100%, while its specificity was 36%. No other relevant factors were identified. In medial knee instability, there were also correlations between medial knee instability and the Lachman test/pivot shift test. However, the correlations were weak and other parameters were not significant. Lateral knee instability was greater in ACL-deficient knees than in uninjured knees. Lateral knee instability was associated with ACL-related instabilities as well as LCL damage on MRI, whereas MRI had low specificity to lateral knee instability. On the other hand, the association of medial knee instability on ACL-related instability was less than that of lateral knee instability. Level IV, case series with no comparison group. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  10. Bladder incarceration following anterior pelvic infix of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation.

    PubMed

    Jain, Mantu; Nanda, Saurav Narayan; Mohapatra, Soumya Shrikanta; Samal, Barada Prasanna

    2017-08-01

    Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior external fixator has been traditionally used in variety of unstable pelvis either singly or in combination of posterior screws. These devices are cumbersome and restrict side turning and sitting particularly in obese patients. An alternative, anterior subcutaneous pelvic internal fixation technique (ASPIF) was developed which is well tolerated by patients for mobility and comfort and biomechanically more stable construct Complications of this construct included irritation of the lateral femoral cutaneous nerve, femoral nerve palsy &heterotypic ossification with reduced rates of infections and aseptic loosening as compared to external fixator. Bladder incarceration following treatment has never been reported and we encountered such a problem during management which we want to highlight.

  11. Varus alignment leads to increased forces in the anterior cruciate ligament.

    PubMed

    van de Pol, Gerrit Jan; Arnold, Markus P; Verdonschot, Nico; van Kampen, Albert

    2009-03-01

    Varus thrust of the knee is a dynamic increase of an often preexisting varus angle and it is suspected to be a major reason for failure of anterior cruciate ligament reconstructions. However, it is not known if a direct relationship exists between varus thrust and forces in the anterior cruciate ligament. Forces in the anterior cruciate ligament increase with increasing varus alignment, and consequently an anterior cruciate ligament deficiency in a varus-aligned leg leads to more lateral tibiofemoral joint opening. Controlled laboratory study. Six human cadaver legs were axially loaded with 3 different weightbearing lines--a neutral weightbearing line, a weightbearing line that passes through the middle of the medial tibial plateau (50% varus), and a line passing the edge of the medial tibial plateau (100% varus)--that were used to create a varus moment. The resulting lateral tibiofemoral joint opening and corresponding anterior cruciate ligament tension were measured. The tests were repeated with and without the anterior cruciate ligament in place. In the neutral aligned legs, there was no apparent lateral joint opening, and no anterior cruciate ligament tension change was noted. The lateral joint opening increased when the weightbearing line increased from 0% to 50% to 100%. The lateral joint opening was significantly higher in 10 degrees of knee flexion compared with knee extension. In the 100% varus weightbearing line, the anterior cruciate ligament tension was significantly higher (53.9 N) compared with neutral (31 N) or the 50% weightbearing line (37.9 N). A thrust could only be observed in the 100% weightbearing line tests. In the absence of an anterior cruciate ligament, there was more lateral joint opening, although this was only significant in the 100% weightbearing line. There is a direct relationship between varus alignment and anterior cruciate ligament tension. In the absence of an anterior cruciate ligament, the amount of lateral opening tends to increase. With increasing lateral opening, a thrust can sometimes be experimentally observed. A varus alignment in an anterior cruciate ligament-deficient knee does not necessarily lead to a varus thrust and therefore does not always need operative varus alignment correction. However, in an unstable anterior cruciate ligament-deficient knee with a varus thrust, it might be safer to perform a high valgus tibial osteotomy to minimize the risk of an anterior cruciate ligament reconstruction failure.

  12. Effect of open wedge high tibial osteotomy on the lateral compartment in sheep. Part I: Analysis of the lateral meniscus.

    PubMed

    Madry, Henning; Ziegler, Raphaela; Orth, Patrick; Goebel, Lars; Ong, Mei Fang; Kohn, Dieter; Cucchiarini, Magali; Pape, Dietrich

    2013-01-01

    To evaluate whether medial open wedge high tibial osteotomy (HTO) results in structural and biochemical changes in the lateral meniscus in adult sheep. Three experimental groups with biplanar osteotomies of the right proximal tibiae were tested: (a) closing wedge HTO resulting in 4.5° of tibial varus, (b) open wedge HTO resulting in 4.5° of tibial valgus (standard correction) and (c) open wedge HTO resulting in 9.5° of valgus (overcorrection), each of which was compared to the contralateral knees with normal limb axes. After 6 months, the lateral menisci were macroscopically and microscopically evaluated. The proteoglycan and DNA contents of the red-red and white-white zones of the anterior, middle and posterior third were determined. Semiquantitative macroscopic and microscopic grading revealed no structural differences between groups. The red-red zone of the middle third of the lateral menisci of animals that underwent overcorrection exhibited a significant 0.7-fold decrease in mean DNA contents compared with the control knee without HTO (P = 0.012). Comparative estimation of the DNA and proteoglycan contents and proteoglycan/DNA ratios of all other parts and zones of the lateral menisci did not reveal significant differences between groups. Open wedge HTO does not lead to significant macroscopic and microscopic structural changes in the lateral meniscus after 6 months in vivo. Overcorrection significantly decreases the proliferative activity of the cells in the red-red zone of the middle third in the sheep model.

  13. Inheritance patterns of morphological laterality in mouth opening of zebrafish, Danio rerio.

    PubMed

    Hata, Hiroki; Hori, Michio

    2012-01-01

    The inheritance patterns of asymmetry in mouth opening in zebrafish were investigated using crossing experiments. Zebrafish exhibit asymmetric laterality in mouth opening, with each individual having either a leftward (righty) or rightward (lefty) bias. All righty incrosses produced only righty F(1), whereas all lefty incrosses resulted in an F(1) L:R ratio of 2:1. All test crosses between lefty and righty individuals resulted in an F(1) L:R=1:1. These results were consistent with the hereditary pattern for Japanese medaka, three Tanganyikan cichlids, and a Japanese riverine goby. The pattern suggests a one-locus two-allele Mendelian model of inheritance, with the lefty allele being dominant over righty and the dominant homozygote being lethal. To determine the reason for the absence of lefty homozygotes, the survival rates of the offspring were examined according to developmental stage. Survival did not differ among combinations of parent laterality. Thus the mechanism underlying the lethality of the dominant homozygote remains unclear. This study showed that the mouth-opening laterality of zebrafish is genetically determined and that the direction follows a Mendelian inheritance pattern that is shared among cypriniform zebrafish, beloniform medaka, perciform cichlids, and a goby, suggesting a common genetic background in mouth-opening laterality among these species.

  14. A pilot hole does not reduce the strains or risk of fracture to the lateral cortex during and following a medial opening wedge high tibial osteotomy in cadaveric specimens.

    PubMed

    Bujnowski, K; Getgood, A; Leitch, K; Farr, J; Dunning, C; Burkhart, T A

    2018-02-01

    It has been suggested that the use of a pilot-hole may reduce the risk of fracture to the lateral cortex. Therefore the purpose of this study was to determine the effect of a pilot hole on the strains and occurrence of fractures at the lateral cortex during the opening of a high tibial osteotomy (HTO) and post-surgery loading. A total of 14 cadaveric tibias were randomized to either a pilot hole (n = 7) or a no-hole (n = 7) condition. Lateral cortex strains were measured while the osteotomy was opened 9 mm and secured in place with a locking plate. The tibias were then subjected to an initial 800 N load that increased by 200 N every 5000 cycles, until failure or a maximum load of 2500 N. There was no significant difference in the strains on the lateral cortex during HTO opening between the pilot hole and no-hole conditions. Similarly, the lateral cortex and fixation plate strains were not significantly different during cyclic loading between the two conditions. Using a pilot hole did not significantly decrease the strains experienced at the lateral cortex, nor did it reduce the risk of fracture. The nonsignificant differences found here most likely occurred because the pilot hole merely translated the stress concentration laterally to a parallel point on the surface of the hole. Cite this article : K. Bujnowski, A. Getgood, K. Leitch, J. Farr, C. Dunning, T. A. Burkhart. A pilot hole does not reduce the strains or risk of fracture to the lateral cortex during and following a medial opening wedge high tibial osteotomy in cadaveric specimens. Bone Joint Res 2018;7:166-172. DOI: 10.1302/2046-3758.72.BJR-2017-0337.R1.

  15. Experimental study on the influence of the opening in brick-masonry wall to seismic performance of reinforced concrete frame structures

    NASA Astrophysics Data System (ADS)

    Maidiawati, Tanjung, Jafril; Medriosa, Hamdeni

    2017-10-01

    Reinforced concrete (RC) frame structures with brick-masonry infills are commonly used in developing countries and high-risk seismic area, such as Indonesia. Significant researches have been carried out for studying the seismic performance of RC frame structures with brick-masonry infills. Only few of them focused on effects of the opening in the brick-masonry infill to the seismic performance of the RC frame structures. The presence of opening in brick-masonry infill is often used for placing doors and windows as well, however, it may reduce the seismic performance of the RC frame structure. In the current study, they influence of the opening in brick-masonry infills to the seismic performance RC frame structure will experimentally evaluated. Five of 1/4-scaled single story and single bay RC frame specimens were prepared, i.e. an RC bare frame, a clay brick-masonry infilled RC frame and three of clay brick-masonry infilled RC frame with openings in the brick-masonry infills. The last three specimens were clay brick infilled RC frame with a center opening, clay brick infilled RC frame with two openings used for placing the windows and clay brick infilled RC frame with opening for placing the door. The specimens pushed over by applying the static monotonic lateral load to the upper beam of the RC frame structures. The incremental of the lateral load and the lateral displacement of RC frame's column was recorded during test. The crack propagation and the major cracks were also observed to identify the mechanism failure of specimens. As the results, the opening in the brick-masonry wall controls the failure mechanism, the lateral strength and the stiffness of the overall of infilled RC frame structure. The diagonal shear crack pattern was found on brick-masonry wall without opening, on other hand the different crack patterns were observed on brick-masonry wall with openings. Although the opening in the brick masonry infill reduced the lateral strength and stiffness of the infilled RC frame, it was still stronger and stiffer than the bare frame.

  16. Endodontic Management of a Maxillary Lateral Incisor with 4 Root Canals and a Dens Invaginatus Tract.

    PubMed

    Nosrat, Ali; Schneider, S Craig

    2015-07-01

    Dens invaginatus (DI) is associated with complex internal anatomy. This article represents a maxillary lateral incisor with 5 root canals including DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. After clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with symptomatic apical periodontitis. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 5 separate canals (4 root canals and 1 DI canal extending through the root to the periodontal ligament), communication between DI and the root canal system, and severe and multiple curvatures of the palatal canals. Root canal treatment was completed in 2 visits. Modified access openings were required to safely treat the dilacerated palatal canals. At the 6-month re-evaluation, the patient reported he had remained asymptomatic and his tooth had remained functional since the treatment was completed. Clinical examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (≤3 mm), and no mobility. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Three-dimensional imaging is recommended for evaluating and treatment planning cases with DI. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. The artificial organ museum in Cleveland (1979-1999) moved to Houston, Texas, and named in 2002 as the ICMT Museum for Artificial Organs.

    PubMed

    Nosé, Yukihiko

    2003-09-01

    The artificial organ museum established in Cleveland, Ohio, in 1979 organized by the International Center for Artificial Organs and Transplantation (ICAOT), was moved to Houston, Texas, in 1999. The museum with expanded and renewed artificial organ exhibits was officially opened on the 8th and 9th of November, 2002, at the Cullen Pavilion of the original Memorial Hermann Hospital. This building is the oldest in the Texas Medical Center, which was built in 1922. The ICMT (International Center for Medical Technologies) Museum for Artificial Organs (Museum) was completed after phase I, II, and III expansions of the exhibit booths, which were made over the last two years. Approximately 250 historically important and currently widely used artificial organs are exhibited in the Museum. The official opening of the Museum was coordinated with the "Symposium on Artificial Organs: Past, Present, and Future" during two days in November. There were approximately 225 participants at these events, and approximately 40 pioneers and clinical experts in the development and practice of various types of artificial organs contributed. During these programs, a proposal to maintain human resources in addition to artificial organ hardware and software was made in addition to the Museum. This new organization would be called the International Academy of Artificial Organ Pioneers (Academy). All contributors to the symposium were invited to be members of the Academy. The attendants of the symposium accepted this proposal unanimously. An additional 40 individuals, who were recognized as contributors to artificial organ technologies, were later added to the original Academy members. Later, the effective utilization of the Museum and Academy was encompassed in the International Faculty for Health and Medical Technologies (Faculty), a new addition to the activities of the ICMT. Dr. Michael DeBakey was elected as Dean of the Faculty. This is considered a "university without walls," a "university linked to the world," and a "university providing simultaneous teaching at multiple sites"--a completely new concept in teaching tools for medical technologies. All of these subsidiary organizations of the ICMT were legally included as nonprofit, nontaxable charity organizations of the state of Texas.

  18. Three-dimensional super-resolved live cell imaging through polarized multi-angle TIRF.

    PubMed

    Zheng, Cheng; Zhao, Guangyuan; Liu, Wenjie; Chen, Youhua; Zhang, Zhimin; Jin, Luhong; Xu, Yingke; Kuang, Cuifang; Liu, Xu

    2018-04-01

    Measuring three-dimensional nanoscale cellular structures is challenging, especially when the structure is dynamic. Owing to the informative total internal reflection fluorescence (TIRF) imaging under varied illumination angles, multi-angle (MA) TIRF has been examined to offer a nanoscale axial and a subsecond temporal resolution. However, conventional MA-TIRF still performs badly in lateral resolution and fails to characterize the depth image in densely distributed regions. Here, we emphasize the lateral super-resolution in the MA-TIRF, exampled by simply introducing polarization modulation into the illumination procedure. Equipped with a sparsity and accelerated proximal algorithm, we examine a more precise 3D sample structure compared with previous methods, enabling live cell imaging with a temporal resolution of 2 s and recovering high-resolution mitochondria fission and fusion processes. We also shared the recovery program, which is the first open-source recovery code for MA-TIRF, to the best of our knowledge.

  19. Osteogenesis Imperfecta Diagnosed from Mandibular and Lower Limb Fractures: A Case Report.

    PubMed

    Kobayashi, Yoshikazu; Satoh, Koji; Mizutani, Hideki

    2016-06-01

    Osteogenesis imperfecta (OI) is a congenital disease characterized by bone fragility and low bone mass. Despite the variety of its manifestation and severity, facial fractures occur very infrequently. Here, we report a case of an infant diagnosed with OI after mandibular and lower limb fractures. A boy aged 1 year and 3 months was brought to his neighboring hospital with a complaint of facial injury. He was transferred to our hospital to undergo operation 3 days later. Computed tomography images revealed multiple mandibular fractures including complete fracture in the symphysis and dislocated condylar fracture on the right side. Open reduction and internal fixation with absorbable implants was performed 7 days after injury. He fractured his right lower limb 2 months later. He was diagnosed with OI type IA by an orthopedist. He will be administered bone-modifying agents if he suffers from frequent fractures.

  20. Bovine xenograft application for treatment of a metatarsal nonunion fracture in an alpaca (Vicugna pacos).

    PubMed

    Longo, F; Finotti, L; Bellini, L; Zavan, B; Busetto, R; Isola, M

    2016-05-01

    A 15-year-old female huacaya alpaca (Vicugna pacos) was referred because of a non-weight-bearing lameness (4/4) in the left pelvic limb caused by a grade three open metatarsal fracture. The referring veterinarian treated the fracture with conservative management using bandages, but it progressively evolved to a non-union. Clinical examination revealed external wounds on the medial and lateral surfaces of the metatarsus. Radiographs confirmed an open, nonarticular, displaced, diaphyseal fracture of the left metatarsus. Cancellous bone was sourced from bovine proximal and distal femur epiphyses, followed by a thermal shock procedure to achieve decellularisation, to produce a xenograft. Open reduction and internal fixation of the fracture using locking plates was performed. Alignment of the fracture fragments was corrected and the xenograft was placed at the debrided fracture site to stimulate and harness osteogenesis in situ. Clinical and radiographic follow-up was performed up to 40 weeks postoperatively. Clinical evaluations revealed that the alpaca gradually increased weight bearing following bandage removal 10 days after surgery. Serial radiographs showed correct alignment of the left metatarsus, progressive bone modelling and, complete bone union at 12 weeks. Ten months postoperatively the alpaca showed no signs of lameness and resumed normal activity. For management of a metatarsal non-union, a combination of bovine xenograft application and angular stable internal fixation progressed toward an excellent long-term recovery.

  1. Mandibular kinematic changes after unilateral cross-bite with lateral shift correction.

    PubMed

    Venancio, F; Alarcon, J A; Lenguas, L; Kassem, M; Martin, C

    2014-10-01

    The aim of this randomised prospective study was to evaluate the effects of slow maxillary expansion with expansion plates and Hyrax expanders on the kinematics of the mandible after cross-bite correction. Thirty children (15 boys and 15 girls), aged 7·1-11·8, with unilateral cross-bite and functional shift were divided into two groups: expansion plate (n = 15) and Hyrax expander (n = 15). Thirty children with normal occlusion (14 boys and 16 girls, aged 7·3-11·6) served as control group. The maximum vertical opening, lateral mandibular shift (from maximum vertical opening to maximum intercuspation, from rest position to maximum intercuspation and from maximum vertical opening to rest position) and lateral excursions were recorded before and 4 months after treatment. After treatment, the expansion plate group showed a greater lateral shift from rest position to maximum intercuspation than did the control group. The expansion plate patients also presented greater left/contralateral excursion than did the control group. Comparisons of changes after treatment in the cross-bite groups showed significant decreases in the lateral shift from the maximum vertical opening to maximum intercuspation and from the maximum vertical opening to rest position, a significant increase in the homolateral excursion and a significant decrease in the contralateral excursion in the Hyrax expander group, whereas no significant differences were found in the expansion plate group. In conclusion, the Hyrax expander showed better results than did the expansion plate. The Hyrax expander with acrylic occlusal covering significantly improved the mandibular lateral shift and normalised the range of lateral excursion. © 2014 John Wiley & Sons Ltd.

  2. Modified arthroscopic Brostrom procedure.

    PubMed

    Lui, Tun Hing

    2015-09-01

    The open modified Brostrom anatomic repair technique is widely accepted as the reference standard for lateral ankle stabilization. However, there is high incidence of intra-articular pathologies associated with chronic lateral ankle instability which may not be addressed by an isolated open Brostrom procedure. Arthroscopic Brostrom procedure with suture anchor has been described for anatomic repair of chronic lateral ankle instability and management of intra-articular lesions. However, the complication rates seemed to be higher than open Brostrom procedure. Modification of the arthroscopic Brostrom procedure with the use of bone tunnel may reduce the risk of certain complications. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  3. Fuselage ventilation due to wind flow about a postcrash aircraft

    NASA Technical Reports Server (NTRS)

    Stuart, J. W.

    1980-01-01

    Postcrash aircraft fuselage fire development, dependent on the internal and external fluid dynamics is discussed. The natural ventilation rate, a major factor in the internal flow patterns and fire development is reviewed. The flow about the fuselage as affected by the wind and external fire is studied. An analysis was performend which estimated the rates of ventilation produced by the wind for a limited idealized environmental configuration. The simulation utilizes the empirical pressure coefficient distribution of an infinite circular cylinder near a wall with its boundary later flow to represent the atmospheric boundary layer. The resulting maximum ventilation rate for two door size openings, with varying circumferential location in a common 10 mph wind was an order of magnitude greater than the forced ventilation specified in full scale fire testing. The parameter discussed are: (1) fuselage size and shape, (2) fuselage orientation and proximity to the ground, (3) fuselage-openings size and location, (4) wind speed and direction, and (5) induced flow of the external fire plume is recommended. The fire testing should be conducted to a maximum ventilation rate at least an order of magnitude greater than the inflight air conditioning rates.

  4. Newly designed anterolateral and posterolateral locking anatomic plates for lateral tibial plateau fractures: a finite element study.

    PubMed

    Chen, Pengbo; Lu, Hua; Shen, Hao; Wang, Wei; Ni, Binbin; Chen, Jishizhan

    2017-02-23

    Lateral column tibial plateau fracture fixation with a locking screw plate has higher mechanical stability than other fixation methods. The objectives of the present study were to introduce two newly designed locking anatomic plates for lateral tibial plateau fracture and to demonstrate their characteristics of the fixation complexes under the axial loads. Three different 3D finite element models of the lateral tibial plateau fracture with the bone plates were created. Various axial forces (100, 500, 1000, and 1500 N) were applied to simulate the axial compressive load on an adult knee during daily life. The equivalent maps of displacement and stress were output, and relative displacement was calculated along the fracture lines. The displacement and stresses in the fixation complexes increased with the axial force. The equivalent displacement or stress map of each fixation under different axial forces showed similar distributing characteristics. The motion characteristics of the three models differed, and the max-shear stress of trabecula increased with the axial load. These two novel plates could fix lateral tibial plateau fractures involving anterolateral and posterolateral fragments. Motions after open reduction and stable internal fixation should be advised to decrease the risk of trabecular microfracture. The relative displacement of the posterolateral fragments is different when using anterolateral plate and posterolateral plate, which should be considered in choosing the implants for different posterolateral plateau fractures.

  5. Knee Joint Kinematics and Kinetics During a Lateral False-Step Maneuver

    PubMed Central

    Golden, Grace M.; Pavol, Michael J.; Hoffman, Mark A.

    2009-01-01

    Abstract Context: Cutting maneuvers have been implicated as a mechanism of noncontact anterior cruciate ligament (ACL) injuries in collegiate female basketball players. Objective: To investigate knee kinematics and kinetics during running when the width of a single step, relative to the path of travel, was manipulated, a lateral false-step maneuver. Design: Crossover design. Setting: University biomechanics laboratory. Patients or Other Participants: Thirteen female collegiate basketball athletes (age  =  19.7 ± 1.1 years, height  =  172.3 ± 8.3 cm, mass  =  71.8 ± 8.7 kg). Intervention(s): Three conditions: normal straight-ahead running, lateral false step of width 20% of body height, and lateral false step of width 35% of body height. Main Outcome Measure(s): Peak angles and internal moments for knee flexion, extension, abduction, adduction, internal rotation, and external rotation. Results: Differences were noted among conditions in peak knee angles (flexion [P < .01], extension [P  =  .02], abduction [P < .01], and internal rotation [P < .01]) and peak internal knee moments (abduction [P < .01], adduction [P < .01], and internal rotation [P  =  .03]). The lateral false step of width 35% of body height was associated with larger peak flexion, abduction, and internal rotation angles and larger peak abduction, adduction, and internal rotation moments than normal running. Peak flexion and internal rotation angles were also larger for the lateral false step of width 20% of body height than for normal running, whereas peak extension angle was smaller. Peak internal rotation angle increased progressively with increasing step width. Conclusions: Performing a lateral false-step maneuver resulted in changes in knee kinematics and kinetics compared with normal running. The differences observed for lateral false steps were consistent with proposed mechanisms of ACL loading, suggesting that lateral false steps represent a hitherto neglected mechanism of noncontact ACL injury. PMID:19771289

  6. Restoration of Long Standing Traumatized Teeth: A Case Report

    PubMed Central

    Kadkol, Prasanna Kumar; Reddy, K. Veera Kishore Kumar; Ainapur, Raghavendra

    2015-01-01

    Children are uniquely susceptible to craniofacial trauma. Injuries to the teeth occur often as a result of falls and sport activities. The pulp often gets infected after dental trauma resulting in to numerous complications. The authors present a case report of successful restoration of traumatized teeth with open apex which were weakened due to long standing infection and internal resorption. Initially antibiotic combination of 3- mix was used to disinfect the root canals. One tooth is treated with conventional endodontic treatment and the other tooth with open apex and perforation is managed by MTA apexification followed by canal reinforcement using glass ionomer cement and fiber reinforced composite post. Core build up is done using light cure composite resin followed by aesthetic crowns. The patient also presented with the peg shaped lateral incisors, which were built to an aesthetic appearance using light cure composite resins. PMID:26436062

  7. Chewing movements altered in the presence of temporomandibular joint internal derangements.

    PubMed

    Radke, John C; Kull, Robert S; Sethi, Manminder S

    2014-07-01

    The objectives were to find specific factors that are mathematically distinct between the chewing timings, movement pattern shapes, variability, and movement velocities of: (1) normal asymptomatic subjects and (2) a group of subjects with verified temporomandibular joint (TMJ) internal derangements. Left- and right-sided chewing movement recordings of 28 subjects (34.5 ± 14.0 years) were randomly selected from a large database of patients exhibiting verified unilateral or bilateral TMJ internal derangements. The chewing movements of an age- and gender-matched control group of 20 asymptomatic subjects (32.5 ± 11.6 years, P>0.60) with verified normal TMJ function were also recorded. Means and standard deviations of the opening, closing, turning point, terminal chewing position, and velocity patterns were calculated. A two-tailed Student's t-test with unequal variances was used to compare the parameters between the two groups (alpha = 0.05). The dysfunctional group functioned significantly slower and with greater variability than the control group. The vertical dimension was consistently smaller in the dysfunctional group (P<0.00001). The terminal chewing position was significantly less precise in the dysfunctional group (vertical: P<0.002 and lateral: P<0.037). The maximum lateral width was significantly less (P<0.0071), and the peak and the average velocities were significantly lower (P<0.00001 for both) in the dysfunctional group. This group of dysfunctional subjects exhibited significantly slower, smaller, and more variable chewing patterns than the control group. The functional pattern of mastication appears to be significantly altered in the presence of an internal derangement of the TMJ.

  8. Open versus closed reduction: diacapitular fractures of the mandibular condyle.

    PubMed

    Chrcanovic, Bruno Ramos

    2012-09-01

    The purpose of the study was to review the literature regarding the evolution of current thoughts on management of diacapitular fractures (DFs) of the mandibular condyle. An electronic search in PubMed was undertaken in March 2012. The titles and abstracts from these results were read to identify studies within the selection criteria. Eligibility criteria included studies reporting clinical series of DFs, including both animal and human studies, without date or language restrictions. The search strategy initially yielded 108 references. Twenty-eight studies were identified without repetition within the selection criteria. Additional hand-searching of the reference lists of selected studies yielded three additional papers. The current indications for open reduction and internal fixation (ORIF) of DFs described in the literature are: (a) fractures affecting the lateral condyle with reduction of mandibular height; (b) fractures in which the proximal fragment dislocates laterally out of the glenoid fossa, which cannot be reduced by closed or open treatment of another part of the mandibular fracture. The indications for conservative treatment are: (a) fractures that do not shorten the condylar height (a fracture with displacement of the medial parts of the condyle); (b) undisplaced fractures; (c) comminution of the condylar head, when the bony fragments are too small for stable fixation; and (d) fractures in children. As the temporomandibular joint disk plays an important role as a barrier preventing ankylosis, it is important to reposition the disk (if displaced/dislocated) during the surgical treatment of DFs. The lateral pterygoid muscle should never be stripped from the medially displaced fragment because its desinsertion disrupts circulation to the medial bony fragment, and also because this muscle helps to restore the muscle function after surgery. ORIF of selected DFs improves prognosis by anatomical bone and soft tissue recovery when combined with physical therapy. If conducted properly, surgical treatment of DFs is a safe and predictable procedure and yields good results.

  9. A comparison of the "All-Inside" arthroscopic Broström procedure with the traditional open modified Broström-Gould technique: A review of 62 patients.

    PubMed

    Rigby, Ryan B; Cottom, James M

    2018-02-05

    The open Broström-Gould lateral ankle stabilization procedure has been the gold standard for primary lateral ankle stabilization. A new minimally invasive all-inside arthroscopic technique has been described for the correction of lateral ankle instability. We performed a review of patients who underwent lateral ankle stabilization by either the traditional open Broström-Gould (BG) or the All-Inside Bröstrom (AIB) technique to compare and identify any discrepancies between functional and/or patient satisfaction outcomes. A total of 62 patients underwent a lateral ankle stabilization. Of those 62 patients, 32 received a traditional open Broström-Gould procedure and 30 patients underwent an All-Inside Bröstrom type procedure. The two groups were compared preoperatively with AOFAS ankle-hindfoot scoring system and Visual Analog Score (VAS) for pain. Postoperatively, AOFAS, Karlsson Peterson and VAS scores were compared. The mean preoperative VAS pain score for the open Broström-Gould was 7.28, the All-Inside Broström was 8.18. The mean postoperative VAS pain score for the open Broström-Gould was 1.2, the All-Inside Broström was 1.5. The mean preoperative AOFAS score for the Broström-Gould was 35.44, the All-Inside Broström was 35.07. The mean postoperative AOFAS score for the open Broström-Gould was 93.53, the All-Inside Broström was 95.33. The mean postoperative Karlsson Peterson score for the open Broström-Gould was 93.41, the All-Inside Broström was 91.80. The mean time to weight bearing for the Broström-Gould was 22 days, the All-Inside Broström was 12 days. There were no statistically significant differences identified in any of the functional or patient satisfaction outcome scores using either technique. This review suggests the minimally invasive arthroscopic technique using bone anchors for lateral ankle stabilization may be comparable to the traditional open Broström-Gould with the added advantage of earlier time to weight bearing. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  10. Contralateral Breast Dose After Whole-Breast Irradiation: An Analysis by Treatment Technique

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

    Williams, Terence M.; Moran, Jean M., E-mail: jmmoran@med.umich.edu; Hsu, Shu-Hui

    2012-04-01

    Purpose: To investigate the contralateral breast dose (CBD) across a continuum of breast-conservation therapy techniques. Methods and Materials: An anthropomorphic phantom was CT-simulated, and six treatment plans were generated: open tangents, tangents with an external wedge on the lateral beam, tangents with lateral and medial external wedges, a simple segment plan (three segments per tangent), a complex segmental intensity-modulated radiotherapy (IMRT) plan (five segments per tangent), and a beamlet IMRT plan (>100 segments). For all techniques, the breast on the phantom was irradiated to 5000 cGy. Contralateral breast dose was measured at a uniform depth at the center and eachmore » quadrant using thermoluminescent detectors. Results: Contralateral breast dose varied with position and was 50 {+-} 7.3 cGy in the inner half, 24 {+-} 4.1 cGy at the center, and 16 {+-} 2.2 cGy in the outer half for the open tangential plan. Compared with an average dose of 31 cGy across all points for the open field, the average doses were simple segment 32 cGy (range, 99-105% compared with open technique), complex segment 34 cGy (range, 103-117% compared with open technique), beamlet IMRT 34 cGy (range, 103-124% compared with open technique), lateral wedge only 46 cGy (range, 133-175% compared with open technique), and medial and lateral wedge 96 cGy (range, 282-370% compared with open technique). Conclusions: Single or dual wedge techniques resulted in the highest CBD increases compared with open tangents. To obtain the desired homogeneity to the treated breast while minimizing CBD, segmental and IMRT techniques should be encouraged over external physical compensators.« less

  11. Randomized clinical trial of transcutaneous electrical posterior tibial nerve stimulation versus lateral internal sphincterotomy for treatment of chronic anal fissure.

    PubMed

    Youssef, Tamer; Youssef, Mohamed; Thabet, Waleed; Lotfy, Ahmed; Shaat, Reham; Abd-Elrazek, Eman; Farid, Mohamed

    2015-10-01

    The objective of this study was to evaluate the efficacy of transcutaneous electrical posterior tibial nerve stimulation in treatment of patients with chronic anal fissure and to compare it with the conventional lateral internal sphincterotomy. Consecutive patients with chronic anal fissure were randomly allocated into two treatment groups: transcutaneous electrical posterior tibial nerve stimulation group and lateral internal sphincterotomy group. The primary outcome measures were number of patients with clinical improvement and healed fissure. Secondary outcome measures were complications, VAS pain scores, Wexner's constipation and Peascatori anal incontinence scores, anorectal manometry, and quality of life index. Seventy-three patients were randomized into two groups of 36 patients who were subjected to transcutaneous electrical nerve stimulation and 37 patients who underwent lateral internal sphincterotomy. All (100%) patients in lateral internal sphincterotomy group had clinical improvement at one month following the procedure in contrast to 27 (75%) patients in transcutaneous electrical nerve stimulation group. Recurrence of anal fissure after one year was reported in one (2.7%) and 11 (40.7%) patients in lateral internal sphincterotomy and transcutaneous electrical nerve stimulation groups respectively. Resting anal pressure and functional anal canal length were significantly reduced after lateral internal sphincterotomy. Transcutaneous electrical posterior tibial nerve stimulation for treatment of chronic anal fissure is a novel, non-invasive procedure and has no complications. However, given the higher rate of clinical improvement and fissure healing and the lower rate of fissure recurrence, lateral internal sphincterotomy remains the gold standard for treating chronic anal fissure. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  12. Effects of Lateral and Medial Wedged Insoles on Knee and Ankle Internal Joint Moments During Walking in Healthy Men.

    PubMed

    Fukuchi, Claudiane A; Lewinson, Ryan T; Worobets, Jay T; Stefanyshyn, Darren J

    2016-11-01

    Wedged insoles have been used to treat knee pathologies and to prevent injuries. Although they have received much attention for the study of knee injury, the effects of wedges on ankle joint biomechanics are not well understood. This study sought to evaluate the immediate effects of lateral and medial wedges on knee and ankle internal joint loading and center of pressure (CoP) in men during walking. Twenty-one healthy men walked at 1.4 m/sec in five footwear conditions: neutral, 6° (LW6) and 9° (LW9) lateral wedges, and 6° (MW6) and 9° (MW9) medial wedges. Peak internal knee abduction moments and angular impulses, internal ankle inversion moments and angular impulses, and mediolateral CoP were analyzed. Analysis of variance with post hoc analysis and Pearson correlations were performed to detect differences between conditions. No differences in internal knee joint loading were found between neutral and any of the wedge conditions. However, as the wedge angle increased from medial to lateral, the internal ankle inversion moment (LW6: P = .020; LW9: P < .001; MW6: P = .046; MW9: P < .001) and angular impulse (LW9: P = .012) increased, and the CoP shifted laterally (LW9: P < .001) and medially (MW9: P < .001) compared with the neutral condition. Neither lateral nor medial wedges were effective in altering internal knee joint loading during walking. However, the greater internal ankle inversion moment and angular impulse observed with lateral wedges could lead to a higher risk of ankle injury. Thus, caution should be taken when lateral wedges need to be prescribed.

  13. Surgical treatment of scapulohumeral subluxation in an alpaca (Vicugna pacos) using osteotomy of the acromion, open reduction and extracapsular tension sutures.

    PubMed

    Kofler, J; Eberspächer, E; Fischl, K; Vidoni, B

    2016-05-01

    A 3.3-year-old male alpaca, weighing 60 kg was referred for investigation of a severe left forelimb lameness of 4 weeks duration. A scapulohumeral subluxation had been diagnosed radiographically by the referring veterinarian. Based on clinical, ultrasonographic and radiographic findings the diagnosis of cranio-lateral subluxation of the left humeral head was confirmed. In addition, a full thickness lesion (approximately 1×1 cm) of the articular cartilage on the caudomedial aspect of the humeral head was diagnosed by arthroscopy. Treatment included open reduction with internal fixation. Severe muscle contraction and local tissue fibrosis around the scapulohumeral joint (SHJ) required osteotomy of the acromion 3 cm proximal to the distal acromial edge, to allow adequate access. Internal stabilisation was achieved by placing tension band sutures between one cortical screw in the scapular neck and two cortical screws, with washers, craniolaterally on the greater tubercle of the humerus. Post-surgery, a carpal flexion sling was applied with the carpus maintained in 70° flexion for 4 weeks to avoid postoperative weight-bearing. An exercise programme was started 8 days after surgery and continued for 12 weeks. The alpaca had an uneventful postsurgical recovery and showed no lameness after 8 weeks. The long-term outcome was excellent; 21 months after surgery the alpaca was sound and the range of movement of the left SHJ was equal to the right SHJ. Even in this chronic case of subluxation of the SHJ of 4 weeks duration, surgical treatment using osteotomy of the acromion, open reduction and internal fixation with extracapsular scapulohumeral tension sutures resulted in an excellent long-term outcome in this alpaca, despite the presence of a cartilage lesion.

  14. Open reduction and internal fixation of Ideberg IV and V glenoid intra-articular fractures through a Judet approach: a retrospective analysis of 11 cases.

    PubMed

    Hu, Chuanzhen; Zhang, Weibin; Qin, Hui; Shen, Yuhui; Xue, Zichao; Ding, Haoliang; An, Zhiquan

    2015-02-01

    To evaluate the methods and the outcomes of complex intra-articular glenoid fractures, treated by open reduction and internal fixations. The outcomes of 11 cases of complex intra-articular glenoid scapular fractures were retrospectively analyzed. The fractures were classified as type IV in five cases, type Va in two and Vb in four cases, according to Ideberg classification system. The mean step or gap between the main articular fragments was 6.3 ± 6.2 (4-25) mm. The fractures were openly reduced through a Judet approach and fixed with reconstructive plates or bands placed on the lateral and medial side of affected scapula, respectively. The main articular fragments were strengthened with a 4.0-mm cannulated screw in five cases. The bone union, the anterior flexion, the external and internal rotation of the shoulders were checked and recorded. The functional outcomes were evaluated using DASH questionnaire, Constant and UCLA shoulder score systems, respectively. 11 patients were followed up with an average of 28.2 ± 12.6 (12-50) months. All the fractures were united smoothly without second intervention. At the latest visiting, the mean anterior flexion of affected shoulder was 157.3 ± 7.37° (range 150°-170°), the mean external rotation of the affected shoulder was 58.2 ± 7.5° (range 50°-70°). When the shoulder in the internal rotation, the extended thumb reached to L4 or L1 or T10 or T7 in one case, to T12 in two cases and to T8 in four cases, respectively, the mean Constant score was 91.7 ± 2.8 (86-96) points. The mean UCLA score was 32.7 ± 1.7 (30-35) points, leading to four cases of excellent and seven cases of good results. The mean DASH score was 7.4 ± 3.3 (3.4-13) points. Good outcomes could be obtained when Ideberg IV and V glenoid fractures were treated by open reduction and internal fixation through a Judet approach.

  15. Transmasseteric anterior parotid approach for condylar fractures: experience of 129 cases.

    PubMed

    Narayanan, Vinod; Ramadorai, Ashok; Ravi, Poornima; Nirvikalpa, Natarajan

    2012-07-01

    We have evaluated the transmasseteric anterior parotid (TMAP) approach in the treatment of 163 condylar fractures in 129 patients. Ninety-five patients presented with unilateral, and 34 with bilateral, fractures. The inclusion criteria were patient's choice for open reduction and internal fixation, displaced unilateral condylar fractures with occlusal derangement, and displaced bilateral condylar fractures with anterior open bite. Mean (SD) maximum interincisal opening after 3 months was 44(5)mm. There were no differences in lateral movements during the reviews 6 weeks and 3 months postoperatively. Protrusive movement at the end of 3 months was 7(2)mm. All patients achieved functional occlusion identical to the pretraumatic occlusion and good reduction of the condyles. No patient developed temporary or permanent facial palsy, sialocele, salivary fistula, or Frey syndrome. The mean (SD) operating time was 46(11)min. The TMAP approach avoids the complications of incision of the parotid gland, minimises the risk of facial nerve palsy, and offers excellent access to the fractured condyle. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. 48 CFR 14.302 - Bid submission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... paragraphs (b) and (c) below as the designated office) not later than the exact time set for opening of bids... later than the time set for the bid opening; (4) The telegraph office that received the telegraphic bid... indicates on its face that it was received in the telegraph office before the telephone call was received by...

  17. Conversion of external fixation to open reduction and internal fixation for complex distal radius fractures.

    PubMed

    Natoli, R M; Baer, M R; Bednar, M S

    2016-05-01

    Distal radius fractures are common injuries treated in a multitude of ways. One treatment paradigm not extensively studied is initial treatment by external fixation (EF) followed by conversion to open reduction internal fixation (ORIF). Such a paradigm may be beneficial in damage control situations, when there is extensive soft tissue injury, or when appropriate personnel/hospital resources are not available for immediate internal fixation. There is no increased risk of infection when converting EF to ORIF in the treatment of complex distal radius fractures when conversion occurs early or if EF pin sites are overlapped by the definitive fixation. Using an IRB approved protocol, medical records over nine years were queried to identify patients with distal radius fractures that had undergone initial EF and were later converted to ORIF. Charts were reviewed for demographic data, injury characteristics, operative details, time to conversion from EF to ORIF, assessment of whether the EF pin sites overlapped the definitive fixation, presence of infection after ORIF, complications, and occupational therapy measurements of range of motion and strength. In total, 16 patients were identified, only one of which developed an infection following conversion to ORIF. Fisher's exact testing showed that infection did not depend on open fracture, time to conversion of one week or less, presence of EF pin sites overlapping definitive fixation, fracture classification, high energy mechanism of injury, or concomitant injury to the DRUJ. Planned staged conversion from EF to ORIF for complex distal radius fractures does not appear to result in an increased rate of infection if conversion occurs early or if the EF pin sites are overlapped by definitive fixation. This treatment paradigm may be reasonable for treating complex distal radius fractures in damage control situations, when there is extensive soft tissue injury, or when appropriate personnel/hospital resources are not available for immediate internal fixation. IV, retrospective case series. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Hydrophobically stabilized open state for the lateral gate of the Sec translocon

    PubMed Central

    Zhang, Bin; Miller, Thomas F.

    2010-01-01

    The Sec translocon is a central component of cellular pathways for protein translocation and membrane integration. Using both atomistic and coarse-grained molecular simulations, we investigate the conformational landscape of the translocon and explore the role of peptide substrates in the regulation of the translocation and integration pathways. Inclusion of a hydrophobic peptide substrate in the translocon stabilizes the opening of the lateral gate for membrane integration, whereas a hydrophilic peptide substrate favors the closed lateral gate conformation. The relative orientation of the plug moiety and a peptide substrate within the translocon channel is similarly dependent on whether the substrate is hydrophobic or hydrophilic in character, and the energetics of the translocon lateral gate opening in the presence of a peptide substrate is governed by the energetics of the peptide interface with the membrane. Implications of these results for the regulation of Sec-mediated pathways for protein translocation vs. membrane integration are discussed. PMID:20203009

  19. Vehicle barrier

    DOEpatents

    Hirsh, Robert A.

    1991-01-01

    A vehicle security barrier which can be conveniently placed across a gate opening as well as readily removed from the gate opening to allow for easy passage. The security barrier includes a barrier gate in the form of a cable/gate member in combination with laterally attached pipe sections fixed by way of the cable to the gate member and lateral, security fixed vertical pipe posts. The security barrier of the present invention provides for the use of cable restraints across gate openings to provide necessary security while at the same time allowing for quick opening and closing of the gate areas without compromising security.

  20. [Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach].

    PubMed

    Zeman, P; Zeman, J; Matejka, J; Koudela, K

    2008-12-01

    To report on the surgical treatment of intra-articular calcaneal fractures by open reduction and internal fixation with a calcaneal locking compression plate (LCP) from an extended lateral approach, and to retrospectively analyze the mid-term results in a group of patients treated by this technique. In the period from August 2005 till March 2007, a total of 49 patients with 61 calcaneal fractures were treated. Of these, 11 (18 %) were treated conservatively. Reduction combined with Kirschner-wire fixation was used in four fractures (6.6 %). Open reduction with internal calcaneal LCP fixation (ORIF- calcaneal LCP) from an extended lateral approach was carried out to treat 46 fractures (75.4 %) in 38 patients. The group evaluated here comprised 29 patients with 33 calcaneal fractures treated by ORIF-calcaneal LCP at a follow-up longer than 6 months. The fractures were classified on the basis of computer tomography (CT) findings as Sanders types I to IV. The group had two woman (6.9 %) and 27 men (93.1 %) with an average age of 34.2 years (range, 19-55 years). In 11 fractures (33.3 %), the primary treatment included filling a central cancellous bone defect area. Calcium phosphate bone substitute material (resorbable ChronOS) was used in nine cases (27.3 %), a self-solidifying hydroxyapatite implant was injected in two (6.1 %) cases (X3 Wright and Norian SRS, respectively), and a bone allograft was implanted in one case (3 %). Indicated for surgery were patients with an intra-articular calcaneal fracture, Sanders type II or type III, with articular surface displacement by more than 1 mm. Contraindications included age over sixty years, poor cooperation, smoking habits, peripheral vascular disease or skin infection. Surgery was performed only after oedema had resolved. The aim of our treatment was to achieve anatomical reconstruction of all articular surfaces, to restore the height, length, width and axis of the heel bone, to carry out primary stable osteosynthesis, and to enable the patient to begin rehabilitation with early mobilization. A passive rehabilitation usually started on the first post-operative day, and full weight-bearing of the extremity was allowed not earlier than 3 months post-operatively. Regular check-ups were at 6 weeks, 3, 6 and 12 months and then every year. The mid-term results were evaluated by the system of Rowe et al., scoring rest pain, possibility of return to preinjury jobs, use of walking aids, restriction of physical activity and limping. RESULTS The most frequent cause of injury was a fall or jump from height; this was recorded in 27 patients (93.1 %). An open fracture was diagnosed on two occasions (6.9 %). Bilateral calcaneal fractures were found in six patients (20.7 %); four (13.8 %) were treated by bilateral ORIF-calcaneal LPC and two (6.9 %) underwent closed reduction on one and Kirschnerwire transfixation on the other extremity. A combined injury to the musculoskeletal system was diagnosed in 11 patients (38 %), in whom four (13.8 %) had a tibial pylon fracture of the contralateral limb and four (13.8 %) had a thoracolumbar spine fracture. The surgical procedure was performed on average within 11.7 days of injury, and the average hospital stay was 18.2 days (range, 6 to 18 days). Early post-operative complications were recorded in six patients (20.7 %). Wound dehiscence was found in two (6.9 %), necrosis of wound edges in two (6.9 %), and early superficial infection responding to antibiotic therapy also in two patients (6.9 %). Deep infection, non-union or post-operative compartment syndrome were not recorded. Excellent Rowe scores were achieved in 10 patients (34.5 %), good in 15 (51.7 %) and satisfactory in two (6.9 %). Only two patients (6.9 %) reported poor outcome. The methods of classification and treatment of calcaneal fractures continue to be a frequently discussed topic. The technique of ORIF-calcaneal LCP from an extended lateral approach has recently been preferred for patients with displaced Sanders type II or III calcaneal fractures. In agreement with other literature references, this approach allowed us to observe the fracture, to reduce both the subtalar and calcaneocuboid articulations, to stabilize the fracture by internal fixation and to begin early rehabilitation. Because of the risk of early complications, the timing of surgery and a thorough consideration of indications and contraindications are of principal importance.We agree with other authors that filling calcaneal bone defects is not necessary. Pre- and post-operative CT scans are necessary. In accordance with literature data, fractures developing compartment syndrome are indicated for urgent fasciotomy and ORIF-calcaneal LCP should be postponed. In patients with multiple trauma and also in those with open calcaneal fractures, a temporary stabilization with an external fixator medially is performed first, and then converted to a second-stage, ORIF-LCP procedure. The surgical treatment of displaced intra-articular fractures that involves open reduction from an extended lateral approach and internal fixation with a calcaneal LCP shows very good preliminary results. A CT examination is required for the diagnosis and classification of fractures and a correct indication for surgery. Good timing is of principal importance. An urgent surgical intervention is necessary in open fractures or in those in which soft tissues are squashed by bone fragments. In the other fractures, surgery is carried out after oedema subsidence. Foot compartment syndrome is a serious complication of calcaneal fractures and urgent fasciotomy is the only adequate therapy. Full weight-bearing of the operated extremity depends on the rate of bone healing; it is usually allowed at 3 months after surgery.

  1. View of Expedition 24 Crew Members in the MRM2

    NASA Image and Video Library

    2010-09-24

    ISS024-E-015327 (24 Sept. 2010) --- Russian cosmonaut Alexander Skvortsov (right), Expedition 24 commander; NASA astronaut Tracy Caldwell Dyson and Russian cosmonaut Mikhail Kornienko, both flight engineers, pose for a photo during final preparations for their departure in the Soyuz TMA-18 docked to the Poisk Mini-Research Module 2 (MRM2) of the International Space Station. Originally scheduled for Sept. 23, the Soyuz undocked a day later due to a Poisk-side hatch sensor problem, which prevented hooks on the Poisk side of the docking interface from opening. The Soyuz undocked at 10:02 p.m. (EDT) on Sept. 24, 2010.

  2. Surgical treatment of intra-articular calcaneal fractures.

    PubMed

    Stapleton, John J; Zgonis, Thomas

    2014-10-01

    Most intra-articular calcaneal fractures are a result of high-energy trauma. The operative management of calcaneal fractures has been based on achieving anatomic reduction and minimizing complications of the compromised soft tissue envelope. The traditional extensile lateral approach offers advantages of achieving adequate fracture reduction with the risk of wound-healing complications and infection. Limited open reduction and internal fixation techniques with or without using external fixation focuses on achieving fracture reduction with less risk of wound complications but higher risk of malunion. This article discusses key points of operative management for various intra-articular calcaneal fracture patterns and clinical presentations. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Influence of ankle joint plantarflexion and dorsiflexion on lateral ankle sprain: A computational study.

    PubMed

    Purevsuren, Tserenchimed; Kim, Kyungsoo; Batbaatar, Myagmarbayar; Lee, SuKyoung; Kim, Yoon Hyuk

    2018-05-01

    Understanding the mechanism of injury involved in lateral ankle sprain is essential to prevent injury, to establish surgical repair and reconstruction, and to plan reliable rehabilitation protocols. Most studies for lateral ankle sprain posit that ankle inversion, internal rotation, and plantarflexion are involved in the mechanism of injury. However, recent studies indicated that ankle dorsiflexion also plays an important role in the lateral ankle sprain mechanism. In this study, the contributions of ankle plantarflexion and dorsiflexion on the ankle joint were evaluated under complex combinations of internal and inversion moments. A multibody ankle joint model including 24 ligaments was developed and validated against two experimental cadaveric studies. The effects of ankle plantarflexion (up to 60°) and dorsiflexion (up to 30°) on the lateral ankle sprain mechanism under ankle inversion moment coupled with internal rotational moment were investigated using the validated model. Lateral ankle sprain injuries can occur during ankle dorsiflexion, in which the calcaneofibular ligament and anterior talofibular ligament tears may occur associated with excessive inversion and internal rotational moment, respectively. Various combinations of inversion and internal moment may lead to anterior talofibular ligament injuries at early ankle plantarflexion, while the inversion moment acts as a primary factor to tear the anterior talofibular ligament in early plantarflexion. It is better to consider inversion and internal rotation as primary factors of the lateral ankle sprain mechanism, while plantarflexion or dorsiflexion can be secondary factor. This information will help to clarify the lateral ankle sprain mechanism of injury.

