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Sample records for quadruple cruciate sign

  1. Knee stability after arthroscopic anterior cruciate ligament reconstruction using the middle third of the patellar ligament and quadrupled hamstring tendons grafts - A two-year follow-up.

    PubMed

    Zoran, Zelić; Ivan, Vidakovic; Egon, Biuk; Dubravka, Biuk; Vjekoslav, Wertheimer; Vjekoslav, Kolarević

    2015-11-01

    Knee stability after surgical anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendons graft (gracilis and semitendinosus) was compared with that using the middle third of the patellar ligament. All subjects participating in this study had ACL rupture diagnosed by clinical examination and MRI and underwent identical surgical procedure apart from the choice of graft. A total of 112 patients with either patellar ligament or quadrupled hamstring tendons graft were evaluated for 24 months following surgery. Patients were similar in terms of age, sex, activity level, knee instability level and rehabilitation programme. Clinical tests and a measuring instrument, the KT-1000 arthrometer, were used to evaluate knee stability after reconstruction. During the 24-month study there were no significant differences in clinical stability of the knee and the use of both grafts resulted in satisfactory knee stability. The difference between the groups according to the graft was noticed 6 months after reconstruction when the results obtained by a measuring instrument showed that knee stability was significantly higher with the patellar ligament graft (Fisher's exact test, p=0.022). Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Two Helpful MRI Signs for Evaluation of Posterolateral Bundle Tears of the Anterior Cruciate Ligament

    PubMed Central

    Volokhina, Yulia V.; Syed, Hasan M.; Pham, Peter H.; Blackburn, Allie K.

    2015-01-01

    Background: Diagnosis of partial anterior cruciate ligament (ACL) tears is difficult on magnetic resonance imaging (MRI), particularly the isolated tears of the posterolateral bundle. Purpose: To describe 2 MRI signs of partial ACL tear involving the posterolateral bundle on conventional knee MRI sequences, specifically, the “gap” and “footprint” signs. Study Design: Case-control study. Methods: We retrospectively reviewed the MRI appearance of the ACL in 11 patients with arthroscopically proven partial ACL tears isolated to the posterolateral bundle, as well as in 10 patients with arthroscopically proven intact ACLs, and evaluated for the presence of gap and/or footprint signs. Results: There was high degree of sensitivity and specificity associated with the MRI findings of “gap” and “footprint” signs with arthroscopically proven isolated posterolateral bundle tears. Conclusion: Gap and footprint signs are suggestive of posterolateral bundle tear of the ACL, and the presence of 1 or both of these imaging findings should alert the radiologist to the possibility of a posterolateral bundle tear. PMID:26535387

  3. A Simple Radiographic Sign of Vertical Anterior Cruciate Ligament Tunnel Placement.

    PubMed

    Farrow, Lutul Dashaun; Morris, Parisa M; Huston, Kellen L; Hall, Evan Tyler; Kaar, Scott

    2015-10-01

    The purpose of this study is to describe a novel radiographic sign indicative of vertical tunnel placement following anterior cruciate ligament (ACL) reconstruction. We reviewed 190 consecutive ACL reconstructions. Operative records, patient charts, arthroscopic images, and preoperative and postoperative orthogonal plain radiographic images were reviewed. We made special note of the operative technique. Note was made of tunnel position and whether the posterior (proximal) aspect of Blumensaat line was violated on standard lateral knee radiographic images. Of 190 patients, 17 patients did not have postoperative imaging and were excluded. Of the 173 remaining knees, 163 were primary ACL reconstructions and 10 were revision ACL reconstructions. We found that no anatomically placed ACL femoral tunnel violated Blumensaat line. In all revision cases exhibiting violation of Blumensaat line, a new femoral tunnel was able to be drilled while completely avoiding the previously placed, nonanatomic ACL femoral tunnel. The principal findings of our study demonstrate that violation of Blumensaat line following ACL reconstruction is an indicator of vertical, nonanatomic femoral tunnel placement. Furthermore, presence of this radiographic sign indicates that an anatomically placed femoral tunnel may be drilled while completely avoiding the existing femoral tunnel during cases of revision ACL reconstruction.

  4. Quadruple screen test

    MedlinePlus

    ... quadruple; Unconjugated estriol - quadruple; uE3 - quadruple; Pregnancy - quadruple; Birth defect - quadruple ... determine the chance of your baby having a birth defect, the test also factors in: Your age ...

  5. The arthroscopical and radiological corelation of lever sign test for the diagnosis of anterior cruciate ligament rupture.

    PubMed

    Deveci, Alper; Cankaya, Deniz; Yilmaz, Serdar; Özdemir, Güzelali; Arslantaş, Emrah; Bozkurt, Murat

    2015-01-01

    The aim of the current study was to evaluate the sensitivity of the lever sign test and the widely used basic tests of the Lachman, anterior drawer and pivot shift tests, both under anaesthesia and without anaesthesia, according to the gold standard diagnostic arthroscopic results in patients undergoing anterior cruciate ligament reconstruction. The study included 117 patients, diagnosed with ACL tear which was definitively determined during an arthroscopic surgical procedure applied. Before anaesthesia and while under anaesthesia, the Lachman, anterior drawer, pivot shift and lever sign tests were applied to all patients. Evaluation was made of MR images for each patient and documented. The patients comprised 96 males and 21 females, witha mean age of 25.8 ± 5.9 years (range, 17-45 years). Total tear was determined in 82 cases, anteromedial (AM) bundle in 14, posterolateral (PL) bundle in 13 and elongation in 8. Pre-anaesthesia positivity was found in lever sign at 94.2 %, Lachman at 80.5 %, pivot shift at 62.3 % and anterior drawer at 60.1 %. These rates were determined after anaesthesia as lever sign 98.4 %, Lachman 88.7 %, pivot shift 88.3 % and anterior drawer 84.2 %. The lever sign test can be easily applied clinically and it seems to have higher sensitivity than the Lachman test which is the basis of classic information, it should be included in routine clinical practice. In the light of the results of this study, further studies are required to review the accepted view that the Lachmann test is the most reliable test.

  6. The "Lever Sign": a new clinical test for the diagnosis of anterior cruciate ligament rupture.

    PubMed

    Lelli, Alessandro; Di Turi, Rita Paola; Spenciner, David B; Dòmini, Marcello

    2016-09-01

    A new clinical test for the diagnosis of ACL rupture is described: the so-called "Lever Sign". This prospective study on four groups of patients divided subjects on the basis of MRI findings (complete or partial ACL lesion) and the clinical phase of the injury (acute or chronic). The hypothesis was that this manual test would be diagnostic for both partial and complete tears of the ACL regardless of the elapsed time from injury. A total of 400 patients were evaluated and divided into four, equal-sized groups based on time elapsed from injury and MRI findings: Group A (acute phase with positive MRI for complete ACL rupture), Group B (chronic phase with positive MRI for complete ACL rupture), Group C (acute phase with positive MRI for partial ACL rupture), and Group D (chronic phase with positive MRI for partial ACL rupture). Clinical assessment was performed with the Lachman test, the Anterior Drawer test, the Pivot Shift test, and the Lever Sign test. The Lever Sign test involves placing a fulcrum under the supine patient's calf and applying a downward force to the quadriceps. Depending on whether the ACL is intact or not, the patient's heel will either rise off of the examination table or remain down. Additionally, the Lever Sign test was performed on the un-injured leg of all 400 patients as a control. All tests were nearly 100 % sensitive for patients with chronic, complete tears of the ACL. However, for patients with acute, partial tears, the sensitivity was much lower for the Lachman test (0.42), Anterior Drawer test (0.29), and Pivot Shift test (0.11), but not the Lever Sign test (1.00). In general, chronic, complete tears were most successfully diagnosed but acute, partial tears were least successfully diagnosed. The Lever Sign test is more sensitive to correctly diagnosing both acute and partial tears of the ACL compared with other common manual tests. The clinical relevance is that some ACL ruptures may be more accurately diagnosed.

  7. Lack of stability at more than 12 months of follow-up after anterior cruciate ligament reconstruction using all-inside quadruple-stranded semitendinosus graft with adjustable cortical button fixation in both femoral and tibial sides.

    PubMed

    Bressy, G; Brun, V; Ferrier, A; Dujardin, D; Oubaya, N; Morel, N; Fontanin, N; Ohl, X

    2016-11-01

    The use of the semitendinosus tendon alone for anterior cruciate ligament reconstruction keeps the gracilis muscle intact and decreases anterior pain in comparison with the use of the patellar tendon. Recently, Lubowitz described a new all-inside technique with an ST4 tendon fixed with a cortical button in both femoral and tibial sides. We hypothesized that this type of graft with cortical button fixation provides well-controlled residual anterior tibial translation (<3mm). The aim of this study was to assess the results obtained with this technique in terms of laxity and IKDC score at more than 1 year of follow-up. We performed a prospective single-center study to evaluate the results with this procedure with at least 1 year of follow-up. The primary endpoint was the objective IKDC score and side-to-side anterior tibial translation difference. The secondary endpoint was the subjective assessment using the subjective IKDC and Lysholm scores. Tunnel positioning was assessed using the Aglietti criteria. Thirty-five patients were included and reviewed with a mean follow-up of 19.7 months. Sixty-three percent of the patients were male and the mean age at the procedure was 28 years. The IKDC score was A or B in 43% of the patients and C or D in 57%; 54% of the patients had a residual side-to-side anterior tibial translation difference less than 3mm and 29% presented significant pivot shift (grade C or D). Five patients underwent revision surgery, including one for rupture of the ACL reconstruction. The meniscal status did not influence postoperative laxity and the IKDC grade. Our hypothesis was not verified and the postoperative stability of the knee was insufficient. Postoperative side-to-side anterior tibial translation difference remained greater than 3mm for 16 patients and the analysis seems to indicate that the distal cortical fixation of the graft with an adjusted loop is insufficient. Prospective study - Level IV. Copyright © 2016 Elsevier Masson SAS. All

  8. Analysis of biomechanical properties of patellar ligament graft and quadruple hamstring tendon graft.

    PubMed

    Biuk, Egon; Zelić, Zoran; Rapan, Saša; Ćurić, Goran; Biuk, Dubravka; Radić, Radivoje

    2015-11-01

    Two types of transplant are commonly used in the surgical management of anterior cruciate ligament lesions: the central part of the patellar ligament and quadruple tendons of the gracilis muscle and semitendinosus muscle. The aim of this study was to determine the biomechanical characteristics of patellar ligament transplants and transplants of the quadruple tendons of the hamstring muscles under tensile force in the laboratory, and to compare the results in each group of samples. The study comprised 160 specimens: 40 specimens of gracilis muscle tendons, 40 of semitendinosus muscle tendons, 40 of quadruple tendons and 40 of the patellar ligament, approximately equally distributed according to sex, age (50-70 years) and the side of the body from which the specimen had been taken. The working curve analysis of the specimens under tensile load of a maximum force of 30N showed the least elongation (0.31%) in the quadruple tendon, followed by the gracilis muscle tendon (1.48%) and patellar ligament tendon (3.91%). The quadruple tendon specimen showed greater strength and higher elasticity compared with the patellar ligament specimen, which proved the starting hypothesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Anterior cruciate ligament (ACL) injury

    MedlinePlus

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... knee. It prevents the knee from bending out. Anterior cruciate ligament (ACL) is in the middle of the knee. ...

  10. Anterior Cruciate Ligament (ACL) Injuries

    MedlinePlus

    ... Week of Healthy Breakfasts Shyness Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  11. Correlation between body mass index and quadrupled hamstring tendon autograft size in ACL reconstruction

    PubMed Central

    ATBAŞI, ZAFER; ERÇIN, ERSIN; ERDEM, YUSUF; EMRE, TULUHAN YUNUS; ATILLA, HALIS ATIL; PARLAK, ADEM

    2016-01-01

    Purpose the aim of this study was to assess the relationship of patient weight, height and body mass index (BMI) with the size of the quadrupled hamstring tendon used in anterior cruciate ligament (ACL) reconstruction. Methods from patient records, we retrospectively assessed the weight, height, BMI and graft sizes of 126 patients who underwent ACL reconstruction using a quadrupled hamstring tendon autograft between January 2010 and January 2013 at our institution. The data obtained from perioperative measurements were studied using correlation analysis. Results statistically significant relationships were found between patient height and graft diameter (p = 0.033, r = 0.19) and between patient weight and graft diameter (p < 0.0001, r = 0.33). No statistically significant relationships were found between graft diameter and BMI or between graft length and patient height, weight and BMI (p > 0.05). Conclusions patient height and weight were found to be related to quadrupled hamstring graft diameter in our patient population. BMI was not related to the quadrupled hamstring graft size. The exact size of the graft cannot be predicted preoperatively on the basis of these variables. Level of evidence Level IV, retrospective case series. PMID:28217655

  12. A graphene based frequency quadrupler

    NASA Astrophysics Data System (ADS)

    Cheng, Chuantong; Huang, Beiju; Mao, Xurui; Zhang, Zanyun; Zhang, Zan; Geng, Zhaoxin; Xue, Ping; Chen, Hongda

    2017-04-01

    Benefit from exceptional electrical transport properties, graphene receives worldwide attentions, especially in the domain of high frequency electronics. Due to absence of effective bandgap causing off-state the device, graphene material is extraordinarily suitable for analog circuits rather than digital applications. With this unique ambipolar behavior, graphene can be exploited and utilized to achieve high performance for frequency multipliers. Here, dual-gated graphene field-effect transistors have been firstly used to achieve frequency quadrupling. Two Dirac points in the transfer curves of the designed GFETs can be observed by tuning top-gate voltages, which is essential to generate the fourth harmonic. By applying 200 kHz sinusoid input, arround 50% of the output signal radio frequency power is concentrated at the desired frequency of 800 kHz. Additionally, in suitable operation areas, our devices can work as high performance frequency doublers and frequency triplers. Considered both simple device structure and potential superhigh carrier mobility of graphene material, graphene-based frequency quadruplers may have lots of superiorities in regards to ultrahigh frequency electronic applications in near future. Moreover, versatility of carbon material system is far-reaching for realization of complementary metal-oxide-semiconductor compatible electrically active devices.

  13. A graphene based frequency quadrupler

    PubMed Central

    Cheng, Chuantong; Huang, Beiju; Mao, Xurui; Zhang, Zanyun; Zhang, Zan; Geng, Zhaoxin; Xue, Ping; Chen, Hongda

    2017-01-01

    Benefit from exceptional electrical transport properties, graphene receives worldwide attentions, especially in the domain of high frequency electronics. Due to absence of effective bandgap causing off-state the device, graphene material is extraordinarily suitable for analog circuits rather than digital applications. With this unique ambipolar behavior, graphene can be exploited and utilized to achieve high performance for frequency multipliers. Here, dual-gated graphene field-effect transistors have been firstly used to achieve frequency quadrupling. Two Dirac points in the transfer curves of the designed GFETs can be observed by tuning top-gate voltages, which is essential to generate the fourth harmonic. By applying 200 kHz sinusoid input, arround 50% of the output signal radio frequency power is concentrated at the desired frequency of 800 kHz. Additionally, in suitable operation areas, our devices can work as high performance frequency doublers and frequency triplers. Considered both simple device structure and potential superhigh carrier mobility of graphene material, graphene-based frequency quadruplers may have lots of superiorities in regards to ultrahigh frequency electronic applications in near future. Moreover, versatility of carbon material system is far-reaching for realization of complementary metal-oxide-semiconductor compatible electrically active devices. PMID:28418013

  14. Quadruple Lap Shear Processing Evaluation

    NASA Technical Reports Server (NTRS)

    Thornton, Tony N.; McCool, A. (Technical Monitor)

    2000-01-01

    The Thiokol, Science and Engineering Huntsville Operations (SEHO) Laboratory has previously experienced significant levels of variation in testing Quadruple Lap Shear (QLS) specimens. The QLS test is used at Thiokol / Utah for the qualification of Reusable Solid Rocket Motor (RSRM) nozzle flex bearing materials. A test was conducted to verify that process changes instituted by SEHO personnel effectively reduced variability, even with normal processing variables introduced. A test matrix was designed to progress in a series of steps; the first establishing a baseline, then introducing additional solvents or other variables. Variables included normal test plan delay times, pre-bond solvent hand-wipes and contaminants. Each condition tested utilized standard QLS hardware bonded with natural rubber, two separate technicians and three replicates. This paper will report the results and conclusions of this investigation.

  15. Editorial Commentary: Renaissance of Primary Anterior Cruciate Ligament Repair: Is History Repeating Itself?

    PubMed

    Hohmann, Erik

    2016-12-01

    In a comparative Level III study, Achtnich et al. compared suture anchor repair of acute proximal anterior cruciate ligament avulsion tears with single-bundle anterior cruciate ligament reconstruction with the quadrupled semitendinosus tendon. Short-term follow-up at a mean of 28 months showed that the between-group differences were not different. These results are encouraging but not different from other published series 25+ years ago. Only time will tell whether the long-term outcomes are identical and whether these techniques will also die a slow death. Hopefully history is not repeating itself.

  16. Suicide Risk Quadruples After Lung Cancer Diagnosis

    MedlinePlus

    ... news/fullstory_165864.html Suicide Risk Quadruples After Lung Cancer Diagnosis Doctors, loved ones need to be on ... TUESDAY, May 23, 2017 (HealthDay News) -- People with lung cancer have a strikingly higher-than-normal risk of ...

  17. Posterior Cruciate Ligament Injury

    MedlinePlus

    ... tear. Contact sports. Athletes in sports such as football and soccer can tear their posterior cruciate ligament ... vehicle accident and participating in sports such as football and soccer are the most common risk factors ...

  18. Anterior cruciate ligament repair - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100230.htm Anterior cruciate ligament repair - Series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The anterior cruciate ligament (ACL) is a ligament in the center of ...

  19. Quadruple space diversity in troposcatter systems

    NASA Astrophysics Data System (ADS)

    Larsen, R.

    1980-03-01

    Experimental evidence from various workers has shown that significant correlations may sometimes occur between some channels of quadruple space diversity troposcatter systems. The experimental data is reviewed, and then the correlations between signals from spaced antennas are studied theoretically. Procedures are derived which allow all six correlations on a quadruple space diversity system to be calculated, and predictions of the theory are found to compare quite well with measurements. Finally the calculations are extended to allow prediction of the diversity performance of any quadruple space diversity troposcatter system. The parameters which are found to have an important influence on space diversity performance are the antenna separations, the beamwidths and the path geometry, particularly the path asymmetry.

  20. Quadruple Beltrami fields in three component plasmas

    NASA Astrophysics Data System (ADS)

    Gondal, S. M.; Iqbal, M.; Khosa, Ashfaq H.; Murtaza, G.

    2017-06-01

    A possibility of three component plasma to self-organize to Quadruple Beltrami State is explored. The Quadruple Beltrami State is characterized by four Beltarmi fields. The state emerges as a natural consequence of the contributions of all the linear and nonlinear forces present in an ideal plasma. The role of species density in the creation of relaxed structures is also investigated and found to be effective in transformation of field structures. The study will be helpful to understand formation of structures in astrophysical and laboratory plasmas.

  1. Bone tunnel enlargement on anterior cruciate ligament reconstruction

    PubMed Central

    Leonardi, Adriano Barros de Aguiar; Duarte, Aires; Severino, Nilson Roberto

    2014-01-01

    Objective: To assess the presence of tibial bone tunnel enlargement after surgical reconstruction of the anterior cruciate ligament using quadruple graft of the flexor tendons and correlate the functional results in their presence. Methods: The studied lasted six months and included 25 patients, with ages ranging from 18 to 43 years old. Assessment was based on radiographs taken immediately postoperatively and at the third and sixth month of follow up in the anterior cruciate ligament reconstruction. Reconstruction of ligaments was performed with tendon grafts of the semitendinosus and gracilis muscle fixated in the femur with transverse metal screw and in the tibia with interference screws. Patients were evaluated objectively by tests ligament, graded from zero to four crosses and subjectively by the Lysholm method preoperative and after sixth month follow up. Results: Significant increase in the tunnels diameters were observed, 20.56% for radiographs in the anteroposterior view, 26.48% in profile view and 23.22% in computed tomography. Descriptive statistics showed significant improvement in subjective and objective clinical parameters. Conclusions: The bone tunnel enlargement is a phenomenon found in the first months after surgical reconstruction of the anterior cruciate ligament and it has no implications on clinical outcomes in the short term. Level of Evidence II, Prospective Study. PMID:25328430

  2. Cranial cruciate ligament disease in dogs: biology versus biomechanics.

    PubMed

    Cook, James L

    2010-04-01

    The stifle joint of dogs is an organ comprised of multiple tissue types that must work in concert to maintain joint health and function. Cruciate disease in dogs is caused by a spectrum of causal and risk factors that result in a final common pathway of abnormal biomechanics and abnormal biology causing osteoarthritis, or organ failure, of the stifle and the clinical signs of lameness, pain, and limb dysfunction. It is vital to understand the components of the biologic and biomechanical pathologies to improve our understanding of cruciate disease in dogs so that we can improve preventative, diagnostic, and therapeutic strategies for our canine patients.

  3. Aetiology and pathogenesis of cranial cruciate ligament rupture in cats by histological examination.

    PubMed

    Wessely, Marlis; Reese, Sven; Schnabl-Feichter, Eva

    2017-06-01

    of cats revealed no other signs of degeneration in the cranial cruciate ligaments. Thus, degeneration is likely not an aetiological factor for cranial cruciate ligament rupture in cats.

  4. Ganglion cysts of the posterior cruciate ligament.

    PubMed

    Shetty, Gautam M; Nha, Kyung Wook; Patil, Sachin P; Chae, Dong Ju; Kang, Ki Hoon; Yoon, Jung Ro; Choo, Suk Kyu; Yi, Jeong Woo; Kim, Ji Hoon; Baek, Jong Ryoon

    2008-08-01

    Ganglion cysts of the posterior cruciate ligament (PCL) are uncommon lesions found incidentally on MRI and arthroscopy. Twenty patients (11 males and nine females) with the mean age of 35 years presenting with a variety of knee signs and symptoms were found to have PCL cysts on MRI. Out of these, thirteen patients (65%) had isolated symptomatic PCL cysts and seven patients had associated chondral and meniscal lesions. Eight out of the 20 patients (40%) gave a history of antecedent trauma. On arthroscopy, the majority of the cysts were situated at the midsubstance of the ligament with inter-cruciate distension and no involvement of the substance of the ligament. The content of the cysts varied with the majority having yellowish viscous fluid and three containing serous and bloody fluid. All cysts were successfully treated arthroscopically through standard anterior, posteromedial and posterolateral portals with no signs of recurrence on MRI at a mean followup of 24 months. PCL cysts may clinically mimic meniscal or chondral lesions and preoperatively, MRI is essential for the diagnosis of ganglion cysts arising from the PCL. Ganglion cysts of the PCL can be successfully treated arthroscopically using standard portals.

  5. Single to quadruple quantum dots with tunable tunnel couplings

    SciTech Connect

    Takakura, T.; Noiri, A.; Obata, T.; Yoneda, J.; Yoshida, K.; Otsuka, T.; Tarucha, S.

    2014-03-17

    We prepare a gate-defined quadruple quantum dot to study the gate-tunability of single to quadruple quantum dots with finite inter-dot tunnel couplings. The measured charging energies of various double dots suggest that the dot size is governed by the gate geometry. For the triple and quadruple dots, we study the gate-tunable inter-dot tunnel couplings. For the triple dot, we find that the effective tunnel coupling between side dots significantly depends on the alignment of the center dot potential. These results imply that the present quadruple dot has a gate performance relevant for implementing spin-based four-qubits with controllable exchange couplings.

  6. Thermally tunable quadruple Vernier racetrack resonators.

    PubMed

    Boeck, Robert; Chrostowski, Lukas; Jaeger, Nicolas A F

    2013-07-15

    The spectral responses of series-coupled racetrack resonators exhibiting the Vernier effect have many attractive features as compared to the spectral responses of identical series-coupled racetrack resonators, such as free spectral range (FSR) extension and enhanced wavelength tunability. Here we present experimental results of a thermally tunable quadruple series-coupled silicon racetrack resonator exhibiting the Vernier effect. We thermally tune two of the four racetrack resonators to enable discrete switching of the major peak by 15.54 nm. Also, our device has an interstitial peak suppression of 35.4 dB, a 3 dB bandwidth of 0.45 nm, and an extended FSR of 37.66 nm.

  7. Bioengineered anterior cruciate ligament

    NASA Technical Reports Server (NTRS)

    Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor); Martin, Ivan (Inventor)

    2001-01-01

    The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

  8. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    PubMed

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  9. Incidental Anterior Cruciate Ligament Calcification: Case Report

    PubMed Central

    Hayashi, Hisami; Fischer, Hans

    2016-01-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding. PMID:27200163

  10. Reconfigurable quadruple quantum dots in a silicon nanowire transistor

    SciTech Connect

    Betz, A. C. Broström, M.; Gonzalez-Zalba, M. F.; Tagliaferri, M. L. V.; Vinet, M.

    2016-05-16

    We present a reconfigurable metal-oxide-semiconductor multi-gate transistor that can host a quadruple quantum dot in silicon. The device consists of an industrial quadruple-gate silicon nanowire field-effect transistor. Exploiting the corner effect, we study the versatility of the structure in the single quantum dot and the serial double quantum dot regimes and extract the relevant capacitance parameters. We address the fabrication variability of the quadruple-gate approach which, paired with improved silicon fabrication techniques, makes the corner state quantum dot approach a promising candidate for a scalable quantum information architecture.

  11. Histological analysis of cross-sectional area of quadruple hamstring tendons and patellar ligament samples in relation to age and gender.

    PubMed

    Biuk, Egon; Zelić, Zoran; Rapan, Saša; Lovric, Ivan; Biuk, Dubravka; Radic, Radivoje

    2015-11-01

    The middle of the patellar ligament and the quadruple hamstring tendons (gracilis and semitendinosus) are two types of graft predominantly used in anterior cruciate ligament (ACL) reconstruction. The aim of this study was to determine the morphometric characteristics of patellar ligament grafts and hamstring tendon grafts and to compare the results according to subject age and gender. The study was conducted on a total of 120 samples: 40 of gracilis tendon, 40 of semitendinosus tendon and 40 of patellar ligament, distributed equally according to gender, age (50-75 years) and the side of the body from which the sample was harvested. Morphometric and histological analyses showed that patellar ligament samples had less cross-sectional area than quadruple tendon samples (49.29 mm(2) compared with 51.46 mm(2), respectively). Sexual dimorphism was noticed in distal cross-sections of gracilis tendons (p=0.09), cross-sections of quadruple tendons (p=0.07) and patellar ligament samples (p=0.01) because of different muscular build. All samples obtained from male subjects had larger cross-sectional areas compared with the samples taken from females. Furthermore, samples obtained from subjects aged 60 years or under had larger cross-sectional areas than samples obtained from subjects aged at least 61 years for all types of graft. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Spontaneous locking of the knee after anterior cruciate ligament reconstruction as a result of a broken tibial fixation device.

    PubMed

    Metcalfe, Andrew J; James, Stuart H; Fairclough, John A

    2008-10-01

    The Intrafix device (DePuy Mitek, Raynham, MA) is one of a number of recently developed products whose aim is to improve fixation of quadrupled hamstring grafts when used for anterior cruciate ligament reconstruction. We present a case of failure and intra-articular migration of the sleeve of an Intrafix device causing locking of the knee 10 weeks after anterior cruciate ligament reconstruction. We were unable to identify the cause of the failure or migration of the device. Rehabilitation had been progressing normally and without incident. The broken fragments were removed arthroscopically, and the reconstruction was found to be intact and healing well. Presumably, the device retained enough mechanical function to allow healing to progress, despite failure of the sleeve. This is, to our knowledge, the first reported case of such an event occurring with the new generation of hamstring graft fixation devices.

  13. Anterior cruciate ligament - updating article.

    PubMed

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  14. HOW CAN BONE TUNNEL ENLARGEMENT IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION SURGERY BE MEASURED? DESCRIPTION OF A TECHNIQUE

    PubMed Central

    Aguiar Leonardi, Adriano Barros de; Severino, Nilson Roberto; Junior, Aires Duarte

    2015-01-01

    To assess the presence of tibial bone tunnel enlargement after surgery to reconstruct the anterior cruciate ligament using quadruple flexor tendon grafts, and to propose a new technique for its measurement. Methods: The study involved 25 patients aged 18-43 years over a six-month period. The assessment was based on radiographs taken immediately postoperatively and in the third and sixth months of evolution after operations to reconstruct the anterior cruciate ligament using grafts from the tendons of the semitendinosus and gracilis muscles, fixed in the femur with a transverse metal screw and in the tibia with an interference screw. The radiographs were evaluated in terms of the relative value between the diameter of the tunnel and the bone, both at 2 cm below the medial tibial condyle. Results: There were significant increases in tunnel diameters: 20.56% for radiographs in anteroposterior view and 26.48% in lateral view. Enlargement was present in 48% of anteroposterior and lateral radiographs, but was present in both views in only 16% of the cases. Conclusions: Bone tunnel enlargement is a phenomenon found in the first months after surgery to reconstruct the anterior cruciate ligament. The measurement technique proposed in this study was sufficient to detect it. PMID:27027030

  15. Signes Iconiques, Signes Linguistiques (Iconic Signs, Linguistic Signs)

    ERIC Educational Resources Information Center

    Besse, Henri

    1974-01-01

    This article discusses the audiovisual image as sign; the classification of signs according to two different semiologies, and two different semantic theories; and the relation to different pedagogical approaches. (Text is in French.) (AM)

  16. Transphyseal Reconstruction of the Anterior Cruciate Ligament Using Hamstring Autograft in Skeletally Immature Adolescents

    PubMed Central

    Seon, Jong Keun; Yoon, Taek Rim; Park, Sang Jin

    2005-01-01

    Eleven skeletally immature adolescents underwent anterior cruciate ligament reconstruction using a transphyseal tibial and femoral tunnel. An autologous quadrupled hamstring tendon was used in all cases and the average follow-up was 77.7 months. Clinical results were evaluated using Lysholm knee scores and a return to pre-injury sports activities. Radiological results were evaluated using side-to-side differences of instrumented laxities and growth disturbances compared with the uninjured side on final follow-up orthoroentgenograms. The mean Lysholm score was 97.8 (range 94-100) and mean side-to-side laxity difference was 2.4 mm (range 1-4). Ten of 11 patients returned to pre-injury sports activity. No patient had a leg length discrepancy of over 1 cm or a significant abnormal angular deformity of the knee joint. Therefore, anterior cruciate ligament reconstruction using the transphyseal tunnel and hamstring autograft in skeletally immature adolescents is believed to be a reliable treatment method, which is not associated with significant leg length discrepancy or abnormal angular deformity of the knee joint. PMID:16361818

  17. Single-electron Spin Resonance in a Quadruple Quantum Dot.

    PubMed

    Otsuka, Tomohiro; Nakajima, Takashi; Delbecq, Matthieu R; Amaha, Shinichi; Yoneda, Jun; Takeda, Kenta; Allison, Giles; Ito, Takumi; Sugawara, Retsu; Noiri, Akito; Ludwig, Arne; Wieck, Andreas D; Tarucha, Seigo

    2016-08-23

    Electron spins in semiconductor quantum dots are good candidates of quantum bits for quantum information processing. Basic operations of the qubit have been realized in recent years: initialization, manipulation of single spins, two qubit entanglement operations, and readout. Now it becomes crucial to demonstrate scalability of this architecture by conducting spin operations on a scaled up system. Here, we demonstrate single-electron spin resonance in a quadruple quantum dot. A few-electron quadruple quantum dot is formed within a magnetic field gradient created by a micro-magnet. We oscillate the wave functions of the electrons in the quantum dots by applying microwave voltages and this induces electron spin resonance. The resonance energies of the four quantum dots are slightly different because of the stray field created by the micro-magnet and therefore frequency-resolved addressable control of each electron spin resonance is possible.

  18. Single-electron Spin Resonance in a Quadruple Quantum Dot

    NASA Astrophysics Data System (ADS)

    Otsuka, Tomohiro; Nakajima, Takashi; Delbecq, Matthieu R.; Amaha, Shinichi; Yoneda, Jun; Takeda, Kenta; Allison, Giles; Ito, Takumi; Sugawara, Retsu; Noiri, Akito; Ludwig, Arne; Wieck, Andreas D.; Tarucha, Seigo

    2016-08-01

    Electron spins in semiconductor quantum dots are good candidates of quantum bits for quantum information processing. Basic operations of the qubit have been realized in recent years: initialization, manipulation of single spins, two qubit entanglement operations, and readout. Now it becomes crucial to demonstrate scalability of this architecture by conducting spin operations on a scaled up system. Here, we demonstrate single-electron spin resonance in a quadruple quantum dot. A few-electron quadruple quantum dot is formed within a magnetic field gradient created by a micro-magnet. We oscillate the wave functions of the electrons in the quantum dots by applying microwave voltages and this induces electron spin resonance. The resonance energies of the four quantum dots are slightly different because of the stray field created by the micro-magnet and therefore frequency-resolved addressable control of each electron spin resonance is possible.

  19. Single-electron Spin Resonance in a Quadruple Quantum Dot

    PubMed Central

    Otsuka, Tomohiro; Nakajima, Takashi; Delbecq, Matthieu R.; Amaha, Shinichi; Yoneda, Jun; Takeda, Kenta; Allison, Giles; Ito, Takumi; Sugawara, Retsu; Noiri, Akito; Ludwig, Arne; Wieck, Andreas D.; Tarucha, Seigo

    2016-01-01

    Electron spins in semiconductor quantum dots are good candidates of quantum bits for quantum information processing. Basic operations of the qubit have been realized in recent years: initialization, manipulation of single spins, two qubit entanglement operations, and readout. Now it becomes crucial to demonstrate scalability of this architecture by conducting spin operations on a scaled up system. Here, we demonstrate single-electron spin resonance in a quadruple quantum dot. A few-electron quadruple quantum dot is formed within a magnetic field gradient created by a micro-magnet. We oscillate the wave functions of the electrons in the quantum dots by applying microwave voltages and this induces electron spin resonance. The resonance energies of the four quantum dots are slightly different because of the stray field created by the micro-magnet and therefore frequency-resolved addressable control of each electron spin resonance is possible. PMID:27550534

  20. Subfactors of Index Less Than 5, Part 3: Quadruple Points

    NASA Astrophysics Data System (ADS)

    Izumi, Masaki; Jones, Vaughan F. R.; Morrison, Scott; Snyder, Noah

    2012-12-01

    One major obstacle in extending the classification of small index subfactors beyond {3 +sqrt{3}} is the appearance of infinite families of candidate principal graphs with 4-valent vertices (in particular, the "weeds" {{Q}} and {{Q}'} from Part 1 (Morrison and Snyder in Commun. Math. Phys., doi: 10.1007/s00220-012-1426-y, 2012). Thus instead of using triple point obstructions to eliminate candidate graphs, we need to develop new quadruple point obstructions. In this paper we prove two quadruple point obstructions. The first uses quadratic tangles techniques and eliminates the weed {{Q}'} immediately. The second uses connections, and when combined with an additional number theoretic argument it eliminates both weeds {{Q}} and {{Q}'} . Finally, we prove the uniqueness (up to taking duals) of the 3311 Goodman-de la Harpe-Jones subfactor using a combination of planar algebra techniques and connections.

  1. Isolated posterior cruciate ligament calcification

    PubMed Central

    Koukoulias, Nikolaos E; Papastergiou, Stergios G

    2011-01-01

    The authors present a case of calcified posterior cruciate ligament (PCL). A 61-year-old female presented in our department reporting 12 months history of knee pain that was getting worse during the night. The patient was under medication for epileptic seizure, osteoporosis and hyperthyroidism. X-rays demonstrated calcification of the PCL. CT and MRI excluded any other intra-articular and extra-articular pathology. Arthroscopic debridement of the calcium deposits was performed and the symptoms resolved immediately, while the postoperative x-rays were normal. Histological examination confirmed the calcium nature of the lesion. Two years postoperatively the patient remains asymptomatic. PMID:22669889

  2. Cruciate retaining and cruciate substituting ultra-congruent insert

    PubMed Central

    Deledda, Davide; Rosso, Federica; Ratto, Nicola; Bruzzone, Matteo; Bonasia, Davide Edoardo; Rossi, Roberto

    2016-01-01

    The posterior cruciate ligament (PCL) conservation and the polyethylene insert constraint in total knee arthroplasty (TKA) are still debated. The PCL is one of the primary stabilizers of the joint, but cruciate retaining (CR) implants have the disadvantage of a difficult balancing of the PCL. Postero-stabilized (PS) implants were introduced to reduce this problem. However, also the PS implants have some disadvantages, due to the cam-mechanism, such as high risk of cam-mechanism polyethylene wear. To minimize the polyethylene wear of the cam-mechanism and the bone sacrifice due to the intercondylar box, different types of inserts were developed, trying to increase the implant conformity and to reduce stresses on the bone-implant interface. In this scenario ultra-congruent (UC) inserts were developed. Those inserts are characterized by a high anterior wall and a deep-dished plate. This conformation should guarantee a good stability without the posterior cam. Few studies on both kinematic and clinical outcomes of UC inserts are available. Clinical and radiological outcomes, as well as kinematic data are similar between UC mobile bearing (MB) and standard PS MB inserts at short to mid-term follow-up. In this manuscript biomechanics and clinical outcomes of UC inserts will be described, and they will be compared to standard PS or CR inserts. PMID:26855938

  3. Versatile Quadruple-Trap Optical Tweezers for Dual DNA Experiments.

    PubMed

    Heller, Iddo; Laurens, Niels; Vorselen, Daan; Broekmans, Onno D; Biebricher, Andreas S; King, Graeme A; Brouwer, Ineke; Wuite, Gijs J L; Peterman, Erwin J G

    2017-01-01

    Optical manipulation techniques provide researchers the powerful ability to directly move, probe and interrogate molecular complexes. Quadruple optical trapping is an emerging method for optical manipulation and force spectroscopy that has found its primary use in studying dual DNA interactions, but is certainly not limited to DNA investigations. The key benefit of quadruple optical trapping is that two molecular strands can be manipulated independently and simultaneously. The molecular geometries of the strands can thus be controlled and their interactions can be quantified by force measurements. Accurate control of molecular geometry is of critical importance for the analysis of, for example, protein-mediated DNA-bridging, which plays an important role in DNA compaction. Here, we describe the design of a dedicated and robust quadruple optical trapping-instrument. This instrument can be switched straightforwardly to a high-resolution dual trap and it is integrated with microfluidics and single-molecule fluorescence microscopy, making it a highly versatile tool for correlative single-molecule analysis of a wide range of biomolecular systems.

  4. [Efficacy observation of Guan's quadruple therapy for kidney disease on the treatment of chronic renal failure].

    PubMed

    Zuo, Zheng; Chen, Xiao-Mei; Jiang, Yun-Wu; Tang, Xiao-Yun; Guan, Zun-Xin

    2014-07-01

    To compare the differences in the clinical efficacy between Guan's quadruple therapy for kidney disease and the conventional western medication in the treatment of chronic renal failure (CRF). Eighty patients were randomized into an observation group and a control group, 40 cases in each one. In the observation group, besides the physician instruction of low protein and low phosphorus diet in the two groups, Guan's quadruple therapy for kidney disease was applied, including (1) the isolated herbal moxibustion at Shenshu (BL 23) and Pishu (BL 21), or Ganshu (BL 18), Zusanli (ST 36) and Guanyuan (CV 4) alternatively; (2) acupuncture at the auricular points such as shen (CO10), jiaogan (AHR6), Shenshangxian (TG2), fei (CO14) and pizhixia (AT4); (3) injection of mixture of astragalus injection and lidocaine injection at Feishu (BL 13), Pishu (BL 21), Shenshu (BL 23) and the others; (4) modified Shenshuai Yihao decoction according to syndrome differentiation. In the control group, the conventional western medication was used. After 6 months of treatment, the differences were observed between the two groups in the clinical efficacy, serum creatinine (Scr), blood urea nitrogen (BUN), endogenous creatinine (Ccr) and 24 h urine protein quantitation (UPQ). In the observation group, after treatment, the remarkably effective rate was 50.0% (20/40) and the total effective rate was 82.5% (33/40), which were superior to 25.0% (10/40) and 45.0% (18/40) in the control group (both P < 0.05). After treatment, the levels of Scr, BUN and 24 h UPQ were reduced apparently (all P < 0.05), and the level of Ccr was increased apparently in the two groups (both P < 0.05). After treatment, the levels of Scr, BUN and 24 h UPQ were reduced much more apparently in the observation group as compared with those in the control group (all P < 0.05). Guan's quadruple therapy for kidney disease achieves a better efficacy on CRF compared with the conventional western medication. This therapy improves

  5. Anterior cruciate ligament (ACL) injury -- aftercare

    MedlinePlus

    ... ACL injury - aftercare References Amy E, Micheo W. Anterior cruciate ligament tear. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation . 2nd ed. St. Louis, MO: ...

  6. Posterior cruciate ligament (PCL) injury - aftercare

    MedlinePlus

    Adib F, Curtis C, Bienkowski P Micheli LJ. Posterior cruciate ligament sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, ...

  7. Anterior Cruciate: Methods of Physical Examination

    PubMed Central

    Grant, John; Kirby, R. Lee

    1982-01-01

    Tear of the anterior cruciate ligament is a common, serious injury. Since the long-range consequences of uncorrected anterior cruciate incompetence are better understood, and surgical and rehabilitative measures improved, early accurate diagnosis is increasingly important. Besides a careful history, diagnosis requires the use of specific physical examination methods to reproduce the symptomatic subluxation (anterior shift or internal rotation) and to assess functional performance of the knee. ImagesFig. 1Fig. 2Fig. 3 PMID:21286055

  8. Prosthetic Anterior Cruciate Ligament Repairs: Current Status.

    DTIC Science & Technology

    1985-01-01

    patellar tendon was (dev eloped to augment or reconstruct the repaired anteriormenu cruciate ligamnent.’ The purpose of this app~roach was to provide an...intercondvlar niotch in the manner of Eriksson. ’ Thus the transfe~rred patellar tendon lay adjacent to the repairedI anterior cruciate ligament and supportedl...splint.’ B y using a hiode- hinli(tionl).ly gradable ligament. autogenous tissue grafts. such ats at portion of the, patella tendon . at asfied with would

  9. Sidewall spacer quadruple patterning for 15nm half-pitch

    NASA Astrophysics Data System (ADS)

    Xu, Ping; Chen, Yongmei; Chen, Yijian; Miao, Liyan; Sun, Shiyu; Kim, Sung-Woo; Berger, Ami; Mao, Daxin; Bencher, Christ; Hung, Raymond; Ngai, Chris

    2011-04-01

    193nm immersion lithography, with the single-exposure resolution limitation of half-pitch 38nm, has extended its patterning capability to about 20nm using the double-patterning technique[1]. Despite the non-trivial sub-20nm patterning challenges, several NAND Flash manufacturers are already pursuing for sub-16nm patterning technology. 25nm NAND flash memory has already begun production in 2010, and given the typical 2-year scaling cycle, sub-16nm NAND devices should see pilot or mass production as early as 2014. Using novel patterning techniques such as sidewall spacer quadruple patterning (upon 120nm to 128nm pitch using dry ArF lithography) or triple patterning (upon 90nm pitch using immersion ArF lithography), we are able to extend optical lithography to sub-16nm half-pitch and demonstrate the lithographic performance that can nearly meet the ITRS roadmap requirements. In this paper, we conduct an in-depth review and demonstration of sidewall spacer quadruple patterning; including 300mm wafer level data of the mean values and CDU along with a mathematical assessment of the various data pools for sub-16nm lines and spaces. By understanding which processes (lithography, deposition, and etch) define the critical dimension of each data pool, we can make predictions of CDU capability for the sidewall spacer quad patterning. Our VeritySEM4i CD SEM tool demonstrated high measurement yield during fully automated measurements, which enables accurate lines, spaces and CDU measurements of the sub-16nm. The patterns generated from the sidewall spacer quadruple patterning techniques are used as a hardmask to transfer sub-16nm lines and spaces patterns to underneath amorphous silicon and silicon oxide layers, or poly silicon layer for 1X STI or poly gate applications.

  10. Experimental performance of DWDM quadruple Vernier racetrack resonators.

    PubMed

    Boeck, Robert; Flueckiger, Jonas; Chrostowski, Lukas; Jaeger, Nicolas A F

    2013-04-08

    We demonstrate that one can meet numerous commercial requirements for filters used in dense wavelength-division multiplexing applications using quadruple Vernier racetrack resonators in the silicon-on-insulator platform. Experimental performance shows a ripple of 0.2 dB, an interstitial peak suppression of 39.7 dB, an adjacent channel isolation of 37.2 dB, an express channel isolation of 10.2 dB, and a free spectral range of 37.52 nm.

  11. Bifunctional Oxygen Reaction Catalysis of Quadruple Manganese Perovskites.

    PubMed

    Yamada, Ikuya; Fujii, Hiroshi; Takamatsu, Akihiko; Ikeno, Hidekazu; Wada, Kouhei; Tsukasaki, Hirofumi; Kawaguchi, Shogo; Mori, Shigeo; Yagi, Shunsuke

    2017-01-01

    Bifunctional electrocatalysts for oxygen evolution/reduction reaction (OER/ORR) are desirable for the development of energy conversion technologies. It is discovered that the manganese quadruple perovskites CaMn7 O12 and LaMn7 O12 show bifunctional catalysis in the OER/ORR. A possible origin of the high OER activity is the unique surface structure through corner-shared planar MnO4 and octahedral MnO6 units to promote direct OO bond formations. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Vital Signs

    MedlinePlus

    ... and your weight. Respiratory rate, which measures your breathing. Mild breathing changes can be from causes such as a ... nose or hard exercise. But slow or fast breathing can also be a sign of a serious ...

  13. The formation of a quadruple star system with wide separation.

    PubMed

    Pineda, Jaime E; Offner, Stella S R; Parker, Richard J; Arce, Héctor G; Goodman, Alyssa A; Caselli, Paola; Fuller, Gary A; Bourke, Tyler L; Corder, Stuartt A

    2015-02-12

    The initial multiplicity of stellar systems is highly uncertain. A number of mechanisms have been proposed to explain the origin of binary and multiple star systems, including core fragmentation, disk fragmentation and stellar capture. Observations show that protostellar and pre-main-sequence multiplicity is higher than the multiplicity found in field stars, which suggests that dynamical interactions occur early, splitting up multiple systems and modifying the initial stellar separations. Without direct, high-resolution observations of forming systems, however, it is difficult to determine the true initial multiplicity and the dominant binary formation mechanism. Here we report observations of a wide-separation (greater than 1,000 astronomical units) quadruple system composed of a young protostar and three gravitationally bound dense gas condensations. These condensations are the result of fragmentation of dense gas filaments, and each condensation is expected to form a star on a timescale of 40,000 years. We determine that the closest pair will form a bound binary, while the quadruple stellar system itself is bound but unstable on timescales of 500,000 years (comparable to the lifetime of the embedded protostellar phase). These observations suggest that filament fragmentation on length scales of about 5,000 astronomical units offers a viable pathway to the formation of multiple systems.

  14. Characterization of inductively coupled plasma generated by a quadruple antenna

    NASA Astrophysics Data System (ADS)

    Shafir, G.; Zolotukhin, D.; Godyak, V.; Shlapakovski, A.; Gleizer, S.; Slutsker, Ya; Gad, R.; Bernshtam, V.; Ralchenko, Yu; Krasik, Ya E.

    2017-02-01

    The results of the characterization of large-scale RF plasma for studying nonlinear interaction with a high-power (˜400 MW) short duration (˜0.8 ns) microwave (˜10 GHz) beam are presented. The plasma was generated inside a Pyrex tube 80 cm in length and 25 cm in diameter filled by either Ar or He gas at a pressure in the range 1.3-13 Pa using a 2 MHz RF generator with a matching system and a quadruple antenna. Good matching was obtained between the plasma parameters, which were determined using different methods including a movable Langmuir probe, microwave cut-off, interferometry, and optical emission spectroscopy. It was shown that, depending on the gas pressure and RF power delivered to the antenna, the plasma density and electron temperature can be controlled in the range 1 × 1010-5 × 1012 cm-3 and 1-3.5 eV, respectively. The plasma density was found to be uniform in terms of axial (˜60 cm) and radial (˜10 cm) dimensions. Further, it was also shown that the application of the quadruple antenna, with resonating capacitors inserted in its arms, decreases the capacitive coupling of the antenna and the plasma as well as the RF power loss along the antenna. These features make this plasma source suitable for microwave plasma wake field experiments.

  15. Simple arthroscopic partial meniscectomy associated with anterior cruciate-deficient knees.

    PubMed

    Marshall, S; Levas, M G; Harrah, A

    1985-01-01

    Twenty-five patients with combined tears of the meniscus and anterior cruciate ligament in the same knee were evaluated for the results of a simple arthroscopic meniscectomy that preserved the meniscal rim. These patients, classified as "recreational athletes," were analyzed to determine their postoperative functional capabilities. Using the presence or absence of the pivot shift sign as the most important indicator of functional capability, we found that partial meniscectomy was effective in allowing patients to regain a high degree of normal functional ability and in permitting forward motion activities. However, all patients were left with an anterior cruciate-deficient knee that caused laxity in the anterior plane and frequently in the rotatory plane. Rotatory laxity markedly limits activities, and those patients unable to adjust to their instability are considering further surgery.

  16. The Cruciate Ligaments in Total Knee Arthroplasty.

    PubMed

    Parcells, Bertrand W; Tria, Alfred J

    2016-01-01

    The early knee replacements were hinge designs that ignored the ligaments of the knee and resurfaced the joint, allowing freedom of motion in a single plane. Advances in implant fixation paved the way for modern designs, including the posterior-stabilized (PS) total knee arthroplasty (TKA) that sacrifices both cruciate ligaments while substituting for the posterior cruciate ligament (PCL), and the cruciate-retaining (CR) TKA designs that sacrifice the anterior cruciate ligament but retain the PCL. The early bicruciate retaining (BCR) TKA designs suffered from loosening and early failures. Townley and Cartier designed BCR knees that had better clinical results but the surgical techniques were challenging.Kinematic studies suggest that normal motion relies on preservation of both cruciate ligaments. Unicompartmental knee arthroplasty retains all knee ligaments and closely matches normal motion, while PS and CR TKA deviate further from normal. The 15% to 20% dissatisfaction rate with current TKA has renewed interest in the BCR design. Replication of normal knee kinematics and proprioception may address some of the dissatisfaction.

  17. Sandwich-type tetrakis(phthalocyaninato) dysprosium-cadmium quadruple-decker SMM.

    PubMed

    Wang, Hailong; Qian, Kang; Wang, Kang; Bian, Yongzhong; Jiang, Jianzhuang; Gao, Song

    2011-09-14

    Homoleptic tetrakis[2,3,9,10,16,17,23,24-octa(butyloxy)phthalocyaninato] dysprosium-cadmium quadruple-decker complex 1 was isolated in relatively good yield of 43% from a simple one-pot reaction. This compound represents the first sandwich-type tetrakis(phthalocyaninato) rare earth-cadmium quadruple-decker SMM that has been structurally characterized.

  18. Anterior Cruciate Ligament Graft Choices

    PubMed Central

    Macaulay, Alec A.; Perfetti, Dean C.; Levine, William N.

    2012-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is a common surgical procedure; however, there is no consensus to what the best graft option is to replace the injured ACL. The main options available consist of allografts and autografts, which include patellar tendon, hamstring tendon, and quadriceps tendon autografts. Evidence Acquisition: The PubMed database was searched in August 2010 for English-language articles pertaining to ACL grafts. Results: Postoperative outcome variables were analyzed to determine similarities and differences among the different graft options. These variables include stability, strength, function, return to sports, patient satisfaction, complications, and cost. Conclusions: Both allografts and the 3 main options for autografts can provide excellent results in ACL reconstruction and lead to a high percentage of satisfied patients. However, differences exist among the graft choices. Both the similarities and the differences are important to discuss with a patient who will be undergoing ACL reconstruction so that he or she has the best information available when making a choice of graft. PMID:23016071

  19. Rare quadruple malaria infection in Irian Jaya Indonesia.

    PubMed

    Purnomo; Solihin, A; Gomez-Saladin, E; Bangs, M J

    1999-06-01

    We report an exceptional finding from a blood slide collected in a remote area in the western half of New Guinea Island (Irian Jaya Province, Indonesia). One adolescent patient was found patently coinfected with all 4 known human malaria species, Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale. Diagnostic erythrocytic stages of all 4 species were clearly seen in the peripheral blood. A nested polymerase chain reaction, using species-specific primer pairs to detect DNA, helped substantiate this finding. Previous reports from Africa, Thailand, and New Guinea have detected all 4 species in a population but not simultaneously in an individual with a patent, microscopically detectable infection. We believe this quadruple infection represents the first reported natural case of all 4 human malaria parasites observed concurrently in the peripheral blood from a single Giemsa-stained slide.

  20. Self-aligned quadruple patterning-compliant placement

    NASA Astrophysics Data System (ADS)

    Nakajima, Fumiharu; Kodama, Chikaaki; Nakayama, Koichi; Nojima, Shigeki; Kotani, Toshiya

    2015-03-01

    Self-Aligned Quadruple Patterning (SAQP) will be one of the leading candidates for sub-14nm node and beyond. However, compared with triple patterning, making a feasible standard cell placement has following problems. (1) When coloring conflicts occur between two adjoining cells, they may not be solved easily since SAQP layout has stronger coloring constraints. (2) SAQP layout cannot use stitch to solve coloring conflict. In this paper, we present a framework of SAQP-aware standard cell placement considering the above problems. When standard cell is placed, the proposed method tries to solve coloring conflicts between two cells by exchanging two of three colors. If some conflicts remain between adjoining cells, dummy space will be inserted to keep coloring constraints of SAQP. We show some examples to confirm effectiveness of the proposed framework. To our best knowledge, this is the first framework of SAQP-aware standard cell placement.

  1. Vital Signs.

    ERIC Educational Resources Information Center

    Brown, Lester R.

    1993-01-01

    Presents an excerpt from the first edition of Vital Signs, a Worldwide Institute publication that provides an annual update on global environmental trends. Includes discussion of the dismantling of nuclear arms, reduction in chlorofluorocarbon production, growth in bicycle production, the decline in cigarette smoking, and decline in military…

  2. Vital signs

    MedlinePlus

    ... overall health. Normal vital sign ranges for the average healthy adult while resting are: Blood pressure: 90/60 mm/Hg to 120/80 mm/Hg Breathing: 12 to 18 breaths per minute Pulse: 60 to 100 beats per minute Temperature: 97.8°F to 99.1°F (36. ...

  3. Vital Signs.

    ERIC Educational Resources Information Center

    Brown, Lester R.

    1993-01-01

    Presents an excerpt from the first edition of Vital Signs, a Worldwide Institute publication that provides an annual update on global environmental trends. Includes discussion of the dismantling of nuclear arms, reduction in chlorofluorocarbon production, growth in bicycle production, the decline in cigarette smoking, and decline in military…

  4. The probable quadruple systems FK Aql and FZ Del

    NASA Astrophysics Data System (ADS)

    Khaliullina, A. I.

    2017-07-01

    Orbital-period variations of the eclipsing binaries FK Aql and FZ Del are analyzed. For each of the systems, a superposition of two cyclic variations of their orbital periods is found. FK Aql may be a quadruple system that contains two more bodies, besides the eclipsing binary, with masses M 3 ⩾ 1.75 M ⊙ and M 4 ⩾ 1.47 M ⊙, and the corresponding periods 15 and 82 yrs. This could also be a triple system with a third body of mass M 3 ⩾ 1.75 M ⊙ and a period of the long-period orbit P 3 = 15 yrs, or with a third body of mass M 3 ⩾ 1.30 M ⊙ and a period of the long-period orbit P 3 = 82 yrs. FZ Del may be a quadruple system with the additional componentmasses M 3 ⩾ 0.2 M ⊙ and M 4 ⩾ 0.3 M ⊙, with the periods 10.2 and 53.7 yrs. This could also be a triple system with a third-body mass M 3 ⩾ 0.2 M ⊙ and a period of the long-period orbit P 3 = 10.2 yrs. In both systems, the residual period variations could be due to magnetic cycles of the secondary. The period variations of the eclipsing binary FZ Del could also be due to apsidal motion, together with the influence of a third body or the effects of magnetic activity.

  5. The Quadruple-lined, Doubly Eclipsing System V482 Persei

    NASA Astrophysics Data System (ADS)

    Torres, Guillermo; Sandberg Lacy, Claud H.; Fekel, Francis C.; Wolf, Marek; Muterspaugh, Matthew W.

    2017-09-01

    We report spectroscopic and differential photometric observations of the A-type system V482 Per, which reveal it to be a rare hierarchical quadruple system containing two eclipsing binaries. One binary has the previously known orbital period of 2.4 days and a circular orbit, and the other a period of 6 days, a slightly eccentric orbit (e = 0.11), and shallow eclipses only 2.3% deep. The two binaries revolve around their common center of mass in a highly elongated orbit (e = 0.85) with a period of 16.67 yr. Radial velocities are measured for all components from our quadruple-lined spectra and are combined with the light curves and measurements of times of minimum light for the 2.4 day binary to solve for the elements of the inner and outer orbits simultaneously. The line-of-sight inclination angles of the three orbits are similar, suggesting they may be close to coplanar. The available observations appear to indicate that the 6 day binary experiences significant retrograde apsidal motion in the amount of about 60 deg per century. We derive absolute masses for the four stars good to better than 1.5%, along with radii with formal errors of 1.1% and 3.5% for the 2.4 day binary and ∼9% for the 6 day binary. A comparison of these and other physical properties with current stellar evolution models gives excellent agreement for a metallicity of [{Fe}/{{H}}]=-0.15 and an age of 360 Myr.

  6. Furazolidone-based triple and quadruple eradication therapy for Helicobacter pylori infection

    PubMed Central

    Xie, Yong; Zhu, Yin; Zhou, Hong; Lu, Zhi-Fa; Yang, Zhen; Shu, Xu; Guo, Xiao-Bai; Fan, Hui-Zhen; Tang, Jian-Hua; Zeng, Xue-Ping; Wen, Jian-Bo; Li, Xiao-Qing; He, Xing-Xing; Ma, Jiu-Hong; Liu, Dong-Sheng; Huang, Cai-Bin; Xu, Ning-Jian; Wang, Nong-Rong; Lu, Nong-Hua

    2014-01-01

    AIM: To evaluate the efficacy of furazolidone-based triple and quadruple therapy in eradicating Helicobacter pylori (H. pylori) in a multi-center randomized controlled trial. METHODS: A total of 720 H. pylori positive patients with duodenal ulcer disease were enrolled at 10 different hospitals in Jiangxi province in China. The patients were randomly assigned to four treatment groups as follows: patients in Groups 1 and 3 received rabeprazole (10 mg), amoxicillin (1000 mg) and furazolidone (100 mg) twice daily for 7 and 10 d, respectively; patients in Groups 2 and 4 received rabeprazole (10 mg), bismuth (220 mg), amoxicillin (1000 mg) and furazolidone (100 mg) twice daily for 7 and 10 d, respectively. The primary outcome measure was H. pylori eradication rate 4 wk after treatment by intention-to-treat and per protocol analysis, while the secondary outcome measures were symptom and sign changes at the end of treatment and 4 wk after the end of treatment, as well as the proportion of patients who developed adverse events. RESULTS: The demographic data of the four groups were not significantly different. Overall, 666 patients completed the scheme and were re-assessed with the 13C-urea breath test. The intention-to-treat analysis of the H. pylori eradication rates in Groups 1, 2, 3 and 4 were 74.44%, 82.78%, 78.89% and 86.11%, respectively. The H. pylori eradication rate in Group 4 was significantly higher than that in Group 1. According to the per protocol analysis, the H. pylori eradication rates in Groups 1, 2, 3 and 4 were 81.21%, 89.22%, 85.54% and 92.26%, respectively. The H. pylori eradication rate in Group 4 was significantly higher than that in Group 1. The number of adverse events was 15 (8.3%), 16 (8.9%), 15 (8.3%) and 17 (9.4%) in Groups 1, 2, 3 and 4, respectively, including dizziness, vomiting, diarrhea, nausea, skin rash, itchy skin, and malaise. The symptoms were relieved without special treatment in all of the patients. CONCLUSION: Both 7- and 10-d

  7. Revision Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Wilde, Jeffrey; Bedi, Asheesh; Altchek, David W.

    2014-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is one of the most common surgical procedures, with more than 200,000 ACL tears occurring annually. Although primary ACL reconstruction is a successful operation, success rates still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database (1988-2013) as well as from textbook chapters and surgical technique papers. Study Design: Clinical review. Level of Evidence: Level 4. Results: The clinical outcomes after revision ACL reconstruction are largely based on level IV case series. Much of the existing literature is heterogenous with regard to patient populations, primary and revision surgical techniques, concomitant ligamentous injuries, and additional procedures performed at the time of the revision, which limits generalizability. Nevertheless, there is a general consensus that the outcomes for revision ACL reconstruction are inferior to primary reconstruction. Conclusion: Excellent results can be achieved with regard to graft stability, return to play, and functional knee instability but are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal graft selection, tunnel position, graft fixation, or biological milieu for tendon-bone healing. Strength-of-Recommendation Taxonomy (SORT): Good results may still be achieved with regard to graft stability, return to play, and functional knee instability, but results are generally inferior to primary ACL reconstruction: Level B. PMID:25364483

  8. Simulation of growing grains under orientation relation - dependent quadruple point dragging

    NASA Astrophysics Data System (ADS)

    Ito, K.

    2015-04-01

    The growth behaviour of a specified grain embedded in matrix grains, for which the migration mobility of the quadruple points depended on the relation between the orientations of the growing and shrinking grains, was studied using a modified Potts MC-type threedimensional simulation. Large embedded grains continued to grow without being overcome by coarsening matrix grains, whereas small embedded grains disappeared, under the influence of the relative mobilities of the quadruple points, the composition of the matrix grain texture and the width of the grain size distribution of the matrix grains. These results indicate that orientation relation-dependent quadruple point dragging can affect the recrystallization texture during the grain coarsening stage.

  9. Molecular tectonics: from 1-D interwoven racemic chains to quadruple-stranded helices.

    PubMed

    Lin, Mei-Jin; Jouaiti, Abdelaziz; Kyritsakas, Nathalie; Hosseini, Mir Wais

    2010-01-07

    The combination of two positional isomers tectons 1 and 2, based on a racemic 1,1'-spirobi(indane) scaffold bearing two pyridine units, with HgCl(2) affords doubly interwoven and quadruple-stranded helical architectures, respectively.

  10. N-heteroquinones: quadruple weak hydrogen bonds and n-channel transistors.

    PubMed

    Tang, Qin; Liang, Zhixiong; Liu, Jing; Xu, Jianbin; Miao, Qian

    2010-05-07

    This study demonstrates that the easily synthesized N-heteroquinones, having unusual quadruple weak hydrogen bonds of a DDAA-AADD pattern, can function as n-type organic semiconductors in OTFTs with high electron mobility.