  4. Traumatic aneurysms of the internal carotid artery at the base of the skull. Two cases treated surgically.

    PubMed

    Magnan, P E; Branchereau, A; Cannoni, M

    1992-01-01

    Internal carotid aneurysms at the base of the skull after blunt trauma are infrequent but their management is difficult, leading many surgeons to only attempt ligation. We report 2 cases presenting with high traumatic aneurysms, following motorcycle accidents. The 2 aneurysms underwent repair by a venous graft. The petrous portion of the carotid artery was approached and controlled by an ENT surgeon. This "infratemporal" approach was used exposing the facial nerve, combined with temporary anterior sub-luxation of the temporomaxillary joint to expose the lower part of the carotid canal which was opened up with a drill in order to control the carotid artery in the petrous canal. Both patients developed facial nerve palsies which improved within 3 months. Postoperative angiography showed patent vein grafts and the patients were doing well, without any symptoms 18 and 24 months later.

  5. Locked nailing for the treatment of displaced articular fractures of the calcaneus: description of a new procedure with calcanail(®).

    PubMed

    Goldzak, Mario; Mittlmeier, Thomas; Simon, Patrick

    2012-05-01

    Although open reduction and internal fixation is considered the best method for treating displaced articular fractures of the calcaneus, lateral approach is at high risk for wound healing complications. For this reason, the authors developed a posterior approach and a new implant to perform both intrafocal reduction and internal fixation. The aim of this technical note is to describe this method of treatment for displaced articular fractures of the calcaneus, which offered the following advantages: (a) the creation of a working channel that provides also a significant bone autograft, (b) the intrafocal reduction of the displaced articular surface, (c) the insertion of a locking nail that maintains the reduced articular surface at the right height, (d) the possibility to switch from an ORIF to a reconstruction arthrodesis with the same approach and instrumentation in case of severely damaged posterior facet.

  6. Effect of open wedge high tibial osteotomy on the lateral tibiofemoral compartment in sheep. Part III: analysis of the microstructure of the subchondral bone and correlations with the articular cartilage and meniscus.

    PubMed

    Ziegler, Raphaela; Goebel, Lars; Seidel, Roland; Cucchiarini, Magali; Pape, Dietrich; Madry, Henning

    2015-09-01

    First, to evaluate whether medial open wedge high tibial osteotomy (HTO) induces alterations of the microstructure of the lateral tibial subchondral bone plate of sheep. Second, to test the hypothesis that specific correlations exist between topographical structural alterations of the subchondral bone, the cartilage and the lateral meniscus. Three experimental groups received biplanar osteotomies of the right proximal tibiae: (a) closing wedge HTO (4.5° of tibial varus), (b) opening wedge HTO (4.5° tibial valgus; standard correction) and (c) opening wedge HTO (9.5° of valgus; overcorrection), each of which was compared to the non-osteotomised contralateral proximal tibiae. After 6 months, subchondral bone structure indices were measured by computed tomography. Correlations between the subchondral bone, the articular cartilage and the lateral meniscus were determined. Increased loading by valgus overcorrection led to an enlarged specific bone surface (BS/BV) in the subarticular spongiosa compared with unloading by varisation. The subchondral bone plate was 3.9-fold thicker in the central region of the lateral tibial plateau than in the submeniscal periphery. Its thickness in the central region significantly correlated with the thickness of the articular cartilage. In the submeniscal region, such correlation did not exist. In general, a higher degree of osteoarthritis (OA) correlated with alterations of the subchondral bone plate microstructure. OA of the submeniscal articular cartilage also correlated with worse matrix staining of the lateral meniscus. Osteoarthritis changes are associated with alterations of the subchondral bone plate microstructure. Specific topographical relationships exist in the central region between the articular cartilage and subchondral bone plate thickness, and in the submeniscal periphery between and the articular cartilage and lateral meniscus. From a clinical perspective, the combined follow-up data from this and the previous two investigations suggest that open wedge valgus HTO is a safe procedure for the lateral compartment to manage medial osteoarthritis of the knee with varus malalignment in the short term.

  7. Dissolved organic carbon export and internal cycling in small, headwater lakes

    USGS Publications Warehouse

    Stets, Edward G.; Striegl, Robert G.; Aiken, George R.

    2010-01-01

    Carbon (C) cycling in freshwater lakes is intense but poorly integrated into our current understanding of overall C transport from the land to the oceans. We quantified dissolved organic carbon export (DOCX) and compared it with modeled gross DOC mineralization (DOCR) to determine whether hydrologic or within-lake processes dominated DOC cycling in a small headwaters watershed in Minnesota, USA. We also used DOC optical properties to gather information about DOC sources. We then compared our results to a data set of approximately 1500 lakes in the Eastern USA (Eastern Lake Survey, ELS, data set) to place our results in context of lakes more broadly. In the open-basin lakes in our watershed (n = 5), DOCX ranged from 60 to 183 g C m−2 lake area yr−1, whereas DOCR ranged from 15 to 21 g C m−2 lake area yr−1, emphasizing that lateral DOC fluxes dominated. DOCX calculated in our study watershed clustered near the 75th percentile of open-basin lakes in the ELS data set, suggesting that these results were not unusual. In contrast, DOCX in closed-basin lakes (n = 2) was approximately 5 g C m−2 lake area yr−1, whereas DOCR was 37 to 42 g C m−2 lake area yr−1, suggesting that internal C cycling dominated. In the ELS data set, median DOCX was 32 and 12 g C m−2 yr−1 in open-basin and closed-basin lakes, respectively. Although not as high as what was observed in our study watershed, DOCX is an important component of lake C flux more generally, particularly in open-basin lakes.

  8. Intraoperative Fluorescence Imaging for Detection of Sentinel Lymph Nodes and Lymphatic Vessels during Open Prostatectomy using Indocyanine Green.

    PubMed

    Yuen, Keiji; Miura, Tetsuya; Sakai, Iori; Kiyosue, Akiko; Yamashita, Masuo

    2015-08-01

    We investigated the feasibility and validity of intraoperative fluorescence imaging using indocyanine green for the detection of sentinel lymph nodes and lymphatic vessels during open prostatectomy. Indocyanine green was injected into the prostate under transrectal ultrasound guidance just before surgery. Intraoperative fluorescence imaging was performed using a near-infrared camera system in 66 consecutive patients with clinically localized prostate cancer after a 10-patient pilot test to optimize indocyanine green dosing, observation timing and injection method. Lymphatic vessels were visualized and followed to identify the sentinel lymph nodes. Confirmatory pelvic lymph node dissection including all fluorescent nodes and open radical prostatectomy were performed in all patients. Lymphatic vessels were successfully visualized in 65 patients (98%) and sentinel lymph nodes in 64 patients (97%). Sentinel lymph nodes were located in the obturator fossa, internal and external iliac regions, and rarely in the common iliac and presacral regions. A median of 4 sentinel lymph nodes per patient was detected. Three lymphatic pathways, the paravesical, internal and lateral routes, were identified. Pathological examination revealed metastases to 9 sentinel lymph nodes in 6 patients (9%). All pathologically positive lymph nodes were detected as sentinel lymph nodes using this imaging. No adverse reactions due to the use of indocyanine green were observed. Intraoperative fluorescence imaging using indocyanine green during open prostatectomy enables the detection of lymphatic vessels and sentinel lymph nodes with high sensitivity. This novel method is technically feasible, safe and easy to apply with minimal additional operative time. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Internal curvature signal and noise in low- and high-level vision

    PubMed Central

    Grabowecky, Marcia; Kim, Yee Joon; Suzuki, Satoru

    2011-01-01

    How does internal processing contribute to visual pattern perception? By modeling visual search performance, we estimated internal signal and noise relevant to perception of curvature, a basic feature important for encoding of three-dimensional surfaces and objects. We used isolated, sparse, crowded, and face contexts to determine how internal curvature signal and noise depended on image crowding, lateral feature interactions, and level of pattern processing. Observers reported the curvature of a briefly flashed segment, which was presented alone (without lateral interaction) or among multiple straight segments (with lateral interaction). Each segment was presented with no context (engaging low-to-intermediate-level curvature processing), embedded within a face context as the mouth (engaging high-level face processing), or embedded within an inverted-scrambled-face context as a control for crowding. Using a simple, biologically plausible model of curvature perception, we estimated internal curvature signal and noise as the mean and standard deviation, respectively, of the Gaussian-distributed population activity of local curvature-tuned channels that best simulated behavioral curvature responses. Internal noise was increased by crowding but not by face context (irrespective of lateral interactions), suggesting prevention of noise accumulation in high-level pattern processing. In contrast, internal curvature signal was unaffected by crowding but modulated by lateral interactions. Lateral interactions (with straight segments) increased curvature signal when no contextual elements were added, but equivalent interactions reduced curvature signal when each segment was presented within a face. These opposing effects of lateral interactions are consistent with the phenomena of local-feature contrast in low-level processing and global-feature averaging in high-level processing. PMID:21209356

  10. Low Wound Complication Rates for the Lateral Extensile Approach for Calcaneal ORIF When the Lateral Calcaneal Artery Is Patent.

    PubMed

    Bibbo, Christopher; Ehrlich, David A; Nguyen, Hoang M L; Levin, L Scott; Kovach, Stephen J

    2014-07-01

    Historically, the lateral extensile approach for calcaneal fracture osteosynthesis has had relatively high rates of wound healing problems. The vascular territory (angiosome) of the lateral foot is now known to be dependent upon the lateral calcaneal branch of the peroneal artery (LCBP artery). We postulated that patency of the LCBP artery may have a profound positive impact on incisional wound healing for calcaneal open reduction and internal fixation (ORIF). Ninety consecutive calcaneal fractures that met operative criteria were preoperatively evaluated for the presence of a Doppler signal in the LCBP artery and were followed for the development of wound healing problems. Among these 90 fractures, 85 had a positive preoperative Doppler signal along the course of the LCBP artery (94%) and 5 had no Doppler signal (6%). All patients underwent ORIF via a lateral extensile approach. Overall, incisional wound healing problems occurred in 6 of 90 calcaneal incisions (6.5%). All 5 feet that exhibited an absent Doppler signal in the LCPB artery developed an incisional wound healing complication (5/6, approximately 83%): 2 large apical wounds and 3 major dehiscence/slough. However, among the 84 feet that possessed a positive preoperative Doppler signal in the LCBP artery, there was only 1 (1/84, approximately 1%) incisional wound healing problem (P < .0001, Fischer's exact test). Smokers with a positive Doppler signal in the LCBP artery did not develop a wound healing complication. This study suggests a strong link to low incisional wound healing complications for the lateral extensile approach to the calcaneus when a preoperative Doppler signal is present in the LCBP artery. We believe this simple examination should be routinely performed prior to calcaneal ORIF. Level III, comparative case series. © The Author(s) 2014.

  11. Lateral epitaxial overgowth of GaAs by organometallic chemical vapor deposition

    NASA Technical Reports Server (NTRS)

    Gale, R. P.; Mcclelland, R. W.; Fan, J. C. C.; Bozler, C. O.

    1982-01-01

    Lateral epitaxial overgrowth of GaAs by organometallic chemical vapor deposition has been demonstrated. Pyrolytic decomposition of trimethylgallium and arsine, without the use of HCl, was used to deposit GaAs on substrates prepared by coating (110) GaAs wafers with SiO2, then using photolithography to open narrow stripes in the oxide. Lateral overgrowth was seeded by epitaxial deposits formed on the GaAs surfaces exposed by the stripe openings. The extent of lateral overgrowth was investigated as a function of stripe orientation and growth temperature. Ratios of lateral to vertical growth rates greater than five have been obtained. The lateral growth is due to surface-kinetic control for the two-dimensional growth geometry studied. A continuous epitaxial GaAs layer 3 microns thick has been grown over a patterned mask on a GaAs substrate and then cleaved from the substrate.

  12. Open-wedge high tibial osteotomy: incidence of lateral cortex fractures and influence of fixation device on osteotomy healing.

    PubMed

    Dexel, Julian; Fritzsche, Hagen; Beyer, Franziska; Harman, Melinda K; Lützner, Jörg

    2017-03-01

    Open-wedge high tibial osteotomy (HTO) is an established treatment for young and middle-aged patients with medial compartment knee osteoarthritis and varus malalignment. Although not intended, a lateral cortex fracture might occur during this procedure. Different fixation devices are available to repair such fractures. This study was performed to evaluate osteotomy healing after fixation with two different locking plates. Sixty-nine medial open-wedge HTO without bone grafting were followed until osteotomy healing. In patients with an intact lateral hinge, no problems were noted with either locking plate. A fracture of the lateral cortex occurred in 21 patients (30.4 %). In ten patients, the fracture was not recognized during surgery but was visible on the radiographs at the 6-week follow-up. Lateral cortex fracture resulted in non-union with the need for surgical treatment in three out of eight (37.5 %) patients using the newly introduced locking plate (Position HTO Maxi Plate), while this did not occur with a well-established locking plate (TomoFix) (0 out of 13, p = 0.023). With regard to other adverse events, no differences between both implants were observed. In cases of lateral cortex fracture, fixation with a smaller locking plate resulted in a relevant number of non-unions. Therefore, it is recommended that bone grafting, another fixation system, or an additional lateral fixation should be used in cases with lateral cortex fracture. III.

  13. Results of operative fixation of unstable ankle fractures in geriatric patients.

    PubMed

    Pagliaro, A J; Michelson, J D; Mizel, M S

    2001-05-01

    It is widely accepted that operative fixation of unstable ankle fractures yields predictably good outcomes in the general population. The current literature, however reports less acceptable results in the geriatric population age 65 years and older. The current study analyzes the outcome of the surgical treatment of unstable ankle fractures in patients at least 65 years old. Twenty three patient over 65 years old were surgically treated after sustaining 21 (91%) closed and 2 (9%) open grade II unstable ankle fractures. Fractures were classified according to the Danis-Weber and Lauge-Hansen schemes. Fracture type was predominantly Weber B (21/23, 91%), or supination external rotation stage IV (21/23, 91%). Fracture union rate was 100%. There were three significant complications including a lateral wound dehiscence with delayed fibular union in an open fracture dislocation, and two below knee amputations, neither of which was directly related to the fracture treatment. There were three minor complications; one superficial wound infection and two cases of prolonged incision drainage, all of which resolved without further surgical intervention. Complications were associated with open fractures and preexisting systemic disease. These results indicate that open reduction and internal fixation of unstable ankle fractures in geriatric patients is an efficacious treatment regime that with results that are comparable to the general population.

  14. 76 FR 53165 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-25

    ... on Women in International Economic Policy. This meeting is open to public participation, though... DEPARTMENT OF STATE [Public Notice 7457] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p...

  15. 26 CFR 1.101-4 - Payment of life insurance proceeds at a date later than death.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... later than death. 1.101-4 Section 1.101-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Income § 1.101-4 Payment of life insurance proceeds at a date later than death. (a) In general. (1)(i... the death of the insured which are paid to a beneficiary on a date or dates later than the death of...

  16. 26 CFR 1.101-4 - Payment of life insurance proceeds at a date later than death.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... later than death. 1.101-4 Section 1.101-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Income § 1.101-4 Payment of life insurance proceeds at a date later than death. (a) In general. (1)(i... the death of the insured which are paid to a beneficiary on a date or dates later than the death of...

  17. 26 CFR 1.101-4 - Payment of life insurance proceeds at a date later than death.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... later than death. 1.101-4 Section 1.101-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Income § 1.101-4 Payment of life insurance proceeds at a date later than death. (a) In general. (1)(i... the death of the insured which are paid to a beneficiary on a date or dates later than the death of...

  18. 26 CFR 1.101-4 - Payment of life insurance proceeds at a date later than death.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... later than death. 1.101-4 Section 1.101-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Income § 1.101-4 Payment of life insurance proceeds at a date later than death. (a) In general. (1)(i... the death of the insured which are paid to a beneficiary on a date or dates later than the death of...

  19. Effect of implant angulation and impression technique on impressions of NobelActive implants.

    PubMed

    Alexander Hazboun, Gillian Brewer; Masri, Radi; Romberg, Elaine; Kempler, Joanna; Driscoll, Carl F

    2015-05-01

    How the configuration of the NobelActive internal conical connection affects implant impressions is uncertain. The purpose of this study was to measure the effect in vitro of closed and open tray impression techniques for NobelActive implants placed at various angulations. Six NobelActive implants were placed in a master maxillary cast as follows: 0 degrees of angulation to a line drawn perpendicular to the occlusal plane in the first molar area, 15 degrees of angulation to a line drawn perpendicular to the occlusal plane in the first premolar area, and 30 degrees of angulation to a line drawn perpendicular to the occlusal plane in the lateral incisor area. Twelve open tray and 12 closed tray impressions were made. Occlusal, lateral, and frontal view photographs of the resulting casts were used to measure the linear and angular displacement of implant analogs. Statistical analysis was performed with a factorial analysis of variance (ANOVA), followed by the Tukey HSD test (α=.05). No significant difference was found in the impressions made of NobelActive implants with the open or closed tray technique (linear displacement: F=0.93, P=.34; angular displacement: F=2.09, P=.15). In addition, implant angulation (0, 15, or 30 degrees) had no effect on the linear or angular displacement of impressions (linear displacement: F=2.72, P=.07; angular displacement: F=0.86, P=.43). Finally, no significant interaction was found between impression technique and implant angulation on NobelActive implants (F=0.25, P=.77; F=1.60, P=.20). Within the limitations of this study, impression technique (open vs closed tray) and implant angulation (0, 15, and 30 degrees) had no significant effect on in vitro impressions of NobelActive implants. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  20. Electromagnet Move Down William Floyd Parkway, 6/24/13

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

    None

    At midnight on Monday, June 24, 2013, a 50-foot-wide, circular electromagnet began the second leg of a 3,200-mile land and sea voyage from Brookhaven National Laboratory in New York to a new home at Fermilab in Illinois. There, scientists will use it to study the properties of muons, subatomic particles that live only 2.2 millionths of a second, and the results could open the door to new realms of particle physics. During this leg, Emmert International transported the electromagnet 10 miles down William Floyd Parkway to the Smith Point Marina, where it was loaded on a barge later in themore » day.« less

  1. Arthroscopic Anatomic Reconstruction of the Lateral Ligaments of the Ankle With Gracilis Autograft

    PubMed Central

    Guillo, Stéphane; Archbold, Pooler; Perera, Anthony; Bauer, Thomas; Sonnery-Cottet, Bertrand

    2014-01-01

    Lateral ankle sprains are common; if conservative treatment fails and chronic instability develops, stabilization surgery is indicated. Numerous surgical procedures have been described, but those that most closely reproduce normal ankle lateral ligament anatomy and kinematics have been shown to have the best outcomes. Arthroscopy is a common adjunct to open ligament surgery, but it is traditionally only used to improve the diagnosis and the management of any associated intra-articular lesions. The stabilization itself is performed open because standard anterior ankle arthroscopy provides only partial visualization of the anterior talofibular ligament from above and the calcaneofibular ligament attachments cannot be seen at all. However, lateral ankle endoscopy can provide a view of this area that is superior to open surgery. We have developed a technique of ankle endoscopy that enables anatomic positioning of the repair or fixation of the graft. In this article we describe a safe and reproducible arthroscopic anatomic reconstruction of the lateral ligaments of the ankle using a gracilis autograft. The aim of this procedure is to obtain a more physiological reconstruction while maintaining all the advantages of an arthroscopic approach. PMID:25473613

  2. Changes in patellofemoral alignment do not cause clinical impact after open-wedge high tibial osteotomy.

    PubMed

    Lee, Yong Seuk; Lee, Sang Bok; Oh, Won Seok; Kwon, Yong Eok; Lee, Beom Koo

    2016-01-01

    The objectives of this study were (1) to evaluate the clinical and radiologic outcomes of open-wedge high tibial osteotomy focusing on patellofemoral alignment and (2) to search for correlation between variables and patellofemoral malalignment. A total of 46 knees (46 patients) from 32 females and 14 males who underwent open-wedge high tibial osteotomy were included in this retrospective case series. Outcomes were evaluated using clinical scales and radiologic parameters at the last follow-up. Pre-operative and final follow-up values were compared for the outcome analysis. For the focused analysis of the patellofemoral joint, correlation analyses between patellofemoral variables and pre- and post-operative weight-bearing line (WBL), clinical score, posterior slope, Blackburn Peel ratio, lateral patellar tilt, lateral patellar shift, and congruence angle were performed. The minimum follow-up period was 2 years and median follow-up period was 44 months (range 24-88 months). The percentage of weight-bearing line was shifted from 17.2 ± 11.1 to 56.7 ± 12.7%, and it was statistically significant (p < 0.01). Regarding the clinical results, statistical significance was observed using all scores (p < 0.01). In the radiologic evaluation, patellar descent was observed with statistical significance (p < 0.01). Last follow-up lateral patellar tilt was decreased with statistical significance (p < 0.01). In correlation analysis between variables of patellofemoral malalignment, the pre-operative weight-bearing line showed an association with the change in lateral patellar tilt and lateral patellar shift (correlation coefficient: 0.3). After open-wedge high tibial osteotomy, clinical results showed improvement, compared to pre-operative values. The patellar tilt and lateral patellar shift were not changed; however, descent of the patella was observed. Therefore, mild patellofemoral problems should not be a contraindication of the open-wedge high tibial osteotomy. Case series, Level IV.

  3. 78 FR 48044 - Safety Zone; San Diego International Airport Terminal Two West Grand Opening Fireworks; San Diego...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ...-AA00 Safety Zone; San Diego International Airport Terminal Two West Grand Opening Fireworks; San Diego... Opening of Lindbergh Airport Terminal Two West on August 8, 2013. This temporary safety zone is necessary... Diego International Airport Terminal Two grand opening. This safety zone is necessary to provide for the...

  4. Impact of roof height non-uniformity on pollutant transport between a street canyon and intersections.

    PubMed

    Nosek, Štěpán; Kukačka, Libor; Jurčáková, Klára; Kellnerová, Radka; Jaňour, Zbyněk

    2017-08-01

    This paper presents an extension of our previous wind-tunnel study (Nosek et al., 2016) in which we highlighted the need for investigation of the removal mechanisms of traffic pollution from all openings of a 3D street canyon. The extension represents the pollution flux (turbulent and advective) measurements at the lateral openings of three different 3D street canyons for the winds perpendicular and oblique to the along-canyon axis. The pollution was simulated by emitting a passive gas (ethane) from a homogeneous ground-level line source positioned along the centreline of the investigated street canyons. The street canyons were formed by courtyard-type buildings of two different regular urban-array models. The first model has a uniform building roof height, while the second model has a non-uniform roof height along each building's wall. The mean flow and concentration fields at the canyons' lateral openings confirm the findings of other studies that the buildings' roof-height variability at the intersections plays an important role in the dispersion of the traffic pollutants within the canyons. For the perpendicular wind, the non-uniform roof-height canyon appreciably removes or entrains the pollutant through its lateral openings, contrary to the uniform canyon, where the pollutant was removed primarily through the top. The analysis of the turbulent mass transport revealed that the coherent flow structures of the lateral momentum transport correlate with the ventilation processes at the lateral openings of all studied canyons. These flow structures coincide at the same areas and hence simultaneously transport the pollutant in opposite directions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Do open youth unemployment and youth programs leave the same mental health scars?--Evidence from a Swedish 27-year cohort study.

    PubMed

    Strandh, Mattias; Nilsson, Karina; Nordlund, Madelene; Hammarström, Anne

    2015-11-20

    Recent findings suggest that the mental health costs of unemployment are related to both short- and long-term mental health scars. The main policy tools for dealing with young people at risk of labor market exclusion are Active Labor Market Policy programs for youths (youth programs). There has been little research on the potential effects of participation in youth programs on mental health and even less on whether participation in such programs alleviates the long-term mental health scarring caused by unemployment. This study compares exposure to open youth unemployment and exposure to youth program participation between ages 18 and 21 in relation to adult internalized mental health immediately after the end of the exposure period at age 21 and two decades later at age 43. The study uses a five wave Swedish 27-year prospective cohort study consisting of all graduates from compulsory school in an industrial town in Sweden initiated in 1981. Of the original 1083 participants 94.3% of those alive were still participating at the 27-year follow up. Exposure to open unemployment and youth programs were measured between ages 18-21. Mental health, indicated through an ordinal level three item composite index of internalized mental health symptoms (IMHS), was measured pre-exposure at age 16 and post exposure at ages 21 and 42. Ordinal regressions of internalized mental health at ages 21 and 43 were performed using the Polytomous Universal Model (PLUM). Models were controlled for pre-exposure internalized mental health as well as other available confounders. Results show strong and significant relationships between exposure to open youth unemployment and IMHS at age 21 (OR = 2.48, CI = 1.57-3.60) as well as at age 43 (OR = 1.71, CI = 1.20-2.43). No such significant relationship is observed for exposure to youth programs at age 21 (OR = 0.95, CI = 0.72-1.26) or at age 43 (OR = 1.23, CI = 0.93-1.63). A considered and consistent active labor market policy directed at youths could potentially reduce the short- and long-term mental health costs of youth unemployment.

  6. Arthroscopic Latarjet Techniques: Graft and Fixation Positioning Assessed With 2-Dimensional Computed Tomography Is Not Equivalent With Standard Open Technique.

    PubMed

    Neyton, Lionel; Barth, Johannes; Nourissat, Geoffroy; Métais, Pierre; Boileau, Pascal; Walch, Gilles; Lafosse, Laurent

    2018-05-19

    To analyze graft and fixation (screw and EndoButton) positioning after the arthroscopic Latarjet technique with 2-dimensional computed tomography (CT) and to compare it with the open technique. We performed a retrospective multicenter study (March 2013 to June 2014). The inclusion criteria included patients with recurrent anterior instability treated with the Latarjet procedure. The exclusion criterion was the absence of a postoperative CT scan. The positions of the hardware, the positions of the grafts in the axial and sagittal planes, and the dispersion of values (variability) were compared. The study included 208 patients (79 treated with open technique, 87 treated with arthroscopic Latarjet technique with screw fixation [arthro-screw], and 42 treated with arthroscopic Latarjet technique with EndoButton fixation [arthro-EndoButton]). The angulation of the screws was different in the open group versus the arthro-screw group (superior, 10.3° ± 0.7° vs 16.9° ± 1.0° [P < .001]; inferior, 10.3° ± 0.8° vs 15.7° ± 0.9° [P < .0001]). The angulation of the EndoButtons was 5.7° ± 0.5°; this was different from that of open inferior screws (P = .003). In the axial plane (level of equator), the arthroscopic techniques resulted in lateral positions (arthro-screw, 1.5 ± 0.3 mm lateral [P < .001]; arthro-EndoButton, 0 ± 0.3 mm lateral [P < .0001]) versus the open technique (0.9 ± 0.2 mm medial). At the level of 25% of the glenoid height, the arthroscopic techniques resulted in lateral positions (arthro-screw, 0.3 ± 0.3 mm lateral [P < .001]); (arthro-EndoButton, 0.7 ± 0.3 mm lateral [P < .0001]) versus the open technique (1.0 ± 0.2 mm medial). Higher variability was observed in the arthro-screw group. In the sagittal plane, the arthro-screw technique resulted in higher positions (55% ± 3% of graft below equator) and the arthro-EndoButton technique resulted in lower positions (82% ± 3%, P < .0001) versus the open technique (71% ± 2%). Variability was not different. This study shows that the position of the fixation devices and position of the bone graft with the arthroscopic techniques are statistically significantly different from those with the open technique with 2-dimensional CT assessment. In the sagittal plane, the arthro-screw technique provides the highest positions, and the arthro-EndoButton technique, the lowest. Overall, the mean position of the bone block with the open Latarjet technique in the axial plane is slightly medial to the joint line, as recommended. Conversely, with the arthroscopic techniques, the bone grafts are more lateral with a slight overhang. The main differences are observed in the dispersion of the values (more extreme positions) with the arthro-screw technique, given the acknowledged limitations. Despite the statistical significance, the clinical significance of these differences is yet unknown. Level III, retrospective comparative study. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. Lateral orbitotomy for treatment of an orbital abscess in a dog.

    PubMed

    Vallefuoco, R; Molas, C; Moissonnier, P; Chahory, S

    2014-10-01

    A two-year-old Jack Russell terrier was diagnosed with a retrobulbar abscess and orbital cellulitis. The diagnosis was confirmed by ultrasound, magnetic resonance imaging examination and ultrasound-guided fine-needle aspiration. Transoral ventral drainage was attempted but was unsuccessful. The abscess was successfully treated by open drainage through a lateral orbitotomy. Despite the exposure of the orbital structures, the orbital soft tissues healed by second intention without further complications. The open drainage was well tolerated and resulted in immediate reduction of inflammation and pain, allowing a quick recovery. This report describes the diagnosis and, surgical management and the long-term (3 years) follow-up of an unusual case of orbital abscess associated with diffuse periorbital cellulitis successfully treated by open drainage through a lateral orbitotomy. © 2014 British Small Animal Veterinary Association.

  8. A cost/utility analysis of open reduction and internal fixation versus cast immobilization for acute nondisplaced mid-waist scaphoid fractures.

    PubMed

    Davis, Erika N; Chung, Kevin C; Kotsis, Sandra V; Lau, Frank H; Vijan, Sandeep

    2006-04-01

    Open reduction and internal fixation and cast immobilization are both acceptable treatment options for nondisplaced waist fractures of the scaphoid. The authors conducted a cost/utility analysis to weigh open reduction and internal fixation against cast immobilization in the treatment of acute nondisplaced mid-waist scaphoid fractures. The authors used a decision-analytic model to calculate the outcomes and costs of open reduction and internal fixation and cast immobilization, assuming the societal perspective. Utilities were assessed from 50 randomly selected medical students using the time trade-off method. Outcome probabilities taken from the literature were factored into the calculation of quality-adjusted life-years associated with each treatment. The authors estimated medical costs using Medicare reimbursement rates, and costs of lost productivity were estimated by average wages obtained from the U.S. Bureau of Labor Statistics. Open reduction and internal fixation offers greater quality-adjusted life-years compared with casting, with an increase ranging from 0.21 quality-adjusted life-years for the 25- to 34-year age group to 0.04 quality-adjusted life-years for the > or =65-year age group. Open reduction and internal fixation is less costly than casting ($7940 versus $13,851 per patient) because of a longer period of lost productivity with casting. Open reduction and internal fixation is therefore the dominant strategy. When considering only direct costs, the incremental cost/utility ratio for open reduction and internal fixation ranges from $5438 per quality-adjusted life-year for the 25- to 34-year age group to $11,420 for the 55- to 64-year age group, and $29,850 for the > or =65-year age group. Compared with casting, open reduction and internal fixation is cost saving from the societal perspective ($5911 less per patient). When considering only direct costs, open reduction and internal fixation is cost-effective relative to other widely accepted interventions.

  9. Displaced humeral lateral condyle fractures in children: should we bury the pins?

    PubMed

    Das De, Soumen; Bae, Donald S; Waters, Peter M

    2012-09-01

    The purpose of this investigation was to determine if leaving Kirschner wires exposed is more cost-effective than burying them subcutaneously after open reduction and internal fixation (ORIF) of humeral lateral condyle fractures. A retrospective cohort study of all lateral condyle fractures treated over a 10-year period at a single institution was performed. Data on surgical technique, fracture healing, and complications were analyzed, as well as treatment costs. A decision analysis model was then constructed to compare the strategies of leaving the pins exposed versus buried. Finally, sensitivity analyses were performed, assessing cost-effectiveness when infection rates and costs of treating deep infections were varied. A total of 235 children with displaced fractures were treated with ORIF using Kirschner wires. Pins were left exposed in 41 cases (17.4%) and buried in 194 cases (82.6%); the age, sex, injury mechanisms, and fracture patterns were similar in both the groups. The median time to removal of implants was shorter with exposed versus buried pins (4 vs. 6 wk, P<0.001), although there was no difference in fracture union or loss of reduction rates. The rate of superficial infection was higher with exposed pins (9.8% vs. 3.1%), but this was not statistically significant (P=0.076). There were no deep infections with exposed pins, whereas the rate of deep infection was 0.5% with buried pins (P=1.00). Buried pins were associated with additional complications, including symptomatic implants (7.2%); pins protruding through the skin (16%); internal pin migration necessitating additional surgery (1%); and skin necrosis (1%). The decision analysis revealed that leaving pins exposed resulted in an average cost savings of $3442 per patient. This strategy remained cost-effective even when infection rates with exposed pins approached 40%. Leaving the pins exposed after ORIF of lateral condyle fractures is safe and more cost-effective than burying the pins subcutaneously. Retrospective cohort study (level III).

  10. [GNU Pattern: open source pattern hunter for biological sequences based on SPLASH algorithm].

    PubMed

    Xu, Ying; Li, Yi-xue; Kong, Xiang-yin

    2005-06-01

    To construct a high performance open source software engine based on IBM SPLASH algorithm for later research on pattern discovery. Gpat, which is based on SPLASH algorithm, was developed by using open source software. GNU Pattern (Gpat) software was developped, which efficiently implemented the core part of SPLASH algorithm. Full source code of Gpat was also available for other researchers to modify the program under the GNU license. Gpat is a successful implementation of SPLASH algorithm and can be used as a basic framework for later research on pattern recognition in biological sequences.

  11. Color Doppler sonography of the lateral thoracic (breast-feeding) arteries: a new approach to the diagnosis of breast disease?

    PubMed

    Obwegeser, R; Berghammer, P; Lorenz, K; Auerbach, L; Kubista, E

    2001-11-01

    The main arteries to the breast are the lateral thoracic artery and to a lesser extent the internal thoracic artery. In this prospective open diagnostic study involving 94 women, we compared the intraindividual differences of Doppler indices in the lateral thoracic (breast-feeding) artery of breasts affected by cancer with those unaffected by disease. Sixty-seven consecutive patients were recruited from an outpatient unit for breast surgery and 27 volunteers were studied who were known to be without any breast disease (controls). In each patient we attempted to obtain Doppler indices from the lateral thoracic artery of both breasts. The difference in Doppler indices in each individual was assessed and statistical analysis was performed to assess whether these differences were significantly altered in women with cancer compared to healthy women. Lateral thoracic arteries could be visualized in 88% of the study population. Significantly lower values for pulsatility and resistance indices and systolic/diastolic ratios were obtained in the lateral thoracic arteries of breasts affected by cancer as compared to the contralateral breasts (1.73 +/- 0.39 vs. 2.05 +/- 0.47, P = 0.003; 0.78 +/- 0.06 vs. 0.84 +/- 0.06, P < 0.0001; 4.71 +/- 1.24 vs. 6.75 +/- 3.38, P = 0.0008, respectively). Using the intraindividual difference of pulsatility index, resistance index and systolic/diastolic ratio to screen for malignancy, sensitivities for breast cancer of 78%, 85% and 83%, respectively, were achieved. Depending on the cut-off level, specificity reached 94%. The intraindividual difference in Doppler indices in women with breast cancer may be a useful test for the diagnosis of breast lesions.

  12. A modified surgical technique for neglected fracture of lateral humeral condyle in children.

    PubMed

    Sulaiman, Abdul Razak; Munajat, Ismail; Mohd, Emil Fazliq

    2011-11-01

    Operative treatment for neglected fracture of lateral humeral condyle (LHC) is difficult because of contracted muscle, fibrous tissue formation, and indistinct bony edges. Its success depends on the ability to preserve blood supply during the surgery. We retrospectively reviewed eight cases of neglected fracture of LHC in children treated with open reduction with selected multiple 'V' lengthening of common extensor muscle and internal fixation. The patients were between 3 and 8 years of age. The period of neglect was between 3 and 20 weeks. Four patients with displacement of more than 10 mm and neglect for 5 weeks or more required lengthening of common extensor muscle aponeurosis. The follow-up assessments were between 1 and 6.3 years with a mean of 4.4 years. All patients had union by 2 months. They gained improvement of flexion range of motion between 60° and 120° with a mean of 86.3°. Loss of final range of motion compared with the normal side was between 5° and 35° with a mean of 10°. No patient had limitation of activities or pain. Six cases had excellent and two cases had good Dillon functional score. All patients had lateral condyle prominent with different severities. There was one mild avascular necrosis and one fishtail deformity. Both of them had almost full range of motion. All patients had early physeal closure, except one, who had only 1 year follow-up. There was no case of progressive valgus deformity. Children with neglected fracture of LHC would benefit from anatomical reduction and internal fixation through a proper exposure and if indicated combined with multiple 'V' lengthening of common extensor muscle aponeurosis. This is a level IV study.

  13. Comparative sacral morphology and the reconstructed tail lengths of five extinct primates: Proconsul heseloni, Epipliopithecus vindobonensis, Archaeolemur edwardsi, Megaladapis grandidieri, and Palaeopropithecus kelyus.

    PubMed

    Russo, Gabrielle A

    2016-01-01

    This study evaluated the relationship between the morphology of the sacrum-the sole bony link between the tail or coccyx and the rest of the body-and tail length (including presence/absence) and function using a comparative sample of extant mammals spanning six orders (Primates, Carnivora, Rodentia, Diprotodontia, Pilosa, Scandentia; N = 472). Phylogenetically-informed regression methods were used to assess how tail length varied with respect to 11 external and internal (i.e., trabecular) bony sacral variables with known or suspected biomechanical significance across all mammals, only primates, and only non-primates. Sacral variables were also evaluated for primates assigned to tail categories ('tailless,' 'nonprehensile short-tailed,' 'nonprehensile long-tailed,' and 'prehensile-tailed'). Compared to primates with reduced tail lengths, primates with longer tails generally exhibited sacra having larger caudal neural openings than cranial neural openings, and last sacral vertebrae with more mediolaterally-expanded caudal articular surfaces than cranial articular surfaces, more laterally-expanded transverse processes, more dorsally-projecting spinous processes, and larger caudal articular surface areas. Observations were corroborated by the comparative sample, which showed that shorter-tailed (e.g., Lynx rufus [bobcat]) and longer-tailed (e.g., Acinonyx jubatus [cheetah]) non-primate mammals morphologically converge with shorter-tailed (e.g., Macaca nemestrina) and longer-tailed (e.g., Macaca fascicularis) primates, respectively. 'Prehensile-tailed' primates exhibited last sacral vertebrae with more laterally-expanded transverse processes and greater caudal articular surface areas than 'nonprehensile long-tailed' primates. Internal sacral variables performed poorly compared to external sacral variables in analyses of extant primates, and were thus deemed less useful for making inferences concerning tail length and function in extinct primates. The tails lengths of five extinct primates were reconstructed from the external sacral variables: Archaeolemur edwardsi had a 'nonprehensile long tail,' Megaladapis grandidieri, Palaeopropithecus kelyus, and Epipliopithecus vindobonensis probably had 'nonprehensile short tails,' and Proconsul heseloni was 'tailless.' Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Effects of the visual-feedback-based force platform training with functional electric stimulation on the balance and prevention of falls in older adults: a randomized controlled trial.

    PubMed

    Li, Zhen; Wang, Xiu-Xia; Liang, Yan-Yi; Chen, Shu-Yan; Sheng, Jing; Ma, Shao-Jun

    2018-01-01

    Force platform training with functional electric stimulation aimed at improving balance may be effective in fall prevention for older adults. Aim of the study is to evaluate the effects of the visual-feedback-based force platform balance training with functional electric stimulation on balance and fall prevention in older adults. A single-centre, unblinded, randomized controlled trial was conducted. One hundred and twenty older adults were randomly allocated to two groups: the control group ( n  = 60, one-leg standing balance exercise, 12 min/d) or the intervention group ( n  = 60, force platform training with functional electric stimulation, 12 min/d). The training was provided 15 days a month for 3 months by physical therapists. Medial-lateral and anterior-posterior maximal range of sway with eyes open and closed, the Berg Balance Scale, the Barthel Index, the Falls Efficacy scale-International were assessed at baseline and after the 3-month intervention. A fall diary was kept by each participant during the 6-month follow-up. On comparing the two groups, the intervention group showed significantly decreased ( p  < 0.01) medial-lateral and anterior-posterior maximal range of sway with eyes open and closed. There was significantly higher improvement in the Berg Balance Scale ( p  < 0.05), the Barthel Index ( p  < 0.05) and the Falls Efficacy Scale-International ( p  < 0.05), along with significantly lesser number of injurious fallers ( p  < 0.05), number of fallers ( p  < 0.05), and fall rates ( p  < 0.05) during the 6-month follow-up in the intervention group. This study showed that the visual feedback-based force platform training with functional electric stimulation improved balance and prevented falls in older adults.

  15. Operative Treatment of Fifth Metatarsal Jones Fractures (Zones II and III) in the NBA.

    PubMed

    O'Malley, Martin; DeSandis, Bridget; Allen, Answorth; Levitsky, Matthew; O'Malley, Quinn; Williams, Riley

    2016-05-01

    Proximal fractures of the fifth metatarsal (zone II and III) are common in the elite athlete and can be difficult to treat because of a tendency toward delayed union, nonunion, or refracture. The purpose of this case series was to report our experience in treating 10 NBA players, determine the healing rate, return to play, refracture rate, and role of foot type in these athletes. The records of 10 professional basketball players were retrospectively reviewed. Seven athletes underwent standard percutaneous internal fixation with bone marrow aspirate concentrate (BMAC) whereas the other 3 had open bone grafting primarily in addition to fixation and BMAC. Radiographic features evaluated included fourth-fifth intermetatarsal, fifth metatarsal lateral deviation, calcaneal pitch, and metatarsus adductus angles. Radiographic healing was observed at an overall average of 7.5 weeks and return to play was 9.8 weeks. Three athletes experienced refractures. There were no significant differences in clinical features or radiographic measurements except that the refracture group had the highest metatatarsus adductus angles. Most athletes were pes planus and 9 of 10 had a bony prominence under the fifth metatarsal styloid. This is the largest published series of operatively treated professional basketball players who exemplify a specific patient population at high risk for fifth metatarsal fracture. These players were large and possessed a unique foot type that seemed to be associated with increased risk of fifth metatarsal fracture and refracture. This foot type had forefoot metatarsus adductus and a fifth metatarsal that was curved with a prominent base. We continue to use standard internal fixation with bone marrow aspirate but advocate additional prophylactic open bone grafting in patients with high fourth-to-fifth intermetatarsal, fifth metatarsal lateral deviation, and metatarsus adductus angles as well as prominent fifth metatarsal styloids in order to improve fracture healing and potentially decrease the risk of refracture. Level IV, case series. © The Author(s) 2016.

  16. 78 FR 42148 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... DEPARTMENT OF STATE [Public Notice 8380] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2... for Multinational Enterprises. This meeting is open to public participation, though seating is limited...

  17. Modified Arthroscopic Brostrom Procedure With Bone Tunnels.

    PubMed

    Lui, Tun Hing

    2016-08-01

    The open anatomic repair of the anterior talofibular and calcaneofibular ligaments (modified Brostrom procedure) is widely accepted as the standard surgical stabilization procedure for lateral ankle instability that does not respond to conservative measures. Arthroscopic Brostrom procedures with a suture anchor have been reported to achieve both anatomic repair of the lateral ankle ligaments and management of the associated intra-articular lesions. However, the complication rates are higher than open Brostom procedures. Many of these complications are associated with the use of a suture anchor. We report a modified arthroscopic Brostrom procedure in which the anterolateral ankle capsule is anchored to the lateral malleolus through small bone tunnels instead of suture anchors.

  18. Protective Factors Interrupting the Continuity from School Bullying to Later Internalizing and Externalizing Problems: A Systematic Review of Prospective Longitudinal Studies

    ERIC Educational Resources Information Center

    Ttofi, Maria M.; Bowes, Lucy; Farrington, David P.; Lösel, Friedrich

    2014-01-01

    A systematic review is presented, based on prospective longitudinal studies, on protective factors that interrupt the continuity from bullying perpetration at school to externalizing problem behaviors later in life; and from bullying victimization to later internalizing problems. Some common factors were established, which seem to interrupt the…

  19. Internal hernia in late pregnancy after laparoscopic Roux-en-Y gastric bypass.

    PubMed

    Gruetter, Florian; Kraljević, Marko; Nebiker, Christian A; Delko, Tarik

    2014-12-23

    A 27-year-old patient in late pregnancy presented to the department of obstetrics with crampy abdominal pain located in the right flank, 3 years after a laparoscopic Roux-en-Y gastric bypass. Clinical investigation showed tenderness on palpation in the upper abdomen without signs of peritonitis. The cardiotocogram and blood tests were normal. The ultrasound showed a hydronephrosis on the right side, and a pigtail catheter was inserted. The abdominal symptoms did not abate and the abdominal surgeon was consulted 36 hours after admission. Diagnostic laparoscopy was performed promptly because of high suspicion of internal hernia (IH). Laparoscopy showed IH at the mesojejunal intermesenteric defect with a herniated common channel and volvulus of the anastomosis. Conversion to open reduction and complete closure with non-absorbable interrupted sutures was performed. Small bowel resection was avoided. The patient was discharged 10 days after the operation and a healthy boy was born 4 weeks later. 2014 BMJ Publishing Group Ltd.

  20. A Method for Measuring International Openness

    ERIC Educational Resources Information Center

    Ferrieri, Gaetano

    2006-01-01

    The author illustrates a method for measuring international openness by bringing forward some examples. The index proposed measures the capacity of countries for a given phenomenon, adjusted for their weight in the phenomena concerned. In this study, the Index is applied to measure the degree of openness to international migration in a number of…

  1. 76 FR 37199 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Arizona, Arkansas...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... public comments, ideas, and suggestions on improving customer service at the Internal Revenue Service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy... Texas) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open...

  2. 76 FR 6188 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Arizona, Arkansas...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... public comments, ideas, and suggestions on improving customer service at the Internal Revenue Service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy... Texas) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open...

  3. 75 FR 11998 - Open Meeting of the Area 4 Taxpayer Advocacy Panel (Including the States of Illinois, Indiana...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... comments, ideas, and suggestions on improving customer service at the Internal Revenue Service. DATES: The... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 4 Taxpayer Advocacy...) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of Meeting. SUMMARY: An open meeting of...

  4. 75 FR 4140 - Open Meeting of the Area 4 Taxpayer Advocacy Panel (Including the States of Illinois, Indiana...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... comments, ideas, and suggestions on improving customer service at the Internal Revenue Service. DATES: The... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 4 Taxpayer Advocacy...) AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of...

  5. The inaccuracy of surface-measured model-derived tibiofemoral kinematics

    PubMed Central

    Li, Kang; Zheng, Liying; Tashman, Scott; Zhang, Xudong

    2014-01-01

    This study assessed the accuracy of surface-measured OpenSim-derived tibiofemoral kinematics in functional activities. Ten subjects with unilateral, isolated grade II PCL deficiency performed level running and stair ascent. A dynamic stereo radiography (DSX) system and a Vicon motion capture system simultaneously measured their knee or lower extremity movement. Surface marker motion data from the Vicon system were used to create subject-specific models in OpenSim and derive the tibiofemoral kinematics. The surface-measured model-derived tibiofemoral kinematics in all 6 degrees of freedom (DOFs) were then compared with those measured by the DSX as the benchmarks. The differences between surface- and DSX-measured tibiofemoral kinematics were found to be substantial: the overall mean (±SD) RMS differences during running were 9.1±3.2°, 2.0 ± 1.2°, 6.4 ± 4.5° for the flexion-extension, abduction-adduction, and internal-external rotations, and 7.1± 3.2mm, 8.8± 3.7mm, and 1.9± 1.2mm for anterior-posterior, proximal-distal, and medial-lateral translations. The differences were more pronounced in the relatively higher speed running than in stair ascent. It was also found that surface-based measures significantly underestimated the mean as well as inter-subject variability of the differences between PCL-injured and intact knees in abduction-adduction, internal-external rotation, and anterior-posterior translation. PMID:22964018

  6. [Heparin-induced thrombocytopenia developed during the acute phase after left upper lobectomy for lung cancer].

    PubMed

    Mitomo, Hideki; Miyamoto, Akira; Tabata, Toshiharu; Sugawara, Takafumi; Yabuki, Hiroshi; Fujimura, Shigefumi

    2014-12-01

    Heparin-induced thrombocytopenia (HIT) is a serious adverse effect of heparin administration. This must not be rarely encountered but is not often reported in Japan compared to Western countries. A 68-year-old woman underwent left upper lobectomy for lung cancer. Low-dose unfractionated heparin was administrated to prevent thromboembolism after the operation. Two days later, sudden dyspnea appeared and ultracardiosonography showing an extensive thromboembolus from the main trunk to both main branches of pulmonary artery indicated pulmonary embolization. After the establishment of percutaneous cardiopulmonary support (PCPS) support, the embolus was removed by emergent open heart surgery. However, despite further unfractionated heparin administration following embolization surgery, other thrombus was identified in both the bi-lateral internal jagular veins and inferior vena cava by ultrasonography and contrast computed tomography( CT). Her platelet count was decreased gradually despite platelet transfusion. Plate factor 4( PF4) antibody against heparin in her blood examination was found, and HIT II was diagnosed. Discontinuation of unfractionated heparin and administration of antithrombin agent improved platelet count, and no additional embolization was identified.

  7. Orthodontic management of congenitally missing maxillary lateral incisors: a case report.

    PubMed

    Paduano, Sergio; Cioffi, Iacopo; Rongo, Roberto; Cupo, Antonello; Bucci, Rosaria; Valletta, Rosa

    2014-01-01

    This case report describes the orthodontic treatment of a woman, aged 15 years, with permanent dentition, brachyfacial typology, with congenitally missing maxillary lateral incisors. Multibracket straightwire fixed appliance was used to open the space for dental implant placement, and treat the impaired occlusion. The missing lateral incisors were substituted with oral implants.

  8. The investigation of the lateral interaction effect's on traffic flow behavior under open boundaries

    NASA Astrophysics Data System (ADS)

    Bouadi, M.; Jetto, K.; Benyoussef, A.; El Kenz, A.

    2017-11-01

    In this paper, an open boundaries traffic flow system is studied by taking into account the lateral interaction with spatial defects. For a random defects distribution, if the vehicles velocities are weakly correlated, the traffic phases can be predicted by considering the corresponding inflow and outflow functions. Conversely, if the vehicles velocities are strongly correlated, a phase segregation appears inside the system's bulk which induces the maximum current appearance. Such velocity correlation depends mainly on the defects densities and the probabilities of lateral deceleration. However, for a compact defects distribution, the traffic phases are predictable by using the inflow in the system beginning, the inflow entering the defects zone and the outflow function.

  9. 75 FR 4138 - Open Meeting of the Area 5 Taxpayer Advocacy Panel (Including the States of Iowa, Kansas...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ..., and suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 5 Taxpayer Advocacy...: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 5...