  11. Communication: The performance of non-iterative coupled cluster quadruples models.

    PubMed

    Eriksen, Janus J; Matthews, Devin A; Jørgensen, Poul; Gauss, Jürgen

    2015-07-28

    We compare the numerical performance of various non-iterative coupled cluster (CC) quadruples models. The results collectively show how approaches that attempt to correct the CC singles and doubles energy for the combined effect of triple and quadruple excitations all fail at recovering the correlation energy of the full CC singles, doubles, triples, and quadruples (CCSDTQ) model to within sufficient accuracy. Such a level of accuracy is only achieved by models that make corrections to the full CC singles, doubles, and triples (CCSDT) energy for the isolated effect of quadruple excitations of which the CCSDT(Q-3) and CCSDT(Q-4) models of the Lagrangian-based CCSDT(Q-n) perturbation series are found to outperform alternative models that add either of the established [Q] and (Q) corrections to the CCSDT energy.

  12. Quadruple valve replacement and bypass surgery 23 years after the Ross operation†.

    PubMed

    Oeser, Claudia; Andreas, Martin; Habertheuer, Andreas; Kocher, Alfred

    2015-07-01

    This report describes a case of simultaneous quadruple valve replacement, coronary artery bypass surgery and reconstruction of one aortic sinus performed in a patient who had undergone the Ross operation 23 years previously.

  13. Posterior tibial slope and femoral sizing affect posterior cruciate ligament tension in posterior cruciate-retaining total knee arthroplasty.

    PubMed

    Kuriyama, Shinichi; Ishikawa, Masahiro; Nakamura, Shinichiro; Furu, Moritoshi; Ito, Hiromu; Matsuda, Shuichi

    2015-08-01

    During cruciate-retaining total knee arthroplasty, surgeons sometimes encounter increased tension of the posterior cruciate ligament. This study investigated the effects of femoral size, posterior tibial slope, and rotational alignment of the femoral and tibial components on forces at the posterior cruciate ligament in cruciate-retaining total knee arthroplasty using a musculoskeletal computer simulation. Forces at the posterior cruciate ligament were assessed with the standard femoral component, as well as with 2-mm upsizing and 2-mm downsizing in the anterior-posterior dimension. These forces were also determined with posterior tibial slope angles of 5°, 7°, and 9°, and lastly, were measured in 5° increments when the femoral (tibial) components were positioned from 5° (15°) of internal rotation to 5° (15°) of external rotation. Forces at the posterior cruciate ligament increased by up to 718N with the standard procedure during squatting. The 2-mm downsizing of the femoral component decreased the force at the posterior cruciate ligament by up to 47%. The 2° increment in posterior tibial slope decreased the force at the posterior cruciate ligament by up to 41%. In addition, posterior cruciate ligament tension increased by 11% during internal rotation of the femoral component, and increased by 18% during external rotation of the tibial component. These findings suggest that accurate sizing and bone preparation are very important to maintain posterior cruciate ligament forces in cruciate-retaining total knee arthroplasty. Care should also be taken regarding malrotation of the femoral and tibial components because this increases posterior cruciate ligament tension. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. The Unusual Quadruple System HD 91962 with a "Planetary" Architecture

    NASA Astrophysics Data System (ADS)

    Tokovinin, Andrei; Latham, David W.; Mason, Brian D.

    2015-06-01

    The young nearby solar-type star HD 91962 is a rare quadruple system where three companions revolve around the main component with periods of 170.3 days, 8.85 years, and 205 years. The two outer orbits are nearly co-planar, and all orbits have small eccentricities. We refine the visual orbit of the outer pair and determine the combined spectro-interferometric orbit of the middle 8.8 year pair and the spectroscopic orbit of the inner binary. The middle and inner orbits are likely locked in a 1:19 resonance, and the ratio of the outer and middle periods is ∼23. The masses of all components are estimated (inside-out: 1.14, 0.32, 0.64, 0.64 solar mass). The dynamical parallax is 27.4 ± 0.6 mas. We speculate that this multiple system originated from collapse of an isolated core and that the companions migrated in a dissipative disk. Other multiple systems with similar features (co-planarity, small eccentricity, and period ratio around 20) are known.

  15. Update on quadruple suspension design for Advanced LIGO

    NASA Astrophysics Data System (ADS)

    Aston, S. M.; Barton, M. A.; Bell, A. S.; Beveridge, N.; Bland, B.; Brummitt, A. J.; Cagnoli, G.; Cantley, C. A.; Carbone, L.; Cumming, A. V.; Cunningham, L.; Cutler, R. M.; Greenhalgh, R. J. S.; Hammond, G. D.; Haughian, K.; Hayler, T. M.; Heptonstall, A.; Heefner, J.; Hoyland, D.; Hough, J.; Jones, R.; Kissel, J. S.; Kumar, R.; Lockerbie, N. A.; Lodhia, D.; Martin, I. W.; Murray, P. G.; O'Dell, J.; Plissi, M. V.; Reid, S.; Romie, J.; Robertson, N. A.; Rowan, S.; Shapiro, B.; Speake, C. C.; Strain, K. A.; Tokmakov, K. V.; Torrie, C.; van Veggel, A. A.; Vecchio, A.; Wilmut, I.

    2012-12-01

    We describe the design of the suspension systems for the major optics for Advanced LIGO, the upgrade to LIGO—the Laser Interferometric Gravitational-Wave Observatory. The design is based on that used in GEO600—the German/UK interferometric gravitational wave detector, with further development to meet the more stringent noise requirements for Advanced LIGO. The test mass suspensions consist of a four-stage or quadruple pendulum for enhanced seismic isolation. To minimize suspension thermal noise, the final stage consists of a silica mirror, 40 kg in mass, suspended from another silica mass by four silica fibres welded to silica ears attached to the sides of the masses using hydroxide-catalysis bonding. The design is chosen to achieve a displacement noise level for each of the seismic and thermal noise contributions of 10-19 m/√Hz at 10 Hz, for each test mass. We discuss features of the design which has been developed as a result of experience with prototypes and associated investigations.

  16. Optimal Design of a Center Support Quadruple Mass Gyroscope (CSQMG).

    PubMed

    Zhang, Tian; Zhou, Bin; Yin, Peng; Chen, Zhiyong; Zhang, Rong

    2016-04-28

    This paper reports a more complete description of the design process of the Center Support Quadruple Mass Gyroscope (CSQMG), a gyro expected to provide breakthrough performance for flat structures. The operation of the CSQMG is based on four lumped masses in a circumferential symmetric distribution, oscillating in anti-phase motion, and providing differential signal extraction. With its 4-fold symmetrical axes pattern, the CSQMG achieves a similar operation mode to Hemispherical Resonant Gyroscopes (HRGs). Compared to the conventional flat design, four Y-shaped coupling beams are used in this new pattern in order to adjust mode distribution and enhance the synchronization mechanism of operation modes. For the purpose of obtaining the optimal design of the CSQMG, a kind of applicative optimization flow is developed with a comprehensive derivation of the operation mode coordination, the pseudo mode inhibition, and the lumped mass twisting motion elimination. The experimental characterization of the CSQMG was performed at room temperature, and the center operation frequency is 6.8 kHz after tuning. Experiments show an Allan variance stability 0.12°/h (@100 s) and a white noise level about 0.72°/h/√Hz, which means that the CSQMG possesses great potential to achieve navigation grade performance.

  17. Particle size characterization by quadruple-detector hydrodynamic chromatography.

    PubMed

    Brewer, Amandaa K; Striegel, André M

    2009-01-01

    Particle size and shape and their distribution directly influence a variety of end-use material properties related to packing, mixing, and transport of powders, solutions, and suspensions. Many of the techniques currently employed for particle size characterization have found limited applicability for broadly polydisperse and/or nonspherical particles. Here, we introduce a quadruple-detector hydrodynamic chromatography (HDC) method utilizing static multiangle light scattering (MALS), quasi-elastic light scattering (QELS), differential viscometry (VISC), and differential refractometry (DRI), and apply the technique to characterizing a series of solid and hollow polystyrene latexes with diameters in the approximate range of 40-400 nm. Using HDC/MALS/QELS/VISC/DRI, we were able to determine a multiplicity of size parameters and their polydispersity and to monitor the size of the particles across the elution profile of each sample. Using self-similarity scaling relationships between the molar mass and the various particle radii, we were also able to ascertain the shape of the latexes and the shape constancy as a function of particle size. The particle shape for each latex was confirmed by the dimensionless ratio rho identical with R (G,z )/R (H,z ) which, in addition, provided information on the structure (compactness) of the latexes as a function of particle size. Solid and hollow polystyrene latex samples were also differentiable using these methods. Extension of this method to nonspherical, fractal objects should be possible.

  18. The closest M-dwarf quadruple system to the Sun

    SciTech Connect

    Davison, Cassy L.; White, R. J.; Jao, W.-C.; Henry, T. J.; Quinn, S. N.; Cantrell, J. R.; Winters, J. G.; Bailey, J. I. III; Riedel, A. R.; Subasavage, J. P.; Crockett, C. J.

    2014-02-01

    We report new infrared radial velocity measurements obtained with CSHELL at NASA's Infrared Telescope Facility that reveal the M3.5 dwarf GJ 867B to be a single-lined spectroscopic binary with a period of 1.795 ± 0.017 days. Its velocity semi-amplitude of 21.4 ± 0.5 km s{sup –1} corresponds to a minimum mass of 61 ± 7 M {sub JUP}; the new companion, which we call GJ 867D, could be a brown dwarf. Stable astrometric measurements of GJ 867BD obtained with CTIO's 0.9 m telescope over the last decade exclude the presence of any massive planetary companions (7-18 M {sub JUP}) with longer orbital periods (2-10 yr) for the majority of orientations. These complementary observations are also used to determine the trigonometric distance and proper motion of GJ 867BD; the measurements are consistent with the HIPPARCOS measured values of the M2 dwarf GJ 867AC, which is itself a 4.1 day double-lined spectroscopic binary at a projected separation of 24.''5 (216 AU) from GJ 867BD. These new measurements strengthen the case that GJ 867AC and GJ 867BD are physically associated, making the GJ 867 system one of only four quadruple systems within 10 pc of the Sun (d = 8.82 ± 0.08 pc) and the only among these with all M-dwarf (or cooler) components.

  19. PROPERTIES OF THE CLOSE-IN TERTIARY IN THE QUADRUPLE SYSTEM V401 CYG

    SciTech Connect

    Zhu, L.-Y.; Qian, S.-B.; Zhou, X.; Li, L.-J.; Zhao, E.-G.; Liu, L.; Liu, N.-P.

    2013-08-01

    V401 Cyg is a quadruple system in which the spectroscopic signature of a close-in tertiary and a distant visual companion star were reported. Orbital properties of the close-in companion should provide valuable information on the formation of close binaries and stellar dynamical interaction. By analyzing new times of minimum light together with those collected from the literature, we discovered that the observed-calculated (O - C) curve of V401 Cyg shows a cyclic change with a short period of 3.5 yr and a semi-amplitude of 0.00436 days while it undergoes an upward parabolic variation. Those photoelectric and CCD data covered more than two cycles and were analyzed for the light-travel time effect via the presence of the tertiary companion. The mass of the third body was determined to be M{sub 3}sin i' = 0.65({+-} 0.08) M{sub Sun }, which is close to the value estimated from the spectroscopic data (M{sub 3} {approx} 0.64 M{sub Sun }). This reveals that the orbital inclination of the tertiary was about i' {approx} 90 Degree-Sign , indicating that the contact components of V401 Cyg have the possibility of being eclipsed by the tertiary at an orbital distance of about 3.0 AU, and it may be a triply eclipsing hierarchical triple system. The upward parabolic change indicates a period increase at a rate of (P-dot{sub 2} = 1.5 x 10{sup -7} revealing a mass transfer from the secondary to the primary (M-dot{sub 2} = 5.9 x 10{sup -8} M{sub Sun} yr{sup -1}). This is consistent with the predictions of the theory of thermal relaxation oscillation (TRO) suggesting that V401 Cyg is undergoing an expanding-orbit stage in the TRO cycles.

  20. [Anterior cruciate ligament injuries in children].

    PubMed

    Tercier, S; Zambelli, P-Y

    2013-07-17

    An increasing number of anterior cruciate ligament injuries are now seen in children and girls seem to be equally affected. Such neglected or untreated lesions could be the cause of early degenerative changes. Recently, many authors support the trend toward early surgical management in skeletally immature patients with complex meniscal tear or recurrent knee instability after proper rehabilitation. Improvement in pediatric knowledge and surgical techniques tend to support a tendency for more surgical treatment in children. The type of management is choosing according to history and physical examination. Magnetic resonance imaging is a useful tool not only for diagnosis but also for surgical treatment planning. We usually recommend anterior cruciate ligament reconstruction in children with knee instability or with further damages to the joint.

  1. Imaging of the anterior cruciate ligament

    PubMed Central

    Ng, Wing Hung Alex; Griffith, James Francis; Hung, Esther Hiu Yee; Paunipagar, Bhawan; Law, Billy Kan Yip; Yung, Patrick Shu Hang

    2011-01-01

    The anterior cruciate ligament (ACL) is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament. However, the oblique course of the ACL within the intercondylar fossa limits the visualization and assessment of the pathology of the ligament. This pictorial essay provides a comprehensive and illustrative review of the anatomy and biomechanics as well as updated information on different modalities of radiological investigation of ACL, particularly magnetic resonance imaging. PMID:22474639

  2. Mechanisms of Noncontact Anterior Cruciate Ligament Injury

    PubMed Central

    Shimokochi, Yohei; Shultz, Sandra J

    2008-01-01

    Objective: To examine and summarize previous retrospective and observational studies assessing noncontact anterior cruciate ligament (ACL) injury mechanisms and to examine such reported ACL injury mechanisms based on ACL loading patterns due to knee loadings reported in in vivo, in vitro, and computer simulation studies. Data Sources: We searched MEDLINE from 1950 through 2007 using the key words anterior cruciate ligament + injury + mechanisms; anterior cruciate ligament + injury + mechanisms + retrospective; and anterior cruciate ligament + injury + mechanisms + video analysis. Study Selection: We selected retrospective studies and observational studies that specifically examined the noncontact ACL injury mechanisms (n  =  7) and assessed ACL loading patterns in vivo, in vitro, and using computer simulations (n  =  33). Data Extraction: The motion patterns reported as noncontact ACL injury mechanisms in retrospective and observational studies were assessed and critically compared with ACL loading patterns measured during applied external or internal (or both) forces or moments to the knee. Data Synthesis: Noncontact ACL injuries are likely to happen during deceleration and acceleration motions with excessive quadriceps contraction and reduced hamstrings co-contraction at or near full knee extension. Higher ACL loading during the application of a quadriceps force when combined with a knee internal rotation moment compared with an external rotation moment was noted. The ACL loading was also higher when a valgus load was combined with internal rotation as compared with external rotation. However, because the combination of knee valgus and external rotation motions may lead to ACL impingement, these combined motions cannot be excluded from the noncontact ACL injury mechanisms. Further, excessive valgus knee loads applied during weight-bearing, decelerating activities also increased ACL loading. Conclusions: The findings from this review lend support to ACL

  3. Pattern optimizing verification of self-align quadruple patterning

    NASA Astrophysics Data System (ADS)

    Yamato, Masatoshi; Yamada, Kazuki; Oyama, Kenichi; Hara, Arisa; Natori, Sakurako; Yamauchi, Shouhei; Koike, Kyohei; Yaegashi, Hidetami

    2017-03-01

    Lithographic scaling continues to advance by extending the life of 193nm immersion technology, and spacer-type multi-patterning is undeniably the driving force behind this trend. Multi-patterning techniques such as self-aligned double patterning (SADP) and self-aligned quadruple patterning (SAQP) have come to be used in memory devices, and they have also been adopted in logic devices to create constituent patterns in the formation of 1D layout designs. Multi-patterning has consequently become an indispensible technology in the fabrication of all advanced devices. In general, items that must be managed when using multi-patterning include critical dimension uniformity (CDU), line edge roughness (LER), and line width roughness (LWR). Recently, moreover, there has been increasing focus on judging and managing pattern resolution performance from a more detailed perspective and on making a right/wrong judgment from the perspective of edge placement error (EPE). To begin with, pattern resolution performance in spacer-type multi-patterning is affected by the process accuracy of the core (mandrel) pattern. Improving the controllability of CD and LER of the mandrel is most important, and to reduce LER, an appropriate smoothing technique should be carefully selected. In addition, the atomic layer deposition (ALD) technique is generally used to meet the need for high accuracy in forming the spacer film. Advances in scaling are accompanied by stricter requirements in the controllability of fine processing. In this paper, we first describe our efforts in improving controllability by selecting the most appropriate materials for the mandrel pattern and spacer film. Then, based on the materials selected, we present experimental results on a technique for improving etching selectivity.

  4. Bilateral ganglion cysts of the cruciate ligaments: a case report.

    PubMed

    Willis-Owen, Charles A; Konyves, Arpad; Martin, David K

    2010-08-01

    Symptomatic ganglion cysts of the cruciate ligaments are rare, and bilateral cases are extremely rare, with only one reported case in the literature. We report a case of bilateral cruciate ligament ganglion cysts successfully treated with arthroscopic resection, and review the literature regarding aetiology, diagnosis and management.

  5. Bilateral agenesis of the anterior cruciate ligament: MRI evaluation.

    PubMed

    Bedoya, Maria A; McGraw, Michael H; Wells, Lawrence; Jaramillo, Diego

    2014-09-01

    Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed.

  6. Rabeprazole can overcome the impact of CYP2C19 polymorphism on quadruple therapy.

    PubMed

    Kuo, Chao-Hung; Wang, Sophie S W; Hsu, Wen-Hung; Kuo, Fu-Chen; Weng, Bi-Chuang; Li, Chia-Jung; Hsu, Ping-I; Chen, Angela; Hung, Wen-Chun; Yang, Yuan-Chieh; Wang, Wen-Ming; Wu, Deng-Chyang

    2010-08-01

    The prospective study was designed to clarify the impact of CYP2C19 on quadruple therapies and survey the efficacies of rabeprazole-based quadruple therapy for Helicobacter pylori infection after failure of standard triple therapies. From January 2007 to March 2009, 1055 H. pylori-infected patients received standard triple regimens (proton-pump inhibitor (PPI), clarithromycin, and amoxicillin). Helicobacter pylori eradication was achieved in 865 (81.9%) subjects. One hundred ninety eradication-failure patients were enrolled and randomly assigned to receive a 7-day eradication therapy. Ninety-six patients were treated with esomeprazole-based quadruple rescue therapies (EB), while 94 patients were treated with rabeprazole-based quadruple rescue therapies (RB). Follow-up endoscopy was done 16 weeks later to assess the treatment response. Patients' responses, CYP2C19 genotypes, and antibiotics resistances were also examined. Intention-to-treat analysis revealed that RB had better eradication rates than EB (EB: 72.9%; 95% CI: 64.9-80.9% and RB: 78.7%; 95% CI 72.5-84.9%) (p value = .543). Per-protocol results were EB = 75.3%; 95% CI: 70.3-80.3% and RB = 85.1%; 95% CI: 80.6-89.6% (p value = .0401). Both regimens had similar compliance (p value = 0.155) and adverse events (p value = 0.219). We also surveyed those patients without resistance of any antibiotics. RB still showed better outcome than EB. Our data showed that esomeprazole-based regimen and CYP2C19 Hom EM genotype were important predictors for eradication failure. In quadruple therapy, rabeprazole-based regimens had better efficacy than esomeprazole-based regimens. CYP2C19 polymorphism also played an important role in quadruple therapy. It seems advisable to change PPI to rabeprazole in second-line quadruple therapy.

  7. Impact biomechanics of lateral knee bracing. The anterior cruciate ligament.

    PubMed

    Paulos, L E; Cawley, P W; France, E P

    1991-01-01

    We evaluated the effects of six different prophylactic braces on ACL ligament strain under dynamic valgus loads using a mechanical surrogate limb validated against human cadaveric specimens. Medical collateral ligament and anterior cruciate ligament peak forces, medial collateral ligament and anterior cruciate ligament tension initiation times, and impact safety factors were calculated for both braced and unbraced conditions. These tests were conducted to determine whether or not application of a prophylactic brace might provide protection to the anterior cruciate ligament under valgus loading conditions. The results of this study indicate that those braces that increased impact duration appear to differentially protect the anterior cruciate ligament more than the medial collateral ligament, and that most of the braces tested appear to provide some degree of protection to the anterior cruciate ligament under direct lateral impacts. These findings should be confirmed clinically.

  8. Signing off

    NASA Astrophysics Data System (ADS)

    2001-05-01

    sharp that they cause paper cuts. Stains. If you accidentally spill some food or drink on your clothes, make sure you attempt to remove it as soon as possible and preferably within the same lunar cycle. Some teachers seem to think they should be worn with pride like the stains on a chemistry teacher's white coat. This is a myth. Materials. For scientists continually teaching about the wonder of smart materials, physics teachers are remarkably conservative in their choice of materials for their clothes. Try to break out from the traditional corduroy and tweed and practise what you teach. It is not acceptable to wear the actual tie you wore at school, as this will be at least 20 years old, be rather frayed and will have your name sewn in the back by your mum. Steven Chapman Science Year Manager, British Association for the Advancement of Science Signing Off takes a humorous and irreverent look at physics education. The views expressed here are those of the author and are not endorsed by the Editorial Board for Physics Education. Can you contribute a zany attitude or humorous anecdote? Please send your offering to ped@iop.org marked Signing Off.

  9. Mechanisms for the Generation of Two Quadruplications Associated with Split-Hand Malformation

    PubMed Central

    Gu, Shen; Posey, Jennifer E.; Yuan, Bo; Carvalho, Claudia M.B.; Luk, H.M.; Erikson, Kelly; Lo, Ivan F.M.; Leung, Gordon K.C.; Pickering, Curtis R.; Chung, Brian H.Y.; Lupski, James R.

    2015-01-01

    Germline copy-number variants (CNVs) involving quadruplications are rare and the mechanisms generating them are largely unknown. Previously, we reported a 20-week gestation fetus with split-hand malformation; clinical microarray detected two maternally inherited triplications separated by a copy-number neutral region at 17p13.3, involving BHLHA9 and part of YWHAE. Here, we describe an 18-month-old male sibling of the previously described fetus with split-hand malformation. Custom high-density array and digital droplet PCR revealed the copy-number gains were actually quadruplications in the mother, the fetus and her later born son. This quadruplication-normal-quadruplication pattern was shown to be expanded from the triplication-normal-triplication CNV at the same loci in the maternal grandmother. We mapped two breakpoint junctions and demonstrated that both are mediated by Alu repetitive elements and identical in these four individuals. We propose a three-step process combining Alu-mediated replicative-repair-based mechanism(s) and intergenerational, intrachromosomal non-allelic homologous recombination to generate the quadruplications in this family. PMID:26549411

  10. Signing off

    NASA Astrophysics Data System (ADS)

    2001-09-01

    Physics Related Aptitude Test As the teacher shortage bites anyone with a degree in science expects to walk into a school and be received, with open arms, as a physics teacher. Are they really suitable? To help you decide Signing Off provides the following invaluable psychometric test. Extensively researched and, for single users only, it comes completely free to Physics Education subscribers! (Copies of this Physics Related Aptitude Test are available to credit-card customers from prat@realripoff.com priced #35 per client, 125 dollars to US customers.) This invaluable psychometric test has been extensively researched. Your first lesson of the new school year introduces the study of electricity. Do you: A Use the notes prepared by your predecessor. B Find a video on electricity and play it to the class. C Arrange a series of exciting practical demonstrations to stimulate the young inquiring mind. D Let the children design and make their own circuits to light flashlight bulbs. Your 14-year-olds have completed a written test on heat and energy. Do you: A Mark correct only the work of students who have written their names neatly at the top LEFT HAND corner, as required. B Only set multiple choice tests, so that the computer can mark them for you. C Mark carefully by hand, explaining in detail to each student exactly how and why they have made errors and adding encouraging comments with lots of praise. D Give out correct sets of answers and allow students to mark their own work. There is a staff social. Do you: A Ask for a definition of the term 'social'. B Ask for a web-based version. C Determine to go, so that you can discuss setting up cross-curricular links with colleagues. D Join the organizing committee. Who do you admire most? A Sir Isaac Newton. B Bill Gates. C Leonardo da Vinci. D Leonardo di Caprio. You are required to teach biology class. Your response is: A Denial. B To ask for an appropriate computer simulation. C To attend a specialized course for biology

  11. [Influence of Saccharomyces boulardii Sachets combined with bismuth quadruple therapy for initial Helicobacter pylori eradication].

    PubMed

    Zhu, X Y; Du, J; Wu, J; Zhao, L W; Meng, X; Liu, G F

    2017-08-08

    Objective: To evaluate the efficacy and safety of Saccharomyces boulardii Sachets combined with bismuth quadruple therapy for initial Helicobacter pylori(H.pylori) eradication. Methods: From March 2014 to March 2015, 240 participants from the third hospital of Hebei medical university with H. pylori infection were recruited and randomized into three groups: Quadruple therapy group received bismuth potassium citrate 220 mg bid + Rabeprazole 10 mg bid + amoxicillin 1 000 mg bid+ furazolidone 100 mg bid for 10 days. Short-term group and long-term group received the same quadruple therapy for 10 days as above, as well as Saccharomyces boulardii Sachets 500 mg bid for 14 days and 28 days, respectively. H. pylori eradication was confirmed by (13)C/(14)C-UBT at least 4 weeks after completion of therapy. And side effects were investigated during the therapy. Results: The H. pylori eradication rates in quadruple therapy, short-term and long-term group were 80%, 87.5% and 87.5% by ITT analysis (P=0.321) and 92.8%, 94.6% and 95.9% by PP analysis (P=0.717), respectively. The overall side effect rate and occurrence of diarrhea and abdominal distension were significantly lower in short-term or long-term group as compared with quadruple therapy group(P=0.007, 0.003, 0.004), but there was no significant difference between the two probiotics groups. Conclusions: Both short and long-term Saccharomyces boulardii Sachets reduced the overall side effect rate and occurrence of diarrhea or abdominal distension when combined with bismuth quadruple therapy for initial H. pylori eradication and no difference was observed in efficacy or safety between the two groups.

  12. Technical note: Anterior cruciate ligament reconstruction in the presence of an intramedullary femoral nail using anteromedial drilling.

    PubMed

    Lacey, Matthew; Lamplot, Joseph; Walley, Kempland C; DeAngelis, Joseph P; Ramappa, Arun J

    2017-05-18

    To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology. The ACL remnant and lateral wall soft tissues are removed from the intercondylar, to provide adequate visualization of the ACL footprint. Femoral tunnel placement is performed using a transportal ACL guide with desired offset and the knee flexed to 2.09 rad. The Beath pin is placed through the guide starting at the ACL's anatomic footprint using arthroscopic visualization and/or fluoroscopic guidance. If resistance is met while placing the Beath pin, the arthroscopy should be discontinued and the obstructing hardware should be removed under fluoroscopic guidance. When the Beath pin is successfully placed through the lateral femur, it is overdrilled with a 4.5 mm Endobutton drill. If the Endobutton drill is obstructed, the obstructing hardware should be removed under fluoroscopic guidance. In this case, the obstruction is more likely during Endobutton drilling due to its larger diameter and increased rigidity compared to the Beath pin. The femoral tunnel is then drilled using a best approximation of the graft's outer diameter. We recommend at least 7 mm diameter to minimize the risk of graft failure. Autologous hamstring grafts are generally between 6.8 and 8.6 mm in diameter. After reaming, the knee is flexed to 1.57 rad, the arthroscope placed through the anteromedial portal to confirm the femoral tunnel position, referencing the posterior wall and lateral cortex. For a quadrupled hamstring graft, the gracilis and semitendinosus tendons are then harvested in the standard fashion. The tendons are whip

  13. Technical note: Anterior cruciate ligament reconstruction in the presence of an intramedullary femoral nail using anteromedial drilling

    PubMed Central

    Lacey, Matthew; Lamplot, Joseph; Walley, Kempland C; DeAngelis, Joseph P; Ramappa, Arun J

    2017-01-01

    AIM To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. METHODS Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology. The ACL remnant and lateral wall soft tissues are removed from the intercondylar, to provide adequate visualization of the ACL footprint. Femoral tunnel placement is performed using a transportal ACL guide with desired offset and the knee flexed to 2.09 rad. The Beath pin is placed through the guide starting at the ACL’s anatomic footprint using arthroscopic visualization and/or fluoroscopic guidance. If resistance is met while placing the Beath pin, the arthroscopy should be discontinued and the obstructing hardware should be removed under fluoroscopic guidance. When the Beath pin is successfully placed through the lateral femur, it is overdrilled with a 4.5 mm Endobutton drill. If the Endobutton drill is obstructed, the obstructing hardware should be removed under fluoroscopic guidance. In this case, the obstruction is more likely during Endobutton drilling due to its larger diameter and increased rigidity compared to the Beath pin. The femoral tunnel is then drilled using a best approximation of the graft’s outer diameter. We recommend at least 7 mm diameter to minimize the risk of graft failure. Autologous hamstring grafts are generally between 6.8 and 8.6 mm in diameter. After reaming, the knee is flexed to 1.57 rad, the arthroscope placed through the anteromedial portal to confirm the femoral tunnel position, referencing the posterior wall and lateral cortex. For a quadrupled hamstring graft, the gracilis and semitendinosus tendons are then harvested in the standard fashion. The

  14. Dynamic viscoelasticity measurement under alternative torque using electromagnetically spinning method with quadruple electromagnets

    NASA Astrophysics Data System (ADS)

    Matsuura, Yusuke; Hirano, Taichi; Sakai, Keiji

    2017-07-01

    In this study, we developed a novel type of rheological measurement system. Here, a spherical probe is driven to rotate periodically by applying torques using quadruple electromagnets in a noncontact manner. Moreover, this system is an enhancement of our electromagnetically spinning (EMS) viscometer, which is widely used for measuring rheological flow curves in various industrial fields. The quadruple EMS method provides the frequency spectrum of viscoelasticity, in addition to shear viscosity, in a steady flow by switching the operation modes of the driving torque. We show the results obtained for Newtonian fluids and viscoelastic materials and demonstrate the validity of the system.

  15. Dynamic viscoelasticity measurement under alternative torque using electromagnetically spinning method with quadruple electromagnets.

    PubMed

    Matsuura, Yusuke; Hirano, Taichi; Sakai, Keiji

    2017-07-01

    In this study, we developed a novel type of rheological measurement system. Here, a spherical probe is driven to rotate periodically by applying torques using quadruple electromagnets in a noncontact manner. Moreover, this system is an enhancement of our electromagnetically spinning (EMS) viscometer, which is widely used for measuring rheological flow curves in various industrial fields. The quadruple EMS method provides the frequency spectrum of viscoelasticity, in addition to shear viscosity, in a steady flow by switching the operation modes of the driving torque. We show the results obtained for Newtonian fluids and viscoelastic materials and demonstrate the validity of the system.

  16. Quality assessment of layer-structured semiconductor single crystals by nuclear quadruple resonance method

    NASA Astrophysics Data System (ADS)

    Samila, Andriy; Khandozhko, Alexander; Lastivka, Galina; Politansky, Leonid; Khandozhko, Victor

    2015-11-01

    A method for quality assessment of layer-structured semiconductor single crystals (InSe, GaSe, GaS) grown in evacuated ampoules by the Bridgman technique is proposed. For this purpose, nuclear quadruple resonance method with a consecutive scanning of the entire sample volume and evaluation of crystal perfection by the resulting spectra is used. Effective interaction between high-frequency field and crystal and, accordingly, restriction of scanning area of sample under study is provided with the use of a two-way saddle-shaped coil for a nuclear quadruple resonance spectrometer.

  17. Nonbismuth concomitant quadruple therapy for Helicobacter pylori eradication in Chinese regions: A meta-analysis of randomized controlled trials

    PubMed Central

    Lin, Lien-Chieh; Hsu, Tzu-Herng; Huang, Kuang-Wei; Tam, Ka-Wai

    2016-01-01

    AIM: To evaluate the applicability of nonbismuth concomitant quadruple therapy for Helicobacter pylori (H. pylori) eradication in Chinese regions. METHODS: A systematic review and meta-analysis of randomized controlled trials was performed to evaluate the efficacy of nonbismuth concomitant quadruple therapy between sequential therapy or triple therapy for H. pylori eradication in Chinese regions. The defined Chinese regions include China, Hong Kong, Taiwan, and Singapore. The primary outcome was the H. pylori eradication rate; the secondary outcome was the compliance with therapy. The PubMed, Embase, Scopus, and Cochrane databases were searched for studies published in the period up to March 2016 with no language restriction. RESULTS: We reviewed six randomized controlled trials and 1616 patients. In 3 trials comparing concomitant quadruple therapy with triple therapy, the H. pylori eradication rate was significantly higher for 7-d nonbismuth concomitant quadruple therapy than for 7-d triple therapy (91.2% vs 77.9%, risk ratio = 1.17, 95%CI: 1.09-1.25). In 3 trials comparing quadruple therapy with sequential therapy, the eradication rate was not significant between groups (86.9% vs 86.0%). However, higher compliance was achieved with concomitant therapy than with sequential therapy. CONCLUSION: The H. pylori eradication rate was higher for nonbismuth concomitant quadruple therapy than for triple therapy. Moreover, higher compliance was achieved with nonbismuth concomitant quadruple therapy than with sequential therapy. Thus, nonbismuth concomitant quadruple therapy should be the first-line treatment in Chinese regions. PMID:27340362

  18. Anterior cruciate ligament reconstruction: principles of treatment

    PubMed Central

    Paschos, Nikolaos K.; Howell, Stephen M.

    2016-01-01

    Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in sports medicine. Several areas of controversy exist in ACL tear management which have engaged surgeons and researchers in debates towards identifying an ideal approach for these patients. This instructional review discusses the principles of ACL reconstruction in an attempt to provide guidelines and initiate a critical thinking approach on the most common areas of controversy regarding ACL reconstruction. Using high-level evidence from the literature, as presented in randomised controlled trials, systematic reviews, and meta-analyses, operative versus conservative treatment, timing of surgery, and rehabilitation are discussed. Also, the advantages and disadvantages of the most common types of autografts, such as patellar tendon and hamstrings as well as allografts are presented. Key considerations for the anatomical, histological, biomechanical and clinical data (‘IDEAL’) graft positioning are reviewed. Cite this article: Paschos NK, Howell SM. Anterior cruciate ligament reconstruction: principles of treatment. EFORT Open Rev 2016;398-408. DOI: 10.1302/2058-5241.1.160032. PMID:28461919

  19. Risk Factors for Anterior Cruciate Ligament Injury

    PubMed Central

    Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra; Beynnon, Bruce D.

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) are immediately disabling and are associated with long-term consequences, such as posttraumatic osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 2 of a 2-part series, highlights what is known and still unknown regarding hormonal, genetic, cognitive function, previous injury, and extrinsic risk factors for ACL injury. Data Sources: Studies were identified from MEDLINE (1951–March 2011) using the MeSH terms anterior cruciate ligament, knee injury, and risk factors. The bibliographies of relevant articles and reviews were cross-referenced to complete the search. Study Selection: Prognostic case-control and prospective cohort study designs to evaluate risk factors for ACL injury were included in this review. Results: A total of 50 case-control and prospective cohort articles were included in parts 1 and 2. Twenty-one focused on hormonal, genetic, cognitive function, previous injury, and extrinsic risk factors. Conclusions: Several risk factors are associated with increased risk of suffering ACL injury—such as female sex, prior reconstruction of the ACL, and familial predisposition. These risk factors most likely act in combination with the anatomic factors reviewed in part 1 of this series to influence the risk of suffering ACL injury. PMID:23016083

  20. Warning Signs After Birth

    MedlinePlus

    ... Home > Pregnancy > Postpartum care > Warning signs after birth Warning signs after birth E-mail to a friend ... breast infection Postpartum bleeding Postpartum depression (PPD) What warning signs should you look for? Call your provider ...

  1. Digital infrared thermal imaging following anterior cruciate ligament reconstruction.

    PubMed

    Barker, Lauren E; Markowski, Alycia M; Henneman, Kimberly

    2012-03-01

    This case describes the selective use of digital infrared thermal imaging for a 48-year-old woman who was being treated by a physical therapist following left anterior cruciate ligament (ACL) reconstruction with a semitendinosus autograft.

  2. Sensitivity analysis of silicon-on-insulator quadruple Vernier racetrack resonators

    NASA Astrophysics Data System (ADS)

    Boeck, Robert; Chrostowski, Lukas; Jaeger, Nicolas A. F.

    2015-11-01

    We present a theoretical sensitivity analysis of silicon-on-insulator quadruple Vernier racetrack resonators based on varying, one at a time, various fabrication-dependent parameters. These parameters include the waveguide widths, heights, and propagation losses. We show that it should be possible to design a device that meets typical commercial specifications while being tolerant to changes in these parameters.

  3. Morphologic and functional features of the canine cruciate ligaments.

    PubMed

    de Rooster, Hilde; de Bruin, Tanya; van Bree, Henri

    2006-12-01

    To review the gross, microscopic, and functional anatomy of the cranial cruciate ligament (CCL) in dogs. Literature review. Reports of the anatomy and function of the cruciate ligaments in dogs were retrieved by search of the 1975-2005 PubMed database. The CCL has an important biomechanical function resisting cranial drawer, hyperextension, and internal rotation and acts to fine tune and guide the stifle through its rolling and sliding motion. It has a complex architecture, and distinct geographic regions within the ligament have different functional roles depending on the angle and loading conditions. Collagen type I is the main component of the extracellular matrix; the fibrils have a crimped structure. The cruciate ligaments are almost completely covered by synovium, protecting them from synovial fluid. Cruciate blood supply is mainly of soft tissue origin. The intraligamentous network is relatively limited whereas the core of the middle third of the CCL is even less well vascularized. Neurohistologic studies are very limited in the dog. Various mechanoreceptors and proprioceptive receptors have been identified within the substance of the cruciate ligaments. CCL structural characteristics play an important part in its complex behaviour with the crimped pattern of the collagen fibrils being an important determinant of its biomechanical properties. In contrast to reports of managing CCL rupture, there are few reports describing the microanatomy and neurovascular morphology of the cruciate ligaments. Cruciate disease is likely multi-factorial. Improved understanding of CCL degradation leading to CCL rupture is critical to development of new diagnostic tests for cruciate disease in dogs. Appropriate intervention during the early stages of disease process might preserve CCL structural properties by preventing further collagen degradation. Accurate knowledge of functional and fiber bundle anatomy is imperative for reconstruction and restoration of normal stifle joint

  4. Features extraction in anterior and posterior cruciate ligaments analysis.

    PubMed

    Zarychta, P

    2015-12-01

    The main aim of this research is finding the feature vectors of the anterior and posterior cruciate ligaments (ACL and PCL). These feature vectors have to clearly define the ligaments structure and make it easier to diagnose them. Extraction of feature vectors is obtained by analysis of both anterior and posterior cruciate ligaments. This procedure is performed after the extraction process of both ligaments. In the first stage in order to reduce the area of analysis a region of interest including cruciate ligaments (CL) is outlined in order to reduce the area of analysis. In this case, the fuzzy C-means algorithm with median modification helping to reduce blurred edges has been implemented. After finding the region of interest (ROI), the fuzzy connectedness procedure is performed. This procedure permits to extract the anterior and posterior cruciate ligament structures. In the last stage, on the basis of the extracted anterior and posterior cruciate ligament structures, 3-dimensional models of the anterior and posterior cruciate ligament are built and the feature vectors created. This methodology has been implemented in MATLAB and tested on clinical T1-weighted magnetic resonance imaging (MRI) slices of the knee joint. The 3D display is based on the Visualization Toolkit (VTK). Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Messenger ribonucleic acid levels in disrupted human anterior cruciate ligaments.

    PubMed

    Lo, Ian K Y; Marchuk, Linda; Hart, David A; Frank, Cyril B

    2003-02-01

    Thirty patients had anterior cruciate ligament reconstruction for ongoing instability. Two groups were defined according to gross morphologic features identified during reconstruction: anterior cruciate ligament disruptions with scars attached to a structure in the joint and disruptions without reattachments. Reverse transcription polymerase chain reaction for a subset of extracellular matrix molecules, proteinases, and proteinase inhibitors was done on samples of scarred anterior cruciate ligament tissue removed during reconstructive surgery. Results of the nonattached scar group showed significantly increased mRNA levels for Type I collagen, and an increased Type I to Type III collagen ratio compared with that for the attached scar group. In the first year after injury, decorin mRNA levels in the nonattached scar group also were significantly higher than in the attached scar group. Biglycan mRNA levels in the nonattached scar group correlated closely with Type I collagen mRNA levels. These results suggest differences in cellular expression in torn anterior cruciate ligaments that attach to structures in the joint versus those which do not. Although the molecular mechanisms responsible for these differences have not been delineated, different molecular signals may influence the gross morphologic features of anterior cruciate ligament disruptions or alternatively, differing gross morphologic features may be subject to different mechanical loads leading to altered molecular expression. However, the finding of endogenous cellular activity in injured anterior cruciate ligaments raises the possibility that this activity may be enhanced to improve outcomes.

  6. Medial unicondylar knee arthroplasty combined to anterior cruciate ligament reconstruction.

    PubMed

    Ventura, Alberto; Legnani, Claudio; Terzaghi, Clara; Iori, Stefano; Borgo, Enrico

    2017-03-01

    The purpose of the present study was to retrospectively evaluate the outcomes of patients who underwent combined medial unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament (ACL) reconstruction. The hypothesis was that this procedure would lead to a high success rate in patients affected by isolated medial unicompartmental osteoarthritis and concomitant ACL deficiency. Fourteen patients with primary ACL lesion and concomitant medial compartment symptomatic osteoarthritis treated from 2006 to 2010 were followed up for an average time of 26.7 months (SD 4.2). Assessment included KOOS score, Oxford Knee score, American Knee Society scores, WOMAC index of osteoarthritis, Tegner activity level and objective examination including instrumented laxity test with KT-1000 arthrometer. Radiological assessment was done with standard simple radiographs in order to get information about any presence of loosening of the components. KOOS score, OKS, WOMAC index and the AKSS improved significantly after surgery (p < 0.001). Regarding AKSS, improvement was noted both in the objective score and in the functional one (p < 0.001). There was no clinical evidence of instability in any of the knees as evaluated with clinical laxity testing. No pathologic radiolucent lines were observed around the components. In one patient signs of osteoarthritis in the lateral compartment were observed 28 months after surgery. UKA combined with ACL reconstruction is a valid therapeutic option for the treatment of combined medial unicompartmental knee osteoarthritis and ACL deficiency in young and active patients and confirms subjective and objective clinical improvement 2 years after surgery. The use of a fixed-bearing prosthesis represents a reliable feature as it allows to overcome problems of improper ligament tensioning during the implantation of the components. IV.

  7. Femoral tunnel enlargement after anterior cruciate ligament reconstruction using RigidFix compared with extracortical fixation.

    PubMed

    Lopes, Osmar Valadao; de Freitas Spinelli, Leandro; Leite, Luiz Henrique Cunha; Buzzeto, Bruce Quatrin; Saggin, Paulo Renato Fernades; Kuhn, André

    2017-05-01

    The aim of this study was to compare femoral tunnel enlargement after anterior cruciate ligament (ACL) reconstruction surgery using hamstring autograft tendons fixed by bioabsorbable femoral trans-tunnel pins with that in patients in which the graft was fixed with extracortical fixation. Forty-three patients were randomly selected from our database and included in the study. Femoral tunnel diameter was measured by computed tomography in 20 patients who underwent ACL reconstruction via anteromedial portal technique using autologous quadruple hamstrings, fixed with two bioabsorbable trans-tunnel pins, RigidFix, on the femoral side and compared with 23 patients in whom extracortical fixation, EndoButton CL, was used. The diameter of the femoral tunnel was measured at a distance of 5 mm from the tunnel entrance and at the largest diameter along the tunnel axis. Data were compared with the diameter of the drill used during surgery. Clinical evaluation was performed using the Lysholm score, IKDC subjective score and anterior knee laxity measurements. Femoral tunnel enlargement 5 mm from the entrance and at the largest diameter was greater in the RigidFix group than the EndoButton group. There were no significant differences between the two groups regarding age, gender, post-operative Lysholm score, IKDC subjective score or knee laxity measurements. The present study showed greater enlargement of the femoral bone tunnel when a bioabsorbable trans-tunnel pin system was used with the medial portal technique when compared to extracortical fixation. These findings confirm that femoral tunnel widening should be considered when RigidFix was used in ACL reconstruction by anteromedial portal technique. III.

  8. Early anterior cruciate ligament reconstruction can save meniscus without any complications

    PubMed Central

    Hur, Chang-Ik; Song, Eun-Kyoo; Kim, Sung-Kyu; Lee, Seung-Hun; Seon, Jong-Keun

    2017-01-01

    Background: Early ACL reconstruction, before retuning to activity eliminates recurrent episodes of instability and thereby decreases chances of meniscal and cartilage injury. However, there are no clear and uniform guidelines regarding the timing of ACL reconstruction or clarity in the definition of early and delayed reconstruction to reduce the complications after reconstruction in the ACL injured knee. The purpose of this study was to compare the clinical outcome, stability, muscle power, and postural control after early and delayed anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Patients who had ACL reconstruction with a quadruple hamstring tendon with a minimum 2-year followup were evaluated. Early (within 3 weeks) reconstruction group was 48 knees and delayed (more than 3 months) group was 43 knees. We compared the two groups with regard to Lysholm knee score, range of motion (ROM), Lachman test, Tegner activity scale, associated meniscal or chondral injuries, and anterior laxity. We also compared muscle strength with an isokinetic dynamometer and postural control with computed dynamic posturography at the final followup. Results: While 50% of early and 70% of delayed group had meniscal injuries (P = 0.06), of which were reparable in 42% of early group and 17% of delayed group (P = 0.04). However, there was no significant difference in cartilage injury (P = 0.14). At the final followup, no significant differences were found between two groups for Lysholm score (P = 0.28), Tegner activity scale (P = 0.27), and ROM. The stabilities regarding Lachman and pivot-shift tests, and anterior laxity also showed no significant differences between two groups. The mean extension and flexion muscles power, and postural control showed no significant inter-group differences (P > 0.05). Conclusions: Early ACL reconstruction had excellent clinical results and stability as good as delayed reconstruction without the problem of knee motion, muscle power

  9. EVALUATION OF THE RESULTS OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING FLEXOR TENDONS AND RIGID GUIDE TRANSVERSE SCREW

    PubMed Central

    de Castro, Renato Luiz Bevilacqua; Acras, Sandor Dosa

    2015-01-01

    Objective: The aim of this study was to analyze the results of ACL (anterior cruciate ligament) reconstruction using quadruple flexor tendons as grafts, with ligament fixation in the femur using a rigid guide transverse screw and in the tibia, using a cancellous screw with a fixing washer. Methods: 173 knees (166 from males and seven from females) that had undergone surgery with ACL reconstruction using this technique between December 2002 and February 2007 were evaluated. The mean age was 30 years (from 13 to 56 years), and the mean follow-up time was 30 months (6-55 months). We divided the knees into three groups, which were assessed using the Lysholm scale: Group A with six months of follow-up; Group B with 12 months of follow-up; and Group C with 24 months of follow-up. Results: We evaluated the results, and groups A, B and C received 94, 95 and 95 points respectively on the Lysholm scale. Conclusions: The surgical technique proved to be safe and easy to perform, with good results and a low complication rate. Also, its results were maintained throughout the study period of 24 months. PMID:27027002

  10. All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients: A Surgical Technique Using a Split Tibial Tunnel

    PubMed Central

    Lykissas, Marios G.; Nathan, Senthil T.; Wall, Eric J.

    2012-01-01

    Many techniques have been described for anterior cruciate ligament (ACL) reconstruction in skeletally immature patients, including extra-articular, complete or partial transphyseal, and physeal-sparing techniques. An all-epiphyseal technique places the tendon and its tunnels and fixation all within the child's epiphysis, leaving the growth plates untouched. We describe an all-epiphyseal quadruple-hamstring ACL reconstruction using a split tibial tunnel. The split tibial tunnels drop the tunnel size down to 4.5 to 5.5 mm from 7 to 8 mm because only half the total graft diameter passes through each of the split tunnels. This increases the safety margin for keeping the tunnel within the tibial epiphysis, in addition to avoiding damage into the growth plate. The bone bridge between the 2 tunnels serves as a solid low-profile fixation post. Femoral graft fixation is achieved with an interference screw, which allows precise tensioning and low-profile fixation entirely within the femoral tunnel. By placing the graft at the native ACL's anatomic attachment points without spanning or violating the growth plates at any step of the procedure, an all-epiphyseal ACL reconstruction with a split tibial tunnel theoretically minimizes the risk of growth disturbance in an ACL-deficient child. PMID:23766968

  11. Essentials of anterior cruciate ligament rupture management.

    PubMed

    Klinge, Stephen A; Sawyer, Gregory A; Hulstyn, Michael J

    2013-05-01

    Anterior cruciate ligament (ACL) rupture is a common knee injury and an understanding of current medical knowledge regarding its management is essential. Accurate and prompt diagnosis requires an awareness of injury mechanisms and risk factors, common symptoms and physical/radiologic findings. Early mobilization and physical therapy improves outcomes regardless of treatment modality. Many older patients regain sufficient stability and function after non-operative rehabilitation. Early ACL reconstruction is appropriate for younger patients and those who engage in activities requiring frequent pivoting and rapid direction changes. ACL surgery involves reconstruction of the torn ligament tissue with various replacement graft options, each with advantages and disadvantages. The guidance of a knowledgeable and experienced therapist is required throughout an intensive and prolonged rehabilitation course. Generally excellent outcomes and low complication rates are expected, but treatment does not prevent late osteoarthritis.

  12. Anterior cruciate ligament reconstruction and knee osteoarthritis

    PubMed Central

    Paschos, Nikolaos K

    2017-01-01

    Anterior cruciate ligament (ACL) injury is a traumatic event that can lead to significant functional impairment and inability to participate in high-level sports-related activities. ACL reconstruction is considered the treatment of choice for symptomatic ACL-deficient patients and can assist in full functional recovery. Furthermore, ACL reconstruction restores ligamentous stability to normal, and, therefore, can potentially fully reinstate kinematics of the knee joint. As a consequence, the natural history of ACL injury could be potentially reversed via ACL reconstruction. Evidence from the literature is controversial regarding the effectiveness of ACL reconstruction in preventing the development of knee cartilage degeneration. This editorial aims to present recent high-level evidence in an attempt to answer whether ACL injury inevitably leads to osteoarthritis and whether ACL reconstruction can prevent this development or not. PMID:28361013

  13. Anterior cruciate ligament reconstruction without drill holes.

    PubMed

    Brief, L P

    1991-01-01

    Anterior cruciate ligament (ACL) reconstruction in adolescents with open physes remains a difficult problem for the orthopedic surgeon, especially in view of growing teenage participation in contact sports. Traditionally, treatment of ACL tears in adolescents has been conservative; the patient is advised to delay surgery up to several years for fear of damaging physes by drilling holes across them. Unfortunately, this waiting period may inflict irreparable knee damage. This paper suggests an ACL reconstruction technique that utilizes no drill holes, thus causing no harm to physes or other essential knee structures. A graft consisting of semitendinosus and gracilis (SG) tendons is passed under the anterior horn of the medial meniscus through the knee joint, then brought out through the posterior capsule and secured to the lateral femoral metaphysis. The graft is augmented with an iliotibial band tenodesis. Designed primarily but not exclusively for teenagers with open physes, the procedure has produced encouraging results thus far in a small series.

  14. Infections in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Stucken, Charlton; Garras, David N.; Shaner, Julie L.; Cohen, Steven B.

    2013-01-01

    Context: Anterior cruciate ligament (ACL) reconstruction is a safe, common, and effective method of restoring stability to the knee after injury, but evolving techniques of reconstruction carry inherent risk. Infection after ACL reconstruction, while rare, carries a high morbidity, potentially resulting in a poor clinical outcome. Evidence Acquisition: Data were obtained from previously published peer-reviewed literature through a search of the entire PubMed database (up to December 2012) as well as from textbook chapters. Results: Treatment with culture-specific antibiotics and debridement with graft retention is recommended as initial treatment, but with persistent infection, consideration should be given to graft removal. Graft type likely has no effect on infection rates. Conclusion: The early diagnosis of infection and appropriate treatment are necessary to avoid the complications of articular cartilage damage and arthrofibrosis. PMID:24427432

  15. Postoperative Infection After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Gobbi, Alberto; Karnatzikos, Georgios; Chaurasia, Sanyam; Abhishek, Mudhigere; Bulgherhoni, Erica; Lane, John

    2015-01-01

    Context: Infection after anterior cruciate ligament reconstruction (ACLR) is uncommon; if it occurs, it can lead to disastrous complications. Objective: To analyze post-ACLR infections and identify related complications to provide the most effective treatment protocol. Study Design: Clinical review. Level of Evidence: Level 4. Results: Among approximately 1850 ACLRs performed by a single surgeon over the past 20 years, 7 cases of post-ACLR infection were identified (incidence, 0.37%). Five patients presenting with low-severity infection were successfully treated without any complication or residual functional disability. The remaining 2 patients, although successfully treated, presented with minor residual limitations. From a literature review, 16 studies including 246 cases of infection were reported among 35,795 ACLRs, making the rate of infection 0.68% (range, 0.14%-2.6%). Conclusion: With proper treatment protocols, post-ACLR infection is rare but can compromise outcomes. PMID:26603553

  16. Anterior Cruciate Ligament Injuries in Growing Skeleton

    PubMed Central

    AlHarby, Saleh W.

    2010-01-01

    Anterior cruciate ligament (ACL) injuries in the adult patients are thoroughly studied and published in orthopedic literature. Until recently, little was known about similar injuries in skeletally growing patients. The more frequent involvement of this age group in various athletic activities and the improved diagnostic modalities have increased the awareness and interest of ACL injuries in skeletally immature patients. ACL reconstruction in growing skeleton is controversial and carries some risks to the tibial and femoral growth plate. A guarded approach to ACL reconstruction is recommended in skeletally immature patients. Modification of activity of ACL injured young patient, proper rehabilitation and prudent planning of adolescent age ACL reconstruction carries the least risks of growth plate violation. PMID:21475528

  17. Risk Factors for Anterior Cruciate Ligament Injury

    PubMed Central

    Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) of the knee are immediately debilitating and can cause long-term consequences, including the early onset of osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 1 of a 2-part series, highlights what is known and still unknown regarding anatomic and neuromuscular risk factors for injury to the ACL from the current peer-reviewed literature. Data Sources: Studies were identified from MEDLINE (1951–March 2011) using the MeSH terms anterior cruciate ligament, knee injury, and risk factors. The bibliographies of relevant articles and reviews were cross-referenced to complete the search. Study Selection: Prognostic studies that utilized the case-control and prospective cohort study designs to evaluate risk factors for ACL injury were included in this review. Results: A total of 50 case-control and prospective cohort articles were included in the review, and 30 of these studies focused on neuromuscular and anatomic risk factors. Conclusions: Several anatomic and neuromuscular risk factors are associated with increased risk of suffering ACL injury—such as female sex and specific measures of bony geometry of the knee joint, including decreased intercondylar femoral notch size, decreased depth of concavity of the medial tibial plateau, increased slope of the tibial plateaus, and increased anterior-posterior knee laxity. These risk factors most likely act in combination to influence the risk of ACL injury; however, multivariate risk models that consider all the aforementioned risk factors in combination have not been established to explore this interaction. PMID:23016072

  18. Joint space narrowing after partial medial meniscectomy in the anterior cruciate ligament-intact knee.

    PubMed

    Shelbourne, K Donald; Dickens, Jonathan F

    2007-09-01

    Osteoarthritis of the knee is common after total medial meniscectomy. In anterior cruciate ligament-intact knees, the reported outcomes of partial medial meniscectomy are variable. Radiographic assessment using a posteroanterior weight-bearing view is a reliable tool for detecting minor medial joint space narrowing, which may be an early sign of osteoarthritis. Studies that assessed the effect of partial medial meniscectomy found a low percentage of patients with >50% joint narrowing at 10 to 15 years after surgery. Digital radiography, using a posteroanterior weight-bearing view, is a highly sensitive method for observing minor joint space narrowing in the involved knee. A recent study showed that 88% of patients who underwent partial medial meniscectomy had joint space narrowing of <2 mm, and none had narrowing >or=2 mm, at a mean follow-up of 12 years. Subjective results after partial medial meniscectomy are favorable, with 88% to 95% of patients reporting good to excellent results.

  19. Biomechanical evaluation of a novel dynamic posterior cruciate ligament brace.

    PubMed

    Heinrichs, Christian H; Schmoelz, Werner; Mayr, Raul; Keiler, Alexander; Schöttle, Philip B; Attal, René

    2016-03-01

    Use of a rigid brace or cast immobilization is recommended in conservative treatment or postoperative rehabilitation after a posterior cruciate ligament injury. To prevent the loss of knee joint function and muscle activity often associated with this, a flexible knee brace has been developed that allows an adjustable anteriorly directed force to be applied to the calf in order to prevent posterior tibial translation. The purpose of this biomechanical study was to evaluate the impact of this novel dynamic brace on posterior tibial translation after posterior cruciate ligament injury and reconstruction. A Telos stress device was used to provoke posterior tibial translation in seven human lower limb specimens, and stress radiographs were taken at 90° of knee flexion. Posterior tibial translation was measured in the native knees with an intact posterior cruciate ligament; after arthroscopic posterior cruciate ligament dissection with and without a brace; and after posterior cruciate ligament reconstruction with and without a brace. The force applied with the brace was measured using a pressure sensor. Posterior tibial translation was significantly reduced (P=0.032) after application of the brace with an anteriorly directed force of 50N to the knees with the dissected posterior cruciate ligament. The brace also significantly reduced posterior tibial translation after posterior cruciate ligament reconstruction in comparison with reconstructed knees without a brace (P=0.005). Posterior tibial translation was reduced to physiological values using this dynamic brace system that allows an anteriorly directed force to be applied to the calf. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. [Injuries of the medial collateral ligament and anterior cruciate ligament of the knee joint and Lemaire surgical functional treatment. Long-term outcome].

    PubMed

    Schmid, F

    1996-06-01

    The present paper reports the results of 112 extraarticular ligamento-plasties performed on the knee with the procedure proposed by Lemaire. The series includes isolated tears of the anterior cruciate and medical collateral ligament as well as combined tears of both ligaments. The clinical and radiological results with a mean follow-up time of 11.5 years are compared with the results obtained in a first assessment 8 years ago. Good clinical results are in contrast with increasing osteoarthrosis in 1/3 of the knees radiologically assessed. The operation for a torn anterior cruciate ligament should be performed as soon as possible to avoid secondary meniscal lesions with subsequent severe osteoarthrosis. Presence or absence of arthrotic signs in the X-rays mainly determine the long-term result after ligamento-plasties of the knee. The Lemaire plasties are well tolerated even by elderly still active people and need little postoperative care.

  1. Simultaneous quadruple modal nonlinear optical imaging for gastric diseases diagnosis and characterization

    NASA Astrophysics Data System (ADS)

    Wang, Zi; Zheng, Wei; Lin, Jian; Huang, Zhiwei

    2015-03-01

    We report the development of a unique simultaneous quadruple-modal nonlinear optical microscopy (i.e., stimulated Raman scattering (SRS), second-harmonic generation (SHG), two-photon excitation fluorescence (TPEF), and third-harmonic generation (THG)) platform for characterization of the gastric diseases (i.e., gastritis, intestinal metaplasia (IM), intestinal type adenocarcinoma). SRS highlights the goblet cells found in IM. SHG images the distribution of collagen in lamina propria. Collagen is found to aggregate for intestinal type adenocarcinoma. TPEF reveals the cell morphology and can reflect the damage inside glands caused by the diseases. THG visualizes the nuclei with high spatial resolution, which facilitates the identification of neutrophils that are usually used as a feature of inflammation. This work shows that the co-registration of quadruple-modal images can be an effective means for diagnosis and characterization of gastric diseases at the cellular and molecular levels.

  2. Two Cases of Annular Skin Defects Repaired with Quadruple Fan Flaps (O-X Flap)

    PubMed Central

    Oh, Ji-Eun; Lee, Sang-Min

    2009-01-01

    Nowadays, patients have high expectations when it comes to minimization of postoperative scarring after dermatologic surgical procedures. When an annular lesion is being excised, normal skin should be excised, as well, to prevent a dog ears resulting in a long scar. We introduce a new flap reducing the scar length in annular defects. In order to avoid a long scar, we designed a quadruple fan flap (O-X flap) that is a variation of the rotation flap. It consists of four rotation flaps arranged like fans, with open and closed configuration. We suggest that the quadruple fan flap (O-X flap) is a viable option for treating annular skin defects, because it shortens the scar line, preserves normal tissue, and provides a cosmetically favorable outcome. PMID:20548871

  3. Psychological Aspects of Recovery Following Anterior Cruciate Ligament Reconstruction.

    PubMed

    Christino, Melissa A; Fantry, Amanda J; Vopat, Bryan G

    2015-08-01

    Recovery following anterior cruciate ligament reconstruction is an arduous process that requires a significant mental and physical commitment to rehabilitation. Orthopaedic research in recent years has focused on optimizing anterior cruciate ligament surgical techniques; however, despite stable anterior cruciate ligament reconstructions, many athletes still never achieve their preinjury ability or even return to sport. Psychological factors associated with patient perceptions and functional outcomes following anterior cruciate ligament reconstruction are important to acknowledge and understand. Issues related to emotional disturbance, motivation, self-esteem, locus of control, and self-efficacy can have profound effects on patients' compliance, athletic identity, and readiness to return to sport. The psychological aspects of recovery play a critical role in functional outcomes, and a better understanding of these concepts is essential to optimize the treatment of patients undergoing anterior cruciate ligament reconstruction, particularly those who plan to return to sport. Identifying at-risk patients, encouraging a multidisciplinary approach to patient care, and providing early referral to a sports psychologist may improve patient outcomes and increase return-to-play rates among athletes.

  4. Gross, Arthroscopic, and Radiographic Anatomies of the Anterior Cruciate Ligament: Foundations for Anterior Cruciate Ligament Surgery.

    PubMed

    Irarrázaval, Sebastián; Albers, Marcio; Chao, Tom; Fu, Freddie H

    2017-01-01

    The anterior cruciate ligament (ACL) is one of the more studied structures in the knee joint. It is not a tubular structure, but is much narrower in its midsubstance and broader at its ends, producing an hourglass shape. The ACL is composed of 2 functional bundles, the anteromedial and posterolateral bundles, that are named for their location of insertion on the anterior surface of the tibial plateau. Although the relative contribution in terms of total cross-sectional area of the ACL has been noted to be equal in regards to each bundle, dynamically these bundles demonstrate different properties for knee function.

  5. A novel quadruple excitation in high-Tc SQUID-based non-destructive evaluation

    NASA Astrophysics Data System (ADS)

    Kong, X. Y.; Ren, Y. F.; Li, J. W.; Yu, H. W.; Chen, G. H.; Yang, Q. S.

    2006-02-01

    A high-Tc SQUID-based non-destructive evaluation (NDE) system has been set up in our laboratory. The SQUID was made on a 24° bicystal SrTiO3 substrate. A novel quadruple excitation coil was proposed for the first time and applied in the artificial holes in the aluminium multilayer structure in a noisy unshielded environment. The experimental data shows that it has good balance and is very effective at detecting small hole defects.

  6. Second-line bismuth-containing quadruple therapy for Helicobacter pylori eradication and impact of diabetes

    PubMed Central

    Kim, Sung Eun; Park, Moo In; Park, Seun Ja; Moon, Won; Kim, Jae Hyun; Jung, Kyoungwon; Kim, Hae Koo; Lee, Young Dal

    2017-01-01

    AIM To investigate Helicobacter pylori (H. pylori) eradication rates using second-line bismuth-containing quadruple therapy and to identify predictors of eradication failure. METHODS This study included 636 patients who failed first-line triple therapy and received 7 d of bismuth-containing quadruple therapy between January 2005 and December 2015. We retrospectively demonstrated H. pylori eradication rates with respect to the year of therapy as well as demographic and clinical factors. H. pylori eradication was confirmed by a 13C-urea breath test or a rapid urease test at least 4 wk after the completion of bismuth-based quadruple therapy: proton pump inhibitor, metronidazole, bismuth, and tetracycline. RESULTS The overall eradication rates by intention-to-treat analysis and per-protocol analysis were 73.9% (95%CI: 70.1%-77.4%) and 94.5% (95%CI: 92.4%-96.5%), respectively. Annual eradication rates from 2005 to 2015 were 100.0%, 92.9%, 100.0%, 100.0%, 100.0%, 97.4%, 100.0%, 93.8%, 84.4%, 98.9%, and 92.5%, respectively, by per-protocol analysis. A multivariate analysis showed that diabetes mellitus (OR = 3.99, 95%CI: 1.56-10.20, P = 0.004) was associated with H. pylori eradication therapy failure. CONCLUSION The second-line bismuth-containing quadruple therapy for H. pylori infection is still effective in Korea, and diabetes mellitus is suggested to be a risk factor for eradication failure. PMID:28246480

  7. EPIC 220204960: A Quadruple Star System Containing Two Strongly Interacting Eclipsing Binaries

    NASA Astrophysics Data System (ADS)

    Rappaport, S.; Vanderburg, A.; Borkovits, T.; Kalomeni, B.; Halpern, J. P.; Ngo, H.; Mace, G. N.; Fulton, B. J.; Howard, A. W.; Isaacson, H.; Petigura, E. A.; Mawet, D.; Kristiansen, M. H.; Jacobs, T. L.; LaCourse, D.; Bieryla, A.; Forgács-Dajka, E.; Nelson, L.

    2017-01-01

    We present a strongly interacting quadruple system associated with the K2 target EPIC 220204960. The K2 target itself is a Kp = 12.7 magnitude star at Teff ≃ 6100 K which we designate as "B-N" (blue northerly image). The host of the quadruple system, however, is a Kp ≃ 17 magnitude star with a composite M-star spectrum, which we designate as "R-S" (red southerly image). With a 3.2″ separation and similar radial velocities and photometric distances, `B-N' is likely physically associated with `R-S', making this a quintuple system, but that is incidental to our main claim of a strongly interacting quadruple system in `R-S'. The two binaries in `R-S' have orbital periods of 13.27 d and 14.41 d, respectively, and each has an inclination angle of ≳ 89°. From our analysis of radial velocity measurements, and of the photometric lightcurve, we conclude that all four stars are very similar with masses close to 0.4 M⊙. Both of the binaries exhibit significant ETVs where those of the primary and secondary eclipses `diverge' by 0.05 days over the course of the 80-day observations. Via a systematic set of numerical simulations of quadruple systems consisting of two interacting binaries, we conclude that the outer orbital period is very likely to be between 300 and 500 days. If sufficient time is devoted to RV studies of this faint target, the outer orbit should be measurable within a year.

  8. EPIC 220204960: A Quadruple Star System Containing Two Strongly Interacting Eclipsing Binaries

    NASA Astrophysics Data System (ADS)

    Rappaport, S.; Vanderburg, A.; Borkovits, T.; Kalomeni, B.; Halpern, J. P.; Ngo, H.; Mace, G. N.; Fulton, B. J.; Howard, A. W.; Isaacson, H.; Petigura, E. A.; Mawet, D.; Kristiansen, M. H.; Jacobs, T. L.; LaCourse, D.; Bieryla, A.; Forgács-Dajka, E.; Nelson, L.

    2017-05-01

    We present a strongly interacting quadruple system associated with the K2 target EPIC 220204960. The K2 target itself is a Kp = 12.7-mag star at Teff ≃ 6100 K, which we designate as 'B-N' (blue northerly image). The host of the quadruple system, however, is a Kp ≃ 17-mag star with a composite M-star spectrum, which we designate as 'R-S' (red southerly image). With a 3.2-arcsec separation and similar radial velocities and photometric distances, 'B-N' is likely physically associated with 'R-S', making this a quintuple system, but that is incidental to our main claim of a strongly interacting quadruple system in 'R-S'. The two binaries in 'R-S' have orbital periods of 13.27 and 14.41 d, respectively, and each has an inclination angle of ≳89°. From our analysis of radial-velocity (RV) measurements, and of the photometric light curve, we conclude that all four stars are very similar with masses close to 0.4 M⊙. Both of the binaries exhibit significant eclipse-timing variations where those of the primary and secondary eclipses 'diverge' by 0.05 d over the course of the 80-d observations. Via a systematic set of numerical simulations of quadruple systems consisting of two interacting binaries, we conclude that the outer orbital period is very likely to be between 300 and 500 d. If sufficient time is devoted to RV studies of this faint target, the outer orbit should be measurable within a year.

  9. Yb fiber amplifier at 972.5 nm with frequency quadrupling to 243.1 nm

    NASA Astrophysics Data System (ADS)

    Burkley, Z.; Rasor, C.; Cooper, S. F.; Brandt, A. D.; Yost, D. C.

    2017-01-01

    We demonstrate a continuous-wave ytterbium-doped fiber amplifier which produces 6.3 W at a wavelength of 972.5 nm. We frequency-quadruple this source in two resonant doubling stages to generate 530 mW at 243.1 nm. Radiation at this wavelength is required to excite the 1S-2S transition in atomic hydrogen and could therefore find application in experimental studies of hydrogen and anti-hydrogen.

  10. Quadruple-junction lattice coherency and phase separation in a binary-phase system

    PubMed Central

    Chung, Sung-Yoon; Choi, Si-Young; Kim, Jin-Gyu; Kim, Young-Min

    2015-01-01

    If each phase has an identical crystal structure and small misfit in the lattice parameters in a binary-phase crystalline system, coherent phase boundaries usually form during separation. Although there have been numerous studies on the effect of coherency elastic energy, no attempt has been made to demonstrate how the phase-separation behaviour varies when multiple interfaces meet at a junction. Here we show that a comprehensively different phase-separation morphology is induced, to release the high coherency strain confined to quadruple junctions. High-temperature in-situ transmission electron microscopy reveals that phase boundaries with a new crystallographic orientation emerge over twinned crystals to provide strain relaxation at quadruple junctions. The high coherency strain and the formation of different phase boundaries can be understood in terms of the force equilibrium between interface tensions at a junction point. Visualizing the quadruple points at atomic resolution, our observations emphasize the impact of multiple junctions on the morphology evolution during phase separation. PMID:26346223

  11. Near-Infrared Spectroscopy of a Quadruple System Spanning the Stellar to Planetary Mass Regimes

    NASA Astrophysics Data System (ADS)

    Bowler, Brendan; Hillenbrand, Lynne

    2015-12-01

    High-contrast imaging surveys are discovering a growing number of brown dwarf companions and giant planets orbiting stars at wide separations between 10-100 AU, but the formation of these objects is poorly understood because multiple routes (disk instability, core accretion plus dynamical scattering, and cloud fragmentation) may contribute to this population. I will describe recent observations of 2M0441+2301 AabBab, a unique young (1-3 Myr) hierarchical quadruple system comprising a low-mass star, two brown dwarfs, and a planetary-mass companion in Taurus. Our near-infrared imaging and spectroscopy with Keck/NIRC2 and OSIRIS confirm the young age, late spectral type (~L1), and low temperature (~1800 K) of the faintest component, 2M0441+2301 Bb. With individual masses of ~200 Mjup, 35 Mjup, 19 Mjup, and 9.8 Mjup, 2M0441+2301 AabBab is the lowest-mass quadruple system known. Its hierarchical orbital architecture and mass ratios imply that it formed from the collapse and fragmentation of a molecular cloud core, demonstrating that planetary-mass companions can originate from a stellar-like pathway analogous to higher-mass quadruple star systems. More generally, cloud fragmentation may be an important formation pathway for the massive exoplanets that are now regularly being imaged on wide orbits.

  12. Probing DNA-DNA Interactions with a Combination of Quadruple-Trap Optical Tweezers and Microfluidics.

    PubMed

    Brouwer, Ineke; King, Graeme A; Heller, Iddo; Biebricher, Andreas S; Peterman, Erwin J G; Wuite, Gijs J L

    2017-01-01

    DNA metabolism and DNA compaction in vivo involve frequent interactions of remote DNA segments, mediated by proteins. In order to gain insight into such interactions, quadruple-trap optical tweezers have been developed. This technique provides an unprecedented degree of control through the ability to independently manipulate two DNA molecules in three dimensions. In this way, discrete regions of different DNA molecules can be brought into contact with one another, with a well-defined spatial configuration. At the same time, the tension and extension of the DNA molecules can be monitored. Furthermore, combining quadruple-trap optical tweezers with microfluidics makes fast buffer exchange possible, which is important for in situ generation of the dual DNA-protein constructs needed for these kinds of experiments. In this way, processes such as protein-mediated inter-DNA bridging can be studied with unprecedented control. This chapter provides a step-by-step description of how to perform a dual DNA manipulation experiment using combined quadruple-trap optical tweezers and microfluidics.

  13. Dual-source multi-energy CT with triple or quadruple x-ray beams

    NASA Astrophysics Data System (ADS)

    Yu, Lifeng; Li, Zhoubo; Leng, Shuai; McCollough, Cynthia H.

    2016-03-01

    Energy-resolved photon-counting CT (PCCT) is promising for material decomposition with multi-contrast agents. However, corrections for non-idealities of PCCT detectors are required, which are still active research areas. In addition, PCCT is associated with very high cost due to lack of mass production. In this work, we proposed an alternative approach to performing multi-energy CT, which was achieved by acquiring triple or quadruple x-ray beam measurements on a dual-source CT scanner. This strategy was based on a "Twin Beam" design on a single-source scanner for dual-energy CT. Examples of beam filters and spectra for triple and quadruple x-ray beam were provided. Computer simulation studies were performed to evaluate the accuracy of material decomposition for multi-contrast mixtures using both tri-beam and quadruple-beam configurations. The proposed strategy can be readily implemented on a dual-source scanner, which may allow material decomposition of multi-contrast agents to be performed on clinical CT scanners with energy-integrating detector.

  14. Comparison of Second-Line Quadruple Therapies with or without Bismuth for Helicobacter pylori Infection.

    PubMed

    Jheng, Guang-Hong; Wu, I-Chen; Shih, Hsiang-Yao; Wu, Meng-Chieh; Kuo, Fu-Chen; Hu, Huang-Ming; Liu, Chung-Jung; Hsu, Wen-Hung; Hu, Chi-Tan; Bair, Ming-Jong; Kuo, Chao-Hung; Wu, Deng-Chyang; Hsu, Ping-I

    2015-01-01

    The bismuth-based quadruple regimen has been applied in Helicobacter pylori rescue therapy worldwide. The non-bismuth-based quadruple therapy or "concomitant therapy" is an alternative option in first-line eradication but has not been used in second-line therapy. Discovering a valid regimen for rescue therapy in bismuth-unavailable countries is important. We conducted a randomized controlled trial to compare the efficacies of the standard quadruple therapy and a modified concomitant regimen. One hundred and twenty-four patients were randomly assigned into two groups: RBTM (rabeprozole 20 mg bid., bismuth subcitrate 120 mg qid, tetracycline 500 mg qid, and metronidazole 250 mg qid) and RATM (rabeprozole 20 mg bid., amoxicillin 1 g bid., tetracycline 500 mg qid, and metronidazole 250 mg qid) for 10 days. The eradication rate of the RBTM and RATM regimen was 92.1% and 90.2%, respectively, in intention-to-treat analysis. Patients in both groups had good compliance (~96%). The overall incidence of adverse events was higher in the RATM group (42.6% versus 22.2%, P = 0.02), but only seven patients (11.5%) experienced grades 2-3 events. In conclusion, both regimens had good efficacy, compliance, and acceptable side effects. The 10-day RATM treatment could be an alternative rescue therapy in bismuth-unavailable countries.

  15. Quadruple coaxial catheter system on transvenous embolization for dural arteriovenous fistula.

    PubMed

    Hayashi, Kentaro; Horie, Nobutaka; Morofuji, Yoichi; Fukuda, Shuji; Yamaguchi, Susumu; Morikawa, Minoru

    2015-04-01

    Although transvenous embolization (TVE) is an effective method for treating dural arteriovenous fistula (AVF), directing the catheter to the lesion site is difficult. We report on the utility of a quadruple coaxial catheter system for TVE. The quadruple catheter system comprised a 6 Fr guiding sheath, 6 Fr guiding catheter, 4 Fr intermediate catheter, and a regular microcatheter. The system was utilized in 27 consecutive dural AVF cases treated with TVE. In this study, we reviewed our experience with this system, including the theory, method of use, and complications. Stenosis or obstruction of the vascular access was identified in 12 cases. The catheter could not reach to the lesion in three cases of cavernous sinus (7·4%); therefore, transarterial embolization was employed. Angiographic results revealed that the cases consist of total occlusion (n  =  16, 59·5%), subtotal (n  =  10, 37·0%), and partial occlusion (n  =  1, 3·7%). Complete resolution or improvement of symptoms was observed in 23 patients (85·2%), no improvement of symptoms was observed in three patients (7·4%), and deterioration of symptoms was observed in one patient (3·7%). Venous perforation occurred in one patient without any neurological deficit. The catheter system provided access to the lesion and provided stability during the mechanically demanding process navigating the catheter and placing the coils. We determined that the quadruple coaxial system was safe and efficient for TVE for dural AVF.

  16. Warning Signs of Bullying

    MedlinePlus

    ... to talk to kids about bullying. Respond to Bullying Learn how to respond to bullying . From stopping ... Text Size: A A A Warning Signs for Bullying There are many warning signs that may indicate ...

  17. Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty.

    PubMed

    Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

    2016-01-01

    This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance images to reconstruct solid bones and attachments of ligaments, and assemble femoral and tibial components according representative literatures and operational specifications. Dynamic data of axial tibial rotation and femoral translation from full-extension to 135 were measured for analyzing the motion of knee models. The computational simulation results show that comparing with the posterior cruciate ligament retained knee model and the posterior cruciate ligament substituted knee model, reconstructing anterior cruciate ligament improves the posterior movement of the lateral condyle, medial condyle and tibial internal rotation through a full range of flexion. The maximum posterior translations of the lateral condyle, medial condyle and tibial internal rotation of the anterior cruciate ligament reconstructed knee are 15.3 mm, 4.6 mm and 20.6 at 135 of flexion. Reconstructing anterior cruciate ligament in total knee arthroplasty has been approved to be an more efficient way of maintaining normal knee kinematics comparing to posterior cruciate ligament retained and posterior cruciate ligament substituted total knee arthroplasty.

  18. Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty

    PubMed Central

    Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

    2016-01-01

    Background: This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. Method: We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance images to reconstruct solid bones and attachments of ligaments, and assemble femoral and tibial components according representative literatures and operational specifications. Dynamic data of axial tibial rotation and femoral translation from full-extension to 135 were measured for analyzing the motion of knee models. Findings: The computational simulation results show that comparing with the posterior cruciate ligament retained knee model and the posterior cruciate ligament substituted knee model, reconstructing anterior cruciate ligament improves the posterior movement of the lateral condyle, medial condyle and tibial internal rotation through a full range of flexion. The maximum posterior translations of the lateral condyle, medial condyle and tibial internal rotation of the anterior cruciate ligament reconstructed knee are 15.3 mm, 4.6 mm and 20.6 at 135 of flexion. Interpretation: Reconstructing anterior cruciate ligament in total knee arthroplasty has been approved to be an more efficient way of maintaining normal knee kinematics comparing to posterior cruciate ligament retained and posterior cruciate ligament substituted total knee arthroplasty. PMID:27347334

  19. British Sign Name Customs

    ERIC Educational Resources Information Center

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

    Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

  20. Warning Signs After Birth

    MedlinePlus

    ... what moms and moms-to-be need to know GO donate sign-up sign-in Sign out account center dashboard Our Cause Our mission Fighting premature birth About us Annual report Our work Community impact Global programs Research Need help? Frequently asked questions Contact us Tools & ...

  1. British Sign Name Customs

    ERIC Educational Resources Information Center

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

    Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

  2. Near-infrared Spectroscopy of 2M0441+2301 AabBab: A Quadruple System Spanning the Stellar to Planetary Mass Regimes

    NASA Astrophysics Data System (ADS)

    Bowler, Brendan P.; Hillenbrand, Lynne A.

    2015-10-01

    We present Keck/NIRC2 and OSIRIS near-infrared imaging and spectroscopy of 2M0441+2301 AabBab, a young (1-3 Myr) hierarchical quadruple system comprising a low-mass star, two brown dwarfs, and a planetary-mass companion in Taurus. All four components show spectroscopic signs of low surface gravity, and both 2M0441+2301 Aa and Ab possess Paβ emission indicating they each harbor accretion subdisks. Astrometry spanning 2008-2014 reveals orbital motion in both the Aab (0.″23 separation) and Bab (0.″095 separation) pairs, although the implied orbital periods of >300 years mean dynamical masses will not be possible in the near future. The faintest component (2M0441+2301 Bb) has an angular H-band shape, strong molecular absorption (VO, CO, H2O, and FeH), and shallow alkali lines, confirming its young age, late spectral type (L1 ± 1), and low temperature (≈1800 K). With individual masses of {200}-50+100 MJup, 35 ± 5 MJup, 19 ± 3 MJup, and 9.8 ± 1.8 MJup, 2M0441+2301 AabBab is the lowest-mass quadruple system known. Its hierarchical orbital architecture and mass ratios imply that it formed from the collapse and fragmentation of a molecular cloud core, demonstrating that planetary-mass companions can originate from a stellar-like pathway analogous to higher-mass quadruple star systems as first speculated by Todorov et al. More generally, cloud fragmentation may be an important formation pathway for the massive exoplanets that are now regularly being imaged on wide orbits. The data presented herein were obtained at the W. M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California and the National Aeronautics and Space Administration. The Observatory was made possible by the generous financial support of the W. M. Keck Foundation.

  3. On the System of Person-Denoting Signs in Estonian Sign Language: Estonian Name Signs

    ERIC Educational Resources Information Center

    Paales, Liina

    2010-01-01

    This article discusses Estonian personal name signs. According to study there are four personal name sign categories in Estonian Sign Language: (1) arbitrary name signs; (2) descriptive name signs; (3) initialized-descriptive name signs; (4) loan/borrowed name signs. Mostly there are represented descriptive and borrowed personal name signs among…

  4. On the System of Person-Denoting Signs in Estonian Sign Language: Estonian Name Signs

    ERIC Educational Resources Information Center

    Paales, Liina

    2010-01-01

    This article discusses Estonian personal name signs. According to study there are four personal name sign categories in Estonian Sign Language: (1) arbitrary name signs; (2) descriptive name signs; (3) initialized-descriptive name signs; (4) loan/borrowed name signs. Mostly there are represented descriptive and borrowed personal name signs among…

  5. Isolated posterior cruciate ligament insufficiency induces morphological changes of anterior cruciate ligament collagen fibrils.

    PubMed

    Ochi, M; Murao, T; Sumen, Y; Kobayashi, K; Adachi, N

    1999-04-01

    We studied the ultrastructural changes of the human anterior cruciate ligament (ACL) with transmission electron micrograph cross-sections following isolated posterior cruciate ligament (PCL) injury. Biopsy specimens were obtained from the proximal third and anteromedial aspect of the ACL. Fourteen patients with PCL-deficient knees at a mean of 22.1 months from injury to surgery and 5 normal knees amputated secondary to malignant tumors or traumatic injuries were used as controls. A significant difference was found in the number of collagen fibrils per 1 microm2 between the PCL-deficient knee group and the control group. There was a significant difference found in the collagen fibril diameter between the PCL-deficient knee group and the control group. The collagen packing density (the percentage of sampled area occupied by collagen fibrils) was also significantly different between the PCL-deficient knee and the control group. The current study shows that an isolated PCL insufficiency can induce morphological changes in ACL collagen fibrils, suggesting that a PCL insufficiency can have adverse effects on other ligamentous structures in the knee joint.

  6. Reducing time to surgery after anterior cruciate ligament injury.

    PubMed

    Sapsford, H; Sutherland, A G

    2016-05-01

    Recent work suggests that reconstruction of the ruptured anterior cruciate ligament within 12 months of injury results in better outcomes. We present a complete audit cycle examining the effect of establishment of an Acute Knee Clinic on time to surgery. Records of 20 anterior cruciate ligament reconstructions undertaken by the senior author between June 2003 and May 2004 were examined to identify the time to surgery. The Acute Knee Clinic was established in December 2004. Prospectively collected data on patients attending the Acute Knee Clinic between May 2005 and July 2007 and patients undergoing anterior cruciate ligament reconstruction from September 2006 to 2007 were reviewed with respect to referral route, time from injury to specialist review and time to surgery. Mean time from injury to surgery of the initial cohort was 14 months (range 3-56). After establishment of the Acute Knee Clinic, 90% of referrals from Accident and Emergency (A&E) were seen by a specialist within four weeks. Between September 2006 and September 2007, 49 patients underwent anterior cruciate ligament reconstruction: 21 came via the Acute Knee Clinic, with a mean time from injury to surgery of 6 months; 28 patients from the elective clinic had a mean time to surgery of 25 months. 95% of Acute Knee Clinic patients and 53 % of elective clinic patients had surgery within 12 months of injury. The Acute Knee Clinic has been shown to reduce the time from injury to anterior cruciate ligament reconstruction. The Acute Knee Clinic only accounts for the referral of 40% of anterior cruciate ligament reconstructions in this series: Further education work is required with A&E staff and GPs regarding the referral of knee injuries. Access to the Acute Knee Clinic could be extended to GPs, although this could create service overload. © The Author(s) 2016.

  7. Anterior cruciate ligament injury in professional dancers.

    PubMed

    Meuffels, Duncan E; Verhaar, Jan A N

    2008-08-01

    Anterior cruciate ligament injury (ACL) is a common sport injury; however, there are no data concerning dance and ACL injury. We report the incidence, injury mechanism, and clinical follow-up of ACL injury in professional dancers. In a retrospective cohort study involving the three major dance companies in the Netherlands, by interviewing all 253 dancers who had had a full-time contract during 1991-2002, dancers with symptomatic ACL injury or past ACL reconstruction were identified and examined. 6 dancers (2 of whom were women) had had a symptomatic ACL rupture and reconstruction. Interestingly, all had been on the left side and had had a similar trauma mechanism: while dancing a classical variation they landed, after a jump, on their left leg, in the turned out position with a valgus force on their knee. There was a higher risk of ACL injury in the classical company than in the two contemporary companies. The risk of dancers having a rupture of the left ACL during a 10-year career in this classical company was 7%. ACL injuries are not an infrequently seen type of injury in professional classical dancers, with a very specific mechanism of injury--a landing on the left leg in exorotation. More attention and prophylactic measures should be given to this specific injury mechanism.

  8. Intraoperative anterior cruciate ligament graft contamination.

    PubMed

    Pasque, Charles B; Geib, Timothy M

    2007-03-01

    Intraoperative anterior cruciate ligament graft contamination is a rare but potentially devastating occurrence for any surgeon to encounter. Most instances in our experience have happened when a surgeon first enters practice or is operating in a new environment with new staff. Based on the currently available literature and the senior author's personal experience with 3 cases, intraoperative cleansing of the graft followed by implantation is a reasonable option. The protocol used successfully in these 3 cases includes getting the graft off of the floor immediately, removing any suture material in the graft, cleansing the graft for 15 to 30 minutes each in chlorohexidine and triple antibiotic solution, followed by a normal saline rinse. All graft sutures should then be replaced. The graft should then be resized and the tibial and femoral tunnels adjusted if needed. After implantation of the graft, additional intraoperative and postoperative intravenous antibiotic and/or oral antibiotic administration is also recommended for the first 1 to 2 weeks. Close clinical follow-up is also very important the first 6 weeks postoperatively and should include candid communication with the patient and family.

  9. Principles of postoperative anterior cruciate ligament rehabilitation

    PubMed Central

    Saka, Tolga

    2014-01-01

    It is known that anterior cruciate ligament (ACL) reconstruction needs to be combined with detailed postoperative rehabilitation in order for patients to return to their pre-injury activity levels, and that the rehabilitation process is as important as the reconstruction surgery. Literature studies focus on how early in the postoperative ACL rehabilitation period rehabilitation modalities can be initiated. Despite the sheer number of studies on this topic, postoperative ACL rehabilitation protocols have not been standardized yet. Could common, “ossified” knowledge or modalities really prove themselves in the literature? Could questions such as “is postoperative brace use really necessary?”, “what are the benefits of early restoration of the range of motion (ROM)?”, “to what extent is neuromuscular electrical stimulation (NMES) effective in the protection from muscular atrophy?”, “how early can proprioception training and open chain exercises begin?”, “should strengthening training start in the immediate postoperative period?” be answered for sure? My aim is to review postoperative brace use, early ROM restoration, NMES, proprioception, open/closed chain exercises and early strengthening, which are common modalities in the very comprehensive theme of postoperative ACL rehabilitation, on the basis of several studies (Level of Evidence 1 and 2) and to present the commonly accepted ways they are presently used. Moreover, I have presented the objectives of postoperative ACL rehabilitation in tables and recent miscellaneous studies in the last chapter of the paper. PMID:25232521

  10. Anterior cruciate ligament surgery in the rabbit

    PubMed Central

    2013-01-01

    Background Various methods regarding allograft knee replacements have been described. The animal models, which are generally used for this purpose include sheep, dogs, goats, and pigs, and accrue significant costs for study protocols. The authors herein describe an efficient and cost-effective model to study either native or tissue-engineered allografts for anterior cruciate ligament (ACL) replacement in a New Zealand rabbit model with the potential for transgenic and cell migration studies. Methods ACL reconstructions were performed in rabbits under general anesthesia. For fresh allograft implantations, two animals were operated in parallel. Each right extensor digitorum longus tendon was harvested and prepared for implantation. After excision of the ACL, tibial and femoral bone tunnels were created to implant each graft in the native ACL position. Results During a 2-year period, the authors have successfully undertaken this surgery in 61 rabbits and have not noticed any major complications attributed to this surgical technique. In addition, the authors have observed fast recovery in the animals postoperatively. Conclusion The authors recommend this surgical procedure as an excellent model for the study of knee surgery. PMID:23957941

  11. Guideline on anterior cruciate ligament injury

    PubMed Central

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steering group of the Dutch Orthopaedic Association. What is the role of physical examination and additional diagnostic tools? Which patient-related outcome measures should be used? What are the relevant parameters that influence the indication for an ACL reconstruction? Which findings or complaints are predictive of a bad result of an ACL injury treatment? What is the optimal timing for surgery for an ACL injury? What is the outcome of different conservative treatment modalities? Which kind of graft gives the best result in an ACL reconstruction? What is the optimal postoperative treatment concerning rehabilitation, resumption of sports, and physiotherapy? These 8 questions were answered and recommendations were made, using the “Appraisal of Guidelines for Research and Evaluation” instrument. This instrument seeks to improve the quality and effectiveness of clinical practical guidelines by establishing a shared framework to develop, report, and assess. The steering group has also developed 7 internal indicators to aid in measuring and enhancing the quality of the treatment of patients with an ACL injury, for use in a hospital or practice. PMID:22900914

  12. Anterior cruciate ligament replacement: a review.

    PubMed

    Silver, F H; Tria, A J; Zawadsky, J P; Dunn, M G

    1991-01-01

    The anterior cruciate ligament (ACL) is the major intra-articular mechanical element that limits motion of the tibia with respect to the femur. It is a multi-fasciculated structure composed of crimped aligned collagen fibers. The purpose of this paper is to review the literature on ACL structure and mechanical properties in an effort to stimulate the development of a new generation of more effective replacement devices. Replacement of the ACL is achieved using biologic and synthetic grafts. Biologic grafts include illiotibial band, semitendinosus and gracilis tendons, patellar tendon, and meniscus. Bone-patellar-bone complexes used to replace the ACL are revascularized and ultimately replaced by neo-ligament. Synthetic implants including the Integraft, Leads-Keio ligament, Gore-Tex¿ ligament and Kennedy Ligament Augmentation Device (LAD) have either not been approved or approved by the FDA for limited use as a replacement for the ACL. The Kennedy LAD has been found to increase the strength of autogenous tissue during revascularization. Based on the success of autografts and the Kennedy LAD, we conclude that the next generation of ACL replacement devices will consist of a scaffold and a biodegradable augmentation device. The scaffold will have a structure that mimics the normal ACL as well as stimulates revascularization and healing. A biodegradable augmentation device will be employed to mechanically reinforce the scaffold without stress shielding the neo-ligament. By combining the advantages of autografts and a biodegradable augmentation device, a new generation of ACL replacements will be achieved.

  13. MRI of anterior cruciate ligament healing

    SciTech Connect

    Ihara, Hidetoshi; Miwa, Megumi; Deya, Keizo; Torisu, Kenji

    1996-03-01

    The purpose of this study was to evaluate using MRI the natural healing of the anterior cruciate ligament (ACL) when treated conservatively by early protective motion. Consecutive acute complete intraligamentous ruptures of the ACL in 50 cases that were allowed to heal without surgery were evaluated before and after 3 month treatment by MRI, arthroscopy, and stress radiographs. Twenty-nine of the 50 patients were also reevaluated 11 months from the initial injury, of which 7 were reevaluated again 24 months from the initial injury by MRI. The MR appearance of the treated ACL was categorized into four grades depending on homogeneity, straight band, and size. MR assessment of the ACL after 3 month treatment demonstrated a well defined normal-sized straight band in 37 cases (74%). There was a significant relationship between the 3 and 11 month MR evaluations (r. = 0.801, p < 0.0001). There were also significant relationships between the MR and arthroscopic evaluations (r, = 0.455, p < 0.005) and between the MR and stress radiographic evaluations (r, = 0.348, p < 0.025) after the 3 month treatment. MRI can demonstrate ACL healing when treated conservatively with early protective mobilization. 40 refs., 3 figs., 2 tabs.

  14. Failure of Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Samitier, Gonzalo; Marcano, Alejandro I.; Alentorn-Geli, Eduard; Cugat, Ramon; Farmer, Kevin W; Moser, Michael W

    2015-01-01

    The present review classifies and describes the multifactorial causes of anterior cruciate ligament (ACL) surgery failure, concentrating on preventing and resolving such situations. The article particularly focuses on those causes that require ACL revision due to recurrent instability, without neglecting those that affect function or produce persistent pain. Although primary ACL reconstruction has satisfactory outcome rates as high as 97%, it is important to identify the causes of failure, because satisfactory outcomes in revision surgery can drop to as much as 76%. It is often possible to identify a primary or secondary cause of ACL surgery failure; even the most meticulous planning can give rise to unexpected findings during the intervention. The adopted protocol should therefore be sufficiently flexible to adapt to the course of surgery. Preoperative patient counseling is essential. The surgeon should limit the patient’s expectations for the outcome by explaining the complexity of this kind of procedure. With adequate preoperative planning, close attention to details and realistic patient expectations, ACL revision surgery may offer beneficial and satisfactory results for the patient. PMID:26550585

  15. [Computerizing the radiological sign].

    PubMed

    Bertaud, V; Belhadj, I; Dameron, O; Garcelon, N; Hendaoui, L; Marin, F; Duvauferrier, R

    2007-01-01

    The goal of this article is to present to the radiologist the different theories of the sign and their consequences for sign representation in computer systems. All the theories of the sign are presented, but the most relevant are highlighted in order to explain the great modeling systems currently in use (such as DICOM-SR or the UMLS). The constructivist approach of the notion of disease, the semiosis process, which starting from signs produces new signs, and the structuralist analysis of sign through language are emphasized. The purpose of this analysis is to end up with a consensual representation of the sign that can be understood by human beings and processed by machines. Such a representation, also known as an ontology, is based on a semantic organization of language, thus allowing medicine to become a truly scientific discipline. It aims at disambiguating the symbols given to machines, which will help us in our reasoning.

  16. Sign language Web pages.

    PubMed

    Fels, Deborah I; Richards, Jan; Hardman, Jim; Lee, Daniel G

    2006-01-01

    The WORLD WIDE WEB has changed the way people interact. It has also become an important equalizer of information access for many social sectors. However, for many people, including some sign language users, Web accessing can be difficult. For some, it not only presents another barrier to overcome but has left them without cultural equality. The present article describes a system that allows sign language-only Web pages to be created and linked through a video-based technique called sign-linking. In two studies, 14 Deaf participants examined two iterations of signlinked Web pages to gauge the usability and learnability of a signing Web page interface. The first study indicated that signing Web pages were usable by sign language users but that some interface features required improvement. The second study showed increased usability for those features; users consequently couldnavigate sign language information with ease and pleasure.

  17. The Bridge-Enhanced Anterior Cruciate Ligament Repair (BEAR) Procedure

    PubMed Central

    Murray, Martha M.; Flutie, Brett M.; Kalish, Leslie A.; Ecklund, Kirsten; Fleming, Braden C.; Proffen, Benedikt L.; Micheli, Lyle J.

    2016-01-01

    Background: This study assessed the safety of the newly developed bridge-enhanced anterior cruciate ligament (ACL) repair (BEAR), which involves suture repair of the ligament combined with a bioactive scaffold to bridge the gap between the torn ligament ends. As the intra-articular environment is complex in its response to implanted materials, this study was designed to determine whether there would be a significant rate of adverse reaction to the implanted scaffold. Hypothesis: The primary hypothesis was that the implanted scaffold would not result in a deep joint infection (arthrocentesis with positive culture) or significant inflammation (clinical symptoms justifying arthrocentesis but negative culture). The secondary hypotheses were that patients treated with BEAR would have early postoperative outcomes that were similar to patients treated with ACL reconstruction with an autologous hamstring graft. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 20 patients were enrolled in this nonrandomized, first-in-human study. Ten patients received BEAR treatment and 10 received a hamstring autograft ACL reconstruction. The BEAR procedure was performed by augmenting a suture repair with a proprietary scaffold, the BEAR scaffold, placed in between the torn ends of the ACL at the time of suture repair. The BEAR scaffold is to our knowledge the only device that fills the gap between the torn ligament ends to have current Investigational Device Exemption approval from the Food and Drug Administration. Ten milliliters of autologous whole blood were added to the scaffold prior to wound closure. Outcomes were assessed at 3 months postoperatively. The outcomes measures included postoperative pain, muscle atrophy, loss of joint range of motion, and implant failure (designated by an International Knee Documentation Committee grade C or D Lachman test and/or an absence of continuous ACL tissue on magnetic resonance images). Results: There were no joint

  18. Posterior Cruciate Ligament Injuries Associated With Military Survival Swim Training.

    PubMed

    Crowell, Michael S; Mason, John S; Posner, Matthew A; Haley, Chad A

    2017-07-01

    Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury. With a PCL tear, patients rarely describe an audible "pop" that is commonly reported in ACL injuries. On physical exam, a frequent finding in PCL tears is a loss of 10 to 20° of knee flexion. Although the most common clinical tests for PCL tears include the posterior drawer test, the posterior sag sign, and the quadriceps active test, there is a lack of high-quality diagnostic accuracy studies. Two cases of U.S. Military Academy Cadets who sustained PCL injuries while removing combat boots during military survival swim training are presented. The results of the clinical examination are accompanied by magnetic resonance imaging results and intraoperative arthroscopic images to highlight key findings. Both patients were evaluated and diagnosed with PCL injures within 10 days of their injuries. Each reported feeling/hearing a "pop," which is atypical in PCL tears. Both patients demonstrated a lack of active and passive knee flexion, which is a commonly reported impairment. One patient was managed nonsurgically with physical therapy and eventually returned to full duty without limitations 9 months after his injury. The other patient, who sustained a combined PCL-PLC injury, underwent a PCL reconstruction and PLC repair and reconstruction 8 weeks after his injury. He returned all training, with the exception of contact/collision sports, 9 months after surgery. Both

  19. Spatial Change of Cruciate Ligaments in Rat Embryo Knee Joint by Three-Dimensional Reconstruction

    PubMed Central

    Zhang, Xiangkai; Aoyama, Tomoki; Takaishi, Ryota; Higuchi, Shinya; Yamada, Shigehito; Kuroki, Hiroshi; Takakuwa, Tetsuya

    2015-01-01

    This study aimed to analyze the spatial developmental changes of rat cruciate ligaments by three-dimensional (3D) reconstruction using episcopic fluorescence image capture (EFIC). Cruciate ligaments of Wister rat embryos between embryonic day (E) 16 and E20 were analyzed. Samples were sectioned and visualized using EFIC. 3D reconstructions were generated using Amira software. The length of the cruciate ligaments, distances between attachment points to femur and tibia, angles of the cruciate ligaments and the cross angle of the cruciate ligaments were measured. The shape of cruciate ligaments was clearly visible at E17. The lengths of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) increased gradually from E17 to E19 and drastically at E20. Distances between attachment points to the femur and tibia gradually increased. The ACL angle and PCL angle gradually decreased. The cross angle of the cruciate ligaments changed in three planes. The primordium of the 3D structure of rat cruciate ligaments was constructed from the early stage, with the completion of the development of the structures occurring just before birth. PMID:26098761

  20. Cruciate Retaining Versus Cruciate Stabilising Total Knee Arthroplasty – A Prospective Randomised Kinematic Study

    PubMed Central

    Godwin, T L; Bayan, A

    2016-01-01

    Objective: While there is a large body of research in regards to cruciate retaining(CR) and cruciate sacrificing total condylar knee replacement, the literature is spars in regards to highly conforming polyetheylene such as the triatholon cruciate stabilising tibial insert (CS).The aim was to determine whether there is a difference in the range of motion, kinematics as well as the functional outcome for Triathlon CS and CR TKJR. Methods: A single hospital consecutive series of one surgeon between 2011 and 2013 were enrolled. Kinematic data recorded prospectively at the time of surgery utilizing imageless navigation included preoperative and post-replacement extension, gravity flexion, passive flexion and rotation. Intraoperative femoral and tibial cuts and definitive implants were also recorded. Statistically analysis performed to compare CS and CR TKJR range of motion, deformity correction, and rotation pre and post-operatively. Oxford functional scores were obtained at the final follow up. 124 patients were randomised to 71 CS and 53 CR TKJR. The demographics were comparable between the two groups. Results: No significant difference was found between the groups’ preoperative range of motion. The net gain in extension for the CS group was 5.65 degrees (4.14-7.17) and for CR 5.64 degrees (4.24-7.04, p=0.99) with no significant difference shown. Post-operative gravity flexion significantly increased in CS TKJR with 129.01 degrees (127.37130.66) compared with 126.35 degrees (124.39-128.30, p =0.04) for CR. A weak positive correlation was shown between the size of distal femoral cut and post-operative extension for both CS and CR TKJR. A weak positive correlation was also shown for the difference between the intraoperative cuts (tibial and femoral) and the size of the implants used, in relation to post-operative extension. Post-operative oxford scores at average of 3.4 year follow up comparable between groups. Conclusion: The kinematics of CS and CR TKJR are

  1. Radiographic Risk Factors for Contralateral Rupture in Dogs with Unilateral Cranial Cruciate Ligament Rupture

    PubMed Central

    Chuang, Connie; Ramaker, Megan A.; Kaur, Sirjaut; Csomos, Rebecca A.; Kroner, Kevin T.; Bleedorn, Jason A.; Schaefer, Susan L.; Muir, Peter

    2014-01-01

    Background Complete cranial cruciate ligament rupture (CR) is a common cause of pelvic limb lameness in dogs. Dogs with unilateral CR often develop contralateral CR over time. Although radiographic signs of contralateral stifle joint osteoarthritis (OA) influence risk of subsequent contralateral CR, this risk has not been studied in detail. Methodology/Principal Findings We conducted a retrospective longitudinal cohort study of client-owned dogs with unilateral CR to determine how severity of radiographic stifle synovial effusion and osteophytosis influence risk of contralateral CR over time. Detailed survival analysis was performed for a cohort of 85 dogs after case filtering of an initial sample population of 513 dogs. This population was stratified based on radiographic severity of synovial effusion (graded on a scale of 0, 1, and 2) and severity of osteophytosis (graded on a scale of 0, 1, 2, and 3) of both index and contralateral stifle joints using a reproducible scoring method. Severity of osteophytosis in the index and contralateral stifles was significantly correlated. Rupture of the contralateral cranial cruciate ligament was significantly influenced by radiographic OA in both the index and contralateral stifles at diagnosis. Odds ratio for development of contralateral CR in dogs with severe contralateral radiographic stifle effusion was 13.4 at one year after diagnosis and 11.4 at two years. Odds ratio for development of contralateral CR in dogs with severe contralateral osteophytosis was 9.9 at one year after diagnosis. These odds ratios were associated with decreased time to contralateral CR. Breed, age, body weight, gender, and tibial plateau angle did not significantly influence time to contralateral CR. Conclusion Subsequent contralateral CR is significantly influenced by severity of radiographic stifle effusion and osteophytosis in the contralateral stifle, suggesting that synovitis and arthritic joint degeneration are significant factors in the

  2. Sign language and autism.

    PubMed

    Bonvillian, J D; Nelson, K E; Rhyne, J M

    1981-03-01

    Research findings and issues in teaching sign language to nonspeaking autistic children are reviewed. Data on over 100 children indicate that nearly all autistic children learn receptive and expressive signs, and many learn to combine signs. These children also exhibit marked improvement in adaptive behaviors. Speech skills are acquired by fewer children and may be developed through simultaneous speech and sign training. Possible explanations for these results are given, together with suggestions for future research and data collection. Recommended innovations include exposure to fluent signers and training in discourse and code-switching. Different sign language teaching methods need to be investigated more fully, including emphasis on training sign language within the children's total environment and with greater staff and parental participation.

  3. Military Vital Sign Monitor.

    DTIC Science & Technology

    1984-09-30

    agreement, however, are of a nonspecific nature, and neither discuss vital sign monitors or other technology based life support equipment, nor...evacuations. STANAG 2126, "Medical First-Aid Equipment and Supplies," does not discuss vital sign monitors or other life support equipment. No...1 safety of any life support equipment and ,therefore, do not affect vital sign monitors selected as a result of this investigation. However, they do

  4. Food Signs in Radiology

    PubMed Central

    Hussain, Mehboob; Al Damegh, Saleh

    2007-01-01

    Objective: Certain diseases show classic radiological signs that resemble various types of food items like fruits, meat, vegetables, eggs, bakery, grocery and confectionary items. In this article various food signs are discussed and correlated with the various food items in a pictorial way. The objective of this pictorial essay is to provide the information and learn the characteristic radiological signs resembling various food items. These food signs are easy to recognize and allows a confident diagnosis on the basis of imaging findings alone or can narrow down the differential diagnosis. PMID:21475464

  5. Anterior cruciate ligament reconstruction: allograft versus autograft.

    PubMed

    Chang, Spencer K Y; Egami, Darren K; Shaieb, Mark D; Kan, Darryl M; Richardson, Allen B

    2003-01-01

    This study was performed to compare the minimal 2-year outcome of anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) allografts versus autografts, both augmented with an iliotibial band tenodesis. Retrospective review. Forty-six of 52 BPTB ACL reconstructions using allografts and 33 of 37 BPTB ACL reconstructions using autografts were followed up at a mean of 2.75 and 3.36 years, respectively. All patients had an iliotibial band tenodesis. Evaluations included the Lysholm II scale, a questionnaire, physical examination findings, and KT-1000 arthrometry. No statistically significant differences were seen between groups in Lysholm II scores or in any subjective category. Most patients (91% allograft; 97% autograft) had good to excellent Lysholm II scores. Sixty-five percent of allograft patients and 73% of autograft patients returned to their preinjury activity level. More allograft patients complained of retropatellar pain (16% v 9% for autograft patients). Fifty-three percent of allograft patients versus 23% of autograft patients had a flexion deficit of 5 degrees or more when compared with the normal contralateral side. When comparing KT-1000 side-to-side differences, we found no significant differences between groups. Ninety-one percent of both groups had maximum side-to-side differences less than 5 mm. Three allograft patients (6.5%) had traumatic ruptures at 12, 19, and 43 months postoperatively versus none in the autograft group. All three allograft patients who sustained postoperative traumatic ruptures had received fresh frozen, nonirradiated allografts. Results of ACL reconstruction using allografts or autografts augmented with an iliotibial band tenodesis were comparable. The BPTB autograft should remain the gold standard, although the BPTB allograft in ACL reconstruction is a reasonable alternative.

  6. Rehabilitation After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Kruse, L.M.; Gray, B.; Wright, R.W.

    2012-01-01

    Background: Rigorous rehabilitation after anterior cruciate ligament (ACL) reconstruction is necessary for a successful surgical outcome. A large number of clinical trials continue to assess aspects of this rehabilitation process. Prior systematic reviews evaluated fifty-four Level-I and II clinical trials published through 2005. Methods: Eighty-five articles from 2006 to 2010 were identified utilizing multiple search engines. Twenty-nine Level-I or II studies met inclusion criteria and were evaluated with use of the CONSORT (Consolidated Standards of Reporting Trials) criteria. Topics included in this review are postoperative bracing, accelerated strengthening, home-based rehabilitation, proprioception and neuromuscular training, and six miscellaneous topics investigated in single trials. Results: Bracing following ACL reconstruction remains neither necessary nor beneficial and adds to the cost of the procedure. Early return to sports needs further research. Home-based rehabilitation can be successful. Although neuromuscular interventions are not likely to be harmful to patients, they are also not likely to yield large improvements in outcomes or help patients return to sports faster. Thus, they should not be performed to the exclusion of strengthening and range-of-motion exercises. Vibration training may lead to faster and more complete proprioceptive recovery but further evidence is needed. Conclusions: Several new modalities for rehabilitation after ACL reconstruction may be helpful but should not be performed to the exclusion of range-of-motion, strengthening, and functional exercises. Accelerated rehabilitation does not appear to be harmful but further investigation of rehabilitation timing is warranted. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. PMID:23032584

  7. Contralateral Cruciate Survival in Dogs with Unilateral Non-Contact Cranial Cruciate Ligament Rupture

    PubMed Central

    Muir, Peter; Schwartz, Zeev; Malek, Sarah; Kreines, Abigail; Cabrera, Sady Y.; Buote, Nicole J.; Bleedorn, Jason A.; Schaefer, Susan L.; Holzman, Gerianne; Hao, Zhengling

    2011-01-01

    Background Non-contact cranial cruciate ligament rupture (CrCLR) is an important cause of lameness in client-owned dogs and typically occurs without obvious injury. There is a high incidence of bilateral rupture at presentation or subsequent contralateral rupture in affected dogs. Although stifle synovitis increases risk of contralateral CrCLR, relatively little is known about risk factors for subsequent contralateral rupture, or whether therapeutic intervention may modify this risk. Methodology/Principal Findings We conducted a longitudinal study examining survival of the contralateral CrCL in client-owned dogs with unilateral CrCLR in a large baseline control population (n = 380), and a group of dogs that received disease-modifying therapy with arthroscopic lavage, intra-articular hyaluronic acid and oral doxycycline (n = 16), and were followed for one year. Follow-up in treated dogs included analysis of mobility, radiographic evaluation of stifle effusion and arthritis, and quantification of biomarkers of synovial inflammation. We found that median survival of the contralateral CrCL was 947 days. Increasing tibial plateau angle decreased contralateral ligament survival, whereas increasing age at diagnosis increased survival. Contralateral ligament survival was reduced in neutered dogs. Our disease-modifying therapy did not significantly influence contralateral ligament survival. Correlative analysis of clinical and biomarker variables with development of subsequent contralateral rupture revealed few significant results. However, increased expression of T lymphocyte-associated genes in the index unstable stifle at diagnosis was significantly related to development of subsequent non-contact contralateral CrCLR. Conclusion Subsequent contralateral CrCLR is common in client-owned dogs, with a median ligament survival time of 947 days. In this naturally occurring model of non-contact cruciate ligament rupture, cranial tibial translation is preceded by

  8. Prospective study of the feasibility and effectiveness of a second-trimester quadruple test for Down syndrome in Thailand.

    PubMed

    Kaewsuksai, Peeranan; Jitsurong, Siroj

    2017-11-01

    To evaluate the feasibility and effectiveness of a quadruple test for Down syndrome in the second trimester of pregnancy in clinical settings in Thailand. From October 2015 to September 2016, a prospective study was undertaken in 19 hospitals in Songkhla province, Thailand. Women with a singleton pregnancy of 14-18 weeks were enrolled and underwent the quadruple test. The risk cutoff value was set at 1:250. All women with a positive test (risk ≥1:250) were offered amniocentesis. Women were followed up until delivery. Among 2375 women, 206 (8.7%) had a positive quadruple test; 98 (47.6%) of these women voluntarily underwent amniocentesis. Overall, seven pregnancies were complicated with chromosomal abnormalities (2.9 cases in 1000), including four cases of Down syndrome (1.7 in 1000) and three of other abnormalities. The detection, false-positive, and accuracy rates of the quadruple test for Down syndrome were 75.0%, 8.6%, and 91.4%, respectively. The quadruple test was found to be a feasible and efficient method for screening for Down syndrome in the second trimester of pregnancy in a Thai clinical setting. The test should be performed for pregnant women before an invasive test for Down syndrome. © 2017 International Federation of Gynecology and Obstetrics.

  9. Critical comparison of various connected quadruple excitation approximations in the coupled-cluster treatment of bond breaking

    NASA Astrophysics Data System (ADS)

    Musiał, Monika; Bartlett, Rodney J.

    2005-06-01

    To assess the limits of single-reference coupled-cluster (CC) methods for potential-energy surfaces, several methods have been considered for the inclusion of connected quadruple excitations. Most are based upon the factorized inclusion of the connected quadruple contribution (Qf) [J. Chem. Phys. 108, 9221 (1998)]. We compare the methods for the treatment of potential-energy curves for small molecules. These include CCSD(TQf), where the initial contributions of triple (T) and factorized quadruple excitations are added to coupled-cluster singles (S) and doubles (D), its generalization to CCSD(Q˜f), where instead of measuring their first contribution from orders in H, it is measured from orders in H˜=e-(T1+T2)He(T1+T2); renormalized approximations of both, and CCSD(2) defined in [J. Chem. Phys. 115, 2014 (2001)]. We also consider CCSDT, CCSDT(Qf), CCSDTQ, and CCSDTQP for comparison, where T, Q, and P indicate full triple, quadruple, and pentuple excitations, respectively. Illustrations for F2, the double bond breaking in water, and N2 are shown, including effects of quadruples on equilibrium geometries and vibrational frequencies. Despite the fact that no perturbative approximation, as opposed to an iterative approximation, should be able to separate a molecule correctly for a restricted-Hartree-Fock reference function, some of these higher-order approximations have a role to play in developing new, more robust procedures.

  10. Critical comparison of various connected quadruple excitation approximations in the coupled-cluster treatment of bond breaking.

    PubMed

    Musiał, Monika; Bartlett, Rodney J

    2005-06-08

    To assess the limits of single-reference coupled-cluster (CC) methods for potential-energy surfaces, several methods have been considered for the inclusion of connected quadruple excitations. Most are based upon the factorized inclusion of the connected quadruple contribution (Qf) [J. Chem. Phys. 108, 9221 (1998)]. We compare the methods for the treatment of potential-energy curves for small molecules. These include CCSD(TQf), where the initial contributions of triple (T) and factorized quadruple excitations are added to coupled-cluster singles (S) and doubles (D), its generalization to CCSD(TQf), where instead of measuring their first contribution from orders in H, it is measured from orders in H=e(-(T1+T2))He(T1+T2); renormalized approximations of both, and CCSD2 defined in [J. Chem. Phys. 115, 2014 (2001)]. We also consider CCSDT, CCSDT(Qf), CCSDTQ, and CCSDTQP for comparison, where T, Q, and P indicate full triple, quadruple, and pentuple excitations, respectively. Illustrations for F2, the double bond breaking in water, and N2 are shown, including effects of quadruples on equilibrium geometries and vibrational frequencies. Despite the fact that no perturbative approximation, as opposed to an iterative approximation, should be able to separate a molecule correctly for a restricted-Hartree-Fock reference function, some of these higher-order approximations have a role to play in developing new, more robust procedures.

  11. Characteristics of triple and quadruple toe-loops performed during the Salt Lake City 2002 Winter Olympics.

    PubMed

    King, Deborah; Smith, Sarah; Higginson, Brian; Muncasy, Barry; Scheirman, Gary

    2004-01-01

    The purpose of this study was to compare triple (T) and quadruple (Q) toe-loop figure skating jumps and quantify basic characteristics of these jumps to provide information to coaches that will assist them in teaching quadruple toe-loops to elite figure skaters. High-speed video was taken during men's practice and competition sessions at the 2002 Salt Lake City Winter Olympics; three-dimensional analyses of selected triple and quadruple jumps were completed. The most significant difference between triple and quadruple toe-loops was an increase in rotational velocity in the air. Additionally, increased vertical velocity at take-off and subsequent time in the air were also observed. Three main conclusions were developed: 1) The timing of rotation of the hips and shoulders was different for quadruple toe-loops compared to triples with the differences being observed before toe-pick; 2) Increases in rotational velocity occurred primarily as a result of the skaters assuming different body positions from take-off through landing which resulted in tighter rotating positions for longer durations of the jump; 3) Greater vertical velocity was gained during the propulsive phase due to the extension of the legs during the press off the ice.

  12. An Asymmetric Organocatalytic Quadruple Cascade to Tetraaryl-Substituted 2-Azabicyclo[3.3.0]octadienones

    PubMed Central

    Joie, Céline; Deckers, Kristina; Raabe, Gerhard; Enders, Dieter

    2014-01-01

    A new asymmetric organocatalytic three-component quadruple cascade of α-ketoamides with α,β-unsaturated aldehydes is described. The reaction is catalyzed by the (S)-diphenylprolinol TMS ether catalyst and proceeds via an aza-Michael/aldol condensation/vinylogous Michael/aldol condensation sequence to yield tetraaryl-substituted 2-azabicyclo[3.3.0]octadienone derivatives. The cascade products are obtained with good to very good yields (34–71%), virtually complete diastereoselectivities (>20:1), and very good enantioselectivities (84–97%). PMID:25278633

  13. Generation-independent dimerization behavior of quadruple hydrogen-bond-containing oligoether dendrons.

    PubMed

    Wong, Chun-Ho; Chow, Hak-Fun; Hui, Sin-Kam; Sze, Kong-Hung

    2006-04-27

    [reaction: see text] A new series of self-assembling G1-G3 dendronized dimers bearing oligoether dendrons and a dimeric 2-ureido-4-pyrimidinone (UPy) quadruple hydrogen-bonding core were prepared and characterized. It was found that the nonpolar microenvironment created by the dendrons preserved the UPy unit in its DDAA tautomeric form. As a result, the stabilities of the dimers were exceptionally strong for all three generations (K(dim) > 2 x 10(7) M(-)(1) in CDCl(3) at 25 degrees C). Furthermore, the steric size of the dendrons did not exhibit a significant effect on their dimerization behavior.

  14. Is concomitant quadruple therapy for Helicobacter pylori eradication really needed for Japanese patients?

    PubMed Central

    Francesco, Vincenzo De; Zullo, Angelo; Hassan, Cesare

    2012-01-01

    The study found that the 7 d of concomitant therapy (lansoprazole, amoxicillin, clarithromycin and metronidazole) achieved significantly higher eradication rates compared to 7 d of triple therapy (lansoprazole, amoxicillin, clarithromycin), the intention to treat (ITT) cure rates being 94.9% and 68.3%, respectively. According to our opinion, this study is clinically relevant for Japanese physicians for at least 2 reasons: (1) the standard triple therapy (clarithromycin plus amoxicillin) achieved disappointing cure rates in Japan - in agreement with what was observed in several countries; and (2) the concomitant quadruple therapy is an effective therapeutic alternative. PMID:23494655

  15. Pulsed blue laser source based on frequency quadrupling of a thulium fiber laser

    NASA Astrophysics Data System (ADS)

    Honea, Eric; Savage-Leuchs, Matthias; Bowers, Mark S.; Yilmaz, Tolga; Mead, Roy

    2013-03-01

    We describe a pulsed blue (485 nm) laser source based on frequency quadrupling a pulsed Tm fiber laser. Up to 1.2 W at 485 nm was generated with an M2 of 1.3. At 10 kHz pulse repetition frequency, the output pulse at 485 nm was 65 ns FWHM resulting in an estimated peak power of 1.8 kW. We anticipate further improvements in power scaling with higher power Tm fiber lasers and improved conversion efficiency to the blue with optimized AR coatings and nonlinear optical crystals.

  16. Digital Diversity Combiner (DIDICOM) - An Applique for Obtaining Quadruple Diversity with Dual Diversity Drama Radio Terminals,

    DTIC Science & Technology

    1980-01-01

    AD-ARO 985 ROME AIR DEVELOPMENT CENTER BRIFFISS AF9 NY F/S 17/2.1 DIGITAL DIVERSITY COMBINER (DIDICOM3 - AN APPLIQUE FOR OBTAININ-ETC(U) JAN 80 F 0...In-Houw Report Jenuuuy 19 GO DIGITAL DIVERSITY COMBINER 0 (DIDICOM) - AN APPLIQUE FOR OBTAINING QUADRUPLE DIVERSITY WITH DUAL DIVERSITY DRAMA RADIO...APPROVED: g e14F.r{ FRED I. DIAOND Technical Director Comunications and Control Division FOR THE COHNDR Acting Chief, Plans Office If your address has

  17. Quadruple cancer including Bowen's disease after arsenic injections 40 years earlier: report of a case.

    PubMed

    Murata, K; Iwazawa, T; Takayama, T; Yamashita, K; Okagawa, K

    1994-01-01

    This report describes the successful treatment of quadruple cancer including Bowen's disease in a 71-year-old man who had been given injections of salvarsan, an arsenic compound, for syphilis more than 40 years earlier. Resection of a skin lesion on his chest subsequently confirmed a diagnosis of Bowen's disease, 3 years after which he was operated on for concurrent gastric cancer and sigmoid colon cancer. A fourth cancer was discovered on his left vocal cord 2 weeks after this operation; it was resected 2 years later. A discussion of multiple malignant neoplasms and the possible relationship between arsenic and cancer is presented following this case report.

  18. How to Effectively Use Bismuth Quadruple Therapy: The Good, the Bad, and the Ugly.

    PubMed

    Graham, David Y; Lee, Sun-Young

    2015-09-01

    Bismuth triple therapy was the first effective Helicobacter pylori eradication therapy. The addition of a proton pump inhibitor helped overcome metronidazole resistance. Its primary indication is penicillin allergy or when clarithromycin and metronidazole resistance are both common. Resistance to the primary first-line therapy have centered on complexity and difficulties with compliance. Understanding regional differences in effectiveness remains unexplained because of the lack of studies including susceptibility testing and adherence data. We discuss regimen variations including substitutions of doxycycline, amoxicillin, and twice a day therapy and provide suggestions regarding what is needed to rationally and effectively use bismuth quadruple therapy.

  19. Triple and quadruple excitation contributions to the binding in Be clusters: Calibration calculations on Be3

    NASA Technical Reports Server (NTRS)

    Watts, John D.; Cernusak, Ivan; Noga, Jozef; Bartlett, Rodney J.; Bauschlicher, Charles W., Jr.; Lee, Timothy J.; Rendell, Alistair P.; Taylor, Peter R.

    1991-01-01

    The contribution of connected triple and quadruple excitations to the binding in Be3 is investigated by comparing various coupled-cluster (CC) and truncated configuration interaction (CI) treatments with multireference CI (MRCI) and full CI(FCI) calculations. The CC method with single and double excitations (CCSD) produces results that differ substantially from more elaborate treatments, but most extensions to CCSD that account approximately for connected triple excitations perform very well. In constrast, good agreement with FCI for Be2 can be achieved only with the highest level CC and MRCI methods.

  20. Revision anterior cruciate ligament surgery: experience from Miami.

    PubMed

    Uribe, J W; Hechtman, K S; Zvijac, J E; Tjin-A-Tsoi, E W

    1996-04-01

    Failed anterior cruciate ligament reconstruction as defined by recurrent patholaxity is increasingly commonplace. This report presents the findings of 54 patients who had unsuccessful intraarticular anterior cruciate ligament reconstruction to correct persistent instability and who subsequently underwent revision anterior cruciate ligament surgery. Before revision, patients were evaluated by clinical examination, KT-1000 arthrometer, radiographs, Lysholm knee score, Tegner activity scale, and subjective questionnaire. The results were compared at a mean of 32 months following revision surgery. There was an average of 16 months from index procedure to the time of revision. Autogenous patellar tendon grafts were used in 61% of the cases with 30% of these harvested from the contralateral knee. Fresh frozen patellar tendon was used in 35% and autogenous hamstring tendons in 4%. Revision was successful in objectively improving stability in all patients with an average KT-000 of 2.8 mm. Autogenous tissue grafts provided greater objective stability when compared with allograft tissue with average KT-1000 of 2.2 and 3.3, respectively. Functionally, however, there was no significant difference in outcome between the 2 groups. Harvesting of the contralateral patellar tendon was found to have no adverse long term effect. Subjectively, the results were significantly worse depending on the degree of articular cartilage degeneration. Only 54% of patients returned to their preanterior cruciate ligament injury activity level. Competence in various anterior cruciate ligament reconstruction techniques will facilitate revision surgery especially in avoiding preexisting tunnels and hardware. Correct graft placement and addressing the secondary restraints are critical to successful revision surgery.

  1. Activity progression for anterior cruciate ligament injured individuals☆

    PubMed Central

    Button, Kate; Roos, Paulien E.; van Deursen, Robert W.M.

    2014-01-01

    Background Functional exercises are important in the rehabilitation of anterior cruciate ligament deficient and reconstructed individuals but movement compensations and incomplete recovery persist. This study aimed to identify how tasks pose different challenges; and evaluate if different activities challenge patient groups differently compared to controls. Methods Motion and force data were collected during distance hop, squatting and gait for 20 anterior cruciate ligament deficient, 21 reconstructed and 21 controls. Findings Knee range of motion was greatest during squatting, intermediate during hopping and smallest during gait (P < 0.01). Peak internal knee extensor moments were greatest during distance hop (P < 0.01). The mean value of peak knee moments was reduced in squatting and gait (P < 0.01) compared to hop. Peak internal extensor moments were significantly larger during squatting than gait and peak external adductor moments during gait compared to squatting (P < 0.01). Fluency was highest during squatting (P < 0.01). All patients demonstrated good recovery of gait but anterior cruciate ligament deficient adopted a strategy of increased fluency (P < 0.01). During squatting knee range of motion and peak internal knee extensor moment were reduced in all patients (P < 0.01). Both anterior cruciate ligament groups hopped a shorter distance (P < 0.01) and had reduced knee range of motion (P < 0.025). Anterior cruciate ligament reconstructed had reduced fluency (P < 0.01). Interpretation Distance hop was most challenging; squatting and gait were of similar difficulty but challenged patients in different ways. Despite squatting being an early, less challenging exercise, numerous compensation strategies were identified, indicating that this may be more challenging than gait. PMID:24447417

  2. Standardization of Sign Languages

    ERIC Educational Resources Information Center

    Adam, Robert

    2015-01-01

    Over the years attempts have been made to standardize sign languages. This form of language planning has been tackled by a variety of agents, most notably teachers of Deaf students, social workers, government agencies, and occasionally groups of Deaf people themselves. Their efforts have most often involved the development of sign language books…

  3. Sign-a-Palooza

    ERIC Educational Resources Information Center

    McMorran, Charles; Reynolds, Veronica

    2010-01-01

    A halo of signs, some stuffed into thick plastic sheaths while others curled under yellow tape, cluttered the service desks of the New City Library. They bleated out messages of closings, procedures, and warnings. Their number undermined their cause. All too often a customer would ask a question that was answered by the very sign they had pushed…

  4. Sign-a-Palooza

    ERIC Educational Resources Information Center

    McMorran, Charles; Reynolds, Veronica

    2010-01-01

    A halo of signs, some stuffed into thick plastic sheaths while others curled under yellow tape, cluttered the service desks of the New City Library. They bleated out messages of closings, procedures, and warnings. Their number undermined their cause. All too often a customer would ask a question that was answered by the very sign they had pushed…

  5. Standardization of Sign Languages

    ERIC Educational Resources Information Center

    Adam, Robert

    2015-01-01

    Over the years attempts have been made to standardize sign languages. This form of language planning has been tackled by a variety of agents, most notably teachers of Deaf students, social workers, government agencies, and occasionally groups of Deaf people themselves. Their efforts have most often involved the development of sign language books…

  6. UCR Library Sign System Manual.

    ERIC Educational Resources Information Center

    California Univ., Riverside. Library.