  10. 76 FR 6187 - Open Meeting of the Area 4 Taxpayer Advocacy Panel (Including the States of Illinois, Indiana...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ..., and suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 4 Taxpayer Advocacy...: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 4...

  11. 76 FR 37198 - Open Meeting of the Area 4 Taxpayer Advocacy Panel (Including the States of Illinois, Indiana...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ..., and suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 4 Taxpayer Advocacy...: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 4...

  12. An investigation on the effect of street morphology to ambient air quality using six real-world cases

    NASA Astrophysics Data System (ADS)

    Shen, Jialei; Gao, Zhi; Ding, Wowo; Yu, Ying

    2017-09-01

    Street canyons are vulnerable to air pollution mainly caused by vehicle emissions, which are therefore closely related to pedestrians' health. Previous studies have showed that air quality in street canyons is associated with street morphology, though the majority of them have focused on idealized street models. This paper attempts to investigate the relationship of street morphology to air quality for 6 irregular real-world cases selected from America, Europe, and China, i.e. Manhattan, Paris, Barcelona, Berlin, London and Nanjing. Each street is analyzed as a set of slices to propose a couple of morphology indices for quantitatively assessing the actual street morphology. Pollutant transport rate of mean flows and turbulent diffusion, net escape velocity and age of air are obtained from computational fluid dynamics (CFD) simulations to assess the ventilations and pollutant dispersion within street canyons with a parallel approaching wind. The results show that the street morphology characteristics, including the street width, lateral openings and intersections, are closely related to the air flows in street canyons. The air quality improves with a decreasing aspect ratio of central street owing to a larger vertical exchange through the street roof, which suggests an open central street is of better air quality. The lateral openings and intersections of streets have important effects on the air flows in street canyons, and the effects are particularly pronounced when the street widths are similar. The street continuity ratio indicates street continuity. It relates to the openings and the symmetry of a street and impacts on the air flows and pollutant dispersion through the lateral openings of the central street. The street spatial closure ratio is determined by the street continuity ratio and the aspect ratio of the central street. When the aspect ratio of central street is not excessively high, higher values of street continuity ratio and spatial closure ratio can lead to a stronger channel flow in street canyons and improve the air quality. The octagon intersections are favorable for air flowing through the lateral openings and improve the channel flows. The oblique intersections can also greatly improve the street ventilations, mainly due to the enhanced air flows through the lateral openings and the increased turbulent diffusion through the street roofs.

  13. 75 FR 68403 - Open meeting of the Taxpayer Advocacy Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-05

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open meeting of the Taxpayer Advocacy Panel AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel will be held Tuesday, December 7...

  14. [Significance of lateral release in the therapy of patellar chondromalacia].

    PubMed

    Krüger, T; Göbel, F; Huschenbett, A; Hein, W

    2002-10-01

    A retrospective study was performed in 26 patients who underwent an operation for femoro-patellar pain due to a patellar chondromalacia with or without minor patellar dislocation/lateral pressure syndrome. The average age of the patients was 28.5 (15-39) years. 22 of the 26 patients revealed minor chondral damages of the stages 1 and 2 according to Outerbridge. In 12 patients ("lavage" group), an arthroscopic joint debridement only was carried out, while an additional open, lateral retinaculum release was made in 14 patients ("lateral release" group). The patella's distance of dislocation according to Hepp was reduced on an average of 3.0 (0-7) mm (p = 0.0019). The results of Bentley's score obtained during the follow-up interval on an average of 30.1 (9 to 60) months were almost identical for both groups. "Good" and "very good" results were achieved in the "lavage" group (83.3 %) and "lateral release" group (78.6 % of the patients). Lateral release should be used in cases of patellar decentration between 5 and 10 mm and adequate pain symptoms. The post-operative distance of dislocation should be less than 5 mm. Under such conditions and with minor chondral damage, a combined approach by using an arthroscopic joint debridement and open lateral release is promising to treat a patellar dislocation/lateral pressure syndrome.

  15. Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium.

    PubMed

    Delahunt, Eamonn; Bleakley, Chris M; Bossard, Daniela S; Caulfield, Brian M; Docherty, Carrie L; Doherty, Cailbhe; Fourchet, François; Fong, Daniel T; Hertel, Jay; Hiller, Claire E; Kaminski, Thomas W; McKeon, Patrick O; Refshauge, Kathryn M; Remus, Alexandria; Verhagen, Evert; Vicenzino, Bill T; Wikstrom, Erik A; Gribble, Phillip A

    2018-06-09

    Lateral ankle sprain injury is the most common musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities. Following initial injury, a high proportion of individuals develop long-term injury-associated symptoms and chronic ankle instability. The development of chronic ankle instability is consequent on the interaction of mechanical and sensorimotor insufficiencies/impairments that manifest following acute lateral ankle sprain injury. To reduce the propensity for developing chronic ankle instability, clinical assessments should evaluate whether patients in the acute phase following lateral ankle sprain injury exhibit any mechanical and/or sensorimotor impairments. This modified Delphi study was undertaken under the auspices of the executive committee of the International Ankle Consortium. The primary aim was to develop recommendations, based on expert (n=14) consensus, for structured clinical assessment of acute lateral ankle sprain injuries. After two modified Delphi rounds, consensus was achieved on the clinical assessment of acute lateral ankle sprain injuries. Consensus was reached on a minimum standard clinical diagnostic assessment. Key components of this clinical diagnostic assessment include: establishing the mechanism of injury, as well as the assessment of ankle joint bones and ligaments. Through consensus, the expert panel also developed the International Ankle Consortium Rehabilitation-Oriented ASsessmenT (ROAST). The International Ankle Consortium ROAST will help clinicians identify mechanical and/or sensorimotor impairments that are associated with chronic ankle instability. This consensus statement from the International Ankle Consortium aims to be a key resource for clinicians who regularly assess individuals with acute lateral ankle sprain injuries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Distal Femoral Osteotomy for the Valgus Knee: Medial Closing Wedge Versus Lateral Opening Wedge: A Systematic Review.

    PubMed

    Wylie, James D; Jones, Daniel L; Hartley, Melissa K; Kapron, Ashley L; Krych, Aaron J; Aoki, Stephen K; Maak, Travis G

    2016-10-01

    (1) To determine the radiographic correction/healing rate, patient-reported outcomes, reoperation rate, and complication rate after distal femoral osteotomy (DFO) for the valgus knee with lateral compartment pathology. (2) To summarize the reported results of medial closing wedge and lateral opening wedge DFO. We conducted a systematic review of PubMed, MEDLINE, and CINAHL to identify studies reporting outcomes of DFOs for the valgus knee. Keywords included "distal femoral osteotomy," "chondral," "cartilage," "valgus," "joint restoration," "joint preservation," "arthritis," and "gonarthrosis." Two authors first reviewed the articles; our study exclusion criteria were then applied, and the articles were included on the basis relevance defined by the aforementioned criteria. The Methodological Index for Nonrandomized Studies scale judged the quality of the literature. Sixteen studies were relevant to the research questions out of 191 studies identified by the original search. Sixteen studies were identified reporting on 372 osteotomies with mean follow-up of 45 to 180 months. All studies reported mean radiographic correction to a near neutral mechanical axis, with 3.2% nonunion and 3.8% delayed union rates. There was a 9% complication rate and a 34% reoperation rate, of which 15% were converted to arthroplasty. There were similar results reported for medial closing wedge and lateral opening wedge techniques, with a higher conversion to arthroplasty in the medial closing wedge that was confounded by longer mean follow-up in this group (mean follow-up 100 v 58 months). DFOs for the valgus knee with lateral compartment disease provide improvements in patient-reported knee health-related quality of life at midterm follow-up but have high rates of reoperation. No evidence exists proving better results of either the lateral opening wedge or medial closing wedge techniques. Level IV, systematic review of Level IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. New bomb, no mission

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

    Mello, G.

    1997-05-01

    The cold war may be over, but the nuclear arms race has not quite ended. The United States is fielding a new nuclear weapon-a bomb that was used to threaten Libya, a non-nuclear nation, even before it was deployed. The B61 {open_quotes}mod-11{close_quotes} gravity bomb is the first nuclear capability added to the US arsenal since 1989. It was developed and deployed secretly, without public or congressional debate, and in apparent contradiction to official domestic and international assurances that no new nuclear weapons were being developed in the United States. The B61-11`s unique earth-penetrating characteristic and wide range of yields allowmore » it to threaten otherwide indestructible targets from the air-or, in Pentagonese, to hold such targets {open_quotes}at risk.{close_quotes} That makes the B61-11 a uniquely useful warfighting tool. The 1,200-pound B61-11 replaces the B53, a 8,900-pound, nine-megaton bomb that was developed as a {open_quotes}city buster{close_quotes} and was later designated as a substitute for an earth-penetrating weapon. The B53 was deliverable only by vulnerable B-52s; in contrast, the smaller and lighter B61-11 can be delivered the the stealthier B-2A bomber, or even by F16 fighters.« less

  18. 75 FR 52319 - Texas Eastern Transmission, L.P.; Notice of Intent To Prepare an Environmental Assessment for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-25

    ...; An internal inspection tool (pig \\1\\) launcher to the 16- inch-diameter pipeline lateral; \\1\\ A ``pig..., internal inspections, or other purposes. A pig receiver on the 16-inch-diameter pipeline lateral; and A new...

  19. Orthodontic Management of Congenitally Missing Maxillary Lateral Incisors: A Case Report

    PubMed Central

    Rongo, Roberto; Cupo, Antonello; Valletta, Rosa

    2014-01-01

    This case report describes the orthodontic treatment of a woman, aged 15 years, with permanent dentition, brachyfacial typology, with congenitally missing maxillary lateral incisors. Multibracket straightwire fixed appliance was used to open the space for dental implant placement, and treat the impaired occlusion. The missing lateral incisors were substituted with oral implants. PMID:24711929

  20. Neuroanatomical pathways underlying the effects of hypothalamo-hypophysial-adrenal hormones on exploratory activity.

    PubMed

    Lalonde, Robert; Strazielle, Catherine

    2017-07-26

    When injected via the intracerebroventricular route, corticosterone-releasing hormone (CRH) reduced exploration in the elevated plus-maze, the center region of the open-field, and the large chamber in the defensive withdrawal test. The anxiogenic action of CRH in the elevated plus-maze also occurred when infused in the basolateral amygdala, ventral hippocampus, lateral septum, bed nucleus of the stria terminalis, nucleus accumbens, periaqueductal grey, and medial frontal cortex. The anxiogenic action of CRH in the defensive withdrawal test was reproduced when injected in the locus coeruleus, while the amygdala, hippocampus, lateral septum, nucleus accumbens, and lateral globus pallidus contribute to center zone exploration in the open-field. In addition to elevated plus-maze and open-field tests, the amygdala appears as a target region for CRH-mediated anxiety in the elevated T-maze. Thus, the amygdala is the principal brain region identified with these three tests, and further research must identify the neural circuits underlying this form of anxiety.

  1. Class III malocclusion with complex problems of lateral open bite and severe crowding successfully treated with miniscrew anchorage and lingual orthodontic brackets.

    PubMed

    Yanagita, Takeshi; Kuroda, Shingo; Takano-Yamamoto, Teruko; Yamashiro, Takashi

    2011-05-01

    In this article, we report the successful use of miniscrews in a patient with an Angle Class III malocclusion, lateral open bite, midline deviation, and severe crowding. Simultaneously resolving such problems with conventional Class III treatment is difficult. In this case, the treatment procedure was even more challenging because the patient preferred to have lingual brackets on the maxillary teeth. As a result, miniscrews were used to facilitate significant asymmetric tooth movement in the posterior and downward directions; this contributed to the camouflage of the skeletal mandibular protrusion together with complete resolution of the severe crowding and lateral open bite. Analysis of the jaw motion showed that irregularities in chewing movement were also resolved, and a stable occlusion was achieved. Improvements in the facial profile and dental arches remained stable at the 18-month follow-up. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  2. 77 FR 21157 - Internal Revenue Service; Open Meeting of the Taxpayer Advocacy Panel Refund Processing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... public comments, ideas, and suggestions on improving customer service at the Internal Revenue Service... DEPARTMENT OF THE TREASURY Internal Revenue Service; Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee AGENCY: Internal Revenue Service (IRS), Treasury...

  3. Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study.

    PubMed

    Giza, Eric; Shin, Edward C; Wong, Stephanie E; Acevedo, Jorge I; Mangone, Peter G; Olson, Kirstina; Anderson, Matthew J

    2013-11-01

    Operative treatment of mechanical ankle instability is indicated for patients with multiple sprains and continued episodes of instability. Open repair of the lateral ankle ligaments involves exposure of the attenuated ligaments and advancement back to their anatomic insertions on the fibula using bone tunnels or suture implants. Open and arthroscopic fixation are equal in strength to failure for anatomic Broström repair. Controlled laboratory study. Seven matched pairs of human cadaveric ankle specimens were randomized into 2 groups of anatomic Broström repair: open or arthroscopic. The calcaneofibular ligament and anterior talofibular ligament were excised from their origin on the fibula. In the open repair group, 2 suture anchors were used to reattach the ligaments to their anatomic origins. In the arthroscopic repair group, identical suture anchors were used for repair via an arthroscopic technique. The ligaments were cyclically loaded 20 times and then tested to failure. Torque to failure, degrees to failure, initial stiffness, and working stiffness were measured. A matched-pair analysis was performed. Power analysis of 0.8 demonstrated that 7 pairs needed to show a difference of 30%, with a 15% standard error at a significance level of α = .05. There was no difference in the degrees to failure, torque to failure, or stiffness for the repaired ligament complex. Nine of 14 specimens failed at the suture anchor. There is no statistical difference in strength or stiffness of a traditional open repair as compared with an arthroscopic anatomic repair of the lateral ligaments of the ankle. An arthroscopic technique can be considered for lateral ligament stabilization in patients with mild to moderate mechanical instability.

  4. Childhood negative emotionality predicts biobehavioral dysregulation 15 years later

    PubMed Central

    Hagan, Melissa J.; Luecken, Linda J.; Modecki, Kathryn L.; Sandler, Irwin N.; Wolchik, Sharlene A.

    2016-01-01

    The temperamental trait of negative emotionality (NE) plays an important role in maladaptation among adults experiencing significant life stress. However, the prospective relation between childhood NE and subsequent inter-related behavioral, emotional, and biological dysregulation in later life has not yet been established among children who experience early adversity. Using a longitudinal sample of youth who experienced parental divorce during childhood (N = 160; 53% male; 83% White), we tested the hypothesis that childhood NE would predict physiological, emotional, and behavioral dysregulation 15 years later. NE was assessed by maternal report when youth were between 9-12 years old. Fifteen years later, young adults (mean age = 25.55 years) participated in a psychosocial stress task to assess cortisol reactivity and reported on internalizing symptoms and problematic alcohol use. Structural equation modeling revealed that higher childhood NE predicted significantly greater alcohol use, internalizing symptoms, and total cortisol output during a stress task 15 years later. Importantly, these findings held adjusting for childhood internalizing symptoms. In addition, problematic alcohol use was associated with greater cortisol reactivity and internalizing symptoms. Findings suggest that childhood NE is a critical risk marker for interrelated forms of dysregulation in young adulthood among at-risk youth. PMID:27100364

  5. Regional distribution of circumferential residual strains in the human aorta according to age and gender.

    PubMed

    Sokolis, Dimitrios P; Savva, Giannis D; Papadodima, Stavroula A; Kourkoulis, Stavros K

    2017-03-01

    The biomechanical response of the human aorta varies with axial location, but little is known about the respective variation of residual strains. Such data are available for common lab animals, but in the traditional opening angle measurement the aorta is considered as an ideal cylinder and average residual strains are measured, so that the spatial variations of local residual strains are not determined. The present study provides opening angle and residual strain data throughout the course and around the circumference of the aorta harvested during autopsy. Opening angle showed notable topographical variation; the highest value was at the top of aortic arch, declining abruptly toward the ascending aorta and to a near-constant value in the descending aorta, and rising in the abdominal aorta. The variation of curvature and of external but not internal residual stretch resembled that of opening angle. Extensive residual stress and wall thickness differences were evidenced among quadrants, with the more pre-stressed being also the thicker quadrants. Gender had overall minor effects, but aging led to increased parameters, occurring earlier in the distal aorta but at later stages becoming predominant proximally. Differences in caliber were pronounced in older subjects, unlike those in opening angle, residual stretches, and thickness that were striking in middle-aged subjects. By contrast, curvature decreased with aging in relation to the smaller percentwise opening angle differences. Detailed knowledge of the zero-stress/no-load geometry of the human aortic wall is critical for an in-depth understanding of aortic physiology, while providing the basis for comparison with disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Antenna Technology and other Radio Frequency (RF) Communications Activities at the Glenn Research Center in Support of NASA's Exploration Vision

    NASA Technical Reports Server (NTRS)

    Miranda, Felix A.

    2007-01-01

    NASA s Vision for Space Exploration outlines a very ambitious program for the next several decades of the Space Agency endeavors. Ahead is the completion of the International Space Station (ISS); safely flight the shuttle (STS) until 2010; develop and fly the Crew Exploration Vehicle (Orion) by no later than 2014; return to the moon by no later than 2020; extend human presence across the solar system and beyond; implement a sustainable and affordable human and robotic program; develop supporting innovative technologies, knowledge and infrastructure; and promote international and commercial participation in exploration. To achieve these goals, a series of enabling technologies must be developed or matured in a timely manner. Some of these technologies are: spacecraft RF technology (e.g., high power sources and large antennas which using surface receive arrays can get up to 1 Gbps from Mars), uplink arraying (reduce reliance on large ground-based antennas and high operation costs; single point of failure; enable greater data-rates or greater effective distance; scalable, evolvable, flexible scheduling), software define radio (i.e., reconfigurable, flexible interoperability allows for in flight updates open architecture; reduces mass, power, volume), and optical communications (high capacity communications with low mass/power required; significantly increases data rates for deep space). This presentation will discuss some of the work being performed at the NASA Glenn Research Center, Cleveland, Ohio, in antenna technology as well as other on-going RF communications efforts.

  7. Prestimulus default mode activity influences depth of processing and recognition in an emotional memory task.

    PubMed

    Soravia, Leila M; Witmer, Joëlle S; Schwab, Simon; Nakataki, Masahito; Dierks, Thomas; Wiest, Roland; Henke, Katharina; Federspiel, Andrea; Jann, Kay

    2016-03-01

    Low self-referential thoughts are associated with better concentration, which leads to deeper encoding and increases learning and subsequent retrieval. There is evidence that being engaged in externally rather than internally focused tasks is related to low neural activity in the default mode network (DMN) promoting open mind and the deep elaboration of new information. Thus, reduced DMN activity should lead to enhanced concentration, comprehensive stimulus evaluation including emotional categorization, deeper stimulus processing, and better long-term retention over one whole week. In this fMRI study, we investigated brain activation preceding and during incidental encoding of emotional pictures and on subsequent recognition performance. During fMRI, 24 subjects were exposed to 80 pictures of different emotional valence and subsequently asked to complete an online recognition task one week later. Results indicate that neural activity within the medial temporal lobes during encoding predicts subsequent memory performance. Moreover, a low activity of the default mode network preceding incidental encoding leads to slightly better recognition performance independent of the emotional perception of a picture. The findings indicate that the suppression of internally-oriented thoughts leads to a more comprehensive and thorough evaluation of a stimulus and its emotional valence. Reduced activation of the DMN prior to stimulus onset is associated with deeper encoding and enhanced consolidation and retrieval performance even one week later. Even small prestimulus lapses of attention influence consolidation and subsequent recognition performance. © 2015 Wiley Periodicals, Inc.

  8. The outcome of surgically treated traumatic unstable pelvic fractures by open reduction and internal fixation.

    PubMed

    Mardanpour, Keykhosro; Rahbar, Mahtab

    2013-07-01

    This study was performed to evaluate functional and radiological results of pelvic ring fractures treatment by open reduction and internal fixation. Thirty eight patients with unstable pelvic fractures, treated from 2002 to 2008 were retrospectively reviewed. The mean patients' age was 37 years (range 20 to 67). Twenty six patients were men (4 patients with type B and 22 patients with type C fracture) and 12 women (7 patients with type B and 5 patients with type C fracture). The commonest cause was a road traffic accident (N=37, about 97%). Internal fixation was done by plaque with ilioinguinal and Kocher-Langenbeek approaches for anterior, posterior pelvic wall and acetabulum fracture respectively. Quality of reduction was graded according to Majeed score system. There were 11 type-C and 27 type-B pelvic fractures according to Tile's classification. Thirty six patients sustained additional injuries. The commonest additional injury was lower extremity fracture. The mean follow-up was 45.6 months (range 16 to 84 months).The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients with type B pelvic fractures and functional outcome was excellent in 46%, good in 27%, fair in 27% and poor in 0% of the patients with type C pelvic fractures. There were four postoperative infections. No sexual functional problem was reported. Neurologic problem like Lateral cutaneous nerve of thigh injury recovered completely in 2 patients and partially in 2 patients. There was no significant relation between functional outcome and the site of fracture (P greater than 0.005). Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization. It must be carried out as soon as the general condition of the patient permits, and even up to two weeks.

  9. Epitaxial lateral overgrowth of InP on Si from nano-openings: Theoretical and experimental indication for defect filtering throughout the grown layer

    NASA Astrophysics Data System (ADS)

    Olsson, F.; Xie, M.; Lourdudoss, S.; Prieto, I.; Postigo, P. A.

    2008-11-01

    We present a model for the filtration of dislocations inside the seed window in epitaxial lateral overgrowth (ELO). We found that, when the additive effects of image and gliding forces exceed the defect line tension force, filtering can occur even in the openings. The model is applied to ELO of InP on Si where the opening size and the thermal stress arising due to the mask and the grown material are taken into account and analyzed. Further, we have also designed the mask patterns in net structures, where the tilting angles of the openings in the nets are chosen in order to take advantage of the filtering in the openings more effectively, and to minimize new defects due to coalescence in the ELO. Photoluminescence intensities of ELO InP on Si and on InP are compared and found to be in qualitative agreement with the model.

  10. 26 CFR 301.6110-3 - Deletion of certain information in written determinations open to public inspection.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... determinations open to public inspection. 301.6110-3 Section 301.6110-3 Internal Revenue INTERNAL REVENUE SERVICE... open to public inspection. (a) Information subject to deletion. There shall be deleted from the text of any written determination open to public inspection or subject to inspection upon written request and...

  11. Learning from the Innovative Open Practices of Three International Health Projects: IACAPAP, VCPH and Physiopedia

    ERIC Educational Resources Information Center

    Coughlan, Tony; Perryman, Leigh-Anne

    2015-01-01

    Open educational resources and open educational practices are being increasingly used around the globe to train and support professionals in areas where funding and resources are scarce. This paper evaluates the open educational practices (OEP) of three global health projects operating outside academia--the International Association for Child and…

  12. Using OpenOffice as a Portable Interface to JAVA-Based Applications

    NASA Astrophysics Data System (ADS)

    Comeau, T.; Garrett, B.; Richon, J.; Romelfanger, F.

    2004-07-01

    STScI previously used Microsoft Word and Microsoft Access, a Sybase ODBC driver, and the Adobe Acrobat PDF writer, along with a substantial amount of Visual Basic, to generate a variety of documents for the internal Space Telescope Grants Administration System (STGMS). While investigating an upgrade to Microsoft Office XP, we began considering alternatives, ultimately selecting an open source product, OpenOffice.org. This reduces the total number of products required to operate the internal STGMS system, simplifies the build system, and opens the possibility of moving to a non-Windows platform. We describe the experience of moving from Microsoft Office to OpenOffice.org, and our other internal uses of OpenOffice.org in our development environment.

  13. Two-View Gravity Stress Imaging Protocol for Nondisplaced Type II Supination External Rotation Ankle Fractures: Introducing the Gravity Stress Cross-Table Lateral View.

    PubMed

    Boffeli, Troy J; Collier, Rachel C; Gervais, Samuel J

    Assessing ankle stability in nondisplaced Lauge-Hansen supination external rotation type II injuries requires stress imaging. Gravity stress mortise imaging is routinely used as an alternative to manual stress imaging to assess deltoid integrity with the goal of differentiating type II from type IV injuries in cases without a posterior or medial fracture. A type II injury with a nondisplaced fibula fracture is typically treated with cast immobilization, and a type IV injury is considered unstable and often requires operative repair. The present case series (two patients) highlights a standardized 2-view gravity stress imaging protocol and introduces the gravity stress cross-table lateral view. The gravity stress cross-table lateral view provides a more thorough evaluation of the posterior malleolus owing to the slight external rotation and posteriorly directed stress. External rotation also creates less bony overlap between the tibia and fibula, allowing for better visualization of the fibula fracture. Gravity stress imaging confirmed medial-sided injury in both cases, confirming the presence of supination external rotation type IV or bimalleolar equivalent fractures. Open reduction and internal fixation was performed, and both patients achieved radiographic union. No further treatment was required at 21 and 33 months postoperatively. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Paediatric lateral humeral condyle fractures: internal oblique radiographs alter the course of conservative treatment.

    PubMed

    Kurtulmuş, Tuhan; Sağlam, Necdet; Saka, Gursel; Avcı, Cem Coşkun; Uğurlar, Meriç; Türker, Mehmet

    2014-10-01

    At first presentation of paediatric humeral lateral condyle fractures, radiological methods such as computerised tomography, ultrasonography, magnetic resonance imaging, arthrography, and internal oblique radiography are used to determine stability. Very few studies show which radiological method should be used to evaluate displacement at follow-up for conservatively treated patients. This study aimed to show that internal oblique radiography is a simple, effective method to determine the subsequent development of fracture displacement in patients with an initially non-displaced or minimally displaced fracture. In this retrospective study, 27 paediatric patients with non-displaced or minimally displaced (<2 mm) humerus lateral condyle fracture were evaluated by elbow anteroposterior radiograph. The degree of fracture displacement was evaluated by anteroposterior then by internal oblique radiographs. The first follow-up was made between the 5th and 8th day and thereafter at intervals of 7-10 days. Of the 27 patients identified with non-displaced or minimally displaced (<2 mm) fracture from the initial anteroposterior radiograph, 16 were accepted as displacement >2 mm as a result of the evaluation of the internal oblique radiography and underwent surgery. At follow-up, 2 of 11 patients were defined with displacement from anteroposterior and internal oblique radiographs and 4 from the internal oblique radiographs and underwent surgery. Conservative treatment was applied to 5 patients. Internal oblique radiography is the best imaging showing subsequent fracture displacement in initially non-displaced or minimally displaced humerus lateral condyle fractures. At the first week follow-up, anteroposterior and particularly internal oblique radiographs should be taken of conservatively treated patients.

  15. All-inside, anatomical lateral ankle stabilization for revision and complex primary lateral ankle stabilization: a technique guide.

    PubMed

    Prissel, Mark A; Roukis, Thomas S

    2014-12-01

    Lateral ankle instability is a common mechanical problem that often requires surgical management when conservative efforts fail. Historically, myriad open surgical approaches have been proposed. Recently, consideration for arthroscopic management of lateral ankle instability has become popular, with promising results. Unfortunately, recurrent inversion ankle injury following lateral ankle stabilization can occur and require revision surgery. To date, arthroscopic management for revision lateral ankle stabilization has not been described. We present a novel arthroscopic technique combining an arthroscopic lateral ankle stabilization kit with a suture anchor ligament augmentation system for revision as well as complex primary lateral ankle stabilization. © 2014 The Author(s).

  16. Response of a boreal forest to canopy opening: assessing vertical and lateral tree growth with multi-temporal lidar data.

    PubMed

    Vepakomma, Udayalakshmi; St-Onge, Benoit; Kneeshaw, Daniel

    2011-01-01

    Fine-scale height-growth response of boreal trees to canopy openings is difficult to measure from the ground, and there are important limitations in using stereophotogrammetry in defining gaps and determining individual crowns and height. However, precise knowledge on height growth response to different openings is critical for refining partial harvesting techniques. In this study, we question whether conifers and hardwoods respond equally in terms of sapling growth or lateral growth to openings. We also ask to what distance gaps affect tree growth into the forest. We use multi-temporal lidar to characterize tree/sapling height and lateral growth responses over five years to canopy openings and high resolution images to identify conifers and hardwoods. Species-class-wise height-growth patterns of trees/saplings in various neighborhood contexts were determined across a 6-km matrix of Canadian boreal mixed deciduous coniferous forests. We then use statistical techniques to probe how these growth responses vary by spatial location with respect to the gap edge. Results confirm that both mechanisms of gap closure contribute to the closing of canopies at a rate of 1.2% per annum. Evidence also shows that both hardwood and conifer gap edge trees have a similar lateral growth (average of 22 cm/yr) and similar rates of height growth irrespective of their location and initial height. Height growth of all saplings, however, was strongly dependent on their position within the gap and the size of the gap. Results suggest that hardwood and softwood saplings in gaps have greatest growth rates at distances of 0.5-2 m and 1.5-4 m from the gap edge and in openings smaller than 800 m2 and 250 m2, respectively. Gap effects on the height growth of trees in the intact forest were evident up to 30 m and 20 m from gap edges for hardwood and softwood overstory trees, respectively. Our results thus suggest that foresters should consider silvicultural techniques that create many small openings in mixed coniferous deciduous boreal forests to maximize the growth response of both residual and regenerating trees.

  17. OpenGov Plan 3.0 Outline

    EPA Pesticide Factsheets

    This document serves as an outline for the structure of the Agency’s Open Government Plan 3.0, expected to be published later this summer, along with a description of a candidate being consider as a flagship project.

  18. Open-access microfluidic patch-clamp array with raised lateral cell trapping sites.

    PubMed

    Lau, Adrian Y; Hung, Paul J; Wu, Angela R; Lee, Luke P

    2006-12-01

    A novel open-access microfluidic patch-clamp array chip with lateral cell trapping sites raised above the bottom plane of the chip was developed by combining both a microscale soft-lithography and a macroscale polymer fabrication method. This paper demonstrates the capability of using such an open-access fluidic system for patch-clamp measurements. The surface of the open-access patch-clamp sites prepared by the macroscale hole patterning method of soft-state elastic polydimethylsiloxane (PDMS) is examined; the seal resistances are characterized and correlated with the aperture dimensions. Whole cell patch-clamp measurements are carried out with CHO cells expressing Kv2.1 ion channels. Kv2.1 ion channel blocker (TEA) dosage response is characterized and the binding activity is examined. The results demonstrate that the system is capable of performing whole cell measurements and drug profiling in a more efficient manner than the traditional patch-clamp set-up.

  19. Fungal and fumonisins contamination in Argentine maize (Zea mays L.) silo bags.

    PubMed

    Pacin, Ana M; Ciancio Bovier, Emilia; González, Héctor H L; Whitechurch, Elena M; Martínez, Elena J; Resnik, Silvia L

    2009-04-08

    Fumonisins in maize (Zea mays L.) grain silo bags in the conditions of three Argentine provinces were analyzed to determine how this kind of storage affects contamination and if differential storage durations or times of the year of silo bag closing and opening are factors that could modify it. Moisture content, water activity (a(w)), molds and yeasts present, and fumonisins were analyzed in 163 maize silo bags, at the moment of closing and later at opening. Storage durations ranged from 120 to 226 days. The analysis was centered on fumonisins since most samples were only contaminated with these toxins. Fumonisins, moisture content, and a(w) increased significantly, whereas mold propagules/g and yeasts CFU/g did not present significant differences between silo opening and closing. The date on which silo bags were closed and later opened, however, did affect the level of fumonisin contamination.

  20. Person-Organization Commitment: Bonds of Internal Consumer in the Context of Non-profit Organizations.

    PubMed

    Juaneda-Ayensa, Emma; Clavel San Emeterio, Mónica; González-Menorca, Carlos

    2017-01-01

    From an Organizational Behavior perspective, it is important to recognize the links generated between individuals and the organization that encourage a desire for permanence. After more than a half century of research, Organizational Commitment remains one of the open questions in the Psychology of Organizations. It is considered an essential factor for explaining individual behavior in the organization such as satisfaction, turnover intention, or loyalty. In this paper, we analyze different contributions regarding the nature of the bond between the individual and the organization. Taking into account the peculiarities of Non-profit Organizations, we present different interpretation for later validation, comparing results from the Confirmatory Factor Analysis of the four models obtained using exploratory factor analysis, both conducted on a sample of 235 members of Non-profit Organizations.

  1. Lesbian identity and the politics of representation in Betty Parsons's gallery.

    PubMed

    Gibson, A

    1994-01-01

    Although Betty Parsons had been unusually open about her love relationships with women in the twenties and thirties, she later became reticent, retiring to the closet. Her increased discretion after World War II, during the Cold War, coincided with her rise as the art dealer most prominently associated with the international emergence of Abstract Expressionism. Parsons incurred the objections of her Abstract Expressionists, however, by showing artists who included both abstraction and naturalism in their work, such as Sonia Sekula, Forrest Bess, and Hedda Sterne. This article examines her definition of abstraction as difference through her friend Theodoros Stamos's notion of camp and helps to explain her admiration of Barnett Newman despite her refusal to devote her gallery exclusively to his narrower version of significant abstraction.

  2. Ipsilateral Closed Clavicle and Scapular spine Fracture with Acromioclavicular Joint Disruption.

    PubMed

    Kembhavi, Raghavendra S; James, Boblee

    2015-01-01

    Injuries around shoulder and clavicle are quite common. Injuries involving lateral end of clavicle involving acromioclavicular joints are commoner injuries. In this rare injury, we report about a case involving clavicle and scapular spine fracture with acromioclavicular disruption which has never been described in English literature as per our knowledge. A patient with closed clavicle and scapular spine fracture with acromioclavicular joint disruption was treated with open reduction and internal fixation of clavicle and scapular spine as a staged procedures. Six months post operatively, patient had excellent functional recovery with near full range of movements. Though rare complex injury, clavicle fracture with scapular spine fracture with acromioclavicular disruption, when managed properly with good physiotherapy protocol post operatively will result in good clinical and functional outcome.

  3. Modified Judet approach and minifragment fixation of scapular body and glenoid neck fractures.

    PubMed

    Jones, Clifford B; Cornelius, Jonathan P; Sietsema, Debra L; Ringler, James R; Endres, Terrence J

    2009-09-01

    To describe the technique and to determine the outcome of operatively treated displaced scapular body or glenoid neck fractures using minifragment fixation through a modified Judet approach. Retrospective review of scapular or glenoid fractures. Level 1 teaching trauma center. All treated scapular or glenoid fractures over 7 years (1999-2005) were determined. Of a total of 227 scapular or glenoid fractures, 37 were treated with open reduction internal fixation and formed the basis of study. All patients were followed for a minimum of 1 year until healing or discharge from care. All operatively treated scapular fractures were performed in the lateral position on a radiolucent table. A modified Judet approach was used in all patients. The posterior deltoid was incised off the scapular spine cephalad reaching the lateral scapular border. The interval between the teres minor and infraspinatus was paramount for fracture reduction and implant insertion. The 2.7-mm minifragment plates were applied along the lateral border of the scapula. Radiographic assessment of fracture healing and clinical assessment of shoulder function. The majority of patients were males (31 males, 6 females) who sustained blunt trauma. All scapular fractures maintained fixation and reduction. No wound or muscle dehiscence problems were noted. Average range of motion was 158 degrees (range 90-180 degrees). There were no fixation failures or instances of implant loosening. The modified Judet approach allows for excellent scapular and glenoid fracture visualization and reduction while preserving rotator cuff function. Minifragment fixation along the lateral scapular border provides excellent plate position, screw length, and fracture stability.

  4. An InP/Si heterojunction photodiode fabricated by self-aligned corrugated epitaxial lateral overgrowth

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

    Sun, Y. T., E-mail: yasun@kth.se; Omanakuttan, G.; Lourdudoss, S.

    2015-05-25

    An n-InP/p-Si heterojunction photodiode fabricated by corrugated epitaxial lateral overgrowth (CELOG) method is presented. N-InP/p-Si heterojunction has been achieved from a suitable pattern containing circular shaped openings in a triangular lattice on the InP seed layer on p-Si substrate and subsequent CELOG of completely coalesced n-InP. To avoid current path through the seed layer in the final photodiode, semi-insulating InP:Fe was grown with adequate thickness prior to n-InP growth in a low pressure hydride vapor phase epitaxy reactor. The n-InP/p-Si heterointerface was analyzed by scanning electron microscopy and Raman spectroscopy. Room temperature cross-sectional photoluminescence (PL) mapping illustrates the defect reductionmore » effect in InP grown on Si by CELOG method. The InP PL intensity measured above the InP/Si heterojunction is comparable to that of InP grown on a native planar substrate indicating low interface defect density of CELOG InP despite of 8% lattice mismatch with Si. The processed n-InP/p-Si heterojunction photodiodes show diode characteristics from the current-voltage (I-V) measurements with a dark current density of 0.324 mA/cm{sup 2} at a reverse voltage of −1 V. Under the illumination of AM1.5 conditions, the InP/Si heterojunction photodiode exhibited photovoltaic effect with an open circuit voltage of 180 mV, a short circuit current density of 1.89 mA/cm{sup 2}, an external quantum efficiency of 4.3%, and an internal quantum efficiency of 6.4%. This demonstration of epitaxially grown InP/Si heterojunction photodiode will open the door for low cost and high efficiency solar cells and photonic integration of III-Vs on silicon.« less

  5. 76 FR 64428 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... for discussion of electronic tax administration issues in support of the overriding goal that...

  6. 77 FR 70879 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998, the Internal Revenue Service established the Electronic Tax... for discussion of electronic tax administration issues in support of the overriding goal that...

  7. 77 FR 31441 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... for discussion of electronic tax administration issues in support of the overriding goal that...

  8. Object Management Group object transaction service based on an X/Open and International Organization for Standardization open systems interconnection transaction processing kernel

    NASA Astrophysics Data System (ADS)

    Liang, J.; Sédillot, S.; Traverson, B.

    1997-09-01

    This paper addresses federation of a transactional object standard - Object Management Group (OMG) object transaction service (OTS) - with the X/Open distributed transaction processing (DTP) model and International Organization for Standardization (ISO) open systems interconnection (OSI) transaction processing (TP) communication protocol. The two-phase commit propagation rules within a distributed transaction tree are similar in the X/Open, ISO and OMG models. Building an OTS on an OSI TP protocol machine is possible because the two specifications are somewhat complementary. OTS defines a set of external interfaces without specific internal protocol machine, while OSI TP specifies an internal protocol machine without any application programming interface. Given these observations, and having already implemented an X/Open two-phase commit transaction toolkit based on an OSI TP protocol machine, we analyse the feasibility of using this implementation as a transaction service provider for OMG interfaces. Based on the favourable result of this feasibility study, we are implementing an OTS compliant system, which, by initiating the extensibility and openness strengths of OSI TP, is able to provide interoperability between X/Open DTP and OMG OTS models.

  9. Exposure of wide cerebellomedullary cisterns for vascular lesion surgeries in cerebellomedullary cisterns: opening of unilateral cerebellomedullary fissures combined with lateral foramen magnum approach.

    PubMed

    Matsushima, Toshio; Kawashima, Masatou; Inoue, Kohei; Matsushima, Ken; Miki, Koichi

    2014-11-01

    To clarify microsurgical anatomic features of the cerebellomedullary fissure (CMF), the natural cleavage plane between the cerebellum and the medulla, and its relationship to the cerebellomedullary cistern (CMC) and to describe a surgical technique that uses the unilateral trans-CMF approach for CMC surgeries. In the anatomic study, 2 formalin-fixed cadaver heads were used. In the clinical study, 3 patients with vertebral artery-posterior inferior cerebellar artery aneurysms and 3 patients with glossopharyngeal neuralgia were surgically treated through the unilateral trans-CMF approach combined with the transcondylar fossa approach, which is a lateral foramen magnum approach. The CMC was present at the lateral end of the CMF. The CMF was closed by arachnoidal adhesion, and the cerebellar hemisphere was superiorly attached to the cerebellar peduncle. After the unilateral CMF was completely opened, the cerebellar hemisphere was easily retracted rostrodorsally. Clinically, almost completely opening the unilateral CMF markedly enabled the retraction of the biventral lobule to obtain a wide surgical field safely for vascular CMC lesions. We present 2 representative cases. Combined unilateral trans-CMF/lateral foramen magnum approaches provide a wide and close surgical field in the CMC, allowing easy and safe CMC surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. [Internal screwed plate for recent fractures of the humeral diaphysis in adults].

    PubMed

    Dayez, J

    1999-06-01

    Can medial plating of the humerus, through an antero lateral approach, diminish incidence of iatrogenic radial palsies? We carried out a prospective study of medial plating of humeral shaft fractures through an antero lateral approach between 1988 and 1997. 41 fractures were fixed, 36 were followed up for a mean period of 5.8 years. The indications were multiple injuries (10), displaced fractures (23), and failure of conservative treatment (3). Road traffic accidents and sports injuries were the cause in 68 per cent of cases. Two fractures were open and in 9 cases there was a radial palsy. Bone graft was never used. The approach to the medial aspect of the humerus an antero lateral incision was the essential feature of the technique. After a slightly curved incision on the antero lateral aspect of the arm, the space between biceps and brachialis anterior was bluntly dissected. The assistant holded the elbow flexed in order to relax the biceps and rotated il laterally to expose the medial aspect of the bone. Splitting brachialis fibres longitudinally exposed the fracture site. It was easy to check if the radial nerve was trapped and, if not, the nerve seen during the operation. Postoperatively patients were given a simple sling and mobilised freely, including rotation. We had no intra-operative complications, no infections, no fixation failure, no post operative radial palsies and no non-unions. Results were excellent in 89 per cent of cases (full recovery of pain free range of movement). Four patient had a restriction of elbow movements of 10 degrees but without any discomfort. The mean time to union was 80 days. All radial nerve palsies recovered between 24 hours and 1 year. The plate was removed in 11 cases. Iatrogenic complications of humeral plating have led to the increased popularity of intramedullary nailing. Even if secondary radial palsies and non-unions have decreased, union of the humeral shafts is often difficult. Placing the plate into the medial surface allowed to preserve the radial nerve, but still permitted to check its continuity when it was trapped in the fracture site. Restoration of the length and rotational alignment of the humerus puts the radial nerve in the best condition for its recovery. An antero lateral approach and a medially placed plate allowed to avoid secondary radial plasies and non-unions, which can complicate internal fixation of the humeral shaft.

  11. Mechanical strength assessment of a drilled hole in the contralateral cortex at the end of the open wedge for high tibial osteotomy.

    PubMed

    Diffo Kaze, Arnaud; Maas, Stefan; Hoffmann, Alexander; Pape, Dietrich

    2017-12-01

    This study aimed to investigate, by means of finite element analysis, the effect of a drill hole at the end of a horizontal osteotomy to reduce the risk of lateral cortex fracture while performing an opening wedge high tibial osteotomy (OWHTO). The question was whether drilling a hole relieves stress and increases the maximum correction angle without fracture of the lateral cortex depending on the ductility of the cortical bone. Two different types of osteotomy cuts were considered; one with a drill hole (diameter 5 mm) and the other without the hole. The drill holes were located about 20 mm distally to the tibial plateau and 6 mm medially to the lateral cortex, such that the minimal thickness of the contralateral cortical bone was 5 mm. Based on finite element calculations, two approaches were used to compare the two types of osteotomy cuts considered: (1) Assessing the static strength using local stresses following the idea of the FKM-guideline, subsequently referred to as the "FKM approach" and (2) limiting the total strain during the opening of the osteotomy wedge, subsequently referred to as "strain approach". A critical opening angle leading to crack initiation in the opposite lateral cortex was determined for each approach and was defined as comparative parameter. The relation to bone aging was investigated by considering the material parameters of cortical bones from young and old subjects. The maximum equivalent (von-Mises) stress was smaller for the cases with a drill hole at the end of the osteotomy cut. The critical angle was approximately 1.5 times higher for the specimens with a drill hole compared to those without. This corresponds to an average increase of 50%. The calculated critical angle for all approaches is below 5°. The critical angle depends on the used approach, on patient's age and assumed ductility of the cortical bone. Drilling a hole at the end of the osteotomy reduces the stresses in the lateral cortex and increases the critical opening angle prior to cracking of the opposite cortex in specimen with small correction angles. But the difference from having a drill hole or not is not so significant, especially for older patients. The ductility of the cortical bone is the decisive parameter for the critical opening angle.

  12. The inaccuracy of surface-measured model-derived tibiofemoral kinematics.

    PubMed

    Li, Kang; Zheng, Liying; Tashman, Scott; Zhang, Xudong

    2012-10-11

    This study assessed the accuracy of surface-measured OpenSim-derived tibiofemoral kinematics in functional activities. Ten subjects with unilateral, isolated grade II PCL deficiency performed level running and stair ascent. A dynamic stereo radiography (DSX) system and a Vicon motion capture system simultaneously measured their knee or lower extremity movement. Surface marker motion data from the Vicon system were used to create subject-specific models in OpenSim and derive the tibiofemoral kinematics. The surface-measured model-derived tibiofemoral kinematics in all six degrees of freedom (DOFs) were then compared with those measured by the DSX as the benchmarks. The differences between surface- and DSX-measured tibiofemoral kinematics were found to be substantial: the overall mean (±SD) RMS differences during running were 9.1±3.2°, 2.0±1.2°, and 6.4±4.5° for the flexion-extension, abduction-adduction, and internal-external rotations, respectively, and 7.1±3.2 mm, 8.8±3.7 mm, and 1.9±1.2 mm for anterior-posterior, proximal-distal, and medial-lateral translations, respectively. The differences were more pronounced in relatively higher speed running than in stair ascent. It was also found that surface-based measures significantly underestimated the mean as well as inter-subject variability of the differences between PCL-injured and intact knees in abduction-adduction, internal-external rotations, and anterior-posterior translation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Toward an International Open Skies Regime: Advances, Impediments, and Impacts

    DOT National Transportation Integrated Search

    1998-01-01

    The International Air Transportation Competition Act of 1979 heralded the era of Open Skies in international aviation. This paper traces the post-war regulation and then deregulation of fares, rates, routes, and capacity all the way from Bermuda I th...

  14. 75 FR 71188 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... organized public forum for discussion of electronic tax administration issues in support of the overriding...

  15. 76 FR 12793 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-08

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... organized public forum for discussion of electronic tax administration issues in support of the overriding...

  16. 75 FR 30109 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... Open Meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... organized public forum for discussion of electronic tax administration issues in support of the overriding...

  17. Does Humeral Component Lateralization in Reverse Shoulder Arthroplasty Affect Rotator Cuff Torque? Evaluation in a Cadaver Model.

    PubMed

    Chan, Kevin; Langohr, G Daniel G; Mahaffy, Matthew; Johnson, James A; Athwal, George S

    2017-10-01

    Humeral component lateralization in reverse total shoulder arthroplasty (RTSA) may improve the biomechanical advantage of the rotator cuff, which could improve the torque generated by the rotator cuff and increase internal and external rotation of the shoulder. The purpose of this in vitro biomechanical study was to evaluate the effect of humeral component lateralization (or lateral offset) on the torque of the anterior and posterior rotator cuff. Eight fresh-frozen cadaveric shoulders from eight separate donors (74 ± 8 years; six males, two females) were tested using an in vitro simulator. All shoulders were prescreened for soft tissue deficit and/or deformity before testing. A custom RTSA prosthesis was implanted that allowed five levels of humeral component lateralization (15, 20, 25, 30, 35 mm), which avoided restrictions imposed by commercially available designs. The torques exerted by the anterior and posterior rotator cuff were measured three times and then averaged for varying humeral lateralization, abduction angle (0°, 45°, 90°), and internal and external rotation (-60°, -30°, 0°, 30°, 60°). A three-way repeated measures ANOVA (abduction angle, humeral lateralization, internal rotation and external rotation angles) with a significance level of α = 0.05 was used for statistical analysis. Humeral lateralization only affected posterior rotator cuff torque at 0° abduction, where increasing humeral lateralization from 15 to 35 mm at 60° internal rotation decreased external rotation torque by 1.6 ± 0.4 Nm (95% CI, -0.07 -1.56 Nm; p = 0.06) from 4.0 ± 0.3 Nm to 2.4 ± 0.6 Nm, respectively, but at 60° external rotation increased external rotation torque by 2.2 ± 0.5 Nm (95% CI, -4.2 to -0.2 Nm; p = 0.029) from 6.2 ± 0.5 Nm to 8.3 ± 0.5 Nm, respectively. Anterior cuff torque was affected by humeral lateralization in more arm positions than the posterior cuff, where increasing humeral lateralization from 15 to 35 mm when at 60° internal rotation increased internal rotation torque at 0°, 45°, and 90° abduction by 3.2 ± 0.5 Nm (95% CI, 1.1-5.2 Nm; p = 0.004) from 6.6 ± 0.6 Nm to 9.7 ± 0.6 Nm, 4.0 ± 0.3 Nm (95% CI, 2.8-5.0 Nm; p < 0.001) from 1.7 ± 1.0 Nm to 5.6 ± 0.9 Nm, and 2.2 ± 0.2 Nm (95% CI, 1.4-2.9 Nm; p < 0.001) from 0.6 ± 0.6 Nm to 2.8 ± 0.6 Nm, respectively. In neutral internal and external rotation, increasing humeral lateral offset from 15 to 35 mm increased the internal rotation torque at 45˚ and 90˚ abduction by 1.5 ± 0.3 Nm (95% CI, 0.2-2.7 Nm; p = 0.02) and 1.3 ± 0.2 Nm (95% CI, 0.4-2.3 Nm; p < 0.001), respectively. Humeral component lateralization improves rotator cuff torque. The results of this preliminary in vitro cadaveric study suggest that the lateral offset of the RTSA humeral component plays an important role in the torque generated by the anterior and posterior rotator cuff. However, further studies are needed before clinical application of these results. Increasing humeral offset may have adverse effects, such as the increased risk of implant modularity, increasing tension of the cuff and soft tissues, increased costs often associated with design modifications, and other possible as yet unforeseen negative consequences.