    This manual outlines the procedures to be used for producing and placing signs within the libraries of the University of California, Riverside and presents examples of signs which conform to the library sign policy. The sign policy itself is described as well as procedures for requesting new or revised signs and for sign removal. Drawings of…

  7. Surgical treatment of partial anterior cruciate ligament lesions: medium-term results

    PubMed Central

    BERRUTO, MASSIMO; GALA, LUCA; FERRUA, PAOLO; UBOLDI, FRANCESCO; FERRARA, FABRIZIO; PASQUALOTTO, STEFANO; MARELLI, BRUNO M.

    2014-01-01

    Purpose this study was conducted to evaluate subjective and objective clinical outcomes of partial reconstruction of the anterior cruciate ligament (ACL) in comparison with complete ACL reconstruction. Methods three groups, each comprising 20 patients, were evaluated at a minimum follow-up of 12 months. The group 1 patients underwent partial ACL reconstruction, while those in group 2 and group 3 underwent complete ACL reconstruction, performed using either bone-patellar tendon-bone (BPTB) or quadrupled hamstring tendon (HT) grafts, respectively. The subjective outcome was evaluated using the Lysholm knee scale and the subjective International Knee Documentation Committee (IKDC) scoring system. A visual analog scale (VAS) was used for pain assessment and sporting activity was rated using the Tegner activity scale. Objective evaluation was performed using the IKDC objective form, KT-1000 arthrometer and KiRA triaxial accelerometer. Results at the follow-up evaluation, the mean subjective IKDC score was 86.1±10.3 in group 1, 85.2±11.1 in group 2, and 82.7±7.8 in group 3. The Lysholm score was 91.3±7.3 in group 1, 91.7±9.6 in group 2, and 89.4±6.1 in group 3. KT-1000 tests showed a mean side-to-side difference of 1.1 mm ± 1.5 mm (range, 0–5 mm) in group 1; 0.79 mm ± 0.8 mm (range, 0–2mm) in group 2; and 1.45 mm ± 1 mm (range, 0–3 mm) in group 3. The differences between groups were not statistically significant. Conclusions both subjective and objective outcomes of partial ACL reconstruction were comparable to those of complete reconstruction, but partial reconstruction in the presence of a partial lesion of the ACL is considered by the authors to be more respectful of the native vascularization, innervation and anatomy of the ACL, conferring an advantage in terms of recovery of the complete function of the knee. Level of evidence Level III, retrospective comparative study. PMID:25750906

  8. Autologous Hamstring Anterior Cruciate Ligament Graft Failure Using the Anteromedial Portal Technique With Suspensory Femoral Fixation

    PubMed Central

    Galdi, Balazs; Reyes, Allan; Brabston, Eugene W.; Levine, William N.

    2015-01-01

    Background: The anteromedial portal technique for drilling of the femoral tunnel during anterior cruciate ligament (ACL) reconstruction has been advocated by many surgeons as allowing improved access to the anatomical footprint. Furthermore, suspensory fixation of soft tissue grafts has become popularized because of complications associated with cross-pin fixation. Concerns regarding the use of both have recently arisen. Purpose: To raise awareness of the increased risk of graft failure when using the anteromedial portal technique with suspensory femoral fixation during ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: From November 1998 to August 2012, a total of 465 primary ACL reconstructions were performed using quadrupled hamstring autograft tendons, with drilling of the femoral tunnel performed via the transtibial portal. Graft fixation on the femur was achieved with cross-pin fixation, while interference screw fixation was used on the tibia. From September 2012 to October 2013, there were 69 reconstructions performed through an anteromedial portal. While there was no change in graft choice, a change was made to using suspensory femoral fixation. No other surgical or postoperative rehabilitation changes were made. Results: During the 14-year period in which ACL reconstructions were performed via the transtibial portal and with cross-pin fixation, 2 graft failures (0.4% failure rate) were reported. After switching to the anteromedial portal with suspensory fixation, 7 graft failures (10.1% failure rate) were reported over a 13-month period. These were 5 male and 2 female patients, with a mean age of 18.8 years—all elite athletes. The same surgical technique was used in all patients, and all patients had at least an 8 mm–diameter graft. Patients were cleared to return to sport at an average of 8.4 months postoperatively, after completing functional performance tests. Of the 7 patients, 6 sustained a rerupture of the graft within

  9. Reconstruction for chronic grade-II posterior cruciate ligament deficiency in Malaysian military personnel.

    PubMed

    Ahmad, Shahrulazua; Mahidon, Rafedon; Shukur, Mohammad Hassan; Hamdan, Amiruddin; Kasmin, Musa

    2014-12-01

    To evaluate the outcome of reconstruction for chronic grade-II posterior cruciate ligament (PCL) deficiency in Malaysian military personnel. Medical records of 16 male military personnel aged 25 to 41 years who underwent reconstruction for chronic grade-II PCL deficiency using the quadruple hamstrings tendon by a single surgeon were reviewed. The mean time from injury to surgery was 43.6 (range, 3-104) months. 10 patients had grade-I (n=4), grade-III (n=2), and grade-IV (n=4) lesions of the medial femoral condyles. Seven patients had medial (n=6) and lateral (n=1) meniscus tears. At the 2-year follow-up, patients were asked to complete a questionnaire consisting of the Lysholm score, Tegner activity level, and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form. Posterior drawer test, KT-2000 arthrometer test for posterior translation of the tibia, and military health grade (MHG) were assessed by an independent assessor. At the 2-year follow-up, the mean Lysholm score was 83; the score was excellent in 2 patients, good in 9, fair in 4, and poor in one. The mean IKDC subjective score was 74. The median Tegner activity level increased from 5.5 to 6. The posterior drawer test of 11 patients improved to grade I and the remaining 5 remained at grade II. The mean posterior translation of the tibia was 2.4 mm postoperatively; the posterior translation was normal in 8 patients, nearly normal in 7, and abnormal (≥ 6 mm) in one. The MHG improved in 14 patients and remained unchanged in 2. The latter 2 patients had no chondral lesion or meniscus injury. The first one was 40 years old with a postoperative IKDC score of 55 and a Tegner activity level of 2. The second one was 34 years old with a postoperative IKDC score of 65 and posterior translation of the tibia of 6 mm. Surgical reconstruction for chronic grade-II PCL injury achieved satisfactory outcome and may be appropriate for military personnel.

  10. Incidence of Major Tendon Ruptures and Anterior Cruciate Ligament Tears in US Army Soldiers

    DTIC Science & Technology

    2007-08-01

    DATES COVERED - 4. TITLE AND SUBTITLE Incidence of major tendon ruptures and anterior cruciate ligament tears in US Army soldiers 5a. CONTRACT...we have also reviewed the ACL reconstructions dur- ing the same period. Anterior cruciate ligament tears occur during participation in similar high... Anterior Cruciate Ligament Injury During this same period, 325 patients underwent ACL reconstruction at WAMC, of whom 289 (89%) were male and 246 (76

  11. Tibial Fixation of Anterior Cruciate Ligament Allograft Tendons. Comparison of 1-, 2-, and 4-Stranded Constructs

    DTIC Science & Technology

    2009-01-01

    2009 to 00-00-2009 4. TITLE AND SUBTITLE Tibial Fixation of Anterior Cruciate Ligament Allograft Tendons 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...2009 The Author(s) Tibial Fixation of Anterior Cruciate Ligament Allograft Tendons Comparison of 1-, 2-, and 4-Stranded Constructs Daniel K. Park,* MD...4-stranded allografts are used for soft tissue anterior cruciate ligament reconstruction; however, the fixation properties of fixation devices are

  12. Dual-Source Multi-Energy CT with Triple or Quadruple X-ray Beams.

    PubMed

    Yu, Lifeng; Leng, Shuai; McCollough, Cynthia H

    2016-02-01

    Energy-resolved photon-counting CT (PCCT) is promising for material decomposition with multi-contrast agents. However, corrections for non-idealities of PCCT detectors are required, which are still active research areas. In addition, PCCT is associated with very high cost due to lack of mass production. In this work, we proposed an alternative approach to performing multi-energy CT, which was achieved by acquiring triple or quadruple x-ray beam measurements on a dual-source CT scanner. This strategy was based on a "Twin Beam" design on a single-source scanner for dual-energy CT. Examples of beam filters and spectra for triple and quadruple x-ray beam were provided. Computer simulation studies were performed to evaluate the accuracy of material decomposition for multi-contrast mixtures using a tri-beam configuration. The proposed strategy can be readily implemented on a dual-source scanner, which may allow material decomposition of multi-contrast agents to be performed on clinical CT scanners with energy-integrating detector.

  13. The Quadruple Bonding in C2 Reproduces the Properties of the Molecule.

    PubMed

    Shaik, Sason; Danovich, David; Braida, Benoit; Hiberty, Philippe C

    2016-03-14

    Ever since Lewis depicted the triple bond for acetylene, triple bonding has been considered as the highest limit of multiple bonding for main elements. Here we show that C2 is bonded by a quadruple bond that can be distinctly characterized by valence-bond (VB) calculations. We demonstrate that the quadruply-bonded structure determines the key observables of the molecule, and accounts by itself for about 90% of the molecule's bond dissociation energy, and for its bond lengths and its force constant. The quadruply-bonded structure is made of two strong π bonds, one strong σ bond and a weaker fourth σ-type bond, the bond strength of which is estimated as 17-21 kcal mol(-1). Alternative VB structures with double bonds; either two π bonds or one π bond and one σ bond lie at 129.5 and 106.1 kcal mol(-1), respectively, above the quadruply-bonded structure, and they collapse to the latter structure given freedom to improve their double bonding by dative σ bonding. The usefulness of the quadruply-bonded model is underscored by "predicting" the properties of the (3)Σ+u state. C2's very high reactivity is rooted in its fourth weak bond. Thus, carbon and first-row main elements are open to quadruple bonding!

  14. Quadruple 9-mer-based protein binding microarray with DsRed fusion protein

    PubMed Central

    Kim, Min-Jeong; Lee, Tae-Ho; Pahk, Yoon-Mok; Kim, Yul-Ho; Park, Hyang-Mi; Choi, Yang Do; Nahm, Baek Hie; Kim, Yeon-Ki

    2009-01-01

    Background The interaction between a transcription factor and DNA motif (cis-acting element) is an important regulatory step in gene regulation. Comprehensive genome-wide methods have been developed to characterize protein-DNA interactions. Recently, the universal protein binding microarray (PBM) was introduced to determine if a DNA motif interacts with proteins in a genome-wide manner. Results We facilitated the PBM technology using a DsRed fluorescent protein and a concatenated sequence of oligonucleotides. The PBM was designed in such a way that target probes were synthesized as quadruples of all possible 9-mer combinations, permitting unequivocal interpretation of the cis-acting elements. The complimentary DNA strands of the features were synthesized with a primer and DNA polymerase on microarray slides. Proteins were labeled via N-terminal fusion with DsRed fluorescent protein, which circumvents the need for a multi-step incubation. The PBM presented herein confirmed the well-known DNA binding sequences of Cbf1 and CBF1/DREB1B, and it was also applied to elucidate the unidentified cis-acting element of the OsNAC6 rice transcription factor. Conclusion Our method demonstrated PBM can be conveniently performed by adopting: (1) quadruple 9-mers may increase protein-DNA binding interactions in the microarray, and (2) a one-step incubation shortens the wash and hybridization steps. This technology will facilitate greater understanding of genome-wide interactions between proteins and DNA. PMID:19761621

  15. Dual-Source Multi-Energy CT with Triple or Quadruple X-ray Beams

    PubMed Central

    Yu, Lifeng; Leng, Shuai; McCollough, Cynthia H.

    2016-01-01

    Energy-resolved photon-counting CT (PCCT) is promising for material decomposition with multi-contrast agents. However, corrections for non-idealities of PCCT detectors are required, which are still active research areas. In addition, PCCT is associated with very high cost due to lack of mass production. In this work, we proposed an alternative approach to performing multi-energy CT, which was achieved by acquiring triple or quadruple x-ray beam measurements on a dual-source CT scanner. This strategy was based on a “Twin Beam” design on a single-source scanner for dual-energy CT. Examples of beam filters and spectra for triple and quadruple x-ray beam were provided. Computer simulation studies were performed to evaluate the accuracy of material decomposition for multi-contrast mixtures using a tri-beam configuration. The proposed strategy can be readily implemented on a dual-source scanner, which may allow material decomposition of multi-contrast agents to be performed on clinical CT scanners with energy-integrating detector. PMID:27330237

  16. The Construction of Homochiral Lanthanide Quadruple-Stranded Helicates with Multiresponsive Sensing Properties toward Fluoride Anions.

    PubMed

    Chen, Wanmin; Tang, Xiaoliang; Dou, Wei; Wang, Bei; Guo, Lirong; Ju, Zhenghua; Liu, Weisheng

    2017-07-21

    A series of unique homochiral lanthanide tetranuclear quadruple-stranded helicates have been self-assembled controllably by using the intrinsic advantages of chiral bridging ligands, (S)-H2 L and (R)-H2 L, and lanthanide ions with high coordination numbers. The self-assembly process of these chiral helicates not only ensures the structural stability and quadruple-stranded feature of lanthanide cluster in the solid state and solution, but also achieves effective transfer and amplification of the chirality code from the ligand to a higher supramolecular level. Moreover, through using optical rotation, circular dichroism spectra analysis, and luminescence measurements, we demonstrate that these chiral lanthanide helicates could serve as sensitive and multi-responsive sensors to recognize and detect F(-) anions based on the change of chiral signal and NIR luminescence simultaneously, which represents a meaningful exploration for developing functional lanthanide-based polynuclear clusters. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Complex Genomic Rearrangements at the PLP1 Locus Include Triplication and Quadruplication

    PubMed Central

    Beck, Christine R.; Carvalho, Claudia M. B.; Banser, Linda; Gambin, Tomasz; Stubbolo, Danielle; Yuan, Bo; Sperle, Karen; McCahan, Suzanne M.; Henneke, Marco; Seeman, Pavel; Hobson, Grace M.; Lupski, James R.

    2015-01-01

    Inverted repeats (IRs) can facilitate structural variation as crucibles of genomic rearrangement. Complex duplication—inverted triplication—duplication (DUP-TRP/INV-DUP) rearrangements that contain breakpoint junctions within IRs have been recently associated with both MECP2 duplication syndrome (MIM#300260) and Pelizaeus-Merzbacher disease (PMD, MIM#312080). We investigated 17 unrelated PMD subjects with copy number gains at the PLP1 locus including triplication and quadruplication of specific genomic intervals—16/17 were found to have a DUP-TRP/INV-DUP rearrangement product. An IR distal to PLP1 facilitates DUP-TRP/INV-DUP formation as well as an inversion structural variation found frequently amongst normal individuals. We show that a homology—or homeology—driven replicative mechanism of DNA repair can apparently mediate template switches within stretches of microhomology. Moreover, we provide evidence that quadruplication and potentially higher order amplification of a genomic interval can occur in a manner consistent with rolling circle amplification as predicted by the microhomology-mediated break induced replication (MMBIR) model. PMID:25749076

  18. Pain Assessment After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Okoroha, Kelechi R.; Keller, Robert A.; Jung, Edward K.; Khalil, Lafi; Marshall, Nathan; Kolowich, Patricia A.; Moutzouros, Vasilios

    2016-01-01

    Background: Anterior cruciate ligament (ACL) reconstruction is a common outpatient procedure that is accompanied by significant postoperative pain. Purpose: To determine differences in acute pain levels between patients undergoing ACL reconstruction with bone–patellar tendon–bone (BTB) versus hamstring tendon (HS) autograft. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 70 patients who underwent primary ACL reconstruction using either BTB or HS autografts consented to participate. The primary outcome of the study was postoperative pain levels (visual analog scale), which were collected immediately after surgery and for 3 days postoperatively. Secondary outcome measures included opioid consumption (intravenous morphine equivalents), hours slept, patient satisfaction, reported breakthrough pain, and calls to the physician. Results: Patients treated with BTB had increased pain when compared with those treated with HS in the acute postoperative period (mean ± SD: day 0, 6.0 ± 1.7 vs 5.2 ± 2.0 [P = .066]; day 1, 5.9 ± 1.7 vs 4.9 ±1.7 [P = .024]; day 2, 5.2 ± 1.9 vs 4.1 ± 2.0 [P = .032]; day 3, 4.8 ± 2.1 vs 3.9 ± 2.3 [P = .151]). There were also significant increases in reported breakthrough pain (day 0, 76% vs 43% [P = .009]; day 1, 64% vs 35% [P = .003]) and calls to the physician due to pain (day 1, 19% vs 0% [P = .041]) in the BTB group. There were no significant differences in narcotic requirements or sleep disturbances. Overall, the BTB group reported significantly less satisfaction with pain management on days 0 and 1 (P = .024 and .027, respectively). Conclusion: A significant increase in acute postoperative pain was found when performing ACL reconstruction with BTB compared with HS. Patients treated with BTB were more likely to have breakthrough pain, decreased satisfaction with their pain management, and to contact their physician due to pain. These findings suggest a difference in early postoperative pain between the 2 most

  19. Anterior Cruciate Ligament Injuries in Baseball Players.

    PubMed

    Dugas, Jeffrey R; Bedford, Benjamin B; Andrachuk, John S; Scillia, Anthony J; Aune, Kyle T; Cain, E Lyle; Andrews, James R; Fleisig, Glenn S

    2016-11-01

    To determine common mechanisms of anterior cruciate ligament (ACL) injury in baseball players and to quantify the rate of return to play after primary surgical reconstruction and review intermediate clinical outcomes. Surgical injuries involving the ACL in youth, high school, collegiate, and professional baseball players were queried for an 11-year period (2001 to 2011). Over the study period, 42 baseball players were identified who had undergone arthroscopically assisted primary ACL reconstruction by 1 of 3 attending surgeons. Retrospective chart review was performed for all 42 patients to evaluate variables of age, level of competition, position, mechanism of injury, graft choice, and associated meniscal injuries. Twenty-six patients were reached for telephone survey and International Knee Documentation Committee questionnaire and they answered questions about their original injury and playing history. The most common mechanism of injury was fielding, followed by base running. Infielders and outfielders (32% each) were the most commonly injured position, followed by pitchers (29%). Among the 32 players for whom it could be determined, 30 (94%) were able to return to playing baseball at a mean follow-up of 4.2 years (range 1.0 to 9.9 years). The mean International Knee Documentation Committee score was 84.0 (range 63 to 91). Among the 26 patients contacted for telephone interview, no one required revision ACL surgery, but 3 required a subsequent procedure for meniscal tear. Twenty-five patients (96%) denied any episodes of instability in the knee after reconstruction. The overwhelming majority of baseball players that sustain ACL injuries do so while fielding or base running. Outfielders are significantly more likely than infielders to suffer ACL injuries while fielding versus base running. The results with respect to return to play are promising, as nearly all patients were able to return to baseball and none required a revision ACL surgery at a mean follow

  20. Static and dynamic tibial translation before, 5 weeks after, and 5 years after anterior cruciate ligament reconstruction.

    PubMed

    Tagesson, Sofi; Öberg, Birgitta; Kvist, Joanna

    2015-12-01

    To evaluate static and dynamic tibial translation before, 5 weeks after, and 5 years after anterior cruciate ligament (ACL) reconstruction. To explore whether static and dynamic tibial translation are correlated. Ten patients undergoing quadruple hamstring tendon graft ACL reconstruction were evaluated before, 5 weeks after, and 5 years after ACL reconstruction. Sagittal tibial translation was measured during the Lachman test (static translation) and during gait (dynamic translation) using a CA-4000 electrogoniometer. Five years after ACL reconstruction, static tibial translation did not differ between knees (Lachman test 90 N and 134 N n.s.). In contrast, there was greater maximal anterior tibial translation during gait in ACL-reconstructed knees than in uninjured knees (5.5 ± 1.4 vs. 4.5 ± 1.6 mm, P = 0.028). There were no differences in static or dynamic tibial translation between the 5-year follow-up and before ACL reconstruction or between the 5-year follow-up and the 5-week follow-up. There were no correlations between static and dynamic tibial translation. Although static tibial translation did not differ between knees 5 years after ACL reconstruction, dynamic tibial translation during gait was greater in ACL-reconstructed knees than in uninjured knees. Neither static nor dynamic tibial translation changed 5 years after ACL reconstruction as compared to before surgery and 5 weeks after surgery. Static tibial translation did not correlate with dynamic tibial translation. This study indicates that although the knee is stable during static measurements, kinematics during gait is impaired 5 years after ACL reconstruction. This may affect the return to sport and risk of osteoarthritis. Case series, Level IV.

  1. Functional results from reconstruction of the anterior cruciate ligament using the central third of the patellar ligament and flexor tendons☆

    PubMed Central

    de Souza Leao, Marcos George; Pampolha, Abelardo Gautama Moreira; Orlando Junior, Nilton

    2015-01-01

    Objectives To evaluate knee function in patients undergoing reconstruction of the anterior cruciate ligament (ACL) using the central third of the patellar ligament or the medial flexor tendons of the knee, i.e. quadruple ligaments from the semitendinosus and gracilis (ST-G), by means of the Knee Society Score (KSS) and the Lysholm scale. Methods This was a randomized prospective longitudinal study on 40 patients who underwent arthroscopic ACL reconstruction between September 2013 and August 2014. They comprised 37 males and three females, with ages ranging from 16 to 52 years. The patients were numbered randomly from 1 to 40: the even numbers underwent surgical correction using the ST-G tendons and the odd numbers, using the patellar tendon. Functional evaluations were made using the KSS and Lysholm scale, applied in the evening before the surgical procedure and six months after the operation. Results From the statistical analysis, it could be seen that the patients’ functional capacity was significantly greater after the operation than before the operation. There was strong evidence that the two forms of therapy had similar results (p = >0.05), in all the comparisons. Conclusions The results from the ACL reconstructions were similar with regard to functional recovery of the knee and improvement of quality of life, independent of the type of graft. It was not possible to identify the best method of surgical treatment. The surgeon's clinical and technical experience and the patient are the factors that determine the choice of graft type for use in ACL surgery. PMID:27218084

  2. Predictive value of preoperative 3-dimensional computer tomography measurement of semitendinosus tendon harvested for anterior cruciate ligament reconstruction.

    PubMed

    Yasumoto, Masanori; Deie, Masataka; Sunagawa, Toru; Adachi, Nobuo; Kobayashi, Kenji; Ochi, Mitsuo

    2006-03-01

    The aim of this study was to evaluate preoperative measurement of the semitendinosus tendon (ST) by 3-dimensional computed tomography (3-D CT), before using ST as the substitute in the anterior cruciate ligament (ACL) reconstruction. Cross-sectional study to compare anatomic findings with clinical findings. The study involved 28 patients who underwent ACL reconstruction using autogenous ST graft. Preoperative 3-D CT images of ST were obtained with a multidetector-row CT scanner, and rendered qualitatively by the volume-rendering technique. The length and cross-sectional area of ST measured with 3-D CT were compared with the length of the harvested ST and the cross-sectional area of the grafted quadrupled tendon. The total length of ST measured with 3-D CT ranged from 220.3 to 285.4 mm, with a mean (+/- SD) of 248.0 +/- 17.1 mm, and that measured at surgery ranged from 230.0 to 290.0 mm, with a mean of 257.1 +/- 16.5 mm. These 2 values showed a close positive correlation (gamma = 0.634, P = .002). The cross-sectional area of ST measured with 3-D CT ranged from 4.29 to 18.5 mm2 with a mean of 11.9 +/- 4.6 mm2, and that of the substitute measured at surgery ranged from 28.3 to 56.7 mm2 with a mean of 45.5 +/- 6.9 mm2). There was no significant correlation between the areas of ST measured by CT and the areas of ST measured during surgery. Preoperative 3-D CT imaging predicts the length of ST. These findings support the measurement of ST length by 3-D CT as a useful tool for planning ACL reconstructive surgery and for providing important preoperative information to patients. Level III, diagnostic study.

  3. Arthroscopic Reconstruction of Chronic Isolated Posterior Cruciate Ligament Instability in a Professional Dancer

    PubMed Central

    Aksu, Neslihan; Abay, Burak; Soydan, Ramazan; Ercan, Ertuğrul

    2014-01-01

    Objectives: Chronic isolated injuries of the posterior cruciate ligament (PCL) are very rare in the literature. PCL injuries are often presented undiagnosed because of the weak signs of the injury compared to the anterior cruciate ligament (ACL) injuries. We report the surgical outcome of arthroscopic reconstruction of the chronic isolated PCL rupture with ipsilateral autologous hamstring tendon in a professional Caucasian dancer. Methods: A 21-year-old male professional Caucasian dancer presented severe instability without any pain in his right knee lasting for one year. The patient did not describe any specific traumatic event but his both knees received repeatitive direct pretibial trauma during hyperflexion of the knee while landing to the floor. At the physical examination, posterior sagging of the tibia was observed on the affected side at 90o of knee flexion and step off test and posterior drawer test were positive preoperatively under general anesthesia. The Tegner Lysholm score was evaluated as 59 (poor). A magnetic resonance image (MRI) revealed the isolated total rupture of PCL. The treatment of choice was arthroscopic single bundle reconstruction of PCL with ipsilateral autologous hamstring tendon. A standard arthroscopic exploration of the joint was performed preoperatively and we didn't observe any meniscal, cartilage or ligamentous lesion. Anteromedial and anterolateral portals were made in order to visualize the posterior cortex of the tibia with a 70 degree scope. Intra-operative fluroscopy was used to confirm proper tunnel position. During postoperatively first week, the patient was allowed to mobilize nonweight bearing with the use of two crutches without functional knee brace. Quadriceps musculature and passive range of motion was trained. Results: At the 6 month- follow-up, the patient achieved full symmetric restoration of motion. He had returned to full daily activies. The Tegner Lysholm score was evaluated as 95 (excellent) postoperatively

  4. Sign On to Computers: A Dictionary of Computer Signs.

    ERIC Educational Resources Information Center

    Zier, Cathy Diane; And Others

    This manual defines basic computer terminology and presents sign language gestures for the terms. The manual uses the Atlanta Area School for the Deaf's Manually Coded English Sign Language System, a compilation of signs derived from Signing Exact English and American Sign Language; it also indicates those instances where fingerspelling is…

  5. Signs of Overload

    MedlinePlus

    ... Listen Text Size Email Print Share Signs of Overload Page Content Article Body Although stress is a ... 12 (Copyright © 2004 American Academy of Pediatrics) The information contained on this Web site should not be ...

  6. Dermatomyositis: Signs and Symptoms

    MedlinePlus

    ... Meet our Partners How to Get Involved Donate Dermatomyositis (DM) Share print email share facebook twitter google ... Signs and Symptoms What happens to someone with dermatomyositis? For many decades, DM was considered “ polymyositis with ...

  7. Signs and Symptoms (Smallpox)

    MedlinePlus

    ... Smallpox Website NIH Smallpox Research CDC Poxvirus and Rabies Branch Poxvirus Diseases Signs and Symptoms Recommend on ... Smallpox Website NIH Smallpox Research CDC Poxvirus and Rabies Branch Poxvirus Diseases File Formats Help: How do ...

  8. Stop Sign Crater

    NASA Image and Video Library

    2003-03-06

    With its rim eroded off by catastrophic floods in Tiu Vallis and its strangely angular shape, this 12 km about 7.5 mile diameter crater imaged by NASA Mars Odyssey spacecraft looks vaguely like a stop sign.

  9. MENTOR/PROTEGE SIGNING

    NASA Image and Video Library

    2015-12-07

    MENTOR PROTÉGÉ AGREEMENT SIGNING CEREMONY, DECEMBER 7, 2015 L TO R STANDING: STEVE MILEY, TYLER COCHRAN, STEVE WOFFORD, DAVID BROCK (ALL NASA) L TO R SEATED: DANIEL ADAMSKI (AEROJET ROCKETDYNE), JOE MCCOLLISTER (NASA), EDWINA CIOFFI (ICO RALLY)

  10. Detecting Signs of Intrusion.

    DTIC Science & Technology

    1997-08-01

    your systems, you should investigate any warnings they sound. Although monitors are not fool- proof, they can be part of an effective early warning ...Carnegie Mellon University Software Engineering Institute Detecting Signs of Intrusion Robert Firth Gary Ford Barbara Fräser John Kochmar...1997 Detecting Signs of Intrusion Robert Firth Gary Ford Barbara Fräser John Kochmar Suresh Konda John Richael Derek Simmel Networked Systems

  11. Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport

    PubMed Central

    Paterno, Mark V.; Schmitt, Laura C.; Ford, Kevin R.; Rauh, Mitchell J.; Myer, Gregory D.; Huang, Bin; Hewett, Timothy E.

    2016-01-01

    Background Athletes who return to sport participation after anterior cruciate ligament reconstruction (ACLR) have a higher risk of a second anterior cruciate ligament injury (either reinjury or contralateral injury) compared with non–anterior cruciate ligament–injured athletes. Hypotheses Prospective measures of neuromuscular control and postural stability after ACLR will predict relative increased risk for a second anterior cruciate ligament injury. Study Design Cohort study (prognosis); Level of evidence, 2. Methods Fifty-six athletes underwent a prospective biomechanical screening after ACLR using 3-dimensional motion analysis during a drop vertical jump maneuver and postural stability assessment before return to pivoting and cutting sports. After the initial test session, each subject was followed for 12 months for occurrence of a second anterior cruciate ligament injury. Lower extremity joint kinematics, kinetics, and postural stability were assessed and analyzed. Analysis of variance and logistic regression were used to identify predictors of a second anterior cruciate ligament injury. Results Thirteen athletes suffered a subsequent second anterior cruciate ligament injury. Transverse plane hip kinetics and frontal plane knee kinematics during landing, sagittal plane knee moments at landing, and deficits in postural stability predicted a second injury in this population (C statistic = 0.94) with excellent sensitivity (0.92) and specificity (0.88). Specific predictive parameters included an increase in total frontal plane (valgus) movement, greater asymmetry in internal knee extensor moment at initial contact, and a deficit in single-leg postural stability of the involved limb, as measured by the Biodex stability system. Hip rotation moment independently predicted second anterior cruciate ligament injury (C = 0.81) with high sensitivity (0.77) and specificity (0.81). Conclusion Altered neuromuscular control of the hip and knee during a dynamic landing task

  12. Current Rehabilitation Concepts for Anterior Cruciate Ligament Surgery in Athletes.

    PubMed

    Malempati, Chaitu; Jurjans, John; Noehren, Brian; Ireland, Mary L; Johnson, Darren L

    2015-11-01

    The anterior cruciate ligament is the most commonly disrupted ligament in the knee in high-performance athletes. Most recently, advancements in surgical technique and graft fixation have enabled athletes to participate in early postoperative rehabilitation, focusing on range of motion and progressing to patellar mobilization, strengthening, and neuromuscular control. Several rehabilitation protocols exist with variations in specific exercises, progression through phases, and key components. The ultimate goal of rehabilitation is to return the athlete to preinjury performance level, including motion and strength, without injuring or elongating the graft. Each athlete is unique; thus, safe return to play should be individualized rather than follow a particular postoperative month or time line. This article provides an overview of the application and the scientific basis for formulating a rehabilitation protocol prior to and following anterior cruciate ligament surgery.

  13. Anterior Cruciate Ligament Injury, Reconstruction, and the Optimization of Outcome

    PubMed Central

    Bliss, James Philip

    2017-01-01

    Anterior cruciate ligament reconstruction (ACLR) provides an established surgical intervention to control pathological tibiofemoral translational and rotational movement. ACLR is a safe and reproducible intervention, but there remains an underlying rate of failure to return to preinjury sporting activity levels. Postoperative pathological laxity and graft reinjury remain concerns. Previously, unrecognized meniscal lesions, disruption of the lateral capsule, and extracapsular structures offer potential avenues to treat and to therefore improve kinematic outcome and functional results, following reconstruction. Addressing laterally based injuries may also improve the durability of intraarticular ACLR. Improving the anterior cruciate ligament (ACL) graft replication of the normal ACL attachment points on the femur and the tibia, using either double bundle or anatomical single bundle techniques, improves kinematics, which may benefit outcome and functionality, following reconstruction. PMID:28966384

  14. Ganglion cyst of the posterior cruciate ligament in a child.

    PubMed

    Hameed, Shamsi Abdul; Sujir, Premjit; Naik, Monappa A; Rao, Sharath K

    2012-04-01

    Ganglion cysts are more commonly associated with the anterior cruciate ligament than the posterior cruciate ligament (PCL). A literature review showed that all reported cases of ganglion cysts to date involved adults. We report a rare case of ganglion cyst in the PCL of a four-year-old boy, and discuss its aetiology, clinical presentation, imaging features and management. Ganglion cysts of the PCL may be confused with meniscal cysts arising from tears of the posterior horn of the medial meniscus on magnetic resonance (MR) imaging. Hence, the posterior horn of the medial meniscus has to be carefully evaluated to rule out a tear. MR imaging is the method of choice to confirm diagnosis, and arthroscopic resection is a safe treatment modality even in children.

  15. Recent advances in the rehabilitation of anterior cruciate ligament injuries.

    PubMed

    Wilk, Kevin E; Macrina, Leonard C; Cain, E Lyle; Dugas, Jeffrey R; Andrews, James R

    2012-03-01

    Rehabilitation following anterior cruciate ligament surgery continues to change, with the current emphasis being on immediate weight bearing and range of motion, and progressive muscular strengthening, proprioception, dynamic stability, and neuromuscular control drills. The rehabilitation program should be based on scientific and clinical research and focus on specific drills and exercises designed to return the patient to the desired functional goals. The goal is to return the patient's knee to homeostasis and the patient to his or her sport or activity as safely as possible. Unique rehabilitation techniques and special considerations for the female athlete will also be discussed. The purpose of this article is to provide the reader with a thorough scientific basis for anterior cruciate ligament rehabilitation based on graft selection, patient population, and concomitant injuries.

  16. Fast presurgical magnetic resonance imaging of meniscal tears and concurrent subchondral bone marrow lesions. Study of dogs with naturally occurring cranial cruciate ligament rupture.

    PubMed

    Olive, J; d'Anjou, M-A; Cabassu, J; Chailleux, N; Blond, L

    2014-01-01

    Meniscal tears and subchondral bone marrow lesions have both been described in dogs with cranial cruciate ligament rupture, but their possible concurrence has not been evaluated. In a population of 14 dogs exhibiting signs of stifle pain with surgically confirmed cranial cruciate ligament rupture, a short presurgical 1.5T magnetic resonance (MR) imaging protocol including dorsal proton density, dorsal T1-weighted gradient recalled echo, and sagittal fat-saturated dual echo sequences was tested to further investigate these features and illustrate meniscal tears. Interobserver agreement for detection of medial meniscal tears (k=0.83) and bone marrow lesions (k=0.87) was excellent. Consensus MR reading allowed detection of nine out of 12 surgically confirmed medial meniscal tears and there was no false positive. All dogs had cruciate ligament enthesis-related bone marrow lesions in the tibia, femur or both bones. Additionally, among the 12 dogs with confirmed medial meniscal tears, subchondral bone marrow lesions were present in the caudomedial (9 dogs) and caudoaxial (11 dogs) regions of the tibial plateau, resulting in odds ratios (13.6, p=0.12, and 38.3, p=0.04, respectively) that had large confidence intervals due to the small group size of this study. The other two dogs had neither tibial bone marrow lesions in these locations nor medial meniscal tears. These encouraging preliminary results warrant further investigation using this clinically realistic preoperative MR protocol. As direct diagnosis of meniscal tears remained challenging in dogs even with high-field MR, identification of associated signs such as subchondral bone marrow lesions might indirectly allow suspicion of an otherwise unrecognized meniscal tear.

  17. Controversies in knee rehabilitation: anterior cruciate ligament injury.

    PubMed

    Failla, Mathew J; Arundale, Amelia J H; Logerstedt, David S; Snyder-Mackler, Lynn

    2015-04-01

    Controversy in management of athletes exists after anterior cruciate ligament (ACL) injury and reconstruction. Consensus criteria for evaluating successful outcomes following ACL injury include no reinjury or recurrent giving way, no joint effusion, quadriceps strength symmetry, restored activity level and function, and returning to preinjury sports. Using these criteria, the success rates of current management strategies after ACL injury are reviewed and recommendations are provided for the counseling of athletes after ACL injury.

  18. Popliteal artery injury during posterior cruciate ligament reconstruction.

    PubMed

    Cenni, Marcos Henrique Frauendorf; do Nascimento, Bruno Fajardo; Carneiro, Guilherme Galvão Barreto; de Andrade, Rodrigo Cristiano; Pinheiro Júnior, Lúcio Flávio Biondi; Nicolai, Oscar Pinheiro

    2015-01-01

    This study reports a case of popliteal artery injury during arthroscopic reconstruction of the posterior cruciate ligament. The evolution of the injury is described and comments are made regarding the anatomy of this artery and potential risks of this surgical technique. This study had the aims of alerting the medical community, especially knee surgeons, regarding a severe surgical complication and discussing the ways of preventing it.

  19. [Injuries of the anterior cruciate ligament in athletes].

    PubMed

    Shafizadeh, S; Schneider, M M; Bouillon, B

    2014-10-01

    Anterior cruciate ligament ruptures represent serious injuries for athletes which are often associated with accompanying injuries and lead to relevant kinematic alterations in the femorotibial roll-glide mechanism of the knee joint. Instability resulting in recurrent giving way events, as well as instability-related meniscal and cartilage lesions can cause functional long-term impairment that may limit the athlete's career. Anterior cruciate ligament replacement is therefore considered to be the gold standard for recovery of physical performance and to prevent secondary meniscal and cartilage damage. Continuous changes in the reconstruction of the anterior cruciate ligament have led to a variety of different methods, including graft choice, fixation devices and surgical techniques, which support the consideration of individual requirements of the athlete as well as sport-specific aspects. One of the main factors for restoring stability and the physiological kinematic roll-glide mechanism of the knee is an anatomical tunnel placement as well as a stable graft fixation in the tibia and femur. By achieving of these fundamental technical requirements an early functional rehabilitation and accelerated recovery of neuromuscular skills, strength and coordination can be achieved, so that an early return to sport activities is possible.

  20. Ganglion cyst on the posterior cruciate ligament: a case report

    PubMed Central

    Durante, Jaclyn A.

    2009-01-01

    Objective: To present the diagnostic and clinical features of a ganglion cyst located on the posterior cruciate ligament and create awareness amongst clinicians of this uncommon diagnosis. Clinical Features: A 24-year old woman complaining of intermittent left knee pain brought on by an increase in mileage during her training for a half-marathon. A diagnosis of mild chondromalacia patella and a ganglion cyst on the posterior cruciate ligament was made via diagnostic imaging. Intervention and outcome: Patient was followed up with imaging. The patient chose to withdraw a surgical consult due to patient preference. No conservative treatment was provided. Conclusion: Although chondromalacia patella is the more probable, a secondary diagnostic consideration in this patient could be a ganglion cyst. A ganglion cyst on the posterior cruciate ligament is an uncommon diagnosis and the clinical manifestations are variable and non-specific. It is important to be aware of its clinical features and to obtain appropriate methods of imaging to generate the diagnosis promptly. PMID:20037698

  1. Posterior Cruciate Ligament Function Following Total Knee Arthroplasty

    PubMed Central

    Emodi, George J; Callaghan, John J; Pedersen, Douglas R; Brown, Thomas D

    1999-01-01

    One of the most commonly cited reasons for retaining the posterior cruciate ligament (PCL) during total knee arthroplasty is to preserve femoral rollback and theoretically improve extensor mechanism efficiency (lengthening the moment arm). This study was undertaken to assess PCL function in this regard and to delineate the effects of joint line elevation that can be manipulated intraoperatively by the surgeon. The anterior movement of tibiofemoral contact following PCL resection at flexion angles 60 degrees demonstrated the beneficial effect of the PCL on extensor function. This anterior translation and the concomitant increases in quadriceps tendon load and patellofemoral contact pressures were consistently observed. This study demonstrated that small changes of the joint line position significantly influenced PCL strain and knee kinematics. In order to preserve the desired functions that would be lost with an overly lax PCL and to avoid the potential adverse effects of an overly tight PCL (posterior edge loading and increased tibiofemoral contact), the surgeon should make every effort to restore the preoperative joint line. If this is not possible, consideration should be given to posterior cruciate recession or use of a posterior cruciate substituting design. PMID:10847521

  2. Tubular woven narrow fabrics for replacement of cruciate ligaments.

    PubMed

    Gloy, Yves-Simon; Loehrer, M; Lang, B; Rongen, L; Gries, T; Jockenhoevel, S

    2013-09-01

    The human knee is one of the most frequently injured joints. More than half of these injuries are related to a failure of the anterior cruciate ligament. Current treatments (allogeneic and autologous) bear several disadvantages which can be overcome through the use of synthetic structures. Within the scope of this paper the potential of tubular woven fabrics for the use as artificial ligaments has been evaluated. Twelve fabrics made of polyethylene terephthalate and polytetrafluoroethylene were produced using shuttle weaving technology. Mechanical and biological properties of the fabrics were assessed using static tensile testing and cytotoxicity assays. The results obtained within this study show that woven tubular fabrics can be potentially used as artificial ligament structures as they can provide the desired medical and mechanical properties for cruciate ligament replacements. Through the choice of material and weaving parameters the fabrics' tensile properties can imitate the stress-strain characteristic of the human cruciate ligament. Further assessments in terms of cyclic loading behavior and abrasion resistance of the material are needed to evaluate the success in long term implantation.

  3. Revisiting cruciate paralysis: A case report and systematic review

    PubMed Central

    Hopkins, Benjamin; Khanna, Ryan; Dahdaleh, Nader S

    2016-01-01

    Objective: Cruciate paralysis is a rare, poorly understood condition of the upper craniovertebral junction that allows for selective paralysis of the upper extremities while sparing the lower extremities. Reported cases are few and best treatment practices remain up for debate. The purpose of this study was to conduct a systemic literature review in an attempt to identify prognostic predictors and outcome trends associated with cases previously reported in the literature. Materials and Methods: We conducted a systematic literature review for all cases using the term “Cruciate Paralysis,” reviewing a total of 37 reported cases. All outcomes were assigned a numerical value based on examination at the last follow-up. These numerical values were further analyzed and tested for statistical significance. Results: Of the 37 cases, 78.4% were of traumatic causes. Of these, there were considerably worse outcomes associated with patients over the age of 65 years (P < 0.001). Those patients undergoing surgical treatment showed potentially worse outcomes, with a P value approaching significance at P = 0.08. Conclusion: Numerous cases of trauma-associated cruciate paralysis have been reported in the literature; however, there remains a strong need for further study of the condition. While certain risk factors can be elicited from currently reported studies, insignificant data exist to make any sound conclusion concerning whether surgical intervention is always the best method of treatment. PMID:27891037

  4. Tibial inlay for posterior cruciate ligament reconstruction: a systematic review.

    PubMed

    Papalia, Rocco; Osti, Leonardo; Del Buono, Angelo; Denaro, Vincenzo; Maffulli, Nicola

    2010-08-01

    Although no consensus has been reached regarding the management of PCL deficiency, in vitro and in vivo studies have investigated whether the tibial inlay technique restores the anatomical site of insertion of the PCL, prevents elongation, stretching, graft failure, and improves long-term PCL stability. A systematic search using PubMed, Ovid, the Cochrane Reviews, and Google Scholar databases using 'posterior cruciate ligament tear', 'Tibial inlay technique' and 'posterior cruciate ligament reconstruction' as keywords identified 71 publications, of which 10 were relevant to the topic, and included a total of 255 patients. The tibial inlay technique restores the anatomic insertion site of the PCL, eliminates the killer turn effect, and places the graft at lower potential risk for abrasion and subsequent rupture. It has the disadvantages of increased operating time and risk to the posterior neurovascular structures. There was no evidence of an association between outcome results and Coleman methodology score, but the Coleman methodology scores correlated positively with the level-of-evidence rating. The methodological quality of the studies included has not improved over the years. Given the few reported published findings, we cannot ascertain whether this procedure may provide a consistent alternative to commonly used PCL surgical strategies. The lack of published randomized clinical trials and few reported findings did not allow to ascertain whether the tibial inlay for posterior cruciate ligament reconstruction may provide a consistent alternative to commonly used PCL surgical strategies and to demonstrate procedure efficacy. Copyright 2010 Elsevier B.V. All rights reserved.

  5. An Asymmetric Organocatalytic Quadruple Domino Reaction Employing a Vinylogous Friedel-Crafts/Michael/Michael/Aldol Condensation Sequence.

    PubMed

    Philipps, Arne R; Fritze, Lars; Erdmann, Nico; Enders, Dieter

    2015-04-02

    An organocatalytic quadruple cascade initiated by a Friedel-Crafts-type reaction is described. The (S)-diphenylprolinol trimethylsilyl ether catalyzed reaction yields highly functionalized cyclohexenecarbaldehydes bearing a 1,1-bis[4-(dialkylamino)phenyl]ethene moiety and three contiguous stereogenic centers. The reaction tolerates various functional groups and all products are obtained with very good diastereoselectivity and with virtually complete enantiomeric excess.

  6. A continuous wave 10 W cryogenic fiber amplifier at 1015 nm and frequency quadrupling to 254 nm.

    PubMed

    Steinborn, R; Koglbauer, A; Bachor, P; Diehl, T; Kolbe, D; Stappel, M; Walz, J

    2013-09-23

    A stable, continuous wave, single frequency fiber amplifier system at 1015 nm with 10 W output power is presented. It is based on a large mode double clad fiber cooled to liquid nitrogen temperature. The amplified light is frequency quadrupled to 254 nm and used for spectroscopy of the 6¹S → 6³P transition in mercury.

  7. The formulation and performance of a perturbative correction to the perfect quadruples model

    NASA Astrophysics Data System (ADS)

    Parkhill, John A.; Azar, Julian; Head-Gordon, Martin

    2011-04-01

    A recently published alternative hierarchy of coupled-cluster approximations is reformulated as a perturbative correction. A single variant, a model for the total electronic energy based on the perfect quadruples model, is explored in detail. The computational scaling of the method developed is the same as canonical second order Møller-Plesset perturbation theory (fifth order in the number of molecular orbitals), but its accuracy competes with the high-accuracy, high-cost standard CCSD(T), even when the latter is allowed to break spin-symmetry. The variation presented can be implemented without explicit calculation and storage of the most expensive energy contributions, thereby improving the range of systems which can be treated. The performance and scaling of the method are demonstrated with calculations on the water, fluorine, and oxirane molecules, and compared to the parent model.

  8. Quasi-3D modeling of surface potential and threshold voltage of Triple Metal Quadruple Gate MOSFETs

    NASA Astrophysics Data System (ADS)

    Gupta, Santosh Kumar; Shah, Mihir Kumar P.

    2017-01-01

    In this paper we present electrostatic model of 3D Triple Metal Quadruple Gate (TMQG) MOSFET of rectangular cross-section based on quasi-3D method. The analytical equations for channel potential and characteristic length have been derived by decomposing TMQG into two 2D perpendicular cross-sections (triple metal double gate, TMDG) and the effective characteristic length of TMQG is found using equivalent number of gates (ENG) method. For each of the TMDG, 2D Poisson's equation is solved by parabolic approximation and proper boundary conditions to calculate channel potential. The threshold voltage expression is developed using inversion carrier charge sheet density method. The developed models for channel potential and threshold voltage are validated using numerical simulations of TMQG. The developed model provides the design guidelines for TMQG with improved HCEs and SCEs.

  9. Electronic density topology of metal—metal quadruple bond in some Mo complexes

    NASA Astrophysics Data System (ADS)

    Sierraalta, Anibal

    1994-09-01

    The nature of the quadruple metal—metal bond form MMo(O 2CH) 4 (M=Mo, Cr), and Mo 2X 4(PH 3) 4) (X=Cl, Br, I) complexes, was investigated using the Bader theory and relativistic pseudopotentials. The topological results show that the direct metalmetal interaction is dominated by a strong charge depletion at the bond critical point. The identity of the halide ligands in Mo 2X 4(PH 3) 4 complexes does not affect the electronic density of the MoMo bond. This result is in accord with the experimental fact that the MoMo distances in Mo 2X 4(PMe 3) 4 appears to be independent of the halide ligands.

  10. Characterization and decomposition of self-aligned quadruple patterning friendly layout

    NASA Astrophysics Data System (ADS)

    Zhang, Hongbo; Du, Yuelin; Wong, Martin D. F.; Topaloglu, Rasit O.

    2012-03-01

    Self-aligned quadruple patterning (SAQP) lithography is one of the major techniques for the future process requirement after 16nm/14nm technology node. In this paper, based on the existing knowledge of current 193nm lithography and process flow of SAQP, we will process an early study on the definition of SAQP-friendly layout. With the exploration of the feasible feature regions and possible combinations of adjacent features, we will define several simple but important geometry rules to help define the SAQP-friendliness. Then, we will introduce a conflicting graph algorithm to generate the feature region assignment for SAQP decomposition. Our experimental results validate our SAQP-friendly layout definition, and basic circuit building blocks in the low level metal layer are analyzed.

  11. Nanosecond-timescale spin transfer using individual electrons in a quadruple-quantum-dot device

    SciTech Connect

    Baart, T. A.; Jovanovic, N.; Vandersypen, L. M. K.; Reichl, C.; Wegscheider, W.

    2016-07-25

    The ability to coherently transport electron-spin states between different sites of gate-defined semiconductor quantum dots is an essential ingredient for a quantum-dot-based quantum computer. Previous shuttles using electrostatic gating were too slow to move an electron within the spin dephasing time across an array. Here, we report a nanosecond-timescale spin transfer of individual electrons across a quadruple-quantum-dot device. Utilizing enhanced relaxation rates at a so-called hot spot, we can upper bound the shuttle time to at most 150 ns. While actual shuttle times are likely shorter, 150 ns is already fast enough to preserve spin coherence in, e.g., silicon based quantum dots. This work therefore realizes an important prerequisite for coherent spin transfer in quantum dot arrays.

  12. Coulomb interactions-induced perfect spin-filtering effect in a quadruple quantum-dot cell

    NASA Astrophysics Data System (ADS)

    Kagan, M. Yu.; Val'kov, V. V.; Aksenov, S. V.

    2017-10-01

    A quadruple quantum-dot (QQD) cell is proposed as a spin filter. The transport properties of the QQD cell were studied in linear response regime on the basis of the equations of motion for retarded Green's functions. The developed approach allowed us to take into account the influence of both intra- and interdot Coulomb interactions on charge carriers' spin polarization. It was shown that the presence of the insulating bands in the conductance due to the Coulomb correlations results in the emergence of spin-polarized windows (SPWs) in magnetic field leading to the high spin polarization. We demonstrated that the SPWs can be effectively manipulated by gate fields and considering the hopping between central dots in both isotropic and anisotropic regimes.

  13. Simultaneous occurrence of quadruple Lewis acid-base interactions between selenium atoms in selenocarbonyl dimers.

    PubMed

    Buralli, Gabriel Jesús; Duarte, Darío Jorge Roberto; Peruchena, Nélida María; Alkorta, Ibon

    2017-08-29

    High-level quantum chemical calculations have been performed to investigated the interactions C=Se∙∙∙Se=C. Bounded structures are found with binding energies between -4 and -7 kJ mol-1. The energy decomposition analysis shows that the dispersion is the more attractive term and in all cases save one, the electrostatic interaction is attractive despite every selenium atom has a positive -hole at the extension of the C=Se bond. The topological analysis of the molecular electrostatic potential and L(r)=-2ρ(r) function, and natural bond orbital analysis reveal that these particular Se∙∙∙Se contacts can be considered as quadruple Lewis acid-base interactions. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Line width roughness accuracy analysis during pattern transfer in self-aligned quadruple patterning process

    NASA Astrophysics Data System (ADS)

    Lorusso, Gian Francesco; Inoue, Osamu; Ohashi, Takeyoshi; Altamirano Sanchez, Efrain; Constantoudis, Vassilios; Koshihara, Shunsuke

    2016-03-01

    Line edge roughness (LER) and line width roughness (LWR) are analyzed during pattern transfer in a self-aligned quadruple patterning (SAQP) process. This patterning process leads to a final pitch of 22.5nm, relevant for N7/N5 technologies. Measurements performed by CD SEM (Critical Dimension Scanning Electron Microscope) using different settings in terms of averaging, field of view, and pixel size are compared with reference metrology performed by planar TEM and three-Dimensional Atomic Force Microscope (3D AFM) for each patterning process step in order to investigate the optimal condition for an in-line LWR characterization. Pattern wiggling is als0 quantitatively analyzed during LER/LWR transfer in the SAQP process.

  15. Modulated spin helicity stabilized by incommensurate orbital density waves in a quadruple perovskite manganite

    NASA Astrophysics Data System (ADS)

    Johnson, R. D.; Khalyavin, D. D.; Manuel, P.; Bombardi, A.; Martin, C.; Chapon, L. C.; Radaelli, P. G.

    2016-05-01

    Through a combination of neutron diffraction and Landau theory we describe the spin ordering in the ground state of the quadruple perovskite manganite CaMn7O12 —a magnetic multiferroic supporting an incommensurate orbital density wave that onsets above the magnetic ordering temperature, TN 1=90 K. The multi-k magnetic structure in the ground state was found to be a nearly-constant-moment helix with modulated spin helicity, which oscillates in phase with the orbital occupancies on the Mn3 + sites via trilinear magneto-orbital coupling. Our phenomenological model also shows that, above TN 2=48 K, the primary magnetic order parameter is locked into the orbital wave by an admixture of helical and collinear spin density wave structures. Furthermore, our model naturally explains the lack of a sharp dielectric anomaly at TN 1 and the unusual temperature dependence of the electrical polarization.

  16. Improved stability and stabilization design for networked control systems using new quadruple-integral functionals.

    PubMed

    Li, Zhichen; Bai, Yan; Li, Tianqi

    2016-07-01

    This paper investigates stability analysis and stabilization for networked control systems. By a refined delay decomposition approach, slightly different Lyapunov-Krasovskii functionals (LKFs) with quadruple-integral terms and augmented vectors containing triple-integral forms of state are constructed. New integral inequalities are proposed to estimate the cross terms from derivatives of the LKFs, which can be proved to offer tighter bounds than what the Jensen one produces theoretically. Moreover, the non-strictly proper rational functions in deriving process are fully handled via reciprocally convex approach. A state feedback controller design approach is also developed. Numerical examples and applications to practical power and oscillator systems demonstrate the superiority of the proposed criteria in conservatism reduction compared to some existing ones. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  17. Wideband Diagonal Quadruple-Ridge Orthomode Transducer for Circular Polarization Detection

    NASA Astrophysics Data System (ADS)

    Coutts, Gordon M.

    2011-06-01

    A novel diagonal quadruple-ridge OMT with a compact geometry is proposed for detecting circularly polarized signals when used in conjunction with a 90 degree phase shifter. X-Band OMT prototypes, covering 8 GHz-12 GHz, have been fabricated and tested, and exceed specifications by a wide margin, with no evidence of trapped-mode resonances in the operating bandwidth. In addition to having good reflection and transmission performance, measured results show that the fabricated OMT performs well in separating orthogonal circularly polarized signal components. The OMT design is discussed in detail, focusing on impedance matching as well as the methods used to avoid in-band trapped-mode resonances. Since the OMT design focuses on performance, manufacturability and ease of tuning, the new design would be well suited to array applications. Furthermore, the new OMT design is amenable to multiple-pixel feeds as a result of its narrow geometry.

  18. Control of coherence transfer via tunneling in quadruple and multiple quantum dots

    NASA Astrophysics Data System (ADS)

    Tian, Si-Cong; Xing, En-Bo; Wan, Ren-Gang; Wang, Chun-Liang; Wang, Li-Jie; Shu, Shi-Li; Tong, Cun-Zhu; Wang, Li-Jun

    2016-12-01

    Transfer and manipulation of coherence among the ground state and indirect exciton states via tunneling in quadruple and multiple quantum dots is analyzed. By applying suitable amplitudes and sequences of the pump and tunneling pulses, a complete transfer of coherence or an arbitrary distribution of coherence of multiple states can be realized. The method, which is an adiabatic passage process, is different from previous works on quantum dot molecules in the way that the population can transfer from the ground state to the indirect exciton states without populating the direct exciton state, and thus no spontaneous emission occurs. This investigation can provide further insight to help the experimental development of coherence transfer in semiconductor structures, and may have potential applications in quantum information processing.

  19. Frustration relieved ferrimagnetism in novel A- and B-site-ordered quadruple perovskite.

    PubMed

    Chen, Wei-tin; Mizumaki, Masaichiro; Saito, Takashi; Shimakawa, Yuichi

    2013-07-28

    A novel A- and B-site-ordered quadruple perovskite CaCu3Fe2Sb2O12 was obtained and it shows ferrimagnetism below about 170 K. The B-site Fe spin sublattice adapts a tetrahedral framework in a cubic structure and the Fe(3+)-Fe(3+) antiferromagnetic interaction can result in a geometrical spin frustration as seen in a simple perovskite Ca2FeSbO6. With the introduction of Cu(2+) into the A' site, the antiferromagnetic spin frustration is relieved by the strong Cu(2+)-Fe(3+) interaction, and a ferrimagnetic ordering appears at a much higher temperature than the spin-glass transition temperature.

  20. Reduced Southern Hemispheric circulation response to quadrupled CO2 due to stratospheric ozone feedback

    NASA Astrophysics Data System (ADS)

    Chiodo, Gabriel; Polvani, Lorenzo M.

    2017-01-01

    Due to computational constraints, interactive stratospheric ozone chemistry is commonly neglected in most climate models participating in intercomparison projects. The impact of this simplification on the modeled response to external forcings remains unexplored. In this work, we examine the importance of including interactive stratospheric ozone chemistry on the Southern Hemispheric circulation response to an abrupt quadrupling of CO2. We find that including interactive ozone significantly reduces (by 20%) the response of the midlatitude jet to CO2, even though it does not alter the surface temperature response. The reduction of the tropospheric circulation response is due to CO2 induced ozone changes and their effects on the meridional temperature gradient near the tropopause. Our findings suggest that neglecting this stratospheric ozone feedback results in an overestimate of the circulation response to increased CO2. This has important implications for climate projections of the Southern Hemispheric circulation response to CO2.

  1. A Smile Face Monopole Antenna with Quadruple Band-Notched Characteristics

    NASA Astrophysics Data System (ADS)

    Yang, Xiao-Lin; Kong, Fang-Ling; Wang, Yan

    2015-05-01

    A compact planar ultra-wideband (UWB) monopole antenna with quadruple band-notched characteristics is presented. The notched band at 3.3-4.2 GHz (C-band) is obtained by embedding a pair of Z-shaped slots on the elliptical radiation patch. Meanwhile, a modified U-shaped slot is etched in the radiation patch to create the notched band at 4.9-5.4 GHz for WLAN. In addition, by introducing E-shaped stubs on the back layer, the notched bands at 5.5-6.1 GHz for WLAN and 7-8.15 GHz for downlink of X-band satellite communication system are obtained. The antenna is fabricated and measured, showing broadband matched impedance and good Omni-directional patterns with high fidelity and phase linearity (outside the notched bands).

  2. Full control of quadruple quantum dot circuit charge states in the single electron regime

    SciTech Connect

    Delbecq, M. R. Nakajima, T.; Otsuka, T.; Amaha, S.; Watson, J. D.; Manfra, M. J.; Tarucha, S.

    2014-05-05

    We report the realization of an array of four tunnel coupled quantum dots in the single electron regime, which is the first required step toward a scalable solid state spin qubit architecture. We achieve an efficient tunability of the system but also find out that the conditions to realize spin blockade readout are not as straightforwardly obtained as for double and triple quantum dot circuits. We use a simple capacitive model of the series quadruple quantum dots circuit to investigate its complex charge state diagrams and are able to find the most suitable configurations for future Pauli spin blockade measurements. We then experimentally realize the corresponding charge states with a good agreement to our model.

  3. Ozone concentration-monitoring photoacoustic system based on a frequency-quadrupled Nd:YAG laser

    NASA Astrophysics Data System (ADS)

    Ajtai, T.; Filep, Á.; Varga, A.; Motika, G.; Bozóki, Z.; Szabó, G.

    2010-10-01

    A novel type of system based on a frequency-quadrupled Nd:YAG laser light source at 266 nm and a dual-cell photoacoustic detection unit was developed, and its applicability for ozone-concentration measurement with a minimum detectable ozone concentration of about 100 pptV was demonstrated. The instrument was calibrated against an ozone generator, and it was installed at a regional environmental monitoring station to be operated in parallel with a commercial UV-absorption photometry based ozone-monitoring instrument. While good agreement between the readings of the two systems was found, the photoacoustic system outperformed its optical absorption based counterpart as far as minimum detectable concentration and measurement accuracy is concerned.

  4. Olefin metathesis and quadruple hydrogen bonding: A powerful combination in multistep supramolecular synthesis

    PubMed Central

    Scherman, Oren A.; Ligthart, G. B. W. L.; Ohkawa, Haruki; Sijbesma, Rint P.; Meijer, E. W.

    2006-01-01

    We show that combining concepts generally used in covalent organic synthesis such as retrosynthetic analysis and the use of protecting groups, and applying them to the self-assembly of polymeric building blocks in multiple steps, results in a powerful strategy for the self-assembly of dynamic materials with a high level of architectural control. We present a highly efficient synthesis of bifunctional telechelic polymers by ring-opening metathesis polymerization (ROMP) with complementary quadruple hydrogen-bonding motifs. Because the degree of functionality for the polymers is 2.0, the formation of alternating, blocky copolymers was demonstrated in both solution and the bulk leading to stable, microphase-separated copolymer morphologies. PMID:16877543

  5. A Comparison of Anterior and Posterior Cruciate Ligament Laxity Between Female and Male Basketball Players.

    ERIC Educational Resources Information Center

    Weesner, Carol L.; And Others

    1986-01-01

    The anterior cruciate ligament and posterior cruciate ligament laxity of 90 uninjured male and female high school players were measured. No significant differences were found, indicating that the greater female injury rate may be due to inadequate conditioning, not greater knee ligament laxity. (Author/MT)

  6. On the origin of the flux ratio anomaly in quadruple lens systems

    NASA Astrophysics Data System (ADS)

    Inoue, Kaiki Taro

    2016-09-01

    We explore the origin of the flux ratio anomaly in quadruple lens systems. Using a semi-analytic method based on N-body simulations, we estimate the effect of a possible magnification perturbation caused by subhaloes with a mass scale of ≲109 h-1 M⊙ in lensing galaxy haloes. Taking into account astrometric shifts and assuming that the primary lens is described by a singular isothermal ellipsoid, the expected change to the flux ratios for a multiply lensed image is just a few per cent and the mean of the expected convergence perturbation at the effective Einstein radius of the lensing galaxy halo is <δκsub> = 0.003, corresponding to the mean of the ratio of a projected dark matter mass fraction in subhaloes at the effective Einstein radius = 0.006. In contrast, the expected change to the flux ratio caused by line-of-sight structures is typically ˜10 per cent and the mean of the convergence perturbation is <|δκlos|> = 0.008, corresponding to = 0.017. The contribution of the magnification perturbation caused by subhaloes is ˜40 per cent of the total at a source redshift zS = 0.7 and decreases monotonically in zS to ˜20 per cent at zS = 3.6. Assuming statistical isotropy, the convergence perturbation estimated from 11 observed quadruple lens systems has a positive correlation with the source redshift zS, which is much stronger than that with the lens redshift zL. This feature also supports that the flux ratio anomaly is caused mainly by line-of-sight structures rather than subhaloes. We also discuss a possible imprint of line-of-sight structures in the demagnification of minimum images due to locally underdense structures in the line of sight.

  7. An Unsaturated Four-Coordinate Dimethyl Dimolybdenum Complex with a Molybdenum-Molybdenum Quadruple Bond.

    PubMed

    Curado, Natalia; Carrasco, Mario; Campos, Jesús; Maya, Celia; Rodríguez, Amor; Ruiz, Eliseo; Álvarez, Santiago; Carmona, Ernesto

    2017-01-01

    We describe the synthesis and the molecular and electronic structures of the complex [Mo2 Me2 {μ-HC(NDipp)2 }2 ] (2; Dipp=2,6-iPr2 C6 H3 ), which contains a dimetallic core with an Mo-Mo quadruple bond and features uncommon four-coordinate geometry and has a fourteen-electron count for each molybdenum atom. The coordination polyhedron approaches a square pyramid, with one of the molybdenum atoms nearly co-planar with the basal square plane, in which the trans coordination position with respect to the Mo-Me bond is vacant. The other three sites are occupied by two trans nitrogen atoms of different amidinate ligands and the methyl group. The second Mo atom occupies the apex of the pyramid and forms an Mo-Mo bond of length 2.080(1) Å, consistent with a quadruple bond. Compound 2 reacts with tetrahydrofuran (THF) and trimethylphosphine to yield the mono-adducts [Mo2 Me(μ-Me){μ-HC(NDipp)2 }2 (L)] (3⋅THF and 3⋅PMe3 , respectively) with one terminal and one bridging methyl group. In contrast, 4-dimethylaminopyridine (dmap) forms the bis-adduct [Mo2 Me2 {μ-HC(NDipp)2 }2 (dmap)2 ] (4), with terminally coordinated methyl groups. Hydrogenolysis of complex 2 leads to the bis(hydride) [Mo2 H2 {μ-HC(NDipp)2 }2 (thf)2 ] (5⋅THF) with elimination of CH4 . Computational, kinetic, and mechanistic studies, which included the use of D2 and of complex 2 labelled with (13) C (99 %) at the Mo-CH3 sites, supported the intermediacy of a methyl-hydride reactive species. A computational DFT analysis of the terminal and bridging coordination of the methyl groups to the Mo≣Mo core is also reported. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. THE QUADRUPLE PRE-MAIN-SEQUENCE SYSTEM LkCa 3: IMPLICATIONS FOR STELLAR EVOLUTION MODELS

    SciTech Connect

    Torres, Guillermo; Latham, David W.; Ruiz-Rodriguez, Dary; Prato, L.; Wasserman, Lawrence H.; Badenas, Mariona; Schaefer, G. H.; Mathieu, Robert D.

    2013-08-10

    We report the discovery that the pre-main-sequence (PMS) object LkCa 3 in the Taurus-Auriga star-forming region is a hierarchical quadruple system of M stars. It was previously known to be a close ({approx}0.''5) visual pair, with one component being a moderately eccentric 12.94 day single-lined spectroscopic binary. A re-analysis of archival optical spectra complemented by new near-infrared (NIR) spectroscopy shows both visual components to be double lined; the second one has a period of 4.06 days and a circular orbit. In addition to the orbital elements, we determine optical and NIR flux ratios, effective temperatures, and projected rotational velocities for all four stars. Using existing photometric monitoring observations of the system that had previously revealed the rotational period of the primary in the longer-period binary, we also detect the rotational signal of the primary in the 4.06 day binary, which is synchronized with the orbital motion. With only the assumption of coevality, a comparison of all of these constraints with current stellar evolution models from the Dartmouth series points to an age of 1.4 Myr and a distance of 133 pc, consistent with previous estimates for the region and suggesting that the system is on the near side of the Taurus complex. Similar comparisons of the properties of LkCa 3 and the well-known quadruple PMS system GG Tau with the widely used models from the Lyon series for a mixing length parameter of {alpha}{sub ML} = 1.0 strongly favor the Dartmouth models.

  9. The Quadruple Pre-main-sequence System LkCa 3: Implications for Stellar Evolution Models

    NASA Astrophysics Data System (ADS)

    Torres, Guillermo; Ruíz-Rodríguez, Dary; Badenas, Mariona; Prato, L.; Schaefer, G. H.; Wasserman, Lawrence H.; Mathieu, Robert D.; Latham, David W.

    2013-08-01

    We report the discovery that the pre-main-sequence (PMS) object LkCa 3 in the Taurus-Auriga star-forming region is a hierarchical quadruple system of M stars. It was previously known to be a close (~0.''5) visual pair, with one component being a moderately eccentric 12.94 day single-lined spectroscopic binary. A re-analysis of archival optical spectra complemented by new near-infrared (NIR) spectroscopy shows both visual components to be double lined; the second one has a period of 4.06 days and a circular orbit. In addition to the orbital elements, we determine optical and NIR flux ratios, effective temperatures, and projected rotational velocities for all four stars. Using existing photometric monitoring observations of the system that had previously revealed the rotational period of the primary in the longer-period binary, we also detect the rotational signal of the primary in the 4.06 day binary, which is synchronized with the orbital motion. With only the assumption of coevality, a comparison of all of these constraints with current stellar evolution models from the Dartmouth series points to an age of 1.4 Myr and a distance of 133 pc, consistent with previous estimates for the region and suggesting that the system is on the near side of the Taurus complex. Similar comparisons of the properties of LkCa 3 and the well-known quadruple PMS system GG Tau with the widely used models from the Lyon series for a mixing length parameter of αML = 1.0 strongly favor the Dartmouth models.

  10. Berberine containing quadruple therapy for initial Helicobacter pylori eradication: An open-label randomized phase IV trial.

    PubMed

    Zhang, Di; Ke, Li; Ni, Zhen; Chen, Yu; Zhang, Lin-Hui; Zhu, Shao-Hua; Li, Chan-Juan; Shang, Lei; Liang, Jie; Shi, Yong-Quan

    2017-08-01

    Due to increasing antimicrobial resistance, a bismuth-based quadruple regimen has been recommended as an alternative first-line therapy for Helicobacter pylori (H pylori) eradication. However, different results are varied greatly and the availability of bismuth was limited in some countries. We assessed the efficacy and safety of 14-day berberine-containing quadruple therapy as an alternative regimen for H pylori eradication. In a randomized, open-label, non-inferiority, phase IV trial between November 25, 2014, and October 15, 2015, 612 treatment-naive patients were randomly assigned to 14-day berberine-containing (n = 308) or 14-day bismuth-containing (n = 304) quadruple therapy. The primary outcomes were eradication rates determined by the C urea breath test (C-UBT) 28 days after the end of treatment. The secondary outcomes were adverse events and compliance. The baseline demographic data including age, gender, body mass index (BMI), general condition and severity score were not statistically different in both groups. The eradication rates in bismuth and berberine groups were 86.4% (266/308) and 90.1% (274/304) in intention-to-treat (ITT) analysis (P = .149), and 89.6% (266/297) and 91.3% (273/299) in per-protocol (PP) analysis (P = .470), respectively. No statistically significant difference was found in the overall incidence of adverse events between both groups (35.7% vs 28.6%, P = .060). Both regimens achieved the recommended efficacy for H pylori eradication. The berberine-containing quadruple regimen was not inferior to bismuth-containing quadruple regimen and can be recommended as an alternative regimen for H pylori eradication in the local region.

  11. Comparison Between Sequential Therapy and Modified Bismuth-Included Quadruple Therapy for Helicobacter pylori Eradication in Chinese Patients.

    PubMed

    Yang, Xiuhong; Tan, Pengsheng; Song, Lianying; Lu, Zhanying

    To compare the efficacy and safety of sequential therapy and modified bismuth-included quadruple therapy as a first-line Helicobacter pylori eradication in China. The patients were randomized to receive sequential therapy [n = 90; rabeprazole (20 mg twice daily) and amoxicillin (1 g twice daily) for 5 days, followed by rabeprazole (20 mg twice daily), tinidazole (500 mg twice daily) plus clarithromycin (500 mg twice daily) for another 5 days] or modified bismuth-included quadruple therapy [n = 109; rabeprazole (20 mg twice daily), levofloxacin hydrochloride (400 mg twice daily), clarithromycin (500 mg twice daily), and colloidal bismuth pectin (200 mg 3 times a day) for 7 days]. A follow-up urea breath test was applied 4 weeks later. A total of 199 patients were diagnosed with H. pylori infection. The intention-to-treat and per-protocol (PP) eradication rates were 91.7% and 92.6%, respectively, in the modified bismuth-included quadruple therapy group, and 74.4% and 76.1%, respectively, in the sequential therapy group. The eradication rates were significantly higher in the modified bismuth-included quadruple therapy group, compared with the sequential therapy group (P = 0.001 for intention to treat and P = 0.001 for PP). Adverse effects were reported by patients from both groups, but the difference did not reach significant level (P = 0.280). The modified bismuth-included quadruple therapy seemed to be superior to the sequential therapy as the first-line regimen for H. pylori eradication in Chinese patients.

  12. The Meaning of Signs:

    PubMed Central

    Stein, Claudia

    2006-01-01

    This article reconstructs the diagnostic act of the French pox in the French-disease hospital of sixteenth-century Augsburg. It focuses on how the participants in the clinical encounter imagined the configuration of the pox and its localization in the human body. Of central importance for answering this question is the early modern conception of physical signs. It has been argued that it was due to a specific understanding of bodily signs and their relationship to a disease and its causes, that disease definition and classification in the early modern period showed a high degree of flexibility and fluidity. This paper looks at how the sixteenth-century theoretical conception of physical signs not only shaped the diagnosis and treatment of the pox but also reflected the overall organization of institutions. PMID:17242549

  13. Vital Signs Rate Meter.

    DTIC Science & Technology

    1987-09-01

    S15 VITAL SIGNS RTE NETER(U) TEXAS R FW4D A UNIV COLLEGE 1/1 STATION IENGINEERING PROGM C S LESSAD ET RL. SEP 8? USRFSN-TR-$?-14 F33615-S3-D-0602...UNCLMSIFIED F/O 6/12 ML IIB 125 11 128 11.2.5_ ka7 U S S SS S S S S S0 02.2 36 * . * * * . - * . - .. . - - . Q -- .* USAFSAM-TR-87-1 4 VITAL SIGNS RATE...UNIT ELEMENT NO. INO.I NO. IACESSION NO. 622027 2729 02 21 11 TITLE ft ml’S111111:1111"ll vital Signs Rae ~t= 12. PERSONAL AUTWOR(S) Lessard, Cierles

  14. Eponymous signs in dermatology

    PubMed Central

    Madke, Bhushan; Nayak, Chitra

    2012-01-01

    Clinical signs reflect the sheer and close observatory quality of an astute physician. Many new dermatological signs both in clinical and diagnostic aspects of various dermatoses are being reported and no single book on dermatology literature gives a comprehensive list of these “signs” and postgraduate students in dermatology finds it difficult to have access to the description, as most of these resident doctor do not have access to the said journal articles. “Signs” commonly found in dermatologic literature with a brief discussion and explanation is reviewed in this paper. PMID:23189246

  15. Solar powered highway sign

    NASA Astrophysics Data System (ADS)

    Hayden, R. L.; Hutter, W.

    1980-09-01

    A roadside sign was equipped with lights powered by photovoltaic solar panels to improve nighttime visibility and evaluate equipment performance and needs. The photovoltaic panels were found to be reliable and effective for powering flashing lights on a highway warning sign. Cost of the panels is high so their use should be limited to locations where commercial electrical power is not available. Solar electric systems should be carefully designed to minimize costs and produce a reliable system. Sufficient prediction for the solar panels should be provided in areas where theft or vandalism might be a problem.

  16. [Suture of the anterior cruciate ligament--what is the real value of this method?].

    PubMed

    Seiler, H; Frank, H R

    1993-09-01

    After suture of the anterior cruciate ligament without anatomical augmentation, used as a routine method, 88 patients were followed up after a minimum of 2 years using the Lysholm score and the activity scale. Residual laxity was checked clinically and with the KT-1000. For comparison, 20 patients with chronic symptomatic anterolateral instability were followed up who had been operated on using the Eriksson technique during the same time period. Postoperative treatment was a limited functional approach. The peripheral ligament structures were treated following the Hughston and Müller principles. In two-thirds of the knees lateral tenodesis was added. The results of the suture method were disappointing and inferior to the results obtained by the Eriksson technique (trend). The Lysholm score was 77 and 82, respectively. The activity scale was 4.4 (recreational sports) for both groups. The Lachmann sign (KT-1000) in side-to-side comparison (89 N) showed a residual laxity of 1.9 mm and 0.8 mm (average), respectively. In no series was tractopexy of demonstrable advantage. The final conclusion must be that the suture method (with iliotibial tract tenodesis) is not superior to guided conservative treatment. Despite an unfavorable situation preoperatively, the (abandoned) technique of ligament substitution is superior to the suture method (trend). In isokinetic testing dominant knees fare better. In good results, a high hamstrings-quadriceps ratio is typical. The reasons for this are not well-trained hamstrings, but the relative insufficiency of the quadriceps mechanism.

  17. Signs in Speare's "The Sign of the Beaver."

    ERIC Educational Resources Information Center

    Moseley, Ann

    1995-01-01

    Describes the use of signs in Elizabeth George Speare's "The Sign of the Beaver," in which a settler youth and a young Indian learn to communicate by signs, and how the signs reveal much about each character's culture. Summarizes the plot elements of the book, including characters who are not as sympathetic to the Indian point of view.…

  18. Combined chronic anterior cruciate ligament and posterior cruciate ligament reconstruction: functional and clinical results.

    PubMed

    Denti, Matteo; Tornese, Davide; Melegati, Gianluca; Schonhuber, Herbert; Quaglia, Alessandro; Volpi, Piero

    2015-10-01

    Multiligamentous injury to the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) is an uncommon but debilitating event. Patients with combined ligament injuries typically complain of painful, debilitating knee instability that restricts their sports and daily activities. The purpose of this retrospective study was to evaluate functional and clinical outcomes of patients with chronic ACL and PCL deficiency who underwent simultaneous single-stage arthroscopic reconstruction of the central pivot. Medical records of 20 consecutive patients with chronic ACL and PCL deficiency who underwent simultaneous single-stage arthroscopic reconstruction of the central pivot were retrospectively reviewed. All patients had received either an allograft (group A) or a semitendinosus-gracilis graft for ACL repair and a bone-patellar tibial-bone graft for PCL repair (group B). Functional outcomes, after the initial follow-up period at 24-month FU, were assessed with concentric isokinetic knee extensor-flexor testing at 60 and 180°/s. The secondary aim was to compare long-term clinical recovery by the administration of the IKDC (International Knee Document Committee) Knee Ligament Evaluation Form, the Lysholm Knee Scoring Scale and the Cincinnati Knee Rating Scale. The mean per cent quadriceps strength deficit in the operated as compared to the healthy knee was 13.5 % in group A and 15 % in group B (angular velocity 60°/s) and 13.5 % in group A and 9.4 % in group B (angular velocity 180°/s). The mean per cent flexor strength deficit in the operated as compared to the healthy knee was 10.4 % in group A and 12.3 % in group B (angular velocity 60°/s) and 12.2 % in group A and 9 % in group B (angular velocity of 180°/s). The flexor-quadriceps ratio was 49.4 % in group A and 48.8 % in group B in the healthy knee and 53.2 % in group A and 53.8 % in group B in the operated knee (angular velocity 60°/s) and 63.9 % in group A and 60.7 % in group B in

  19. Sign Language Web Pages

    ERIC Educational Resources Information Center

    Fels, Deborah I.; Richards, Jan; Hardman, Jim; Lee, Daniel G.

    2006-01-01

    The World Wide Web has changed the way people interact. It has also become an important equalizer of information access for many social sectors. However, for many people, including some sign language users, Web accessing can be difficult. For some, it not only presents another barrier to overcome but has left them without cultural equality. The…

  20. Signing in Science

    ERIC Educational Resources Information Center

    Ashby, Rachael

    2013-01-01

    This article describes British Sign Language (BSL) as a viable option for teaching science. BSL is used by a vast number of people in Britain but is seldom taught in schools or included informally alongside lessons. With its new addition of a large scientific glossary, invented to modernise the way science is taught to deaf children, BSL breaks…

  1. Derivative Sign Patterns

    ERIC Educational Resources Information Center

    Clark, Jeffrey

    2011-01-01

    Analysis of the patterns of signs of infinitely differentiable real functions shows that only four patterns are possible if the function is required to exhibit the pattern at all points in its domain and that domain is the set of all real numbers. On the other hand all patterns are possible if the domain is a bounded open interval.

  2. Derivative Sign Patterns

    ERIC Educational Resources Information Center

    Clark, Jeffrey

    2011-01-01

    Analysis of the patterns of signs of infinitely differentiable real functions shows that only four patterns are possible if the function is required to exhibit the pattern at all points in its domain and that domain is the set of all real numbers. On the other hand all patterns are possible if the domain is a bounded open interval.

  3. Buffer Zone Sign Template

    EPA Pesticide Factsheets

    The certified pesticide applicator is required to post a comparable sign, designating a buffer zone around the soil fumigant application block in order to control exposure risk. It must include the don't walk symbol, product name, and applicator contact.

  4. Sign-away Pressures

    ERIC Educational Resources Information Center

    Rosen, Catherine E.

    1976-01-01

    Why would mental health clients sign release-of-information forms unless they thought a refusal to do so would jeopardize their access to service? The author believes that the practice of not advising clients of their rights to privacy has ethical implications that can compromise the value of the treatment. (Author)

  5. Signing in Science

    ERIC Educational Resources Information Center

    Ashby, Rachael

    2013-01-01

    This article describes British Sign Language (BSL) as a viable option for teaching science. BSL is used by a vast number of people in Britain but is seldom taught in schools or included informally alongside lessons. With its new addition of a large scientific glossary, invented to modernise the way science is taught to deaf children, BSL breaks…

  6. Bilateral fatigue fracture of the femoral components in a cruciate-retaining cementless total knee prosthesis.

    PubMed

    Saito, Shu; Tokuhashi, Yasuaki; Ishii, Takao; Mori, Sei; Hosaka, Kunihiro; Ryu, Keinosuke; Suzuki, Gen

    2011-10-05

    This article reports a case of bilateral fatigue fracture of the femoral components in a cruciate-retaining uncemented total knee arthroplasty (TKA). A 75-year-old woman (height, 158 cm; weight, 72 kg; body mass index, 29.2) had undergone one-stage bilateral TKA for osteoarthritis 11 years previously at the author's institution. Surgery was performed using an uncemented Flexible Nichidai Knee. Equal tension of the collateral ligaments and normal mechanical axis were achieved during the primary procedure. The patient was an ardent lover of the game of badminton and had higher activity levels with daily playing. At 8 years postoperatively, she started complaining of mild pain in both knees. The pain gradually increased, and at 11 years postoperatively, she had difficulty walking. Anteroposterior radiographs showed narrowing of the medial joint space, indicating wear of the polyethylene insert. Lateral radiographs showed signs of broken implants in both knees. There were no signs of gross implant loosening or osteolysis. One-stage revision surgery was performed, and the knees were converted to cemented posterior-stabilized TKAs. At revision, the bilateral femoral components were found to be fractured at the junction between the trochlear flange and the medial condyle, anteriorly to the medial peg. The polyethylene insert showed mild wear at the medial middle portion. In the majority of case reports, stress fractures of the femoral component have predominantly affected the medial condyle, following uncemented implantation of fixed-bearing knees. In this case, failure of bone ingrowth in uncemented components, higher body mass index, and a higher athletic activity led to fatigue fracture of the femoral components.

  7. Some clinical aspects of reconstruction for chronic anterior cruciate ligament deficiency.

    PubMed Central

    Dandy, D. J.

    1995-01-01

    A total of 250 patients was reviewed 71.8 months (range 49-105 months) after anterior cruciate ligament (ACL) reconstruction for disabling instability that had not responded to conservative treatment or correction of internal derangements. Knees that had undergone previous operation or had damage to other ligaments were excluded. Four techniques were used; MacIntosh extra-articular lateral substitution alone (n = 18), extra-articular reconstruction plus intra-articular carbon fibre (n = 29), extra-articular reconstruction plus a free graft from the medial third of the patellar tendon (n = 74), or extra-articular reconstruction plus a Leeds-Keio prosthesis (n = 129). The knees were assessed 1, 3 and 6 years after reconstruction using the Lysholm score and clinical examination for the anterior drawer, Lachman and pivot shift signs. The mean Lysholm score after 6 years was 77.4 (range 31-100) in the extra-articular group; 74.4 (range 34-100) in the carbon fibre group; 95.4 (range 43-100) in the patellar tendon group; and 91.2 (range 45-100) in the Leeds-Keio group. The patellar tendon group had the highest scores (P < 0.003). The pivot shift sign returned in 39% of the extra-articular group; 48% of the carbon fibre group; 1% of the patellar tendon group, and 36% of the Leeds-Keio group. The pivot shift returned least often in the patellar tendon group (P < 0.001). There were 44% satisfactory results (pivot shift negative and Lysholm score 77 or more) in the extra-articular group; 55% in the carbon fibre group; 92% in the patellar tendon group; and 60% in the Leeds-Keio group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7574323

  8. Comparative evaluation of different anchoring techniques for synthetic cruciate ligaments. A biomechanical and animal investigation.

    PubMed

    Letsch, R

    1994-01-01

    Under certain well-defined indications alloplastic material may be used in cruciate ligament surgery. The stability and survival of such a synthetic ligament is to a great extent dependent on the anchorage with which it is fastened to the bone. Most fixation methods have proved to be too weak or have revealed other essential drawbacks, resulting in clinical and experimental failure. A new ligament fixation device (LFD) was developed and tested biomechanically and in animal experiments. In the biomechanic investigation the new LFD was compared to single staples, double staples in the belt-buckle technique, and ligament guidance through additional bone tunnels (Z-technique). The tests were carried out on human cadaver knees, plastic bones, and dog stifle joints. The evaluated parameters were linear and maximum load, stiffness, and elongation. In addition, hysteresis tests were performed to assay the long-term resistance of the fixation. The tests showed a significant superiority of the LFD in all measured variables compared to the other anchorages. The pull-out strength, at 1866 +/- 43 N (cadaver knee), was about four times that for the single staple, and about twice as high as that for the double staple and Z-technique. The animal experiments were performed on German shepherd cross-breed dogs. In six animals the anterior cruciate ligaments were excised bilaterally and replaced by a 6-mm Trevira ligament, on one side anchored with staples in the Z-technique, on the other with the LFD. Postoperatively the dogs were allowed to move freely; no additional protection was employed. After 6 months the animals were sacrificed and the knees examined macroscopically, radiologically, microscopically, and by biomechanical testing. After half a year of implantation, the pull-out strength of the alloplastic ligament was 662 +/- 62 N for the LFD and 531 +/- 67 N for the staples. Three ligaments in the staple group and one in the LFD group had ruptured completely, and two ligaments

  9. Wrong Signs in Regression Coefficients

    NASA Technical Reports Server (NTRS)

    McGee, Holly

    1999-01-01

    When using parametric cost estimation, it is important to note the possibility of the regression coefficients having the wrong sign. A wrong sign is defined as a sign on the regression coefficient opposite to the researcher's intuition and experience. Some possible causes for the wrong sign discussed in this paper are a small range of x's, leverage points, missing variables, multicollinearity, and computational error. Additionally, techniques for determining the cause of the wrong sign are given.

  10. Wrong Signs in Regression Coefficients

    NASA Technical Reports Server (NTRS)

    McGee, Holly

    1999-01-01

    When using parametric cost estimation, it is important to note the possibility of the regression coefficients having the wrong sign. A wrong sign is defined as a sign on the regression coefficient opposite to the researcher's intuition and experience. Some possible causes for the wrong sign discussed in this paper are a small range of x's, leverage points, missing variables, multicollinearity, and computational error. Additionally, techniques for determining the cause of the wrong sign are given.

  11. Democracy and environment as references for quadruple and quintuple helix innovation systems

    NASA Astrophysics Data System (ADS)

    Carayannis, Elias G.; Campbell, David F. J.; Orr, Barron J.

    2015-04-01

    The perspective of democracy and the ecological context define key references for knowledge production and innovation in innovation systems. Particularly under conditions of environmental change where enhancing the potential for adaptation is critical, this requires a closer look at ecological responsibility and sensitivity in the different innovation models and governance regimes. The "Quintuple Helix" innovation model is an approach that stresses the necessary socio-ecological transition of society and economy by adding an environment helix to an innovation system already made up of three (university-industry-government) or four (civil society relations) helices in a way that supports adaptation by incorporating global warming as both a challenge to and a driver of innovation. There is the proposition that knowledge production and innovation co-evolve with democracy (Carayannis and Campbell, 2014). In the Triple Helix model (Etzkowitz and Leydesdorff, 2000) the existence of a democracy does not appear to be necessary for knowledge production and innovation. However, the Quadruple Helix (Carayannis and Campbell, 2009, 2010 and 2014) is defined and represented by additional key attributes and components: "media-based and culture-based public", "civil society" and "arts, artistic research and arts-based innovation" (Bast, Carayannis and Campbell, 2015). Implications of this are that the fourth helix in the Quadruple Helix innovation systems brings in and represents the perspective of "dimension of democracy" or the "context of democracy" for knowledge in general and knowledge production and innovation in more particular. Within theories of democracy there is a competition between narrow and broader concepts of democracy (Campbell, 2013). This is particularly true when democracy is to be understood to transcend more substantially the narrow understanding of being primarily based on or being primarily rooted in government institutions (within a Triple Helix

  12. Ergonomic guidelines for traffic sign design increase sign comprehension.

    PubMed

    Ben-Bassat, Tamar; Shinar, David

    2006-01-01

    This research directly tests the relationship between comprehension probability of highway signs and the extent to which they comply with three ergonomic principles of design: sign-content compatibility, familiarity, and standardization. A recent study that evaluated comprehension of traffic signs in four different countries showed that comprehension level varies widely and is apparently related to the extent that the sign's design incorporates ergonomic guidelines for good design (D. Shinar, R. E. Dewar, H. Summala, and L. Zakowska 2003). Participants were presented with 30 signs and asked to describe each sign's meaning. They then evaluated each sign in terms of each of three ergonomic principles. In addition, a group of human factors/ergonomics experts evaluated each sign on its standardization and compatibility. There were high correlations between the ratings of the students and the ratings of the experts on compatibility (rho = .94) and on standardization (rho = .84), validating the use of the students' evaluations of the signs on these variables. There was a great variability in signs' comprehension and high and statistically significant correlations between the comprehension level of each sign and the extent to which it complied with compatibility (R = .76), familiarity (R = .89), and standardization (R = .88) principles. The more signs conform to universal ergonomic principles of good design, the more likely they are to be comprehended by drivers of different cultural backgrounds. Sign design should be guided by established ergonomics principles to enhance comprehension, especially for drivers who have not had any prior encounters with specific signs.

  13. Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty.

    PubMed

    Cromie, Melinda J; Siston, Robert A; Giori, Nicholas J; Delp, Scott L

    2008-11-01

    Abnormal anterior translation of the femur on the tibia has been observed in mid flexion (20-60 degrees ) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes of this abnormal motion remain unknown. The purpose of this study was to isolate the effects of posterior cruciate ligament removal on knee motion after total knee arthroplasty. We posed two questions: Does removing the posterior cruciate ligament introduce abnormal anterior femoral translation? Does implanting a posterior stabilized prosthesis change the kinematics from the cruciate deficient case? Using a navigation system, we measured passive knee kinematics of ten male osteoarthritic patients during surgery after initial exposure, after removing the anterior cruciate ligament, after removing the posterior cruciate ligament, and after implanting the prosthesis. Passively flexing and extending the knee, we calculated anterior femoral translation and the flexion angle at which femoral rollback began. Removing the posterior cruciate ligament doubled anterior translation (from 5.1 +/- 4.3 mm to 10.4 +/- 5.1 mm) and increased the flexion angle at which femoral rollback began (from 31.2 +/- 9.6 degrees to 49.3 +/- 7.3 degrees). Implanting the prosthesis increased the amount of anterior translation (to 16.1 +/- 4.4 mm), and did not change the flexion angle at which femoral rollback began. Abnormal anterior translation was observed in low and mid flexion (0-60 degrees) after removing the posterior cruciate ligament, and normal motion was not restored by the posterior stabilized prosthesis.

  14. Manual Signing in Adults with Intellectual Disability: Influence of Sign Characteristics on Functional Sign Vocabulary

    ERIC Educational Resources Information Center

    Meuris, Kristien; Maes, Bea; De Meyer, Anne-Marie; Zink, Inge

    2014-01-01

    Purpose: The purpose of this study was to investigate the influence of sign characteristics in a key word signing (KWS) system on the functional use of those signs by adults with intellectual disability (ID). Method: All 507 signs from a Flemish KWS system were characterized in terms of phonological, iconic, and referential characteristics.…

  15. Manual Signing in Adults with Intellectual Disability: Influence of Sign Characteristics on Functional Sign Vocabulary

    ERIC Educational Resources Information Center

    Meuris, Kristien; Maes, Bea; De Meyer, Anne-Marie; Zink, Inge

    2014-01-01

    Purpose: The purpose of this study was to investigate the influence of sign characteristics in a key word signing (KWS) system on the functional use of those signs by adults with intellectual disability (ID). Method: All 507 signs from a Flemish KWS system were characterized in terms of phonological, iconic, and referential characteristics.…

  16. Vital signs monitoring system

    NASA Technical Reports Server (NTRS)

    Steffen, Dale A. (Inventor); Sturm, Ronald E. (Inventor); Rinard, George A. (Inventor)

    1981-01-01

    A system is disclosed for monitoring vital physiological signs. Each of the system components utilizes a single hybrid circuit with each component having high accuracy without the necessity of repeated calibration. The system also has low power requirements, provides a digital display, and is of sufficiently small size to be incorporated into a hand-carried case for portable use. Components of the system may also provide independent outputs making the component useful, of itself, for monitoring one or more vital signs. The overall system preferably includes an ECG amplifier and cardiotachometer signal conditioner unit, an impedance pneumograph and respiration rate signal conditioner unit, a heart/breath rate processor unit, a temperature monitoring unit, a selector switch, a clock unit, and an LCD driver unit and associated LCDs, with the system being capable of being expanded as needed or desired, such as, for example, by addition of a systolic/diastolic blood pressure unit.

  17. Modified sequential therapy vs quadruple therapy as initial therapy in patients with Helicobacter infection

    PubMed Central

    Liao, Xiao-Min; Nong, Gao-Hui; Chen, Mei-Zu; Huang, Xue-Ping; Cong, Yun-Yan; Huang, Yi-Ying; Wu, Bai-He; Wei, Jin-Qi

    2015-01-01

    AIM: To evaluate the efficacy and safety of modified sequential therapy and to compare modified sequential therapy with standard quadruple therapy for Helicobacter pylori (H. pylori) eradication. METHODS: In total, 200 consecutive patients who were diagnosed with H. pylori-infected chronic gastritis by electronic endoscopy and rapid urease testing from December 2012 to October 2013 were enrolled in this study. The patients had not previously received H. pylori eradication treatment, and were randomized into two groups. The patients in Group A (n = 101) were treated with ilaprazole + bismuth potassium citrate + amoxicillin and clavulanate potassium + levofloxacin, and the patients in Group B (n = 99) were administered a modified sequential therapy composed of ilaprazole at 5 mg bid and amoxicillin and clavulanate potassium at 914 mg for the first five days followed by ilaprazole at 5 mg bid, furazolidone at 100 mg bid and levofloxacin at 500 mg qid for the next five days. Four to six weeks after the end of treatment, a 14C-urea breath test was performed for all the subjects to confirm the eradication of H. pylori. The intention-to-treat and per-protocol eradication rates were determined. RESULTS: A total of 190 of the 200 patients completed the study. All 200 patients were included in the intention-to-treat analysis, whereas 190 patients were included in the per-protocol analysis. In the intention-to-treat analysis, the rates of H. pylori eradication in Groups A and B were 85.15% (86/101) and 81.82% (81/99), respectively. In the per-protocol analysis, the H. pylori eradication rates in Groups A and B were 88.66% (86/97) and 87.09% (81/93), respectively. No significant difference was observed (χ2 = 0.109, P = 0.741) in the eradication rate between Groups A and B. The rates of adverse effects observed in the groups were similar at 6.19% (6/97) for Group A and 7.53% (7/93) for Group B (P > 0.05). No mortality or major morbidities were observed in any of the patients

  18. Arthroscopy Up to Date: Anterior Cruciate Ligament Anatomy.

    PubMed

    Schillhammer, Carl K; Reid, John B; Rister, Jamie; Jani, Sunil S; Marvil, Sean C; Chen, Austin W; Anderson, Chris G; D'Agostino, Sophia; Lubowitz, James H

    2016-01-01

    To categorize and summarize up-to-date anterior cruciate ligament (ACL) research published in Arthroscopy and The American Journal of Sports Medicine and systematically review each subcategory, beginning with ACL anatomy. After searching for "anterior cruciate ligament" OR "ACL" in Arthroscopy and The American Journal of Sports Medicine from January 2012 through December 2014, we excluded articles more pertinent to ACL augmentation; open growth plates; and meniscal, chondral, or multiligamentous pathology. Studies were subcategorized for data extraction. We included 212 studies that were classified into 8 categories: anatomy; basic science and biomechanics; tunnel position; graft selection; graft fixation; injury risk and rehabilitation; practice patterns and outcomes; and complications. Anatomic risk factors for ACL injury and post-reconstruction graft failure include a narrow intercondylar notch, low native ACL volume, and increased posterior slope. Regarding anatomic footprints, the femoral attachment is 43% of the proximal-to-distal lateral femoral condylar length whereas the posterior border of the tendon is 2.5 mm from the articular margin. The tibial attachment of the ACL is two-fifths of the medial-to-lateral interspinous distance and 15 mm anterior to the posterior cruciate ligament. Anatomic research using radiology and computed tomography to evaluate ACL graft placement shows poor interobserver and intraobserver reliability. With a mind to improving outcomes, surgeons should be aware of anatomic risk factors (stenotic femoral notch, low ligament volume, and increased posterior slope) for ACL graft failure, have a precise understanding of arthroscopic landmarks identifying femoral and tibial footprint locations, and understand that imaging to evaluate graft placement is unreliable. Level III, systematic review of Level III evidence. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. Expedition 18 Door Signing

    NASA Image and Video Library

    2008-10-11

    Expedition 18 Flight Engineer Yuri V. Lonchakov signs the door of a hotel room at the Cosmonaut Hotel prior to departing for the launch aboard a Soyuz TMA-13 spacecraft, Sunday, Oct. 12, 2008, in Baikonur, Kazakhstan. The Soyuz TMA-13 spacecraft launched from the Baikonur Cosmodrome in Kazakhstan carrying Expedition 18 Commander Michael Fincke, Flight Engineer Yuri V. Lonchakov and American spaceflight participant Richard Garriott. Photo Credit: (NASA/Bill Ingalls)

  20. Expedition 18 Door Signing

    NASA Image and Video Library

    2008-10-11

    Expedition 18 Commander Michael Fincke signs the door of a hotel room at the Cosmonaut Hotel prior to departing for the launch aboard a Soyuz TMA-13 spacecraft, Sunday, Oct. 12, 2008, in Baikonur, Kazakhstan. The Soyuz TMA-13 spacecraft launched from the Baikonur Cosmodrome in Kazakhstan carrying Expedition 18 Commander Michael Fincke, Flight Engineer Yuri V. Lonchakov and American spaceflight participant Richard Garriott. Photo Credit: (NASA/Bill Ingalls)

  1. NASA EPA MOA Signing

    NASA Image and Video Library

    2010-04-25

    NASA Administrator Charles Bolden, left, and U.S. Environmental Protection Agency (EPA) Administrator Lisa P. Jackson, right, sign a Memorandum of Agreement (MOA) to promote collaboration between the two agencies for cooperation in environmental and Earth sciences and environmental management applications as students from the Howard University Middle School of Mathematics and Science look on, Monday, April 26, 2010, at the school in Washington. Photo Credit: (NASA/Paul E. Alers)

  2. NASA EPA MOA Signing

    NASA Image and Video Library

    2010-04-25

    NASA Administrator Charles Bolden, left, and U.S. Environmental Protection Agency (EPA) Administrator Lisa P. Jackson, right, answer questions from students and faculty from the Howard University Middle School of Mathematics and Science after signing a Memorandum of Agreement (MOA) to promote collaboration between the two agencies for cooperation in environmental and Earth sciences and environmental management applications, Monday, April 26, 2010, at the school in Washington. Photo Credit: (NASA/Paul E. Alers)

  3. NASA EPA MOA Signing

    NASA Image and Video Library

    2010-04-25

    NASA Administrator Charles Bolden, foreground, speaks with Howard University students after he and and U.S. Environmental Protection Agency (EPA) Administrator Lisa P. Jackson, right, signed a Memorandum of Agreement (MOA) to promote collaboration between the two agencies for cooperation in environmental and Earth sciences and environmental management applications at the Howard University Middle School of Mathematics and Science, Monday, April 26, 2010, in Washington. Photo Credit: (NASA/Paul E. Alers)

  4. The Integral Sign Galaxy

    NASA Astrophysics Data System (ADS)

    Noll, Keith

    2007-07-01

    We will observe the unusual warped disk galaxy known as the Integral Sign Galaxy, UGC 3697, with a small two-position WFPC2 mosaic. Observations will be obtained in three broad band filters and the resulting image will be released on the 19th anniversary of the launch of the Hubble Space Telescope on ~April 24, 2009. Multidrizzled mosaics will be made available through the archive.

  5. Expedition 37 Door Signing

    NASA Image and Video Library

    2013-09-25

    Expedition 37/38 NASA Flight Engineer Michael Hopkins performs the traditional door signing before he and fellow crewmates, Soyuz Commander Oleg Kotov, Russian Flight Engineer Sergey Ryazanskiy depart the Cosmonaut Hotel for their Soyuz launch to the International Space Station on Wednesday, Sept. 25, 2013, in Baikonur, Kazakhstan. Launch of the Soyuz rocket will send Hopkins, Kotov and Ryazanskiy on a five-month mission aboard the International Space Station. Photo Credit: (NASA/Carla Cioffi)

  6. Expedition 37 Door Signing

    NASA Image and Video Library

    2013-09-25

    Expedition 37/38 Russian Flight Engineer Sergey Ryazanskiy performs the traditional door signing before he and fellow crewmates, Soyuz Commander Oleg Kotov and NASA Flight Engineer Michael Hopkins depart the Cosmonaut Hotel for their Soyuz launch to the International Space Station on Wednesday, Sept. 25, 2013, in Baikonur, Kazakhstan. Launch of the Soyuz rocket will send Hopkins, Kotov and Ryazanskiy on a five-month mission aboard the International Space Station. Photo Credit: (NASA/Carla Cioffi)

  7. Expedition 35 Door Signing

    NASA Image and Video Library

    2013-03-28

    Expedition 35 Soyuz Commander Pavel Vinogradov performs the traditional door signing before he and fellow crewmates, Flight Engineers Chris Cassidy and Alexander Misurkin depart the Cosmonaut Hotel for their Soyuz launch to the International Space Station, Thursday, March 28, 2013, in Baikonur, Kazakhstan. Launch of the Soyuz rocket will send Vinogradov, Cassidy and Misurkin on a five and a half month mission aboard the International Space Station. Photo Credit: (NASA/Carla Cioffi)

  8. Expedition 39 Door Signing

    NASA Image and Video Library

    2014-03-25

    Expedition 39 Flight Engineer Oleg Artemyev, left, of the Russian Federal Space Agency, Roscosmos, performs the traditional door signing at the Cosmonaut hotel as Soyuz Commander Alexander Skvortsov of Roscosmos, looks on, Tuesday, March 25, 2014, in Baikonur, Kazakhstan. Artemyev, Skvortsov, and fellow crew member Flight Engineer Steve Swanson of NASA will launch in their Soyuz TMA-12M spacecraft to the International Space Station to begin a six-month mission. Photo Credit (NASA/Joel Kowsky)

  9. Expedition 35 Door Signing

    NASA Image and Video Library

    2013-03-28

    Expedition 35 NASA Flight Engineer Chris Cassidy performs the traditional door signing before he and fellow crewmates, Soyuz Commander Pavel Vinogradov and Flight Engineer Alexander Misurkin depart the Cosmonaut Hotel for their Soyuz launch to the International Space Station, Thursday, March 28, 2013, in Baikonur, Kazakhstan. Launch of the Soyuz rocket will send Cassidy, Vinogradov and Misurkin on a five and a half month mission aboard the International Space Station. Photo Credit: (NASA/Carla Cioffi)

  10. Expedition 37 Door Signing

    NASA Image and Video Library

    2013-09-25

    Expedition 37/38 Soyuz Commander Oleg Kotov performs the traditional door signing before he and fellow crewmates, NASA Flight Engineer Michael Hopkins, Russian Flight Engineer Sergey Ryazanskiy depart the Cosmonaut Hotel for their Soyuz launch to the International Space Station on Wednesday, Sept. 25, 2013, in Baikonur, Kazakhstan. Launch of the Soyuz rocket will send Hopkins, Kotov and Ryazanskiy on a five-month mission aboard the International Space Station. Photo Credit: (NASA/Carla Cioffi)

  11. Expedition 35 Door Signing

    NASA Image and Video Library

    2013-03-28

    Expedition 35 Russian Flight Engineer Alexander Misurkin performs the traditional door signing before he and fellow crewmates, Soyuz Commander Pavel Vinogradov and NASA Flight Engineer Chris Cassidy depart the Cosmonaut Hotel for their Soyuz launch to the International Space Station, Thursday, March 28, 2013, in Baikonur, Kazakhstan. Launch of the Soyuz rocket will send Misurkin, Vinogradov and Cassidy on a five and a half month mission aboard the International Space Station. Photo Credit: (NASA/Carla Cioffi)

  12. [Anterior cruciate ligament-plasty using the "U-dos" technique].

    PubMed

    Morales-Trevizo, C; Paz-García, M; Leal-Berumen, I; Leal-Contreras, C; Berumen-Nafarrate, E

    2013-01-01

    The knee is a compound diarthrodial joint, vulnerable to serious injuries such as ligament injuries of: medial collateral ligament, lateral collateral ligament, anterior cruciate ligament and posterior cruciate ligament, as cruciate ligaments limit rotation movement in the joint. The purpose of our study was to create a new technique to treat injuries of the anterior cruciate ligament, which is composed of two bundles--anteromedial and posterolateral--trying to achieve an anatomical reconstruction that allows for a normal biomechanical recovery. This technique reduces the use of fixation material and costs. The diagnosis of anterior cruciate ligament injuries was made with the pivot shift test. There are currently two repair methods for anterior cruciate ligament injuries: single bundle or double bundle repair; none of these techniques is considered as the gold standard, as their results are very similar. This paper describes a technique used for the treatment of anterior cruciate ligament injuries, known as "U-dos", and its clinical results. Cross-sectional, observational study that enrolled 20 patients with total anterior cruciate ligament injuries who underwent anterior cruciate ligament plasty using the "U-dos" technique between June 2009 and June 2010. The technique requires the use of bone bank allograft, in this case of the anterior tibial ligament. Patients were assessed using the Lysholm scale and the pivot shift test. Our results show that all the pivot shift tests were negative and assessments according to the Lysholm scale were from normal to excellent in 95% of cases (19/20). Only one failure was reported, with avulsion of the graft attachment which required a surgical intervention.

  13. Trunk position modulates anterior cruciate ligament forces and strains during a single-leg squat.

    PubMed

    Kulas, Anthony S; Hortobágyi, Tibor; DeVita, Paul

    2012-01-01

    Although the squat exercise and its variations are commonly prescribed for anterior cruciate ligament rehabilitation, whether trunk position affects these ligament forces and strains during the squat is unclear. Our purpose was to evaluate the effects of trunk position on anterior cruciate ligament forces and strains during a single-leg squat. While instrumented for biomechanical analysis, twelve recreationally active subjects performed single-leg squats with minimal and moderate amounts of forward trunk lean. A combination of inverse dynamics, Hill-type muscle modeling, and mathematical computations estimated anterior cruciate ligament forces, strains and quadriceps, hamstrings, and gastrocnemius forces. The moderate forward trunk lean condition vs. minimal forward trunk lean condition had lower peak anterior cruciate ligament forces (↓24%), strains (↓16%), and average anterior cruciate ligament forces and strains during knee flexion ranges of motion of 25-55°(descent) and 35-55°(ascent). A moderate vs. minimal forward trunk lean also produced 35% higher hamstring forces throughout the majority of the squat, but lower quadriceps forces only at knee flexion angles greater than 65°. Single-leg squats performed with a moderate forward trunk lean (~40°) can minimize anterior cruciate ligament loads. Mechanistically, trunk lean reduced anterior cruciate ligament forces and strains through concomitant modulations in hip flexion angle and biarticular thigh muscle forces. These findings are clinically relevant for anterior cruciate ligament rehabilitation as a common goal is to minimize anterior cruciate ligament forces and strains through enhancing hamstring and quadriceps co-contractions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Planetary Vital Signs

    NASA Astrophysics Data System (ADS)

    Kennel, Charles; Briggs, Stephen; Victor, David

    2016-07-01

    The climate is beginning to behave in unusual ways. The global temperature reached unprecedented highs in 2015 and 2016, which led climatologists to predict an enormous El Nino that would cure California's record drought. It did not happen the way they expected. That tells us just how unreliable temperature has become as an indicator of important aspects of climate change. The world needs to go beyond global temperature to a set of planetary vital signs. Politicians should not over focus policy on one indicator. They need to look at the balance of evidence. A coalition of scientists and policy makers should start to develop vital signs at once, since they should be ready at the entry into force of the Paris Agreement in 2020. But vital signs are only the beginning. The world needs to learn how to use the vast knowledge we will be acquiring about climate change and its impacts. Is it not time to use all the tools at hand- observations from space and ground networks; demographic, economic and societal measures; big data statistical techniques; and numerical models-to inform politicians, managers, and the public of the evolving risks of climate change at global, regional, and local scales? Should we not think in advance of an always-on social and information network that provides decision-ready knowledge to those who hold the responsibility to act, wherever they are, at times of their choosing?

  15. Anterior Cruciate Ligament Reconstruction in Ehlers-Danlos Syndrome

    PubMed Central

    Williams, John; Hutt, Jonathan; Rickman, Mark

    2015-01-01

    This report details the reconstruction of the anterior cruciate ligament in an 18-year-old man with Ehlers-Danlos syndrome (EDS). The reduced mechanical properties of the tissue in EDS can pose a challenge to the orthopaedic surgeon. In this case, we describe the use of a hamstring autograft combined with a Ligament Advanced Reinforcement System (LARS). There was a good radiographical, clinical, and functional outcome after two years. This technique gave a successful outcome in the reconstruction of the ACL in a patient with EDS and therefore may help surgeons faced with the same clinical scenario. PMID:26221555

  16. Anterior Cruciate Ligament Injuries in Children and Adolescents.

    PubMed

    Fabricant, Peter D; Kocher, Mininder S

    2016-10-01

    Dramatic increases in youth competitive athletic activity, early sport specialization, and year-round training and competition, along with increased awareness of anterior cruciate ligament (ACL) injuries in children, have led to a commensurate increase in the frequency of ACL tears in the skeletally immature. Recent understanding of the risks of nonoperative treatment and surgical delay have supported a trend toward early operative treatment. This article discusses treatment strategies for ACL injuries in children and adolescents, and offers our preferred treatment strategy for skeletally immature youth athletes with ACL tears.

  17. Anatomical reconstruction of the anterior cruciate ligament: a logical approach

    PubMed Central

    Gali, Julio Cesar

    2015-01-01

    We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL) reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP) and femoral tunnel drilling through an accessory anteromedial portal (AMP). The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-in technique is used) and also can be used for double-bundle ACL reconstruction. PMID:26417571

  18. Anatomical reconstruction of the anterior cruciate ligament: a logical approach.

    PubMed

    Gali, Julio Cesar

    2015-01-01

    We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL) reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP) and femoral tunnel drilling through an accessory anteromedial portal (AMP). The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-in technique is used) and also can be used for double-bundle ACL reconstruction.

  19. Prevention of anterior cruciate ligament injury in the female athlete

    PubMed Central

    Silvers, Holly Jacinda; Mandelbaum, Bert R

    2007-01-01

    The relationships of gender, age and training to the incidence of anterior cruciate ligament (ACL) injury are pivotal to developing a comprehensive neuromuscular and proprioceptive training programme to decrease ACL injuries in female athletes. A prophylactic neuromuscular and proprioceptive training programme may have direct benefit in decreasing the number of ACL injuries in female athletes. This research foundation endorses further epidemiological and biomechanical studies to determine the exact mechanism of ACL injury and the most effective intervention for decreasing ACL injuries in this high‐risk population. PMID:17609222

  20. Posterior Wall Blowout in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Mitchell, Justin J.; Dean, Chase S.; Chahla, Jorge; Menge, Travis J.; Cram, Tyler R.; LaPrade, Robert F.

    2016-01-01

    Violation of the posterior femoral cortex, commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament (ACL) reconstruction and lead to loss of graft fixation or early graft failure. If cortical blowout occurs despite careful planning and adherence to proper surgical technique, a thorough knowledge of the anatomy and alternative fixation techniques is imperative to ensure optimal patient outcomes. This article highlights anatomic considerations for femoral tunnel placement in ACL reconstruction and techniques for avoidance and salvage of a posterior wall blowout. PMID:27335885

  1. Broad-search algorithms for finding triple-and quadruple-satellite-aided captures at Jupiter from 2020 to 2080

    NASA Astrophysics Data System (ADS)

    Lynam, Alfred E.

    2015-04-01

    Multiple-satellite-aided capture is a -efficient technique for capturing a spacecraft into orbit at Jupiter. However, finding the times when the Galilean moons of Jupiter align such that three or four of them can be encountered in a single pass is difficult using standard astrodynamics algorithms such as Lambert's problem. In this paper, we present simple but powerful techniques that simplify the dynamics and geometry of the Galilean satellites so that many of these triple- and quadruple-satellite-aided capture sequences can be found quickly over an extended 60-year time period from 2020 to 2080. The techniques find many low-fidelity trajectories that could be used as initial guesses for future high-fidelity optimization. Results indicate the existence of approximately 3,100 unique triple-satellite-aided capture trajectories and 6 unique quadruple-satellite-aided capture trajectories during the 60-year time period. The entire search takes less than one minute of computational time.

  2. Risks, benefits, and evidence-based recommendations for improving anterior cruciate ligament outcomes.

    PubMed

    Lubowitz, James H; Verma, Nikhil N; Tokish, John M; Goradia, Vipool K; McNeil, John W; Provencher, Matthew T

    2014-01-01

    Recently, injuries to the anterior cruciate ligament and subsequent surgical reconstructions have seen a great increase in interest from the perspectives of basic science, anatomy, mechanics, and clinical outcomes. Over the past few years, an emerging body of evidence has shown the importance of a more anatomic anterior cruciate ligament reconstruction, which uses sound anatomic and surgical principles, identifies an ideal graft for the patient, and ensures that all aspects of care (including postoperative rehabilitation) are fully addressed. It is helpful for orthopaedic surgeons to review the surgically relevant anatomy of the anterior cruciate ligament, graft choices, fixation techniques and constructs, and rehabilitation guidelines to optimize outcomes for their patients.

  3. A morphologic and quantitative comparison of mechanoreceptors in the tibial remnants of the ruptured human anterior cruciate ligament

    PubMed Central

    Sha, Lin; Xie, Guoming; Zhao, Song; Zhao, Jinzhong

    2017-01-01

    Abstract Reconstruction of the ruptured anterior cruciate ligament (ACL) does not always result in expected successful outcome. A satisfactory outcome depends not only on the tightness or strength of the graft but also on the quality of proprioceptive restoration. Mechanoreceptors of ACL are supposed to play considerable roles in the proprioceptive feedback system of knee. This study aimed to observe the condition and number of the surviving mechanoreceptors in the tibial remnant of ruptured ACL in human knees. From April 2009 to January 2012, 60 patients with existing free tibial remnants who had undergone arthroscopic ACL reconstruction were enrolled and divided into 4 groups according to the time duration of injury to surgery (Group I: no more than 3 months; Group II: 3 to 6 months; Group III, 6 months to 1 year; Group IV: more than 1 year). Six normal ACL specimens were taken as controls. Specimens were obtained from ACL tibial remnant and stained by the immunohistochemical staining method. The type, size, and quantity of mechanoreceptors were observed under the light microscope. A total of 92 Ruffini-like corpuscles, 9 Pacini-like corpuscles, 5 unclassified neural endings, and free nerve endings were identified via immunohistochemical staining. There were no significant differences in the number of mechanoreceptors in the 5 groups (P = 0.238). Some degenerative changes were observed in Group IV. The results suggest that the residual mechanoreceptors in the ruptured ACL exhibit long-term survival and showed no obvious signs of withering within 1 year. Residual mechanoreceptors do exist in the tibial remnants of ruptured anterior cruciate ligament in human knees and identified clearly by using immunohistochemistry staining. No significant difference was found regarding quantitative variation of the residual mechanoreceptors about the injury duration. PMID:28151920

  4. A morphologic and quantitative comparison of mechanoreceptors in the tibial remnants of the ruptured human anterior cruciate ligament.

    PubMed

    Sha, Lin; Xie, Guoming; Zhao, Song; Zhao, Jinzhong

    2017-02-01

    Reconstruction of the ruptured anterior cruciate ligament (ACL) does not always result in expected successful outcome. A satisfactory outcome depends not only on the tightness or strength of the graft but also on the quality of proprioceptive restoration. Mechanoreceptors of ACL are supposed to play considerable roles in the proprioceptive feedback system of knee. This study aimed to observe the condition and number of the surviving mechanoreceptors in the tibial remnant of ruptured ACL in human knees.From April 2009 to January 2012, 60 patients with existing free tibial remnants who had undergone arthroscopic ACL reconstruction were enrolled and divided into 4 groups according to the time duration of injury to surgery (Group I: no more than 3 months; Group II: 3 to 6 months; Group III, 6 months to 1 year; Group IV: more than 1 year). Six normal ACL specimens were taken as controls. Specimens were obtained from ACL tibial remnant and stained by the immunohistochemical staining method. The type, size, and quantity of mechanoreceptors were observed under the light microscope. A total of 92 Ruffini-like corpuscles, 9 Pacini-like corpuscles, 5 unclassified neural endings, and free nerve endings were identified via immunohistochemical staining.There were no significant differences in the number of mechanoreceptors in the 5 groups (P = 0.238). Some degenerative changes were observed in Group IV. The results suggest that the residual mechanoreceptors in the ruptured ACL exhibit long-term survival and showed no obvious signs of withering within 1 year.Residual mechanoreceptors do exist in the tibial remnants of ruptured anterior cruciate ligament in human knees and identified clearly by using immunohistochemistry staining. No significant difference was found regarding quantitative variation of the residual mechanoreceptors about the injury duration.

  5. Morphologic Characteristics Help Explain the Gender Difference in Peak Anterior Cruciate Ligament Strain During a Simulated Pivot Landing

    PubMed Central

    Lipps, David B.; Oh, Youkeun K.; Ashton-Miller, James A.; Wojtys, Edward M.

    2015-01-01

    Background Gender differences exist in anterior cruciate ligament (ACL) cross-sectional area and lateral tibial slope. Biomechanical principles suggest that the direction of these gender differences should induce larger peak ACL strains in females under dynamic loading. Hypothesis Peak ACL relative strain during a simulated pivot landing is significantly greater in female ACLs than male ACLs. Study Design Controlled laboratory study. Methods Twenty cadaveric knees from height- and weight-matched male and female cadavers were subjected to impulsive 3-dimensional test loads of 2 times body weight in compression, flexion, and internal tibial torque starting at 15° of flexion. Load cells measured the 3-dimensional forces and moments applied to the knee, and forces in the pretensioned quadriceps, hamstring, and gastrocnemius muscle equivalents. A novel, gender-specific, nonlinear spring simulated short-range and longer range quadriceps muscle tensile stiffness. Peak relative strain in the anteromedial bundle of the ACL (AM-ACL) was measured using a differential variable reluctance transducer, while ACL cross-sectional area and lateral tibial slope were measured using magnetic resonance imaging. A repeated-measures Mann-Whitney signed-rank test was used to test the hypothesis. Results Female knees exhibited 95% greater peak AM-ACL relative strain than male knees (6.37% [22.53%] vs 3.26% [11.89%]; P = .004). Anterior cruciate ligament cross-sectional area and lateral tibial slope were significant predictors of peak AM-ACL relative strain (R2 = .59; P = .001). Conclusion Peak AM-ACL relative strain was significantly greater in female than male knees from donors of the same height and weight. This gender difference is attributed to a smaller female ACL cross-sectional area and a greater lateral tibial slope. Clinical Relevance Since female ACLs are systematically exposed to greater strain than their male counterparts, training and injury prevention programs should take

  6. Assessment of the accuracy of coupled cluster perturbation theory for open-shell systems. II. Quadruples expansions.

    PubMed

    Eriksen, Janus J; Matthews, Devin A; Jørgensen, Poul; Gauss, Jürgen

    2016-05-21

    We extend our assessment of the potential of perturbative coupled cluster (CC) expansions for a test set of open-shell atoms and organic radicals to the description of quadruple excitations. Namely, the second- through sixth-order models of the recently proposed CCSDT(Q-n) quadruples series [J. J. Eriksen et al., J. Chem. Phys. 140, 064108 (2014)] are compared to the prominent CCSDT(Q) and ΛCCSDT(Q) models. From a comparison of the models in terms of their recovery of total CC singles, doubles, triples, and quadruples (CCSDTQ) energies, we find that the performance of the CCSDT(Q-n) models is independent of the reference used (unrestricted or restricted (open-shell) Hartree-Fock), in contrast to the CCSDT(Q) and ΛCCSDT(Q) models, for which the accuracy is strongly dependent on the spin of the molecular ground state. By further comparing the ability of the models to recover relative CCSDTQ total atomization energies, the discrepancy between them is found to be even more pronounced, stressing how a balanced description of both closed- and open-shell species-as found in the CCSDT(Q-n) models-is indeed of paramount importance if any perturbative CC model is to be of chemical relevance for high-accuracy applications. In particular, the third-order CCSDT(Q-3) model is found to offer an encouraging alternative to the existing choices of quadruples models used in modern computational thermochemistry, since the model is still only of moderate cost, albeit markedly more costly than, e.g., the CCSDT(Q) and ΛCCSDT(Q) models.

  7. Quadruple-first line drug resistance in Mycobacterium tuberculosis in Vietnam: What can we learn from genes?

    PubMed

    Nguyen, Huy Quang; Nguyen, Nhung Viet; Contamin, Lucie; Tran, Thanh Hoa Thi; Vu, Thuong Thi; Nguyen, Hung Van; Nguyen, Ngoc Lan Thi; Nguyen, Son Thai; Dang, Anh Duc; Bañuls, Anne-Laure; Nguyen, Van Anh Thi

    2017-06-01

    In Vietnam, a country with high tuberculosis (137/100.000 population) and multidrug-resistant (MDR)-TB burdens (7.8/100.000 population), little is known about the molecular signatures of drug resistance in general and more particularly of second line drug (SLD) resistance. This study is specifically focused on Mycobacterium tuberculosis isolates resistant to four first-line drugs (FLDs) that make TB much more difficult to treat. The aim is to determine the proportion of SLD resistance in these quadruple drug resistant isolates and the genetic determinants linked to drug resistance to better understand the genetic processes leading to quadruple and extremely drug resistance (XDR). 91 quadruple (rifampicin, isoniazid, ethambutol and streptomycin) FLD resistant and 55 susceptible isolates were included. Spoligotyping and 24-locus MIRU-VNTR techniques were performed and 9 genes and promoters linked to FLD and SLD resistance were sequenced. SLD susceptibility testing was carried out on a subsample of isolates. High proportion of quadruple-FLD resistant isolates was resistant to fluoroquinolones (27%) and second-line injectable drugs (30.2%) by drug susceptibility testing. The sequencing revealed high mutation diversity with prevailing mutations at positions katG315, inhA-15, rpoB531, embB306, rrs1401, rpsL43 and gyrA94. The sensitivity and specificity were high for most drug resistances (>86%), but the sensitivity was lower for injectable drug resistances (<69%). The mutation patterns revealed 23.1% of pre-XDR and 7.7% of XDR isolates, mostly belonging to Beijing family. The genotypic diversity and the variety of mutations reflect the existence of various evolutionary paths leading to FLD and SLD resistance. Nevertheless, particular mutation patterns linked to high-level resistance and low fitness costs seem to be favored. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Theoretical sensitivity analysis of quadruple Vernier racetrack resonators designed for fabrication on the silicon-on-insulator platform

    NASA Astrophysics Data System (ADS)

    Boeck, Robert; Chrostowski, Lukas; Jaeger, Nicolas A. F.

    2014-09-01

    Vernier racetrack resonators offer advantages over single racetrack resonators such as extending the free spectral range (FSR).1-3 Here, we have presented a theoretical sensitivity analysis on quadruple Vernier racetrack resonators based on varying, one at a time, various fabrication dependent parameters. These parameters include the waveguide widths, heights, and propagation losses. We have shown that it should be possible to design a device that meets typical commercial specifications while being tolerant to changes in these parameters.

  9. Triazine-Based Highly Stable AADD-Type Self-Complementary Quadruple Hydrogen-Bonded Systems Devoid of Prototropy.

    PubMed

    Kheria, Sanjeev; Rayavarapu, Suresh; Kotmale, Amol S; Gonnade, Rajesh G; Sanjayan, Gangadhar J

    2017-01-18

    A new class of 1,3,5-triazine-based quadruple hydrogen-bonded system featuring AADD-type self-complementary arrays has been developed and characterized. This system forms highly stable molecular duplex in non-polar solvent (Kdim >1.9×10(7)  m(-1) in CDCl3 ) without prototropy-related issues, raising its prospects for application in supramolecular polymer science.