  18. High resolution digital elevation modelling from TLS and UAV campaign reveals structural complexity at the 2014/15 Holuhraun eruption site, Iceland

    NASA Astrophysics Data System (ADS)

    Müller, Daniel; Walter, Thomas R.; Schöpa, Anne; Witt, Tanja; Steinke, Bastian; Gudmundsson, Magnús T.; Dürig, Tobias

    2017-07-01

    Fissure eruptions are commonly linked to magma dikes at depth, associated with elastic and anelastic surface deformation. Elastic deformation is well described by subsidence above, uplift and lateral widening perpendicular to the dike plane. The anelastic part is associated with the formation of a graben, bordered by graben parallel faults that might express as sets of fractures at the surface. Additionally secondary structures, like push ups, bends and step overs yield information about the deforming domain. The formation of such structures associated with fissure eruptions, however, is barely preserved in nature because of the rapid erosion or sediment coverage. Therefore, simple normal fault displacements are commonly assumed at dikes. At the 2014/2015 Holuhraun eruption sites (Iceland), evidence is increasing that the developing fractures are showing variations in their displacement modes. In an attempt to investigate these variations, a fieldwork mapping project combining Terrestrial Laser Scanning (TLS) and Unmanned Aerial Vehicle (UAV) based aerophoto analysis was realized. From this data, we generated locally high resolution Digital Elevation Models (DEMs) and a structural map that allows for identification of kinematic indicators and assessing particularities of the observed structures. We identified 315 fracture segments from satellite data. For single segments we measured strike directions including the amount of opening and opening angles, indicating that many of the measured fractures show transtensional dislocations. Out of these, 81 % are showing significant left-lateral slip, only 17% right-lateral slip and 2% pure tensile opening. We show that local complexities in the fracture traces and geometries are closely related to variations in the transtensional opening direction. Moreover, we identified local changes in fracture azimuths and offsets close to eruption sites, which we speculate to be associated with geometrical changes in the magma feeder itself. Results highlight that opening of fractures associated with an erupting fissure commonly show transtensional modes having both, left-lateral and right-lateral slip, with important implications for interpreting the expression of surface structures at rift zones elsewhere. Results further highlight the great value of UAV based high resolution data to contribute to the integrity of observations of structural complexities at local geologic events.

  19. Radiographic prevalence of CAM-type femoroacetabular impingement after open reduction and internal fixation of femoral neck fractures.

    PubMed

    Mathew, G; Kowalczuk, M; Hetaimish, B; Bedi, A; Philippon, M J; Bhandari, M; Simunovic, N; Crouch, S; Ayeni, O R

    2014-04-01

    The purpose of this study was to estimate the radiographic prevalence of CAM-type femoroacetabular impingement (FAI) in elderly patients (≥ 50 years) who have undergone internal fixation for femoral neck fracture. A total of 187 frog-leg lateral radiographs of elderly patients who underwent internal fixation for a femoral neck fracture were reviewed by two independent reviewers. The alpha angle, beta angle, and femoral head-neck offset ratio were calculated. The presence of two abnormal radiographic parameters was deemed to be diagnostic of radiographic CAM-type impingement. Radiographic CAM-type FAI was identified in 157 out of 187 (84 %) patients who underwent internal fixation for fractures of the femoral neck. Moderate-to-good inter-observer reliability was achieved in the measurement of radiographic parameters. With reference to fracture subtypes and prevalence of radiographic features of CAM-type morphology, 97 (72 %) out of 134 patients were positive for CAM in Garden subtypes I and II, whereas 49 (85.9 %) out of 57 patients had radiographic CAM in Garden III and IV subtypes. There was a high prevalence of CAM-type FAI in patients that underwent surgical fixation of femoral neck fractures. This is significantly higher than the reported prevalence in non-fracture patient populations. The high prevalence of CAM morphology could be related to several factors, including age, fracture morphology, quality of reduction, type of fixation, and fracture healing.

  20. Breakage of internal maxillary distractor: considerable complication of maxillary distraction osteogenesis.

    PubMed

    Aikawa, Tomonao; Iida, Seiji; Isomura, Emiko T; Namikawa, Mari; Matsuoka, Yudai; Yamada, Chiaki; Yamamoto, Taku; Takigawa, Yoko

    2008-07-01

    Maxillary distraction osteogenesis using intraoral distractors is now one of the standard treatments of maxillary retrusion. This report shows 2 cases of breakage of this internal maxillary distractor in patients with cleft lip and palate; one was observed during the distraction period and the other was during the retention period. The first case required a rotational movement of the distraction segment, and this movement caused the laterally dislocation of the posterior part of the distractor, where the distractor suffered some mechanical forces by mouth opening. In the latter case, breakage of distractor was observed on the radiographs taken 3 months after distraction and this complication may have been caused by mechanical force by occlusion and mastication. Both breakages were found at the joint of the anchorage plate and the extension rod, which has some flexibility for adjusting the plate to the bone surface. Therefore, surgeons should pay special attention for this mechanical weak area in this distractor not only during the advancement period, but also during the retention period and should avoid unnecessary frequent bending for adopting the bone surface, which directly weakens the joint.

  1. 76 FR 45007 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications...

  2. 77 FR 67735 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of Meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications...

  3. NREL: International Activities - Assessments and Tools

    Science.gov Websites

    for Solar and Wind Energy, a collaborative, open-architecture project led by the International Renewable Energy Agency (IRENA) for Multilateral Solar and Wind Working Group of the Clean Energy associated with integrating variable renewable energy into the power grid. OpenEI: Open Energy Information

  4. Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial.

    PubMed

    Bartl, Christoph; Stengel, Dirk; Bruckner, Thomas; Rossion, Inga; Luntz, Steffen; Seiler, Christoph; Gebhard, Florian

    2011-03-22

    Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF) with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation.Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius) is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool.The primary objective is to determine differences in the Short Form 36 (SF-36) Physical Component Score (PCS) between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH) instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery), as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture involves a central statistical unit, an independent monitoring institute, and a data safety monitoring board. Following approval by the institutional review boards of all participating centers, conduct and reporting will strictly adhere to national and international rules, regulations, and recommendations (e.g., Good Clinical Practice, data safety laws, and EQUATOR/CONSORT proposals). To our knowledge, ORCHID is the first multicenter RCT designed to assess quality of life and functional outcomes following operative treatment compared to conservative treatment of complex, intra-articular fractures of the distal radius in elderly patients. The results are expected to influence future treatment recommendations and policies on an international level. ISRCTN: ISRCTN76120052 Registration date: 31.07.2008; Randomization of first patient: 15.09.2008.

  5. [Three dimensional finite element model of a modified posterior cervical single open-door laminoplasty].

    PubMed

    Wang, Q; Yang, Y; Fei, Q; Li, D; Li, J J; Meng, H; Su, N; Fan, Z H; Wang, B Q

    2017-06-06

    Objective: To build a three-dimensional finite element models of a modified posterior cervical single open-door laminoplasty with short-segmental lateral mass screws fusion. Methods: The C(2)-C(7) segmental data were obtained from computed tomography (CT) scans of a male patient with cervical spondylotic myelopathy and spinal stenosis.Three-dimensional finite element models of a modified cervical single open-door laminoplasty (before and after surgery) were constructed by the combination of software package MIMICS, Geomagic and ABAQUS.The models were composed of bony vertebrae, articulating facets, intervertebral disc and associated ligaments.The loads of moments 1.5Nm at different directions (flexion, extension, lateral bending and axial rotation)were applied at preoperative model to calculate intersegmental ranges of motion.The results were compared with the previous studies to verify the validation of the models. Results: Three-dimensional finite element models of the modified cervical single open- door laminoplasty had 102258 elements (preoperative model) and 161 892 elements (postoperative model) respectively, including C(2-7) six bony vertebraes, C(2-3)-C(6-7) five intervertebral disc, main ligaments and lateral mass screws.The intersegmental responses at the preoperative model under the loads of moments 1.5 Nm at different directions were similar to the previous published data. Conclusion: Three-dimensional finite element models of the modified cervical single open- door laminoplasty were successfully established and had a good biological fidelity, which can be used for further study.

  6. 75 FR 11999 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... Panel is soliciting public comment, ideas, and suggestions on improving customer service at the Internal... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of Meeting. SUMMARY: An...

  7. Intra-articular injuries of the elbow: pitfalls of diagnosis and treatment.

    PubMed Central

    Fowles, J. V.; Rizkallah, R.

    1976-01-01

    Poor results in treating fractures and dislocations about the elbow may be avoided if the surgeon is aware of the possible injuries, examines good radiographs of both elbows, and treats the injury promptly and appropriately. A displaced fracture of the lateral or medial condyle of the humerus should be suspected if there is a flake fracture of the adjoining metaphysis; open reduction and internal fixation give better results than closed reduction. A shear fracture of the capitulum humeri can only be seen on a lateral radiograph; excision of the fragment, followed by mobilization, is sufficient for a good functional result. Dislocation of the elbow in a child may avulse the medial epicondyle, which sometimes lodges in the joint; it is essential to recognize this and remove the fragment without delay to avoid early degenerative arthritis. An apparently isolated fracture of the ulna should alert the surgeon to the possibility of a dislocation of the radial head; the dislocation and the fracture must be reduced and stabilized to conserve elbow function. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 FIG. 5 FIG. 6 FIG. 7 FIG. 8 PMID:943224

  8. 76 FR 52567 - Drawbridge Operation Regulation; Bonfouca Bayou, Slidell, LA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... regulation of the SR 433 swing span bridge be changed in order to allow for signaled openings to begin later... Bonfouca Bayou, mile 7.0 at Slidell, Louisiana be changed in order to allow for signaled openings to begin... that most of the recreational boaters do not signal for an opening prior to 7 a.m. In the interim rule...

  9. Motives and decisions for and against having children among nonheterosexuals and the impact of experiences of discrimination, internalized stigma, and social acceptance.

    PubMed

    Kleinert, Evelyn; Martin, Olaf; Brähler, Elmar; Stöbel-Richter, Yve

    2015-01-01

    Same-sex parents are increasingly a topic of public discourse. A growing number of homosexuals openly speak about their desire to have children or are already living together in different family constellations. The current study examined the decisions for or against having children and the motivations behind those decisions among nonheterosexuals living in Germany. A sample of 1,283 nonheterosexuals participated by means of an online survey. As some nonheterosexual individuals do not identify themselves with a male or female gender identity, a third category, "gender different," was generated. Motives for (not) having children, perceptions of social acceptance, experiences of discrimination in relation to one's sexual orientation, and levels of internalized stigma were taken into account regarding their influence on the decision about parenthood. Most respondents (80%) reported that they did not have children. However, among this group, 43% stated that they had decided to have children later in their lives, 24% were undecided, and 11% had already decided against having children. The most important influences on the decision of whether to have children were respondents' age and their desire for emotional stabilization. Negative experiences as a result of sexual orientation and internalized stigma had no impact on the decisions regarding parenthood.

  10. 77 FR 1548 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ... DEPARTMENT OF STATE [Public Notice: 7721] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p... of State for Economic and Business Affairs Jose W. Fernandez and Committee Chair Ted Kassinger. The...

  11. 76 FR 4987 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-27

    ... DEPARTMENT OF STATE [Public Notice: 7238] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p... Secretary of State for Economic, Energy, and Business Affairs Jose W. Fernandez and Committee Chair Ted...

  12. 78 FR 24784 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... DEPARTMENT OF STATE [Public Notice 8300] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2... Assistant Secretary of State for Economic and Business Affairs Jose W. Fernandez and Committee Chair Ted...

  13. 77 FR 33014 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-04

    ... DEPARTMENT OF STATE [Public Notice 7912] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p... of State for Economic and Business Affairs Jose W. Fernandez and Committee Chair Ted Kassinger. The...

  14. 75 FR 42813 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... DEPARTMENT OF STATE [Public Notice: 7092] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p... 1107, Washington, DC. The meeting will be hosted by the Assistant Secretary of State for Economic...

  15. 76 FR 71617 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... DEPARTMENT OF STATE [Public Notice 7654] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p... of State for Economic, Energy, and Business Affairs Jose W. Fernandez and Committee Chair Ted...

  16. 75 FR 67804 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... DEPARTMENT OF STATE [Public Notice 7224] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p...., Room 1105, Washington, DC. The meeting will be hosted by the Assistant Secretary of State for Economic...

  17. The Intern Studio: A Pilot Study.

    ERIC Educational Resources Information Center

    Wix, Linney

    1995-01-01

    Describes and discusses the Intern Studio Project, which consists of the provision of regular open studio time for art therapy interns in a state university graduate program. Psychological and artistic bases for the open studio approach are discussed, and include the relational approach, Hillman's essentialist paradigm, and series and context…

  18. 75 FR 16894 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ....S. Government in a solely advisory capacity, and provides advice concerning issues and challenges in... DEPARTMENT OF STATE [Public Notice 6910] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p...

  19. 77 FR 57180 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-17

    ... DEPARTMENT OF STATE [Public Notice 8022] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2 p... of State for Economic and Business Affairs Jose W. Fernandez and Committee Chair Ted Kassinger. The...

  20. 77 FR 21155 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... improving customer service at the Internal Revenue Service. DATES: The meeting will be held Tuesday, May 8... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of...

  1. 78 FR 15125 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice...

  2. 76 FR 37199 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  3. 75 FR 4140 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION...

  4. 77 FR 61053 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  5. 77 FR 21156 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  6. 77 FR 8328 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... improving customer service at the Internal Revenue Service. DATES: The meeting will be held Tuesday, March... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of...

  7. 77 FR 61054 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... improving customer service at the Internal Revenue Service. DATES: The meeting will be held Tuesday... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of...

  8. 76 FR 6189 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  9. 75 FR 11998 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... improving customer service at the Internal Revenue Service. DATES: The meeting will be held Tuesday, April... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of...

  10. 77 FR 8328 - Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Return Processing Delays Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION...

  11. 78 FR 11277 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice...

  12. 75 FR 4139 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  13. 75 FR 4137 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... improving customer service at the Internal Revenue Service. DATES: The meeting will be held Tuesday... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of...

  14. 75 FR 4631 - Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... continued input into the development and implementation of the Internal Revenue Service (IRS) strategy for...

  15. 76 FR 37198 - Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Alabama, Georgia...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Alabama, Georgia, Florida, Louisiana, Mississippi, Tennessee, and Puerto Rico) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open...

  16. 76 FR 6187 - Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Alabama, Georgia...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Alabama, Georgia, Florida, Louisiana, Mississippi, Tennessee, and Puerto Rico AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open...

  17. 76 FR 2195 - Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Alabama, Georgia...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Alabama, Georgia, Florida, Louisiana, Mississippi, Tennessee, and Puerto Rico. AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open...

  18. 75 FR 62630 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications/MLI Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications/MLI Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Tax Forms and...

  19. 75 FR 39330 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications/MLI Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications/MLI Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Tax Forms and...

  20. 75 FR 55404 - Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications/MLI Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Tax Forms and Publications/MLI Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Tax Forms and...

  1. 76 FR 37199 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  2. 75 FR 55406 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  3. 76 FR 6188 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  4. 76 FR 45005 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  5. 76 FR 63716 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  6. 75 FR 47061 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-04

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  7. 76 FR 17994 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  8. 75 FR 25315 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  9. 75 FR 11998 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of Meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  10. 75 FR 4139 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  11. 76 FR 2194 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  12. 76 FR 22170 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  13. 75 FR 7541 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  14. 75 FR 62630 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  15. 76 FR 32023 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of Meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  16. 75 FR 39330 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Area 7 Taxpayer Advocacy...

  17. A new corporoplasty based on stratified structure of tunica albuginea for the treatment of congenital penile curvature - long-term results.

    PubMed

    Perdzyński, Wojciech; Adamek, Marek

    2015-01-01

    The aim of the study was to report long-term results of treatment of patients with congenital penile curvature (CPC) with a new corporoplasty based on stratified structure of tunica albuginea, in which corporal bodies are not opened. From October 2006 to September 2013, the authors operated on 111 adult men with CPC. Ventral curvature was detected in 65 patients, lateral in 34, and dorsal in 12. Skin was incised longitudinally on convex surface of curvature. In ventral curvature, dorsal neuro-vascular bundles (NVBs) were separated from tunica albuginea and elliptical fragments of external (longitudinal) layer of tunica were excised. The tunica was sutured with absorbable sutures, which invaginated the internal (transversal) layer of tunica. In dorsal curvature, excisions were performed on both sides of the urethra, in lateral curvature - on the convex penile surface. Follow-up period was from 12 to 84 months. The penis was completely straight in 109 out of 111 patients. In 2 patients (1.8%) recurrent curvature of up to 20 degrees was detected. Redo surgery was done in one individual (0.9%) at patient's request. Glandular sensation loss or erectile dysfunction was not detected in any patient during the period of observation. A new operation for correction of CPC, which consists of excision of an elliptical fragment of the external layer of the tunica albuginea and plication of the internal layer gives good short and long-term results. Surgery done without penetrating the corpora cavernosa is minimally invasive, which diminishes the potential risk of complications, especially intra- and postoperative bleeding.

  18. Analysis of functional outcome of Hoffa fractures: A retrospective review of 32 patients.

    PubMed

    Trikha, Vivek; Das, Saubhik; Gaba, Sahil; Agrawal, Prabhat

    2017-01-01

    Hoffa fractures are uncommon intra-articular fractures of femoral condyle in coronal plane. The purpose of our study is to assess radiologic and functional outcome in operatively treated Hoffa fractures. We retrospectively reviewed 32 patients of isolated Hoffa fracture from January 2010 to March 2015. All were treated with open reduction and internal fixation using lateral approach for lateral Hoffa and medial approach for medial Hoffa fracture. Cancellous screws in lag mode and/or antiglide plate were employed for fixation in accordance with fracture anatomy. All patients were subjected to aggressive physical therapy postoperatively. Knee Society Score (KSS), International Knee Documentation Committee Score (IKDC), and Knee range of motion (ROM) were documented at final follow-up for functional evaluation. All fractures united by mean time of 11.56 ± 1.5 weeks. No evidence of subsequent displacement or fixation failure, arthritis, Avascular necrosis (AVN) of femoral condyle was elicited in any of the patients. Documented mean KSS and mean IKDC Score at final follow-up were 83.19 ± 8.43 and 81.62± 6.95, respectively. ROM at final follow-up was ranging from 0° to mean 116.41° ± 13.98°. Complications included stiffness of the involved knee in four patients, including one patient who developed infection and had to undergo implant removal after fracture union. Operative treatment of Hoffa fractures yields fairly good functional outcome. One must endeavor to achieve adequate intraoperative exposure and stable congruous articular reconstruction. Early aggressive physical therapy is a harbinger of optimal outcome.

  19. Effect of passengers' active head tilt and opening/closure of eyes on motion sickness in lateral acceleration environment of cars.

    PubMed

    Wada, Takahiro; Yoshida, Keigo

    2016-08-01

    This study examined the effect of passengers' active head-tilt and eyes-open/eyes-closed conditions on the severity of motion sickness in the lateral acceleration environment of cars. In the centrifugal head-tilt condition, participants intentionally tilted their heads towards the centrifugal force, whereas in the centripetal head-tilt condition, the participants tilted their heads against the centrifugal acceleration. The eyes-open and eyes-closed cases were investigated for each head-tilt condition. In the experimental runs, the sickness rating in the centripetal head-tilt condition was significantly lower than that in the centrifugal head-tilt condition. Moreover, the sickness rating in the eyes-open condition was significantly lower than that in the eyes-closed condition. The results suggest that an active head-tilt motion against the centrifugal acceleration reduces the severity of motion sickness both in the eyes-open and eyes-closed conditions. They also demonstrate that the eyes-open condition significantly reduces the motion sickness even when the head-tilt strategy is used. Practitioner Summary: Little is known about the effect of head-tilt strategies on motion sickness. This study investigated the effects of head-tilt direction and eyes-open/eyes-closed conditions on motion sickness during slalom automobile driving. Passengers' active head tilt towards the centripetal direction and the eyes-open condition greatly reduce the severity of motion sickness.

  20. Computer-Aided Design/Computer-Assisted Manufacture-Derived Needle Guide for Injection of Botulinum Toxin into the Lateral Pterygoid Muscle in Patients with Oromandibular Dystonia.

    PubMed

    Yoshida, Kazuya

    2018-01-01

    To evaluate the effectiveness and safety of botulinum toxin administration into the inferior head of the lateral pterygoid muscle of patients with jaw opening dystonia by using a computer-aided design/computer-assisted manufacture (CAD/CAM)-derived needle guide. A total of 17 patients with jaw opening dystonia were enrolled. After the patient's computed tomography (CT) scan was imported and fused with a scan of a plaster cast model of the maxilla, the optimal needle insertion site over the lateral pterygoid muscle was determined using the NobelClinician software. A total of 13 patients were injected both with and without the guide, and 4 patients underwent guided injection alone. The therapeutic effects of botulinum toxin injection and its associated complications were statistically compared between the guided and unguided procedures using paired t test. Botulinum toxin therapy was performed 42 and 32 times with and without the guides, respectively. The needle was easily inserted without any complications in all procedures. There was a significant difference (P < .001) between the mean comprehensive improvements observed with (66.3%) and without (54.4%) the guides. The findings suggest that the use of needle guides during the injection of botulinum toxin into the inferior head of the lateral pterygoid muscle is very useful for aiding the accurate and safe administration of botulinum toxin therapy for jaw opening dystonia.

  1. The role of topic, interviewee and question in predicting rich interview data in the field of health research.

    PubMed

    Ogden, Jane; Cornwell, Danielle

    2010-11-01

    Although texts recommend the generation of rich data from interviews, no empirical evidence base exists for achieving this. This study aimed to operationalise richness and to assess which components of the interview (for example, topic, interviewee, question) were predictive. A total of 400 interview questions and their corresponding responses were selected from 10 qualitative studies in the area of health identified from university colleagues and the UK Data Archive database. The analysis used the text analysis program, Linguistic Inquiry and Word Count, and additional rating scales. Richness was operationalised along five dimensions. 'Length of response' was predicted by a personal, less specific or positive topic, not being a layperson, later questions, open or double questions; 'personal richness' was predicted by being a healthy participant and questions about the past and future; 'analytical responses' were predicted by a personal or less specific topic, not being a layperson, later questions, questions relating to insight and causation; 'action responses' were predicted by a less specific topic, not being a layperson, being healthy, later and open questions. The model for 'descriptive richness' was not significant. Overall, open questions, located later on and framed in the present or past tense, tended to be most predictive of richness. This could inform improvements in interview technique. © 2010 The Authors. Sociology of Health & Illness © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  2. Person-Organization Commitment: Bonds of Internal Consumer in the Context of Non-profit Organizations

    PubMed Central

    Juaneda-Ayensa, Emma; Clavel San Emeterio, Mónica; González-Menorca, Carlos

    2017-01-01

    From an Organizational Behavior perspective, it is important to recognize the links generated between individuals and the organization that encourage a desire for permanence. After more than a half century of research, Organizational Commitment remains one of the open questions in the Psychology of Organizations. It is considered an essential factor for explaining individual behavior in the organization such as satisfaction, turnover intention, or loyalty. In this paper, we analyze different contributions regarding the nature of the bond between the individual and the organization. Taking into account the peculiarities of Non-profit Organizations, we present different interpretation for later validation, comparing results from the Confirmatory Factor Analysis of the four models obtained using exploratory factor analysis, both conducted on a sample of 235 members of Non-profit Organizations. PMID:28775699

  3. The Effect of Modified Brostrom-Gould Repair for Lateral Ankle Instability on In Vivo Tibiotalar Kinematics

    PubMed Central

    Wainright, William B; Spritzer, Charles E.; Lee, Jun Young; Easley, Mark E.; DeOrio, James K.; Nunley, James A.; DeFrate, Louis E.

    2012-01-01

    Background Lateral ankle instability leads to an increased risk of tibiotalar joint osteoarthritis. Previous studies have found abnormal tibiotalar joint motions with lateral ankle instability that may contribute to this increased incidence of osteoarthritis, including increased anterior translation and internal rotation of the talus under weight-bearing loading. Surgical repairs for lateral ankle instability have shown good clinical results, but the effects of repair on in vivo ankle motion are not well understood. Hypothesis The modified Broström-Gould lateral ligament reconstruction decreases anterior translation and internal rotation of the talus under in vivo weight-bearing loading conditions. Study Design Controlled laboratory study. Methods Seven patients underwent modified Brostöm-Gould repair for unilateral lateral ankle instability. Ankle joint kinematics as a function of increasing body weight were studied with magnetic resonance imaging and biplanar fluoroscopy. Tibiotalar kinematics were measured in unstable ankles preoperatively and postoperatively at a mean follow-up of 12 months, as well as in the uninjured contralateral ankles of the same individuals. Results Surgical repair resulted in statistically significant decreases in anterior translation of the talus (0.9±0.3mm, p=0.018) at 100% bodyweight and internal rotation of the talus at 75% (2.6±0.8°, p=0.019) and 100% (2.7±0.8°, p=0.013) bodyweight compared to ankle kinematics measured before repair. No statistically significant differences were detected between repaired ankles and contralateral normal ankles. Conclusion The modified Broström-Gould repair improved the abnormal joint motion observed in patients with lateral ankle instability, decreasing anterior translation and internal rotation of the talus. Clinical Relevance Altered kinematics may contribute to the tibiotalar joint degeneration that occurs with chronic lateral ankle instability. The findings of the current study support the efficacy of this repair in improving the abnormal ankle motion observed in these patients. PMID:22886690

  4. Differences in Lateral Drop Jumps From an Unknown Height Among Individuals With Functional Ankle Instability

    PubMed Central

    Rosen, Adam; Swanik, Charles; Thomas, Stephen; Glutting, Joseph; Knight, Christopher; Kaminski, Thomas W.

    2013-01-01

    Context: Functional ankle instability (FAI) is a debilitating condition that has been reported to occur after 20% to 50% of all ankle sprains. Landing from a jump is one common mechanism of ankle injury, yet few researchers have explored the role of visual cues and anticipatory muscle contractions, which may influence ankle stability, in lateral jumping maneuvers. Objective: To examine muscle-activation strategies between FAI and stable ankles under a lateral load and to evaluate the differences in muscle activation in participants with FAI and participants with stable ankles when they were unable to anticipate the onset of lateral loads during eyes-open versus eyes-closed conditions. Design: Case-control study. Setting: Controlled laboratory setting. Patients or Other Participants: A total of 40 people participated: 20 with FAI and 20 healthy, uninjured, sex- and age-matched persons (control group). Intervention(s): Participants performed a 2-legged lateral jump off a platform onto a force plate set to heights of 35 cm or 50 cm and then immediately jumped for maximal height. They performed jumps in 2 conditions (eyes open, eyes closed) and were unaware of the jump height when their eyes were closed. Main Outcome Measure(s): Amplitude normalized electromyographic (EMG) area (%), peak (%), and time to peak in the tibialis anterior (TA), peroneus longus (PL), and lateral gastrocnemius (LG) muscles were measured. Results: Regardless of the eyes-open or eyes-closed condition, participants with FAI had less preparatory TA (t158 = 2.22, P = .03) and PL (t158 = 2.09, P = .04) EMG area and TA (t158 = 2.45, P = .02) and PL (t158 = 2.17, P = .03) peak EMG than control-group participants. Conclusions: By removing visual cues, unanticipated lateral joint loads occurred simultaneously with decreased muscle activity, which may reduce dynamic restraint capabilities in persons with FAI. Regardless of visual impairment and jump height, participants with FAI exhibited PL and TA inhibition, which may limit talonavicular stability and intensify lateral joint surface compression and pain. PMID:23952040

  5. Radiographic comparison of surgical hip dislocation and hip arthroscopy for treatment of cam deformity in femoroacetabular impingement.

    PubMed

    Bedi, Asheesh; Zaltz, Ira; De La Torre, Katrina; Kelly, Bryan T

    2011-07-01

    Whether open or arthroscopic techniques are employed, the goal of femoroacetabular impingement (FAI) surgery is to achieve impingement-free range of motion. While arthroscopic approaches have improved and gained popularity, an objective evaluation of the surgical correction achieved with this approach compared with open surgery remains to be defined in the literature. This study was undertaken to compare the efficacy of arthroscopic osteoplasty and open surgical dislocation in treating FAI dysmorphology in a consecutive series of patients. Cohort study; Level of evidence, 3. Surgical treatment was performed in 60 male patients under 40 years of age for symptomatic FAI refractory to nonoperative management. Patients were matched (not randomized) to treatment groups: 30 patients (15 left and 15 right hips) underwent arthroscopic cam and/or rim osteoplasty with labral debridement and/or refixation by an arthroscopic surgeon; and 30 (14 left and 16 right hips) underwent open surgical dislocation, cam and/or rim osteoplasty, and labral debridement or refixation by a hip preservation surgeon. Anteroposterior (AP) pelvis and extended-neck (Dunn) lateral radiographs were obtained and the depth of resection and arc of resection were measured by assessment of anterior femoral head-neck offset, AP and lateral α angle, and β angle on preoperative and postoperative radiographs. In the arthroscopic group, the extended-neck lateral α angle was reduced by a mean of 17.2° (28.3%, P < .05), AP α angle was reduced by a mean of 12.6° (16.8%), anterior head-neck offset improved 5.0 mm (111%, P < .05), and β angle increased by a mean of 23.1°. In the open dislocation group, the extended-neck lateral α angle was reduced by a mean of 21.2° (30.7%, P < .05), AP α angle was reduced by a mean of 20.1° (25.7%), anterior head-neck offset improved 6.56 mm (108%, P < .05), and β angle increased by a mean of 18.35°. Arthroscopic osteoplasty can restore head-neck offset and achieve similar depth, arc, and proximal-distal resection with comparable efficacy to open surgical dislocation for anterior and anterosuperior cam and focal rim impingement deformity. The open technique, however, may allow greater correction of posterosuperior loss of femoral offset and may be favorable for FAI patterns that demonstrate considerable proximal femoral deformity on AP radiographs.

  6. Open adoption of infants: adoptive parents' feelings seven years later.

    PubMed

    Siegel, Deborah H

    2003-07-01

    Adoptions today increasingly include contact between adoptive and birth families. What do these "open adoptions" look like? How do the participants feel about them? This article, based on part of a longitudinal study that first examined adoptive parents' perceptions of their infants' open adoptions seven years ago, explores the parents' reactions now that their children are school age. This qualitative descriptive research revealed changes in the openness in the adoptions over time and identified four dimensions along which open adoptions vary. Findings showed parents' enthusiasm for the openness in their adoptions, regardless of the type and extent of openness. Implications for social work practice, education, and policy are explored.

  7. Internal pedestrian circulation and common open space, also illustrating mature ...

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

    Internal pedestrian circulation and common open space, also illustrating mature landscape features. Building 35 at left foreground. Facing east - Harbor Hills Housing Project, 26607 Western Avenue, Lomita, Los Angeles County, CA

  8. [Complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures: a meta-analysis].

    PubMed

    Yang, Z; Yuan, Z Z; Ma, J X; Ma, X L

    2016-12-20

    Objective: To make a systematic assessment of the complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Method: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed.The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected.The included trials were screened out strictly based on the criterion of inclusion and exclusion.The quality of included trials was evaluated.RevMan 5.0 was used for data analysis. Result: A total of 17 studies involving 1 402 patients were included.There were 687 patients with open reduction and internal fixation and 715 with external fixation.The results of Meta-analysis indicated that there were statistically significant differences with regard to the postoperatively total complications, infection, malunion, tendon rupture ( I 2 =8%, RR =0.77(95% CI 0.65-0.91, Z =3.10, P <0.05). There were no statistically significant differences observed between two approaches with respect to nounion, re-operation, complex regional pain syndrome, carpal tunnel syndrome, neurapraxia, tendonitis, painful hardware, scar( P >0.05). Conclusion: Postoperative complications are present in both open reduction and internal fixation and external fixation.Compared with external fixation, open reduction and internal fixation is lower in total complications postoperatively, infection and malunion, but external fixation has lower tendon rupture incidence.

  9. 75 FR 11999 - Open Meeting of the Area 2 Taxpayer Advocacy Panel (Including the States of Delaware, North...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 2 Taxpayer Advocacy..., Pennsylvania, Virginia, West Virginia and the District of Columbia) AGENCY: Internal Revenue Service (IRS...

  10. 75 FR 4138 - Open Meeting of the Area 2 Taxpayer Advocacy Panel (Including the States of Delaware, North...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... customer service at the Internal Revenue Service. DATES: The meeting will be held Wednesday, February 17... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 2 Taxpayer Advocacy..., Pennsylvania, Virginia, West Virginia and the District of Columbia) AGENCY: Internal Revenue Service (IRS...

  11. The Role of Language and Culture in Open Learning in International Collaborative Programmes

    ERIC Educational Resources Information Center

    Scarino, Angela; Crichton, Jonathan; Woods, Megan

    2007-01-01

    In the context of internationalisation, the delivery of higher education programmes increasingly combines open learning with collaborations among people of diverse languages and cultures. In this paper we argue that while the literature on international education focuses on mapping modes of delivery in international education, there is also a need…

  12. International Federation of Library Associations General Conference, Montreal 1982. Official Opening Statements and Speeches. Plenary Session I and II. Papers.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    Official opening statements and papers on networking and the development of information technology which were presented at the 1982 International Federation of Library Associations (IFLA) conference include: (1) opening speeches by Else Granheim (IFLA president) and Kenneth H. Rogers (UNESCO Representative); (2) "The Importance of Networks…

  13. Assessment of the financial implications for laparoscopic liver surgery: a single-centre UK cost analysis for minor and major hepatectomy.

    PubMed

    Abu Hilal, Mohammed; Di Fabio, Francesco; Syed, Shareef; Wiltshire, Robert; Dimovska, Eleonora; Turner, David; Primrose, John N; Pearce, Neil W

    2013-07-01

    Laparoscopic hepatectomy is progressively gaining popularity. However, it is still unclear whether the laparoscopic approach offers cost advantages compared with the open approach, especially when major hepatectomies are required. Data providing useful insights into the costs of the laparoscopic approach for clinicians and hospitals are needed. The aim of this study is to assess the financial implications of the laparoscopic approach for two standardized minor and major hepatectomies: left lateral sectionectomy and right hepatectomy. A cost comparison analysis of patients undergoing laparoscopic right hepatectomy (LRH) and laparoscopic left lateral sectionectomy (LLLS) versus the open counterparts was performed. Data considered for the comparison analysis were operative costs (theatre cost, consumables and surgeon/anaesthetic labour cost), postoperative costs (hospital stay, complication management and readmissions) and overall costs. A total of 149 patients were included: 38 patients underwent LRH and 46 open right hepatectomy (ORH); 46 patients underwent LLLS and 19 open left lateral sectionectomy (OLLS). For LRH the mean operative, postoperative and overall costs were £10,181, £4,037 and £14,218; for ORH the mean operative, postoperative and overall costs were £6,483 (p < 0.0001), £10,304 (p < 0.0001) and £16,787 (p = 0.886). Regarding LLLS, the mean operative, postoperative and overall costs were £5,460, £2,599 and £8,059; for OLLS the mean operative, postoperative and overall costs were £5,841 (p = 0.874), £5,796 (p < 0.0001) and £11,637 (p = 0.0001). Our data support the cost advantage of the laparoscopic approach for left lateral sectionectomy and the cost neutrality for right hepatectomy.

  14. How Shigella Utilizes Ca(2+) Jagged Edge Signals during Invasion of Epithelial Cells.

    PubMed

    Bonnet, Mariette; Tran Van Nhieu, Guy

    2016-01-01

    Shigella, the causative agent of bacillary dysentery invades intestinal epithelial cells using a type III secretion system (T3SS). Through the injection of type III effectors, Shigella manipulates the actin cytoskeleton to induce its internalization in epithelial cells. At early invasion stages, Shigella induces atypical Ca(2+) responses confined at entry sites allowing local cytoskeletal remodeling for bacteria engulfment. Global Ca(2+) increase in the cell triggers the opening of connexin hemichannels at the plasma membrane that releases ATP in the extracellular milieu, favoring Shigella invasion and spreading through purinergic receptor signaling. During intracellular replication, Shigella regulates inflammatory and death pathways to disseminate within the epithelium. At later stages of infection, Shigella downregulates hemichannel opening and the release of extracellular ATP to dampen inflammatory signals. To avoid premature cell death, Shigella activates cell survival by upregulating the PI3K/Akt pathway and downregulating the levels of p53. Furthermore, Shigella interferes with pro-apoptotic caspases, and orients infected cells toward a slow necrotic cell death linked to mitochondrial Ca(2+) overload. In this review, we will focus on the role of Ca(2+) responses and their regulation by Shigella during the different stages of bacterial infection.

  15. How Shigella Utilizes Ca2+ Jagged Edge Signals during Invasion of Epithelial Cells

    PubMed Central

    Bonnet, Mariette; Tran Van Nhieu, Guy

    2016-01-01

    Shigella, the causative agent of bacillary dysentery invades intestinal epithelial cells using a type III secretion system (T3SS). Through the injection of type III effectors, Shigella manipulates the actin cytoskeleton to induce its internalization in epithelial cells. At early invasion stages, Shigella induces atypical Ca2+ responses confined at entry sites allowing local cytoskeletal remodeling for bacteria engulfment. Global Ca2+ increase in the cell triggers the opening of connexin hemichannels at the plasma membrane that releases ATP in the extracellular milieu, favoring Shigella invasion and spreading through purinergic receptor signaling. During intracellular replication, Shigella regulates inflammatory and death pathways to disseminate within the epithelium. At later stages of infection, Shigella downregulates hemichannel opening and the release of extracellular ATP to dampen inflammatory signals. To avoid premature cell death, Shigella activates cell survival by upregulating the PI3K/Akt pathway and downregulating the levels of p53. Furthermore, Shigella interferes with pro-apoptotic caspases, and orients infected cells toward a slow necrotic cell death linked to mitochondrial Ca2+ overload. In this review, we will focus on the role of Ca2+ responses and their regulation by Shigella during the different stages of bacterial infection. PMID:26904514

  16. [Long-term follow-up study of titanium implant impact on pediatric mandibular growth and development].

    PubMed

    Hu, Yun; Li, Wei; Chen, Qi; Song, Fumin; Tang, Wei; Wang, Hang

    2015-08-01

    To explore the impact of titanium implant on the growth and development of pediatric mandible after suffering from mandibular fracture and undergoing open reduction and internal fixation (ORIF) compared with those that underwent titanium plate removal postoperatively. Fifteen pediatric patients with mandibular fracture who underwent ORIF were included in this study. Eight patients did not undergo titanium implant removal postoperatively, whereas the other seven patients underwent the routine. The postoperative data of the pediatrics were collected for comparative analysis by taking the patients' frontal and lateral photos, recording the inter-incisor distance, and measuring the height of mandibular ramus, length of the mandibular body, and combined length of the mandible in three-dimensional reconstruction image. All patients had acceptable facial contour, mouth opening, and occlusion, without obvious abnormalities. The radiography showed no significant difference between the bilateral mandibular lengths in the two groups of patients (P>0.05). The titanium plants have no significant impact on the growth and development of pediatric mandible postoperatively; hence, the question on whether the titanium plates should be removed or not may be neglected. The removal operation may lead to secondary trauma; thus, performing titanium plate removal routinely is not recommended.

  17. Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

    PubMed

    Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

    2017-05-01

    This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p < 0.05): open fracture (OR 3.78; 95% CI 2.71-5.27), compartment syndrome (OR 3.53; 95% CI 2.13-5.86), operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection. Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

  18. Resting-state sensorimotor rhythm (SMR) power predicts the ability to up-regulate SMR in an EEG-instrumental conditioning paradigm.

    PubMed

    Reichert, Johanna Louise; Kober, Silvia Erika; Neuper, Christa; Wood, Guilherme

    2015-11-01

    Instrumental conditioning of EEG activity (EEG-IC) is a promising method for improvement and rehabilitation of cognitive functions. However, it has been found that even healthy adults are not always able to learn how to regulate their brain activity during EEG-IC. In the present study, the role of a neurophysiological predictor of EEG-IC learning performance, the resting-state power of sensorimotor rhythm (rs-SMR, 12-15Hz), was investigated. Eyes-open and eyes-closed rs-SMR power was assessed before N=28 healthy adults underwent 10 training sessions of instrumental SMR conditioning (ISC), in which participants should learn to voluntarily increase their SMR power by means of audio-visual feedback. A control group of N=19 participants received gamma (40-43Hz) or sham EEG-IC. N=19 of the ISC participants could be classified as "responders" as they were able to increase SMR power during training sessions, while N=9 participants ("non-responders") were not able to increase SMR power. Rs-SMR power in responders before start of ISC was higher in widespread parieto-occipital areas than in non-responders. A discriminant analysis indicated that eyes-open rs-SMR power in a central brain region specifically predicted later ISC performance, but not an increase of SMR in the control group. Together, these findings indicate that rs-SMR power is a specific and easy-to-measure predictor of later ISC learning performance. The assessment of factors that influence the ability to regulate brain activity is of high relevance, as it could be used to avoid potentially frustrating and expensive EEG-IC training sessions for participants who have a low chance of success. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Long-term effects of routine morphine infusion in mechanically ventilated neonates on children's functioning: five-year follow-up of a randomized controlled trial.

    PubMed

    de Graaf, Joke; van Lingen, Richard A; Simons, Sinno H P; Anand, Kanwaljeet J S; Duivenvoorden, Hugo J; Weisglas-Kuperus, Nynke; Roofthooft, Daniella W E; Groot Jebbink, Liesbeth J M; Veenstra, Ravian R; Tibboel, Dick; van Dijk, Monique

    2011-06-01

    Newborns on ventilatory support often receive morphine to induce analgesia. Animal experiments suggest that this may impair subsequent cognitive and behavioral development. There are sparse human data on long-term effects of neonatal morphine. We aimed to investigate the effects of continuous morphine administered in the neonatal period on the child's functioning. We conducted a follow-up study among 5-year-olds who, as mechanically ventilated neonates, had participated in a placebo-controlled trial on effects of morphine administration on pain and neurologic outcome. They were now tested on intelligence, visual motor integration, behavior, chronic pain, and health-related quality of life. Univariate analyses showed significantly lower overall intelligence quotient (IQ) scores for children who earlier had received morphine, that is, mean 94 (SD 14.5) versus 100 (SD 12.9) for those who received placebo (P = 0.049). Other between-group differences in outcomes were not found. The statistical difference disappeared after correction for treatment condition, open-label morphine consumption over the first 28 days, and a propensity score for clinically relevant co-variables in multiple regression analyses. However, scores on one IQ subtest, "visual analysis," were significantly negatively related to having received morphine and to open-label morphine consumption the first 28 days. The finding of a significant effect of morphine on the "visual analysis" IQ subtest calls for follow-up at a later age focusing on the higher-order neurocognitive functions. Morphine received in the neonatal period has negative effects on the child's cognitive functioning at the age of 5 years which warrants follow-up at a later age. Copyright © 2011 International Association for the Study of Pain. All rights reserved.

  20. Modified surgical treatment of intermittent open-mouth mandibular locking in a cat.

    PubMed

    Lobprise, H B; Wiggs, R B

    1992-03-01

    Intermittent open-mouth locking related to disorders of the temporomandibular joint are not uncommon. As a result of joint laxity, the mandible shifts to one side. The coronoid process then becomes locked lateral to the zygomatic arch. These patients present with the mouth opened and an inability to close the mouth. This article describes a case of intermittent open-mouth mandibular locking in a cat and a modified surgical treatment combining zygomatic arch and coronoid process reduction.

  1. 76 FR 6187 - Open Meeting of the Area 1 Taxpayer Advocacy Panel (Including the States of New York, New Jersey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 1 Taxpayer Advocacy... Hampshire, Vermont and Maine) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting...

  2. 76 FR 37198 - Open Meeting of the Area 1 Taxpayer Advocacy Panel (Including the States of New York, New Jersey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Panel is soliciting public comments, ideas and suggestions on improving customer service at the Internal... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 1 Taxpayer Advocacy... Hampshire, Vermont and Maine) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting...

  3. Translation, Transcultural Adaptation, and Validation of the Empathy, Spirituality, and Wellness in Medicine Scale to the Brazilian Portuguese Language.

    PubMed

    Cangussu Silva, Alexander; Ezequiel, Oscarina da Silva; Damiano, Rodolfo Furlan; Granero Lucchetti, Alessandra Lamas; DiLalla, Lisabeth Fisher; Dorsey, J Kevin; Lucchetti, Giancarlo

    2018-04-09

    Construct: The Empathy, Spirituality, and Wellness in Medicine Scale (ESWIM) is a 43-item multidimensional scale developed to investigate different dimensions of physicians and medical students. Medical education research requires the use of several different instruments with dozens of items that evaluate each construct separately, making their application slow and increasing the likelihood of students providing a large number of incomplete or missing responses. To provide an alternative measure, this study aims to translate, adapt, and validate the multidimensional ESWIM instrument for Brazilian medical students. This is a very promising instrument because it is multidimensional, relatively short, and cost free; it evaluates important constructs; and it has been explicitly designed for use in the medical context. The English-language instrument was translated and adapted into the Brazilian Portuguese language using standard procedures: translation, transcultural adaptation, and back-translation. ESWIM was administered to students in all years of the medical curriculum. A retest was given 45 days later to evaluate reliability. To assess validity, the questionnaire also included sociodemographic data, the Duke Religion Index, the Empathy Inventory, the brief version of the World Health Organization Quality of Life (WHOQOL-Bref), and the Oldenburg Burnout Inventory. A total of 776 medical students (M age = 22.34 years, SD = 3.11) were assessed. The Brazilian Portuguese version of ESWIM showed good internal consistency for the factor of Empathy (α = 0.79-0.81) and borderline internal consistency for the other factors: Openness to Spirituality (α = 0.61-0.66), Wellness (α = 0.57-0.68), and Tolerance (α = 0.56-0.65). The principal component analysis revealed a four-factor structure; however, the confirmatory factor analysis showed a better fit for a three-factor structure. We found a significant positive correlation between ESWIM empathy and empathy measured by the Empathy Inventory (r = .444, p < .01), as well as negative correlations between ESWIM empathy and burnout (r = -.145 to -.224, p < .01). ESWIM openness to spirituality was also significantly correlated with different subscales of religiosity (r = .301-.417, p < .01), and ESWIM wellness was significantly correlated with the WHOQOL-Bref factors (r = .390-.673, p < .01). The test-retest reliability (applied to 83 students) was high for all factors except Tolerance. This study provides supportive evidence regarding the reliability and validity of ESWIM empathy scores. The ESWIM scale opens a new field of research in relation to openness to spirituality by introducing a scale that measures this openness attitude. Despite borderline internal consistency, ESWIM wellness was strongly associated with quality of life and had good test-retest reliability. Thus, ESWIM appears to be a valid option for evaluating these constructs in medical students.

  4. Biomechanical implications of lateral pterygoid contribution to biting and jaw opening in humans.

    PubMed

    Osborn, J W

    1995-12-01

    The contributions of the lateral pterygoid muscle to a variety of different tasks were analysed by a linear programming mode based on the equations for static equilibrium in three dimensions and containing 12 muscles. The model was used to study lateral pterygoid activity at maximum bite force (MBF) for changes in (i) the direction and point of application of the bite force, (ii) the orientation of the masseter and medial pterygoid muscles and (iii) the slope of the articular eminence (glenoid slope). The effects on MBF of removing one or both lateral pterygoids were also examined. Lateral pterygoid provided a very important indirect contribution to some clenching forces. Under some conditions removing one lateral pterygoid muscle (simulating guarding an injured muscle) halved the MBF. Its activity at MBF was reduced as masseter was tilted more forward, the glenoid slope was made more horizontal and the bite force was made more vertical. The muscle helped to oppose (balance) the horizontal reaction forces at the bite point and joints, which potentially pushed the condyle backward. A balancing muscle is now defined as one (like lateral pterygoid) whose activity increases the output force by far more than its direct contribution to that force. In a larger model containing 16 muscles, every muscle was most active when its line of action was parallel to the output force. Finally, in a model which divided lateral pterygoid into superior and inferior heads, activity suddenly switched from the superior head to the inferior head when the angle of opening changed from 120 degrees (forward from the vertical) to 140 degrees.

  5. 77 FR 65928 - The Secretary of State's International Council on Women's Business Leadership; Notice of Open...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... Business Leadership; Notice of Open Meeting The Secretary of State's International Council on Women's Business Leadership (ICWBL) will meet from 3:00 p.m. to 4:00 p.m. on Tuesday, November 27, 2012, in the... Leadership Subcommittee. This meeting is open to public participation, via live webcast on the Internet at...

  6. Evaluate the Relative Importance of Subsurface Lateral Energy Exchange to Ground Heat Flux and Energy Balance over the Heterogeneous Surface of a Sub-tropical Wetland

    NASA Astrophysics Data System (ADS)

    CUI, W.; Chui, T. F. M.

    2016-12-01

    Subsurface lateral water and energy exchanges are often ignored in methods involving a surface energy balance under the homogeneity assumption, which may affect the estimation of evapotranspiration over a heterogeneous surface. Wetlands, however, are heterogeneous with vegetated areas and open water, making it difficult to accurately measure and estimate evapotranspiration. This study estimated the subsurface lateral energy exchange between the reed bed and shallow open water of a wetland within Mai Po Nature Reserve in Hong Kong, and further discussed its relative importance to the ground heat flux and energy balance over the wetland surface. An array of water level and temperature sensors were installed in the reed bed and the adjacent water, together with an eddy covariance system. The results suggested that the lateral energy exchange was over 30% of ground heat flux for half of the monitoring period, and should therefore be accounted for during the measurement of ground heat flux. However, the lateral energy exchange could not explain the energy balance disclosure at the site, as the variation was in phase with the residual of energy budget during the summer but was out of phase during the winter. Furthermore, this study developed a convolution model to estimate the lateral energy exchange based on air temperature which is readily available at many sites worldwide. This study overall enhanced our understanding of the subsurface lateral energy exchange, and possibly our estimation of evapotranspiration in heterogeneous environment.

  7. The improvement of postural control in patients with mechanical ankle instability after lateral ankle ligaments reconstruction.

    PubMed

    Li, Hong-Yun; Zheng, Jie-Jiao; Zhang, Jian; Cai, Ye-Hua; Hua, Ying-Hui; Chen, Shi-Yi

    2016-04-01

    Lateral ankle sprain is the most common injury. A previous study demonstrated that patients with mechanical ankle instability suffered deficits in postural control, indicating that structural damage of the lateral ankle ligaments may produce a balance deficit. The purpose of this study was to confirm that lateral ligaments reconstruction could improve postural control in patients with mechanical ankle instability. A total of 15 patients were included in the study. Each patient had a history of an ankle sprain with persistent symptoms of ankle instability and a positive anterior drawer test and had been treated nonoperatively for at least 3 months. All patients were diagnosed with lateral ankle ligaments tear by ultrasonography and magnetic resonance imaging. They underwent arthroscopic debridement and open lateral ankle ligaments reconstruction with a modified Broström procedure. One day before and 6 months after the operation, all of the participants underwent single-limb postural sway tests. The anterior drawer test and the American Orthopedic Foot and Ankle Society scale score were used to evaluate the clinical results in these patients. At 6 months after the operation, with the patients' eyes closed, there was significantly decreased postural sway in the anteroposterior direction, the circumferential area, and the total path length on the operated ankles compared with those measurements before the operation. With eyes open, however, no difference was found in postural sway before and after the operation. Postural control was improved by reconstructing the lateral ligaments. IV.

  8. [Case-control study on transverse carpal ligament resection for the prevention of delayed carpal tunnel syndrome after distal radius fracture].