  10. Twice daily (mid-day and evening) quadruple therapy for H. pylori infection in the United States.

    PubMed

    Graham, D Y; Belson, G; Abudayyeh, S; Osato, M S; Dore, M P; El-Zimaity, H M T

    2004-06-01

    Quadruple therapy provided inadequate eradication rate when given twice-a-day at breakfast and evening meals. To test twice daily (mid-day and evening) quadruple therapy for Helicobacter pylori eradication. This was a single-centre pilot study in which H. pylori-infected (positive histology and culture and RUT) patients were given 2 x 250 mg of metronidazole and 2 x 250 mg of tetracycline, two Pepto-Bismol tablets, plus one 20 mg rabeprazole tablet twice-a-day for 14 days. H. pylori status was confirmed 4 or more weeks after the end of therapy. Thirty-seven patients including 3 with peptic ulcer disease, 19 asymptomatic infected, 4 GERD, and 11 with NUD. Mid-day quadruple therapy was successful in 92.3% (95% CI: 79-98%) including 96.2% of those with metronidazole-susceptible strains, and in 83.3% (10/12) of those with metronidazole-resistant H. pylori. Compliance was 100% by pill count except in one individual who stopped medication after 12 days because of side-effects and who failed therapy. Moderate or greater side-effects were experienced by five patients. Twice-a-day, mid-day, quadruple therapy proved effective using the combination of bismuth subsalicylate and rabeprazole instead of bismuth subcitrate and omeprazole. Detailed studies of different formulations (e.g. 2 x 250 mg versus 1 x 500 mg of metronidazole or tetracycline) and timing of administration (breakfast and evening meal versus mid-day and evening meals) may result in significant improvements in H. pylori eradication regimens.

  11. [Drug susceptibility test guided therapy and novel empirical quadruple therapy for Helicobacter pylori infection: a network Meta-analysis].

    PubMed

    Gou, Q Y; Yu, R B; Shi, R H

    2017-05-10

    Objective: To compare the efficacy and the risk of adverse effect of drug susceptibility test guided therapy and novel empirical quadruple therapy for Helicobacter (H.) pylori infection. Methods: Literature retrieval was conducted by using major databases. Related papers published up to June 2015 were considered eligible if they were randomized control trials comparing different pharmacological formulations for H. pylori infection and used in a network Meta-analysis and a single rate Meta-analysis to evaluate the relative and absolute rates of H. pylori eradication and the risk of adverse effect. The Jadad score was used to evaluate the methodological quality. Funnel plot was constructed to evaluate the risk of publication bias. Begg's rank correlation test or Egger's regression intercept test was done for the asymmetry of funnel plot. Results: Twenty randomized control trials for the treatment of 6 753 initial treated patients with H. pylori infection were included. Drug susceptibility test guided therapy was significantly superior to concomitant therapy, hybrid therapy, sequential therapy and bismuth quadruple therapy. The culture-based therapy had the highest likelihood of improving clinical efficacy, with lowest risk of adverse effect. Concomitant therapy had the highest probability of causing adverse effect despite its effectiveness. Hybrid therapy and bismuth quadruple therapy were associated with lower risk of adverse effect and higher effectiveness. Conclusion: Drug susceptibility test guided therapy showed superiority to other 4 interventions for H. pylori eradication mentioned above. Hybrid therapy and bismuth quadruple therapy might be applied in the settings where the culture-based strategy is not available.

  12. Assessment of the accuracy of coupled cluster perturbation theory for open-shell systems. II. Quadruples expansions

    NASA Astrophysics Data System (ADS)

    Eriksen, Janus J.; Matthews, Devin A.; Jørgensen, Poul; Gauss, Jürgen

    2016-05-01

    We extend our assessment of the potential of perturbative coupled cluster (CC) expansions for a test set of open-shell atoms and organic radicals to the description of quadruple excitations. Namely, the second- through sixth-order models of the recently proposed CCSDT(Q-n) quadruples series [J. J. Eriksen et al., J. Chem. Phys. 140, 064108 (2014)] are compared to the prominent CCSDT(Q) and ΛCCSDT(Q) models. From a comparison of the models in terms of their recovery of total CC singles, doubles, triples, and quadruples (CCSDTQ) energies, we find that the performance of the CCSDT(Q-n) models is independent of the reference used (unrestricted or restricted (open-shell) Hartree-Fock), in contrast to the CCSDT(Q) and ΛCCSDT(Q) models, for which the accuracy is strongly dependent on the spin of the molecular ground state. By further comparing the ability of the models to recover relative CCSDTQ total atomization energies, the discrepancy between them is found to be even more pronounced, stressing how a balanced description of both closed- and open-shell species—as found in the CCSDT(Q-n) models—is indeed of paramount importance if any perturbative CC model is to be of chemical relevance for high-accuracy applications. In particular, the third-order CCSDT(Q-3) model is found to offer an encouraging alternative to the existing choices of quadruples models used in modern computational thermochemistry, since the model is still only of moderate cost, albeit markedly more costly than, e.g., the CCSDT(Q) and ΛCCSDT(Q) models.

  13. Quadruple wild-type (WT) GIST: defining the subset of GIST that lacks abnormalities of KIT, PDGFRA, SDH, or RAS signaling pathways.

    PubMed

    Pantaleo, Maria A; Nannini, Margherita; Corless, Christopher L; Heinrich, Michael C

    2015-01-01

    A subset of GISTs lack mutations in the KIT/PDGFRA or RAS pathways and yet retain an intact succinate dehydrogensase (SDH) complex. We propose that these KIT/PDGFRA/SDH/RAS-P WT GIST tumors be designated as quadruple wild-type (WT) GIST. Further molecular and clinicophatological characterization of quadruple WT GIST will help to determine their prognosis as well as assist in the optimization of medical management, including clinical test of novel therapies.

  14. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS): Longitudinal MRI-based whole joint assessment of anterior cruciate ligament injury.

    PubMed

    Roemer, Frank W; Frobell, Richard; Lohmander, L Stefan; Niu, Jingbo; Guermazi, Ali

    2014-05-01

    To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. Baseline and follow-up 1.5 T MRI examinations from 20 patients of the KANON study, a randomized controlled study comparing a surgical and non-surgical treatment strategy, were assessed for up to six longitudinal visits using a novel MRI scoring system incorporating acute structural tissue damage and longitudinal changes including osteoarthritis (OA) features. Joint features assessed were acute osteochondral injury, traumatic and degenerative bone marrow lesions (BMLs), meniscus morphology and extrusion, osteophytes, collateral and cruciate ligaments including ACL graft, Hoffa-synovitis and effusion-synovitis. Cross-sectional (baseline) and longitudinal (all time points and change) intra- and inter-observer reliability was calculated using weighted (w) kappa statistics and overall percent agreement on a compartmental basis (medial tibio-femoral, lateral tibio-femoral, patello-femoral). Altogether 87 time points were evaluated. Intra-observer reliability ranged between 0.52 (baseline, Hoffa-synovitis) and 1.00 (several features), percent agreement between 52% (all time points, Hoffa-synovitis) and 100% (several features). Inter-observer reliability ranged between 0.00 and 1.00, which is explained by low frequency of some of the features. Altogether, 73% of all assessed 142 parameters showed w-kappa values between 0.80 and 1.00 and 92% showed agreement above 80%. ACLOAS allows reliable scoring of acute ACL injury and longitudinal changes. This novel scoring system incorporates features that may be relevant for structural outcome not covered by established OA scoring instruments. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  15. Triple/quadruple patterning layout decomposition via linear programming and iterative rounding

    NASA Astrophysics Data System (ADS)

    Lin, Yibo; Xu, Xiaoqing; Yu, Bei; Baldick, Ross; Pan, David Z.

    2017-04-01

    As the feature size of the semiconductor technology scales down to 10 nm and beyond, multiple patterning lithography (MPL) has become one of the most practical candidates for lithography, along with other emerging technologies, such as extreme ultraviolet lithography (EUVL), e-beam lithography (EBL), and directed self-assembly. Due to the delay of EUVL and EBL, triple and even quadruple patterning is considered to be used for lower metal and contact layers with tight pitches. In the process of MPL, layout decomposition is the key design stage, where a layout is split into various parts and each part is manufactured through a separate mask. For metal layers, stitching may be allowed to resolve conflicts, whereas it is forbidden for contact and via layers. We focus on the application of layout decomposition where stitching is not allowed, such as for contact and via layers. We propose a linear programming (LP) and iterative rounding solving technique to reduce the number of nonintegers in the LP relaxation problem. Experimental results show that the proposed algorithms can provide high quality decomposition solutions efficiently while introducing as few conflicts as possible.

  16. State-conditional coherent charge qubit oscillations in a Si/SiGe quadruple quantum dot

    SciTech Connect

    Ward, Daniel R.; Kim, Dohun; Savage, Donald E.; Lagally, Max G.; Foote, Ryan H.; Friesen, Mark; Coppersmith, Susan N.; Eriksson, Mark A.

    2016-10-18

    Universal quantum computation requires high-fidelity single-qubit rotations and controlled two-qubit gates. Along with high-fidelity single-qubit gates, strong efforts have been made in developing robust two-qubit logic gates in electrically gated quantum dot systems to realise a compact and nanofabrication-compatible architecture. Here we perform measurements of state-conditional coherent oscillations of a charge qubit. Using a quadruple quantum dot formed in a Si/SiGe heterostructure, we show the first demonstration of coherent two-axis control of a double quantum dot charge qubit in undoped Si/SiGe, performing Larmor and Ramsey oscillation measurements. We extract the strength of the capacitive coupling between a pair of double quantum dots by measuring the detuning energy shift (≈75 μeV) of one double dot depending on the excess charge configuration of the other double dot. Finally, we further demonstrate that the strong capacitive coupling allows fast, state-conditional Landau–Zener–Stückelberg oscillations with a conditional π phase flip time of about 80 ps, showing a promising pathway towards multi-qubit entanglement and control in semiconductor quantum dots.

  17. State-conditional coherent charge qubit oscillations in a Si/SiGe quadruple quantum dot

    DOE PAGES

    Ward, Daniel R.; Kim, Dohun; Savage, Donald E.; ...

    2016-10-18

    Universal quantum computation requires high-fidelity single-qubit rotations and controlled two-qubit gates. Along with high-fidelity single-qubit gates, strong efforts have been made in developing robust two-qubit logic gates in electrically gated quantum dot systems to realise a compact and nanofabrication-compatible architecture. Here we perform measurements of state-conditional coherent oscillations of a charge qubit. Using a quadruple quantum dot formed in a Si/SiGe heterostructure, we show the first demonstration of coherent two-axis control of a double quantum dot charge qubit in undoped Si/SiGe, performing Larmor and Ramsey oscillation measurements. We extract the strength of the capacitive coupling between a pair of doublemore » quantum dots by measuring the detuning energy shift (≈75 μeV) of one double dot depending on the excess charge configuration of the other double dot. Finally, we further demonstrate that the strong capacitive coupling allows fast, state-conditional Landau–Zener–Stückelberg oscillations with a conditional π phase flip time of about 80 ps, showing a promising pathway towards multi-qubit entanglement and control in semiconductor quantum dots.« less

  18. How to Effectively Use Bismuth Quadruple Therapy: The Good, the Bad, and the Ugly

    PubMed Central

    Graham, David Y.; Lee, Sun-Young

    2015-01-01

    Bismuth triple therapy was the first truly effective Helicobacter pylori eradication therapy. The addition of a proton pump inhibitor largely overcame the problem of metronidazole resistance. Resistance to its being the primary first line therapy have centered on convenience (the large number of tablets required) and side effects causing difficulties with patient adherence. Understanding why the regimen is less successful in some regions remains unexplained in part because of the lack of studies including susceptibility testing. A number of modifications have been proposed such as twice-a-day therapy which addresses both major criticism but the studies with susceptibility testing required to prove its effectiveness in high metronidazole resistance areas are lacking. Most publications lack the data required to understand why they were successful or failed (e.g., detailed resistance and adherence data) and are therefore of little value. We discuss and provide recommendations regarding variations including substitution of doxycycline, amoxicillin, and twice a day therapy. We describe what is known and unknown and provide suggestions regarding what is needed to rationally and effectively use bismuth quadruple therapy. Its primary use is when penicillin cannot be used or when clarithromycin and metronidazole resistance is common. Durations of therapy less than 14 days are not recommended. PMID:26314667

  19. Reduction of Beam Emittance of Pep-X Using Quadruple Bend Achromat Cell

    SciTech Connect

    Wang, Min-Huey; Cai, Yunhai; Hettel, Robert; Nosochkov, Yuri; /SLAC

    2009-05-26

    SLAC National Accelerator Laboratory is studying an option of building a high brightness synchrotron light source machine, PEP-X, in the existing PEP-II tunnel [1, 2]. By replacing 6 arcs of FODO cells of PEPII High Energy Ring (HER) with two arcs of DBA and four arcs of TME and installation of 89.3 m long damping wiggler an ultra low beam emittance of 0.14 nm-rad (including intra-beam scattering) at 4.5 GeV is achieved. In this paper we study the possibility to further reduce the beam emittance by releasing the constraint of the dispersion free in the DBA straight. The QBA (Quadruple Bend Achromat) cell is used to replace the DBA. The ratio of outer and inner bending angle is optimized. The dispersion function in the non-dispersion straight is controlled to compromise with lower emittance and beam size at the dispersion straight. An undulator of period length 23 mm, maximum magnetic field of 1.053 T, and total periods of 150 is used to put in the 30 straights to simulate the effects of these IDs on the beam emittance and energy spread. The brightness including all the ID effects is calculated and compared to the original PEP-X design.

  20. Quadruple-layered perovskite (CuCl)Ca2NaNb4O13

    NASA Astrophysics Data System (ADS)

    Kitada, A.; Tsujimoto, Y.; Yamamoto, T.; Kobayashi, Y.; Narumi, Y.; Kindo, K.; Aczel, A. A.; Luke, G. M.; Uemura, Y. J.; Kiuchi, Y.; Ueda, Y.; Yoshimura, K.; Ajiro, Y.; Kageyama, H.

    2012-01-01

    We will present the synthesis, structure and magnetic properties of a new quadruple-layered perovskite (CuCl)Ca2NaNb4O13. Through a topotactic ion-exchange reaction with CuCl2, the precursor RbCa2NaNb4O13 presumably having an incoherent octahederal tliting changes into (CuCl)Ca2NaNb4O13 with a 2ap×2ap×2cp superstructure (tetragonal; a=7.73232(5) Å, c=39.2156(4) Å). The well-defined superstructure for the ion-exchanged product should be stabilized by the inserted CuCl4O2 octahedral layers that firmly connect with neighboring perovskite layers. Magnetic studies show the absence of long-range magnetic ordering down to 2 K despite strong in-plane interactions. Aleksandrov‧s group theory and Rietveld refinement of synchrotron X-ray diffraction data suggest the structure to be of I4/mmm space group with in-phase tilting along the a and b axes, a two-tilt system (++0).

  1. Self-aligned quadruple patterning using spacer on spacer integration optimization for N5

    NASA Astrophysics Data System (ADS)

    Thibaut, Sophie; Raley, Angélique; Mohanty, Nihar; Kal, Subhadeep; Liu, Eric; Ko, Akiteru; O'Meara, David; Tapily, Kandabara; Biolsi, Peter

    2017-04-01

    To meet scaling requirements, the semiconductor industry has extended 193nm immersion lithography beyond its minimum pitch limitation using multiple patterning schemes such as self-aligned double patterning, self-aligned quadruple patterning and litho-etch / litho etch iterations. Those techniques have been declined in numerous options in the last few years. Spacer on spacer pitch splitting integration has been proven to show multiple advantages compared to conventional pitch splitting approach. Reducing the number of pattern transfer steps associated with sacrificial layers resulted in significant decrease of cost and an overall simplification of the double pitch split technique. While demonstrating attractive aspects, SAQP spacer on spacer flow brings challenges of its own. Namely, material set selections and etch chemistry development for adequate selectivities, mandrel shape and spacer shape engineering to improve edge placement error (EPE). In this paper we follow up and extend upon our previous learning and proceed into more details on the robustness of the integration in regards to final pattern transfer and full wafer critical dimension uniformity. Furthermore, since the number of intermediate steps is reduced, one will expect improved uniformity and pitch walking control. This assertion will be verified through a thorough pitch walking analysis.

  2. A quadruple-scanning-probe force microscope for electrical property measurements of microscopic materials.

    PubMed

    Higuchi, Seiji; Kubo, Osamu; Kuramochi, Hiromi; Aono, Masakazu; Nakayama, Tomonobu

    2011-07-15

    Four-terminal electrical measurement is realized on a microscopic structure in air, without a lithographic process, using a home-built quadruple-scanning-probe force microscope (QSPFM). The QSPFM has four probes whose positions are individually controlled by obtaining images of a sample in the manner of atomic force microscopy (AFM), and uses the probes as contacting electrodes for electrical measurements. A specially arranged tuning fork probe (TFP) is used as a self-detection force sensor to operate each probe in a frequency modulation AFM mode, resulting in simultaneous imaging of the same microscopic feature on an insulator using the four TFPs. Four-terminal electrical measurement is then demonstrated in air by placing each probe electrode in contact with a graphene flake exfoliated on a silicon dioxide film, and the sheet resistance of the flake is measured by the van der Pauw method. The present work shows that the QSPFM has the potential to measure the intrinsic electrical properties of a wide range of microscopic materials in situ without electrode fabrication.

  3. A quadruple-scanning-probe force microscope for electrical property measurements of microscopic materials

    NASA Astrophysics Data System (ADS)

    Higuchi, Seiji; Kubo, Osamu; Kuramochi, Hiromi; Aono, Masakazu; Nakayama, Tomonobu

    2011-07-01

    Four-terminal electrical measurement is realized on a microscopic structure in air, without a lithographic process, using a home-built quadruple-scanning-probe force microscope (QSPFM). The QSPFM has four probes whose positions are individually controlled by obtaining images of a sample in the manner of atomic force microscopy (AFM), and uses the probes as contacting electrodes for electrical measurements. A specially arranged tuning fork probe (TFP) is used as a self-detection force sensor to operate each probe in a frequency modulation AFM mode, resulting in simultaneous imaging of the same microscopic feature on an insulator using the four TFPs. Four-terminal electrical measurement is then demonstrated in air by placing each probe electrode in contact with a graphene flake exfoliated on a silicon dioxide film, and the sheet resistance of the flake is measured by the van der Pauw method. The present work shows that the QSPFM has the potential to measure the intrinsic electrical properties of a wide range of microscopic materials in situ without electrode fabrication.

  4. SMOS, ASCAT, SMAP and ERA soil moisture comparison through the triple and quadruple collocation technique

    NASA Astrophysics Data System (ADS)

    Fascetti, F.; Pierdicca, N.; Pulvirenti, L.; Crapolicchio, R.

    2016-10-01

    In this work, a comparison between soil moisture products derived from satellite and land model data was performed; in particular, the soil moisture retrievals of SMOS and ASCAT were compared with those of the ERA-Interim/Land model, produced by the ECMWF in a timeframe of 3 years. Subsequently, for a limited period of time, the product from the SMAP radiometer was joined to SMOS, ASCAT and ERA-Interim model data as a fourth dataset. In both cases, the whole H-SAF region of interest, which includes Northern Africa and Europe, was analysed. In order to validate the products, the Triple Collocation technique was applied to estimate the independent error standard deviation of three systems that observe the same target parameter. When more than three datasets were available, the Quadruple Collocation technique was used to jointly estimate the error standard deviation of four sources. Moreover, when the SMOS and SMAP radiometer products were considered, the Extended Collocation was adopted in order to evaluate the error variances of the systems, taking into account the possible presence of an error cross-correlation between the radiometer retrievals.

  5. Neuraminidase Subtyping of Avian Influenza Viruses with PrimerHunter-Designed Primers and Quadruplicate Primer Pools

    PubMed Central

    Huang, Yanyan; Khan, Mazhar; Măndoiu, Ion I.

    2013-01-01

    We have previously developed a software package called PrimerHunter to design primers for PCR-based virus subtyping. In this study, 9 pairs of primers were designed with PrimerHunter and successfully used to differentiate the 9 neuraminidase (NA) genes of avian influenza viruses (AIVs) in multiple PCR-based assays. Furthermore, primer pools were designed and successfully used to decrease the number of reactions needed for NA subtyping from 9 to 4. The quadruplicate primer-pool method is cost-saving, and was shown to be suitable for the NA subtyping of both cultured AIVs and uncultured AIV swab samples. The primers selected for this study showed excellent sensitivity and specificity in NA subtyping by RT-PCR, SYBR green-based Real-time PCR and Real-time RT-PCR methods. AIV RNA of 2 to 200 copies (varied by NA subtypes) could be detected by these reactions. No unspecific amplification was displayed when detecting RNAs of other avian infectious viruses such as Infectious bronchitis virus, Infectious bursal disease virus and Newcastle disease virus. In summary, this study introduced several sensitive and specific PCR-based assays for NA subtyping of AIVs and also validated again the effectiveness of the PrimerHunter tool for the design of subtyping primers. PMID:24312367

  6. Multiple-antibiotic-resistant Helicobacter pylori infection eradicated with a tailor-made quadruple therapy.

    PubMed

    Nakajima, Shigemi; Inoue, Hisayuki; Inoue, Tetsuya; Maruoka, Yuri

    2012-04-01

    In 2008, a 44-year-old woman with mild epigastralgia diagnosed as having Helicobacter pylori-positive chronic gastritis without peptic ulcer underwent eradication therapy with lansoprazole (LPZ), amoxicillin (AMPC) and clarithromycin (CAM) for 7 days, but it failed, so treatment with rabeprazole, AMPC, and metronidazole (MNZ) for another 7 days was given, but it also failed. She was then prescribed a modified, 14-day sequential therapy of LPZ and AMPC with an increased dose of CAM followed by MNZ supplement, but the infection was still not eradicated. The H. pylori was cultured and examined for antibiotic susceptibility with the agar dilution method and was found to be resistant to CAM, MNZ, and levofloxacin, and non-sensitive to AMPC, namely multiple-antibiotic-resistant, although sensitive to minocycline. The CYP2C19 genotype of the patient was an extensive metabolizer (G681A: G/A, G636A: G/G). In 2010, she gave informed consent for a 14-day, tailor-made, modified classical (or modified high-dose PPI + AMPC) quadruple therapy comprising 30 mg LPZ, 500 mg AMPC and 500 mg bismuth subnitrate, qid, and 100 mg minocycline, bid. Two months later, her urea breath test was negative. Histology and bacterial culture were still negative 1 year after the therapy. She did not have any adverse events during or after the novel therapy, nor did she feel any further epigastralgia.

  7. The quadruple bottom line: the advantages of incorporating Green Chemistry into the undergraduate chemistry major

    NASA Astrophysics Data System (ADS)

    Bodner, George M.

    2017-08-01

    When the author first became involved with the Green Chemistry movement, he noted that his colleagues in industry who were involved in one of the ACS Green Chemistry Institute® industrial roundtables emphasized the take-home message they described as the "triple bottom line." They noted that introducing Green Chemistry in industrial settings had economic, social, and environmental benefits. As someone who first went to school at age 5, and has been "going to school" most days for 65 years, it was easy for the author to see why introducing Green Chemistry into academics had similar beneficial effects within the context of economic, social and environmental domains at the college/university level. He was prepared to understand why faculty who had taught traditional courses often saw the advantage of incorporating Green Chemistry into the courses they teach. What was not as obvious is why students who were encountering chemistry for the first time were often equally passionate about the Green Chemistry movement. Recent attention has been paid, however, to a model that brings clarity to the hitherto vague term of "relevance" that might explain why integrating Green Chemistry into the undergraduate chemistry classroom can achieve a "quadruple bottom-line" for students because of potentially positive effects of adding a domain of "relevance" to the existing economic, social, and environmental domains.

  8. THE UNUSUAL QUADRUPLE SYSTEM HD 91962 WITH A “PLANETARY” ARCHITECTURE

    SciTech Connect

    Tokovinin, Andrei; Latham, David W.; Mason, Brian D. E-mail: dlatham@cfa.harvard.edu

    2015-06-15

    The young nearby solar-type star HD 91962 is a rare quadruple system where three companions revolve around the main component with periods of 170.3 days, 8.85 years, and 205 years. The two outer orbits are nearly co-planar, and all orbits have small eccentricities. We refine the visual orbit of the outer pair and determine the combined spectro-interferometric orbit of the middle 8.8 year pair and the spectroscopic orbit of the inner binary. The middle and inner orbits are likely locked in a 1:19 resonance, and the ratio of the outer and middle periods is ∼23. The masses of all components are estimated (inside-out: 1.14, 0.32, 0.64, 0.64 solar mass).  The dynamical parallax is 27.4 ± 0.6 mas. We speculate that this multiple system originated from collapse of an isolated core and that the companions migrated in a dissipative disk. Other multiple systems with similar features (co-planarity, small eccentricity, and period ratio around 20) are known.

  9. Simulation and performance analysis of a quadruple-effect lithium bromide-water absorption

    SciTech Connect

    Grossman, G.; Zaltash, A.; DeVault, R.C.

    1994-04-01

    In order to investigate the possibility of improving utilization of high temperature heat sources, such as natural gas, for absorption chillers, performance simulation has been conducted for a quadruple-effect lithium bromide-water cycle, capable of substantial performance improvement over state-of-the-art double-effect cycles. The system investigated includes four condensers and four desorbers coupled together, forming an extension of the conventional double-effect cycle; based on prior experience, a parallel flow system was perferred over series flow, and double-condenser coupling (DCC) was employed, extending from triple-effect cycles, to further improve performance. A modular computer code for simulation of absorption systems (ABSIM) was used to investigate the performances of the cycle. The simulation was carried out over a range of operating conditions, including investigation of the influence of some major design parameters. A coefficient of performance in the neighborhood of 2.0 (cooling) was calculated at the design point, with a heat supply temperature of 600{degrees}F at the solution outlet from the high temperature desorber. With some optimization of the weak (pumped) solution flowrate and of the solution split among the four desorbers, this COP may be raised above 2.2, without any increase in the heat transfer surface of the system`s components.

  10. A quadruple wavelength IR sensor system for label-free tumour screening

    NASA Astrophysics Data System (ADS)

    van den Driesche, Sander; Witarski, Wojciech; Pastorekova, Silvia; Vellekoop, Michael J.

    2009-12-01

    In this contribution, we present a novel quadruple wavelength infrared sensor system for measuring the CH2-symmetric/CH2-antisymmetric stretch ratio of biological cells. This ratio can be used as a marker to distinguish between healthy and carcinoma cells. Compared to common techniques our system does not require specific labelling or staining, or the use of expensive liquid nitrogen cooled IR spectrometers. Two of the four wavelengths, 3.33 and 3.57 µm, are used as reference points and the other two represent CH2-symmetric and CH2-antisymmetric stretch absorption (respectively at 3.51 and 3.42 µm). IR absorbance spectra recordings of healthy (MDCK) and malignant (Caki-1) epithelial kidney cells with a conventional IR spectroscope showed significant differences in the absorbance ratio 3.51 µm/3.42 µm (CH2-symmetric/CH2-antisymmetric stretch). The sensor has been validated by measuring the CH2 stretch ratio of yeast samples both by IR spectroscopy and the sensor system. The methods yielded similar results. The application potential of our system is demonstrated by CH2 stretch measurements on healthy and carcinoma epithelial kidney cells. Measurements on both cell types yielded significant differences in CH2 stretch ratio. The sensor has the potential to be further developed into a fast, low-cost and label-free screening system for suspicious biopsy samples.

  11. Optimal Design of a Center Support Quadruple Mass Gyroscope (CSQMG) †

    PubMed Central

    Zhang, Tian; Zhou, Bin; Yin, Peng; Chen, Zhiyong; Zhang, Rong

    2016-01-01

    This paper reports a more complete description of the design process of the Center Support Quadruple Mass Gyroscope (CSQMG), a gyro expected to provide breakthrough performance for flat structures. The operation of the CSQMG is based on four lumped masses in a circumferential symmetric distribution, oscillating in anti-phase motion, and providing differential signal extraction. With its 4-fold symmetrical axes pattern, the CSQMG achieves a similar operation mode to Hemispherical Resonant Gyroscopes (HRGs). Compared to the conventional flat design, four Y-shaped coupling beams are used in this new pattern in order to adjust mode distribution and enhance the synchronization mechanism of operation modes. For the purpose of obtaining the optimal design of the CSQMG, a kind of applicative optimization flow is developed with a comprehensive derivation of the operation mode coordination, the pseudo mode inhibition, and the lumped mass twisting motion elimination. The experimental characterization of the CSQMG was performed at room temperature, and the center operation frequency is 6.8 kHz after tuning. Experiments show an Allan variance stability 0.12°/h (@100 s) and a white noise level about 0.72°/h/√Hz, which means that the CSQMG possesses great potential to achieve navigation grade performance. PMID:27136557

  12. Triple/quadruple patterning layout decomposition via novel linear programming and iterative rounding

    NASA Astrophysics Data System (ADS)

    Lin, Yibo; Xu, Xiaoqing; Yu, Bei; Baldick, Ross; Pan, David Z.

    2016-03-01

    As feature size of the semiconductor technology scales down to 10nm and beyond, multiple patterning lithography (MPL) has become one of the most practical candidates for lithography, along with other emerging technologies such as extreme ultraviolet lithography (EUVL), e-beam lithography (EBL) and directed self assembly (DSA). Due to the delay of EUVL and EBL, triple and even quadruple patterning are considered to be used for lower metal and contact layers with tight pitches. In the process of MPL, layout decomposition is the key design stage, where a layout is split into various parts and each part is manufactured through a separate mask. For metal layers, stitching may be allowed to resolve conflicts, while it is forbidden for contact and via layers. In this paper, we focus on the application of layout decomposition where stitching is not allowed such as for contact and via layers. We propose a linear programming and iterative rounding (LPIR) solving technique to reduce the number of non-integers in the LP relaxation problem. Experimental results show that the proposed algorithms can provide high quality decomposition solutions efficiently while introducing as few conflicts as possible.

  13. Effects of anisotropy and Coulomb interactions on quantum transport in a quadruple quantum-dot structure

    NASA Astrophysics Data System (ADS)

    Kagan, M. Yu.; Val'kov, V. V.; Aksenov, S. V.

    2017-01-01

    We present an analytical and numerical investigation of the spectral and transport properties of a quadruple quantum-dot (QQD) structure which is one of the popular low-dimensional systems in the context of fundamental quantum physics study, future electronic applications, and quantum calculations. The density of states, occupation numbers, and conductance of the structure were analyzed using the nonequilibrium Green's functions in the tight-binding approach and the equation-of-motion method. In particular the anisotropy of hopping integrals and on-site electron energies as well as the effects of the finite intra- and interdot Coulomb interactions were investigated. It was found out that the anisotropy of the kinetic processes in the system leads to the Fano-Feshbach asymmetrical peak. We demonstrated that the conductance of the QQD device has a wide insulating band with steep edges separating triple-peak structures if the intradot Coulomb interactions are taken into account. The interdot Coulomb correlations between the central QDs result in the broadening of this band and the occurrence of an additional band with low conductance due to the Fano antiresonances. It was shown that in this case the conductance of the anisotropic QQD device can be dramatically changed by tuning the anisotropy of on-site electron energies.

  14. Preventing cerebral oedema in acute liver failure: the case for quadruple-H therapy.

    PubMed

    Warrillow, S J; Bellomo, R

    2014-01-01

    Severe cerebral oedema is a life-threatening complication of acute liver failure. Hyperammonaemia and cerebral hyperaemia are major contributing factors. A multimodal approach, which incorporates hyperventilation, haemodiafiltration, hypernatraemia and hypothermia (quadruple-H therapy), may prevent or attenuate severe cerebral oedema. This approach is readily administered by critical care clinicians and is likely to be more effective than the use of single therapies. Targeting of PaCO2 in the mild hyperventilation range, as seen in acute liver failure patients before intubation, aims to minimise hyperaemic cerebral oedema. Haemodiafiltration aims to achieve the rapid control of elevated blood ammonia concentrations by its removal and to reduce production via the lowering of core temperature. The administration of concentrated saline increases serum tonicity and further reduces cerebral swelling. In addition, the pathologically increased cerebral blood-flow is further attenuated by therapeutic hypothermia. The combination of all four treatments in a multimodal approach may be a safe and effective means of attenuating or treating the cerebral oedema of acute liver failure and preventing death from neurological complications.

  15. Temperature and baric dependence of nuclear quadruple resonance spectra in indium and gallium monoselenides

    NASA Astrophysics Data System (ADS)

    Khandozhko, Victor; Raranskii, Nikolai; Balazjuk, Vitaly; Samila, Andriy; Kovalyuk, Zahar

    2013-12-01

    Pulsed radiospectroscopy method has been used to study nuclear quadruple resonance (NQR) spectra of 69Ga and 115In isotopes in the layered semiconductors GaSe and InSe. It has been found that in GaSe and InSe there is a considerable temperature dependence of NQR frequency which in the temperature range of 250 to 390 K is practically linear with conversion slope 1.54 kHz/degree for 69Ga and 2.35 kHz/degree for 115In. In the same crystals the effect of uniaxial pressure on NQR spectra applied along the optical axis с up to the values of 500 kg/сm2 has been studied. A strong attenuation of NQR spectra intensity with increase in pressure on layered crystal package has been established. The unvaried multiplicity of resonance spectra indicates the absence of structural transformations in these layered crystals over the investigated range of temperatures and pressures.

  16. Neuraminidase subtyping of avian influenza viruses with PrimerHunter-designed primers and quadruplicate primer pools.

    PubMed

    Huang, Yanyan; Khan, Mazhar I; Khan, Mazhar; Măndoiu, Ion; Măndoiu, Ion I

    2013-01-01

    We have previously developed a software package called PrimerHunter to design primers for PCR-based virus subtyping. In this study, 9 pairs of primers were designed with PrimerHunter and successfully used to differentiate the 9 neuraminidase (NA) genes of avian influenza viruses (AIVs) in multiple PCR-based assays. Furthermore, primer pools were designed and successfully used to decrease the number of reactions needed for NA subtyping from 9 to 4. The quadruplicate primer-pool method is cost-saving, and was shown to be suitable for the NA subtyping of both cultured AIVs and uncultured AIV swab samples. The primers selected for this study showed excellent sensitivity and specificity in NA subtyping by RT-PCR, SYBR green-based Real-time PCR and Real-time RT-PCR methods. AIV RNA of 2 to 200 copies (varied by NA subtypes) could be detected by these reactions. No unspecific amplification was displayed when detecting RNAs of other avian infectious viruses such as Infectious bronchitis virus, Infectious bursal disease virus and Newcastle disease virus. In summary, this study introduced several sensitive and specific PCR-based assays for NA subtyping of AIVs and also validated again the effectiveness of the PrimerHunter tool for the design of subtyping primers.

  17. Infrared/ultraviolet quadruple resonance spectroscopy to investigate structures of electronically excited states

    SciTech Connect

    Weiler, M.; Bartl, K.; Gerhards, M.

    2012-03-21

    Molecular beam investigations in combination with IR/UV spectroscopy offer the possibility to obtain structural information on isolated molecules and clusters. One of the demanding tasks is the discrimination of different isomers, e.g., by the use of isomer specific UV excitations. If this discrimination fails due to overlaying UV spectra of different isomers, IR/IR methods offer another possibility. Here, we present a new IR/UV/IR/UV quadruple resonance technique to distinguish between different isomers especially in the electronically excited state. Due to the IR spectra, structural changes and photochemical pathways in excited states can be assigned and identified. The method is applied to the dihydrated cluster of 3-hydroxyflavone which has been investigated as photochemically relevant system and proton wire model in the S{sub 1} state. By applying the new IR/UV/IR/UV technique, we are able to show experimentally that both in the electronic ground (S{sub 0}) and the electronically excited state (S{sub 1}) two isomers have to be assigned.

  18. Quadruple Injection of Hypothalamic Peptides to Evaluate Pituitary Function in Normal Subjects

    PubMed Central

    Kaltenborn, K. C.; Jubiz, William

    1985-01-01

    A single intravenous injection of four hypothalamic releasing hormones—corticotropin-, growth hormone-, gonadotropin- and thyrotropin-releasing hormones—was administered to normal subjects. Except for the plasma adrenocorticotropic hormone (ACTH) level, a statistically significant increase in all anterior pituitary hormone levels occurred. Transient flushing was the only consistent side effect. In the same persons, results were compared with those obtained with insulin-induced hypoglycemia and a single-dose overnight metyrapone test. Growth hormone and cortisol responses to insulin-induced hypoglycemia were similar but prolactin increment was less than that obtained by the peptide injection. ACTH increments from both tests were substantially less than those obtained by the overnight metyrapone test. We conclude that pituitary function can be effectively studied in normal subjects by the combination of a metyrapone test with a triple bolus of growth hormone-, thytropin- and gonadotropin-releasing hormones, but not by a quadruple bolus of the hypothalamic peptides. Compared with insulin-induced hypoglycemia, this approach yields more information with fewer side effects. PMID:3919507

  19. Quadruple injection of hypothalamic peptides to evaluate pituitary function in normal subjects.

    PubMed

    Kaltenborn, K C; Jubiz, W

    1985-01-01

    A single intravenous injection of four hypothalamic releasing hormones-corticotropin-, growth hormone-, gonadotropin- and thyrotropin-releasing hormones-was administered to normal subjects. Except for the plasma adrenocorticotropic hormone (ACTH) level, a statistically significant increase in all anterior pituitary hormone levels occurred. Transient flushing was the only consistent side effect. In the same persons, results were compared with those obtained with insulin-induced hypoglycemia and a single-dose overnight metyrapone test. Growth hormone and cortisol responses to insulin-induced hypoglycemia were similar but prolactin increment was less than that obtained by the peptide injection. ACTH increments from both tests were substantially less than those obtained by the overnight metyrapone test. We conclude that pituitary function can be effectively studied in normal subjects by the combination of a metyrapone test with a triple bolus of growth hormone-, thytropin- and gonadotropin-releasing hormones, but not by a quadruple bolus of the hypothalamic peptides. Compared with insulin-induced hypoglycemia, this approach yields more information with fewer side effects.

  20. Three unsuccessful treatments of Helicobacter pylori infection by a highly virulent strain with quadruple antibiotic resistance.

    PubMed

    Boyanova, Lyudmila; Evstatiev, Ivailo; Yordanov, Daniel; Markovska, Rumyana; Mitov, Ivan

    2016-07-01

    We report a case of an adult patient undergoing three unsuccessful Helicobacter pylori treatments, including proton pump inhibitor (PPI), bismuth subcitrate, metronidazole and tetracycline in 2012, PPI, amoxicillin and clarithromycin in 2013, and PPI, amoxicillin and rifampin in 2014. Following the first treatment, the isolate was metronidazole and ciprofloxacin/levofloxacin resistant. After the second treatment, the isolate was resistant to metronidazole, ciprofloxacin/levofloxacin and rifampin, developing secondary clarithromycin resistance by A2143G mutation and was susceptible only to tetracycline. After the third treatment, the patient still remained H. pylori positive. Patient's strain was highly virulent (cagA (+) , cagE (+) and vacA s1a/m1/i1). The evolution of the patient's disease was from gastroesophageal reflux disease in 2012 to two duodenal ulcers in 2015. Briefly, the infecting strain showed quadruple antibiotic resistance and a transient amoxicillin resistance. Triple clarithromycin-based treatment induced secondary clarithromycin resistance by A2143G mutation, while rifampin resistance caused the third treatment failure. Several options for the next treatment regimens are discussed.

  1. Process control on modified III Quadruple Tank using LabVIEW aplication

    NASA Astrophysics Data System (ADS)

    Azizah, Zahrotul; Arlita, Amalia Dyah; Rahayu, Santi Puteri; Arifin, Imam; Hisyam, Anwaruddin; Renanto, Juwari

    2017-05-01

    Generally, chemical industry processes have the characteristics of a multi-variable process, and influenced by the disturbances which may be detrimental to the process. Quadruple tank process is a simple prototype which represents the complicated multivariable dynamic process. However, this system originally doesn't have time delay that always occure in industrial process. Thus, this study modify the system by adding heater in tank I and tank 2. In addition, interaction between tank I and tank 2 also tank 3 and tank 4 was modified [2]. Two controllers are implemented to maintain level and temperature of tank I and tank 2 i.e. PI-PID and 2DoF IMC. The PI-PID controller parameters are determined by Ziegler-Nichols tuning method which detuned by Mc Avoy method and BLT method, while the 2DoF IMC controller parameter is determined by MP-GM method. In the minimum phase, based on the value of IAE, the PI controller with detuning Mc Avoy better than the 2DoF-IMC in controlling levels and 2DoF-IMC better than control of temperature compared with PI-PID controllers. In the non-minimum phase, based on the value of IAE, the PI-PID controller is better than the control 2DoF-IMC.

  2. A Lagrangian framework for deriving triples and quadruples corrections to the CCSD energy.

    PubMed

    Eriksen, Janus J; Kristensen, Kasper; Kjærgaard, Thomas; Jørgensen, Poul; Gauss, Jürgen

    2014-02-14

    Using the coupled cluster Lagrangian technique, we have determined perturbative corrections to the coupled cluster singles and doubles (CCSD) energy that converge towards the coupled cluster singles, doubles, and triples (CCSDT) and coupled cluster singles, doubles, triples, and quadruples (CCSDTQ) energies, considering the CCSD state as the unperturbed reference state and the fluctuation potential as the perturbation. Since the Lagrangian technique is utilized, the energy corrections satisfy Wigner's 2n + 1 rule for the cluster amplitudes and the 2n + 2 rule for the Lagrange multipliers. The energy corrections define the CCSD perturbation series, CCSD(T-n) and CCSD(TQ-n), which are term-wise size extensive to any order in the perturbation. A detailed comparison of the CCSD(TQ-n) series and the CC(2)PT(n) series of Hirata et al. [J. Chem. Phys. 114, 3919 (2001)] has been performed, revealing some deficiencies of the latter related to the target energy of the series and its lack of size extensivity.

  3. State-conditional coherent charge qubit oscillations in a Si/SiGe quadruple quantum dot

    NASA Astrophysics Data System (ADS)

    Ward, Daniel R.; Kim, Dohun; Savage, Donald E.; Lagally, Max G.; Foote, Ryan H.; Friesen, Mark; Coppersmith, Susan N.; Eriksson, Mark A.

    2016-10-01

    Universal quantum computation requires high-fidelity single-qubit rotations and controlled two-qubit gates. Along with high-fidelity single-qubit gates, strong efforts have been made in developing robust two-qubit logic gates in electrically gated quantum dot systems to realise a compact and nanofabrication-compatible architecture. Here we perform measurements of state-conditional coherent oscillations of a charge qubit. Using a quadruple quantum dot formed in a Si/SiGe heterostructure, we show the first demonstration of coherent two-axis control of a double quantum dot charge qubit in undoped Si/SiGe, performing Larmor and Ramsey oscillation measurements. We extract the strength of the capacitive coupling between a pair of double quantum dots by measuring the detuning energy shift (≈75 μeV) of one double dot depending on the excess charge configuration of the other double dot. We further demonstrate that the strong capacitive coupling allows fast, state-conditional Landau-Zener-Stückelberg oscillations with a conditional π phase flip time of about 80 ps, showing a promising pathway towards multi-qubit entanglement and control in semiconductor quantum dots.

  4. Head movements quadruple the range of speeds encoded by the insect motion vision system in hawkmoths.

    PubMed

    Windsor, Shane P; Taylor, Graham K

    2017-10-11

    Flying insects use compensatory head movements to stabilize gaze. Like other optokinetic responses, these movements can reduce image displacement, motion and misalignment, and simplify the optic flow field. Because gaze is imperfectly stabilized in insects, we hypothesized that compensatory head movements serve to extend the range of velocities of self-motion that the visual system encodes. We tested this by measuring head movements in hawkmoths Hyles lineata responding to full-field visual stimuli of differing oscillation amplitudes, oscillation frequencies and spatial frequencies. We used frequency-domain system identification techniques to characterize the head's roll response, and simulated how this would have affected the output of the motion vision system, modelled as a computational array of Reichardt detectors. The moths' head movements were modulated to allow encoding of both fast and slow self-motion, effectively quadrupling the working range of the visual system for flight control. By using its own output to drive compensatory head movements, the motion vision system thereby works as an adaptive sensor, which will be especially beneficial in nocturnal species with inherently slow vision. Studies of the ecology of motion vision must therefore consider the tuning of motion-sensitive interneurons in the context of the closed-loop systems in which they function. © 2017 The Author(s).

  5. Shape memory effect of thermoplastic segmented polyurethanes with self-complementary quadruple hydrogen bonding in soft segments

    NASA Astrophysics Data System (ADS)

    Zhu, Yong; Hu, Jinlian; Liu, Yijun

    2009-01-01

    This paper describes the fact that a kind of thermoplastic shape memory polyurethane with self-complementary quadruple hydrogen bonding units in soft segments can present a significant shape memory effect under the usually used thermodynamic programming condition. Compared with the control sample, it was observed that the introduction of self-complementary quadruple hydrogen bonding into soft segments increases the glass transition temperature from 28.3 ° C to 73.3 ° C. Therefore, the temporary deformation can be fixed well after cooling at room temperature; subsequently thermal responsive shape memory recovery can be triggered by heating up to 86 ° C. The immediate shape recovery ratio and shape fixity ratio can be 95.8% and 95.9%. Even after 24 hours relaxation for the stretched films, the corresponding Rr and Rf can be 94% and 60%. In contrast, the sample without quadruple hydrogen bonding shows that the elasticity and the deformation cannot be fixed after 24 hours relaxation. Supplementary material in the form of a doc file available from the journal web page at 10.1140/epje/i2008-10395-2 and are accessible for authorised users.

  6. Sign language perception research for improving automatic sign language recognition

    NASA Astrophysics Data System (ADS)

    ten Holt, Gineke A.; Arendsen, Jeroen; de Ridder, Huib; Koenderink-van Doorn, Andrea J.; Reinders, Marcel J. T.; Hendriks, Emile A.

    2009-02-01

    Current automatic sign language recognition (ASLR) seldom uses perceptual knowledge about the recognition of sign language. Using such knowledge can improve ASLR because it can give an indication which elements or phases of a sign are important for its meaning. Also, the current generation of data-driven ASLR methods has shortcomings which may not be solvable without the use of knowledge on human sign language processing. Handling variation in the precise execution of signs is an example of such shortcomings: data-driven methods (which include almost all current methods) have difficulty recognizing signs that deviate too much from the examples that were used to train the method. Insight into human sign processing is needed to solve these problems. Perceptual research on sign language can provide such insights. This paper discusses knowledge derived from a set of sign perception experiments, and the application of such knowledge in ASLR. Among the findings are the facts that not all phases and elements of a sign are equally informative, that defining the 'correct' form for a sign is not trivial, and that statistical ASLR methods do not necessarily arrive at sign representations that resemble those of human beings. Apparently, current ASLR methods are quite different from human observers: their method of learning gives them different sign definitions, they regard each moment and element of a sign as equally important and they employ a single definition of 'correct' for all circumstances. If the object is for an ASLR method to handle natural sign language, then the insights from sign perception research must be integrated into ASLR.

  7. Sign Lowering and Phonetic Reduction in American Sign Language

    PubMed Central

    Tyrone, Martha E.; Mauk, Claude E.

    2010-01-01

    This study examines sign lowering as a form of phonetic reduction in American Sign Language. Phonetic reduction occurs in the course of normal language production, when instead of producing a carefully articulated form of a word, the language user produces a less clearly articulated form. When signs are produced in context by native signers, they often differ from the citation forms of signs. In some cases, phonetic reduction is manifested as a sign being produced at a lower location than in the citation form. Sign lowering has been documented previously, but this is the first study to examine it in phonetic detail. The data presented here are tokens of the sign WONDER, as produced by six native signers, in two phonetic contexts and at three signing rates, which were captured by optoelectronic motion capture. The results indicate that sign lowering occurred for all signers, according to the factors we manipulated. Sign production was affected by several phonetic factors that also influence speech production, namely, production rate, phonetic context, and position within an utterance. In addition, we have discovered interesting variations in sign production, which could underlie distinctions in signing style, analogous to accent or voice quality in speech. PMID:20607146

  8. Sign Language Comprehension: The Case of Spanish Sign Language

    ERIC Educational Resources Information Center

    Rodriguez Ortiz, I. R.

    2008-01-01

    This study aims to answer the question, how much of Spanish Sign Language interpreting deaf individuals really understand. Study sampling included 36 deaf people (deafness ranging from severe to profound; variety depending on the age at which they learned sign language) and 36 hearing people who had good knowledge of sign language (most were…

  9. Sign Language Comprehension: The Case of Spanish Sign Language

    ERIC Educational Resources Information Center

    Rodriguez Ortiz, I. R.

    2008-01-01

    This study aims to answer the question, how much of Spanish Sign Language interpreting deaf individuals really understand. Study sampling included 36 deaf people (deafness ranging from severe to profound; variety depending on the age at which they learned sign language) and 36 hearing people who had good knowledge of sign language (most were…

  10. Expedition 39 Door Signing

    NASA Image and Video Library

    2014-03-25

    Expedition 39 Soyuz Commander Alexander Skvortsov of the Russian Federal Space Agency, Roscosmos, performs the traditional door signing at the Cosmonaut hotel prior to departing the hotel for launch in a Soyuz rocket with fellow crew mates, Flight Engineer Steve Swanson of NASA and Flight Engineer Oleg Artemyev of Roscosmos, Tuesday, March 25, 2014, in Baikonur, Kazakhstan. Skvortsov, Swanson, and Artemyev will launch in their Soyuz TMA-12M spacecraft to the International Space Station to begin a six-month mission. Photo Credit (NASA/Joel Kowsky)

  11. Expedition 42 Door Signing

    NASA Image and Video Library

    2014-11-23

    Expedition 42 Soyuz Commander Anton Shkaplerov of the Russian Federal Space Agency (Roscosmos) performs the traditional door signing at the Cosmonaut Hotel prior to departing the hotel for launch in a Soyuz rocket with fellow crewmates, Flight Engineers Samantha Cristoforetti of the European Space Agency (ESA) and Terry Virts of NASA, Sunday, Nov. 23, 2014 in Baikonur, Kazakhstan. Launch of the Soyuz rocket is scheduled for the early hours of Nov. 24 Kazakhstan time and will carry Shkaplerov, Cristoforetti, and Virts into orbit to begin their five and a half month mission on the International Space Station. Photo Credit (NASA/Aubrey Gemignani)

  12. Expedition 42 Door Signing

    NASA Image and Video Library

    2014-11-23

    Expedition 42 Flight Engineer Terry Virts of NASA performs the traditional door signing at the Cosmonaut Hotel prior to departing the hotel for launch in a Soyuz rocket with fellow crewmates, Soyuz Commander Anton Shkaplerov of the Russian Federal Space Agency (Roscosmos) and Flight Engineer Samantha Cristoforetti of the European Space Agency (ESA), Sunday, Nov. 23, 2014 in Baikonur, Kazakhstan. Launch of the Soyuz rocket is scheduled for the early hours of Nov. 24 Kazakhstan time and will carry Virts, Shkaplerov, and Cristoforetti into orbit to begin their five and a half month mission on the International Space Station. Photo Credit: (NASA/Aubrey Gemignani)

  13. Expedition 39 Door Signing

    NASA Image and Video Library

    2014-03-25

    Expedition 39 Flight Engineer Oleg Artemyev of the Russian Federal Space Agency, Roscosmos, performs the traditional door signing at the Cosmonaut hotel prior to departing the hotel for launch in a Soyuz rocket with fellow crew mates, Soyuz Commander Alexander Skvortsov of Roscosmos, and Flight Engineer Steve Swanson of NASA, Tuesday, March 25, 2014, in Baikonur, Kazakhstan. Artemyev, Skvortsov, and Swanson will launch in their Soyuz TMA-12M spacecraft to the International Space Station to begin a six-month mission. Photo Credit (NASA/Joel Kowsky)

  14. Expedition 39 Door Signing

    NASA Image and Video Library

    2014-03-25

    Expedition 39 Flight Engineer Steve Swanson of NASA, performs the traditional door signing at the Cosmonaut hotel prior to departing the hotel for launch in a Soyuz rocket with fellow crew mates, Soyuz Commander Alexander Skvortsov of the Russian Federal Space Agency, Roscosmos, and Flight Engineer Oleg Artemyev of Roscosmos, Tuesday, March 25, 2014, in Baikonur, Kazakhstan. Swanson, Skvortsov and, and Artemyev will launch in their Soyuz TMA-12M spacecraft to the International Space Station to begin a six-month mission. Photo Credit (NASA/Joel Kowsky)

  15. Expedition 42 Door Signing

    NASA Image and Video Library

    2014-11-23

    Expedition 42 Flight Engineer Samantha Cristoforetti of the European Space Agency (ESA), performs the traditional door signing at the Cosmonaut Hotel prior to departing the hotel for launch in a Soyuz rocket with fellow crewmates, Soyuz Commander Anton Shkaplerov of the Russian Federal Space Agency (Roscosmos) and Flight Engineer Terry Virts of NASA, Sunday, Nov. 23, 2014 in Baikonur, Kazakhstan. Launch of the Soyuz rocket is scheduled for the early hours of Nov. 24 Kazakhstan time and will carry Cristoforetti, Virts, and Shkaplerov into orbit to begin their five and a half month mission on the International Space Station. Photo Credit (NASA/Aubrey Gemignani)

  16. Seeing the signs.

    PubMed

    Blewitt, Jane

    2016-04-01

    Invasive meningococcal disease, causing meningitis and/or septicaemia, can kill within hours and leave a significant number of survivors with lifelong disability. Even though there are now three meningococcal vaccines in the U.K. routine immunisation schedule, not all cases will be prevented. There are also other bacterial, viral and fungal causes of meningitis that are not prevented by vaccines, it is too early to assess the impact of recent changes to the schedule and it is vital that everyone is aware of the signs and symptoms, and remains vigilant.

  17. Sign of coma.

    PubMed

    Skjaerlund, J M

    1988-06-15

    The oblique focusing defect of spherical lenses, known as coma, is described by Seidel as the second of five correction terms (third order) to the Gauss theory. The concept is clear for a refracting surface that is free of spherical aberration; however, the impossibility of eliminating spherical aberration from a single lens with spherical surfaces can confuse the understanding of the second aberration, coma. A way of understanding the comatic effect even in the presence of spherical aberration is described. Confusion over the sign of coma, as indicated by mistakes in optics textbooks, is addressed. This paper suggests corrections to some interpretations of coma found in the literature.

  18. Single-Stage Reconstruction of Both Cruciate Ligaments

    PubMed Central

    Andreoli, Mauro; Zicaro, Juan Pablo; Yacuzzi, Carlos; Costa-Paz, Matias

    2017-01-01

    Objectives: Isolated Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL), or central pivot lesions are rare. These are frequently associated with collateral ligaments injuries. The purpose of this retrospective study was to evaluate clinical and functional outcomes of 4 patients with acute ACL and PCL injury who underwent a simultaneous single-stage arthroscopic reconstruction. Methods: The inclusion criteria were patients with isolated ACL and PCL injuries, with a minimum follow-up of 2 years. We evaluated the type of graft used, the surgical technique and postoperative complications. The scales used for clinical evaluation were the Knee Society Score (KSS), IKDC, Lysholm and Tegner. Knee stability was assessed using the KT-1000 arthrometer. Results: Three men and one woman, with an average age of 48 years (45 to 56 years) were evaluated. Three presented a sport injury and one a car accident. Mean follow-up was 8 years. In all patients allograft was used for ligament reconstruction. Average postoperative results were: KSS 74-82, Lysholm 76, IKDC 63 and Tegner 6. KT-1000 arthrometer showed an average difference of 4mm compared to the contralateral knee. One patient underwent reintervention due to meniscal injury. Conclusion: ACL and PCL simultaneous single-stage reconstruction is a really demanding surgery. We achieved good results using allograft for both ligaments reconstruction. No clinical or functional postoperative complications were recorded.

  19. REHABILITATION PROTOCOL AFTER ISOLATED POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

    PubMed Central

    de Paula Leite Cury, Ricardo; Kiyomoto, Henry Dan; Rosal, Gustavo Fogolin; Bryk, Flávio Fernandes; de Oliveira, Victor Marques; de Camargo, Osmar Pedro Arbix

    2015-01-01

    To create a rehabilitation protocol following reconstruction of the posterior cruciate ligament (PCL), through a literature review. The literature review was conducted in the Medline and Embase databases, to search for data on biomechanical concepts and analyses relating to the posterior cruciate ligament of the knee. The search strategy was set up using the following rules: problem or injury in association with anatomical location terms; or surgical intervention procedure in association with rehabilitation terms. We began the process in this manner and subsequently introduced restrictions on certain terms to improve the search specificity. To design the protocol, a table was created for better data assessment, based on the time that elapsed between surgery and the start of physiotherapy. A rehabilitation protocol was created to improve weight-bearing control in the initial weeks after surgery, with the aid of a knee brace. Our aim was to achieve gains in total range of motion of the knee, which should be attained by the third month, thereby avoiding contractures resulting from the tissue healing process. Strengthening exercises and sensory-motor training were guided accordingly, thus avoiding overload on the graft and respecting the healing phases. The protocol proposed through this review was based on the current evidence relating to this subject. PMID:27047844

  20. Healing Potential of the Anterior Cruciate Ligament Remnant Stump.

    PubMed

    Trocan, Ilie; Ceausu, Raluca A; Jitariu, Andreea A; Haragus, Horia; Damian, Gratian; Raica, Marius

    2016-01-01

    The aim of this study was to analyze the microstructural architecture and cellular differentiation of the anterior cruciate ligament (ACL) stumps in different stages after injury, as this could augment graft biointegration. The histological appearance and immunoreaction for cluster of differentiation 34 antigen (CD34) of 54 biopsies from 27 remnants were compared to 10 biopsies from 5 normal cruciate ligaments. CD34 reaction in endothelial cells, fibroblasts and fibrocytes was consistently positive in small synovial vessels. Remnants also exhibited CD34(+) cells among collagen fibers. Blood vessel density varied between specimens. The mean vascular microdensity was 43 per ×200 field in remnants compared to 15.2 in controls. A total of 94.44% of remnant ACL samples had significant hyperplasia of stellate and fusiform stromal cells, CD34(+); 22.4% had developed capillary vessels inside the ligament; 33% exhibited ongoing angiogenesis. Significant differences exist between torn and intact ACL regarding microvascularization. The remnants contain stellate stromal cells and CD34(+) fibrocytes, and display angiogenesis both at synovia as well as in the ligament itself. These findings underline the potential contribution to neoligament healing when remnants are preserved. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  1. Variations in cell morphology in the canine cruciate ligament complex.

    PubMed

    Smith, K D; Vaughan-Thomas, A; Spiller, D G; Clegg, P D; Innes, J F; Comerford, E J

    2012-08-01

    Cell morphology may reflect the mechanical environment of tissues and influence tissue physiology and response to injury. Normal cruciate ligaments (CLs) from disease-free stifle joints were harvested from dog breeds with a high (Labrador retriever) and low (Greyhound) risk of cranial cruciate ligament (CCL) rupture. Antibodies against the cytoskeletal components vimentin and alpha tubulin were used to analyse cell morphology; nuclei were stained with 4',6-diamidino-2-phenylindole, and images were collected using conventional and confocal microscopy. Both cranial and caudal CLs contained cells of heterogenous morphologies. Cells were arranged between collagen bundles and frequently had cytoplasmic processes. Some of these processes were long (type A cells), others were shorter, thicker and more branched (type B cells), and some had no processes (type C cells). Processes were frequently shown to contact other cells, extending longitudinally and transversely through the CLs. Cells with longer processes had fusiform nuclei, and those with no processes had rounded nuclei and were more frequent in the mid-substance of both CLs. Cells with long processes were more commonly noted in the CLs of the Greyhound. As contact between cells may facilitate direct communication, variances in cell morphology between breeds at a differing risk of CCL rupture may reflect differences in CL physiology.

  2. Signs of a Heart Attack

    MedlinePlus

    ... attack Heart Health and Stroke Signs of a heart attack Related information Make the Call. Don't Miss ... to top More information on Signs of a heart attack Read more from womenshealth.gov Make the Call, ...

  3. Warning Signs of Lung Disease

    MedlinePlus

    ... Warning Signs of Lung Disease Warning Signs of Lung Disease A nagging cough or slight wheeze may ... prepare for you next office visit. Questions about Lung Health? Call our Lung HelpLine. Get free counseling ...

  4. INFINITY construction contract signed

    NASA Image and Video Library

    2010-04-06

    Key state and community leaders celebrated April 6 with the signing of a construction contract for the state-of-the-art INFINITY Science Center planned near John C. Stennis Space Center in south Mississippi. Gulfport Mayor George Schloegel (l to r), chair of non-profit INFINITY Science Center Inc., was joined for the signing ceremony at the Hancock Bank in Gulfport by Virginia Wagner, sister of late Hancock Bank President Leo Seal Jr.; and Roy Anderson III, president and CEO of Roy Anderson Corp. Seal was the first chair of INFINITY Science Center Inc., which has led in development of the project. Roy Anderson Corp. plans to begin construction on the 72,000-square-foot, $28 million science and education center in May. The Mississippi Department of Transportation (MDOT) also is set to begin construction of a $2 million access road to the new center. The April 6 ceremony was attended by numerous officials, including former Stennis Space Center Directors Jerry Hlass and Roy Estess; Mississippi Senate President Pro Tempore Billy Hewes, R-Gulfport; Mississippi Rep. Diane Peranich, D-Pass Christian; and MDOT Southern District Commissioner Wayne Brown.

  5. INFINITY construction contract signed

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Key state and community leaders celebrated April 6 with the signing of a construction contract for the state-of-the-art INFINITY Science Center planned near John C. Stennis Space Center in south Mississippi. Gulfport Mayor George Schloegel (l to r), chair of non-profit INFINITY Science Center Inc., was joined for the signing ceremony at the Hancock Bank in Gulfport by Virginia Wagner, sister of late Hancock Bank President Leo Seal Jr.; and Roy Anderson III, president and CEO of Roy Anderson Corp. Seal was the first chair of INFINITY Science Center Inc., which has led in development of the project. Roy Anderson Corp. plans to begin construction on the 72,000-square-foot, $28 million science and education center in May. The Mississippi Department of Transportation (MDOT) also is set to begin construction of a $2 million access road to the new center. The April 6 ceremony was attended by numerous officials, including former Stennis Space Center Directors Jerry Hlass and Roy Estess; Mississippi Senate President Pro Tempore Billy Hewes, R-Gulfport; Mississippi Rep. Diane Peranich, D-Pass Christian; and MDOT Southern District Commissioner Wayne Brown.

  6. INFINITY construction contract signed

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Key state and community leaders celebrated April 6 with the signing of a construction contract for the state-of-the-art INFINITY Science Center planned near John C. Stennis Space Center in south Mississippi. Gulfport Mayor George Schloegel (l to r), chair of non-profit INFINITY Science Center Inc., was joined for the signing ceremony at the Hancock Bank in Gulfport by Virginia Wagner, sister of late Hancock Bank President Leo Seal Jr.; and Roy Anderson III, president and CEO of Roy Anderson Corp. Seal was the first chair of INFINITY Science Center Inc., which has led in development of the project. Roy Anderson Corp. plans to begin construction on the 72,000-square-foot, $28 million science and education center in May. The Mississippi Department of Transportation (MDOT) also is set to begin construction of a $2 million access road to the new center. The April 6 ceremony was attended by numerous officials, including former Stennis Space Center Directors Jerry Hlass and Roy Estess; Mississippi Senate President Pro Tempore Billy Hewes, R-Gulfport; Mississippi Rep. Diane Peranich, D-Pass Christian; and MDOT Southern District Commissioner Wayne Brown.

  7. Prospective correlation between serum relaxin concentration and anterior cruciate ligament tears among elite collegiate female athletes.

    PubMed

    Dragoo, Jason L; Castillo, Tiffany N; Braun, Hillary J; Ridley, Bethany A; Kennedy, Ashleigh C; Golish, S Raymond

    2011-10-01

    The female anterior cruciate ligament may be more susceptible to injury than the male anterior cruciate ligament because of the gender-specific expression of receptors for relaxin, a collagenolytic hormone that promotes remodeling of the anterior cruciate ligament. This study was undertaken to investigate whether collegiate female athletes with elevated serum relaxin concentrations (SRC) sustain anterior cruciate ligament tears at an increased rate compared with those with lower SRC. Cohort study (prognosis); Level of evidence, 2. From 2005 to 2010, 143 Division I female athletes from 2 universities participating in sports at high risk for anterior cruciate ligament tears (basketball, lacrosse, field hockey, soccer, gymnastics, and volleyball) were recruited to participate. Questionnaires and urine luteinizing hormone (LH) tests were used to determine participants' anterior cruciate ligament injury and menstrual history and to identify their mid-luteal phase or projected cycle days 21 to 24. Serum samples were obtained for progesterone and relaxin ELISA (enzyme-linked immunosorbent assay) analysis. Participants were monitored for anterior cruciate ligament injury over their 4-year National Collegiate Athletic Association athletic career. A total of 128 participants completed the study and were eligible for data analysis. The cumulative incidence of complete anterior cruciate ligament tear over the 4-year study period was 21.9%, and varied significantly by sport (P < .001). The mean SRC for athletes with anterior cruciate ligament tears (6.0 ± 8.1 pg/mL) was significantly higher than that for those without anterior cruciate ligament tears (1.8 ± 3.4 pg/mL; P = .013). In subgroup analysis of the 46 athletes who had detectable SRC, the cumulative incidence of anterior cruciate ligament tear was 14 of 46 (30.4%); the mean SRC among athletes with anterior cruciate ligament tears (14 of 46) was 12.1 ± 7.7 pg/mL and without anterior cruciate ligament tears (32 of 46

  8. Surgical Treatment of a Rare Isolated Bilateral Agenesis of Anterior and Posterior Cruciate Ligaments

    PubMed Central

    2014-01-01

    The isolated bilateral agenesis of both cruciate ligaments is a rare congenital disorder. A 17-year-old male came to our attention due to an alteration in gait pattern, pain, and tendency to walk on the forefoot with his knee flexed. The patient did not recall previous injuries. Upon physical examination anterior and posterior chronic instability were observed. Radiographic examination of both knees showed hypoplasia of the tibial eminence, a hypoplastic lateral femoral condyle, and a narrow intercondylar notch. MRI brought to light a bilateral agenesis of both posterior cruciate ligaments. Arthroscopic evaluation confirmed bilateral isolated agenesis of both cruciate ligaments. We recommended a rehabilitation program to prepare the patient for the arthroscopic construction of both cruciate ligaments. PMID:25197599

  9. LEG'S COMPARTMENT SYNDROME AFTER RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT: CASE REPORT.

    PubMed

    Filho, Jorge Sayum; Ramos, Leonardo Adeo; Sayum, Jorge; de Carvalho, Rogério Teixeira; Ejnisman, Benno; Matsuda, Marcelo Mitsuro; Nicolini, Alexandre; Cohen, Moisés

    2011-01-01

    The authors report a case of a patient that was submitted to a surgery of reconstruction of anterior cruciate ligament and collateral medial ligament repair of the left knee that complicated to a compartment syndrome.

  10. [Cruciate hemiplegia associated with basilar impression, Arnold-Chiari malformation and syringomyelia. Case report].

    PubMed

    da Silva, J A; da Costa, M D; Leal, A B; dos Reis, F R; de Queiroz, R B

    1996-12-01

    The authors report a case of cruciate hemiplegia associated with basilar impression, Chiari malformation and syringomyelia. The neuroanatomical controversy, the surgical treatment and the good outcome of the patient are discussed.

  11. LEG'S COMPARTMENT SYNDROME AFTER RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT: CASE REPORT

    PubMed Central

    Filho, Jorge Sayum; Ramos, Leonardo Adeo; Sayum, Jorge; de Carvalho, Rogério Teixeira; Ejnisman, Benno; Matsuda, Marcelo Mitsuro; Nicolini, Alexandre; Cohen, Moisés

    2015-01-01

    The authors report a case of a patient that was submitted to a surgery of reconstruction of anterior cruciate ligament and collateral medial ligament repair of the left knee that complicated to a compartment syndrome. PMID:27047834

  12. Dictionary of Braille Music Signs.

    ERIC Educational Resources Information Center

    Krolick, Bettye

    This dictionary gathers into a single resource definitions of braille music signs used since 1888 and provides explanations of the wide variety of formats in which these signs have been used at different times by publishers around the world. More than 400 music signs and approximately 100 literary abbreviations are included, but musical terms are…

  13. Quine and the Segregrational Sign.

    ERIC Educational Resources Information Center

    Wolf, George

    1999-01-01

    In the context of theory of integrational linguistics, the segregational sign is distinguished from the integrational sign, and the operation of the former is analyzed. Focus is on how logic guides the sign, and how the theory of W. V. Quine accounts for these issues. (MSE)

  14. 3 CFR - Presidential Signing Statements

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... issued statements addressing constitutional or other legal questions upon signing bills into law (signing statements). Particularly since omnibus bills have become prevalent, signing statements have often been used... veto of the entire bill. In recent years, there has been considerable public discussion and criticism...

  15. Kinship in Mongolian Sign Language

    ERIC Educational Resources Information Center

    Geer, Leah

    2011-01-01

    Information and research on Mongolian Sign Language is scant. To date, only one dictionary is available in the United States (Badnaa and Boll 1995), and even that dictionary presents only a subset of the signs employed in Mongolia. The present study describes the kinship system used in Mongolian Sign Language (MSL) based on data elicited from…

  16. Kinship in Mongolian Sign Language

    ERIC Educational Resources Information Center

    Geer, Leah

    2011-01-01

    Information and research on Mongolian Sign Language is scant. To date, only one dictionary is available in the United States (Badnaa and Boll 1995), and even that dictionary presents only a subset of the signs employed in Mongolia. The present study describes the kinship system used in Mongolian Sign Language (MSL) based on data elicited from…

  17. Manual signing in adults with intellectual disability: influence of sign characteristics on functional sign vocabulary.

    PubMed

    Meuris, Kristien; Maes, Bea; De Meyer, Anne-Marie; Zink, Inge

    2014-06-01

    The purpose of this study was to investigate the influence of sign characteristics in a key word signing (KWS) system on the functional use of those signs by adults with intellectual disability (ID). All 507 signs from a Flemish KWS system were characterized in terms of phonological, iconic, and referential characteristics. Phonological and referential characteristics were assigned to the signs by speech-language pathologists. The iconicity (i.e., transparency, guessing the meaning of the sign; and translucency, rating on a 6-point scale) of the signs were tested in 467 students. Sign functionality was studied in 119 adults with ID (mean mental age of 50.54 months) by means of a questionnaire, filled out by a support worker. A generalized linear model with a negative binomial distribution (with log-link) showed that semantic category was the factor with the strongest influence on sign functionality, with grammatical class, referential concreteness, and translucency also playing a part. No sign phonological characteristics were found to be of significant influence on sign use. The meaning of a sign is the most important factor regarding its functionality (i.e., whether a sign is used in everyday communication). Phonological characteristics seem only of minor importance.

  18. Initial evaluation of posterior cruciate ligament injuries: history, physical examination, imaging studies, surgical and nonsurgical indications.

    PubMed

    Lopez-Vidriero, Emilio; Simon, David A; Johnson, Donald H

    2010-12-01

    Compared with anterior cruciate ligament injuries, posterior cruciate ligament injuries are a rare event. The mechanisms are predictable and a thorough physical examination is mandatory to rule out or define combined injury patterns. Stress radiography and magnetic resonance imaging studies are very helpful adjuncts. Acute and chronic injuries require slightly different approaches. As our understanding of normal and pathologic knee joint kinematics develops, nonoperative rehabilitation goals and operative techniques continue to evolve.

  19. Anterior cruciate ligament injury in the athlete--an update in prevention strategies.

    PubMed

    Peterson, Judith R; Peterson, Erik D

    2012-11-01

    Anterior cruciate ligament (ACL) injuries are a common athletic injury. Athletes with this injury experience significant acute morbidity. These athletes are predisposed to the development of knee osteoarthritis with decreased knee quality of life. The public health implications of these injuries are profound. This article reviews the epidemiology of and risk factors for anterior cruciate ligament injuries in sports. The economic impact of these injuries is discussed. Effective strategies to prevent these significant knee injuries are presented.

  20. [Temporary postoperative protection of the anterior cruciate ligament with transarticular wire rope].

    PubMed

    Weigand, H; Storm, H; Birne, F U

    1990-04-01

    This article describes an operational method for the temporary protection of the anterior cruciate ligament after acute or late ligament reconstruction. In line with the course of the anterior cruciate ligament a wire rope is transarticularly implanted and fixed with a screw each at the femur (proximally) and at the tibia bone (distally). This easily performed method permits both the healing of the ligament lesion while preserving the original ligament length and the execution of an early functional exercise therapy.

  1. [Simultaneous rupture of the anterior cruciate ligament and the patellar tendon: a case report].

    PubMed

    Achkoun, Abdessalam; Houjairi, Khalid; Quahtan, Omar; Hassoun, Jalal; Arssi, Mohamed; Rahmi, Mohamed; Garch, Abdelhak

    2016-01-01

    Simultaneous rupture of both the patellar tendon and the anterior cruciate ligament is a relatively rare injury. Its diagnosis can easily be missed during the initial examination. Treatment options include immediate repair of the patellar tendon with either simultaneous or delayed reconstruction of the ACL. We present the case of a combined rupture of the patellar tendon, the anterior cruciate ligament in a 22-year old footballer. A two-stage treatment approach was performed with an excellent functional outcome.

  2. A study of isokinetic strength and laxity with and without anterior cruciate ligament injury

    PubMed Central

    Kim, Kewwan; Jeon, Kyoungkyu; Mullineaux, David R.; Cho, Eunok

    2016-01-01

    [Purpose] The purpose of this study was to provide useful information for future treatments and to organize rehabilitation programs for anterior cruciate ligament injury by assessing isokinetic muscle strength and laxity of knee joints in athletes with anterior cruciate ligament injuries. [Subjects and Methods] Thirty-one high school athletes with anterior cruciate ligament injuries participated in this study. Isokinetic muscle strength at 60°/sec and anterior cruciate ligament laxity for non-involved and involved sides, classified on the basis of the severity of anterior cruciate ligament injury, were assessed. [Results] A comparison of isokinetic muscle strength measured from the non-involved and involved sides showed a significant difference in the maximum strength and knee flexor muscle strength. For laxity, a significant difference was observed in the anterior drawer test results obtained with a force of 88 N. [Conclusion] In conclusion, this study has shown that the assessment of isokinetic muscle strength and ligament laxity from athletes with anterior cruciate ligament injury should be utilized to provide baseline data for prevention and prediction of injury. PMID:28174432

  3. A study of isokinetic strength and laxity with and without anterior cruciate ligament injury.

    PubMed

    Kim, Kewwan; Jeon, Kyoungkyu; Mullineaux, David R; Cho, Eunok

    2016-12-01

    [Purpose] The purpose of this study was to provide useful information for future treatments and to organize rehabilitation programs for anterior cruciate ligament injury by assessing isokinetic muscle strength and laxity of knee joints in athletes with anterior cruciate ligament injuries. [Subjects and Methods] Thirty-one high school athletes with anterior cruciate ligament injuries participated in this study. Isokinetic muscle strength at 60°/sec and anterior cruciate ligament laxity for non-involved and involved sides, classified on the basis of the severity of anterior cruciate ligament injury, were assessed. [Results] A comparison of isokinetic muscle strength measured from the non-involved and involved sides showed a significant difference in the maximum strength and knee flexor muscle strength. For laxity, a significant difference was observed in the anterior drawer test results obtained with a force of 88 N. [Conclusion] In conclusion, this study has shown that the assessment of isokinetic muscle strength and ligament laxity from athletes with anterior cruciate ligament injury should be utilized to provide baseline data for prevention and prediction of injury.

  4. Isokinetic torque peak and hamstrings/quadriceps ratios in endurance athletes with anterior cruciate ligament laxity.

    PubMed

    Portes, Eliane Magaieski; Portes, Leslie Andrews; Botelho, Viviane Gomes; Souza Pinto, Sérgio de

    2007-04-01

    To evaluate torque and the hamstring/quadriceps ratio of the knee of athletes with and without anterior cruciate ligament laxity. Twenty-eight male athletes, 19 without anterior cruciate ligament laxity and 9 with anterior cruciate ligament laxity, were evaluated with an isokinetic machine model Cybex 770. The peak torque of quadriceps and hamstrings was compared, and the hamstring/quadriceps ratio on the constant angular speed of 60 masculine per second were also compared. In athletes with anterior cruciate ligament laxity, the peak torque values (right and left knees) of flexors (120 +/- 15 and 116 +/- 15 Nm) and of extensors (218 +/- 36 Nm and 207 +/- 26 Nm) were not different than those of athletes without laxity (109 +/- 21 Nm and 111 +/- 22 Nm; 191 +/- 5 Nm and 188 +/- 35 Nm). The hamstring/quadriceps ratio of athletes with laxity (right: 57 +/- 6% and left: 56 +/- 8%) did not differ from those without anterior cruciate ligament laxity (right: 58 +/- 9% and left: 58 +/- 7%). The anterior cruciate ligament laxity of long distances running athletes did not significantly alter the peak torque of flexors and of extensors or the hamstring/quadriceps ratio.

  5. The relationship between posterior tibial slope and anterior cruciate ligament injury.

    PubMed

    Ristić, Vladimir; Maljanović, Mirsad C; Pericin, Branislav; Harhaji, Vladimir; Milankov, Miroslav

    2014-01-01

    The aim of this study was to identify an increased posterior tibial slope as a possible risk factor for anterior cruciate ligament injury. Sixty patients were divided into two groups (with and without anterior cruciate ligament rupture). The posterior tibial slope on the lateral and medial condyles was measured by sagittal magnetic resonance imaging slices by means of computerized method using circles to determine tibial axis. The patients with anterior cruciate ligament rupture had a statistically significantly (p = 0.06) greater posterior tibial slope on the lateral tibial condyle than the control group (6.68 degrees:5.64 degrees), and a greater slope on the medial condyle (5.49 degrees:4.67 degrees) in comparison to the patients with the intact anterior cruciate ligament. No significant difference in the average values of angles was observed between males and females with anterior cruciate ligament rupture, the average value being 6.23 degrees in men and 5.84 degrees in women on the lateral condyle, and 4.53 degrees in men and 4.53 degrees in women on the medial condyle. A statistically significant difference between the values of posterior tibial slope was observed between the groups with and without anterior cruciate ligament rupture, the sex having no affect on the value of the posterior tibial slope. The method of measuring angles should be unique.

  6. Planet Hunters: A Transiting Circumbinary Planet in a Quadruple Star System

    NASA Astrophysics Data System (ADS)

    Schwamb, Megan E.; Orosz, Jerome A.; Carter, Joshua A.; Welsh, William F.; Fischer, Debra A.; Torres, Guillermo; Howard, Andrew W.; Crepp, Justin R.; Keel, William C.; Lintott, Chris J.; Kaib, Nathan A.; Terrell, Dirk; Gagliano, Robert; Jek, Kian J.; Parrish, Michael; Smith, Arfon M.; Lynn, Stuart; Simpson, Robert J.; Giguere, Matthew J.; Schawinski, Kevin

    2013-05-01

    We report the discovery and confirmation of a transiting circumbinary planet (PH1b) around KIC 4862625, an eclipsing binary in the Kepler field. The planet was discovered by volunteers searching the first six Quarters of publicly available Kepler data as part of the Planet Hunters citizen science project. Transits of the planet across the larger and brighter of the eclipsing stars are detectable by visual inspection every ~137 days, with seven transits identified in Quarters 1-11. The physical and orbital parameters of both the host stars and planet were obtained via a photometric-dynamical model, simultaneously fitting both the measured radial velocities and the Kepler light curve of KIC 4862625. The 6.18 ± 0.17 R ⊕ planet orbits outside the 20 day orbit of an eclipsing binary consisting of an F dwarf (1.734 ± 0.044 R ⊙, 1.528 ± 0.087 M ⊙) and M dwarf (0.378 ± 0.023 R ⊙, 0.408 ± 0.024 M ⊙). For the planet, we find an upper mass limit of 169 M ⊕ (0.531 Jupiter masses) at the 99.7% confidence level. With a radius and mass less than that of Jupiter, PH1b is well within the planetary regime. Outside the planet's orbit, at ~1000 AU, a previously unknown visual binary has been identified that is likely bound to the planetary system, making this the first known case of a quadruple star system with a transiting planet.

  7. THE PROPOSED QUADRUPLE SYSTEM SZ HERCULIS: REVISED LITE MODEL AND ORBITAL STABILITY STUDY

    SciTech Connect

    Hinse, Tobias Cornelius; Lee, Jae Woo; Lee, Chung-Uk; Gozdziewski, Krzysztof; Haghighipour, Nader

    2012-08-15

    In a recent study, Lee et al. presented new photometric follow-up timing observations of the semidetached binary system SZ Herculis and proposed the existence of two hierarchical cirumbinary companions. Based on the light-travel time effect, the two low-mass M-dwarf companions are found to orbit the binary pair on moderate to high eccentric orbits. The derived periods of these two companions are close to a 2:1 mean-motion orbital resonance. We have studied the stability of the system using the osculating orbital elements as presented by Lee et al. Results indicate an orbit-crossing architecture exhibiting short-term dynamical instabilities leading to the escape of one of the proposed companions. We have examined the system's underlying model parameter space by following a Monte Carlo approach and found an improved fit to the timing data. A study of the stability of our best-fitting orbits also indicates that the proposed system is generally unstable. If the observed anomalous timing variations of the binary period is due to additional circumbinary companions, then the resulting system should exhibit a long-term stable orbital configuration much different from the orbits suggested by Lee et al. We, therefore, suggest that based on Newtonian-dynamical considerations, the proposed quadruple system cannot exist. To uncover the true nature of the observed period variations of this system, we recommend future photometric follow-up observations that could further constrain eclipse-timing variations and/or refine light-travel time models.

  8. Properties of the Close-in Tertiary in the Quadruple System V401 Cyg

    NASA Astrophysics Data System (ADS)

    Zhu, L.-Y.; Qian, S.-B.; Zhou, X.; Li, L.-J.; Zhao, E.-G.; Liu, L.; Liu, N.-P.

    2013-08-01

    V401 Cyg is a quadruple system in which the spectroscopic signature of a close-in tertiary and a distant visual companion star were reported. Orbital properties of the close-in companion should provide valuable information on the formation of close binaries and stellar dynamical interaction. By analyzing new times of minimum light together with those collected from the literature, we discovered that the observed-calculated (O - C) curve of V401 Cyg shows a cyclic change with a short period of 3.5 yr and a semi-amplitude of 0.00436 days while it undergoes an upward parabolic variation. Those photoelectric and CCD data covered more than two cycles and were analyzed for the light-travel time effect via the presence of the tertiary companion. The mass of the third body was determined to be M 3sin i' = 0.65(± 0.08) M ⊙, which is close to the value estimated from the spectroscopic data (M 3 ~ 0.64 M ⊙). This reveals that the orbital inclination of the tertiary was about i' ~ 90°, indicating that the contact components of V401 Cyg have the possibility of being eclipsed by the tertiary at an orbital distance of about 3.0 AU, and it may be a triply eclipsing hierarchical triple system. The upward parabolic change indicates a period increase at a rate of \\dot{P}=1.5\\times {10^{-7}} revealing a mass transfer from the secondary to the primary (\\dot{M}_{2}=5.9\\times {10^{-8}} M ⊙ yr-1). This is consistent with the predictions of the theory of thermal relaxation oscillation (TRO) suggesting that V401 Cyg is undergoing an expanding-orbit stage in the TRO cycles.

  9. HH 222: A Giant Herbig-Haro Flow from the Quadruple System V380 Ori

    NASA Astrophysics Data System (ADS)

    Reipurth, Bo; Bally, John; Aspin, Colin; Connelley, M. S.; Geballe, T. R.; Kraus, Stefan; Appenzeller, Immo; Burgasser, Adam

    2013-11-01

    HH 222 is a giant shocked region in the L1641 cloud, and is popularly known as the Orion Streamers or "the waterfall" on account of its unusual structure. At the center of these streamers are two infrared sources coincident with a nonthermal radio jet aligned along the principal streamer. The unique morphology of HH 222 has long been associated with this radio jet. However, new infrared images show that the two sources are distant elliptical galaxies, indicating that the radio jet is merely an improbable line-of-sight coincidence. Accurate proper motion measurements of HH 222 reveal that the shock structure is a giant bow shock moving directly away from the well-known, very young, Herbig Be star V380 Ori. The already known Herbig-Haro object HH 35 forms part of this flow. A new Herbig-Haro object, HH 1041, is found precisely in the opposite direction of HH 222 and is likely to form part of a counterflow. The total projected extent of this HH complex is 5.3 pc, making it among the largest HH flows known. A second outflow episode from V380 Ori is identified as a pair of HH objects, HH 1031 to the northwest and the already known HH 130 to the southeast, along an axis that deviates from that of HH 222/HH 1041 by only 3.°7. V380 Ori is a hierarchical quadruple system, including a faint companion of spectral type M5 or M6, which at an age of ~1 Myr corresponds to an object straddling the stellar-to-brown dwarf boundary. We suggest that the HH 222 giant bow shock is a direct result of the dynamical interactions that led to the conversion from an initial non-hierarchical multiple system into a hierarchical configuration. This event occurred no more than 28,000 yr ago, as derived from the proper motions of the HH 222 giant bow shock.

  10. Levofloxacin/amoxicillin-based schemes vs quadruple therapy for Helicobacter pylori eradication in second-line

    PubMed Central

    Di Caro, Simona; Fini, Lucia; Daoud, Yayha; Grizzi, Fabio; Gasbarrini, Antonio; De Lorenzo, Antonino; Di Renzo, Laura; McCartney, Sara; Bloom, Stuart

    2012-01-01

    Worldwide prevalence of Helicobacter pylori (H. pylori) infection is approximately 50%, with the highest being in developing countries. We compared cure rates and tolerability (SE) of second-line anti-H. pylori levofloxacin/amoxicillin (LA)-based triple regimens vs standard quadruple therapy (QT). An English language literature search was performed up to October 2010. A meta-analysis was performed including randomized clinical trials comparing 7- or 10-d LA with 7-d QT. In total, 10 articles and four abstracts were identified. Overall eradication rate in LA was 76.5% (95% CI: 64.4%-97.6%). When only 7-d regimens were included, cure rate was 70.6% (95% CI: 40.2%-99.1%), whereas for 10-d combinations, cure rate was significantly higher (88.7%; 95% CI: 56.1%-109.9%; P < 0.05). Main eradication rate for QT was 67.4% (95% CI: 49.7%-67.9%). The 7-d LA and QT showed comparable efficacy [odds ratio (OR): 1.09; 95% CI: 0.63-1.87], whereas the 10-d LA regimen was significantly more effective than QT (OR: 5.05; 95% CI: 2.74-9.31; P < 0.001; I2 = 75%). No differences were reported in QT eradication rates among Asian and European studies, whereas LA regimens were more effective in European populations (78.3% vs 67.7%; P = 0.05). Incidence of SE was lower in LA therapy than QT (OR: 0.39; 95% CI: 0.18-0.85; P = 0.02). A higher rate of side effects was reported in Asian patients who received QT. Our findings support the use of 10-d LA as a simple second-line treatment for H. pylori eradication with an excellent eradication rate and tolerability. The optimal second-line alternative scheme might differ among countries depending on quinolone resistance. PMID:23155306

  11. HH 222: A GIANT HERBIG-HARO FLOW FROM THE QUADRUPLE SYSTEM V380 ORI

    SciTech Connect

    Reipurth, Bo; Aspin, Colin; Connelley, M. S.; Bally, John; Geballe, T. R.; Kraus, Stefan; Appenzeller, Immo; Burgasser, Adam E-mail: caa@ifa.hawaii.edu E-mail: John.Bally@colorado.edu E-mail: stefan.kraus@cfa.harvard.edu E-mail: aburgasser@ucsd.edu

    2013-11-01

    HH 222 is a giant shocked region in the L1641 cloud, and is popularly known as the Orion Streamers or ''the waterfall'' on account of its unusual structure. At the center of these streamers are two infrared sources coincident with a nonthermal radio jet aligned along the principal streamer. The unique morphology of HH 222 has long been associated with this radio jet. However, new infrared images show that the two sources are distant elliptical galaxies, indicating that the radio jet is merely an improbable line-of-sight coincidence. Accurate proper motion measurements of HH 222 reveal that the shock structure is a giant bow shock moving directly away from the well-known, very young, Herbig Be star V380 Ori. The already known Herbig-Haro object HH 35 forms part of this flow. A new Herbig-Haro object, HH 1041, is found precisely in the opposite direction of HH 222 and is likely to form part of a counterflow. The total projected extent of this HH complex is 5.3 pc, making it among the largest HH flows known. A second outflow episode from V380 Ori is identified as a pair of HH objects, HH 1031 to the northwest and the already known HH 130 to the southeast, along an axis that deviates from that of HH 222/HH 1041 by only 3.°7. V380 Ori is a hierarchical quadruple system, including a faint companion of spectral type M5 or M6, which at an age of ∼1 Myr corresponds to an object straddling the stellar-to-brown dwarf boundary. We suggest that the HH 222 giant bow shock is a direct result of the dynamical interactions that led to the conversion from an initial non-hierarchical multiple system into a hierarchical configuration. This event occurred no more than 28,000 yr ago, as derived from the proper motions of the HH 222 giant bow shock.

  12. Quadruple Quorum-Sensing Inputs Control Vibrio cholerae Virulence and Maintain System Robustness

    PubMed Central

    Jung, Sarah A.; Chapman, Christine A.; Ng, Wai-Leung

    2015-01-01

    Bacteria use quorum sensing (QS) for cell-cell communication to carry out group behaviors. This intercellular signaling process relies on cell density-dependent production and detection of chemical signals called autoinducers (AIs). Vibrio cholerae, the causative agent of cholera, detects two AIs, CAI-1 and AI-2, with two histidine kinases, CqsS and LuxQ, respectively, to control biofilm formation and virulence factor production. At low cell density, these two signal receptors function in parallel to activate the key regulator LuxO, which is essential for virulence of this pathogen. At high cell density, binding of AIs to their respective receptors leads to deactivation of LuxO and repression of virulence factor production. However, mutants lacking CqsS and LuxQ maintain a normal LuxO activation level and remain virulent, suggesting that LuxO is activated by additional, unidentified signaling pathways. Here we show that two other histidine kinases, CqsR (formerly known as VC1831) and VpsS, act upstream in the central QS circuit of V. cholerae to activate LuxO. V. cholerae strains expressing any one of these four receptors are QS proficient and capable of colonizing animal hosts. In contrast, mutants lacking all four receptors are phenotypically identical to LuxO-defective mutants. Importantly, these four functionally redundant receptors act together to prevent premature induction of a QS response caused by signal perturbations. We suggest that the V. cholerae QS circuit is composed of quadruple sensory inputs and has evolved to be refractory to sporadic AI level perturbations. PMID:25874462

  13. Bismuth-containing quadruple therapy for Helicobacter pylori: Lessons from China

    PubMed Central

    Lu, Hong; Zhang, Wei; Graham, David Y.

    2013-01-01

    Objective Antimicrobial resistance has continued to undermine many popular anti-Helicobacter pylori therapies. Antibiotic resistance to commonly used anti-H. pylori drugs in China has increased remarkably making China an ideal site to identify regimens that remain effective despite widespread antimicrobial resistance. Bismuth is one of the few antimicrobials to which resistance does not develop. Factors contributing to H. pylori treatment success include host factors (e.g., genetic differences in metabolism of the drugs used), bacterial factors (e.g., susceptibility) and details of the regimen (e.g., doses, dosing interval, dosing in relation of meals, formulation, etc). Methods We reviewed the recent experience in China with bismuth-containing quadruple therapies. The experience consists of 16 studies with 25 arms involving 1,971 patients to identify successful regimens (defined as reliably obtaining 90% or greater eradication per protocol) deserving of further study. Results Despite high rates of resistance to commonly used antimicrobials, several regimens were able to achieve high success. These were characteristically 14 day regimens containing a proton pump inhibitor and either tetracycline and metronidazole or furazolidone and amoxicillin. Conclusions We propose approaches for further development including for optimization and simplification relation to convenience and side effects (e.g., twice rather than three or 4 times daily or administration at the noon and evening meal instead of at breakfast and evening) while maintaining effectiveness ≥ 90%. Studies in China identified regimens that were highly effective despite the high prevalence of resistance to metronidazole, fluoroquinolones, and macrolides. Multicenter randomized studies will be required to confirm which is best. PMID:23778309

  14. PLANET HUNTERS: A TRANSITING CIRCUMBINARY PLANET IN A QUADRUPLE STAR SYSTEM

    SciTech Connect

    Schwamb, Megan E.; Schawinski, Kevin; Orosz, Jerome A.; Welsh, William F.; and others

    2013-05-10

    We report the discovery and confirmation of a transiting circumbinary planet (PH1b) around KIC 4862625, an eclipsing binary in the Kepler field. The planet was discovered by volunteers searching the first six Quarters of publicly available Kepler data as part of the Planet Hunters citizen science project. Transits of the planet across the larger and brighter of the eclipsing stars are detectable by visual inspection every {approx}137 days, with seven transits identified in Quarters 1-11. The physical and orbital parameters of both the host stars and planet were obtained via a photometric-dynamical model, simultaneously fitting both the measured radial velocities and the Kepler light curve of KIC 4862625. The 6.18 {+-} 0.17 R{sub Circled-Plus} planet orbits outside the 20 day orbit of an eclipsing binary consisting of an F dwarf (1.734 {+-} 0.044 R{sub Sun }, 1.528 {+-} 0.087 M{sub Sun }) and M dwarf (0.378 {+-} 0.023 R{sub Sun }, 0.408 {+-} 0.024 M{sub Sun }). For the planet, we find an upper mass limit of 169 M{sub Circled-Plus} (0.531 Jupiter masses) at the 99.7% confidence level. With a radius and mass less than that of Jupiter, PH1b is well within the planetary regime. Outside the planet's orbit, at {approx}1000 AU, a previously unknown visual binary has been identified that is likely bound to the planetary system, making this the first known case of a quadruple star system with a transiting planet.

  15. Innovative scatterometry approach for self-aligned quadruple patterning (SAQP) process control

    NASA Astrophysics Data System (ADS)

    Gunay-Demirkol, Anil; Altamirano Sanchez, Efrain; Heraud, Stephane; Godny, Stephane; Charley, Anne-Laure; Leray, Philippe; Urenski, Ronen; Cohen, Oded; Turovets, Igor; Wolfling, Shay

    2016-03-01

    In this work, capabilities of scatterometry at various steps of the self-aligned quadruple patterning (SAQP) process flow for 7nm (N7) technology node are demonstrated including the pitch walk measurement on the final fin etch step. The scatterometry solutions for each step are verified using reference metrology and the capability to follow the planned process design-of-experiment (DOE) and the sensitivity to catch the small process variations are demonstrated. Pitch walk, which is pitch variation in the four line/space (L/S) populations, is one of the main process challenges for SAQP. Scatterometry, which is a versatile optical technique for critical dimensions (CD) and shape metrology, can find the direct measurement of pitch walk challenging because it is a very weak parameter. In this work, the pitch walk measurement is managed via scatterometry using an advanced technique of parallel interpretation of scatterometry pads with varying pitches. The three populations of trenches could be clearly distinguished with the scatterometry and the consistency with the reference data and with the process DOE are presented. In addition, the root cause of the within-wafer non-uniformity of fin CD is determined. The measurements were done on-site at IMEC as a part of the process development and control of the IMEC SAQP processes [1]. All in all, in this work it is demonstrated that scatterometry is capable of monitoring each process step of FEOL SAQP and it can measure three different space populations separately and extract pitch walk information at the final fin etch step.

  16. Surgical treatment of acute and chronic anterior and posterior cruciate ligament and lateral side injuries of the knee.

    PubMed

    Levy, Bruce A; Boyd, Joel L; Stuart, Michael J

    2011-06-01

    Combined anterior cruciate ligament, posterior cruciate ligament, and lateral-sided injuries of the knee most often occurs secondary to a forced varus moment or after knee dislocation. Management controversies include the optimal timing of surgery, operative techniques, and postoperative rehabilitation. Recent systematic literature reviews have demonstrated higher rates of failure with repair of the lateral and posterolateral corner structures, as opposed to reconstruction. However, the ideal ligament reconstruction techniques remain unclear. This chapter will review the combined anterior cruciate ligament/posterior cruciate ligament/lateral-sided injury pattern, including the physical examination findings, imaging, timing of surgery, graft selection, operative techniques, and postoperative rehabilitation protocols.

  17. [The Einstein sign].

    PubMed

    Treska, V

    2003-02-01

    Untreated rupture of an aneurysm of the abdominal aorta is fatal in almost 100% of the patients. In the majority of cases the assessment of a correct, early diagnosis is simple (hypotension, backache, abdominal pain, pulsating resistance in the abdomen) and makes a prompt surgical or endovascular operation possible. In some instances however rupture of aneurysms of the abdominal aorta simulates other clinical conditions (acute cholecystitis, acute diverculitis of the sigmoid) which may delay the correct diagnosis and reduce the patient's chance of survival. The author describes, based on historical documents, the treacherous course of the disease in the scientific genius Albert Einstein where rupture of an aneurysm simulated acute cholecystitis, and in the world literature this symptomatology was subsequently described as Einstein's sign.

  18. Effect of Glucosamine Sulfate on Osteoarthritis in the Cruciate-Deficient Canine Model of Osteoarthritis.

    PubMed

    Wenz, Wolfram; Hornung, Christian; Cramer, Christopher; Schroeder, Malte; Hoffmann, Michael

    2017-04-01

    Objective Osteoarthritis (OA) is a major cause of musculoskeletal pain and disability worldwide. The investigation of disease-modifying treatment options for OA has become an important aspect of orthopedic care. To assess the effect of intra-articular and oral glucosamine sulfate (GS) versus placebo on osteoarthritis in a canine model. Materials In this randomized, placebo-controlled, double-blinded study, OA was induced by anterior cruciate ligament transection (ACLT) according to the Pond-Nuki model in 32 canines. All canines were allocated into 4 treatment subgroups with treatment administered for 8 weeks: GS (400 mg) intra-articular, placebo intra-articular, GS (200 mg/kg body weight) oral, and placebo oral. The contralateral nonoperated stifle (knee) served as control. After 8 weeks, the medial and lateral femoral condyles, the medial and lateral tibial plateau and patella were histologically examined and anatomic changes quantified by light microscopy using the modified Mankin score. Results After 8 weeks, mean Mankin score values significantly ( P < 0.002) decreased in the intra-articular GS group (8.1; range 7.9-8.8) compared with the intra-articular placebo group (13.9; range 11.6-15.9) and again significantly ( P < 0.002) in the oral GS group (12.1; range 9.9-12.7) compared with the oral placebo group (15.1; range 12.5-17.0). Mean Mankin score values were significantly ( P < 0.002) lower in the intra-articular GS group compared with the oral GS group. Conclusion Both, intra-articular and oral administered GS significantly reduced histological signs of OA in the Pond-Nuki model, with the intra-articular application being more effective compared to oral administration.

  19. Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction.

    PubMed

    Çelebi, Mehmet Mesut; Başkak, Bora; Saka, Tolga; Devrimci Özgüven, Halise; Ülkar, Bülent; Atalar, Ebru

    2015-01-01

    The aim of this study is to evaluate early phase depression and anxiety in the proffessional athletes who underwent anterior cruciate ligament (ACL) reconstruction and compare them with the functional improvement of knee. Thirty-eight patients (35 males, 3 females; mean age±SD: 26.84±8.03) were included in this study. Measurements were obtained immediately following the operation and at Week 6 of postoperative rehabilitation. Depression and anxiety symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS), and knee function was evaluated by Lysholm Knee Scoring Scale (LKSS). Change in total LKSS scores from the time of admission (56.4±20.2) to the end of the sixth week (78.7±13.8) was significant (t=-8.21, p<0.001). Neither the HADS depression nor the HADS anxiety scores were above the cutoff values in the 2 assessments. Significant difference was noted in HADS anxiety scores between the time of admission (6.21±3.50) and at the sixth week (5.33±3.33) (t=2.02, p=0.05). However, HADS depression scores were not statistically different between the 2 evaluations (5.95±3.68 and 5.35±3.50 at admission and Week 6 week, respectively) (t=1.07, p=0.29). Changes between the 2 LKSS and HADS anxiety assessments were negatively correlated (r=-0.49, p=0.002), but there no correlation was detected between the total LKSS and HADS score changes. The decline of the signs of anxiety and depression at the sixth week of rehabilitation indicate that proper rehabilitation positively affects the emotional status of ACL reconstruction patients.

  20. Hamstring Tendon Regeneration After Harvest for Anterior Cruciate Ligament Reconstruction: A Systematic Review.

    PubMed

    Papalia, Rocco; Franceschi, Francesco; D'Adamio, Stefano; Diaz Balzani, Lorenzo; Maffulli, Nicola; Denaro, Vincenzo

    2015-06-01

    To assess whether the portions of the semitendinosus and gracilis tendons harvested for anterior cruciate ligament reconstruction have the potential to regenerate and, if so, to evaluate the histologic properties and actual function of this newly formed tissue. We performed a comprehensive search of CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, Medline, the Cochrane Central Registry of Controlled Trials, and SPORTDiscus from inception of the databases to July 2014, using various combinations of keywords. Studies focusing on hamstring tendon and muscle regeneration through imaging and histology, as well as on the related functional outcomes, were selected. We included studies assessing evidence of tissue regeneration with imaging (magnetic resonance imaging, 3-dimensional computed tomography, ultrasonography) or with histologic examination of biopsy samples (or a combination thereof). Nineteen articles were included in this review, with a total of 400 patients observed. The overall rate of tissue regeneration was 86.0%, with similar values shown in most studies regardless of the methodology of the assessment. Biopsy confirmed that the tissue found at the site in 74% of the cases showed typical histologic features of the tendon. The mean modified Coleman Methodology Score of the studies included was 52.7 points, showing a modest methodologic quality for the studies published to date. In over 85% of the cases analyzed, regeneration signs of the harvested tendon were found through different imaging and histologic methodologies. A torque deficit in deep knee flexion is always present postoperatively, but the cause for this is still unclear. There is a need for better-designed trials featuring a higher level of evidence to further investigate this matter, and the effects of postoperative care and the surgical approach used on the regeneration process should be analyzed in the future. Level IV, systematic review of Level II, III, and IV

  1. Ergonomics and design: traffic sign and street name sign.

    PubMed

    Moroni, Janaina Luisa da Silva; Aymone, José Luís Farinatti

    2012-01-01

    This work proposes a design methodology using ergonomics and anthropometry concepts applied to traffic sign and street name sign projects. Initially, a literature revision on cognitive ergonomics and anthropometry is performed. Several authors and their design methodologies are analyzed and the aspects to be considered in projects of traffic and street name signs are selected and other specific aspects are proposed for the design methodology. A case study of the signs of "Street of Antiques" in Porto Alegre city is presented. To do that, interviews with the population are made to evaluate the current situation of signs. After that, a new sign proposal with virtual prototyping is done using the developed methodology. The results obtained with new interviews about the proposal show the user satisfaction and the importance of cognitive ergonomics to development of this type of urban furniture.

  2. Sign language comprehension: the case of Spanish sign language.

    PubMed

    Rodríguez Ortiz, I R

    2008-01-01

    This study aims to answer the question, how much of Spanish Sign Language interpreting deaf individuals really understand. Study sampling included 36 deaf people (deafness ranging from severe to profound; variety depending on the age at which they learned sign language) and 36 hearing people who had good knowledge of sign language (most were interpreters). Sign language comprehension was assessed using passages of secondary level. After being exposed to the passages, the participants had to tell what they had understood about them, answer a set of related questions, and offer a title for the passage. Sign language comprehension by deaf participants was quite acceptable but not as good as that by hearing signers who, unlike deaf participants, were not only late learners of sign language as a second language but had also learned it through formal training.

  3. Segmentation of the lateral femoral notch sign with MRI using a new measurement technique.

    PubMed

    Hoffelner, Thomas; Pichler, Isabel; Moroder, Philipp; Osti, Michael; Hudelmaier, Martin; Wirth, Wolfgang; Resch, Herbert; Auffarth, Alexander

    2015-08-21

    The goal of this present study was to precisely determine the dimension and location of the impaction fracture on the lateral femoral condyle in patients with an ACL rupture. All patients with post-injury bi-plane radiographs and MRI images after sustaining a tear to the anterior cruciate ligament were included. Lateral radiographs of the affected knee were inspected for a lateral femoral notch sign. MRIs of patients with a lateral condylopatellar sulcus ≥1.5 mm were used to segment and measure the lateral condylopatellar sulcus. The MRI examination was interpreted by an expert in musculoskeletal radiology. The study was approved by the ethics committee of the state of Salzburg. A "lateral femoral notch sign"was seen in 50 patients. The average total surface area of the lateral femoral condyle was 3271.7 mm(2) (SD 739.5 mm(2)). The defect had a mean surface area of 266.1 mm(2) (SD 125.5 mm(2)), a mean volume of 456.5 mm(3) (SD 278.5 mm(3)), a mean depth of 3.0 mm (SD 0.8 mm). On average 169 mm(2) (SD 99.6 mm(2)) of the surface of the condyle were affected by the impaction fracture which corresponds to 5.2% (SD 2.8%) of the surface of the lateral femoral condyle. In 51 % the impaction fracture was located in the central-external area of the femoral condyle. In cases of a clinically suspected ACL rupture lateral radiographs of the knee should be checked for a lateral femoral notch sign further MRI for confirmation should be performed. Knowing of the precise defect on the lateral femoral condyle is an additionally valuable information, as concomitant injuries to a rupture of the anterior cruciate ligament increase the risk for early-onset osteoarthritis in the future.

  4. LSE-Sign: A lexical database for Spanish Sign Language.

    PubMed

    Gutierrez-Sigut, Eva; Costello, Brendan; Baus, Cristina; Carreiras, Manuel

    2016-03-01

    The LSE-Sign database is a free online tool for selecting Spanish Sign Language stimulus materials to be used in experiments. It contains 2,400 individual signs taken from a recent standardized LSE dictionary, and a further 2,700 related nonsigns. Each entry is coded for a wide range of grammatical, phonological, and articulatory information, including handshape, location, movement, and non-manual elements. The database is accessible via a graphically based search facility which is highly flexible both in terms of the search options available and the way the results are displayed. LSE-Sign is available at the following website: http://www.bcbl.eu/databases/lse/.

  5. Anterior cruciate ligament and medial collateral ligament injuries.

    PubMed

    Bollier, Matthew; Smith, Patrick A

    2014-10-01

    The diagnosis and treatment of combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries have evolved over the past 30 years. A detailed physical examination along with careful review of the magnetic resonance imaging and stress radiographs will guide decision making. Early ACL reconstruction and acute MCL repair are recommended when there is increased medial joint space opening with valgus stress in extension, a significant meniscotibial deep MCL injury (high-riding medial meniscus), or a displaced tibial-sided superficial MCL avulsion (stener lesion of the knee). Delayed ACL reconstruction to allow for MCL healing is advised when increased valgus laxity is present only at 30 degrees of flexion and not at 0 degree. However, at the time of ACL surgery, medial stability has to be re-assessed after the reconstruction is completed. In patients with neutral alignment in the chronic setting, graft reconstruction of both the ACL and MCL is recommended.

  6. Epidemiology of cranial cruciate ligament rupture in dogs.

    PubMed

    Whitehair, J G; Vasseur, P B; Willits, N H

    1993-10-01

    Data from 10,769 dogs with rupture of the cranial cruciate ligament (CCL) were compared with data from a control population of 591,548 dogs to determine whether age, breed, gender, or body weight was associated with prevalence of CCL rupture. Prevalence of CCL rupture increased as dogs became older, with peak prevalence in dogs 7 to 10 years old. Among breeds represented by > 1,000 individuals, Rottweilers, Newfoundlands, and Staffordshire Terriers had the highest prevalence of CCL rupture, whereas Dachshunds, Basset Hounds, and Old English Sheepdogs had the lowest. Neutered dogs, whether male or female, had a higher prevalence of CCL rupture than did sexually intact dogs. The dog's age at the time of ovariohysterectomy was not associated with prevalence of CCL rupture. Dogs weighing > 22 kg had a higher prevalence of CCL rupture, compared with dogs weighing < 22 kg, and tended to rupture their CCL at a younger age.

  7. Compartment pressure monitoring during anterior cruciate ligament reconstruction.

    PubMed

    Amendola, A; Faber, K; Willits, K; Miniaci, A; Labib, S; Fowler, P

    1999-09-01

    A prospective double blind randomized study was carried out using 20 healthy males with anterior cruciate ligament (ACL) insufficiency undergoing bone-patellar tendon-bone ACL reconstruction. The subjects were randomized into either water or saline irrigation and then underwent identical reconstructive procedures using an arthroscopic pump. Continuous preoperative, intraoperative, and postoperative pressures were monitored using the slit catheter technique. Blood pressure and compartment pressure measurements were continuously recorded and noted at all stages of the procedure. Mean preoperative anterior and posterior compartment pressures were similar in both groups. No significant differences were noted between the anterior and posterior compartments of each group. No difference between water and saline irrigation was identified throughout the procedure. In both groups, postoperative pressures were slightly lower in the anterior and posterior compartments compared with preoperative pressures, but not significantly.

  8. Popliteal pseudoaneurysm after arthroscopic posterior cruciate ligament reconstruction.

    PubMed

    van Dorp, Karin B; Breugem, Stefan J M; Driessen, Marcel J M

    2014-09-01

    This report presents the case of a 30-year-old motocross (BMX) cyclist with a third-degree posterior cruciate ligament rupture. The technique used for reconstruction was the transtibial single-bundle autologous hamstring technique. Unfortunately, the procedure was complicated by a popliteal pseudoaneurysm, which was located in line with the tibial canal. The pseudoaneurysm was treated with an end-to-end anastomosis and the patient recovered without further complaints. In this case, the popliteal artery was damaged most probably by the edge of the reamer or the guide wire during removal. Vascular complications can be limb- and life-threatening. This case report aims to increase the awareness of this serious complication with a review of the literature.

  9. Popliteal Pseudoaneurysm after Arthroscopic Posterior Cruciate Ligament Reconstruction

    PubMed Central

    Breugem, Stefan J.M.; Driessen, Marcel J.M.

    2014-01-01

    This report presents the case of a 30-year-old motocross (BMX) cyclist with a third-degree posterior cruciate ligament rupture. The technique used for reconstruction was the transtibial single-bundle autologous hamstring technique. Unfortunately, the procedure was complicated by a popliteal pseudoaneurysm, which was located in line with the tibial canal. The pseudoaneurysm was treated with an end-to-end anastomosis and the patient recovered without further complaints. In this case, the popliteal artery was damaged most probably by the edge of the reamer or the guide wire during removal. Vascular complications can be limb- and life-threatening. This case report aims to increase the awareness of this serious complication with a review of the literature. PMID:25229050

  10. Neuromuscular disorder in response to anterior cruciate ligament creep.

    PubMed

    Chu, Derrick; LeBlanc, Robby; D'Ambrosia, Peter; D'Ambrosia, Renee; Baratta, Richard V; Solomonow, Moshe

    2003-03-01

    To determine the effect of creep developed in the anterior cruciate ligament and other viscoelastic knee structures on the function of the flexor and extensor muscles of males and females. Static load applied to the proximal tibia of young healthy male and female subjects in a laboratory setting with maximal voluntary knee flexion and extension performed before and after the load application. Static loads applied to various joints during occupational and sports activities are epidemiologically linked to higher than normal rates of disability reports. The physiological and biomechanical processes active in the development of such a neuromuscular disorder are not known. We hypothesize that creep developed in the anterior cruciate ligament due to prolonged static load will have pronounced impact on the reflexive activation of the associated musculature in a manner that may increase the risk of injury. Females are expected to be exposed to higher risk than males. Male and female groups performed maximal voluntary knee flexion and extension before and after applying 200 and 150 N, respectively, to the proximal tibia for a 10 min period. Flexion and extension forces as well as electromyograph from agonist and antagonist muscles were measured at 35 degrees and 90 degrees knee flexion. Data was analyzed through repeated measures of analysis of variance. It was found that in extension, quadriceps electromyographic activity increased significantly after anterior cruciate ligament creep while hamstrings co-activation did not change. There was also a trend towards increased extension force after creep was developed, with significant effect of gender (larger increase in females). Similarly, significant increase in hamstrings electromyographic activity and a trend towards increased force during knee flexion was observed but with no effect of gender. Electromyographic spasms from the flexors and extensors were recorded in 30% of the subjects during the 10 min static loading

  11. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction.

    PubMed

    Alrowaili, Majed

    2016-04-26

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

  12. Vascular Complications in Arthroscopic Repair Of Posterior Cruciate Ligament

    PubMed Central

    Agotegaray, Juan Ignacio; Comba, Ignacio; Bisiach, Luciana; Grignaffini, María Emilia

    2017-01-01

    Introduction: Posterior cruciate ligament is the primary stabilizer of the knee. Among the potential complications in arthroscopic repair of this ligament, there are vascular lesions, due to laceration, thrombosis and injury of the intima of the popliteal artery. We used one case to show the vascular complications that may arise in arthroscopic repair of the posterior cruciate ligament, how to handle it and the results. Methods: One patient, 33 years old, with a history of traffic accident. In a physical exam the patient shows pain and swelling of the knee, positive posterior drawer test and positive Godfrey test. X-rays on the knee show posterior tibial translation and MRI a complete fibers rupture at the middle third of the posterior cruciate ligament. An arthroscopic repair surgery was scheduled three weeks after trauma, with PCL reconstruction using simple band technique.After surgical intervention, hemostatic cuff was released, no peripheral pulse, paleness and coldness of the member was confirmed. An arteriography was carried out, which confirmed absences of distal vascular filling in the popliteal artery. An urgent referral was carried out with Vascular Surgery Services, who had been informed of the surgery previously (a notification that is part of our routine for this kind of interventions). Arteriorrhaphy and venorrhaphy of the popliteal arteries was fulfilled 12 hours later, with a leg fasciotomy. Daily monitoring was performed, and after 72 hours, muscle necrosis is seen with wound drainage, analysis shows presence of gram-negative bacilli, Proteus Mirabilis-Pseudomonas spp and the lab results showed leukocytes: 8.700/ml, ESR: 58, CRP: 48. A new surgery is performed with complete resection of the anterior external compartment of the leg, and a system of continuous cleansing is applied with physiological saline solution and boric acid for 14 days until drainage is eliminated. Vancomycin and ceftazidime EV was indicated for 14 days and, after a good

  13. Mechanism of anterior cruciate ligament injuries in soccer.

    PubMed

    Faunø, P; Wulff Jakobsen, B

    2006-01-01

    One hundred and thirteen patients, consecutively admitted to our clinic with an anterior cruciate ligament (ACL) rupture sustained while playing soccer, were surveyed and the mechanism behind their injury analyzed. The diagnosis was made arthroscopically or by instrumented laxity testing. The findings showed that the vast majority of the injuries were of the non-contact type and that very few were associated with foul play. No player positions were over- or underrepresented and goal keepers are apparently just as prone to ACL injury as their teammates. The findings of this study have helped our understanding of the mechanism behind ACL injuries in soccer and could be an aid to establishing future prophylactic measures. The findings also emphasize that certain injury mechanisms on the soccer field should alert the physician and draw his attention to a possible ACL injury.

  14. Simultaneous bilateral ganglion cysts of the anterior cruciate ligaments.

    PubMed

    Demircay, Emre; Ofluoglu, Demet; Ozel, Omer; Oztop, Pinar

    2015-04-01

    Intra-articular ganglion cysts of the anterior cruciate ligament (ACL) are rare, and bilateral ganglion cysts are even rarer. These cysts may cause intermittent or chronic nonspecific knee discomfort. Although three cases of bilateral ganglion cysts have been reported in the literature, the knees were not simultaneously affected in those cases. Herein, we report the case of a 56-year-old woman who presented with simultaneous bilateral ganglion cysts of the ACL that were symptomatic. She was successfully treated with arthroscopic resection and debridement. We also present a brief review of the literature, highlighting the aetiology, diagnosis and management of ganglion cysts of the ACL. To the best of our knowledge, this is the first report of simultaneous bilateral intra-articular ganglion cysts of the ACL.

  15. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    2016-01-01

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status. PMID:27478579

  16. Two-Stage Revision Anterior Cruciate Ligament Reconstruction.

    PubMed

    Erickson, Brandon J; Cvetanovich, Gregory; Waliullah, Khalid; Khair, Michael; Smith, Patrick; Bach, Bernard; Sherman, Seth

    2016-05-01

    The number of primary anterior cruciate ligament (ACL) tears is rapidly increasing. In patients who wish to return to their preoperative level of function, specifically as it pertains to participation in sports, the gold standard of treatment following an ACL tear remains an anterior cruciate ligament (ACL) reconstruction. Despite a majority of good/excellent results following primary ACL reconstruction, there is a growing subset of patients with persistent or recurrent functional instability who require revision ACL reconstruction. Preoperative planning for revision ACL reconstruction requires a careful understanding of the root cause of ACL failure, including possible technical causes of primary ACL failure and the presence of combined knee pathology that was not addressed at the index ACL reconstruction. The decision to perform 2-stage revision ACL reconstruction is multifactorial and is reached by technical considerations that may make a 1-stage revision less optimal, including tunnel widening, arthrofibrosis, active infection, and others. Concomitant knee pathology such as meniscal deficiency, malalignment (including an increase in posterior tibial slope), chondral lesions, and other ligamentous laxity may also require a staged approach to treatment. This evidence-based review covers the indications for 2-stage revision ACL reconstruction, surgical techniques, evidence for and technique of bone grafting prior ACL tunnels, and outcomes of 2-stage revision stratified by initial cause of ACL reconstruction failure. With proper preoperative planning and an understanding of the cause of failure following the primary ACL reconstruction, revision ACL reconstruction can offer excellent outcomes in the motivated patient. [Orthopedics. 2016; 39(3):e456-e464.].

  17. Anterior Cruciate Ligament Strain In Vivo: A Systematic Review.

    PubMed

    Luque-Seron, Juan Antonio; Medina-Porqueres, Ivan

    2016-09-01

    Distinct exercises have been proposed for knee rehabilitation after anterior cruciate ligament (ACL) reconstruction. There is a need to understand ACL strain behavior during different rehabilitation exercises to protect the graft from excessive strain that could interfere with its healing process. To critically review studies that directly measured normal ACL strain in vivo during different movements, conditions, or exercises to gain insight into which of them may produce more strain on the ligament or the ligament graft in the case of reconstructed knees. A literature search of PubMed, CINAHL, SPORTDiscus, and PEDro databases was conducted. Keywords included anterior cruciate ligament, strain, stress, deformation, transducer, rehabilitation, rehabilitation exercise, physical therapy, and physiotherapy. Inclusion criteria were (1) peer-reviewed studies published in English or Spanish, (2) research conducted on adult human subjects with normal ACLs and healthy knees, and (3) ACL strain directly measured during different movements, conditions, or exercises by using a transducer. Systematic review. Level 4. Specific data were abstracted from the selected studies, including isometric quadriceps and hamstrings activity, active and passive flexion-extension of the knee, closed kinetic chain exercises, and application of joint compressive load. A total of 10 studies met all criteria and were included in the final analysis. The strain values produced by closed kinetic chain and open kinetic chain exercises were similar. However, closed kinetic chain exercises appear to attenuate the strain increase that occurs in open kinetic chain exercises when increasing resistance. These data may be relevant to develop rehabilitation exercises or programs that do not endanger the healing ACL graft and to provide a basis for future clinical trials. © 2016 The Author(s).

  18. Registration rate in the Norwegian Cruciate Ligament Register

    PubMed Central

    2012-01-01

    Background and purpose The Norwegian Cruciate Ligament Register (NCLR) was founded in 2004. The purpose of the NCLR is to provide representative and reliable data for future research. In this study we evaluated the development of the registration rate in the NCLR. Methods The Norwegian Patient Register (NPR) and the electronic patient charts (EPCs) were used as reference data for public and private hospitals, respectively. Data were retrieved for all primary and revision anterior cruciate ligament (ACL) surgery during 2008–2009 in public hospitals and during 2008 in private hospitals. The NOMESCO classification of surgical procedures was used for identification of ACL surgeries. Public hospitals were divided into subgroups according to the annual number of operations in the NPR: small hospitals (< 30 operations) and large hospitals (≥ 30 operations). Results For the 2-year data extracted from public hospitals, 2,781 and 2,393 operations met the inclusion criteria according to the NPR and the NCLR, respectively, giving an average registration rate of 86% (95% CI: 0.85–0.87). The registration rate for small public hospitals was 69% (CI: 0.65–0.73), which was significantly less than for large public hospitals (89%, CI: 0.88–0.90; p < 0.001). In 2008, private hospitals reported 548 operations to the NCLR while 637 were found in the EPCs, giving a registration rate of 86% (CI: 0.83–0.89). In that year, the registration rate for public hospitals was 86%, which was similar to that for private hospitals. Interpretation The NCLR registration rate for the period 2008–09 was similar in both 2008 and 2009, and is satisfactory for research. There is room for improvement of registration rates, particularly in hospitals with a small volume of ACL operations. PMID:22489890

  19. Sonographically Guided Anterior Cruciate Ligament Injection: Technique and Validation.

    PubMed

    Smith, Jay; Hackel, Joshua G; Khan, Umar; Pawlina, Wojciech; Sellon, Jacob L

    2015-07-01

    To describe and validate a practical technique for sonographically guided anterior cruciate ligament (ACL) injections. Prospective, cadaveric laboratory investigation. Procedural skills laboratory in a tertiary medical center. Ten unembalmed, cadaveric mid-thigh-knee-ankle foot specimens (5 left knees and 5 right knees; 5 male and 5 female) from 10 donors aged 76 to 93 years (mean 85.6 years) with body mass indices of 17.6 to 42.2 kg/m(2) (mean 28.8 kg/m(2)). A single, experienced operator used a 22-gauge, 63.5-mm stainless steel needle and a 12-3-MHz linear transducer to inject 1.5 mL of diluted colored latex into the ACLs of 10 unembalmed cadaveric specimens via an in-plane, caudad-to-cephalad approach, long axis to the ACL. At a minimum of 24 hours postinjection, specimens were dissected, and the presence and distribution of latex within the ACL assessed by a study co-investigator. Presence and distribution of latex within the ACL. All 10 injections accurately delivered latex into the proximal (femoral), midsubstance, and distal (tibial) portions of the ACL. No specimens exhibited evidence of needle injury or latex infiltration with respect to the menisci, hyaline cartilage, or posterior cruciate ligament. Sonographically guided intra-ligamentous ACL injections are technically feasible and can be performed with a high degree of accuracy. Sonographically guided ACL injections could be considered for research and clinical purposes to directly deliver injectable agents into the healing ACL postinjury or postreconstruction. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  20. Sonographically Guided Posterior Cruciate Ligament Injections: Technique and Validation.

    PubMed

    Hackel, Joshua G; Khan, Umar; Loveland, Dustin M; Smith, Jay

    2016-03-01

    To describe and validate a technique for sonographically guided posterior cruciate ligament (PCL) injections. Prospective, cadaveric laboratory investigation. Procedural skills laboratory. Eight unembalmed, cadaveric, mid-thigh-knee specimens (4 left knees and 4 right knees) obtained from 4 male and 4 female donors aged 57 to 64 years (mean 60.8 years) with body mass indices of 27.7 to 36.5 kg/m(2) (mean 32 kg/m(2)). A 5-2-MHz curvilinear probe and a 22-gauge, 78-mm stainless steel needle was used to inject 2 mL of diluted blue latex into the PCL of each specimen using an in-plane, caudad-to-cephalad approach. At a minimum of 24 hours postinjection, each specimen was dissected to assess the presence and distribution of latex within the PCL. Presence and distribution of latex within the PCL. All 8 injections accurately delivered latex throughout the PCL, including the tibial and femoral footprints. In 2 of 8 specimens (25%), a small amount of latex was noted to extend beyond the PCL and into the joint space. No specimens exhibited evidence of needle injury of latex infiltration with respect to the popliteal neurovascular bundle, menisci, hyaline cartilage, or anterior cruciate ligament. Sonographically guided intraligamentous PCL injections are technically feasible and can be performed with a high degree of accuracy. Sonographically guided PCL injections should be considered for research and clinical purposes to deliver therapeutic agents into the PCL postinjury or postreconstruction. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  1. Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management.

    PubMed

    Siegel, Leon; Vandenakker-Albanese, Carol; Siegel, David

    2012-07-01

    Anterior cruciate ligament (ACL) injuries are the most common ligament injury in the United States. These injuries can be career ending for athletes and severely disabling for all individuals. Our objectives are to review the epidemiology of these injuries, as well as ACL biomechanics, anatomy, and nonsurgical and surgical management so that generalists as well as sports medicine physicians, orthopedists, and others will have a better understanding of this serious injury as well as choices in its management. PubMed was used to identify relevant articles. These articles were then used to identify other sources. Anterior cruciate ligament injuries occur more commonly in women than in men due to a variety of anatomical factors. The ACL consists of 2 major bundles, the posterolateral and the anteromedial bundles. Forces transmitted through these bundles vary with knee-joint position. Some patients with ACL injuries may not be candidates for surgery because of serious comorbid medical conditions. However, without surgical repair, the knee generally remains unstable and prone to further injury. There are a variety of surgical decisions that can influence outcomes. Single-bundle versus double-bundle repair, whether to leave the ruptured ACL remnant in the knee, the selection of the graft tissue, graft placement, and whether to use the transtibial, far anteromedial portal, or tibial tunnel-independent technique are choices that must be made. With a sound knowledge of the anatomy and kinetics of the knee, newer improved surgical techniques have been developed that can restore proper knee function and have allowed many athletes to resume their careers. These new techniques have also limited the disability in nonathletes.

  2. Rescue Therapy for Helicobacter pylori Eradication: A Randomized Non-Inferiority Trial of Amoxicillin or Tetracycline in Bismuth Quadruple Therapy.