    PubMed

    Wang, Yan-jie; Wang, Shi-gang; Miao, Shu-juan; Su, Xia

    2011-06-01

    To investigate the effects of open reduction by palm side for the distal radius fracture and T shape plate internal fixation with simultaneous anterior transverse carpal ligament resection for the prevention of delayed carpal tunnel syndrome after operation. From March 2000 to March 2007, 32 patients (8 males and 24 females, ranging in age from 46 to 66 years) with distal radius fracture were treated with open reduction by palm side and T shape plate internal fixation with simultaneous anterior transverse carpal ligament resection; while 30 patients (7 males and 23 females,ranging in age from 45 to 65 years) only with open reduction by palm side and T shape plate internal fixation. The incidences of delayed carpal tunnel syndrome between the two groups were compared. Among 32 patients treated with open reduction by palm side and T shape plate internal fixation with anterior transverse carpal ligament resection, 3 patients had delayed carpal tunnel syndrome; while in 30 patients treated with open reduction by palm side and T shape plate internal fixation, 10 patients had delayed carpal tunnel syndrome. There was significant statistically difference (P < 0.05%). Simultaneous anterior transverse carpal ligament resection can effectively prevent the delayed carpal tunnel syndrome occurrence for the distal radius fracture with open reduction by palm side.

  9. Lateral compression open cap splint with circummandibular wiring for management of pediatric mandibular fractures: a retrospective audit of 10 cases.

    PubMed

    Bhola, Nitin; Jadhav, Anendd; Borle, Rajiv; Khemka, Gaurav; Adwani, Nitin; Bhattad, Mayur

    2014-03-01

    Mandibular fractures are relatively less frequent in children when compared to adults. Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning and in their functional needs. We currently describe our experience with lateral compression open cap splint with circummandibular wiring as a treatment modality which involves fewer risks in treating pediatric symphysis/parasymphysis/body mandibular fractures. A retrospective analysis of pediatric patients with mandibular symphysis/parasymphysis/body fractures operated from January 2007 to January 2012 was performed. Clinical photographs and orthopantomogram assessment at the time of presentation, after treatment, and at 6 months postoperatively were evaluated. All the 10 patients were followed up until the period of 6 months, and none of them had any major complications. Postoperatively, there was satisfactory healing and union of fracture fragments in all the patients. Only one patient developed infection at submental region. The 6-month follow-up showed good occlusion, without interference in teeth eruption and no signs of temporomandibular joint problems. Lateral compression open cap splints for treatment of pediatric mandibular symphysis/parasymphysis/body fractures are reliable treatment modalities with regard to occlusion-guided fracture reduction.

  10. [Clinical effect modified Chevron osteotomy combined with lateral tissue loosening in treating mild-moderate hallux valgus through internal signal approach].

    PubMed

    Chen, Xue-Qiang; Wu, Qun-Feng; Dong, Wei-Qin; Yu, Li-Xin; Li, Xiong-Feng

    2018-03-25

    To explore clinical effect of modified Chevron osteotomy combined with lateral tissue loosening for the treatment of mild-moderate hallux valgus through internal signal approach. From July 2015 to June 2016, 26 patients with mild-moderate hallux valgus treated with modified Chevron osteotomy combined with lateral tissue loosening through internal signal approach, including 2 males and 24 females aged from 45 to 65 years old with an average of(54.6±4.8) years old;the courses of diseases ranged from 1 to 5 months with an average of (7.5±3.3) months. Hallux valgus angle(HVA), inter metatarsal angle(IMA) were measured at 12 months after operation, and AOFAS score was applied to evaluate clinical effect before and after operation. All incisions were healed at stage I. No incision occurred infection, metatarsal necrosis and recurrence of hallux valgus deformity. Two patients occurred skin numbness caused by musculocutaneous nerve injury. Twenty-six patients were followed up from 6 to 12 months with an average of(9.12±2.06) months. HVA, IMA were(30.01±3.71)°, (14.00±1.50)° before operation and(9.41±4.16)°, (7.00±0.60)° after operation, which had significant difference. There was statistical significance in AOFAS score before operation 54.77±9.59 and after operation 92.73±5.47, and 19 cases obtained excellent results and 7 moderate. Modified Chevron osteotomy combined with full thread headless pressure screw fixation and lateral tissue loosening for the treatment of mild-moderate hallux valgus has advantages of excellent exposure, simple operation, stable fixation, rapid recovery. Akin osteotomy with internal capsulorrhaphy were used with lateral loosening and could recover soft tissue balance between lateral and internal, and could receive satisfied clinical effects. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

  11. Developing international open science collaborations: Funder reflections on the Open Science Prize.

    PubMed

    Kittrie, Elizabeth; Atienza, Audie A; Kiley, Robert; Carr, David; MacFarlane, Aki; Pai, Vinay; Couch, Jennifer; Bajkowski, Jared; Bonner, Joseph F; Mietchen, Daniel; Bourne, Philip E

    2017-08-01

    The Open Science Prize was established with the following objectives: first, to encourage the crowdsourcing of open data to make breakthroughs that are of biomedical significance; second, to illustrate that funders can indeed work together when scientific interests are aligned; and finally, to encourage international collaboration between investigators with the intent of achieving important innovations that would not be possible otherwise. The process for running the competition and the successes and challenges that arose are presented.

  12. Developing international open science collaborations: Funder reflections on the Open Science Prize

    PubMed Central

    Kittrie, Elizabeth; Atienza, Audie A.; Kiley, Robert; Carr, David; MacFarlane, Aki; Pai, Vinay; Couch, Jennifer; Bajkowski, Jared; Bonner, Joseph F.; Mietchen, Daniel

    2017-01-01

    The Open Science Prize was established with the following objectives: first, to encourage the crowdsourcing of open data to make breakthroughs that are of biomedical significance; second, to illustrate that funders can indeed work together when scientific interests are aligned; and finally, to encourage international collaboration between investigators with the intent of achieving important innovations that would not be possible otherwise. The process for running the competition and the successes and challenges that arose are presented. PMID:28763440

  13. Open Adoption: Adoptive Parents' Reactions Two Decades Later

    ERIC Educational Resources Information Center

    Siegel, Deborah H.

    2013-01-01

    Unlike in the past, most adoption agencies today offer birth parents and adoptive parents the opportunity to share identifying information and have contact with each other. To understand the impacts of different open adoption arrangements, a qualitative descriptive study using a snowball sample of 44 adoptive parents throughout New England began…

  14. 76 FR 22674 - Manufacturing Extension Partnership Advisory Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... Open Meeting. SUMMARY: NIST announces that the Manufacturing Extension Partnership (MEP) Advisory Board, National Institute of Standards and Technology (NIST) will hold an open meeting on Sunday, May 15, [email protected]nist.gov or 301-975-5614) no later than May 2, 2011. FOR FURTHER INFORMATION CONTACT: Karen Lellock...

  15. 75 FR 50749 - Manufacturing Extension Partnership Advisory Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-17

    ... open meeting. SUMMARY: NIST announces that the Manufacturing Extension Partnership (MEP) Advisory Board, National Institute of Standards and Technology (NIST) will hold an open meeting on Monday, September 13...-mail address and phone number to Susan Hayduk ( [email protected]nist.gov or 301-975-5614) no later than...

  16. 30 CFR 291.106 - How do I file a complaint?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....106 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR APPEALS OPEN AND NONDISCRIMINATORY ACCESS TO OIL AND GAS PIPELINES UNDER THE OUTER CONTINENTAL SHELF LANDS ACT § 291.106 How do I... later than two (2) years from the time of the alleged access denial. If the complaint is filed later...

  17. 30 CFR 291.106 - How do I file a complaint?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... THE INTERIOR APPEALS OPEN AND NONDISCRIMINATORY ACCESS TO OIL AND GAS PIPELINES UNDER THE OUTER... complaint. (d) Complaints shall not be filed later than two (2) years from the time of the alleged access denial. If the complaint is filed later than two (2) years from the time of the alleged access denial...

  18. Laparoscopic versus open-component separation: a comparative analysis in a porcine model.

    PubMed

    Rosen, Michael J; Williams, Christina; Jin, Judy; McGee, Michael F; Schomisch, Steve; Marks, Jeffrey; Ponsky, Jeffrey

    2007-09-01

    The ideal surgical treatment for complicated ventral hernias remains elusive. Traditional component separation provides local advancement of native tissue for tension-free closure without prosthetic materials. This technique requires an extensive subcutaneous dissection with division of perforating vessels predisposing to skin-flap necrosis and complicated wound infections. A minimally invasive component separation may decrease wound complication rates; however, the adequacy of the myofascial advancement has not been studied. Five 25-kg pigs underwent bilateral laparoscopic component separation. A 10-mm incision was made lateral to the rectus abdominus muscle. The external oblique fascia was incised, and a dissecting balloon was inflated between the internal and external oblique muscles. Two additional ports were placed in the intermuscular space. The external oblique was incised from the costal margin to the inguinal ligament. The maximal abdominal wall advancement was recorded. A formal open-component separation was performed and maximal advancement 5 cm superior and 5 cm inferior to the umbilicus was recorded for comparison. Groups were compared using standard statistical analysis. The laparoscopic component separation was completed successfully in all animals, with a mean of 22 min/side. Laparoscopic component separation yielded 3.9 cm (SD 1.1) of fascial advancement above the umbilicus, whereas 4.4 cm (1.2) was obtained after open release (P = .24). Below the umbilicus, laparoscopic release achieved 5.0 cm (1.0) of advancement, whereas 5.8 cm (1.2) was gained after open release (P = .13). The minimally invasive component separation achieved an average of 86% of the myofascial advancement compared with a formal open release. The laparoscopic approach does not require extensive subcutaneous dissection and might theoretically result in a decreased incidence or decreased complexity of postoperative wound infections or skin-flap necrosis. Based on our preliminary data in this porcine model, further comparative studies of laparoscopic versus open component separation in complex ventral hernia repair is warranted to evaluate postoperative morbidity and long-term hernia recurrence rates.

  19. Polarity-inverted lateral overgrowth and selective wet-etching and regrowth (PILOSWER) of GaN.

    PubMed

    Jang, Dongsoo; Jue, Miyeon; Kim, Donghoi; Kim, Hwa Seob; Lee, Hyunkyu; Kim, Chinkyo

    2018-03-07

    On an SiO 2 -patterned c-plane sapphire substrate, GaN domains were grown with their polarity controlled in accordance with the pattern. While N-polar GaN was grown on hexagonally arranged circular openings, Ga-polar GaN was laterally overgrown on mask regions due to polarity inversion occurring at the boundary of the circular openings. After etching of N-polar GaN on the circular openings by H 3 PO 4 , this template was coated with 40-nm Si by sputtering and was slightly etched by KOH. After slight etching, a thin layer of Si left on the circular openings of sapphire,but not on GaN, was oxidized during thermal annealing and served as a dielectric mask during subsequent regrowth. Thus, the subsequent growth of GaN was made only on the existing Ga-polar GaN domains, not on the circular openings of the sapphire substrate. Transmission electron microscopy analysis revealed no sign of threading dislocations in this film. This approach may help fabricating an unholed and merged GaN film physically attached to but epitaxially separated from the SiO 2 -patterned sapphire.

  20. Internal and external spatial attention examined with lateralized EEG power spectra.

    PubMed

    Van der Lubbe, Rob H J; Bundt, Carsten; Abrahamse, Elger L

    2014-10-02

    Several authors argued that retrieval of an item from visual short term memory (internal spatial attention) and focusing attention on an externally presented item (external spatial attention) are similar. Part of the neuroimaging support for this view may be due to the employed experimental procedures. Furthermore, as internal spatial attention may have a more induced than evoked nature some effects may not have been visible in event related analyses of the electroencephalogram (EEG), which limits the possibility to demonstrate differences. In the current study, a colored frame cued which stimulus, one out of four presented in separate quadrants, required a response, which depended on the form of the cued stimulus (circle or square). Importantly, the frame occurred either before (precue), simultaneously with (simultaneous cue), or after the stimuli (postcue). The precue and simultaneous cue condition both concern external attention, while the postcue condition implies the involvement of internal spatial attention. Event-related lateralizations (ERLs), reflecting evoked effects, and lateralized power spectra (LPS), reflecting both evoked and induced effects, were determined. ERLs revealed a posterior contralateral negativity (PCN) only in the precue condition. LPS analyses on the raw EEG showed early increased contralateral theta power at posterior sites and later increased ipsilateral alpha power at occipito-temporal sites in all cue conditions. Responses were faster when the internally or externally attended location corresponded with the required response side than when not. These findings provide further support for the view that internal and external spatial attention share their underlying mechanism. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Free, Fair and Efficient? Open Internal Job Advertising. IES Report.

    ERIC Educational Resources Information Center

    Hirsh, W.; Pollard, E.; Tamkin, P.

    In the 1990s, many major employers in the United Kingdom have moved to more open internal job markets (OIJMs). OIJMs give the job of filling internal vacancies to line managers and employees who see the job advertised and apply for it. The development and operation of OIJMs at the following firms were studied: Rolls-Royce; British Gas Trading;…

  2. [Private companies: an opportunity for hepatitis B virus (HBV) prevention and care in Ivory Coast in the wake of HIV/AIDS?].

    PubMed

    Bekelynck, A

    2015-02-01

    In the 1990s, defenders of "aids exceptionnalism" have promised that the inequities caused by HIV/AIDS could provide leverage in the care of other health issues later. Fifteen years later, this argument can be rethought at the light of the current context of hepatitis B virus (HBV) in Ivory Coast. In fact, in this country, the challenges caused by HBVecho those of HIV/AIDS fifteen years ago: high prevalence (8-10%), ignorance of the disease, and high cost of care. To this end, this article compares the role of private companies in the fights against HIV/AIDS in the 2000s and its role in the fight against HBV today. Although some private firms played a critical role in the promotion of universal access to ART, today, they are one of the few places where HBV screening, vaccination and treatment are offered in the country. HIV/AIDS opened the door for private companies to address other diseases through their health care systems. However, many challenges still need to be met: the absence of qualitative ongoing training for health professionals, illness representations and the costs of treatments, which are all related to the lack of international and national collective action. In Ivory Coast, at the early stage of the HIV/AIDS epidemic, national authorities took up the leadership in the fight against AIDS in West Africa, by developing extraverted strategies (Xth ICASA's organization, Unaids initiative hosting). The exceptional international mobilization and the creation of innovative funding mechanisms [International Therapeutic Solidarity Fund (ITSF), Global Fund (GM), and President's Emergency Plan for AIDS Relief (PEPFAR)] have facilitated easy access to ARV. Although 380 million people are infected by chronic HBV in the world, even so, international and national collective actions are fledgling and remained weak. Moreover, private firms have represented leverage for testing, treatment, and the provision of universal access to medication in the context of the HIV/AIDS epidemic in Ivory Coast, as relayed by other public and private actors. In the HBV context, private companies can only be a vector for the development of a two tier healthcare system. Therefore, the lack of a strong international commitment prevents public and private local initiatives to generalize HBV prevention and treatment.

  3. Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy

    PubMed Central

    Hernandez-Andrade, Edgar; Aurioles-Garibay, Alma; Garcia, Maynor; Korzeniewski, Steven J.; Schwartz, Alyse G.; Ahn, Hyunyoung; Martinez-Varea, Alicia; Yeo, Lami; Chaiworapongsa, Tinnakorn; Hassan, Sonia S.; Romero, Roberto

    2014-01-01

    Aim To investigate the effect of depth on cervical shear-wave elastography. Methods Shear-wave elastography was applied to estimate the velocity of propagation of the acoustic force impulse (shear-wave) in the cervix of 154 pregnant women at 11-36 weeks of gestation. Shear-wave speed (SWS) was evaluated in cross-sectional views of the internal and external cervical os in five regions of interest: anterior, posterior, lateral right, lateral left, and endocervix. Distance from the center of the US transducer to the center of the each region of interest was registered. Results In all regions, SWS decreased significantly with gestational age (p=0.006). In the internal os SWS was similar among the anterior, posterior and lateral regions, and lower in the endocervix. In the external os, the endocervix and anterior regions showed similar SWS values, lower than those from the posterior and lateral regions. In the endocervix, these differences remained significant after adjustment for depth, gestational age and cervical length. SWS estimations in all regions of the internal os were higher than those of the external os, suggesting denser tissue. Conclusion Depth from the ultrasound probe to different regions in the cervix did not significantly affect the SWS estimations. PMID:25029081

  4. Enabling cost-effective multimodal trip planners through open transit data.

    DOT National Transportation Integrated Search

    2011-05-01

    This study examined whether multimodal trip planners can be developed using opensource software and open data sources. : OpenStreetMap (OSM), maintained by the nonprofit OpenStreetMap Foundation, is an open, freely available international : rep...

  5. Enabling cost-effective multimodal trip planners through open transit data.

    DOT National Transportation Integrated Search

    2011-05-01

    This study examined whether multimodal trip planners can be developed using opensource software and open data sources. OpenStreetMap (OSM), maintained by the nonprofit OpenStreetMap Foundation, is an open, freely available international reposit...

  6. [Operative treatment of displaced intra-articular calcaneal fractures].

    PubMed

    Zwipp, H; Rammelt, S; Amlang, M; Pompach, M; Dürr, C

    2013-12-01

    Anatomic reduction of displaced intra-articular calcaneal fractures with restoration of height, length, and axial alignment and reconstruction of the subtalar and calcaneocuboid joints. Displaced intra-articular calcaneal fractures with incongruity of the posterior facet of the subtalar joint, loss of height, and axial malalignment. High perioperative risk, soft tissue infection, advanced peripheral arterial disease (stage III), neurogenic osteoarthropathy, poor patient compliance (e. g., substance abuse). Extended lateral approach with the patient placed on the uninjured side. Reduction of the anatomic shape and joint surfaces according to the preoperative CT-based planning. Reduction of the medial wall and step-wise reconstruction of the posterior facet from medial to lateral. Reduction of the tuberosity and anterior process fragments to the posterior joint block and temporary fixation with Kirschner wires. Internal fixation with an anatomic lateral plate in a locking or nonlocking mode. Alternatively less invasive internal fixation with a calcaneus nail over a sinus tarsi approach for less severe fracture types. The lower leg is immobilized in a brace until the wound is healed. Range of motion exercises of the ankle and subtalar joints are initiated on the second postoperative day. Patients are mobilized in their own shoe with partial weight bearing of 20 kg for 6-12 weeks depending on fracture severity and bone quality. Over a 4-year period, 163 patients with 184 displaced, intra-articular calcaneal fractures were treated with a lateral plate via an extended approach. In all, 102 patients with 116 fractures were followed for a mean of 8 years. A surgical revision was necessary in 4 cases (3.4%) of postoperative hematoma, 2 (1.7%) superficial and 5 (4.3%) deep infections. Of the latter, 2 patients needed a free flap for definite wound coverage, no calcanectomy or amputation was needed. Secondary subtalar fusion for symptomatic posttraumatic arthritis was performed in 9 cases (7.8%). At follow-up, the AOFAS Ankle/Hindfoot Score averaged 70.2, the Zwipp Score averaged 76.0, the German versions of the Foot Function Index and SF-36 physical component averaged 32.8 and 42.2, respectively. Scores were significantly lower with increasing fracture severity according to the Sanders and Zwipp classifications, bilateral fractures, open fractures, and with work-related injuries. With less invasive fixation using a calcaneal nail, superficial wound edge necrosis was seen in 2 of 75 cases (2.7%).

  7. [New varieties of lateral metatarsophalangeal dislocations of the great toe].

    PubMed

    Bousselmame, N; Rachid, K; Lazrak, K; Galuia, F; Taobane, H; Moulay, I

    2001-04-01

    We report seven cases of traumatic dislocation of the great toe, detailing the anatomy, the mechanism of injury and the radiographic diagnosis. We propose an additional classification based on three hereto unreported cases. Between october 1994 and october 1997, we treated seven patients with traumatic dislocation of the first metatarso-phalangeal joint of the great toe. There were six men and one woman, mean age 35 years (range 24 - 44 years). Dislocation was caused by motor vehicle accidents in four cases and by falls in three. Diagnosis was made on anteroposterior, lateral and medial oblique radiographs. According to Jahss' classification, there was one type I and three type IIB dislocations. There was also one open lateral dislocation and two dorsomedial dislocations. Only these dorsomedial dislocations required open reduction, done via a dorsal approach. Mean follow-up was 17.5 months (range 9 - 24 months) in six cases. One patient was lost to follow-up. The outcome was good in six cases and poor in one (dorsomedial dislocation). Dislocation of the first metatarso-phalangeal joint of the great toe is an uncommon injury. In 1980, Jahss reported two cases and reviewed three others described in the literature. He proposed three types of dislocation based on the feasibility of closed reduction (type I, II and IIB). In 1991, Copeland and Kanat reported a unique case in which there was an association of IIA and IIB lesions. They proposed an addition to the classification (type IIC). In 1994, Garcia Mata et al. reported another case which had not been described by Jahss and proposed another addition. All dislocations reported to date have been sagittal dislocations. Pathological alteration of the collateral ligaments has not been previously reported. In our experience, we have seen one case of open lateral dislocation due, at surgical exploration, to medial ligament rupture and two cases of dorsomedial dislocation due, at surgical exploration, to lateral ligament rupture. We propose another additional classification with pure lateral dislocation (type III) and dorso-lateral dislocation (type IL or IIL+), which are related to the formerly described variants.

  8. A Short History of the Air University, Maxwell AFB, and the 42nd Air Base Wing

    DTIC Science & Technology

    2013-07-31

    Aircraft and Engine Repair Depot No. 3 at the former Wright flying field. The depot operations continued until early 1919. In 1921, the 22nd (later...Forces (AAF) announced the opening of a specialized four- engine pilot school, initially to train air crews for the B-24 Liberator and, later, for the...systems engineering in March 2007, followed three months later by ACSC’s offering an on-line graduate degree. On 2 Mar 2009, the CCAF initiated the

  9. Pre-reconstruction of cervical-to-petrous internal carotid artery: An improved technique for treatment of vascular lesions involving internal carotid artery at the lateral skull base.

    PubMed

    Li, Fang-Da; Gao, Zhi-Qiang; Ren, Hua-Liang; Liu, Chang-Wei; Song, Xiao-Jun; Li, Yan-Feng; Zheng, Yue-Hong

    2016-04-01

    Reconstruction of the internal carotid artery (ICA) is an operative challenge for lesions involving the lateral skull base because of excessive blood loss, intraoperative cranial nerve injury, and difficulties in cerebral protection. Between January 2010 and October 2014, 9 patients with vascular lesions at the lateral skull base were treated with a "pre-reconstruction" technique, which means reconstruction of the ICA in advance of excising the lesions. All operations were technically successful with no mortality or strokes. The mean blood loss was 921 ± 210 mL. The mean total clamping time was 18 ± 5 minutes. Among the 5 patients without invasion of specific cranial nerves, no long-term sequelae occurred during the follow-up period ranging from 11 to 54 months. With less blood loss, slighter cranial nerve injuries, and shorter clamping time, the "pre-reconstruction" technique was safe and effective for the treatment of vascular lesions at the lateral skull base. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1562-E1567, 2016. © 2016 Wiley Periodicals, Inc.

  10. External-environmental and internal-health early life predictors of adolescent development.

    PubMed

    Hartman, Sarah; Li, Zhi; Nettle, Daniel; Belsky, Jay

    2017-12-01

    A wealth of evidence documents associations between various aspects of the rearing environment and later development. Two evolutionary-inspired models advance explanations for why and how such early experiences shape later functioning: (a) the external-prediction model, which highlights the role of the early environment (e.g., parenting) in regulating children's development, and (b) the internal-prediction model, which emphasizes internal state (i.e., health) as the critical regulator. Thus, by using data from the NICHD Study of Early Child Care and Youth Development, the current project draws from both models by investigating whether the effect of the early environment on later adolescent functioning is subject to an indirect effect by internal-health variables. Results showed a significant indirect effect of internal health on the relation between the early environment and adolescent behavior. Specifically, early environmental adversity during the first 5 years of life predicted lower quality health during childhood, which then led to problematic adolescent functioning and earlier age of menarche for girls. In addition, for girls, early adversity predicted lower quality health that forecasted earlier age of menarche leading to increased adolescent risk taking. The discussion highlights the importance of integrating both internal and external models to further understand the developmental processes that effect adolescent behavior.

  11. Strategic Genius

    DTIC Science & Technology

    2015-05-21

    complex adaptive systems, emergence, lateral thinking, bias, communication, buy-in, discourses, ecologies 16. SECURITY CLASSIFICATION OF: 17...consistent logic. Dr. Alice Butler-Smith dramatically opened my mind to understand the nature of design and the ecology of discourses. I’m also indebted to...perspectives. A lifelong student in the classical Greek style, Scipio possessed a highly lateral background in logic, ethics , astronomy, geometry

  12. Quantifying root lateral distribution and turnover using pine trees with a distinct stable carbon isotope signature

    Treesearch

    Kurt H. Johnsen; Chris A. Maier; Lance W. Kress

    2005-01-01

    In order to help assess spatial competition for below-ground resources, we quantified the effects of fertilization on root biomass quantity and lateral root distribution of midrotation Pinus taeda trees. Open-top chambers exposed trees to ambient or ambient plus 200 µmol mol-1 atmospheric CO2...

  13. Transnasal endoscopic resection of a nasopharyngeal pleomorphic adenoma: a rare case report.

    PubMed

    Martínez-Capoccioni, Gabriel; Martín-Martín, Carlos; Espinosa-Restrepo, Federico

    2012-08-01

    Pleomorphic adenoma (PA) is the most common benign tumor of the major and minor salivary glands, but rarely found in the nasopharynx. A PA originating from the left lateral wall of the nasopharynx was found in a 52-year-old female who presented with nasal obstruction, left-side otalgia, aural fullness, tinnitus and subjective hearing loss. It was successfully removed by transnasal endoscopic surgery (TES) and navigator system assessed our location, due to the proximity of critical anatomic structures such as the left internal carotid. We believe that the TES for primary and recurrent nasopharyngeal benign tumors is feasible and safe in properly selected patients, due to superior functional and cosmetic results and a low complication rate. Tumor characteristics and location should be taken into account when selecting cases for the right procedure for this lesions; transnasal endoscopic surgery is safe and preferable, carrying less potential morbidity compared to open procedures.

  14. Anomalous photovoltaic effect in organic-inorganic hybrid perovskite solar cells.

    PubMed

    Yuan, Yongbo; Li, Tao; Wang, Qi; Xing, Jie; Gruverman, Alexei; Huang, Jinsong

    2017-03-01

    Organic-inorganic hybrid perovskites (OIHPs) have been demonstrated to be highly successful photovoltaic materials yielding very-high-efficiency solar cells. We report the room temperature observation of an anomalous photovoltaic (APV) effect in lateral structure OIHP devices manifested by the device's open-circuit voltage ( V OC ) that is much larger than the bandgap of OIHPs. The persistent V OC is proportional to the electrode spacing, resembling that of ferroelectric photovoltaic devices. However, the APV effect in OIHP devices is not caused by ferroelectricity. The APV effect can be explained by the formation of tunneling junctions randomly dispersed in the polycrystalline films, which allows the accumulation of photovoltage at a macroscopic level. The formation of internal tunneling junctions as a result of ion migration is visualized with Kelvin probe force microscopy scanning. This observation points out a new avenue for the formation of large and continuously tunable V OC without being limited by the materials' bandgap.

  15. Anomalous photovoltaic effect in organic-inorganic hybrid perovskite solar cells

    PubMed Central

    Yuan, Yongbo; Li, Tao; Wang, Qi; Xing, Jie; Gruverman, Alexei; Huang, Jinsong

    2017-01-01

    Organic-inorganic hybrid perovskites (OIHPs) have been demonstrated to be highly successful photovoltaic materials yielding very-high-efficiency solar cells. We report the room temperature observation of an anomalous photovoltaic (APV) effect in lateral structure OIHP devices manifested by the device’s open-circuit voltage (VOC) that is much larger than the bandgap of OIHPs. The persistent VOC is proportional to the electrode spacing, resembling that of ferroelectric photovoltaic devices. However, the APV effect in OIHP devices is not caused by ferroelectricity. The APV effect can be explained by the formation of tunneling junctions randomly dispersed in the polycrystalline films, which allows the accumulation of photovoltage at a macroscopic level. The formation of internal tunneling junctions as a result of ion migration is visualized with Kelvin probe force microscopy scanning. This observation points out a new avenue for the formation of large and continuously tunable VOC without being limited by the materials’ bandgap. PMID:28345043

  16. [Usefulness of endovascular treatment for delayed massive epistaxis following endoscopic endonasal transsphenoidal surgery: a case report].

    PubMed

    Oka, Tetsuo; Sugiu, Kenji; Ishida, Joji; Hishikawa, Tomohito; Ono, Shigeki; Tokunaga, Koji; Date, Isao

    2012-01-01

    We report here a case of massive nasal bleeding from the sphenopalatine artery three weeks after endonasal transsphenoidal surgery. This 66-year-old male suffered from massive nasal bleeding with the status of hypovolemic shock. Under general anesthesia, an emergent angiography revealed an extravasation from the sphenopalatine artery. Trans-arterial embolization using coil and n-butyl-cyanoacrylate (NBCA) was performed following the diagnostic angiography. Complete occlusion of the injured artery was achieved. The patient showed good recovery from general anesthesia. Delayed nasal bleeding after endonasal transsphenoidal surgery is a rare but important complication. The sphenopalatine artery and its branch are located in the hidden inferior lateral corner of the sphenoid sinus and may be injured during enlargement of the sphenoid opening. When massive delayed nasal bleeding follows transsphenoidal surgery and damage of the internal carotid artery has been ruled out, endovascular treatment of the external carotid artery should be considered.

  17. Perceived mother and father acceptance-rejection predict four unique aspects of child adjustment across nine countries.

    PubMed

    Putnick, Diane L; Bornstein, Marc H; Lansford, Jennifer E; Malone, Patrick S; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Zelli, Arnaldo; Alampay, Liane Peña; Al-Hassan, Suha M; Bacchini, Dario; Bombi, Anna Silvia; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A; Oburu, Paul

    2015-08-01

    It is generally believed that parental rejection of children leads to child maladaptation. However, the specific effects of perceived parental acceptance-rejection on diverse domains of child adjustment and development have been incompletely documented, and whether these effects hold across diverse populations and for mothers and fathers are still open questions. This study assessed children's perceptions of mother and father acceptance-rejection in 1,247 families from China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States as antecedent predictors of later internalizing and externalizing behavior problems, school performance, prosocial behavior, and social competence. Higher perceived parental rejection predicted increases in internalizing and externalizing behavior problems and decreases in school performance and prosocial behavior across 3 years controlling for within-wave relations, stability across waves, and parental age, education, and social desirability bias. Patterns of relations were similar across mothers and fathers and, with a few exceptions, all nine countries. Children's perceptions of maternal and paternal acceptance-rejection have small but nearly universal effects on multiple aspects of their adjustment and development regardless of the family's country of origin. © 2014 Association for Child and Adolescent Mental Health.

  18. Perceived mother and father acceptance-rejection predict four unique aspects of child adjustment across nine countries

    PubMed Central

    Putnick, Diane L.; Bornstein, Marc H.; Lansford, Jennifer E.; Malone, Patrick S.; Pastorelli, Concetta; Skinner, Ann T.; Sorbring, Emma; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Zelli, Arnaldo; Alampay, Liane Peña; Al-Hassan, Suha M.; Bacchini, Dario; Bombi, Anna Silvia; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A.; Oburu, Paul

    2014-01-01

    Background It is generally believed that parental rejection of children leads to child maladaptation. However, the specific effects of perceived parental acceptance-rejection on diverse domains of child adjustment and development have been incompletely documented, and whether these effects hold across diverse populations and for mothers and fathers are still open questions. Methods This study assessed children's perceptions of mother and father acceptance-rejection in 1247 families from China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States as antecedent predictors of later internalizing and externalizing behavior problems, school performance, prosocial behavior, and social competence. Results Higher perceived parental rejection predicted increases in internalizing and externalizing behavior problems and decreases in school performance and prosocial behavior across three years controlling for within-wave relations, stability across waves, and parental age, education, and social desirability bias. Patterns of relations were similar across mothers and fathers and, with a few exceptions, all 9 countries. Conclusions Children's perceptions of maternal and paternal acceptance-rejection have small but nearly universal effects on multiple aspects of their adjustment and development regardless of the family's country of origin. PMID:25492267

  19. 75 FR 76521 - Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 7 Taxpayer Advocacy Panel (Including the States of Alaska, California, Hawaii, and Nevada) AGENCY: Internal Revenue Service (IRS) Treasury. [[Page 76522

  20. Open Ocean Internal Waves, South China Sea

    NASA Technical Reports Server (NTRS)

    1989-01-01

    These open ocean internal waves were seen in the south China Sea (19.5N, 114.5E). These sets of internal waves most likely coincide with tidal periods about 12 hours apart. The wave length (distance from crest to crest) varies between 1.5 and 5.0 miles and the crest lengths stretch across and beyond this photo for over 75 miles. At lower right, the surface waves are moving at a 30% angle to the internal waves, with parallel low level clouds.

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

    Wagner, Michael; Ma, Zhiwen; Martinek, Janna

    An aspect of the present disclosure is a receiver for receiving radiation from a heliostat array that includes at least one external panel configured to form an internal cavity and an open face. The open face is positioned substantially perpendicular to a longitudinal axis and forms an entrance to the internal cavity. The receiver also includes at least one internal panel positioned within the cavity and aligned substantially parallel to the longitudinal axis, and the at least one internal panel includes at least one channel configured to distribute a heat transfer medium.

  2. Denticle-embedded ampullary organs in a Cretaceous shark provide unique insight into the evolution of elasmobranch electroreceptors

    NASA Astrophysics Data System (ADS)

    Vullo, Romain; Guinot, Guillaume

    2015-10-01

    Here, we report a novel type of dermal denticle (or placoid scale), unknown among both living and fossil chondrichthyan fishes, in a Cretaceous lamniform shark. By their morphology and location, these dermal denticles, grouped into clusters in the cephalic region, appear to have been directly associated with the electrosensory ampullary system. These denticles have a relatively enlarged (˜350 μm in diameter), ornamented crown with a small (˜100 μm) asterisk- or cross-shaped central perforation connected to a multi-alveolate internal cavity. The formation of such a complex structure can be explained by the annular coalescence and fusion, around an ampullary vesicle, of several developmental units still at papillary stage (i.e. before mineralization), leading to a single denticle embedding an alveolar ampulla devoid of canal. This differs from larger typical ampullae of Lorenzini with a well-developed canal opening in a pore of the skin and may represent another adaptive response to low skin resistance. Since it has been recently demonstrated that ampullary organs arise from lateral line placodes in chondrichthyans, this highly specialized type of dermal denticle (most likely non-deciduous) may be derived from the modified placoid scales covering the superficial neuromasts (pit organs) of the mechanosensory lateral line system of many modern sharks.

  3. How does practise of internal Chinese martial arts influence postural reaction control?

    PubMed

    Gorgy, Olivier; Vercher, Jean-Louis; Coyle, Thelma

    2008-04-01

    The aim of this study was to determine the effects of Chinese martial arts practice on postural reaction control after perturbation. Participants standing in Romberg tandem posture were subjected to an unexpected lateral platform translation with the eyes open or closed at two translation amplitudes. The peak displacement of the centre of pressure and of the centre of mass, and the onset latency of muscular activity (tibialis anterior, gastrocnemius, lumbodorsal muscular group, and rectus abdominis), were evaluated for martial arts practitioners and for sport and non-sport participants. Compared with the sport and non-sport participants, the martial arts group showed lower maximal centre of pressure and centre of mass peak displacements in both the lateral and anterior - posterior directions, but no difference was found in the onset of muscular responses. We conclude that martial arts practice influences postural reaction control during a fixed-support strategy in a tandem task. The martial arts group used the ankle joint more frequently than the sport and non-sport participants, especially in the eyes-closed conditions. Our results suggest that the better balance recovery in the martial arts group is a consequence of better control of biomechanical properties of the lower limbs (e.g. through muscular response by co-contraction), not a change in the neuromuscular temporal pattern.

  4. Primary stability of an intramedullary calcaneal nail and an angular stable calcaneal plate in a biomechanical testing model of intraarticular calcaneal fracture.

    PubMed

    Goldzak, M; Simon, P; Mittlmeier, T; Chaussemier, M; Chiergatti, R

    2014-01-01

    Nowadays, open anatomic reduction and internal fixation can be considered as a valuable treatment for displaced intra-articular fractures of the calcaneus. However, the application of a calcaneal plate via an extensile lateral approach is at risk for a substantial rate of complications including delayed healing, skin necrosis, or infection. There is some evidence that a limited exposure might contribute to a decreased soft tissue complication rate bearing in mind that most minimally invasive techniques have to accept a reduced primary stability compared with the open application of an angular stable plate. Recently, an intrafocal minimal invasive reduction technique has been established employing an intramedullary nail for fracture stabilisation and support of the subtalar joint. The aim of this study was to compare the primary biomechanical performance of the new device versus lateral angular stable plating. Biomechanical testings were performed on 14 human cadaveric feet (7 pairs). Dry calcaneal bones were fractured resulting in a Sanders type IIB fracture pattern and fixed by either a calcaneal locking plate or an intramedullary calcaneal nail. Compressive testing via the corresponding talus was employed at a constant loading velocity until failure with an universal testing machine and a specific mounting device to avoid any shear forces. Apart from the data of the load deformation diagram the relative motion of the fracture elements during loading was recorded by 8 extensometric transducers. After failure the specimens were carefully examined to check the failure patterns. The displacement of the subtalar joint fragment was substantially lower in specimens fixed with the nail. Stiffness and load to failure were significantly higher after fixation with the intramedullary nail than after application of the angular stable plate. Failure with both fixation modes generally occurred at the anterior calcaneal process fragment. The primary stability of an intramedullary nail appeared to be superior to an angular stable plate representing the present standard technique in open reconstruction of the fractured calcaneus. The results from the experimental model speak in favour of the clinical use of the intramedullary calcaneal nail. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Importance of rodents for hydrology: lessons learnt from various field experiments

    NASA Astrophysics Data System (ADS)

    van Schaik, Loes; Zangerlé, Anne; Schneider, Anne-Kathrin; Schröder, Boris; Eccard, Jana

    2017-04-01

    organisms are known to create soil macropores of different sizes and with varying extent and orientation: most commonly earthworms, rodents, moles and roots. Preferential flow through macropore networks is dynamic and typically occurs when short individual macropores become connected at the hillslope scale as the nodes between the macropores become wet. Large lateral macropores may contribute to rapid subsurface stormflow of water and solutes at hillslope scale and supply a significant part of the catchment scale discharge during high intensity rainfall events even under relatively dry catchment state. Outflow from soil pipes, especially in the valley bottom or along the banking near to streams, is frequently observed, however, it remains a challenge to measure the spatial distribution, extent and connectivity of macropores at hill slope scales. We hypothesize that local information on organism abundances may be used as an indicator for spatial variability in infiltration, water storage and fluxes at the small scale and that knowledge on the landscape scale spatial distribution of organisms can provide information on connectivity of macropores at hillslope scale. Here we summarize the lessons learnt during three years of measurements aimed at determining the influence of rodent burrows on soil hydrology in a meso-scale catchment. Within the Attert Catchment (297 km2) in Luxembourg we performed sprinkling experiments with a brilliant blue tracer on twelve plots, of which six directly above rodent burrow openings and six on a surface without a rodent burrow opening, in order to examine the influence of the burrow openings on the infiltration pattern. Then we tested the extent of flow through mice burrows in different forest types, with varying geology and slope, by supplying 5 Liters of water with brilliant blue tracer directly to 24 burrow openings at soil surface. We excavated the burrows to measure how far the water was transported laterally in the burrow. Though we have serendipitous evidence of lateral water flow through large macropores in deeper soil layers from other projects, with the experiments we performed with the purpose to characterize this, the water did not seem to infiltrate into the burrow openings at the soil surface at all and the infiltration pattern under burrows was not different from that in soils without these openings. The five liter of brilliant blue dyed water which we poured into burrow openings did not flow far into the burrows, it generally infiltrated straight away into the surrounding soil. These results seem to show that the infiltration of water to rodent macropores during high intensity events does not take place at the soil surface but rather through other macropores, e.g. earthworm channels, which connect to deeper lateral channels. Also the lateral flow of water through the rodent burrows is apparently more effective in the deeper soils, where we occasionally saw a burrow with completely blue walls but little infiltration into the surrounding matrix.

  6. NASA's Exploration Architecture

    NASA Technical Reports Server (NTRS)

    Tyburski, Timothy

    2006-01-01

    A Bold Vision for Space Exploration includes: 1) Complete the International Space Station; 2) Safely fly the Space Shuttle until 2010; 3) Develop and fly the Crew Exploration Vehicle no later than 2012; 4) Return to the moon no later than 2020; 5) Extend human presence across the solar system and beyond; 6) Implement a sustained and affordable human and robotic program; 7) Develop supporting innovative technologies, knowledge, and infrastructures; and 8) Promote international and commercial participation in exploration.

  7. Report on the Status of the SFWST Campaign International Activities in Disposal Research at SNL

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

    McMahon, Kevin A.

    The following summaries are provided as fulfillment of milestone M4SF-17SN080305022 and represent international coordination activities in disposal research funded by the US DOE Spent Fuel and Waste Storage and Technologies (SFWST) Campaign during Fiscal Year 2017: SFWST funded bi-lateral interactions with Taiwan, OECD-NEA Repository Metadata (RepMet) project, SFWST funded bi-lateral interactions with the Republic of Korea.

  8. Endodontic treatment of a maxillary lateral incisor with a perforating internal resorption by using cone beam computed tomography as a diagnostic aid: a case report.

    PubMed

    Takita, Toshiya; Tsurumachi, Tamotsu; Ogiso, Bunnai

    2011-10-01

    This case report presents the endodontic treatment of a maxillary right lateral incisor with a perforating internal resorption in a 50-year-old woman. Radiographically, internal resorption appears as a fairly uniform, radiolucent enlargement of the pulp canal and distortion of the original root canal outline. The use of cone beam computed tomography can help the clinician in making a confirmatory diagnosis and determining the treatment plan before undertaking the actual treatment. After cleaning the root canal space and the resorptive defect by mechanic instrumentation, irrigation, and interim calcium hydroxide dressing, the apical third canal was filled with a gutta-percha point by lateral condensation. The resorptive defect was filled with mineral trioxide aggregate. Follow-up radiographs at 3 years showed adequate repair of the resorption, and the tooth remained asymptomatic.

  9. Biomechanical Comparison of an Open vs Arthroscopic Approach for Lateral Ankle Instability.

    PubMed

    Drakos, Mark C; Behrens, Steve B; Paller, Dave; Murphy, Conor; DiGiovanni, Christopher W

    2014-08-01

    The current clinical standard for the surgical treatment of ankle instability remains the open modified Broström procedure. Modern advents in arthroscopic technology have allowed physicians to perform certain foot and ankle procedures arthroscopically as opposed to traditional open approaches. Twenty matched lower extremity cadaver specimens were obtained. Steinman pins were inserted into the tibia and talus with 6 sensors affixed to each pin. Specimens were placed in a Telos ankle stress apparatus in an anteroposterior and then lateral position, while a 1.7 N-m load was applied. For each of these tests, movement of the sensors was measured in 3 planes using the Optotrak Computer Navigation System. Changes in position were calculated and compared with the unloaded state. The anteriortalofibular ligament and the calcaneofibular ligament were thereafter sectioned from the fibula. The aforementioned measurements in the loaded and unloaded states were repeated on the specimens. The sectioned ligaments were then repaired using 2 corkscrew anchors. Ten specimens were repaired using a standard open Broström-type repair, while the matched pairs were repaired using an arthroscopic technique. Measurements were repeated and compared using a paired t test. There was a statistically significant difference between the sectioned state and the other 3 states (P < .05). There were no statistically significant differences between the intact state and either the open or arthroscopic state (P > .05). There were no significant differences between the open and arthroscopic repairs with respect to translation and total combined motion during the talar tilt test (P > .05). Statistically significant differences were demonstrated between the 2 methods in 3 specific axes of movement during talar tilt (P = .04). Biomechanically effective ankle stabilization may be amenable to a minimally invasive approach. A minimally invasive, arthroscopic approach can be considered for treating patients with lateral ankle instability who have failed conservative treatment. © The Author(s) 2014.

  10. Towards a coastal ocean forecasting system in Southern Adriatic Northern Ionian seas based on unstructured-grid model

    NASA Astrophysics Data System (ADS)

    Federico, Ivan; Oddo, Paolo; Pinardi, Nadia; Coppini, Giovanni

    2014-05-01

    The Southern Adriatic Northern Ionian Forecasting System (SANIFS) operational chain is based on a nesting approach. The large scale model for the entire Mediterranean basin (MFS, Mediterranean Forecasting system, operated by INGV, e.g. Tonani et al. 2008, Oddo et al. 2009) provides lateral open boundary conditions to the regional model for Adriatic and Ionian seas (AIFS, Adriatic Ionian Forecasting System) which provides the open-sea fields (initial conditions and lateral open boundary conditions) to SANIFS. The latter, here presented, is a coastal ocean model based on SHYFEM (Shallow HYdrodynamics Finite Element Model) code, which is an unstructured grid, finite element three-dimensional hydrodynamic model (e.g. Umgiesser et al., 2004, Ferrarin et al., 2013). The SANIFS hydrodynamic model component has been designed to provide accurate information of hydrodynamics and active tracer fields in the coastal waters of Southern Eastern Italy (Apulia, Basilicata and Calabria regions), where the model is characterized by a resolution of about of 200-500 m. The horizontal resolution is also accurate in open-sea areas, where the elements size is approximately 3 km. During the development phase the model has been initialized and forced at the lateral open boundaries through a full nesting strategy directly with the MFS fields. The heat fluxes has been computed by bulk formulae using as input data the operational analyses of European Centre for Medium-Range Weather Forecasts. Short range pre-operational forecast tests have been performed in different seasons to evaluate the robustness of the implemented model in different oceanographic conditions. Model results are validated by means of comparison with MFS operational results and observations. The model is able to reproduce the large-scale oceanographic structures of the area (keeping similar structures of MFS in open sea), while in the coastal area significant improvements in terms of reproduced structures and dynamics are evident.

  11. [Treatment of open tile type C pelvic fractures by open reduction and internal fixation through anterior and posterior approaches at early stage].

    PubMed

    Li, Baichuan

    2014-05-01

    To explore the effectiveness of open reduction and internal fixation through anterior and posterior approaches in treatment of open Tile type C pelvic fractures at early stage. Between January 2009 and April 2012, 12 patients with open Tile C pelvic fractures were treated. There were 7 males and 5 females, aged 6-53 years (median, 31 years). Of 12 cases, 4 were classified as Tile type C1, 6 as Tile type C2, and 2 as Tile type C3; 5 were rated as Gustilo type II and 7 as Gustilo type III. The injury severity score was 18-57 (mean, 37.2). The interval of injury and admission ranged from 15 minutes to 3 days (median, 50 minutes). The debridement and external fixation were performed at first stage; then open reduction and internal fixation were used through anterior approach (reconstruction plate) and posterior approach (cannulated lag screws). The vacuum sealing drainage was performed during treatment until the wounds healed. Delayed healing of incison was obtained in 12 cases because of wound infection. Anatomical reduction or approximate anatomical reduction was achieved in all 12 cases. The patients were followed up 3-39 months (median, 18 months). No loosening of internal fixation or fracture displacement was observed during follow-up. The fracture healing time was 7-13 weeks (mean, 9.7 weeks). At last follow-up, according to the Matta standard, the outcome was excellent in 10 cases and good in 2 cases; according to Majeed score, the results were excellent in 9 cases, good in 1, and poor in 2. Early internal fixation operation of open Tile type C pelvic fractures can effectively restore the pelvic anatomical structure and stability, reduce the complication, and achieve satisfactory effectiveness.

  12. Upper Ocean Evolution Across the Beaufort Sea Marginal Ice Zone from Autonomous Gliders

    NASA Astrophysics Data System (ADS)

    Lee, Craig; Rainville, Luc; Perry, Mary Jane

    2016-04-01

    The observed reduction of Arctic summertime sea ice extent and expansion of the marginal ice zone (MIZ) have profound impacts on the balance of processes controlling sea ice evolution, including the introduction of several positive feedback mechanisms that may act to accelerate melting. Examples of such feedbacks include increased upper ocean warming though absorption of solar radiation, elevated internal wave energy and mixing that may entrain heat stored in subsurface watermasses (e.g., the relatively warm Pacific Summer (PSW) and Atlantic (AW) waters), and elevated surface wave energy that acts to deform and fracture sea ice. Spatial and temporal variability in ice properties and open water fraction impact these processes. To investigate how upper ocean structure varies with changing ice cover, and how the balance of processes shift as a function of ice fraction and distance from open water, four long-endurance autonomous Seagliders occupied sections that extended from open water, through the marginal ice zone, deep into the pack during summer 2014 in the Beaufort Sea. Sections reveal strong fronts where cold, ice-covered waters meet waters that have been exposed to solar warming, and O(10 km) scale eddies near the ice edge. In the pack, Pacific Summer Water and a deep chlorophyll maximum form distinct layers at roughly 60 m and 80 m, respectively, which become increasingly diffuse as they progress through the MIZ and into open water. The isopynal layer between 1023 and 1024 kgm-3, just above the PSW, consistently thickens near the ice edge, likely due to mixing or energetic vertical exchange associated with strong lateral gradients in this region. This presentation will discuss the upper ocean variability, its relationship to sea ice extent, and evolution over the summer to the start of freeze up.

  13. Upper Ocean Evolution Across the Beaufort Sea Marginal Ice Zone from Autonomous Gliders

    NASA Astrophysics Data System (ADS)

    Lee, C.; Rainville, L.; Perry, M. J.

    2016-02-01

    The observed reduction of Arctic summertime sea ice extent and expansion of the marginal ice zone (MIZ) have profound impacts on the balance of processes controlling sea ice evolution, including the introduction of several positive feedback mechanisms that may act to accelerate melting. Examples of such feedbacks include increased upper ocean warming though absorption of solar radiation, elevated internal wave energy and mixing that may entrain heat stored in subsurface watermasses (e.g., the relatively warm Pacific Summer (PSW) and Atlantic (AW) waters), and elevated surface wave energy that acts to deform and fracture sea ice. Spatial and temporal variability in ice properties and open water fraction impact these processes. To investigate how upper ocean structure varies with changing ice cover, and how the balance of processes shift as a function of ice fraction and distance from open water, four long-endurance autonomous Seagliders occupied sections that extended from open water, through the marginal ice zone, deep into the pack during summer 2014 in the Beaufort Sea. Sections reveal strong fronts where cold, ice-covered waters meet waters that have been exposed to solar warming, and O(10 km) scale eddies near the ice edge. In the pack, Pacific Summer Water and a deep chlorophyll maximum form distinct layers at roughly 60 m and 80 m, respectively, which become increasingly diffuse as they progress through the MIZ and into open water. The isopynal layer between 1023 and 1024 kg m-3, just above the PSW, consistently thickens near the ice edge, likely due to mixing or energetic vertical exchange associated with strong lateral gradients in this region. This presentation will discuss the upper ocean variability, its relationship to sea ice extent, and evolution over the summer to the start of freeze up.

  14. Effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts.

    PubMed

    Ebadian, Behnaz; Rismanchian, Mansor; Dastgheib, Badrosadat; Bajoghli, Farshad

    2015-01-01

    Different factors such as impression techniques and materials can affect the passive fit between the superstructure and implant. The aim of this study was to determine the effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts. Four internal hex implants (Biohorizons Ø4 mm) were placed on a metal maxillary model perpendicular to the horizontal plane in maxillary lateral incisors, right canine and left first premolar areas. Three impression techniques including open tray, closed tray using ball top screw abutments and closed tray using short impression copings and two impression materials (polyether and polyvinyl siloxane) were evaluated (n = 60). The changes in distances between implant analogues in mediolateral (x) and anteroposterior (y) directions and analogue angles in x/z and y/z directions in the horizontal plane on the definitive casts were measured by coordinate measuring machine. The data were analyzed by multivariate two-way analysis of variance and one sample t-test (α = 0.05). No statistical significant differences were observed between different impression techniques and materials. However, deviation and distortion of definitive casts had a significant difference with the master model when short impression copings and polyvinyl siloxane impression material were used (P < 0.05). In open tray technique, there was a significant difference in the rotation of analogs compared with the master model with both impression materials (P < 0.05). There was no difference between open and closed tray impression techniques; however, less distortion and deviation were observed in the open tray technique. In the closed tray impression technique, ball top screw was more accurate than short impression copings.

  15. Effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts

    PubMed Central

    Ebadian, Behnaz; Rismanchian, Mansor; Dastgheib, Badrosadat; Bajoghli, Farshad

    2015-01-01

    Background: Different factors such as impression techniques and materials can affect the passive fit between the superstructure and implant. The aim of this study was to determine the effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts. Materials and Methods: Four internal hex implants (Biohorizons Ø4 mm) were placed on a metal maxillary model perpendicular to the horizontal plane in maxillary lateral incisors, right canine and left first premolar areas. Three impression techniques including open tray, closed tray using ball top screw abutments and closed tray using short impression copings and two impression materials (polyether and polyvinyl siloxane) were evaluated (n = 60). The changes in distances between implant analogues in mediolateral (x) and anteroposterior (y) directions and analogue angles in x/z and y/z directions in the horizontal plane on the definitive casts were measured by coordinate measuring machine. The data were analyzed by multivariate two-way analysis of variance and one sample t-test (α = 0.05). Results: No statistical significant differences were observed between different impression techniques and materials. However, deviation and distortion of definitive casts had a significant difference with the master model when short impression copings and polyvinyl siloxane impression material were used (P < 0.05). In open tray technique, there was a significant difference in the rotation of analogs compared with the master model with both impression materials (P < 0.05). Conclusion: There was no difference between open and closed tray impression techniques; however, less distortion and deviation were observed in the open tray technique. In the closed tray impression technique, ball top screw was more accurate than short impression copings. PMID:25878678

  16. Opening ceremonies of the 2000 Law Enforcement Games held at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    An international gathering of police officers march in a parade at the KSC Visitor Complex during opening ceremonies of the 2000 International Law Enforcement Games. More than 1,850 participants and their families took part in the opening, held in the Rocket Garden. The ceremony includes parades, torch lighting and a tug of war. The games feature officers from 15 countries and 37 United States in competitions around Brevard County, Fla.

  17. Clinical efficacy of open reduction and semirigid internal fixation in management of displaced pediatric mandibular fractures: a series of 10 cases and surgical guidelines.

    PubMed

    Joshi, Samir; Kshirsagar, Rajesh; Mishra, Akshay; Shah, Rahul

    2015-01-01

    To evaluate the efficacy of open reduction and semirigid internal fixation in the management of displaced pediatric mandibular fractures. Ten patients with displaced mandibular fractures treated with 1.5 mm four holed titanium mini-plate and 4 mm screws which were removed within four month after surgery. All cases showed satisfactory bone healing without any growth disturbance. Open reduction and rigid internal fixation (ORIF) with 1.5 mm titanium mini- plates and 4 mm screws is a reliable and safe method in treatment of displaced paediatric mandibular fractures.

  18. Re-Invigorating Openness at The Open University: The Role of Open Educational Resources

    ERIC Educational Resources Information Center

    Gourley, Brenda; Lane, Andy

    2009-01-01

    This paper describes the internal motivations and external drivers that led The Open University UK to enter the field of Open Educational Resources through its institution-wide OpenLearn initiative (www.open.ac.uk/openlearn). It also describes some of the emerging evidence of the impacts inside and outside the university. Through the rapid…

  19. 76 FR 37197 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An...

  20. 78 FR 15126 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An...

  1. 77 FR 61054 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An...

  2. 77 FR 21156 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An...

  3. 77 FR 8327 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An...

  4. 77 FR 5313 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An...

  5. 78 FR 11277 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of Meeting. SUMMARY: An...

  6. 77 FR 20488 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An...

  7. 76 FR 6190 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... Panel is soliciting public comments, ideas, and suggestions on improving customer service at the... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Joint Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An...

  8. Real-Time Fluorescence Measurements of ROS and [Ca2+] in Ischemic / Reperfused Rat Hearts: Detectable Increases Occur only after Mitochondrial Pore Opening and Are Attenuated by Ischemic Preconditioning

    PubMed Central

    Rossbach, Andreas; Halestrap, Andrew P

    2016-01-01

    Mitochondrial permeability transition pore (mPTP) opening is critical for ischemia / reperfusion (I/R) injury and is associated with increased [Ca2+] and reactive oxygen species (ROS). Here we employ surface fluorescence to establish the temporal sequence of these events in beating perfused hearts subject to global I/R. A bespoke fluorimeter was used to synchronously monitor surface fluorescence and reflectance of Langendorff-perfused rat hearts at multiple wavelengths, with simultaneous measurements of hemodynamic function. Potential interference by motion artefacts and internal filtering was assessed and minimised. Re-oxidation of NAD(P)H and flavoproteins on reperfusion (detected using autofluorescence) was rapid (t0.5 < 15 s) and significantly slower following ischemic preconditioning (IP). This argues against superoxide production from reduced Complex 1 being a critical mediator of initial mPTP opening during early reperfusion. Furthermore, MitoPY1 (a mitochondria-targeted H2O2-sensitive fluorescent probe) and aconitase activity measurements failed to detect matrix ROS increases during early reperfusion. However, two different fluorescent cytosolic ROS probes did detect ROS increases after 2–3 min of reperfusion, which was shown to be after initiation of mPTP opening. Cyclosporin A (CsA) and IP attenuated these responses and reduced infarct size. [Ca2+]i (monitored with Indo-1) increased progressively during ischemia, but dropped rapidly within 90 s of reperfusion when total mitochondrial [Ca2+] was shown to be increased. These early changes in [Ca2+] were not attenuated by IP, but substantial [Ca2+] increases were observed after 2–3 min reperfusion and these were prevented by both IP and CsA. Our data suggest that the major increases in ROS and [Ca2+] detected later in reperfusion are secondary to mPTP opening. If earlier IP-sensitive changes occur that might trigger initial mPTP opening they are below our limit of detection. Rather, we suggest that IP may inhibit initial mPTP opening by alternative mechanisms such as prevention of hexokinase 2 dissociation from mitochondria during ischemia. PMID:27907091

  9. Real-Time Fluorescence Measurements of ROS and [Ca2+] in Ischemic / Reperfused Rat Hearts: Detectable Increases Occur only after Mitochondrial Pore Opening and Are Attenuated by Ischemic Preconditioning.

    PubMed

    Andrienko, Tatyana; Pasdois, Philippe; Rossbach, Andreas; Halestrap, Andrew P

    2016-01-01

    Mitochondrial permeability transition pore (mPTP) opening is critical for ischemia / reperfusion (I/R) injury and is associated with increased [Ca2+] and reactive oxygen species (ROS). Here we employ surface fluorescence to establish the temporal sequence of these events in beating perfused hearts subject to global I/R. A bespoke fluorimeter was used to synchronously monitor surface fluorescence and reflectance of Langendorff-perfused rat hearts at multiple wavelengths, with simultaneous measurements of hemodynamic function. Potential interference by motion artefacts and internal filtering was assessed and minimised. Re-oxidation of NAD(P)H and flavoproteins on reperfusion (detected using autofluorescence) was rapid (t0.5 < 15 s) and significantly slower following ischemic preconditioning (IP). This argues against superoxide production from reduced Complex 1 being a critical mediator of initial mPTP opening during early reperfusion. Furthermore, MitoPY1 (a mitochondria-targeted H2O2-sensitive fluorescent probe) and aconitase activity measurements failed to detect matrix ROS increases during early reperfusion. However, two different fluorescent cytosolic ROS probes did detect ROS increases after 2-3 min of reperfusion, which was shown to be after initiation of mPTP opening. Cyclosporin A (CsA) and IP attenuated these responses and reduced infarct size. [Ca2+]i (monitored with Indo-1) increased progressively during ischemia, but dropped rapidly within 90 s of reperfusion when total mitochondrial [Ca2+] was shown to be increased. These early changes in [Ca2+] were not attenuated by IP, but substantial [Ca2+] increases were observed after 2-3 min reperfusion and these were prevented by both IP and CsA. Our data suggest that the major increases in ROS and [Ca2+] detected later in reperfusion are secondary to mPTP opening. If earlier IP-sensitive changes occur that might trigger initial mPTP opening they are below our limit of detection. Rather, we suggest that IP may inhibit initial mPTP opening by alternative mechanisms such as prevention of hexokinase 2 dissociation from mitochondria during ischemia.

  10. The use of laterally vectored thrust to counter thrust asymmetry in a tactical jet aircraft

    NASA Technical Reports Server (NTRS)

    1983-01-01

    A nonlinear, six degree-of-freedom flight simulator for a twin engine tactical jet was built on a hybrid computer to investigate lateral vectoring of the remaining thrust component for the case of a single engine failure at low dynamic pressures. Aircraft control was provided by an automatic controller rather than a pilot, and thrust vector control was provided by an open-loop controller that deflected a vane (located on the periphery of each exhaust jet and normally streamlined for noninterference with the flow). Lateral thrust vectoring decreased peak values of lateral control deflections, eliminated the requirement for steady-state lateral aerodynamic control deflections, and decreased the amount of altitude lost for a single engine failure.

  11. Propagation of dikes at Vesuvio (Italy) and the effect of Mt. Somma

    NASA Astrophysics Data System (ADS)

    Acocella, V.; Porreca, M.; Neri, M.; Massimi, E.; Mattei, M.

    2006-04-01

    Dikes provide crucial information on how magma propagates within volcanoes. Somma-Vesuvio (Italy) consists of the active Vesuvio cone, partly bordered by the older Mt. Somma edifice. Historical chronicles on the fissure eruptions in 1694-1944 are matched with an analytical solution to define the propagation path of the related dikes and to study any control of the Mt. Somma relief. The fissures always consisted of the downslope migration of vents from an open summit conduit, indicating lateral propagation as the predominant mechanism for shallow dike emplacement. No fissure emplaced beyond Mt. Somma, suggesting that its buttressing hinders the propagation of the radial dikes. An analytical solution is defined to describe the mechanism of formation of the laterally propagating dikes and to evaluate the effect of topography. The application to Somma-Vesuvio suggests that, under ordinary excess magmatic pressures, the dikes should not propagate laterally at depths >240-480 m below the surface, as the increased lithostatic pressure requires magmatic pressures higher than average. This implies that, when the conduit is open, the lateral emplacement of dikes is expectable on the S, W and E slopes. The lack of fissures N of Mt. Somma is explained by its buttressing, which hinders dike propagation.

  12. Internalization of subcellular-scale microfabricated chips by healthy and cancer cells

    PubMed Central

    Wong, H.-S. Philip

    2018-01-01

    Continuous monitoring of physiological parameters inside a living cell will lead to major advances in our understanding of biology and complex diseases, such as cancer. It also enables the development of new medical diagnostics and therapeutics. Progress in nanofabrication and wireless communication has opened up the potential of making a wireless chip small enough that it can be wholly inserted into a living cell. To investigate how such chips could be internalized into various types of living single cells and how this process might affect cells’ physiology, we designed and fabricated a series of multilayered micron-scale tag structures with different sizes as potential RFID (Radio Frequency IDentification) cell trackers. While the present structures are test structures that do not resonate, the tags that do resonate have similar structure from device fabrication, material properties, and device size point of view. The structures are in four different sizes, the largest with the lateral dimension of 9 μm × 21 μm. The thickness for these structures is kept constant at 1.5 μm. We demonstrate successful delivery of our fabricated chips into various types of living cells, such as melanoma skin cancer, breast cancer, colon cancer and healthy/normal fibroblast skin cells. To our surprise, we observed a remarkable internalization rate difference between each cell type; the uptake rate was faster for more aggressive cancer cells than the normal/healthy cells. Cell viability before and after tag cellular internalization and persistence of the internalized tags have also been recorded over the course of five days of incubation. These results establish the foundations of the possibility of long term, wireless, intracellular physiological signal monitoring. PMID:29601607

  13. 77 FR 61052 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting...

  14. 77 FR 21156 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of Meeting...

  15. 77 FR 8328 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... Taxpayer Advocacy Panel is soliciting public comments, ideas and suggestions on improving customer service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting...

  16. Managing an Open Access, Multi-Institutional, International Digital Library: The Digital Library of the Caribbean

    ERIC Educational Resources Information Center

    Wooldridge, Brooke; Taylor, Laurie; Sullivan, Mark

    2009-01-01

    Developing an Open Access, multi-institutional, multilingual, international digital library requires robust technological and institutional infrastructures that support both the needs of individual institutions alongside the needs of the growing partnership and ensure continuous communication and development of the shared vision for the digital…

  17. 77 FR 20489 - Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... returns, (3) tax software developers, (4) large and small business, (5) employers and payroll service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  18. 78 FR 10693 - Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... returns, (3) tax software developers, (4) large and small business, (5) employers and payroll service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  19. Athletic pubalgia: definition and surgical treatment.

    PubMed

    Ahumada, Leonik A; Ashruf, Salman; Espinosa-de-los-Monteros, Antonio; Long, James N; de la Torre, Jorge I; Garth, William P; Vasconez, Luis O

    2005-10-01

    Athletic pubalgia, or "sports hernia," affects people actively engaged in sports. Previously described in high-performance athletes, it can occur in recreational athletes. It presents with inguinal pain exacerbated with physical activity. Examination reveals absence of a hernia with pubic point tenderness accentuated by resisted adduction of the hip. Diagnosis is by history and physical findings. Treatment with an internal oblique flap reinforced with mesh alleviates symptoms. A retrospective review from December 1998 to November 2004 for patients with athletic pubalgia who underwent operative repair was performed. Descriptive variables included age, gender, laterality, sport, time to presentation, outcome, anatomy, and length of follow-up. Twelve patients, 1 female, with median age 25 years were evaluated. Activities included running (33%), basketball (25%), soccer (17%), football (17%), and baseball (8%). The majority were recreational athletes (50%). Median time to presentation was 9 months, with a median 4 months of follow-up. The most common intraoperative findings were nonspecific attenuation of the inguinal floor and cord lipomas. All underwent open inguinal repair, with 9 being reinforced with mesh. Four had adductor tenotomy. Results were 83.3% excellent and 16.7% satisfactory. All returned to sports. Diagnosis of athletic pubalgia can be elusive, but is established by history and physical examination. It can be found in recreational athletes. An open approach using mesh relieves the pain and restores activity.

  20. Sequential avulsions of the tibial tubercle in an adolescent basketball player.

    PubMed

    Huang, Ying Chieh; Chao, Ying-Hao; Lien, Fang-Chieh

    2010-05-01

    Tibial tubercle avulsion is an uncommon fracture in physically active adolescents. Sequential avulsion of tibial tubercles is extremely rare. We reported a healthy, active 15-year-old boy who suffered from left tibial tubercle avulsion fracture during a basketball game. He received open reduction and internal fixation with two smooth Kirschner wires and a cannulated screw, with every effort to reduce the plate injury. Long-leg splint was used for protection followed by programmed rehabilitation. He recovered uneventfully and returned to his previous level of activity soon. Another avulsion fracture happened at the right tibial tubercle 3.5 months later when he was playing the basketball. From the encouragement of previous successful treatment, we provided him open reduction and fixation with two small-caliber screws. He recovered uneventfully and returned to his previous level of activity soon. No genu recurvatum or other deformity was happening in our case at the end of 2-year follow-up. No evidence of Osgood-Schlatter disease or osteogenesis imperfecta was found. Sequential avulsion fractures of tibial tubercles are rare. Good functional recovery can often be obtained like our case if we treat it well. To a physically active adolescent, we should never overstate the risk of sequential avulsion of the other leg to postpone the return to an active, functional life.

  1. Distribution and size of mucous glands in the ferret tracheobronchial tree.

    PubMed

    Hajighasemi-Ossareh, Mohammad; Borthwell, Rachel M; Lachowicz-Scroggins, Marrah; Stevens, Jeremy E; Finkbeiner, Walter E; Widdicombe, Jonathan H

    2013-11-01

    A transgenic ferret model of cystic fibrosis has recently been generated. It is probable that malfunction of airway mucous glands contributes significantly to the airway pathology of this disease. The usefulness of the ferret model may therefore depend in part on how closely the airway glands of ferrets resemble those of humans. Here, we show that in the ferret trachea glands are commonest in its most ventral aspect and disappear about half way up the lateral walls; they are virtually absent from the dorsal membranous portion. Further, the aggregate volume of glands per unit mucosal surface declines progressively by about 60% between the larynx and the carina. The average frequency of glands openings for the ferret trachea as a whole is only about one-fifth that in humans (where gland openings are found at approximately the same frequency throughout the trachea). Glands in the ferret trachea are on average about one-third the size of those in the human. Therefore, the aggregate volume of tracheal glands (per unit mucosal surface area) in the ferret is only about 6% that in humans. As in other mammalian species, airway glands in the ferret disappear at an airway internal diameter of ∼1 mm, corresponding approximately in this species to airway generation 6. Copyright © 2013 Wiley Periodicals, Inc.

  2. Sanders II type calcaneal fractures: a retrospective trial of percutaneous versus operative treatment.

    PubMed

    Wang, Ye-ming; Wei, Wan-fu

    2015-02-01

    The purpose of this study was to compare the clinical results of percutaneous reduction and Steinman pin fixation for Sanders II calcaneal fractures with those of operative management through an extensile lateral approach. Fifty-three patients treated with standard open reduction and internal fixation (ORIF group) and 54 patients who had undergone percutaneous reduction and Steinman pin fixation (CRIF group) were retrospectively reviewed. There were no differences between the groups regarding sex, age or fracture classification. Pain and functional outcome were evaluated with a visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Wound complications and radiological results were compared. At a mean follow-up of 40.4 months (24 to 56 months), there were no differences between the two groups in mean AOFAS score, VAS score or radiologically determined variables. Two cases of deep infection and six of poor wound healing occurred in the ORIF group and none in the CRIF group. Subtalar and ankle motion was found to be better in the CRIF group. Percutaneous reduction and Steinman pin fixation minimizes complications and achieves functional outcomes comparable to those of the open techniques in patients with Sanders II calcaneal fractures. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  3. [Percutaneous ablation of malignant kidney tumors in rabbits by low frequency radio energy].

    PubMed

    Moskovitz, B; Nativ, O; Sabo, E; Barbara, Y; Mordohovich, D; Kaftori, Y; Shalhav, A; Goldwasser, B

    1998-01-01

    Radio-frequency (RF) current has been used successfully to ablate normal human tissue. To investigate further the clinical application of this modality in tumors, we studied the potential of using RF percutaneously to destroy experimental kidney tumors. 35 outbred albino rabbits underwent direct-implantation of renal VX2 tumor during open surgery. After 21 days, ultrasonography was performed to show tumor presence and size. A shielded RF needle was designed to be inserted percutaneously through an introduction needle. An electrical insulation shield covering the RF needle was retractable, controlling the length of exposure of the RF needle inside the tissue. 22 days after tumor implantation, RF was applied via this special needle using a ZoMed International RF generator. In one group of rabbits the procedure was performed under direct vision during open surgery, while in another group treatment was percutaneous, the needle guided by palpation of the tumor. Rabbits were killed 3 days later and revealed 4-25 mm intra-tumoral RF-induced lesions. A direct relation was found between lesion size and the power and duration of RF applied (at 7.5 W, R = 0.48, and P = 0.32). Based on our preliminary results we can conclude that RF may have clinical applications in the near future for percutaneous local tumor control in parenchymal organs.

  4. A Kinetic Analysis of the Auxin Transcriptome Reveals Cell Wall Remodeling Proteins That Modulate Lateral Root Development in Arabidopsis[W][OPEN

    PubMed Central

    Lewis, Daniel R.; Olex, Amy L.; Lundy, Stacey R.; Turkett, William H.; Fetrow, Jacquelyn S.; Muday, Gloria K.

    2013-01-01

    To identify gene products that participate in auxin-dependent lateral root formation, a high temporal resolution, genome-wide transcript abundance analysis was performed with auxin-treated Arabidopsis thaliana roots. Data analysis identified 1246 transcripts that were consistently regulated by indole-3-acetic acid (IAA), partitioning into 60 clusters with distinct response kinetics. We identified rapidly induced clusters containing auxin-response functional annotations and clusters exhibiting delayed induction linked to cell division temporally correlated with lateral root induction. Several clusters were enriched with genes encoding proteins involved in cell wall modification, opening the possibility for understanding mechanistic details of cell structural changes that result in root formation following auxin treatment. Mutants with insertions in 72 genes annotated with a cell wall remodeling function were examined for alterations in IAA-regulated root growth and development. This reverse-genetic screen yielded eight mutants with root phenotypes. Detailed characterization of seedlings with mutations in CELLULASE3/GLYCOSYLHYDROLASE9B3 and LEUCINE RICH EXTENSIN2, genes not normally linked to auxin response, revealed defects in the early and late stages of lateral root development, respectively. The genes identified here using kinetic insight into expression changes lay the foundation for mechanistic understanding of auxin-mediated cell wall remodeling as an essential feature of lateral root development. PMID:24045021

  5. Allgöwer-Donati Versus Vertical Mattress Suture Technique Impact on Perfusion in Ankle Fracture Surgery: A Randomized Clinical Trial Using Intraoperative Angiography.

    PubMed

    Shannon, Steven F; Houdek, Matthew T; Wyles, Cody C; Yuan, Brandon J; Cross, William W; Cass, Joseph R; Sems, Stephen A

    2017-02-01

    The purpose of this study was to evaluate which primary wound closure technique for ankle fractures affords the most robust perfusion as measured by laser-assisted indocyanine green angiography: Allgöwer-Donati or vertical mattress. Prospective, randomized. Level 1 Academic Trauma Center. Thirty patients undergoing open reduction internal fixation for ankle fractures were prospectively randomized to Allgöwer-Donati (n = 15) or vertical mattress (n = 15) closure. Demographics were similar for both cohorts with respect to age, sex, body mass index, surgical timing, and OTA/AO fracture classification. Skin perfusion (mean incision perfusion and mean perfusion impairment) was quantified in fluorescence units with laser-assisted indocyanine green angiography along the lateral incision as well as anterior and posterior to the incision at 30 separate locations. Minimum follow-up was 3 months with a mean follow-up 4.7 months. Allgöwer-Donati enabled superior perfusion compared with the vertical mattress suture technique. Mean incision perfusion for Allgöwer-Donati was 51 (SD = 13) and for vertical mattress was 28 (SD = 10, P < 0.0001). Mean perfusion impairment was less in the Allgöwer-Donati cohort (12.8, SD = 9) compared with that in the vertical mattress cohort (23.4, SD = 14; P = 0.03). One patient in each cohort experienced a wound complication. The Allgöwer-Donati suture technique offers improved incision perfusion compared with vertical mattress closure after open reduction internal fixation of ankle fractures. Theoretically, this may enhance soft tissue healing and decrease the risk of wound complications. Surgeons may take this into consideration when deciding closure techniques for ankle fractures. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

  6. Open access, open education resources and open data in Uganda.

    PubMed

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students' Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country.

  7. Lateral internal sphincterotomy for surgically recurrent chronic anal fissure.

    PubMed

    Liang, Jennifer; Church, James M

    2015-10-01

    Lateral internal sphincterotomy cures chronic anal fissure by preventing internal sphincter hypertonia. However, cutting sphincter predisposes to sphincter dysfunction, manifests as incontinence of gas, liquid, or stool. Surgeons, therefore, can be too cautious in its use, making ineffective superficial incisions or avoiding the operation altogether. This study is designed to confirm the role of redo lateral internal sphincterotomy in the treatment of surgically recurrent chronic anal fissure. Patients undergoing repeat lateral internal sphincterotomy for surgically recurrent chronic anal fissure were accessed from a prospectively maintained database. Chronicity was defined by symptoms persisting more than 3 weeks. Contralateral sphincterotomy was performed with electrocautery through a stab incision over the intersphincteric plane. The length of sphincter division was the same as the length of the fissure. Phone questionnaire was administered and fecal continence was assessed by modified Cleveland Clinic Incontinence Score. Patients were asked to rank their overall satisfaction with the operation, and pre- and postoperative quality of life. There were 57 patients, 24 women and 33 men; mean age was 47.9 ± 14.8 years. Mean follow-up was 12.5 ± 4.2 years (range 6.2 to 25.2 years). Presenting symptoms included pain (100%), bleeding (80%), pruritus ani (39%), constipation (26%), and diarrhea. Fifty patients (90%) presented with 1 fissure, and 40 were posterior. Most procedures were performed on an outpatient basis. Fissure healing rate was 98%, and 2 patients (4%) developed minor incontinence postoperatively (one of gas, the other, gas and seepage). Overall satisfaction was 9.7 ± .9 out of 10 with a significant improvement in the quality of life from 5.7 ± 2.4 out of 10 to 9.3 ± 1.4 out of 10 (P < .001). Judicious repeat lateral sphincterotomy cures recurrent chronic fissures with minimal risk of incontinence. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Early mathematical competencies and later achievement: insights from the Longitudinal Study of Australian Children

    NASA Astrophysics Data System (ADS)

    MacDonald, Amy; Carmichael, Colin

    2017-11-01

    International research suggests that early mathematical competence predicts later mathematical achievement. In this article, we explore the relationship between mathematical competencies at 4-5 years, as measured by teacher ratings, and later results on Years 3, 5, 7 and 9 National Assessment Program - Literacy and Numeracy (NAPLAN) numeracy tests. Data from a nationally representative sample of 2343 children participating in the Longitudinal Study of Australian Children (LSAC) are examined. In line with international studies, we report moderate correlations between preschool-entry mathematics and later NAPLAN numeracy test results. However, analysis of individual growth trajectories indicates that early mathematics predicts the initial (Year 3) level, but not subsequent growth. This suggests that early mathematical competencies are important for enhancing achievement in early schooling, but that the quality of mathematics education provided in the schooling years is critical for future development.

  9. Internal stresses at the crystalline scale in textured ZrO2 films before lateral cracking

    NASA Astrophysics Data System (ADS)

    Berdin, Clotilde; Pascal, Serge; Tang, Yan

    2015-05-01

    Zirconium oxide layers are submitted to internal stresses that play a role in damage of the layer. Lateral cracking is often observed during Zr alloys oxidation. In this paper, we investigated the influence of the microstresses at the crystalline scale on the lateral cracking within a growing oxide on a plane substrate. A parametric study was carried out taking into account the crystallographic texture of the oxide and the presence of a tetragonal zirconia at the metal-oxide interface. Macroscopic computations and polycrystalline aggregate computations were performed. The result indicating the (1 0 6 bar) fiber texture as the most favorable was recovered. It was found that under macroscopic compressive stresses parallel to the plane metal-oxide interface, positive microstresses perpendicular to the interface develops. They can trigger the lateral cracking and the phenomenon is promoted by the presence of tetragonal zirconia at the metal-oxide interface.

  10. The lateral septum and anterior hypothalamus act in tandem to regulate burying in the shock-probe test but not open-arm avoidance in the elevated plus-maze.

    PubMed

    Lamontagne, Steven J; Olmstead, Mary C; Menard, Janet L

    2016-11-01

    Both the lateral septum (LS) and anterior hypothalamus (AHA) regulate behavioural defense. We tested whether those two interconnected structures act in serial in that regard. Infusions of the GABAA agonist muscimol into one side of the LS and the contralateral (but not ipsilateral) AHA suppressed rats' burying in the shock-probe test whereas none of our muscimol infusion approaches altered their open-arm avoidance in the elevated plus-maze. These results suggest that the LS-AHA circuit serves a specialized role in defensive responses towards discrete, localizable threat stimuli but not towards potential threats. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Lower Limb Interjoint Postural Coordination One Year after First-Time Lateral Ankle Sprain.

    PubMed

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Sweeney, Kevin; Patterson, Matthew R; Delahunt, Eamonn

    2015-11-01

    Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of lower limb interjoint coordination and stabilometry to evaluate static unipedal stance with the eyes open (condition 1) and closed (condition 2) in a group of participants with chronic ankle instability (CAI) compared to lateral ankle sprain "copers" (both recruited 12 months after sustaining an acute first-time lateral ankle sprain) and a group of noninjured controls. Twenty-eight participants with CAI, 42 lateral ankle sprain "copers," and 20 noninjured controls completed three 20-s single-limb stance trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb three-dimensional kinematic data for similarity to establish patterns of interjoint coordination. The fractal dimension of the stance limb center of pressure path was also calculated. Between-group analyses revealed that participants with CAI displayed notable increases in ankle-hip linked coordination compared with both lateral ankle sprain "copers" (-0.52 (1.05) vs 0.28 (0.9), P = 0.007) and controls (-0.52 (1.05) vs 0.63 (0.64), P = 0.006) in condition 1 and compared with controls only (0.62 (1.92) vs 0.1 (1.0) P = 0.002) in condition 2. Participants with CAI also exhibited a decrease in the fractal dimension of the center-of-pressure path during condition 2 compared with both controls and lateral ankle sprain "copers." Participants with CAI present with a hip-dominant strategy of eyes-open and eyes-closed static unipedal stance. This coincided with reduced complexity of the stance limb center of pressure path in the eyes-closed condition.

  12. Inhibition of Bcl-2 Sensitizes Mitochondrial Permeability Transition Pore (MPTP) Opening in Ischemia-Damaged Mitochondria

    PubMed Central

    Chen, Qun; Xu, Haishan; Xu, Aijun; Ross, Thomas; Bowler, Elizabeth; Hu, Ying; Lesnefsky, Edward J.

    2015-01-01

    Background Mitochondria are critical to cardiac injury during reperfusion as a result of damage sustained during ischemia, including the loss of bcl-2. We asked if bcl-2 depletion not only leads to selective permeation of the outer mitochondrial membrane (MOMP) favoring cytochrome c release and programmed cell death, but also favors opening of the mitochondrial permeability transition pore (MPTP). An increase in MPTP susceptibility would support a role for bcl-2 depletion mediated cell death in the calcium overload setting of early reperfusion via MPTP as well as later in reperfusion via MOMP as myocardial calcium content normalizes. Methods Calcium retention capacity (CRC) was used to reflect the sensitivity of the MPTP opening in isolated cardiac mitochondria. To study the relationship between bcl-2 inhibition and MPTP opening, mitochondria were incubated with a bcl-2 inhibitor (HA14-1) and CRC measured. The contribution of preserved bcl-2 content to MPTP opening following ischemia-reperfusion was explored using transgenic bcl-2 overexpressed mice. Results CRC was decreased in mitochondria following reperfusion compared to ischemia alone, indicating that reperfusion further sensitizes to MPTP opening. Incubation of ischemia-damaged mitochondria with increasing HA14-1concentrations increased calcium-stimulated MPTP opening, supporting that functional inhibition of bcl-2 during simulated reperfusion favors MPTP opening. Moreover, HA14-1 sensitivity was increased by ischemia compared to non-ischemic controls. Overexpression of bcl-2 attenuated MPTP opening in following ischemia-reperfusion. HA14-1 inhibition also increased the permeability of the outer membrane in the absence of exogenous calcium, indicating that bcl-2 inhibition favors MOMP when calcium is low. Conclusions The depletion and functional inhibition of bcl-2 contributes to cardiac injury by increasing susceptibility to MPTP opening in high calcium environments and MOMP in the absence of calcium overload. Thus, ischemia-damaged mitochondria with decreased bcl-2 content are susceptible to MPTP opening in early reperfusion and MOMP later in reperfusion when cytosolic calcium has normalized. PMID:25756500

  13. Recurrent thyroid abscess - Is it a fourth branchial archanomaly?

    PubMed

    Desai, A A; Pandya, V K; Chougule, Sachin; Nair, Unnikrishnnan

    2006-04-01

    Branchial fistulae are of congenital origin(6) and consists of skin lined tract opening internally at junction of cartilaginous and bony meatus in case of 1(st) arch anomaly, tonsillar fossa in case of 2(nd) arch, while 3(rd) and 4(th) arch sinuses have internal opening at level of pyriform sinus or below. A complete tract of 3(rd) or 4(th) arch fistulae is yet to be described. Fourth arch fistulae(1) have a distinct clinical pattern of internal opening at pyriform apex, are left sided and associated with suppurative thyroiditis(3), they manifest at a younger age and treatment involves excision of tract with ipsilateral thyroid lobectomy.

  14. Emotional Reactivity and Regulation in Head Start Children: Links to Ecologically-Valid Behaviors and Internalizing Problems

    PubMed Central

    Morgan, Judith K.; Izard, Carroll E.; Hyde, Christopher

    2013-01-01

    Children’s emotional reactivity may interact with their regulatory behaviors to contribute to internalizing problems and social functioning even early in development. Ninety-one preschool children participated in a longitudinal project examining children’s reactivity and regulatory behaviors as predictors of internalizing problems and positive and negative social behavior in the classroom. Children who paired negative emotion expression with disengagement during a laboratory task showed higher levels of internalizing problems and more negative social behavior in the classroom six months later. Positive emotion expression paired with engagement during a laboratory task predicted more positive social behavior in the classroom six months later. Physiological reactivity and regulation also predicted children’s social behavior in the classroom. Findings suggest that preschool children with maladaptive reactivity and regulatory patterns may be at greater risk for internalizing problems even in early childhood. PMID:25067866

  15. Relations over Time among Children's Shyness, Emotionality, and Internalizing Problems.

    PubMed

    Eggum, Natalie D; Eisenberg, Nancy; Reiser, Mark; Spinrad, Tracy L; Michalik, Nicole M; Valiente, Carlos; Liew, Jeffrey; Sallquist, Julie

    2012-02-01

    Data regarding children's shyness and emotionality were collected at three time points, two years apart (T1: N = 214, M = 6.12 years; T2: N = 185, M = 7.67 years; T3: N = 185, M = 9.70 years), and internalizing data were collected at T1 and T3. Relations among parent-rated shyness, emotionality (parent- and teacher-rated anger, sadness, and positive emotional intensity [EI]), and mother-rated internalizing were examined in panel models. In some cases, shyness predicted emotionality two years later (teacher-rated anger, parent-rated sadness, teacher-rated positive EI) and emotionality sometimes predicted shyness two years later (teacher-rated sadness, parent-rated positive EI, teacher-rated positive EI). Parent-rated shyness and/or emotionality (parent-rated anger and parent-rated sadness) predicted internalizing at T3. Results shed light on developmental relations between emotionality and shyness, as well as processes of risk for, or protection against, the development of internalizing problems.

  16. Opening ceremonies of the 2000 Law Enforcement Games held at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Members of KSC's Native America International Tribal Council and the Space Coast Indian Association (Brevard County) gather in the KSC Visitor Complex during opening ceremonies of the 2000 International Law Enforcement Games. More than 1,850 participants and their families took part in the opening, held in the Rocket Garden. The ceremony included parades, torch lighting and a tug of war. The games feature officers from 15 countries and 37 United States in competitions around Brevard County, Fla.

  17. A Framework System for Intelligent Support in Open Distributed Learning Environments--A Look Back from 16 Years Later

    ERIC Educational Resources Information Center

    Hoppe, H. Ulrich

    2016-01-01

    The 1998 paper by Martin Mühlenbrock, Frank Tewissen, and myself introduced a multi-agent architecture and a component engineering approach for building open distributed learning environments to support group learning in different types of classroom settings. It took up prior work on "multiple student modeling" as a method to configure…

  18. A new Be star in an open cluster - NGC 6871-8

    NASA Technical Reports Server (NTRS)

    Grigsby, James A.; Morrison, Nancy D.

    1988-01-01

    Spectroscopic observations of H-alpha show that star eight in the open cluster NGC 6871 is a previously-undiscovered Be star. The H-alpha profile was observed to vary from clear emission to pure absorption over a period of ten days; later observations over a five-day interval show weak emission along with asymmetries and filling in of the profile.

  19. Meat Processing and Garden City, KS: Boom and Bust

    ERIC Educational Resources Information Center

    Broadway, Michael J.; Stull, Donald D.

    2006-01-01

    In December 1980, the world's largest beef processing plant opened 10 miles west of Garden City, KS. Three years later another beef plant opened on Garden City's eastern edge. Full employment in the surrounding region meant that most of the 4000 workers needed to run these plants had to come from elsewhere--and they did. Garden City grew by…

  20. ICDE Librarians' Roundtable (Hong Kong, October 11-12, 1999).

    ERIC Educational Resources Information Center

    Wai-man, Wong; Schafer, Steve; Watson, Elizabeth F.; Tai-loon, Fong

    The International Council for Open and Distance Education (ICDE) Librarians' Roundtable is the first of its kind for librarians of international distance and open education institutions to exchange their views on how to cope with the development of their institutions in the use of new technology, and in the provision of library services to…

  1. 75 FR 4138 - Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Florida, Georgia...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 3 Taxpayer Advocacy Panel (Including the States of Florida, Georgia, Alabama, Mississippi, Louisiana, Arkansas, and the Territory of Puerto Rico) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting...

  2. 76 FR 6188 - Open Meeting of the Area 6 Taxpayer Advocacy Panel (Including the States of Idaho, Iowa...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... Taxpayer Advocacy Panel is soliciting public comment, ideas, and suggestions on improving customer service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 6 Taxpayer Advocacy... Dakota, Utah, Washington, and Wyoming) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice...

  3. 76 FR 37197 - Open Meeting of the Area 6 Taxpayer Advocacy Panel (Including the States of Idaho, Iowa...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Taxpayer Advocacy Panel is soliciting public comment, ideas, and suggestions on improving customer service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 6 Taxpayer Advocacy... Dakota, Utah, Washington, and Wyoming) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice...

  4. 76 FR 2195 - Open Meeting of the Area 1 Taxpayer Advocacy Panel (Including the States of New York, New Jersey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 1 Taxpayer Advocacy Panel (Including the States of New York, New Jersey, Connecticut, Massachusetts, Rhode Island, New Hampshire, Vermont and Maine) AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting...

  5. 76 FR 32022 - Open Meeting of the Area 1 Taxpayer Advocacy Panel (Including the States of New York, New Jersey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Area 1 Taxpayer Advocacy Panel (Including the States of New York, New Jersey, Connecticut, Massachusetts, Rhode Island, New Hampshire, Vermont and Maine) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of Meeting...

  6. 77 FR 47165 - Open Meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ... Toll-Free Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Toll-Free Project Committee will be conducted. The... at the Internal Revenue Service. DATES: The meeting will be held Tuesday, September 4, 2012. FOR...

  7. 75 FR 55405 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  8. 75 FR 33893 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  9. 75 FR 25317 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Small Business/Self Employed Issue Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  10. 75 FR 11999 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  11. 75 FR 47348 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  12. 75 FR 7539 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS) Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  13. 75 FR 62630 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  14. 75 FR 18957 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  15. 75 FR 39331 - Open Meeting of the Taxpayer Advocacy Panel Small Business/Self Employed Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Small Business/Self Employed Project Committee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of meeting. SUMMARY: An open meeting of the Taxpayer Advocacy Panel Small Business/ Self Employed... suggestions on improving customer service at the Internal Revenue Service. DATES: The meeting will be held...

  16. Open ocean Internal Waves, Namibia Coast, Africa.

    NASA Technical Reports Server (NTRS)

    1990-01-01

    These open ocean Internal Waves were seen off the Namibia Coast, Africa (19.5S, 11.5E). The periodic and regularly spaced sets of incoming internal appear to be diffracting against the coastline and recombining to form a network of interference patterns. They seem to coincide with tidal periods about 12 hours apart and wave length (distance from crest to crest) varies between 1.5 and 5.0 miles and the crest lengths stretch beyond the image.

  17. Open ocean Internal Waves, Namibia Coast, Africa.

    NASA Image and Video Library

    1990-12-10

    These open ocean Internal Waves were seen off the Namibia Coast, Africa (19.5S, 11.5E). The periodic and regularly spaced sets of incoming internal appear to be diffracting against the coastline and recombining to form a network of interference patterns. They seem to coincide with tidal periods about 12 hours apart and wave length (distance from crest to crest) varies between 1.5 and 5.0 miles and the crest lengths stretch beyond the image.

  18. Open ocean Internal Waves, Namibia Coast, Africa.

    NASA Image and Video Library

    1990-12-10

    These open ocean Internal Waves were seen off the Namibia Coast, Africa (23.0S, 14.0E). The periodic and regularly spaced sets of internal waves most likely coincide with tidal periods about 12 hours apart. The wave length (distance from crest to crest) varies between 1.5 and 5.0 miles and the crest lengths stretch across and beyond the distance of the photo. The waves are intersecting the Namibia coastline at about a 30 degree angle.

  19. Open ocean Internal Waves, Namibia Coast, Africa.

    NASA Technical Reports Server (NTRS)

    1990-01-01

    These open ocean Internal Waves were seen off the Namibia Coast, Africa (23.0S, 14.0E). The periodic and regularly spaced sets of internal waves most likely coincide with tidal periods about 12 hours apart. The wave length (distance from crest to crest) varies between 1.5 and 5.0 miles and the crest lengths stretch across and beyond the distance of the photo. The waves are intersecting the Namibia coastline at about a 30 degree angle.

  20. Open Data as Open Educational Resources: Towards Transversal Skills and Global Citizenship

    ERIC Educational Resources Information Center

    Atenas, Javiera; Havemann, Leo; Priego, Ernesto

    2015-01-01

    Open Data is the name given to datasets which have been generated by international organisations, governments, NGOs and academic researchers, and made freely available online and openly-licensed. These datasets can be used by educators as Open Educational Resources (OER) to support different teaching and learning activities, allowing students to…

  1. Developed lower-positioned transverse ligament restricts eyelid opening and folding and determines Japanese as being with or without visible superior palpebral crease.

    PubMed

    Ban, Midori; Matsuo, Kiyoshi; Ban, Ryokuya; Yuzuriha, Shunsuke; Kaneko, Ai

    2013-01-01

    We have reported that a developed lower-positioned transverse ligament between the superior-medial orbital rim and the lateral orbital rim on the lateral horn in the lower orbital fat space antagonizes eyelid opening and folding in certain Japanese to produce narrow eye, no visible superior palpebral crease, and full eyelid. In this study, we confirmed relationship between development of the lower-positioned transverse ligament and presence of the superior palpebral crease. We evaluated whether (1) digital immobilization of eyebrow movement during eyelid opening and (2) a developed lower-positioned transverse ligament could classify Japanese subjects as being with or without visible superior palpebral crease. Digital immobilization of eyebrow movement restricted eyelid opening in all subjects without visible superior palpebral crease but did not restrict in any subject with visible superior palpebral crease. Macroscopic and microscopic evidence revealed that the lower-positioned transverse ligament behind the lower orbital septum in subjects without visible superior palpebral crease was significantly more developed than that in subjects with visible superior palpebral crease. Since a developed lower-positioned transverse ligament antagonizes opening and folding of the anterior lamella of the upper eyelid in subjects without visible superior palpebral crease, these individuals open their eyelids by lifting the eyebrow with the anterior lamella and the lower-positioned transverse ligament owing to increased tonic contraction of the frontalis muscle, in addition to the retractile force of the levator aponeurotic expansions. In subjects with visible superior palpebral crease, the undeveloped lower-positioned transverse ligament does not antagonize opening and folding of the anterior lamella, and so they open their eyelids by folding the anterior lamella on the superior palpebral crease via the retractile force of the levator aponeurotic expansions.

  2. Developed Lower-Positioned Transverse Ligament Restricts Eyelid Opening and Folding and Determines Japanese as Being With or Without Visible Superior Palpebral Crease

    PubMed Central

    Ban, Midori; Matsuo, Kiyoshi; Ban, Ryokuya; Yuzuriha, Shunsuke; Kaneko, Ai

    2013-01-01

    Introduction: We have reported that a developed lower-positioned transverse ligament between the superior-medial orbital rim and the lateral orbital rim on the lateral horn in the lower orbital fat space antagonizes eyelid opening and folding in certain Japanese to produce narrow eye, no visible superior palpebral crease, and full eyelid. In this study, we confirmed relationship between development of the lower-positioned transverse ligament and presence of the superior palpebral crease. Methods: We evaluated whether (1) digital immobilization of eyebrow movement during eyelid opening and (2) a developed lower-positioned transverse ligament could classify Japanese subjects as being with or without visible superior palpebral crease. Results: Digital immobilization of eyebrow movement restricted eyelid opening in all subjects without visible superior palpebral crease but did not restrict in any subject with visible superior palpebral crease. Macroscopic and microscopic evidence revealed that the lower-positioned transverse ligament behind the lower orbital septum in subjects without visible superior palpebral crease was significantly more developed than that in subjects with visible superior palpebral crease. Conclusions: Since a developed lower-positioned transverse ligament antagonizes opening and folding of the anterior lamella of the upper eyelid in subjects without visible superior palpebral crease, these individuals open their eyelids by lifting the eyebrow with the anterior lamella and the lower-positioned transverse ligament owing to increased tonic contraction of the frontalis muscle, in addition to the retractile force of the levator aponeurotic expansions. In subjects with visible superior palpebral crease, the undeveloped lower-positioned transverse ligament does not antagonize opening and folding of the anterior lamella, and so they open their eyelids by folding the anterior lamella on the superior palpebral crease via the retractile force of the levator aponeurotic expansions. PMID:23943676

  3. International outreach for promoting open geoscience content in Finnish university libraries - libraries as the advocates of citizen science awareness on emerging open geospatial data repositories in Finnish society

    NASA Astrophysics Data System (ADS)

    Rousi, A. M.; Branch, B. D.; Kong, N.; Fosmire, M.

    2013-12-01

    In their Finnish National Spatial Strategy 2010-2015 the Finland's Ministry of Agriculture and Forestry delineated e.g. that spatial data skills should support citizens everyday activities and facilitate decision-making and participation of citizens. Studies also predict that open data, particularly open spatial data, would create, when fully realizing their potential, a 15% increase into the turnovers of Finnish private sector companies. Finnish libraries have a long tradition of serving at the heart of Finnish information society. However, with the emerging possibilities of educating their users on open spatial data a very few initiatives have been made. The National Survey of Finland opened its data in 2012. Finnish technology university libraries, such as Aalto University Library, are open environments for all citizens, and seem suitable of being the first thriving entities in educating citizens on open geospatial data. There are however many obstacles to overcome, such as lack of knowledge about policies, lack of understanding of geospatial data services and insufficient know-how of GIS software among the personnel. This framework examines the benefits derived from an international collaboration between Purdue University Libraries and Aalto University Library to create local strategies in implementing open spatial data education initiatives in Aalto University Library's context. The results of this international collaboration are explicated for the benefit of the field as a whole.

  4. [Long-term efficacy of open reduction and internal fixation versus external fixation for unstable distal radius fractures: a meta-analysis].

    PubMed

    Yang, Z; Yuan, Z Z; Ma, J X; Ma, X L

    2017-11-07

    Objective: To make a systematic assessment of the Long-term efficacy of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Methods: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed. The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected. The included trials were screened out strictly based on the criterion of inclusion and exclusion. The quality of included trials was evaluated. RevMan 5.0 was used for data analysis. Results: Sixteen studies involving 1 268 patients were included. There were 618 patients with open reduction and internal fixation and 650 with external fixation. The results of meta-analysis indicated that there were statistically significant differences with regard to the complications postoperatively (infection( I (2)=0%, RR =0.27, 95% CI 0.16-0.45, Z =4.92, P <0.000 01) and total complications( I (2)=0%, RR =0.71, 95% CI 0.59-0.85, Z =3.65, P =0.000 3) ), DASH scores( I (2)=37%, MD =-5.67, 95% CI -8.31--3.04, Z =4.22, P <0.000 1) and volar tilt( I (2)=78%, MD =2.29, 95% CI 0.33-4.24, Z =2.30, P =0.02)( P <0.05) at the end of follow-up period were noted. There were no statistically significant differences observed between two approaches with respect to the clinical outcomes (grip strength, flexion, extension, pronation, supination, radial deviation and ulnar deviation) and radiographic outcome(radial length) at the end of follow-up period( P <0.05). Conclusion: Both open reduction and internal fixation and external fixation are effective treatment for unstable distal radius fractures. Compared with external fixation, open reduction and internal fixation provides reduced complications postoperatively, lower DASH scores and better restoration of volar tilt for treatment of distal radius fractures.

  5. Scapular thickness--implications for fracture fixation.

    PubMed

    Burke, Charity S; Roberts, Craig S; Nyland, John A; Radmacher, Paula G; Acland, Robert D; Voor, Michael J

    2006-01-01

    The purpose of this study was to measure and map scapula osseous thickness to identify the optimal areas for internal fixation. Eighteen (9 pairs) scapulae from 2 female and 7 male cadavers were used. After harvest and removal of all soft tissues, standardized measurement lines were made based on anatomic landmarks. For consistency among scapulae, measurements were taken at standard percentage intervals along each line approximating the distance between two consecutive reconstruction plate screw holes. Two-mm-diameter drill holes were made at each point, and a standard depth gauge was used to measure thickness. The glenoid fossa (25 mm) displayed the greatest mean osseous thickness, followed by the lateral scapular border (9.7 mm), the scapula spine (8.3 mm), and the central portion of the body of the scapula (3.0 mm). To optimize screw purchase and internal fixation strength, the lateral border, the lateral aspect of the base of the scapula spine, and the scapula spine itself should be used for anatomic sites of internal fixation of scapula fractures.

  6. Aspects of acculturation stress among international students attending a university in the USA.

    PubMed

    Chavajay, Pablo; Skowronek, Jeffrey

    2008-12-01

    Acculturation stress reported by 130 international students attending a university in Utah for about 2 yr. was examined. On the Acculturative Stress Scale for International Students, few students reported experiencing acculturation stress, but responses to four open-ended questions indicated many students perceived experience of acculturation stresses related to discrimination, feelings of loneliness, and academic concerns. The contrast of findings for the scale scores and the open-ended questions indicate the complexity of assessing international students' acculturation experiences of living and studying in the USA and suggest the usefulness of complementary methodologies for assessing such experience.

  7. Outcome and clinical signs of arthroscopically graded patellar chondromalacia with or without lateral release.

    PubMed

    Korkala, O L; Isotalo, T M; Lavonius, M I; Niskanen, R O

    1995-01-01

    In a follow-up study of 67 patients with an arthroscopically diagnosed patellar chondromalacia, we compared the results of plain conservative treatment with those after an open lateral retinacular release. The mean follow-up was 35 months. In Grade I chondromalacia the lateral release did not affect the result, which was in all cases good or excellent. In Grade II to IV chondromalacia the lateral release appeared beneficial, although the difference did not reach statistical significance. We also examined the validity of three clinical signs in arthroscopically verified patellar chondromalacia. Patellar inhibition and tracking tests were clearly more sensitive than the lateral apprehension test, which often gave a false negative result. If the patellar inhibition test is positive and a Grade II to IV chondromalacia of the patella is found at arthroscopy, lateral release should be considered among other procedures, like patellar shaving or patellar resurfacing.

  8. Image-Guided Internal Fixation of an Oblique Sagittal Split Fracture of C1 Lateral Mass with Motion Preservation: A Technical Report.

    PubMed

    Malcolm, James G; Tan, Lee A; Johnson, Andrew K

    2017-07-20

    A sagittal split fracture of the C1 lateral mass is an unstable subtype of C1 fractures and has a high propensity for developing late deformities and pain with nonoperative management. A primary internal fixation of this type of fracture has been recently described with good clinical outcomes and preservation of motion. We present a modified technique of primary internal fixation using an obliquely inserted C1 lag screw with imaging guidance. We successfully treated a 55-year-old woman with a unilateral C1 oblique sagittal split fracture who failed nonoperative management. Technical nuances are discussed with a review of pertinent literature.

  9. Treatment of Lateral Tibial Condylar Fractures Using Bioactive, Bioresorbable Forged Composites of Raw Particulate Unsintered Hydroxyapatite/Poly-L-Lactide Screws.

    PubMed

    Kuroyanagi, Gen; Yoshihara, Hiroyuki; Yamamoto, Naohiro; Suzuki, Hiroyuki; Yamada, Kunio; Yoshida, Yukio; Otsuka, Takanobu; Takada, Naoya

    2018-05-01

    Forged composites of raw particulate unsintered hydroxyapatite/poly-L-lactide (F-u-HA/PLLA) devices possess high mechanical strength, bioactivity, and radio-opacity. The aim of this study was to assess the efficacy of F-u-HA/PLLA screws in the treatment of lateral tibial condylar fractures. From January 2005 to December 2010, a total of 7 patients with displaced closed lateral tibial condylar fractures (Schatzker type II) were treated using F-u-HA/PLLA screws. Open reduction and internal fixation was performed using 2 or 3 F-u-HA/PLLA screws. After surgery, weight bearing was not allowed for 6 weeks. Range of motion exercise was initiated after removal of the plaster splint. Radiographs were evaluated for fracture healing, joint depression, and the radioopacity of F-u-HA/PLLA screws. Clinical outcomes and postoperative complications were also assessed. Average follow-up was 44 months. All fractures were successfully healed. Average values for joint depression were 4.7 mm (range, 2-9 mm) preoperatively, 0.4 mm (range, 0-1 mm) postoperatively, and 0.4 mm (range, 0-1 mm) at final follow-up. Whole shadows of F-u-HA/PLLA screws were observed during the follow-up period. Breakage of screws, osteolysis, and a radiolucent zone around the screws were not observed at final follow-up. Average knee flexion and extension were 134° (range, 110° to 150°) and -1° (range, -10° to 0°), respectively. No patient had wound infection, late aseptic tissue response, or foreign body reaction postoperatively. None of the patients reported pain at final follow-up. These results suggest that F-u-HA/PLLA screws could be an alternative option for the treatment of lateral tibial condylar fractures. [Orthopedics. 2018; 41(3):e365-e368.]. Copyright 2018, SLACK Incorporated.

  10. Treatment of subtalar calcanean fractures using trans-osseous limited lateral approach.

    PubMed

    Ragab, Abdelaleem H; Mubark, Islam M; Nagi, Ahmed M; Abdelnaby, Mohamed Aly

    2014-01-01

    Calcaneal fractures are the most common fractures of the tarsal bones. The majority of these fractures are produced by axial force like a fall from a height. Controversy still exists on the best line of treatment. This study is to evaluate the results of trans-osseous limited lateral approach as a minimally invasive surgical treatment of the displaced intra-articular calcaneal fractures. The study included forty two patients (46 feet) with displaced intra-articular calcaneal fractures admitted to El-Hadra University Hospital. They were treated by trans-osseous open reduction of subtalar joint and internal fixation by k-wires consuming the trans-osseous limited lateral approach. Out of 42 patients, 36 pateints (85.7%) were males. Using calcaneal fracture scoring system, the mean score was 67.55+17.35. Satisfactory results were found in 26 patients (61.9%), while 16 patients (38.1%) had unsatisfactory results. There was significant relationship between classification of the fracture and the final results (the more the grade of the fracture, the worse the final score) (x 2 =5.914, p=0.05). The value of calcaneal angles were significantly improved after surgery including bohler angle (p=0.0001), gissane angle (p=0.0001), calcaneal pitch angle (p=0.001) and calcaneofibular space (p=0.0021). 1. Trans-osseous limited lateral approach is an effective method for management of intra articular calcaneal fractures. 2. Anatomical reduction for intra articular calcaneal fractures is essential. 3. Functional outcome of intra articular calcaneal fractures depends upon the initial damage of the articular cartilage. 4. There is a need for multi-center prospective randomized study for accurate assessment of the results of operative management of intra articular calcaneal fractures involving pre and post-operative CT for assessment of reduction and using a rational scoring system and a long period of follow up.

  11. Internal Evaluation a Quarter-Century Later: A Conversation with Arnold J. Love

    ERIC Educational Resources Information Center

    Volkov, Boris B.

    2011-01-01

    This chapter features a recent conversation with Dr. Arnold J. Love, a long-time proponent of internal evaluation and one of the most cited internal evaluation authors. In 1983, Love edited the first issue of "New Directions for Program Evaluation" on the topic of internal evaluation. He is the author of the book "Internal…

  12. Increased Accuracy of Ligand Sensing by Receptor Internalization and Lateral Receptor Diffusion

    NASA Astrophysics Data System (ADS)

    Aquino, Gerardo; Endres, Robert

    2010-03-01

    Many types of cells can sense external ligand concentrations with cell-surface receptors at extremely high accuracy. Interestingly, ligand-bound receptors are often internalized, a process also known as receptor-mediated endocytosis. While internalization is involved in a vast number of important functions for the life of a cell, it was recently also suggested to increase the accuracy of sensing ligand as overcounting of the same ligand molecules is reduced. A similar role may be played by receptor diffusion om the cell membrane. Fast, lateral receptor diffusion is known to be relevant in neurotransmission initiated by release of neurotransmitter glutamate in the synaptic cleft between neurons. By binding ligand and removal by diffusion from the region of release of the neurotransmitter, diffusing receptors can be reasonably expected to reduce the local overcounting of the same ligand molecules in the region of signaling. By extending simple ligand-receptor models to out-of-equilibrium thermodynamics, we show that both receptor internalization and lateral diffusion increase the accuracy with which cells can measure ligand concentrations in the external environment. We confirm this with our model and give quantitative predictions for experimental parameters values. We give quantitative predictions, which compare favorably to experimental data of real receptors.

  13. The International Student Question: 45 Years Later

    ERIC Educational Resources Information Center

    Aw, Fanta

    2012-01-01

    Since the publication of Dremuk's article 45 years ago, the landscape of international educational exchange has changed significantly. Some of the most notable trends distinguishing the past from the present are highlighted. Forty-five years ago, Dremuk's article emphasized the importance of institutional commitment to international educational…

  14. [Treatment of thoracolumbar burst fracture with lateral anterior decompression, internal fixation with Ventrofix and bone graft with titanic mesh].

    PubMed

    Zhang, Shi-min; Zhang, Zhao-jie; Liu, Yu-zhang; Zhang, Lu-tang; Li, Xing

    2011-11-01

    To discuss the efficacy of lateral anterior decompression, internal fixation with Ventrofix and bone graft with titanic mesh in the treatment of severe thoracolumbar burst fracture. From January 2008 to January 2010, 21 patients with severe thoracolumbar burst fracture were treated with lateral anterior decompression, internal fixation with Ventrofix, bone graft with titanic mesh. There were 15 males and 6 females, ranging in age from 21 to 46 years with an average of 32.2 years. Segment of fracture: 3 cases were in T11, 6 cases in T12, 7 cases in L1, 5 cases in L2. The mean kyphosis angle was 20.1 degrees and loading of fracture was 7.8 scores. Twenty-one cases accompany with incomplete paralysis. Nerves functions were observed according to Frankel grade; correction and maintain of kyphosis angle were observed by X-rays and CT. All the patients were followed up from 12 to 34 months with an average of 18.5 years. Postoperative complication including injury of pleura in 1 case, dynamic ileus in 2 cases, ilioinguinal nerve injury in 1 case, faulty union of wound in 1 case. All the above complications got recovery after symptomatic treatment. The mean kyphosis angle in fusional segment were 4.2 degrees and the rate of correction was 79%. Nerves functions of all patients got improvement and no internal fixation fail, kyphosis angle obviously lost, titanium mesh shifting, loosening and breakage of screw were found at final follow-up. Lateral anterior decompression, bone graft with titanic mesh, internal fixation with Ventrofix is an idea technique for severe thoracolumber burst fracture, but the method can not be used for patient with severity osteoporosis.

  15. Space closing versus space opening for bilateral missing upper laterals - aesthetic judgments of laypeople: a web-based survey.

    PubMed

    Qadri, Salim; Parkin, Nicola A; Benson, Philip E

    2016-06-01

    To investigate the opinions of laypeople regarding the aesthetic outcome of treating patients with developmental absence of both maxillary lateral incisors using either orthodontic space closure (OSC) or space opening and prosthetic replacement (PR). Cross sectional, web-based survey. A panel of five orthodontists and five restorative dentists examined post-treatment intra-oral images of 21 patients with developmental absence of both upper lateral incisors. A consensus view was obtained about the 10 most attractive images (5 OSC; 5 PR). The 10 selected images were used in a web-based survey involving staff and students at the University of Sheffield. In the first section, the participants were asked to evaluate the attractiveness of the 10 randomly arranged single images using a 5-point Likert scale. In the second section, an image of OSC was paired with an image of PR according to their attractiveness ranking by the clinician panel, and the participants were asked to indicate which of the two images they preferred. The survey received 959 completed responses with 9590 judgements. The images of OSC were perceived to be more attractive (mean rating 3·34 out of 5; SD 0·56) compared with the images of PR (mean rating 3·14 out of 5; SD 0·58) (mean diff 0·21; P < 0·001). Female and staff judges tended to give higher attractiveness ratings. Both females and males preferred the OSC images closing in 3 out of 4 paired images. Space closing was perceived to be more attractive than space opening by lay people. The findings have implications for advising patients about the best aesthetic outcome when both maxillary lateral incisors are missing.

  16. 75 FR 8413 - Sunshine Act Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-24

    .... STATUS: The portion of the meeting dealing with agenda items 1 through 6 will be open to the public. The... podcast. MATTERS TO BE CONSIDERED: 1. Report on international activities (open). 2. Commission participation in Congressional staff briefings (open). 3. Status of Annual Compliance Review (open). 4. Status...

  17. An improved OpenSim gait model with multiple degrees of freedom knee joint and knee ligaments.

    PubMed

    Xu, Hang; Bloswick, Donald; Merryweather, Andrew

    2015-08-01

    Musculoskeletal models are widely used to investigate joint kinematics and predict muscle force during gait. However, the knee is usually simplified as a one degree of freedom joint and knee ligaments are neglected. The aim of this study was to develop an OpenSim gait model with enhanced knee structures. The knee joint in this study included three rotations and three translations. The three knee rotations and mediolateral translation were independent, with proximodistal and anteroposterior translations occurring as a function of knee flexion/extension. Ten elastic elements described the geometrical and mechanical properties of the anterior and posterior cruciate ligaments (ACL and PCL), and the medial and lateral collateral ligaments (MCL and LCL). The three independent knee rotations were evaluated using OpenSim to observe ligament function. The results showed that the anterior and posterior bundles of ACL and PCL (aACL, pACL and aPCL, pPCL) intersected during knee flexion. The aACL and pACL mainly provided force during knee flexion and adduction, respectively. The aPCL was slack throughout the range of three knee rotations; however, the pPCL was utilised for knee abduction and internal rotation. The LCL was employed for knee adduction and rotation, but was slack beyond 20° of knee flexion. The MCL bundles were mainly used during knee adduction and external rotation. All these results suggest that the functions of knee ligaments in this model approximated the behaviour of the physical knee and the enhanced knee structures can improve the ability to investigate knee joint biomechanics during various gait activities.

  18. Fully laparoscopic left hepatectomy - a technical reference proposed for standard practice compared to the open approach: a retrospective propensity score model.

    PubMed

    Valente, Roberto; Sutcliffe, Robert; Levesque, Eric; Costa, Mara; De' Angelis, Nicola; Tayar, Claude; Cherqui, Daniel; Laurent, Alexis

    2018-04-01

    Laparoscopic left hemihepatectomy (LLH) may be an alternative to open (OLH). There are several original variations in the technical aspects of LLH, and no accepted standard. The aim of this study is to assess the safety and effectiveness of the technique developed at Henri Mondor Hospital since 1996. The technique of LLH was conceived for safety and training of two mature generations of lead surgeons. The technique includes full laparoscopy, ventral approach to the common trunk, extrahepatic pedicle dissection, CUSA ® parenchymal transection, division of the left hilar plate laterally to the Arantius ligament, and ventral transection of the left hepatic vein. The outcomes of LLH and OLH were compared. Perioperative analysis included intra- and postoperative, and histology variables. Propensity Score Matching was undertaken of background covariates including age, ASA, BMI, fibrosis, steatosis, tumour size, and specimen weight. 17 LLH and 51 OLH were performed from 1996 to 2014 with perioperative mortality rates of 0% and 6%, respectively. In the LLH group, two patients underwent conversion to open surgery. Propensity matching selected 10 LLH/OLH pairs. The LLH group had a higher proportion of procedures for benign disease. LLH was associated with longer operating time and less blood loss. Perioperative complications occurred in 30% (LLH) and 10% (OLH) (p = 1). Mortality and ITU stay were similar. This technique is recommended as a possible technical reference for standard LLH. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  19. 76 FR 81005 - The Secretary of State's International Council on Women's Business Leadership; Notice of Open...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... Business Leadership; Notice of Open Meeting The Secretary of State's International Council on Women's Business Leadership (ICWBL) will meet from 9:15 a.m. to 10:15 a.m. on Tuesday, January 24, 2012, in the... Access to Finance Subcommittee, the Training and Capacity Building Subcommittee, and the Leadership...

  20. First branchial cleft fistula presenting with internal opening on the Eustachian tube: Illustrated cases and literature review.

    PubMed

    Liu, Yuhe; Li, Tiancheng; Xue, Junfang; Jia, Jun; Xiao, Shuifang; Zhao, Enmin

    2012-05-01

    Two cases of first branchial cleft fistula with internal opening on the Eustachian tube are reported and the diagnosis, management and embryological hypothesis are discussed. Retrospective study and review of the literature. Both patients were young boys with first branchial cleft anomaly clearly identified by computed tomography fistulography scan and direct Methylene Blue dye injection. In both cases, surgical removal revealed a fistula with internal opening located on the Eustachian tube near the nasopharynx. The main embryological theories and classification are reviewed. A connection between the theories of first branchial apparatus development and the classification by Work might explain the reported clinical association. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Adult Degenerative Scoliosis with Spinal Stenosis Treated with Stand-Alone Cage via an Extreme Lateral Transpsoas Approach; a Case Report and Literature Review

    PubMed Central

    von Keudell, Arvind; Alimi, Marjan; Gebhard, Harry; Härtl, Roger

    2015-01-01

    We report the case of a 73-year-old female with severe degenerative scoliosis and back and leg pain that was successfully treated with stand- alone cages via an extreme lateral transpsoas approach. This patient had declined open surgery and instrumentation due to her advanced age concerns about potential side effects. PMID:26110180

  2. Regional Changes in Word-Production Laterality after a Naming Treatment Designed to Produce a Rightward Shift in Frontal Activity

    ERIC Educational Resources Information Center

    Crosson, Bruce; Moore, Anna Bacon; McGregor, Keith M.; Chang, Yu-Ling; Benjamin, Michelle; Gopinath, Kaundinya; Sherod, Megan E.; Wierenga, Christina E.; Peck, Kyung K.; Briggs, Richard W.; Rothi, Leslie J. Gonzalez; White, Keith D.

    2009-01-01

    Five nonfluent aphasia patients participated in a picture-naming treatment that used an intention manipulation (opening a box and pressing a button on a device in the box with the left hand) to initiate naming trials and was designed to re-lateralize word production mechanisms from the left to the right frontal lobe. To test the underlying…

  3. Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy.

    PubMed

    Nakamura, R; Komatsu, N; Fujita, K; Kuroda, K; Takahashi, M; Omi, R; Katsuki, Y; Tsuchiya, H

    2017-10-01

    Open wedge high tibial osteotomy (OWHTO) for medial-compartment osteoarthritis of the knee can be complicated by intra-operative lateral hinge fracture (LHF). We aimed to establish the relationship between hinge position and fracture types, and suggest an appropriate hinge position to reduce the risk of this complication. Consecutive patients undergoing OWHTO were evaluated on coronal multiplanar reconstruction CT images. Hinge positions were divided into five zones in our new classification, by their relationship to the proximal tibiofibular joint (PTFJ). Fractures were classified into types I, II, and III according to the Takeuchi classification. Among 111 patients undergoing OWHTOs, 22 sustained lateral hinge fractures. Of the 89 patients without fractures, 70 had hinges in the zone within the PTFJ and lateral to the medial margin of the PTFJ (zone WL), just above the PTFJ. Among the five zones, the relative risk of unstable fracture was significantly lower in zone WL (relative risk 0.24, confidence interval 0.17 to 0.34). Zone WL appears to offer the safest position for the placement of the osteotomy hinge when trying to avoid a fracture at the osteotomy site. Cite this article: Bone Joint J 2017;99B10:1313-18. ©2017 The British Editorial Society of Bone & Joint Surgery.

  4. Location of Sentinel Lymph Node in Cervical Carcinoma and Factors Associated With Unilateral Detection.

    PubMed

    Wuntakal, Rekha; Papadopoulos, Andreas John; Montalto, Stephen Attard; Perovic, Milica; Coutts, Michael; Devaja, Omer

    2015-11-01

    The aims of this study were to assess locality of the sentinel lymph node (SLN) in cervical carcinoma and examine factors affecting bilateral SLN detection. This was a retrospective review of SLN data (anatomical location, count and laterality) in patients with early-stage cervical cancer (International Federation of Gynecology and Obstetrics stage IA1 with lymphovascular space invasion to stage IIA) using intraoperative gamma probe and blue dye. The preoperative single-photon emission computed tomography with computed tomography was used to detect laterality, number of the SLNs, and rare locations. Patients were treated between January 2005 to January 2015 at the West Kent Gynaecological Oncology Centre, Maidstone Hospital, Maidstone, United Kingdom. A total of 132 women were investigated. The most common SLN location was the external iliac (38.6%) followed by obturator (25.3%) and internal iliac (23.6%) regions. A small percentage was identified in presacral (1.4%) and para-aortic regions (0.7%). Older age (P = 0.01) and an elevated body mass index (P = 0.03) were associated with decreased SLN count by preoperative single-photon emission computed tomography with computed tomography, and only age affected SLN count by gamma probe (P = 0.01). Initial surgery, large loop excision of the transformation zone, or cone biopsy of the cervix had no effect on SLN count. There was no difference observed in bilateral detection with respect to surgical approach (open: n = 48/laparoscopic: n = 84). However, older age was independently associated with a decrease in bilateral SLN detection (P = 0.003). In these patients who underwent unilateral full pelvic lymphadenectomy, all the nonsentinel nodes were negative. The majority of SLNs were located in the external iliac, obturator, and internal iliac regions. Both older age and an elevated body mass index were associated with a reduced SLN count. Unilateral detection of SLN was independently associated with older age, which may be due to sclerosis in the lymphatic vessels or reduced perfusion in the pelvis in these women. If no SLN is detected on one side, the consensus is to perform a full pelvic lymphadenectomy on that side of the pelvis.

  5. Fecal incontinence after minor anorectal surgery.

    PubMed

    Zbar, A P; Beer-Gabel, M; Chiappa, A C; Aslam, M

    2001-11-01

    Fecal leakage after open lateral internal anal sphincterotomy for chronic anal fissure is common, but underreported. The aim of this study was to prospectively assess the physiologic and morphologic effects of sphincterotomy, comparing continent and incontinent patients after surgery. This group was further compared with an unselected group of patients presenting with incontinence after hemorrhoidectomy. Between January 1997 and June 1999, 23 patients were prospectively followed up through internal sphincterotomy with conventional and vector volume anorectal manometry, parametric assessment of the rectoanal inhibitory reflex, and endoanal magnetic resonance imaging. Fourteen continent patients were compared with 9 incontinent postoperative cases, 9 patients referred with incontinence after hemorrhoidectomy, and 33 healthy volunteers without anorectal disease. Significant differences were noted between continent and incontinent postsphincterotomy cases for all resting conventional and vector volume parameters and for some squeeze parameters. Although there was a significant reduction in postoperative high pressure zone length at rest, there were no differences between the postoperative groups. There was an increase in sphincter asymmetry of 6.7 percent (+/- 3.5 percent) in incontinent postsphincterotomy patients and a decrease of 2.8 percent (+/- 3.2 percent) in continent cases. Significant differences were noted for resting parameters between incontinent postsphincterotomy and posthemorrhoidectomy patients, with a higher resting sphincter asymmetry in the latter group. The area under the rectoanal inhibitory curve was smaller in postsphincterotomy incontinent patients when compared with continent cohorts over the distal and intermediate sphincter zones at rest with a reduced latency of inhibition. There was no difference in the magnetic resonance images of the sphincterotomy site between incontinent and continent postsphincterotomy cases and no posthemorrhoidectomy case had evidence of sphincteric damage. There are complex significant differences in the postoperative physiology of patients undergoing lateral internal sphincterotomy who become incontinent when compared with those who maintain continence. These physiologic changes are not reflected in detectable morphologic sphincteric differences. It is unknown whether these changes predict for long-term incontinence, and it is suggested that postoperative incontinence after minor anorectal surgery is not necessarily related either to a preexisting sphincter defect or inadvertent intraoperative sphincter injury.

  6. A New Selective Area Lateral Epitaxy Approach for Depositing a-Plane GaN over r-Plane Sapphire

    NASA Astrophysics Data System (ADS)

    Chen, Changqing; Zhang, Jianping; Yang, Jinwei; Adivarahan, Vinod; Rai, Shiva; Wu, Shuai; Wang, Hongmei; Sun, Wenhong; Su, Ming; Gong, Zheng; Kuokstis, Edmundas; Gaevski, Mikhail; Khan, Muhammad Asif

    2003-07-01

    We report a new epitaxy procedure for growing extremely low defect density a-plane GaN films over r-plane sapphire. By combining selective area growth through a SiO2 mask opening to produce high height to width aspect ratio a-plane GaN pillars and lateral epitaxy from their c-plane facets, we obtained fully coalesced a-plane GaN films. The excellent structural, optical and electrical characteristics of these selective area lateral epitaxy (SALE) deposited films make them ideal for high efficiency III-N electronic and optoelectronic devices.

  7. How I do it: surgical ligation of craniocervical junction dural AV fistulas.

    PubMed

    Sorenson, Thomas J; La Pira, Biagia; Hughes, Joshua; Lanzino, Giuseppe

    2017-08-01

    Dural arteriovenous fistulas (DAVFs) of the craniocervical junction are uncommon vascular lesions, which often require surgical treatment even in the endovascular era. Most commonly, the fistula is placed laterally, and surgical ligation is performed through a lateral suboccipital craniotomy. After dural opening, the area is inspected, and the arterialized vein is identified emerging from the dura, often adjacent to the entry point of the vertebral artery, and ligated. A far lateral craniotomy is the authors' preferred surgical approach for accessing and treating dural arteriovenous fistulas of the craniocervical junction that cannot be reached endovascularly.

  8. Morphology of the infective larval stage of the equid parasite Habronema muscae (Spirurida: Habronematidae), from houseflies (Musca domestica).

    PubMed

    Buzzell, Gerald R; Tariq, Saeed; Traversa, Donato; Schuster, Rolf

    2011-03-01

    The infective larva of the spirurid nematode Habronema muscae, a parasite of houseflies, was measured and specimens fixed in Karnovsky's fluid were examined by scanning electron microscopy. The oral opening contains six teeth and is surrounded by large bilobed dorsal and ventral lips and smaller lateral lips. A pair of amphids lie behind the lateral lips. There are two rows of four cephalic papillae. The body is deeply ridged, both transversely and longitudinally. The caudal end of the worm is studded by small papillae. The position of the anal opening is somewhat ambiguous. These larval morphological features are discussed, as well as the changes which must have occurred in the metamorphosis of the infective larva to the adult in the stomach of horses.

  9. Muscle activity response to external moment during single-leg drop landing in young basketball players: the importance of biceps femoris in reducing internal rotation of knee during landing.

    PubMed

    Fujii, Meguru; Sato, Haruhiko; Takahira, Naonobu

    2012-01-01

    Internal tibial rotation with the knee close to full extension combined with valgus collapse during drop landing generally results in non-contact anterior cruciate ligament (ACL) injury. The purpose of this study was to investigate the relationship between internal rotation of the knee and muscle activity from internal and external rotator muscles, and between the internal rotation of knee and externally applied loads on the knee during landing in collegiate basketball players. Our hypothesis was that the activity of biceps femoris muscle would be an important factor reducing internal knee rotation during landing. The subjects were 10 collegiate basketball students: 5 females and 5 males. The subjects performed a single-leg drop landing from a 25-cm height. Femoral and tibial kinematics were measured using a 3D optoelectronic tracking system during the drop landings, and then the knee angular motions were determined. Ground reaction forces and muscle activation patterns (lateral hamstring and medial hamstring) were simultaneously measured and computed. Results indicated that lower peak internal tibial rotation angle at the time of landing was associated with greater lateral hamstring activity (r = -0.623, p < 0.001). When gender was considered, the statistically significant correlation remained only in females. There was no association between the peak internal tibial rotation angle and the knee internal rotation moment. Control of muscle activity in the lateral to medial hamstring would be an important factor in generating sufficient force to inhibit excessive internal rotation during landing. Strengthening the biceps femoris might mitigate the higher incidence of non-contact ACL injury in female athletes. Key pointsLower activity of the external rotator muscle of the knee, which inhibits internal rotation of the knee, may be the reason why females tend to show a large internal rotation of the knee during drop landing.Externally applied internal rotation moment of the knee during landing would not be expected to explain why female athletes tend to show excessive internal knee rotation.Biceps femoris strength training might help decrease the incidence of non-contact ACL injury in female athletes.

  10. Recommendations from the 4th International Conference on Environmental Education, Ahmedabad, India

    ERIC Educational Resources Information Center

    Journal of Education for Sustainable Development, 2008

    2008-01-01

    The first set of international recommendations to guide environmental education (EE) was developed in Tbilisi, Georgia, in 1977. Ten years later, in 1987, a conference in Moscow, Russia, reviewed progress and focused on institutional strategies and action plans to strengthen environmental education. A third international environmental education…

  11. 19 CFR 351.218 - Sunset reviews under section 751(c) of the Act.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... International Trade Commission and conduct an expedited sunset review and issue final results of review in.... 351.218 Section 351.218 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE...; (2) Notify the International Trade Commission in writing as such normally not later than 20 days...

  12. 19 CFR 351.218 - Sunset reviews under section 751(c) of the Act.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... International Trade Commission and conduct an expedited sunset review and issue final results of review in.... 351.218 Section 351.218 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE...; (2) Notify the International Trade Commission in writing as such normally not later than 20 days...

  13. 19 CFR 351.218 - Sunset reviews under section 751(c) of the Act.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... International Trade Commission and conduct an expedited sunset review and issue final results of review in.... 351.218 Section 351.218 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE...; (2) Notify the International Trade Commission in writing as such normally not later than 20 days...

  14. Peer Victimization in Childhood and Internalizing Problems in Adolescence: A Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Zwierzynska, Karolina; Wolke, Dieter; Lereya, Tanya S.

    2013-01-01

    Traumatic childhood experiences have been found to predict later internalizing problems. This prospective longitudinal study investigated whether repeated and intentional harm doing by peers (peer victimization) in childhood predicts internalizing symptoms in early adolescence. 3,692 children from the Avon Longitudinal Study of Parents and…

  15. 78 FR 36303 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel... open meeting of the Taxpayer Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy... open meeting of the Taxpayer Advocacy Panel Joint Committee will be held Wednesday, July 24, 2013 at 2...

  16. 77 FR 40410 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel... open meeting of the Taxpayer Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy...) that an open meeting of the Taxpayer Advocacy Panel Joint Committee will be held Wednesday, August 22...

  17. 75 FR 15753 - Sunshine Act Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-30

    .... STATUS: Parts of this meeting will be open to the public. The rest of the meeting will be closed to the public. The public session will be podcast. MATTERS TO BE CONSIDERED: PORTIONS OPEN TO THE PUBLIC: 1. Review of Postal-related congressional activity (open). 2. Report on international activities (open). 3...

  18. 78 FR 48231 - Open Meeting of the Taxpayer Advocacy Panel Joint Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel... open meeting of the Taxpayer Advocacy Panel Joint Committee will be conducted. The Taxpayer Advocacy...) that an open meeting of the Taxpayer Advocacy Panel Joint Committee will be held Wednesday, September...

  19. The Ecology of the Open Practitioner: A Conceptual Framework for Open Research

    ERIC Educational Resources Information Center

    Stagg, Adrian

    2017-01-01

    Open Educational Practices (OEP) have gained traction internationally over the last fifteen years, with individuals, institutions, and governments increasingly interested in the affordances of openness. Whilst initiatives, policies, and support mechanisms are evident, there is an ever-present danger of localised contexts being unintentionally…

  20. Treatment of a periorbital cyst in a dog by creation of a permanent drainage opening.

    PubMed

    Kaiser, S; Driesen, A; Malberg, S; Kramer, M; Thiel, C

    2015-01-01

    An inflammatory periorbital cyst with secondary pressure atrophy of the maxilla was treated by surgical creation of a drainage opening to the nasal cavity in a 4-year-old Yorkshire Terrier. Following treatment, clinical signs resolved and computed tomography 5 weeks after surgery confirmed the permanence of the drainage opening. Eight months later, the dog showed no clinical abnormalities. Therefore, the procedure described in this report may offer a suitable treatment option in cases where the cyst's size or localization prevents complete excision.

  1. Ureteroileal bypass: a new technic to treat ureteroenteric strictures in urinary diversion.

    PubMed

    Padovani, Guilherme P; Mello, Marcos F; Coelho, Rafael F; Borges, Leonardo L; Nesrallah, Adriano; Srougi, Miguel; Nahas, William C

    2018-01-01

    To present our technique of ureteroileal bypass to treat uretero-enteric strictures in urinary diversion. One hundred and forty-one medical records were reviewed from patients submitted to radical cystectomy to treat muscle-invasive bladder cancer between 2013 and 2015. Twelve (8.5%) patients developed uretero-enteric anastomotic stricture during follow-up. Five patients were treated with endoscopic dilatation and double J placement. Four were treated surgically with standard terminal-lateral implantation. Three patients with uretero-enteric anastomotic stricture were treated at our institution by "ureteroileal bypass", one of them was treated with robotic surgery. All patients had the diagnosis of uretero-enteric anastomotic stricture via computerized tomography and DTPA renal scan. Time between cystectomy and diagnosis of uretero-enteric anastomotic stricture varied from five months to three years. Mean operative time was 120±17.9 minutes (98 to 142 min) and hospital stay was 3.3±0.62 days (3 to 4 days). Mean follow-up was 24±39.5 months (6 to 72 months). During follow-up, all patients were asymptomatic and presented improvement in ureterohydronephrosis. Serum creatinine of all patients had been stable. Latero-lateral ureter re-implantation is feasible by open or even robotic surgery with positive results, reasonable operation time, and without complications. Copyright® by the International Brazilian Journal of Urology.

  2. Differences between opening versus closing high tibial osteotomy on clinical outcomes and gait analysis.

    PubMed

    Deie, Masataka; Hoso, Takayuki; Shimada, Noboru; Iwaki, Daisuke; Nakamae, Atsuo; Adachi, Nobuo; Ochi, Mitsuo

    2014-12-01

    High tibial osteotomy (HTO) for medial knee osteoarthritis (OA) is mainly performed via two procedures: closing wedge HTO (CW) and opening wedge HTO (OW). In this study, differences between these procedures were assessed by serial clinical evaluation and gait analysis before and after surgery. Twenty-one patients underwent HTO for medial knee OA in 2011 and 2012, with 12 patients undergoing CW and nine undergoing OW. The severity of OA was classified according to the Kellgren-Lawrence classification. The Japanese Orthopedic Association score for assessment of knee OA (JOA score), the Numeric Rating Scale (NRS), and the femoral tibial angle (FTA) on X-ray were evaluated. For gait analysis, gait speed, varus moment, varus angle and lateral thrust were calculated. The JOA score and NRS were improved significantly one year postoperatively in both groups. The FTA was maintained in both groups at one year. Varus angle and varus moment were significantly improved in both groups at each postoperative follow-up, when compared preoperatively. Lateral thrust was significantly improved at three months postoperatively in both groups. However, the significant improvement in lateral thrust had disappeared in the CW group six months postoperatively, whereas it was maintained for at least one year in the OW group. This study found that clinical outcomes were well maintained after HTO. OW reduced knee varus moment and lateral thrust, whereas CW had little effect on reducing lateral thrust. Level IV. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Endoscopic endonasal control of the paraclival internal carotid artery by Fogarty balloon catheter inflation: an anatomical study.

    PubMed

    Ruggeri, Andrea; Enseñat, Joaquim; Prats-Galino, Alberto; Lopez-Rueda, Antonio; Berenguer, Joan; Cappelletti, Martina; De Notaris, Matteo; d'Avella, Elena

    2017-03-01

    OBJECTIVE Neurosurgical management of many vascular and neoplastic lesions necessitates control of the internal carotid artery (ICA). The aim of this study was to investigate the feasibility of achieving control of the ICA through the endoscopic endonasal approach by temporary occlusion with a Fogarty balloon catheter. METHODS Ten endoscopic endonasal paraseptal approaches were performed on cadaveric specimens. A Fogarty balloon catheter was inserted through a sellar bony opening and pushed laterally and posteriorly extraarterially along the paraclival carotid artery. The balloon was then inflated, thus achieving temporary occlusion of the vessel. The position of the catheter was confirmed with CT scans, and occlusion of the ICA was demonstrated with angiography. The technique was performed in 2 surgical cases of pituitary macroadenoma with cavernous sinus invasion. RESULTS Positioning the Fogarty balloon catheter at the level of the paraclival ICA was achieved in all cadaveric dissections and surgical cases through a minimally invasive, quick, and safe approach. Inflation of the Fogarty balloon caused interruption of blood flow in 100% of cases. CONCLUSIONS Temporary occlusion of the paraclival ICA performed through the endoscopic endonasal route with the aid of a Fogarty balloon catheter may be another maneuver for dealing with intraoperative ICA control. Further clinical studies are required to prove the efficacy of this method.

  4. Comparison of different techniques for obturating experimental internal resorptive cavities.

    PubMed

    Goldberg, F; Massone, E J; Esmoris, M; Alfie, D

    2000-06-01

    Forty extracted maxillary central incisors were instrumented at the working length to a #50 file. The roots were sectioned transversely with a diamond disk at 7 mm from the anatomical apex. At the opening of the root canal of each section, hemicircular cavities were drilled with a specially designed bur. The corresponding root sections were cemented with glue, thus obtaining root canals with similar cavities that simulated internal resorptions. Teeth were embedded in plaster casts to facilitate their handling. The specimens were randomly separated into four groups of 10. The following obturation techniques were evaluated: lateral compaction (group A), hybrid technique (group B), Obtura II (group C), and Thermafil (group D). AH26 was used as the sealer. After obturation, the plaster was removed and the teeth were radiographed in buccolingual and mesiodistal directions to evaluate the quality of the obturation at the IRC. The incisors were then cut with a scalpel at the same level as the previous section, to examine, under a stereomicroscope, the type of material that filled the IRC. Obtura II gave the best results and in most of the specimens obturated with this technique, the IRC were filled mainly with gutta-percha. Statistical analysis of the data indicated that the differences between group C and the other groups were significant (P < 0.05).

  5. Self-reinforced bioresorbable poly-L/DL-lactide [SR-P(L/DL)LA] 70/30 miniplates and miniscrews are reliable for fixation of anterior mandibular fractures: a pilot study.

    PubMed

    Ylikontiola, Leena; Sundqvuist, Kai; Sàndor, George K B; Törmälä, Pertti; Ashammakhi, Nureddin

    2004-03-01

    Bioresorbable osteofixation devices are being increasingly used in orthognathic surgery and in cases of trauma to avoid problems associated with conventional metal osteofixation devices. The aim of this clinical study was to assess the reliability and efficacy of bioresorbable self-reinforced poly-L/DL-lactide (SR-P(L/DL)LA 70/30) plates and screws in the fixation of mandibular fractures in adults. Ten patients (20 to 49 years old) with isolated anterior mandibular parasymphyseal fractures were treated by means of open reduction and internal fixation using SR-P(L/DL)LA 70/30 bioresorbable plates and screws. During the minimum of 6 months of follow-up, no problems were encountered except for 1 case where a plate became exposed intraorally and infected. This required debridement and later excision of the exposed part of the plate. Despite this setback the fractured bone healed well. SR-P(L/DL)LA 70/30 plates and screws are reliable for internal fixation of anterior mandibular fractures in adults. Proper soft tissue coverage should be ensured to avoid plate exposure. Should implant exposure occur, it might be necessary to excise the exposed part after fracture healing (6-8 weeks postoperatively).

  6. Regenerative endodontic treatment of an immature tooth with a necrotic pulp and apical periodontitis using platelet-rich plasma (PRP) and mineral trioxide aggregate (MTA): a case report.

    PubMed

    Sachdeva, G S; Sachdeva, L T; Goel, M; Bala, S

    2015-09-01

    To report the successful clinical and radiographic outcome of a regenerative endodontic treatment. A 16-year-old male patient presented with a discoloured, maxillary left lateral incisor with a necrotic pulp. Radiographic examination revealed an incompletely developed root with an open apex. Under local anaesthesia and rubber dam isolation, an access cavity was prepared and the necrotic pulpal remnants were removed. The canal was disinfected without mechanical instrumentation with 5.25% NaOCl solution and dried with sterile paper points. A triple antibiotic (metronidazole, ciprofloxacin and minocycline) mixed with distilled water was packed in the canal and left for 28 days. Ten millimetres of whole blood was drawn by venipuncture from the patients antecubital vein for preparation of platelet-rich plasma (PRP). After removal of the antibiotic mixture, the PRP was injected into the canal space up to the cementoenamel junction level. Three millimetres of white MTA was placed directly over the PRP clot. Two days later, the tooth was restored with permanent filling materials. The patient was recalled for 3, 6, 12, 24 and 36 months clinical/radiographic follow-up. A 3-year follow-up radiograph revealed resolution of the periapical lesion, increased thickening of the root walls, further root development and continued apical closure of the root apex. The tooth was not responsive to cold tests; however, sensitivity tests with an electric pulp tester (EPT) elicited a delayed positive response. Regeneration is a viable treatment modality that allows continued root development of immature teeth with open apices and necrotic pulps. Platelet-rich plasma appears to be a suitable scaffold for regeneration of vital tissues in teeth with a necrotic pulps and an associated periapical lesion. Regenerative endodontic procedures may offer an effective treatment option to save teeth with compromised structural integrity. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  7. Early Weightbearing After Operatively Treated Ankle Fractures: A Biomechanical Analysis.

    PubMed

    Tan, Eric W; Sirisreetreerux, Norachart; Paez, Adrian G; Parks, Brent G; Schon, Lew C; Hasenboehler, Erik A

    2016-06-01

    No consensus exists regarding the timing of weightbearing after surgical fixation of unstable traumatic ankle fractures. We evaluated fracture displacement and timing of displacement with simulated early weightbearing in a cadaveric model. Twenty-four fresh-frozen lower extremities were assigned to Group 1, bimalleolar ankle fracture (n=6); Group 2, trimalleolar ankle fracture with unfixed small posterior malleolar fracture (n=9); or Group 3, trimalleolar ankle fracture with fixed large posterior malleolar fracture (n=9) and tested with axial compressive load at 3 Hz from 0 to 1000 N for 250 000 cycles to simulate 5 weeks of full weightbearing. Displacement was measured by differential variable reluctance transducer. The average motion at all fracture sites in all groups was significantly less than 1 mm (P < .05). Group 1 displacement of the lateral and medial malleolus fracture was 0.1±0.1 mm and 0.4±0.4 mm, respectively. Group 2 displacement of the lateral, medial, and posterior malleolar fracture was 0.6±0.4 mm, 0.5±0.4 mm, and 0.5±0.6 mm, respectively. Group 3 displacement of the lateral, medial, and posterior malleolar fracture was 0.1±0.1 mm, 0.5±0.7 mm, and 0.5±0.4 mm, respectively. The majority of displacement (64.0% to 92.3%) occurred in the first 50 000 cycles. There was no correlation between fracture displacement and bone mineral density. No significant fracture displacement, no hardware failure, and no new fractures occurred in a cadaveric model of early weightbearing in unstable ankle fracture after open reduction and internal fixation. This study supports further investigation of early weightbearing postoperative protocols after fixation of unstable ankle fractures. © The Author(s) 2016.

  8. Expanding the endoscopic transpterygoid corridor to the petroclival region: anatomical study and volumetric comparative analysis.

    PubMed

    Freeman, Jacob L; Sampath, Raghuram; Quattlebaum, Steven Craig; Casey, Michael A; Folzenlogen, Zach A; Ramakrishnan, Vijay R; Youssef, A Samy

    2017-07-21

    OBJECTIVE The endoscopic endonasal transmaxillary transpterygoid (TMTP) approach has been the gateway for lateral skull base exposure. Removal of the cartilaginous eustachian tube (ET) and lateral mobilization of the internal carotid artery (ICA) are technically demanding adjunctive steps that are used to access the petroclival region. The gained expansion of the deep working corridor provided by these maneuvers has yet to be quantified. METHODS The TMTP approach with cartilaginous ET removal and ICA mobilization was performed in 5 adult cadaveric heads (10 sides). Accessible portions of the petrous apex were drilled during the following 3 stages: 1) before ET removal, 2) after ET removal but before ICA mobilization, and 3) after ET removal and ICA repositioning. Resection volumes were calculated using 3D reconstructions generated from thin-slice CT scans obtained before and after each step of the dissection. RESULTS The average petrous temporal bone resection volumes at each stage were 0.21 cm 3 , 0.71 cm 3 , and 1.32 cm 3 (p < 0.05, paired t-test). Without ET removal, inferior and superior access to the petrous apex was limited. Furthermore, without ICA mobilization, drilling was confined to the inferior two-thirds of the petrous apex. After mobilization, the resection was extended superiorly through the upper extent of the petrous apex. CONCLUSIONS The transpterygoid corridor to the petroclival region is maximally expanded by the resection of the cartilaginous ET and mobilization of the paraclival ICA. These added maneuvers expanded the deep window almost 6 times and provided more lateral access to the petroclival region with a maximum volume of 1.5 cm 3 . This may result in the ability to resect small-to-moderate sized intradural petroclival lesions up to that volume. Larger lesions may better be approached through an open transcranial approach.

  9. Effect of lateralized design on muscle and joint reaction forces for reverse shoulder arthroplasty.

    PubMed

    Liou, William; Yang, Yang; Petersen-Fitts, Graysen R; Lombardo, Daniel J; Stine, Sasha; Sabesan, Vani J

    2017-04-01

    Manufacturers of reverse shoulder arthroplasty (RSA) implants have recently designed innovative implants to optimize performance in rotator cuff-deficient shoulders. These advancements are not without tradeoffs and can have negative biomechanical effects. The objective of this study was to develop an integrated finite element analysis-kinematic model to compare the muscle forces and joint reaction forces (JRFs) of 3 different RSA designs. A kinematic model of a normal shoulder joint was adapted from the Delft model and integrated with the well-validated OpenSim shoulder model. Static optimizations then allowed for calculation of the individual muscle forces, moment arms, and JRFs relative to net joint moments. Three-dimensional computer models of 3 RSA designs-humeral lateralized design (HLD), glenoid lateralized design, and Grammont design-were integrated, and parametric studies were performed. Overall, there were decreases in deltoid and rotator cuff muscle forces for all 3 RSA designs. These decreases were greatest in the middle deltoid of the HLD model for abduction and flexion and in the rotator cuff muscles under both internal rotation and external rotation. The JRFs in abduction and flexion decreased similarly for all RSA designs compared with the normal shoulder model, with the greatest decrease seen in the HLD model. These findings demonstrate that the design characteristics implicit in these modified RSA prostheses result in mechanical differences most prominently seen in the deltoid muscle and overall JRFs. Further research using this novel integrated model can help guide continued optimization of RSA design and clinical outcomes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. The clavicle hook plate for Neer type II lateral clavicle fractures.

    PubMed

    Renger, R J; Roukema, G R; Reurings, J C; Raams, P M; Font, J; Verleisdonk, E J M M

    2009-09-01

    To evaluate functional and radiologic outcome in patients with a Neer type II lateral clavicle fracture treated with the clavicle hook plate. Multicenter retrospective study. Five level I and II trauma centers. Forty-four patients, average age 38.4 years (18-66 years), with a Neer type II lateral clavicle fracture treated with the clavicle hook plate between January 1, 2003, and December 31, 2006. Open reduction and internal fixation with the clavicle hook plate. Removal of all 44 implants after consolidation at a mean of 8.4 months (2-33 months) postoperatively. At an average follow-up of 27.4 months (13-48 months), functional outcome was assessed with the Constant-Murley scoring system. Radiographs were taken to evaluate consolidation and to determine the distance between the coracoid process and the clavicle. The average Constant score was 92.4 (74-100). The average distance between the coracoid process and the clavicle was 9.8 mm (7.3-14.8 mm) compared with 9.4 mm (6.9-14.3 mm) on the contralateral nonoperative side. We observed 1 dislocation of an implant (2.2%), 2 cases of pseudarthrosis (4.5%), 2 superficial wound infections (4.5%), 2 patients with hypertrophic scar tissue (4.5%), and 3 times an acromial osteolysis (6.8%). Thirty patients (68%) reported discomfort due to the implant. These implant-related complaints and the acromial osteolysis disappeared after removal of the hook plate. With all the patients, direct functional aftercare was possible. The clavicle hook plate is a suitable implant for Neer type II clavicle fractures. The advantage of this osteosynthesis is the possibility of immediate functional aftercare. We observed a high percentage of discomfort due to the implant; therefore, we advise to remove the implant as soon as consolidation has taken place.

  11. Ultrastructure and regulation of lateralized connexin43 in the failing heart.

    PubMed

    Hesketh, Geoffrey G; Shah, Manish H; Halperin, Victoria L; Cooke, Carol A; Akar, Fadi G; Yen, Timothy E; Kass, David A; Machamer, Carolyn E; Van Eyk, Jennifer E; Tomaselli, Gordon F

    2010-04-02

    Gap junctions mediate cell-to-cell electric coupling of cardiomyocytes. The primary gap junction protein in the working myocardium, connexin43 (Cx43), exhibits increased localization at the lateral membranes of cardiomyocytes in a variety of heart diseases, although the precise location and function of this population is unknown. To define the subcellular location of lateralized gap junctions at the light and electron microscopic level, and further characterize the biochemical regulation of gap junction turnover. By electron microscopy, we characterized gap junctions formed between cardiomyocyte lateral membranes in failing canine ventricular myocardium. These gap junctions were varied in structure and appeared to be extensively internalizing. Internalized gap junctions were incorporated into multilamellar membrane structures, with features characteristic of autophagosomes. Intracellular Cx43 extensively colocalized with the autophagosome marker GFP-LC3 when both proteins were exogenously expressed in HeLa cells, and endogenous Cx43 colocalized with GFP-LC3 in neonatal rat ventricular myocytes. Furthermore, a distinct phosphorylated form of Cx43, as well as the autophagosome-targeted form of LC3 (microtubule-associated protein light chain 3) targeted to lipid rafts in cardiac tissue, and both were increased in heart failure. Our data demonstrate a previously unrecognized pathway of gap junction internalization and degradation in the heart and identify a cellular pathway with potential therapeutic implications.

  12. Influence of inward pressure of the transducer on lateral abdominal muscle thickness during ultrasound imaging.

    PubMed

    Ishida, Hiroshi; Watanabe, Sususmu

    2012-09-01

    Controlled laboratory study, technical note. The purpose of this study was to quantify changes in the thickness of the transversus abdominis, internal oblique, and external oblique muscles induced by different inward pressures of the transducer during ultrasound imaging (USI). USI of the lateral abdominal muscles is increasingly used in managing musculoskeletal dysfunction. However, to the best of our knowledge, no study has evaluated the influence of different inward pressures of the transducer on the lateral abdominal muscle thickness during USI. Thirty healthy male volunteers participated in this study. The thickness of the transversus abdominis, internal oblique, and external oblique muscles was measured with USI by the same rater in 4 conditions of inward pressures of 0.5, 1.0, 2.0, and 4.0 N. Intraclass correlation coefficients (ICC1,1), with 95% confidence intervals, were calculated, and a repeated-measures analysis of variance was used to assess the influence of inward pressure on the thickness of the lateral abdominal muscles. The thickness of the transversus abdominis, internal oblique, and external oblique muscles was significantly different among the 4 conditions (P<.038). The mean difference between the 0.5-N and 4.0-N conditions was greater than the minimal detectable change of the 0.5-N condition in the lateral abdominal muscles. The difference in magnitude produced by the forces under different conditions was meaningful. When using a technique that involves a handheld transducer, the examiner should attempt to maintain consistent inward pressure of the transducer during USI to quantify the thickness of lateral abdominal muscles. J Orthop Sports Phys Ther 2012;42(9):815-818, Epub 19 April 2012. doi:10.2519/jospt.2012.4064.

  13. Diamond heteroepitaxial lateral overgrowth

    DOE PAGES

    Tang, Y. -H.; Bi, B.; Golding, B.

    2015-02-24

    A method of diamond heteroepitaxial lateral overgrowth is demonstrated which utilizes a photolithographic metal mask to pattern a thin (001) epitaxial diamond surface. Significant structural improvement was found, with a threading dislocation density reduced by two orders of magnitude at the top surface of a thick overgrown diamond layer. In the initial stage of overgrowth, a reduction of diamond Raman linewidth in the overgrown area was also realized. Thermally-induced stress and internal stress were determined by Raman spectroscopy of adhering and delaminated diamond films. As a result, the internal stress is found to decrease as sample thickness increases.

  14. Internal lateral nasal osteotomy: double-guarded osteotome and mucosa tearing.

    PubMed

    Mottura, A Aldo

    2011-04-01

    For the internal lateral nasal osteotomy, a 4-mm double-guarded straight osteotome that separates the external periost and mucoperiosteum while the osteotomy is progressing is presented. Before the osteotomy, the external periost and the internal mucoperiosteum are infiltrated with local anesthesia and elevated by tunneling with an elevator. As the sharp part is behind the guards, it is not possible for the osteotome to slip away laterally or medially from the nasal bone. By tunneling just at the base of the nasal bones, arteries, veins, and lymphatics are preserved while the superior part of the external periosteum and the internal mucoperichondrium maintained the bones in a stable position with firm support to both sides. Forty consecutive rhinoplasties were studied with an endoscope. In 35 primary rhinoplasties the mucosa laceration rate was 1.5%, whereas in secondary rhinoplasties it was 80%. The approach to the piriform aperture was intranasal in the first 16 cases and intraoral in the last 24 cases. The intraoral mucosal elevation and osteotomy were easier to carry out than in the intranasal approach. In general, minor lower-lid edema and ecchymosis were observed, possibly related to the fact that the periosteum was elevated, thus preserving the supraperiosteal arteries, veins, and lymphatics. When the mucosa was elevated, the internal irrigation of the mucosa and the lymphatics was also preserved, thus avoiding intraoperative bleeding, intranasal packing, and postoperative bleeding.

  15. Kinematics and age of Early Tertiary trench parallel volcano-tectonic lineaments in southern Mexico: Tectonic implications

    NASA Astrophysics Data System (ADS)

    Martini, M.; Ferrari, L.; Lopez Martinez, M.; Cerca Martinez, M.; Serrano Duran, L.

    2007-05-01

    We present new geological, structural, and geochronological data that constrain the timing and geometry of Early Tertiary strike slip deformation in southwestern Mexico and its relation with the concurrent magmatic activity. Geologic mapping in Guerrero and Michoacan States documented two regional WNW trending volcano-tectonic lineaments sub parallel to the present trench. The southernmost lineament runs for ~140 km from San Miguel Totolapan area (NW Guerrero) to Sanchiqueo (SE Michoacan), and passes through Ciudad Altamirano. Its southeastern part is marked by the alignment of at least eleven silicic to intermediate major domes as well as by the course of the Balsas River. The northwestern part of the lineament is characterized by ductile left lateral shear zones in Early Tertiary plutonic rocks observed in the Rio Chiquito valley. Domes near Ciudad Altamirano are unaffected by ductile shearing and yielded a ~42 Ma 40Ar/39Ar age, setting a minimum age for this deformation. The northern volcano-tectonic lineament runs for ~190 km between the areas of Huitzuco in northern Guerrero and the southern part of the Tzitzio fold in eastern Michoacan. The Huautla, Tilzapotla, Taxco, La Goleta and Nanchititla silicic centers (all in the range 37-34 Ma) are emplaced along this lineament, which continues to the WNW trough a mafic dike swarm exposed north of Tiquicheo (37-35 Ma) and the Purungueo subvolcanic body (~42 Ma). These rocks, unaffected by ductile shearing, give a minimum age of deformation similar to the southern Totolapan-Sanquicheo lineament. Post ~42 Ma deformation is essentially brittle and is characterized by several left lateral and right lateral transcurrent faults with typical Riedel patterns. Other trench-parallel left lateral shear zones active in pre-Oligocene times were recently reported in western Oaxaca. The recognizing of Early Tertiary trench-parallel and left-lateral ductile shearing in internal areas of southern Mexico suggest a field of widely distributed flow and shear zones with relatively small individual displacement that might represent an immature stage of the developing North American-Caribbean plate boundary. The documented transition from ductile to brittle deformation and the localization of shearing and volcanism in the Late Eocene may be related to the focusing of inter-plate deformation in a discrete left lateral transcurrent North America-Caribbean boundary. The opening of the Cayman Through at ~49 Ma may have accelerated this process.

  16. Radiographic follow-up of 84 operatively treated scapula neck and body fractures.

    PubMed

    Cole, Peter A; Gauger, Erich M; Herrera, Diego A; Anavian, Jack; Tarkin, Ivan S

    2012-03-01

    Certain scapula fractures may warrant surgical management to restore shoulder anatomy and promote optimal function. The purpose of this study is to determine the early radiographic follow-up of open reduction internal fixation (ORIF) for displaced, scapular fractures involving the glenoid neck and body. Eighty-four patients with a scapula body or neck fracture (with or without articular involvement) underwent ORIF between 2002 and 2010 at a single level I trauma centre. This study represents a retrospective review of data prospectively collected into a dedicated scapula fracture database. All patients met at least one of the following operative criteria: ≥20 mm medial/lateral (M/L) displacement (lateral border offset), ≥45° of angular deformity on a scapular-Y X-ray, the combination of angulation ≥30° plus M/L displacement ≥15 mm, double disruptions of the superior shoulder suspensory complex both displaced ≥10 mm, glenopolar angle (GPA) ≤22° and open fractures. Eighty-eight percent (74/84) had sufficient follow-up defined as at least 6 months. Measured outcomes included rates of scapula union and malunion, as well as surgical complications and re-operations. All fractures were caused by high-energy trauma with 24 (29%) resulting from motor-vehicle collisions. Associated injuries occurred in 94% of patients, most commonly involving the chest (70%) and ipsilateral shoulder girdle (43%). Forty-eight patients had M/L displacement as an operative indication with a mean displacement of 25.7 mm (range=20-40). Thirty-eight (45%) had ≥2 operative indications. A single surgeon performed ORIF in all patients using a posterior approach. Five patients also required an anterior (deltopectoral) approach. The fixation strategy included lateral and vertebral border stabilisation with dynamic compression and reconstruction plates, respectively. Union was achieved in all cases. There were three cases of malunion based on a GPA difference >10° from the uninjured shoulder. Re-operations included removal of hardware (seven patients) and manipulation under anaesthesia (three patients). There were no infections or wound dehiscence. ORIF for displaced scapula fractures is a relatively safe and effective procedure for restoration of anatomy and promotion of union. Therapeutic study, level IV. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. 49 CFR 192.150 - Passage of internal inspection devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... devices; or (ii) If the design includes taps for lateral connections, the operator can demonstrate, based... circumstances to the use of a tap that will obstruct the passage of instrumented internal inspection devices...

  18. Neglected locked vertical patellar dislocation

    PubMed Central

    Gupta, Rakesh Kumar; Gupta, Vinay; Sangwan, Sukhbir Singh; Kamboj, Pradeep

    2012-01-01

    Patellar dislocations occurring about the vertical and horizontal axis are rare and irreducible. The neglected patellar dislocation is still rarer. We describe the clinical presentation and management of a case of neglected vertical patellar dislocation in a 6 year-old boy who sustained an external rotational strain with a laterally directed force to his knee. Initially the diagnosis was missed and 2 months later open reduction was done. The increased tension generated by the rotation of the lateral extensor retinaculum kept the patella locked in the lateral gutter even with the knee in full extension. Traumatic patellar dislocation with rotation around a vertical axis has been described earlier, but no such neglected case has been reported to the best of our knowledge. PMID:23162154

  19. Lateral epicondylitis of the elbow.

    PubMed

    Tosti, Rick; Jennings, John; Sewards, J Milo

    2013-04-01

    Lateral epicondylitis, or "tennis elbow," is a common musculotendinous degenerative disorder of the extensor origin at the lateral humeral epicondyle. Repetitive occupational or athletic activities involving wrist extension and supination are thought to be causative. The typical symptoms include lateral elbow pain, pain with wrist extension, and weakened grip strength. The diagnosis is made clinically through history and physical examination; however, a thorough understanding of the differential diagnosis is imperative to prevent unnecessary testing and therapies. Most patients improve with nonoperative measures, such as activity modification, physical therapy, and injections. A small percentage of patients will require surgical release of the extensor carpi radialis brevis tendon. Common methods of release may be performed via percutaneous, arthroscopic, or open approaches. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Review and Content Analysis of the "International Review of Research in Open and Distance/Distributed Learning" (2000-2015)

    ERIC Educational Resources Information Center

    Zawacki-Richter, Olaf; Alturki, Uthman; Aldraiweesh, Ahmed

    2017-01-01

    This paper presents a review of distance education literature published in the "International Review of Research in Open and Distance/Distributed Learning" (IRRODL) to describe the status thereof and to identify gaps and priority areas in distance education research based on a validated classification of research areas. All articles (N =…

  1. Cause and solution for false upstream boat velocities measured with a StreamPro acoustic doppler current profiler

    USGS Publications Warehouse

    Mueller, David S.; Rehmel, Mike S.; Wagner, Chad R.

    2007-01-01

    In 2003, Teledyne RD Instruments introduced the StreamPro acoustic Doppler current profiler which does not include an internal compass. During stationary moving-bed tests the StreamPro often tends to swim or kite from the end of the tether (the instrument rotates then moves laterally in the direction of the rotation). Because the StreamPro does not have an internal compass, it cannot account for the rotation. This rotation and lateral movement of the StreamPro on the end of the tether generates a false upstream velocity, which cannot be easily distinguished from a moving-bed bias velocity. A field test was completed to demonstrate that this rotation and lateral movement causes a false upstream boat velocity. The vector dot product of the boat velocity and the unit vector of the depth-averaged water velocity is shown to be an effective method to account for the effect of the rotation and lateral movement.

  2. 26 CFR 1.101-4 - Payment of life insurance proceeds at a date later than death.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Income § 1.101-4 Payment of life insurance proceeds at a date later than death. (a) In general. (1)(i... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Payment of life insurance proceeds at a date... (whether as an option or otherwise) to pay such beneficiary an amount or amounts at a date or dates later...

  3. Rate of displacement for Jakob Type 1 lateral condyle fractures treated with a cast.

    PubMed

    Zale, C; Winthrop, Z A; Hennrikus, W

    2018-04-01

    The aim of this retrospective study is to report the rate of displacement of Jakob Type 1 lateral condyle fractures that were initially treated in a cast. We performed a retrospective review of all patients that were treated for a non-displaced (Jakob Type 1 < 2 mm) lateral condyle fracture of the humerus at our institution between 2002 and 2015. A total of 59 patients were initially treated with casting. Five fractures displaced and were converted to a closed pinning treatment plan with a conversion rate of 8.5%. There was a mean of 13.2 days (4 to 21) between treatment by initial casting and closed pinning. This study demonstrates an 8.5% displacement and conversion rate from cast treatment to closed pinning for initially non-displaced Jakob Type 1 lateral condyle fractures of the humerus. The internal oblique radiograph is most accurate to determine displacement. We recommend obtaining an internal oblique view at initial evaluation and at follow-up in the cast for lateral condyle fractures. To minimize movement at the fracture site, we recommend treating Jakob Type 1 lateral condyle fractures with a long arm cast with the elbow at 90° and the forearm in the supine position with a sling-loop design. IV - retrospective therapeutic study.

  4. A model of mandibular movements during speech: normative pilot study for the Brazilian Portuguese language.

    PubMed

    Bianchini, Esther M G; de Andrade, Cláudia R F

    2006-07-01

    The precision of speech articulation is related to the possibility and freedom of the mandibular movements, modifying the spaces in order to allow the different articulatory positions of each sound. Electrognathography allows the objective delineation and registration of the mandibular movements, determining the level of opening, translations and velocity of these movements. Its use is a resource that can establish quantitative diagnostic parameters. The aim of this study was to verify the amplitude, velocity and characterization of the mandibular movements during speech using computerized electrognathography. Participants were 40 adults, male and female, with no temporomandibular disorders; with no missing teeth; with no dental occlusion alterations or dentofacial deformities; with no dental prostheses; and with no communication, neurological or cognitive deficits. The mandibular movements were observed during the sequential naming of pictures containing all the phonemes of the Brazilian Portuguese language. The registrations were obtained using electrognathography (BioENG-BioPak system), assessing the spatial position, course and velocity of the mandibular movements. The mean values of velocity were: 88.65 mm/sec during opening and 89.90mm/sec during closing. The mean values of amplitude were: sagittal opening: 12.77 mm, frontal opening: 11.21 mm, protrusion: 1.22 mm; retrusion 5.67 mm; translations to the right: 1.49 mm and to the left: 1.59 mm. The velocity of opening is directly related to that of closing. The amplitude of opening demonstrates a direct correlation with the velocity of opening and closing. All participants presented lateral translations during the course of the jaw. The assessment of speech in normal individuals is characterized by: discreet mandibular movements with an anteroposterior component and lateral translations. This study allowed for the delineation of a profile of the mandibular movements during speech in asymptomatic individuals.

  5. Replacing a Missing Tooth

    MedlinePlus

    ... usually shifted, so this must be corrected. A space is often opened up and maintained for later ... with an artificial tooth serves to maintain the space and improve speech and appearance until a definitive ...

  6. Image-Guided Internal Fixation of an Oblique Sagittal Split Fracture of C1 Lateral Mass with Motion Preservation: A Technical Report

    PubMed Central

    Malcolm, James G; Johnson, Andrew K

    2017-01-01

    A sagittal split fracture of the C1 lateral mass is an unstable subtype of C1 fractures and has a high propensity for developing late deformities and pain with nonoperative management. A primary internal fixation of this type of fracture has been recently described with good clinical outcomes and preservation of motion. We present a modified technique of primary internal fixation using an obliquely inserted C1 lag screw with imaging guidance. We successfully treated a 55-year-old woman with a unilateral C1 oblique sagittal split fracture who failed nonoperative management. Technical nuances are discussed with a review of pertinent literature. PMID:28948116

  7. Arthroscopic Lateral Ligament Repair Through Two Portals in Chronic Ankle Instability

    PubMed Central

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Patthauer, Luciano; Ocampo, Manuel

    2017-01-01

    Objectives: Injury to the lateral ligament complex of the ankle is one of the most common sports-related injury. Usually lateral ankle evolves with excellent clinical recovery with non surgical treatment, however, near about 30% develop a lateral chronic instability sequela. Several open and arthroscopic surgical techniques have been described to treat this medical condition. Material and Methods: Of the 22 patients who were treated; 18 males and 4 females, and aged from 17-42 years (mean 28 years). All patients presented a history of more than three ankle sprains in the last two years and presented positive anterior drawer and talar tilt test of the ankle in the physical examination. We perform an anterior arthroscopy of the ankle in order to treat asociated disease and then we performed “All inside¨ lateral ligament repair through two portals (anteromedial and anterolateral) using an anchor knotless suture. Results: Clinical outcome evaluations were performed at a mean follow up of 25 months. (R: 17-31). Overall results has been shown by means of the American Orthopaedic Foot and Ankle Society (AOFAS). Mean AOFAS scores improved from 63 points (range 52–77) preoperatively to 90 points (range 73–100) at final follow up. No recurrences of ankle instability were found in the cases presented. Conclusion: Several surgical procedures have been described during the last years in order to treat chronic ankle instability. ¨All inside¨ lateral ligament reconstruction presents lower local morbidity than open procedures with few complications. Moreover, it is a reproductible technique, with high clinical success rate, few complications and relatively quick return to sports activities. A high knowledge of the anatomic landmarks should be essential to avoid unwated injuries. PMID:29081860

  8. Arthroscopic Lateral Ligament Repair Through Two Portals in Chronic Ankle Instability.

    PubMed

    Batista, Jorge Pablo; Del Vecchio, Jorge Javier; Patthauer, Luciano; Ocampo, Manuel

    2017-01-01

    Injury to the lateral ligament complex of the ankle is one of the most common sports-related injury. Usually lateral ankle evolves with excellent clinical recovery with non surgical treatment, however, near about 30% develop a lateral chronic instability sequela. Several open and arthroscopic surgical techniques have been described to treat this medical condition. Of the 22 patients who were treated; 18 males and 4 females, and aged from 17-42 years (mean 28 years). All patients presented a history of more than three ankle sprains in the last two years and presented positive anterior drawer and talar tilt test of the ankle in the physical examination. We perform an anterior arthroscopy of the ankle in order to treat asociated disease and then we performed "All inside¨ lateral ligament repair through two portals (anteromedial and anterolateral) using an anchor knotless suture. Clinical outcome evaluations were performed at a mean follow up of 25 months. (R: 17-31). Overall results has been shown by means of the American Orthopaedic Foot and Ankle Society (AOFAS). Mean AOFAS scores improved from 63 points (range 52-77) preoperatively to 90 points (range 73-100) at final follow up. No recurrences of ankle instability were found in the cases presented. Several surgical procedures have been described during the last years in order to treat chronic ankle instability. ¨All inside¨ lateral ligament reconstruction presents lower local morbidity than open procedures with few complications. Moreover, it is a reproductible technique, with high clinical success rate, few complications and relatively quick return to sports activities. A high knowledge of the anatomic landmarks should be essential to avoid unwated injuries.

  9. Relations over Time among Children's Shyness, Emotionality, and Internalizing Problems

    PubMed Central

    Eggum, Natalie D.; Eisenberg, Nancy; Reiser, Mark; Spinrad, Tracy L.; Michalik, Nicole M.; Valiente, Carlos; Liew, Jeffrey; Sallquist, Julie

    2011-01-01

    Data regarding children's shyness and emotionality were collected at three time points, two years apart (T1: N = 214, M = 6.12 years; T2: N = 185, M = 7.67 years; T3: N = 185, M = 9.70 years), and internalizing data were collected at T1 and T3. Relations among parent-rated shyness, emotionality (parent- and teacher-rated anger, sadness, and positive emotional intensity [EI]), and mother-rated internalizing were examined in panel models. In some cases, shyness predicted emotionality two years later (teacher-rated anger, parent-rated sadness, teacher-rated positive EI) and emotionality sometimes predicted shyness two years later (teacher-rated sadness, parent-rated positive EI, teacher-rated positive EI). Parent-rated shyness and/or emotionality (parent-rated anger and parent-rated sadness) predicted internalizing at T3. Results shed light on developmental relations between emotionality and shyness, as well as processes of risk for, or protection against, the development of internalizing problems. PMID:22383862

  10. Role of an anatomically contoured plate and metal block for balanced stability between the implant and lateral hinge in open-wedge high-tibial osteotomy.

    PubMed

    Jang, Young Woong; Lim, DoHyung; Seo, Hansol; Lee, Myung Chul; Lee, O-Sung; Lee, Yong Seuk

    2018-07-01

    Open-wedge high tibial osteotomy (OWHTO) is a well-established surgical option for medial compartment osteoarthritis of the varus knee. The initial strength of the fixation plate is critical for successful correction maintenance and healing of the osteotomy site. This study was conducted to verify if a newly designed anatomical plate (LCfit) improves the stability of both the medial implant and lateral hinge area, as well as to evaluate how the metal block contributes to both medial and lateral stability. A finite element (FE) tibial model was combined with TomoFix plate, a LCfit plate with and without a metal block. Data analysis was conducted to evaluate the balanced stability, which refers to the enforced lateral stability resulting from redistribution of overall stress. We assessed the balanced stability of the medial implant and lateral hinge area in three cases using the same Sawbones and loads using the tibia FE model. The LCfit plate reduced stress by 23.1% at the lateral hinge compared to the TomoFix plate (TomoFix vs. LCfit: 34.2 ± 23.3 MPa vs. 26.3 ± 17.5 MPa). The LCfit plate with a metal block reduced stress by 40.1% at the medial plate (210.1 ± 64.2 MPa vs. 125.8 ± 65.7 MPa) and by 31.2% (26.3 ± 17.5 MPa vs. 18.1 ± 12.1 MPa) at the lateral hinge area compared to the reduction using the LCfit plate without a metal block. The newly designed fixation system for OWHTO balanced the overall stress distribution and reduced stress at the lateral hinge area compared to that using a conventional fixation system. The addition of the metal block showed additional benefits for balanced stability between the medial implant and lateral hinge area. However, this conclusion could only be drawn using the FE model in this study. Therefore, further clinical studies are necessary to reveal the clinical effect of reduced lateral stress on the occurrence of the lateral hinge fracture and the biologic effect of the metal block on the healing of the medial cortex.

  11. [Changing of the patient safety culture in the pilot institutes of the Hungarian accreditation program].

    PubMed

    Lám, Judit; Merész, Gergő; Bakacsi, Gyula; Belicza, Éva; Surján, Cecília; Takács, Erika

    2016-10-01

    The accreditation system for health care providers was developed in Hungary aiming to increase safety, efficiency, and efficacy of care and optimise its organisational operation. The aim of this study was to assess changes of organisational culture in pilot institutes of the accreditation program. 7 volunteer pilot institutes using an internationally validated questionnaire were included. The impact study was performed in 2 rounds: the first before the introduction of the accreditation program, and the second a year later, when the standards were already known. Data were analysed using descriptive statistics and logistic regression models. Statistically significant (p<0.05) positive changes were detected in hospitals in three dimensions: organisational learning - continuous improvement, communication openness, teamwork within the unit while in outpatient clinics: overall perceptions of patient safety, and patient safety within the unit. Organisational culture in the observed institutes needs improvement, but positive changes already point to a safer care. Orv. Hetil., 2016, 157(42), 1667-1673.

  12. Children's memories of removal: a test of attachment theory.

    PubMed

    Melinder, Annika; Baugerud, Gunn Astrid; Ovenstad, Kristianne Stigsdatter; Goodman, Gail S

    2013-02-01

    We report a study of parents' attachment orientations and children's autobiographical memory for an experience that according to Bowlby's (1982) attachment theory should be particularly threatening-children's forced separation from their parents. It was hypothesized that individual differences in parents' attachment orientations would be associated with children's distress and memory for this highly traumatic event. Children (n = 28) were observed during forced removal from home or school by Child Protective Services due to allegations of child maltreatment. Children's memory for the removal was tested 1 week later, and biological parents (n = 28) completed an adult attachment measure. Parental attachment anxiety significantly predicted children's distress during less stressful phases of the removal, R(2) = .25, and parents' attachment-related avoidance predicted fewer correct memory reports from the children (i.e., fewer hits to open-ended questions, R(2) = .16, and fewer hits to direct questions, R(2) = .27). The findings indicate that attachment theory provides important guidance for understanding children's autobiographical memory for traumatic events. Copyright © 2013 International Society for Traumatic Stress Studies.

  13. [Status and perspectives in modern neurology. Problems of organization of neurologic services worldwide and in Croatia].

    PubMed

    Barac, Bosko

    2002-05-01

    Modern neurology has completely changed in its concepts of science and medical discipline regarding the etiologies and the capabilities in the diagnostics, management, rehabilitation and prevention of neurological diseases. Advances in neurological sciences produced a rapid growth in the number of neurologists, new subspecialties and neurological institutions worldwide, opening questions on their possible application due to financial restrictions in many countries. Neurology in Croatia followed the modern tendencies in the world: in line with its humanistic tradition its orientation to the patient early appeared. From this experience developed a care on the optimal organization of neurological services, later on initiated in the Research Group on the Organization and Delivery of Neurological Services, founded in the World Federation of Neurology. The main activities and the Recommendations related to Neurology in Public Health are described, with the proposed levels of organization of neurological services, aiming at the optimal and rational neurological care. Problems of international collaboration on cost-effectiveness in neurology are accentuated.

  14. Large-Eddy Simulation of Internal Flow through Human Vocal Folds

    NASA Astrophysics Data System (ADS)

    Lasota, Martin; Šidlof, Petr

    2018-06-01

    The phonatory process occurs when air is expelled from the lungs through the glottis and the pressure drop causes flow-induced oscillations of the vocal folds. The flow fields created in phonation are highly unsteady and the coherent vortex structures are also generated. For accuracy it is essential to compute on humanlike computational domain and appropriate mathematical model. The work deals with numerical simulation of air flow within the space between plicae vocales and plicae vestibulares. In addition to the dynamic width of the rima glottidis, where the sound is generated, there are lateral ventriculus laryngis and sacculus laryngis included in the computational domain as well. The paper presents the results from OpenFOAM which are obtained with a large-eddy simulation using second-order finite volume discretization of incompressible Navier-Stokes equations. Large-eddy simulations with different subgrid scale models are executed on structured mesh. In these cases are used only the subgrid scale models which model turbulence via turbulent viscosity and Boussinesq approximation in subglottal and supraglottal area in larynx.

  15. Pediatric maxillofacial fractures.

    PubMed

    Spring, P M; Cote, D N

    1996-05-01

    Maxillofacial trauma in the pediatric population is a relatively infrequent occurrence. Studies have demonstrated consistently that 5% of all facial fractures occur in children. The low percentage of facial fractures in this age group has been attributed, in part, to the lack of full pneumatization of the sinuses until later in childhood. Review of the literature indicates that boys are more commonly affected than girls and that the majority of pediatric facial fractures occur in children between 6 and 12 years of age. Motor vehicle accidents, falls, and blunt trauma are responsible for the largest number of pediatric facial fractures. The most common site of facial fracture is the nose and dentoalveolan complex, followed by the mandible, orbit, and midface in most pediatric cohorts. Management of the mandible is often conservative owing to the high percentage of isolated condylar fractures in children. Open reduction and internal fixation of pediatric facial fractures is indicated in complex mandible, midface, and orbital fractures. The effect of rigid fixation on facial skeleton growth is not completely understood.

  16. [The Prince Léopold Institute for Tropical Medicine in Antwerp: an overview].

    PubMed

    Baetens, Roland

    2009-01-01

    The struggle against the sleeping sickness in Congo was the major reason for the opening of a School of Tropical Medicine (1906). The edition of new statutes in 1931 at the moment of the transfer to Antwerp conformed the autonomous and neutral character of the Institute. On the other hand, as the person responsible to the community represented by the Ministery of Colonies and--later--the Ministery of Education, she had to publish an annual report on their activities and finances.After the independence of the colony (1960) the teaching and research policy accentuated development aid, and in particular the fight against tropical disease (malaria, sleeping sickness, leishmaniasis...) and HIV (AIDS and Tuberculosis). The Institute delivers postgraduate and master's degrees. Each year, two hundred doctors and nurses attend its classes, and around a hundred students from over the world prepare for their medical degree. The Institute of Tropical Medicine in Antwerp is a'center of excellence' and an important component in an international network that aims for 'Health for all'.

  17. The significance of orbital anatomy and periocular wrinkling when performing laser skin resurfacing.

    PubMed

    Trelles, M A; Pardo, L; Benedetto, A V; García-Solana, L; Torrens, J

    2000-03-01

    Knowledge of orbital anatomy and the interaction of muscle contractions, gravitational forces and photoagingis fundamental in understanding the limitations of carbon dioxide (CO2) laser skin resurfacing when rejuvenating the skin of the periocular area. Laser resurfacing does not change the mimetic behavior of the facial muscles nor does it influence gravitational forces. When resurfacing periocular tissue, the creation of scleral show and ectropion are a potential consequence when there is an over zealous attempt at improving the sagging malar fat pad and eyelid laxity by performing an excess amount of laser passes at the lateral portion of the lower eyelid. This results in an inadvertent widening of the palpebral fissure due to the lateral pull of the Orbicularis oculi. Retrospectively, 85 patients were studied, who had undergone periorbital resurfacing with a CO2 laser using anew treatment approach. The Sharplan 40C CO2 Feather Touchlaser was programmed with a circular scanning pattern and used just for the shoulders of the wrinkles. A final laser pass was performed with the same program over the entire lower eyelid skin surface, excluding the outer lateral portion (e.g. a truncated triangle-like area),corresponding to the lateral canthus. Only a single laser pass was delivered to the lateral canthal triangle to avoid widening the lateral opening of the eyelid, which might lead to the potential complications of scleral show and ectropion. When the area of the crows' feet is to be treated, three passes on the skin of this entire lateral orbital surface are completed by moving laterally and upward toward the hairline. Patients examined on days 1, 7, 15, 30, 60, and one year after laser resurfacing showed good results. At two months after treatment, the clinical improvement was rated by the patient and physician as being "very good" in 81 of the 85 patients reviewed. These patients underwent laser resurfacing without complications. The proposed technique of periocular resurfacing prevents complications of scleral show and laxity in the lateral eyelid opening and even ectropion, because treatment conforms to the osseo-muscular anatomical relationship of eyelid structures.

  18. Tsunami Data and Scientific Data Diplomacy

    NASA Astrophysics Data System (ADS)

    Arcos, N. P.; Dunbar, P. K.; Gusiakov, V. K.; Kong, L. S. L.; Aliaga, B.; Yamamoto, M.; Stroker, K. J.

    2016-12-01

    Free and open access to data and information fosters scientific progress and can build bridges between nations even when political relationships are strained. Data and information held by one stakeholder may be vital for promoting research of another. As an emerging field of inquiry, data diplomacy explores how data-sharing helps create and support positive relationships between countries to enable the use of data for societal and humanitarian benefit. Tsunami has arguably been the only natural hazard that has been addressed so effectively at an international scale and illustrates the success of scientific data diplomacy. Tsunami mitigation requires international scientific cooperation in both tsunami science and technology development. This requires not only international agreements, but working-level relationships between scientists from countries that may have different political and economic policies. For example, following the Pacific wide tsunami of 1960 that killed two thousand people in Chile and then, up to a day later, hundreds in Hawaii, Japan, and the Philippines; delegates from twelve countries met to discuss and draft the requirements for an international tsunami warning system. The Pacific Tsunami Warning System led to the development of local, regional, and global tsunami databases and catalogs. For example, scientists at NOAA/NCEI and the Tsunami Laboratory/Russian Academy of Sciences have collaborated on their tsunami catalogs that are now routinely accessed by scientists and the public around the world. These data support decision-making during tsunami events, are used in developing inundation and evacuation maps, and hazard assessments. This presentation will include additional examples of agreements for data-sharing between countries, as well as challenges in standardization and consistency among the tsunami research community. Tsunami data and scientific data diplomacy have ultimately improved understanding of tsunami and associated impacts.

  19. Children's externalizing and internalizing symptoms over time: the role of individual differences in patterns of RSA responding.

    PubMed

    Hinnant, James Benjamin; El-Sheikh, Mona

    2009-11-01

    We examined associations between basal respiratory sinus arrhythmia (RSA) in conjunction with RSA regulation with the hypothesis that their interaction would explain unique variability in children's prospective adjustment 2 years later. Participants were 176 children (98 girls; 78 boys) in middle childhood. RSA regulation was assessed through social and problem-solving challenges. Parents reported on children's internalizing and externalizing symptoms. Interactions between RSA baseline and regulation to the social stressor predicted children's later internalizing symptoms. Interactions between RSA baseline and responding to the problem-solving stressor predicted children's externalizing symptoms. The highest levels of internalizing symptoms were predicted for children with both lower basal RSA and higher RSA suppression. The highest levels of externalizing symptoms were predicted for children who demonstrated lower basal RSA in conjunction with RSA augmentation. Findings highlight the importance of the contemporaneous consideration of basal RSA and RSA regulation in the prediction of developmental psychopathology symptomology.

  20. An L-Shaped Incision for an Extensive Thoracic Aortic Aneurysm and Coronary Artery Bypass Using the Left Internal Thoracic Artery.

    PubMed

    Abe, Tomonobu; Suenaga, Hiroto; Oshima, Hideki; Araki, Yoshimori; Mutsuga, Masato; Fujimoto, Kazuro; Usui, Akihiko

    2015-04-01

    An L-shaped incision combining an upper half mid-sternotomy and a left antero-lateral thoracotomy at the fourth intercostal space has been proposed by several authors for extensive aneurysms involving the aortic arch and the proximal thoracic descending aorta. This approach usually requires the division of the left internal thoracic artery at its mid position, thus making it unusable for coronary artery bypass. We herein report a modified surgical approach for simultaneous extensive arch and proximal thoracic descending aorta replacement and coronary artery bypass using the left internal thoracic artery combining a left antero-lateral thoracotomy at the sixth intercostal space and upper mid-sternotomy. The visualization of the whole diseased aorta down to the level below the hilum of the left lung was good, and the integrity of the left internal thoracic artery graft was preserved by early heparin administration before sternotomy.

  1. Arms control is everyone`s business: The United States and the United Nations at the mid-point of the 1990`s

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

    Lehman, R.F. II

    1993-03-01

    This presentation encourages current efforts in arms control, non- proliferation, and peacekeeping. Verification is heralded as a confidence building method to bring about more openness in international relations. It is purported that openness has already enhanced democratic forces around the world. The insistence on strict compliance with the decisions of the United Nations Security Council is a show of support for international law. It is recommended that international norms on human rights, non-proliferation, and non-aggression be strengthened.

  2. Associations between Mothers' Sensitivity to Their Infants' Internal States and Children's Later Understanding of Mind and Emotion

    ERIC Educational Resources Information Center

    Ereky-Stevens, Katharina

    2008-01-01

    This study investigated associations between mother-infant interactions and children's subsequent understanding of mind and emotion. Mothers' tendency to comment on their infants' internal world and their general sensitivity to their infants' internal states were measured through coded play interactions at 10 months. The latter measurement…

  3. The Relationships among Internalizing Symptomatology in Kindergarten and Later Self-Concept and Competence

    ERIC Educational Resources Information Center

    Denny, Michelle Setser

    2010-01-01

    This study used a longitudinal sample of 9,160 children participating in the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) to: (a) describe characteristics of children who present with elevated internalizing symptomatology, (b) investigate stability of elevated internalizing status across early and middle childhood, and (c)…

  4. A survey of international legal instruments to examine their effectiveness in improving global health and in realizing health rights.

    PubMed

    Wilson, Arthur; Daar, Abdallah S

    2013-01-01

    Many global health issues, almost by definition, do not recognize state borders and therefore require bi-lateral, or more often multi-lateral international solutions. These latter solutions are articulated in international instruments (declarations, conventions, treaties, constitutions of international bodies, etc). However, the gap between formal adoption of such instruments by signatory states and substantive implementation of the articulated solutions can be very wide. This paper surveys a selection of international legal instruments, including those where the sought after positive outcomes have been achieved, and those that have been ineffective, with little or no real progress being made. The paper looks for commonalities, both in the nature of the problems and the forms of the international legal instruments, to seek answers as to why some instruments ultimately succeeded where others failed. It also provides some guidance to law/ treaty makers to help ensure that they frame future instruments in such a way as to maximize the probability that those instruments will have a substantive positive impact on global health and health rights. © 2013 American Society of Law, Medicine & Ethics, Inc.

  5. Field measurements of diaphragm and top lateral members of three trapezoidal composite box girder bridges.

    DOT National Transportation Integrated Search

    2002-12-01

    The results of field tests on three trapezoidal box girder bridges are presented. The study concentrated on the : measurement of the strains in the external and internal diaphragms and the top laterals of the boxes. The strains were : collected when ...

  6. 16. View of passage (formerly Spicket Street; later, railroad rightofway) ...

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

    16. View of passage (formerly Spicket Street; later, railroad right-of-way) between Paper Machine Building (on left) and Wilder Mill (on right), from Canal Street; view to north. - Champion-International Paper Company, West bank of Spicket River at Canal Street, Lawrence, Essex County, MA

  7. The Cost-Effectiveness of Surgical Fixation of Distal Radial Fractures: A Computer Model-Based Evaluation of Three Operative Modalities.

    PubMed

    Rajan, Prashant V; Qudsi, Rameez A; Dyer, George S M; Losina, Elena

    2018-02-07

    There is no consensus on the optimal fixation method for patients who require a surgical procedure for distal radial fractures. We used cost-effectiveness analyses to determine which of 3 modalities offers the best value: closed reduction and percutaneous pinning, open reduction and internal fixation, or external fixation. We developed a Markov model that projected short-term and long-term health benefits and costs in patients undergoing a surgical procedure for a distal radial fracture. Simulations began at the patient age of 50 years and were run over the patient's lifetime. The analysis was conducted from health-care payer and societal perspectives. We estimated transition probabilities and quality-of-life values from the literature and determined costs from Medicare reimbursement schedules in 2016 U.S. dollars. Suboptimal postoperative outcomes were determined by rates of reduction loss (4% for closed reduction and percutaneous pinning, 1% for open reduction and internal fixation, and 11% for external fixation) and rates of orthopaedic complications. Procedural costs were $7,638 for closed reduction and percutaneous pinning, $10,170 for open reduction and internal fixation, and $9,886 for external fixation. Outputs were total costs and quality-adjusted life-years (QALYs), discounted at 3% per year. We considered willingness-to-pay thresholds of $50,000 and $100,000. We conducted deterministic and probabilistic sensitivity analyses to evaluate the impact of data uncertainty. From the health-care payer perspective, closed reduction and percutaneous pinning dominated (i.e., produced greater QALYs at lower costs than) open reduction and internal fixation and dominated external fixation. From the societal perspective, the incremental cost-effectiveness ratio for closed reduction and percutaneous pinning compared with open reduction and internal fixation was $21,058 per QALY and external fixation was dominated. In probabilistic sensitivity analysis, open reduction and internal fixation was cost-effective roughly 50% of the time compared with roughly 45% for closed reduction and percutaneous pinning. When considering data uncertainty, there is only a 5% to 10% difference in the frequency of probability combinations that find open reduction and internal fixation to be more cost-effective. The current degree of uncertainty in the data produces difficulty in distinguishing either strategy as being more cost-effective overall and thus it may be left to surgeon and patient shared decision-making. Economic Level III. See Instructions for Authors for a complete description of levels of evidence.

  8. Ultrasound-guided tendon fenestration versus open-release surgery for the treatment of chronic lateral epicondylosis of the elbow: protocol for a prospective, randomised, single blinded study.

    PubMed

    Lungu, Eugen; Grondin, Philippe; Tétreault, Patrice; Desmeules, François; Cloutier, Guy; Choinière, Manon; Bureau, Nathalie J

    2018-06-09

    Chronic lateral epicondylosis (CLE) of the elbow is a prevalent condition among middle-aged people with no consensus on optimal care management but for which surgery is generally accepted as a second intention treatment. Among conservative treatment options, ultrasound (US)-guided fenestration has shown encouraging results that should be explored before surgery is considered. The primary objective of this study is to compare the efficacy of US-guided fenestration with open-release surgery in patients with failure to improve following a minimum 6 months of conservative treatment. This study protocol entails a two-arm, single-blinded, randomised, controlled design. Sixty-four eligible patients with clinically confirmed CLE will be assigned to either US-guided fenestration or open-release surgery. Fisher's exact test will be used to compare the proportion of patients reporting a change of 11/100 points or more in the Patient Rated Tennis Elbow Evaluation score at 6 months, according to an intention-to-treat analysis. Secondary analyses will compare the two treatment groups in terms of pain and disability, functional limitations at work, pain-free grip strength, medication burden, patients' global impression of change and level of satisfaction at 6 weeks, 3, 6 and 12 months, using mixed linear models for repeated measures or Fisher's exact test, as appropriate. Finally, recursive partitioning analyses will investigate US and elastography parameters as predictors of treatment success at 6 and 12 months. This data will contribute to evidence-based treatment guidelines for CLE and explore the value of imaging biomarkers to improve risk stratification plans and assist clinicians. The study has been approved by the Research Ethics Board of our institution on 23 March 2016 (REB 15.327). In case of important protocol modifications, a new version of the protocol with appropriate amendments will be submitted to the REB for approval. Study results will be published in peer-reviewed journals and presented at local, national and international conferences. NCT02710682. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. [Case-control study on minimally invasive percutaneous locking compression plate internal fixation for the treatment of type II and III pilon fractures].

    PubMed

    Zhang, Zhi-Da; Ye, Xiu-Yi; Shang, Li-Yong; Xu, Rong-Ming; Zhu, Yan-Zhao

    2011-12-01

    To explore the clinical efficacy of delayed open reduction and internal fixation with minimally invasive percutaneous locking compression plate for the treatment of type II and III Pilon fractures. From January 2007 to September 2009, 32 patients with type II and III Pilon fractures were treated with open reduction and anatomic plate fixation (AP group) and minimally invasive percutaneous locking compression plate osteosynthesis (LCP group). There were 11 males and 6 females in AP group, with an average age of (37.4 +/- 13.3) years (ranged, 19 to 55 years). And there were 10 males and 5 females in LCP group, with an average age of (34.6 +/- 11.3) years(ranged, 21 to 56 years). The operating time, fracture healing time, aligned angulation and ankle function were compared between the two groups. All the patients were followed up, and the during ranged from 12 to 25 months, with a mean of (15.0 +/- 1.7) months. The average operation time was (76.5 +/- 8.3) min for AP group and (58.3 +/- 3.4) min for LCP group; the average time of fracture healing was (20.5 +/- 0.4) weeks for AP group and (15.7 +/- 0.2) weeks for LCP group; the total angulation between anterior posterior film and lateral film was averaged (6.6 +/- 0.5) degrees for AP group and (3.6 +/- 0.2) degrees for LCP group. As to above index, the results of LCP group were better than those of AP group (P < 0.05). According to Kofoed criteria for ankle joint, the results of LCP group were better than those of AP group in ankle joint pain, wakling and ankle joint function (P < 0.05). The method of minimally invasive percutaneous locking compression plate internal fixation is effective in the treatment of Pilon fracture with less invasion, faster bone union, more stabilized fixation, quicker recovery of ankle function and fewer complications, which is more advantaged for type II and III Pilon fractures.

  10. Revisiting an open access monograph experiment: measuring citations and tweets 5 years later.

    PubMed

    Snijder, Ronald

    An experiment run in 2009 could not assess whether making monographs available in open access enhanced scholarly impact. This paper revisits the experiment, drawing on additional citation data and tweets. It attempts to answer the following research question: does open access have a positive influence on the number of citations and tweets a monograph receives, taking into account the influence of scholarly field and language? The correlation between monograph citations and tweets is also investigated. The number of citations and tweets measured in 2014 reveal a slight open access advantage, but the influence of language or subject should also be taken into account. However, Twitter usage and citation behaviour hardly overlap.

  11. Influence of a Full-Body Compression Suit on Trunk Positioning and Knee Joint Mechanics During Lateral Movements.

    PubMed

    Mornieux, Guillaume; Weltin, Elmar; Pauls, Monika; Rott, Franz; Gollhofer, Albert

    2017-08-01

    Trunk positioning has been shown to be associated with knee joint loading during athletic tasks, especially changes of direction. The purpose of the present study was to test whether a full-body compression suit (FBCS) would improve trunk positioning and knee joint control during lateral movements. Twelve female athletes performed lateral reactive jumps (LRJ) and unanticipated cuttings with and without the customized FBCS, while 3D kinematics and kinetics were measured. FBCS did not influence trunk positioning during LRJ and led to increased trunk lateral lean during cuttings (P < .001). However, while wearing FBCS, knee joint abduction and internal rotation angles were reduced during LRJ (P < .001 and P = .013, respectively), whereas knee joint moments were comparable during cuttings. FBCS cannot support the trunk segment during unanticipated dynamic movements. But, increased trunk lateral lean during cutting maneuvers was not high enough to elicit increased knee joint moments. On the contrary, knee joint abduction and internal rotation were reduced during LRJ, speaking for a better knee joint alignment with FBCS. Athletes seeking to improve trunk positioning may not benefit from a FBCS.

  12. KSC-00pp1083

    NASA Image and Video Library

    2000-08-06

    An international gathering of police officers march in a parade at the KSC Visitor Complex during opening ceremonies of the 2000 International Law Enforcement Games. More than 1,850 participants and their families took part in the opening, held in the Rocket Garden. The ceremony includes parades, torch lighting and a tug of war. The games feature officers from 15 countries and 37 United States in competitions around Brevard County, Fla

  13. KSC00pp1083

    NASA Image and Video Library

    2000-08-06

    An international gathering of police officers march in a parade at the KSC Visitor Complex during opening ceremonies of the 2000 International Law Enforcement Games. More than 1,850 participants and their families took part in the opening, held in the Rocket Garden. The ceremony includes parades, torch lighting and a tug of war. The games feature officers from 15 countries and 37 United States in competitions around Brevard County, Fla

  14. Evaluation of Bite Force After Open Reduction and Internal Fixation Using Microplates

    PubMed Central

    Kumar, S Tharani; Saraf, Saurabh; Devi, S Prasanna

    2013-01-01

    The primary aim of this study is to determine maximum bite force in molar and incisor regions of healthy individuals, to evaluate the bite force after open reduction and internal fixation of mandibular fractures using micro plates, for a period of up to 6 weeks and to determine the rate of recovery of maximum bite force in an Indian population. PMID:24910656

  15. Challenges Faced by African International Students at a Metropolitan Research University: A Phenomenological Case Study

    ERIC Educational Resources Information Center

    Evivie, Loretta Gbemudu

    2009-01-01

    The number of international students coming to the United States has increased from 48,486 in 1959-1960 to 623,805 in the 2007-2008 academic years (Open Doors, 2008). These students contributed $15.5 billion to the United States economy, making education the nation's fifth largest service export (Open Doors, 2008). The literature has focused on…

  16. Meteoroid capture cell construction

    NASA Technical Reports Server (NTRS)

    Zook, H. A.; High, R. W. (Inventor)

    1976-01-01

    A thin membrane covering the open side of a meteoroid capture cell causes an impacting meteoroid to disintegrate as it penetrates the membrane. The capture cell then contains and holds the meteoroid particles for later analysis.

  17. Comparison of optical coherence tomography findings and visual field changes in patients with primary open-angle glaucoma and amyotrophic lateral sclerosis.

    PubMed

    Liu, Ziyuan; Wang, Hongli; Fan, Dongsheng; Wang, Wei

    2018-02-01

    Recent studies revealing genetic connection of primary open angle glaucoma (POAG) and amyotrophic lateral sclerosis (ALS) have received particular attention. Exploring the evidence for common pathogenesis of these two progressive neurological disorders may assist in understanding the mechanism and searching for new treatment. Retinal nerve fiber layer (RNFL) defect and corresponding visual field (VF) impairment are well known neuropathy signs in glaucoma. In our study, thickness of certain retinal layer in ALS patients was analyzed to detect ganglion cell's soma and axon, and for first time visual field was examined for ALS. The correlation of retinal involvement and ALS progression were also investigated. The results were compared with those of POAG. The study may provide new knowledge for these two neurodegenerative diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Percutaneous ablation of malignant liver tumor in rabbits using low radio frequency energy.

    PubMed

    Nativ, O; Moskovitz, B; Sabo, E; Shalhav, A; Kaftori, J; Barbara, Y; Mordohovich, D; Goldwasser, B

    1996-09-01

    Radio frequency (RF) current has been used successfully to ablate normal human tissue. To further investigate the clinical application of this modality in tumors we studied the potential of using RF percutaneously to destroy experimental liver tumors. Thirty five outbred albino rabbits underwent liver VX2 tumor direct-implantation during open surgery. After 21 days ultrasonography was performed revealing tumor presence and size. A shielded RF needle was designed so that it could be inserted percutaneously through an introducing needle, and an electrical insulation shield covering the RF needle could be retracted to control the length of the exposed RF needle inside the tissue. Twenty two days after tumor implantation RF was applied via the aforementioned needle using a ZoMed International RF generator. In one group of rabbits the procedure was performed under direct vision during open surgery and on the other group treatment was applied percutaneously, guiding the needle by tumor palpation. Rabbits were killed 3 days later and pathology revealed 4 to 25 mm intratumoral RF induced lesions. A direct relation was found between lesion size, power and duration of RF application (At 7.5 W, r = 0.48, p = 0.032). Based on our preliminary results we may conclude that RF may have clinical application in the near future for percutaneous local tumor control in parenchymal organs.

  19. Floating Classroom Outreach as an Introduction to Ocean Studies

    NASA Astrophysics Data System (ADS)

    McFadden, M.

    2016-02-01

    Many children and young adults living within only one hour of the coast never have the opportunity to explore a beach or go out on a boat because of financial challenges or lack of transportation.These types of experiences are the spark that helped many ocean scientists become fascinated with the ocean and later pursue a career related to the ocean. This presentation will discuss a variety of outreach projects and the efficacy of each. Projects vary in age, complexity and cost. These projects include a Beach Clean-Up open to students and their families at a community college organized by a campus volunteer group with a focus on social issues, a Marine Biology and Physical Oceanography class joint floating classroom trip open to college students to introduce non-STEM students to marine science in an exciting setting, and an education outreach trip for 8-12 years old children from the Boys and Girls Club in Newport, RI in collaboration with The International SeaKeepers Society, a non-profit that facilitates ocean research and education by working closely with the yachting community. Emphasis on environmental education in the U.S. has grown considerably over recent years, and the development of unique and innovative approaches to hands-on marine science education are needed to excite students to explore the marine environment and care about environmental stewardship.

  20. Design of lateral heterostructure from arsenene and antimonene

    NASA Astrophysics Data System (ADS)

    Sun, Qilong; Dai, Ying; Ma, Yandong; Yin, Na; Wei, Wei; Yu, Lin; Huang, Baibiao

    2016-09-01

    Lateral heterostructures fabricated by two-dimensional building blocks have opened up exciting realms in material science and device physics. Identifying suitable materials for creating such heterostructures is urgently needed for the next-generation devices. Here, we demonstrate a novel type of seamless lateral heterostructures with excellent stabilities formed within pristine arsenene and antimonene. We find that these heterostructures could possess direct and reduced energy gaps without any modulations. Moreover, the highly coveted type-II alignment and the high carrier mobility are also identified, marking the enhanced quantum efficiency. The tensile strain can result in efficient bandgap engineering. Besides, the proposed critical condition for favored direct energy gaps would have a guiding significance on the subsequent works. Generally, our predictions not only introduce new vitality into lateral heterostructures, enriching available candidate materials in this field, but also highlight the potential of these lateral heterostructures as appealing materials for future devices.

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