    PubMed

    Chen, Qi; Zhang, Wei; Fu, Qingyan; Liang, Xiao; Liu, Wenzhong; Xiao, Shudong; Lu, Hong

    2016-12-01

    To compare the efficacy and safety of bismuth-containing quadruple therapy with tetracycline or amoxicillin for rescue treatment of Helicobacter pylori. The study was a non-inferiority trial of H. pylori eradication with at least two previous treatment failures. Subjects were randomized to receive 14-day therapy with b.i.d. lansoprazole 30 mg and bismuth 220 mg, plus metronidazole 400 mg q.i.d and amoxicillin 1 g t.i.d (amoxicillin group) or tetracycline 500 mg q.i.d (tetracycline group). Antimicrobial susceptibility was assessed by the agar-dilution method. Primary outcome was H. pylori eradication at 6 weeks after treatment. In all, 312 subjects were randomized, 13 were lost to follow-up; 29 violated the protocol. The intention-to-treat, per-protocol, and modified intention-to-treat eradication rates were (amoxicillin) 88.5% (138/156, 95% confidence interval (CI) 83.4-93.5%), 93.7% (133/142, 95% CI 89.7-97.7%), and 92.6% (138/149, 95% CI 88.4-96.8%). With tetracycline, they were 87.2% (136/156, 95% CI 81.9-92.4%), 95.3% (122/128, 95% CI 91.7-99.0%), and 90.7% (136/150, 95% CI 86.0-95.3%). Amoxicillin-, tetracycline-, and metronidazole-resistant rates were 8.3, 1.0, and 87.8%, respectively. Non-inferiority was confirmed (P<0.025). Metronidazole resistance did not affect the efficacy of either therapy. Compliance was greater and moderate and severe adverse events were less among those receiving amoxicillin than those receiving tetracycline. The novel bismuth-containing quadruple therapy with metronidazole and amoxicillin is an alternative to classical bismuth quadruple therapy for H. pylori rescue treatment as it provides similar eradication with superior safety and compliance.

  3. Comparison of the Eradication Rate between 1- and 2-Week Bismuth-Containing Quadruple Rescue Therapies for Helicobacter pylori Eradication

    PubMed Central

    Yoon, Jai Hoon; Kim, Yeon Soo; Suk, Ki Tae; Shin, Woon Geon; Kim, Kyung Ho; Kim, Kyoung Oh; Park, Cheol Hee; Baik, Il Hyun; Jang, Hyun Joo; Kim, Jin Bong; Kae, Sea Hyub; Kim, Dong Joon; Kim, Hak Yang

    2012-01-01

    Background/Aims First-line therapies against Helicobacter pylori, including proton pump inhibitors (PPIs) plus two antibiotics, may fail in up to 20% of patients. 'Rescue' therapy is usually needed for patients who failed the first-line treatment. This study evaluated the eradication rate of bismuth-containing quadruple rescue therapy over a 1- or 2-week period. Methods We prospectively investigated 169 patients with a persistent H. pylori infection after the first-line triple therapy, which was administered from October 2008 to March 2010. The patients were randomized to receive a 1- or 2-week quadruple rescue therapy (pantoprazole 40 mg b.i.d., tripotassium dicitrate bismuthate 300 mg q.i.d., metronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d.). After the 'rescue' therapy, the eradication rate, compliance, and adverse events were evaluated. Results The 1-week group achieved 83.5% (71/85) and 87.7% (71/81) eradication rates in the intention to treat (ITT) and per-protocol (PP) analyses, respectively. The 2-week group obtained 87.7% (72/84) and 88.9% (72/81) eradication rate in the ITT and PP analyses, respectively. There was no significant difference in the eradication rate, patient compliance or rate of adverse events between the two groups. Conclusions One-week bismuth-containing quadruple therapy can be as effective as a 2-week therapy after the failure of the first-line eradication therapy. PMID:23170146

  4. Landsat 6 contract signed

    NASA Astrophysics Data System (ADS)

    Maggs, William Ward

    A new agreement provides $220 million for development and construction of the Landsat 6 remote sensing satellite and its ground systems. The contract, signed on March 31, 1988, by the Department of Commerce (DOC) and the Earth Observation Satellite (EOSAT) Company of Lanham, Md., came just days after approval of DOC's Landsat commercialization plan by subcommittees of the House and Senate appropriations committees.The Landsat 6 spacecraft is due to be launched into orbit on a Titan II rocket in June 1991 from Vandenburg Air Force Base, Calif. The satellite will carry an Enhanced Thematic Mapper (ETM) sensor, an instrument sensitive to electromagnetic radiation in seven ranges or bands of wavelengths. The satellite's payload will also include the Sea Wide Field Sensor (Sea-WiFS), designed to provide information on sea surface temperature and ocean color. The sensor is being developed in a cooperative effort by EOSAT and the National Aeronautics and Space Administration (NASA). A less certain passenger is a proposed 5-m resolution, three-band sensor sensitive to visible light. EOSAT is trying to find both private financing for the device and potential buyers of the high-resolution imagery that it could produce. The company has been actively courting U.S. television networks, which have in the past used imagery from the European Système Probatoire d'Observation de la Terre (SPOT) satellite for news coverage.

  5. Stop Sign Crater

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    With its rim eroded off by catastrophic floods in Tiu Vallis and its strangely angular shape, this 12 km diameter crater looks vaguely like a stop sign.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

    Image information: VIS instrument. Latitude 8.6, Longitude 329.2 East (30.8 West). 19 meter/pixel resolution.

  6. Stop Sign Crater

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    With its rim eroded off by catastrophic floods in Tiu Vallis and its strangely angular shape, this 12 km diameter crater looks vaguely like a stop sign.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

    Image information: VIS instrument. Latitude 8.6, Longitude 329.2 East (30.8 West). 19 meter/pixel resolution.

  7. Chvostek's sign in paediatric practice.

    PubMed

    Hasan, Zeeshaan U; Absamara, Rania; Ahmed, Mas

    2014-01-01

    Chvostek's Sign was first described in 1876, as a clinical clue associated with patients who suffered from latent tetany, and is induced by percussion of the angle of the jaw. However, over the years many clinicians have called into question the strength of the association with latent tetany, particularly in paediatric practice. This review examines the variation in techniques used to elicit the sign in studies conducted on this phenomenon in children as well as how differences in the classification of a positive Chvostek's sign have lead to varied reports on the strength of the association. Furthermore, an appraisal of the literature regarding the proposed mechanism of Chvostek's sign is reported alongside analysing other diseases which have been associated with Chvostek's sign to uncover any unifying mechanism for the presence of this clinical sign in children.

  8. Sleep improvement in an insomniac patient with global pituitary insufficiency after change from triple to quadruple cortisol replacement therapy.

    PubMed

    Voss, Ursula; Tuin, Inka; Krakow, Karsten

    2007-08-01

    Although cortisol has a distinct circadian rhythm, patients with adrenal insufficiency usually receive diurnal hydrocortisone replacement therapy (HRT), disregarding possible consequences for sleep quality. The case reported here concerns the resolution of severe insomnia in a patient with global hypopituitary insufficiency upon adjustment of triple HRT to quadruple HRT. The data show a strong influence of cortisol on total sleep time and slow wave sleep (SWS) as well as rapid eye movement (REM) sleep. Clinically, the data are suggestive of the need to assimilate HRT to the natural circadian cortisol rhythm and not restrict it to the active part of the day.

  9. Demonstration of optical frequency quadrupling combined with direct/external signal double-sideband suppressed-carrier modulation

    NASA Astrophysics Data System (ADS)

    Lin, Jhe-Min; Ho, Wen-Jeng; Chang, Yu-Peng; Peng, Peng-Chun; Lu, Hai-Han

    2014-04-01

    This study experimentally demonstrates the performance of optical frequency quadrupling generation and base-band signal up-conversion techniques based on the cascaded single-electrode Mach-Zehnder modulator (SEMZM) using different signal modulation schemes. The optical signals in microwave band with double-sideband suppressed-carrier (DSB-SC) modulated format exhibit that the receiver sensitivity and the spectral efficiency are maximized and the power penalty over long-distance delivery is minimized. A simple configuration and low-frequency bandwidth requirement for both electrical and optical components in the proposed schemes also are demonstrated.

  10. Fourteen- vs seven-day bismuth-based quadruple therapy for second-line Helicobacter pylori eradication

    PubMed Central

    Hwang, Jae Jin; Lee, Dong Ho; Lee, Ae-Ra; Yoon, Hyuk; Shin, Cheol Min; Park, Young Soo; Kim, Nayoung

    2015-01-01

    AIM: To compare the efficacy of 14- and 7-d bismuth-based quadruple therapies as second-line eradication treatment for Helicobacter pylori (H. pylori) infection. METHODS: Between 2004 and 2014, the medical records of 790 patients who had experienced failure of first-line proton pump inhibitor (PPI)-based eradication therapy and were then treated with bismuth-based quadruple therapy were retrospectively reviewed. Those who received bismuth-based quadruple therapy [PPI, bismuth, metronidazole, and tetracycline (PBMT)] for either 7 d or 14 d were assigned to a PBMT-7 group (n = 543) or a PBMT-14 group (n = 247), respectively. The eradication rates for both groups were determined by intention-to-treat (ITT) and per-protocol (PP) analyses. ITT analysis compared the treatment groups as originally allocated while the PP analysis including only those patients who had completed the treatment as originally allocated. Successful eradication therapy for H. pylori infection was defined as a negative 13C-urea breath test 4 wk after the end of eradication treatment. RESULTS: The overall ITT eradication rate was 69.1% (546/790). Final ITT eradication rates were 67.4% (366/543; 95%CI: 63.1%-71.7%) in the PBMT-7 group and 72.8% (180/247; 95%CI: 67.4%-78.2%) in the PBMT-14 group (P = 0.028). The overall PP eradication rate was 80.0% (546/682), and the final PP eradication rates were 78.2% (366/468; 95%CI: 72.1%-84.0%) in the PBMT-7 group and 84.1% (180/214; 95%CI: 76.8%-90.8%) in the PBMT-14 group (P = 0.009). The H. pylori eradication rates in the PBMT-14 group were significantly higher than in the PBMT-7 group according to both ITT (P = 0.028) and PP analysis (P = 0.009). Compliance was similar in both groups (PBMT-7 group: 97.9%; PBMT-14 group: 96.4%). Adverse event rates were 10.7% (51/478) and 17.1% (38/222) in the PBMT-7 and PBMT-14 groups, respectively (P = 0.487). CONCLUSION: The 14-d bismuth-based quadruple therapy is a significantly more effective second-line eradication

  11. Delay-dependent stabilisation of systems with time-delayed state and control: application to a quadruple-tank process

    NASA Astrophysics Data System (ADS)

    El Haoussi, F.; Tissir, E. H.; Tadeo, F.; Hmamed, A.

    2011-01-01

    This work presents a study on the stabilisation of linear systems with delays in the control and states, motivated by a benchmark problem from the literature (a quadruple-tank system). A methodology for the stabilisation of this kind of systems is presented, expressing the conditions as LMIs. Using several examples from the literature, it is shown that the proposed stabilisation theorem is less conservative than previous results. Finally, the technique is applied to the benchmark problem, showing how it is possible to derive efficient controllers for realistic problems, using the proposed technique.

  12. Clarithromycin versus Gemifloxacin in Quadruple Therapeutic Regimens for Helicobacter Pylori Infection Eradication.

    PubMed

    Mansour-Ghanaei, Fariborz; Pedarpour, Zahra; Shafaghi, Afshin; Joukar, Farahnaz

    2017-04-01

    BACKGROUND Helicobacter pylori (H. pylori) infection is a major casual factor in any peptic diseases. Clarithromycin as one of the drugs recommended for the infection eradication regimen has shown different levels of resistance. The present study is comparing the effectiveness of clarithromycin- and gemifloxacin - based quadruple regimens in H. pylori eradication. METHODS This was a prospective double blind randomized clinical trial on patients with clear indication of H. pylori eradication. The patients were randomly divided into two groups: "BPAC group" treated with bismuth subcitrate (240 mg), pantoprazole (20 mg), amoxicillin (1 gr), and clarithromycin (500 mg), all twice daily, and the "BPAG group" treated with bismuth subcitrate, pantoprazole, and amoxicillin with same doses as "BPAC group" and gemifloxacin (320 mg daily) all for 10 days. Three months after the end of therapy, 14C-Urea breath test was performed to confirm the eradication. All the patients were assessed for compliance and drug side effects. Based on per-protocol (PP) and intention-to-treat (ITT) methods, data were analyzed and a P value<0.05 was considered as statistically significant. This project has been registered in the Iranian registry of clinical trials (IRCT). RESULTS Three patients were excluded from the survey and finally, 179 patients (89 patients in BPAC group and 90 patients in BPAG group) including 71(39.66%) men with the mean age of 46.4±12.3 years completed the treatment period. The incidence of side effects between the two study groups did not differ significantly. The success rate of BPAC regimen eradication was remarkably greater than BPAG regimen (ITT analysis; 89% vs 77%, respectively; CI 95%: 1.072-5.507, P<0.015 and PP analysis; 91% vs 77.8% respectively; CI 95%: P<0.015). There was no significant relationship between the demographic features and the eradication results. CONCLUSION The results showed that gemifloxacin is not a good alternative for clarithromycin in H

  13. Quadruple parallel mass spectrometry for analysis of vitamin D and triacylglycerols in a dietary supplement.

    PubMed

    Byrdwell, William Craig

    2013-12-13

    A "dilute-and-shoot" method for vitamin D and triacylglycerols is demonstrated that employed four mass spectrometers, operating in different ionization modes, for a "quadruple parallel mass spectrometry" analysis, plus three other detectors, for seven detectors overall. Sets of five samples of dietary supplement gelcaps labeled to contain 25.0μg (1000 International Units, IU) vitamin D3 in olive oil were diluted to 100mL and analyzed in triplicate by atmospheric pressure chemical ionization (APCI) mass spectrometry (MS), atmospheric pressure photoionization (APPI) MS and electrospray ionization (ESI) MS, along with an ultraviolet (UV) detector, corona charged aerosol detector (CAD), and an evaporative light scattering detector (ELSD), simultaneously in parallel. UV detection allowed calculation by internal standard (IS), external standard (ES), and response factor (RF) approaches, which gave values of 0.2861±0.0044, 0.2870±0.0059, and 0.2857±0.0042μg/mL, respectively, which were not statistically significantly different. This indicated an average amount of vitamin D3 of 14.5% over the label amount. APCI-MS analysis by selected ion monitoring (SIM) and two transitions of selected reaction monitoring (SRM) provided values of 0.2849±0.0055, 0.2885±0.0090, and 0.2939±0.0097μg/mL, respectively, relative to vitamin D2 as the IS. The triacylglycerol (TAG) composition was determined by APCI-MS, APPI-MS and ESI-MS, and the fatty acid (FA) compositions calculated from the TAG compositions were compared to the FA composition determined by gas chromatography (GC) with flame ionization detection (FID) of the FA methyl esters (FAME). APCI-MS provided the FA composition closest to that determined by GC-FID of the FAME. A previously reported approach to TAG response factor calculation was employed, which brought all TAG compositions into good agreement with each other, and the calculated FA compositions into excellent agreement with the FA composition determined from GC

  14. Posterior Cruciate Ligament Removal Contributes to Abnormal Knee Motion during Posterior Stabilized Total Knee Arthroplasty

    PubMed Central

    Cromie, Melinda J.; Siston, Robert A.; Giori, Nicholas J.; Delp, Scott L.

    2017-01-01

    Abnormal anterior translation of the femur on the tibia has been observed in mid flexion (20–60°) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes of this abnormal motion remain unknown. The purpose of this study was to isolate the effects of posterior cruciate ligament removal on knee motion after total knee arthroplasty. We posed two questions: Does removing the posterior cruciate ligament introduce abnormal anterior femoral translation? Does implanting a posterior stabilized prosthesis change the kinematics from the cruciate deficient case? Using a navigation system, we measured passive knee kinematics of ten male osteoarthritic patients during surgery after initial exposure, after removing the anterior cruciate ligament, after removing the posterior cruciate ligament, and after implanting the prosthesis. Passively flexing and extending the knee, we calculated anterior femoral translation and the flexion angle at which femoral rollback began. Removing the posterior cruciate ligament doubled anterior translation (from 5.1±4.3 mm to 10.4±5.1 mm) and increased the flexion angle at which femoral rollback began (from 31.2±9.6° to 49.3±7.3°). Implanting the prosthesis increased the amount of anterior translation (to 16.1±4.4 mm), and did not change the flexion angle at which femoral rollback began. Abnormal anterior translation was observed in low and mid flexion (0–60°) after removing the posterior cruciate ligament, and normal motion was not restored by the posterior stabilized prosthesis. PMID:18464260

  15. Effects of Oral Contraceptive Use on Anterior Cruciate Ligament Injury Epidemiology.

    PubMed

    Gray, Aaron M; Gugala, Zbigniew; Baillargeon, Jacques G

    2016-04-01

    Anterior cruciate ligament injuries often incur major consequences for athletes. Elevated estrogen levels are likely increase the risk for injury. This risk may be partially or fully mitigated by the use of oral contraceptives. The purpose of this study was to determine if women undergoing anterior cruciate ligament surgical reconstruction were less likely to use oral contraceptives than matched noninjured population. This is a case-control study utilizing national insurance claims data from 2002 TO 2012. Participants included women age 15-39 yr. Cases were defined as those receiving surgical reconstruction of the anterior cruciate ligament between 2002 and 2012. Controls were matched 3/1 to cases. Exposure to oral contraceptives was defined as the presence of any prescription fill for oral contraceptives during the previous 12 months to index date. Conditional multivariate logistic regression was used to estimate adjusted odds ratios for the use of oral contraceptives. Women age 15-19 yr undergoing surgical repair of the anterior cruciate ligament were 18% less likely to use oral contraceptives than matched controls (adjusted odds ratio, 0.82; 95% CI, 0.75-0.91; P < 0.0001). Cases among two older age groups, 25-29 and 30-34 yr, were more likely to use oral contraceptives than controls with adjusted odds ratios of 1.15 (95% CI, 1.02-1.30; P < 0.05) and 1.16 (95% CI, 1.04-1.31; P < 0.05), respectively. The use of oral contraceptives potentially modifies anterior cruciate ligament injury risk in young women. Despite reports that athletes, who are more prone to anterior cruciate ligament injury, use oral contraceptives at about twice the rate of nonathletes, these data suggest that women ages 15-19 yr undergoing anterior cruciate ligament reconstruction used oral contraceptives at a lower rate than the general population.

  16. Evaluation of static and dynamic balance in athletes with anterior cruciate ligament injury - A controlled study.

    PubMed

    Fernandes, Tiago Lazzaretti; Felix, Ellen Cristina Rodrigues; Bessa, Felipe; Luna, Natália Ms; Sugimoto, Dai; Greve, Júlia Maria D'Andrea; Hernandez, Arnaldo José

    2016-08-01

    Anterior cruciate ligament injury leads to adaptive responses to maintain postural control. However, there is no consensus regarding whether leg dominance also affects postural control in athletes with anterior cruciate ligament injury. The purpose of this study was to evaluate dynamic and static postural control among athletes with and without anterior cruciate ligament injury to the dominant leg. Twenty-eight athletes, twenty-one males and seven females aged 15-45 years, were allocated to one of two groups: the anterior cruciate ligament injury group (26±3 years) or the control group without anterior cruciate ligament injury (25±6.5 years). All subjects performed one legged stance tests under eyes open and eyes closed conditions and squat and kick movement tests using a postural control protocol (AccuSwayPlus force platform, Massachusetts). The center of pressure displacement and speed were measured by the force platform. In addition, the distance traveled on the single-leg hop test was assessed as an objective measure of function. Significantly greater mediolateral sway was found under the eyes closed condition (p=0.04) and during squat movement (p=0.01) in the anterior cruciate ligament injury group than in the control group. Analysis of the single-leg hop test results showed no difference between the groups (p=0.73). Athletes with anterior cruciate ligament injury had greater mediolateral displacement of the center of pressure toward the dominant leg under the eyes closed condition and during squat movement compared to control athletes.

  17. Increasing posterior tibial slope does not raise anterior cruciate ligament strain but decreases tibial rotation ability.

    PubMed

    Nelitz, Manfred; Seitz, Andreas M; Bauer, Jasmin; Reichel, Heiko; Ignatius, Anita; Dürselen, Lutz

    2013-03-01

    It was investigated whether the strain of the anterior cruciate ligament and tibial kinematics are affected by increasing posterior tibial slope. 9 human cadaveric knee joints were passively moved between full extension and 120° flexion in a motion and loading simulator under various loading conditions and at 0°, 5°, 10° and 15° posterior tibial slope angles. The anterior cruciate ligament strain and the tibial rotation angle were registered. To assess the influence of posterior tibial slope on the anterior cruciate ligament strain at a fixed flexion angle the anterior cruciate ligament strain was recorded at three different flexion angles of 0°, 30° and 90° while continuously increasing the osteotomy angle from 5° to 15°. The anterior cruciate ligament strain was either not affected by the posterior tibial slope angle or, in some load cases, was decreased for increasing posterior tibial slope (P<0.05). There was a significant decrease of tibial rotation when the posterior tibial slope was increased to 15° for many of the load cases tested (P<0.05). The mean maximum decrease was from 17.4° (SD 5.7°) to 11.2° (SD 4.7°) observed for flexion-extension motion under 30N axial load in combination with an internal rotation moment. The hypothesis that increasing posterior tibial slope results in higher anterior cruciate ligament strain was not confirmed. However, knee kinematics were affected in terms of a reduced tibial rotation. From a biomechanical point of view the data do not support the efficacy of sagittal osteotomies as performed to stabilize anterior cruciate ligament deficient knees. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Awareness of Deaf Sign Language and Gang Signs.

    ERIC Educational Resources Information Center

    Smith, Cynthia; Morgan, Robert L.

    There have been increasing incidents of innocent people who use American Sign Language (ASL) or another form of sign language being victimized by gang violence due to misinterpretation of ASL hand formations. ASL is familiar to learners with a variety of disabilities, particularly those in the deaf community. The problem is that gang members have…

  19. Planning Sign Languages: Promoting Hearing Hegemony? Conceptualizing Sign Language Standardization

    ERIC Educational Resources Information Center

    Eichmann, Hanna

    2009-01-01

    In light of the absence of a codified standard variety in British Sign Language and German Sign Language ("Deutsche Gebardensprache") there have been repeated calls for the standardization of both languages primarily from outside the Deaf community. The paper is based on a recent grounded theory study which explored perspectives on sign…

  20. Signs of Change: Contemporary Attitudes to Australian Sign Language

    ERIC Educational Resources Information Center

    Slegers, Claudia

    2010-01-01

    This study explores contemporary attitudes to Australian Sign Language (Auslan). Since at least the 1960s, sign languages have been accepted by linguists as natural languages with all of the key ingredients common to spoken languages. However, these visual-spatial languages have historically been subject to ignorance and myth in Australia and…

  1. Planning Sign Languages: Promoting Hearing Hegemony? Conceptualizing Sign Language Standardization

    ERIC Educational Resources Information Center

    Eichmann, Hanna

    2009-01-01

    In light of the absence of a codified standard variety in British Sign Language and German Sign Language ("Deutsche Gebardensprache") there have been repeated calls for the standardization of both languages primarily from outside the Deaf community. The paper is based on a recent grounded theory study which explored perspectives on sign…

  2. In vivo posterior cruciate ligament elongation in running activity after anatomic and non-anatomic anterior cruciate ligament reconstruction.

    PubMed

    Tang, Jing; Thorhauer, Eric; Bowman, Karl; Fu, Freddie H; Tashman, Scott

    2017-04-01

    The goals of this study were to (1) investigate the in vivo elongation behaviour of the posterior cruciate ligament (PCL) during running in the uninjured knee and (2) evaluate changes in PCL elongation during running after anatomic or non-anatomic anterior cruciate ligament (ACL) reconstruction. Seventeen unilateral ACL-injured subjects were recruited after undergoing anatomic (n = 9) or non-anatomic (n = 8) ACL reconstruction. Bilateral high-resolution CT scans were obtained to produce 3D models. Anterolateral (AL) and posteromedial (PM) bundles insertion sites of the PCL were identified on the 3D CT scan reconstructions. Dynamic knee function was assessed during running using a dynamic stereo X-ray (DSX) system. The lengths of the AL and PM bundles were estimated from late swing through mid-stance. The contralateral knees served as normal controls. Control knees demonstrated a slight decrease in AL bundle and a significant decrease in PM bundle length following foot strike. Length and elongation patterns of the both bundles of the PCL in the anatomic ACL reconstruction group were similar to the controls. However, the change in dynamic PCL length was significantly greater in the non-anatomic group than in the anatomic reconstruction group after foot strike (p < 0.05). The AL bundle length decreased slightly, and the PM bundle length significantly decreased after foot strike during running in uninjured knees. Anatomic ACL reconstruction maintained normal PCL elongation patterns more effectively than non-anatomic ACL reconstruction during high-demand, functional loading. These results support the use of anatomic ACL reconstruction to achieve normal knee function in high-demand activities. Case-control study, Level III.

  3. Quadriceps Strength and Endurance After Posterior Cruciate Ligament Tears Versus Matched Group With Anterior Cruciate Ligament Tears.

    PubMed

    Lee, Dae-Hee; Han, Seung-Beom; Lee, Jin-Hyuck; Lee, Seok-Joo; Suh, Dong-Won; Jeong, Hye-Jin

    2015-06-01

    This study was designed to compare the preoperative strengths and endurances of the quadriceps and hamstring muscles in patients with anterior cruciate ligament (ACL) versus posterior cruciate ligament (PCL) tears. Quadriceps and hamstring muscle strength and endurance were compared between 20 prospectively enrolled patients with isolated PCL tears and a retrospective, matched control group of 20 patients with isolated ACL tears. The maximal torque (60°/s) and total work (180°/s) of the quadriceps and hamstring were evaluated with an isokinetic testing device. Total work (1,094.4 ± 505.8 J v 797.5 ± 332.7 J, P = .035) and peak torque (129.9 ± 56.2 N ∙ m v 98.2 ± 37.4 N ∙ m, P = .046) of the quadriceps muscle on the involved side were higher in the PCL tear group than in the ACL tear group. However, there were no significant differences between the PCL tear group and ACL tear group in hamstring muscle strength (45.8 ± 42.3 N ∙ m and 46.0 ± 24.4 N ∙ m, respectively; P = .940) and endurance (429.3 ± 238.9 J and 382.4 ± 256.1 J, respectively; P = .574) on the involved side. The strength and endurance of the quadriceps muscle of the injured limb were greater after PCL tears than after ACL tears. However, there were no significant between-group differences in hamstring muscle strength and endurance on the involved side. Level III, retrospective comparative study. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. Multiple Looping Technique for Tibial Fixation in Posterior Cruciate Ligament Reconstruction of the Knee

    PubMed Central

    Noh, Jung Ho; Yoon, Kyoung Ho; Song, Sang Jun; Roh, Young Hak; Lee, Jae Woo

    2015-01-01

    The outcomes of posterior cruciate ligament reconstruction may be negatively affected by insufficient tibial tunnel fixation due to relatively lower bone density of the proximal tibia. We introduce a new technique of tibial fixation for posterior cruciate ligament reconstruction using free tendon Achilles allograft that is less affected by the bone density of the tibial metaphysis. PMID:25973367

  5. Avulsion fracture of the posterior cruciate ligament in an uncommon location associated with distal injury to the patellar ligament.

    PubMed

    E Albuquerque, Rodrigo Pires; da Palma, Idemar Monteiro; Cobra, Hugo; de Paula Mozella, Alan; Vaques, Victor

    2015-01-01

    Avulsion fractures of the posterior cruciate ligament in unusual locations are rare injuries. We report the first case in the literature of an avulsion fracture of the posterior cruciate ligament associated with distal injury to the patellar ligament. The aim of this study was to present a novel case, the therapy used and the clinical follow-up.

  6. The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) Research on Anterior Cruciate Ligament Reconstruction and Orthopaedic Practice.

    PubMed

    Lynch, T Sean; Parker, Richard D; Patel, Ronak M; Andrish, Jack T; Spindler, Kurt P; Amendola, Annunziata; Brophy, Robert H; Dunn, Warren R; Flanigan, David C; Huston, Laura J; Jones, Morgan H; Kaeding, Christopher C; Marx, Robert G; Matava, Matthew J; McCarty, Eric C; Pedroza, Angela D; Reinke, Emily K; Wolf, Brian R; Wright, Rick W

    2015-03-01

    With an estimated 200,000 anterior cruciate ligament reconstructions performed annually in the United States, there is an emphasis on determining patient-specific information to help educate patients on expected clinically relevant outcomes. The Multicenter Orthopaedic Outcomes Network consortium was created in 2002 to enroll and longitudinally follow a large population cohort of anterior cruciate ligament reconstructions. The study group has enrolled >4,400 anterior cruciate ligament reconstructions from seven institutions to establish the large level I prospective anterior cruciate ligament reconstruction outcomes cohort. The group has become more than a database with information regarding anterior cruciate ligament injuries; it has helped to establish a new benchmark for conducting multicenter, multisurgeon orthopaedic research. The changes in anterior cruciate ligament reconstruction practice resulting from the group include the use of autograft for high school, college, and competitive athletes in their primary anterior cruciate ligament reconstructions. Other modifications include treatment options for meniscus and cartilage injuries, as well as lifestyle choices made after anterior cruciate ligament reconstruction.

  7. Secular chaotic dynamics in hierarchical quadruple systems, with applications to hot Jupiters in stellar binaries and triples

    NASA Astrophysics Data System (ADS)

    Hamers, Adrian S.; Lai, Dong

    2017-09-01

    Hierarchical quadruple systems arise naturally in stellar binaries and triples that harbour planets. Examples are hot Jupiters (HJs) in stellar triple systems, and planetary companions to HJs in stellar binaries. The secular dynamical evolution of these systems is generally complex, with secular chaotic motion possible in certain parameter regimes. The latter can lead to extremely high eccentricities and, therefore, strong interactions such as efficient tidal evolution. These interactions are believed to play an important role in the formation of HJs through high-eccentricity migration. Nevertheless, a deeper understanding of the secular dynamics of these systems is still lacking. Here, we study in detail the secular dynamics of a special case of hierarchical quadruple systems in either the '2+2' or '3+1' configurations. We show how the equations of motion can be cast in a form representing a perturbed hierarchical three-body system, in which the outer orbital angular-momentum vector is precessing steadily around a fixed axis. In this case, we show that eccentricity excitation can be significantly enhanced when the precession period is comparable to the Lidov-Kozai oscillation time-scale of the inner orbit. This arises from an induced large mutual inclination between the inner and outer orbits driven by the precession of the outer orbit, even if the initial mutual inclination is small. We present a simplified semi-analytic model that describes the latter phenomenon.

  8. Light and Electrically Induced Phase Segregation and Its Impact on the Stability of Quadruple Cation High Bandgap Perovskite Solar Cells.

    PubMed

    Duong, The; Mulmudi, Hemant Kumar; Wu, YiLiang; Fu, Xiao; Shen, Heping; Peng, Jun; Wu, Nandi; Nguyen, Hieu T; Macdonald, Daniel; Lockrey, Mark; White, Thomas P; Weber, Klaus; Catchpole, Kylie

    2017-08-16

    Perovskite material with a bandgap of 1.7-1.8 eV is highly desirable for the top cell in a tandem configuration with a lower bandgap bottom cell, such as a silicon cell. This can be achieved by alloying iodide and bromide anions, but light-induced phase-segregation phenomena are often observed in perovskite films of this kind, with implications for solar cell efficiency. Here, we investigate light-induced phase segregation inside quadruple-cation perovskite material in a complete cell structure and find that the magnitude of this phenomenon is dependent on the operating condition of the solar cell. Under short-circuit and even maximum power point conditions, phase segregation is found to be negligible compared to the magnitude of segregation under open-circuit conditions. In accordance with the finding, perovskite cells based on quadruple-cation perovskite with 1.73 eV bandgap retain 94% of the original efficiency after 12 h operation at the maximum power point, while the cell only retains 82% of the original efficiency after 12 h operation at the open-circuit condition. This result highlights the need to have standard methods including light/dark and bias condition for testing the stability of perovskite solar cells. Additionally, phase segregation is observed when the cell was forward biased at 1.2 V in the dark, which indicates that photoexcitation is not required to induce phase segregation.

  9. Epi-detected quadruple-modal nonlinear optical microscopy for label-free imaging of the tooth

    NASA Astrophysics Data System (ADS)

    Wang, Zi; Zheng, Wei; Stephen Hsu, Chin-Ying; Huang, Zhiwei

    2015-01-01

    We present an epi-detected quadruple-modal nonlinear optical microscopic imaging technique (i.e., coherent anti-Stokes Raman scattering (CARS), second-harmonic generation (SHG), third-harmonic generation (THG), and two-photon excited fluorescence (TPEF)) based on a picosecond (ps) laser-pumped optical parametric oscillator system for label-free imaging of the tooth. We demonstrate that high contrast ps-CARS images covering both the fingerprint (500-1800 cm-1) and high-wavenumber (2500-3800 cm-1) regions can be acquired to uncover the distributions of mineral and organic biomaterials in the tooth, while high quality TPEF, SHG, and THG images of the tooth can also be acquired under ps laser excitation without damaging the samples. The quadruple-modal nonlinear microscopic images (CARS/SHG/THG/TPEF) acquired provide better understanding of morphological structures and biochemical/biomolecular distributions in the dentin, enamel, and the dentin-enamel junction of the tooth without labeling, facilitating optical diagnosis and characterization of the tooth in dentistry.

  10. Tetracycline- and furazolidone-containing quadruple regimen as rescue treatment for Helicobacter pylori infection: a single center retrospective study.

    PubMed

    Zhang, Yuemiao; Gao, Wen; Cheng, Hong; Zhang, Xuezhi; Hu, Fulian

    2014-10-01

    Eradication rate of Helicobacter pylori decreases worldwide, while antibiotics resistance rates of H. pylori increase rapidly in recent years. In most cases, H. pylori would be resistant to clarithromycin, metronidazole, and quinolone if these antibiotics had been used as component of eradication regimen. H. pylori strains resistant to both tetracycline and furazolidone are rare. The aim of our study was to evaluate efficacy and side effects of tetracycline- and furazolidone-containing quadruple regimen as rescue treatment. Patients with H. pylori infection given RTFB (rabeprazole 20 mg b.i.d. + tetracycline 750 mg b.i.d. +furazolidone 100 mg b.i.d. + colloidal bismuth subcitrate 200 mg b.i.d.) regimen for 14 days as rescue treatment were enrolled in this retrospective study. Eradication status was evaluated by (13) C-urea breath test, and side effects were collected. One hundred and nine patients were enrolled. The intention-to-treat eradication rate was 91.74% (100 of 109) and 95.24% (100 of 105) per protocol analysis. Side effects including fever, palpitation, and skin rash occurred in 35 patients. The 14-day tetracycline- and furazolidone-containing quadruple regimen can achieve a relatively high eradication rate as rescue treatment. Some side effects including fever may occur during the treatment. © 2014 John Wiley & Sons Ltd.

  11. Epi-detected quadruple-modal nonlinear optical microscopy for label-free imaging of the tooth

    SciTech Connect

    Wang, Zi; Zheng, Wei; Huang, Zhiwei; Stephen Hsu, Chin-Ying

    2015-01-19

    We present an epi-detected quadruple-modal nonlinear optical microscopic imaging technique (i.e., coherent anti-Stokes Raman scattering (CARS), second-harmonic generation (SHG), third-harmonic generation (THG), and two-photon excited fluorescence (TPEF)) based on a picosecond (ps) laser-pumped optical parametric oscillator system for label-free imaging of the tooth. We demonstrate that high contrast ps-CARS images covering both the fingerprint (500–1800 cm{sup −1}) and high-wavenumber (2500–3800 cm{sup −1}) regions can be acquired to uncover the distributions of mineral and organic biomaterials in the tooth, while high quality TPEF, SHG, and THG images of the tooth can also be acquired under ps laser excitation without damaging the samples. The quadruple-modal nonlinear microscopic images (CARS/SHG/THG/TPEF) acquired provide better understanding of morphological structures and biochemical/biomolecular distributions in the dentin, enamel, and the dentin-enamel junction of the tooth without labeling, facilitating optical diagnosis and characterization of the tooth in dentistry.

  12. Photonic generation of frequency quadrupling signal for millimeter-wave communication utilizing three parallel Mach-Zehnder modulators

    NASA Astrophysics Data System (ADS)

    Mu, Hang; Liu, Yanjun; Wang, Daobin; Lei, Jingli; Hou, Shanglin

    2017-02-01

    In this work, we propose a new scheme of generating high quality frequency quadrupling signal for millimeter-wave wireless communication system. The frequency quadrupling scheme is achieved by using three parallel Mach-Zehnder modulators (MZMs) and an optical phase shifter. The first two MZMs are driven by the RF signals to operate at the maximum transmission point. The third MZM is operated with no RF signal and an extra π-phase difference is introduced for it by the optical phase shifter. The advantage of the proposed scheme is that the optical carrier and the fourth optical sideband can be suppressed simultaneously. The performance of proposed scheme is investigated theoretically and evaluated by simulations. Numerical results show that the radio frequency spurious suppression ratio (RFSSR) higher than 44.18 dB and the optical sideband suppression ratio (OSSR) higher than 21 dB can be obtained without optical filter when the extinction ratio (ER) of the MZM is 30 dB. The impact of the non-ideal RF driven voltage and phase difference of RF driven signal applied to the first two sub-MZMs on OSSR and RFSSR is also discussed and analyzed.

  13. Symmetry in Sign Language Poetry

    ERIC Educational Resources Information Center

    Sutton-Spence, Rachel; Kaneko, Michiko

    2007-01-01

    This paper considers the range of ways that sign languages use geometric symmetry temporally and spatially to create poetic effect. Poets use this symmetry in sign language art to highlight duality and thematic contrast, and to create symbolic representations of beauty, order and harmony. (Contains 8 tables, 14 figures and 6 notes.)

  14. Speech Cues and Sign Stimuli.

    ERIC Educational Resources Information Center

    Mattingly, Ignatius G.

    Parallels between sign stimuli and speech cues suggest some interesting speculations about the origins of language. Speech cues may belong to the class of human sign stimuli which, as in animal behavior, may be the product of an innate releasing mechanism. Prelinguistic speech for man may have functioned as a social-releaser system. Human language…

  15. Kinematic Parameters of Signed Verbs

    ERIC Educational Resources Information Center

    Malaia, Evie; Wilbur, Ronnie B.; Milkovic, Marina

    2013-01-01

    Purpose: Sign language users recruit physical properties of visual motion to convey linguistic information. Research on American Sign Language (ASL) indicates that signers systematically use kinematic features (e.g., velocity, deceleration) of dominant hand motion for distinguishing specific semantic properties of verb classes in production…

  16. The Typology of Literary Signs

    ERIC Educational Resources Information Center

    Browne, Robert M.

    1971-01-01

    Discusses the usefulness for literary studies of some of Pierce's key terms and concepts: icon, index, symbol, image, and diagram. Argues that Pierce's description of signs may be usefully applied to literary signs and particularly to the problem of symbolism. Charts. (RB)

  17. Keresan Pueblo Indian Sign Language.

    ERIC Educational Resources Information Center

    Kelley, Walter P.; McGregor, Tony L.

    This paper describes the use of Keresan Pueblo Indian Sign Language (KPISL) in one small, Keresan-speaking pueblo in central New Mexico, where 15 out of 650 tribal members have severe to profound hearing loss (twice the national average). KPISL did not originate for the same purposes as the Plains Indian Sign Language, (PISL) which was developed…

  18. NUHOMS{reg_sign} update

    SciTech Connect

    Rich, N.

    1995-12-31

    NUHOMS{reg_sign} is the dry spent fuel storage and transportation technology selected to date by the majority of commercial nuclear utilities. The author first gives a system overview of the NUHOMS{reg_sign}. Next she discusses the project status and licensing status. She closes with an update of the multi-purpose canister.

  19. Activation Cascading in Sign Production

    ERIC Educational Resources Information Center

    Navarrete, Eduardo; Peressotti, Francesca; Lerose, Luigi; Miozzo, Michele

    2017-01-01

    In this study, we investigated how activation unfolds in sign production by examining whether signs that are not produced have their representations activated by semantics (cascading of activation). Deaf signers were tested with a picture-picture interference task. Participants were presented with pairs of overlapping pictures and named the green…

  20. Symmetry in Sign Language Poetry

    ERIC Educational Resources Information Center

    Sutton-Spence, Rachel; Kaneko, Michiko

    2007-01-01

    This paper considers the range of ways that sign languages use geometric symmetry temporally and spatially to create poetic effect. Poets use this symmetry in sign language art to highlight duality and thematic contrast, and to create symbolic representations of beauty, order and harmony. (Contains 8 tables, 14 figures and 6 notes.)

  1. Activation Cascading in Sign Production

    ERIC Educational Resources Information Center

    Navarrete, Eduardo; Peressotti, Francesca; Lerose, Luigi; Miozzo, Michele

    2017-01-01

    In this study, we investigated how activation unfolds in sign production by examining whether signs that are not produced have their representations activated by semantics (cascading of activation). Deaf signers were tested with a picture-picture interference task. Participants were presented with pairs of overlapping pictures and named the green…

  2. Signing Apes and Evolving Linguistics.

    ERIC Educational Resources Information Center

    Stokoe, William C.

    Linguistics retains from its antecedents, philology and the study of sacred writings, some of their apologetic and theological bias. Thus it has not been able to face squarely the question how linguistic function may have evolved from animal communication. Chimpanzees' use of signs from American Sign Language forces re-examination of language…

  3. Arabic Sign Language: A Perspective

    ERIC Educational Resources Information Center

    Abdel-Fattah, M. A.

    2005-01-01

    Sign language in the Arab World has been recently recognized and documented. Many efforts have been made to establish the sign language used in individual countries, including Jordan, Egypt, Libya, and the Gulf States, by trying to standardize the language and spread it among members of the Deaf community and those concerned. Such efforts produced…

  4. Arabic Sign Language: A Perspective

    ERIC Educational Resources Information Center

    Abdel-Fattah, M. A.

    2005-01-01

    Sign language in the Arab World has been recently recognized and documented. Many efforts have been made to establish the sign language used in individual countries, including Jordan, Egypt, Libya, and the Gulf States, by trying to standardize the language and spread it among members of the Deaf community and those concerned. Such efforts produced…

  5. Genome-wide Analyses Identifies MEN1 and MAX Mutations and a Neuroendocrine-like Molecular Heterogeneity in Quadruple WT GIST.

    PubMed

    Pantaleo, Maria A; Urbini, Milena; Indio, Valentina; Ravegnini, Gloria; Nannini, Margherita; De Luca, Matilde; Tarantino, Giuseppe; Angelini, Sabrina; Gronchi, Alessandro; Vincenzi, Bruno; Grignani, Giovanni; Colombo, Chiara; Fumagalli, Elena; Gatto, Lidia; Saponara, Maristella; Ianni, Manuela; Paterini, Paola; Santini, Donatella; Pirini, Maria Giulia; Ceccarelli, Claudio; Altimari, Annalisa; Gruppioni, Elisa; Renne, Salvatore L; Collini, Paola; Stacchiotti, Silvia; Brandi, Giovanni; Casali, Paolo G; Pinna, Antonio D; Astolfi, Annalisa; Biasco, Guido

    2017-01-27

    Quadruple wild-type (WT) gastrointestinal stromal tumors (GIST) is a genomic subgroup lacking KIT/PDGFRA/RAS pathways mutations, with an intact succinate dehydrogenase (SDH) complex. The aim of this work is to perform a wide comprehensive genomic study on quadruple WT GIST to improve the characterization of these patients. We selected 14 clinical cases of quadruple WT GIST, of which nine cases showed sufficient DNA quality for Whole Exome Sequencing (WES). NF1 alterations were identified directly by WES. Gene expression from Whole Transcriptome Sequencing (WTS) and miRNA profiling were performed using fresh-frozen, quadruple WT GIST tissue specimens and compared to SDH and KIT/PDGFRAmutant GIST. WES identified an average of 18 somatic mutations per sample. The most relevant somatic oncogenic mutations identified were in TP53, MEN1, MAX, FGF1R, CHD4 and CTDNN2. No somatic alterations in NF1 were identified in the analyzed cohort. A total of 247 mRNA transcripts and 66 miRs were differentially expressed specifically in quadruple WT GIST. Overexpression of specific molecular markers (COL22A1, CALCRL) and genes involved in neural and neuroendocrine lineage (ASCL1, Family B GPCRs) were detected and further supported by predicted miRNA target analysis. Quadruple WT GIST show a specific genetic signature that deviates significantly from that of KIT/PDGFRA-mutant and SDH-mutant GIST. Mutations in MEN1 and MAX genes, a neural-committed phenotype and up-regulation of the master neuroendocrine regulator ASCL1, support a genetic similarity with neuroendocrine tumors, with whom they share also the great variability in oncogenic driver genes.

  6. Specialized core stability exercise: a neglected component of anterior cruciate ligament rehabilitation programs.

    PubMed

    Shi, Dong-liang; Li, Jing-long; Zhai, Hua; Wang, Hui-fang; Meng, Han; Wang, Yu-bin

    2012-01-01

    The incidence of anterior cruciate ligament injury has continued to increase over the last two decades. This injury is associated with abnormal gait patterns and osteoarthritis of the knee. In order to accelerate recovery, the introduction of core stability exercises into the rehabilitation program is proposed. The theory underlying the use of core stability exercise relates to the neuroplasticity that follows anterior cruciate ligament injury. Neuroplasticity in lumbar, thoracic, cervical and brain regions diminish activation in the contralateral thalamus, postparietal cortex, SM1, basal ganglia-external globus pallidus, SII, cingulated motor area, premotor cortex, and in the ipsilateral cerebellum and SM1 and increase activation in pre-SMA, SIIp, and pITG, indicating modifications of the CNS. In addition, the neuroplasticity can regulate the movement of trunk muscles, for example, sternocleidomastoid and lower trapezius muscles. Core stability also demonstrates a negative correlation with the incidence of anterior cruciate ligament injury. Therefore, we propose that core stability exercises may improve the rehabilitation of anterior cruciate ligament injuries by increasing core motor control. Specialized core stability exercises aimed at rectifying biomechanical problems associated with gait and core stability may play a key role in the management of anterior cruciate ligament injury.

  7. Computed tomographic evaluation of the canine intercondylar notch in normal and cruciate deficient stifles.

    PubMed

    Lewis, B A; Allen, D A; Henrikson, T D; Lehenbauer, T W

    2008-01-01

    In the human and veterinary orthopaedic literature it has been implied that intercondylar notch stenosis is a mechanical factor in cranial cruciate ligament rupture and intraarticular graft failure. The patients in this study were classified as normal (32), unilateral cruciate rupture (23), or bilateral cruciate rupture (17). The dogs were placed under general anaesthesia and both stifles were scanned via computed tomography (CT) as previously described. Three CT slices at predetermined levels were evaluated within the notch. Measurements included opening notch angle, notch width and height, condyle width, and notch width index (notch width/condyle width) at two different heights within the notch. Intercondylar notch measurements at the most cranial extent were significantly more narrow in unilateral and bilaterally affected stifles when compared to the normal population. Significant differences were noted in the opening notch angle (ONA), notch width index (NWI), NWI at two thirds notch height (NWI2/3), and tibial slope index (TSI). No significant differences were noted between unilateral and bilateral affected stifles. Increased mechanical contact of the cranial cruciate ligament with a stenotic intercondylar notch may predispose the ligament to mechanical wear and structural weakening. Intercondylar notch measurements have been used as a tool to predict the risk of anterior cruciate ligament injury in young human athletes, and to assess the risk factors for intra-articular graft replacements. Our findings may be useful in developing similar predictive models using stifle CT scans.

  8. Effects of postoperative immobilization on the reconstructed anterior cruciate ligament. An experimental study in rabbits.

    PubMed

    Muneta, T; Yamamoto, H; Takakuda, K; Sakai, H; Furuya, K

    1993-01-01

    To investigate the effects of postoperative immobilization and limited motion on reconstructed anterior cruciate ligaments, 28 rabbits received an anterior cruciate ligament reconstruction using autogenous Achilles tendon and were then divided into three groups: fully immobilized, 4 weeks immobilized, and limited motion. Two rabbits from each group were evaluated macroscopically, histologically and microangiographically at 4-week intervals until 12 weeks postoperatively. An additional six rabbits in the 4 weeks immobilized and limited motion groups were studied biomechanically at 12 weeks postoperatively. Macroscopically, both immobilized groups showed more proliferation of the infrapatellar fat pad, which was adherent to the reconstructed anterior cruciate ligament. Histology revealed more rapid regeneration of reconstructed anterior cruciate ligaments in the limited motion group, with no findings of necrosis in the mid-substance. Microangiography indicated faster normalization of vascularity in the limited motion group. The biomechanical study showed no significant difference in laxity between the 4 weeks immobilized and limited motion groups. The graft stiffness and maximum load to failure were greater for the limited motion group, although the increase was not statistically significant. The histologic and microangiographic results from the limited number of animals in this study support limited postoperative motion in the anterior cruciate ligament reconstructed knee. However, there were no differences in terms of the biomechanical parameters at 12 weeks postoperatively between the immobilized and limited motion treatment modes.

  9. A review of ultrasonographic methods for the assessment of the anterior cruciate ligament in patients with knee instability - diagnostics using a posterior approach.

    PubMed

    Poboży, Tomasz; Kielar, Maciej

    2016-09-01

    The purpose of the study was to improve the ultrasonographic assessment of the anterior cruciate ligament by an inclusion of a dynamic element. The proposed functional modification aims to restore normal posterior cruciate ligament tension, which is associated with a visible change in the ligament shape. This method reduces the risk of an error resulting from subjectively assessing the shape of the posterior cruciate ligament. It should be also emphasized that the method combined with other ultrasound anterior cruciate ligament assessment techniques helps increase diagnostic accuracy. Ultrasonography is used as an adjunctive technique in the diagnosis of anterior cruciate ligament injury. The paper presents a sonographic technique for the assessment of suspected anterior cruciate ligament insufficiency supplemented by the use of a dynamic examination. This technique can be recommended as an additional procedure in routine ultrasound diagnostics of anterior cruciate ligament injuries. Supplementing routine ultrasonography with the dynamic assessment of posterior cruciate ligament shape changes in patients with suspected anterior cruciate ligament injury reduces the risk of subjective errors and increases diagnostic accuracy. This is important especially in cases of minor anterior knee instability and bilateral anterior knee instability. An assessment of changes in posterior cruciate ligament using a dynamic ultrasound examination effectively complements routine sonographic diagnostic techniques for anterior cruciate ligament insufficiency.

  10. A review of ultrasonographic methods for the assessment of the anterior cruciate ligament in patients with knee instability – diagnostics using a posterior approach

    PubMed Central

    Kielar, Maciej

    2016-01-01

    Aim The purpose of the study was to improve the ultrasonographic assessment of the anterior cruciate ligament by an inclusion of a dynamic element. The proposed functional modification aims to restore normal posterior cruciate ligament tension, which is associated with a visible change in the ligament shape. This method reduces the risk of an error resulting from subjectively assessing the shape of the posterior cruciate ligament. It should be also emphasized that the method combined with other ultrasound anterior cruciate ligament assessment techniques helps increase diagnostic accuracy. Methods Ultrasonography is used as an adjunctive technique in the diagnosis of anterior cruciate ligament injury. The paper presents a sonographic technique for the assessment of suspected anterior cruciate ligament insufficiency supplemented by the use of a dynamic examination. This technique can be recommended as an additional procedure in routine ultrasound diagnostics of anterior cruciate ligament injuries. Results Supplementing routine ultrasonography with the dynamic assessment of posterior cruciate ligament shape changes in patients with suspected anterior cruciate ligament injury reduces the risk of subjective errors and increases diagnostic accuracy. This is important especially in cases of minor anterior knee instability and bilateral anterior knee instability. Conclusions An assessment of changes in posterior cruciate ligament using a dynamic ultrasound examination effectively complements routine sonographic diagnostic techniques for anterior cruciate ligament insufficiency. PMID:27679732

  11. Modeling the Radio Emission from Cyg OB2 No. 5: A Quadruple System?

    NASA Astrophysics Data System (ADS)

    Kennedy, M.; Dougherty, S. M.; Fink, A.; Williams, P. M.

    2010-02-01

    literature suggests reflex motion of the binary due to Star C, for which a mass of 23+22 -14 M sun is deduced. The natures of NE and Star D are also examined. If NE is a WCR, as suggested by other authors, then the required mass-loss rate is an order of magnitude higher than expected for an early B-type dwarf, and only just consistent with a supergiant. This raises the question of NE as a WCR, but its non-thermal luminosity is consistent with a WCR and a comparison of reddening between Cyg OB2 No. 5 and Star D do not rule out an association, implying Cyg OB2 No. 5 is a quadruple system. Pursuing alternative models for NE, such as an unassociated background source, would require very challenging observations.

  12. Advanced in-line metrology strategy for self-aligned quadruple patterning

    NASA Astrophysics Data System (ADS)

    Chao, Robin; Breton, Mary; L'herron, Benoit; Mendoza, Brock; Muthinti, Raja; Nelson, Florence; De La Pena, Abraham; Le, Fee li; Miller, Eric; Sieg, Stuart; Demarest, James; Gin, Peter; Wormington, Matthew; Cepler, Aron; Bozdog, Cornel; Sendelbach, Matthew; Wolfling, Shay; Cardinal, Tom; Kanakasabapathy, Sivananda; Gaudiello, John; Felix, Nelson

    2016-03-01

    Self-Aligned Quadruple Patterning (SAQP) is a promising technique extending the 193-nm lithography to manufacture structures that are 20nm half pitch or smaller. This process adopts multiple sidewall spacer image transfers to split a rather relaxed design into a quarter of its original pitch. Due to the number of multiple process steps required for the pitch splitting in SAQP, the process error propagates through each deposition and etch, and accumulates at the final step into structure variations, such as pitch walk and poor critical dimension uniformity (CDU). They can further affect the downstream processes and lower the yield. The impact of this error propagation becomes significant for advanced technology nodes when the process specifications of device design CD requirements are at nanometer scale. Therefore, semiconductor manufacturing demands strict in-line process control to ensure a high process yield and improved performance, which must rely on precise measurements to enable corrective actions and quick decision making for process development. This work aims to provide a comprehensive metrology solution for SAQP. During SAQP process development, the challenges in conventional in-line metrology techniques start to surface. For instance, critical-dimension scanning electron microscopy (CDSEM) is commonly the first choice for CD and pitch variation control. However, it is found that the high aspect ratio at mandrel level processes and the trench variations after etch prevent the tool from extracting the true bottom edges of the structure in order to report the position shift. On the other hand, while the complex shape and variations can be captured with scatterometry, or optical CD (OCD), the asymmetric features, such as pitch walk, show low sensitivity with strong correlations in scatterometry. X-ray diffraction (XRD) is known to provide useful direct measurements of the pitch walk in crystalline arrays, yet the data analysis is influenced by the incoming

  13. MODELING THE RADIO EMISSION FROM Cyg OB2 NO. 5: A QUADRUPLE SYSTEM?

    SciTech Connect

    Kennedy, M.; Dougherty, S. M.; Fink, A.; Williams, P. M. E-mail: sean.dougherty@nrc.c E-mail: pmw@roe.ac.u

    2010-02-01

    from the literature suggests reflex motion of the binary due to Star C, for which a mass of 23{sup +22}{sub -14} M{sub sun} is deduced. The natures of NE and Star D are also examined. If NE is a WCR, as suggested by other authors, then the required mass-loss rate is an order of magnitude higher than expected for an early B-type dwarf, and only just consistent with a supergiant. This raises the question of NE as a WCR, but its non-thermal luminosity is consistent with a WCR and a comparison of reddening between Cyg OB2 No. 5 and Star D do not rule out an association, implying Cyg OB2 No. 5 is a quadruple system. Pursuing alternative models for NE, such as an unassociated background source, would require very challenging observations.

  14. Effects of Sign-Language Training on Untrained Sign Use for Single and Multiple Signing.

    ERIC Educational Resources Information Center

    Bucher, Bradley

    1983-01-01

    Two studies examined cross-modal transfer of sign language performance in 11 and 12 children (ages 6-17) with speech, language, or hearing disorders and mild to moderate retardation. Findings indicated that transfer from receptive to productive signing required explicit training, particularly of complex forms. (CL)

  15. Arthroscopic posterior cruciate ligament reconstruction with allograft versus autograft

    PubMed Central

    Sun, Xiujiang; Zhang, Jianfeng; Qu, Xiaoyi

    2015-01-01

    Introduction The aim of the study was to compare and analyze retrospectively the outcomes of arthroscopic posterior cruciate ligament reconstruction with autograft versus allograft. Material and methods Seventy-one patients who underwent arthroscopic posterior cruciate ligament reconstruction with an autograft or allograft met our inclusion criteria. There were 36 patients in the autograft group and 35 patients in the allograft group. All the patients were evaluated by physical examination and a functional ligament test. Comparative analysis was done in terms of operation time, incision length, fever time, postoperative infection rate, incidence of numbness and dysesthesia around the incision, as well as a routine blood test. Results The average follow-up of the autograft group was 3.2 ±0.2 years and that of the allograft group was 3.3 ±0.6 years; there was no significant difference (p > 0.05). No differences existed in knee range of motion, Lysholm scores, International Knee Documentation Committee standard evaluation form and Tegner activity score at final follow-up (p > 0.05), except that patients in the allograft group had a shorter operation time and incision length and a longer fever time (p < 0.05). We found a difference in posterior drawer test and KT-2000 arthrometer assessment (p < 0.05). The posterior tibia displacement averaged 3.8 ±1.5 mm in the autograft group and 4.8 ±1.7 mm in the allograft group (p < 0.05). The incidence of numbness and dysesthesia around the incision in the autograft group was higher than that in the allograft group (p < 0.05). There was no infection postoperatively. The white blood cells and neutrophils in the allograft group increased more than those in the autograft group postoperatively (p < 0.05). Conclusions Both groups of patients had satisfactory outcomes after the operation. However, in the instrumented posterior laxity test, the autograft gave better results than the allograft. No differences in functional scores

  16. Microvascular system of anterior cruciate ligament in dogs.

    PubMed

    Kobayashi, Shigeru; Baba, Hisatoshi; Uchida, Kenzo; Negoro, Kohei; Sato, Mituhiko; Miyazaki, Tsuyoshi; Nomura, Eiki; Murakami, Kaname; Shimizubata, Matsuyuki; Meir, Adam

    2006-07-01

    This study was done to investigate the microvascular system of anterior cruciate ligament (ACL) using dogs. The objective was to study the microvascular architecture and the status of the barrier function of the capillary wall in the ACL by using microangiogram, scanning (SEM), and transmission electron microscopy (TEM). The vascular system in the ACL has been intensively studied by a number of researchers, using several microangiographic techniques in dogs, rabbits, and humans. However, most of these microangiographic studies had significant shortcomings, including the lack of three-dimensional observations and function of the blood-joint barrier in the ACL. In this study, the microstructure of the ACL was examined using microangiogram, SEM, and TEM. We investigated the vasculature of the ACL with SEM of vascular corrosion casts. In addition, we examined the status of the barrier function of the capillary wall in the ACL using the protein tracer horseradish peroxidase (HRP). Feeding vessels of the ligament were predominantly coming from the synovial-derived vessels originating from the synovium attached to the ligament near the tibial and femoral bone insertions of the ACL. The anterior cruciate ligament was surrounded by synovium, which had abundant vessels. The branches of these synovial vessels were penetrating into the ligament and making the intrinsic vascular network. It was also ascertained under SEM that the perivascular space around the intrinsic vessels were communicating through the intrinsic ligament fiber bundles and the mesh-like synovial membrane. The capillaries in the ACL were all of the continuous type under TEM. The protein tracer that was injected into the joint space passed through the synovial membrane and entered into the capillary lumen in the ACL, but the tracer that was injected intravenously did not appear in the perivascular space. The existence of a blood-ACL barrier does not necessarily imply the existence of an ACL-blood barrier. We

  17. The fifty highest cited papers in anterior cruciate ligament injury.

    PubMed

    Vielgut, Ines; Dauwe, Jan; Leithner, Andreas; Holzer, Lukas A

    2017-07-01

    The anterior cruciate ligament (ACL) is one of the most common injured knee ligaments and at the same time, one of the most frequent injuries seen in the sport orthopaedic practice. Due to the clinical relevance of ACL injuries, numerous papers focussing on this topic including biomechanical-, basic science-, clinical- or animal studies, were published. The purpose of this study was to determine the most frequently cited scientific articles which address this subject, establish a ranking of the 50 highest cited papers and analyse them according to their characteristics. The 50 highest cited articles related to Anterior Cruciate Ligament Injury were searched in Thomson ISI Web of Science® by the use of defined search terms. All types of scientific papers with reference to our topic were ranked according to the absolute number of citations and analyzed for the following characteristics: journal title, year of publication, number of citations, citation density, geographic origin, article type and level of evidence. The 50 highest cited articles had up to 1624 citations. The top ten papers on this topic were cited 600 times at least. Most papers were published in the American Journal of Sports Medicine. The publication years spanned from 1941 to 2007, with the 1990s and 2000s accounting for half of the articles (n = 25). Seven countries contributed to the top 50 list, with the USA having by far the most contribution (n = 40). The majority of articles could be attributed to the category "Clinical Science & Outcome". Most of them represent a high level of evidence. Scientific articles in the field of ACL injury are highly cited. The majority of these articles are clinical studies that have a high level of evidence. Although most of the articles were published between 1990 and 2007, the highest cited articles in absolute and relative numbers were published in the early 1980s. These articles contain well established scoring- or classification systems. The

  18. [Skin signs in child abuse].

    PubMed

    Pau-Charles, I; Darwich-Soliva, E; Grimalt, R

    2012-03-01

    Child abuse is far more prevalent today than is generally recognized. Up to 90% of victims suffer physical abuse that can be observed in signs on the skin. Dermatologists are particularly qualified to identify these signs and distinguish them from other conditions that can mimic abuse. This review covers the signs of child abuse that can be observed on the skin. We discuss clues that can help differentiate between lesions caused by abuse and those that are accidental, and we describe the skin conditions that mimic physical abuse.

  19. [Hemiplegia with two Babinski's sign].

    PubMed

    Leon-Sarmiento, Fidias E; Montoya, María C; Camacho, John E; Bayona-Prieto, Jaime; Bayona, Edgardo

    2007-01-01

    Neurological signs and symptoms are very important to establish a correct neurological diagnosis. We present here a Colombian female patient, 60 years-old, who had ischaemic stroke in the left cerebral media artery. It produced right hemiplegia, motor aphasia, "central" facial palsy and atrophy of right platysma muscle. This latter finding, described originally by Joseph Babinski as "The Babinski Sign" was observed only two years and seven months after the ictus even when she had, previously, been evaluated by several neurologists. The underdiagnosis of clinical signs like the one described here may lead to erroneous diagnosis that will, ultimately, affect neurorehabilitation measures.

  20. Hush sign: a new clinical sign in temporal lobe epilepsy.

    PubMed

    Kutlu, Gulnihal; Bilir, Erhan; Erdem, Atilla; Gomceli, Yasemin B; Kurt, G Semiha; Serdaroglu, Ayse

    2005-05-01

    Neurologists have been analyzing the clinical behaviors that occur during seizures for many years. Several ictal behaviors have been defined in temporal lobe epilepsy (TLE). Ictal behaviors are especially important in the evaluation of epilepsy surgery candidates. We propose a new lateralizing sign in TLE originating from the nondominant hemisphere-the "hush" sign. Our patients were 30- and 21-year old women (Cases 1 and 2, respectively). Their epileptogenic foci were localized to the right mesial temporal region after noninvasive presurgical investigations. Case 1 had no cranial MRI abnormality, whereas cranial MRI revealed right hippocampal atrophy in Case 2. These women repeatedly moved their right index fingers to their mouth while puckering their lips during complex partial seizures. We have named this ictal behavior the "hush" sign. Anterior temporal lobectomy with amygdalohippocampectomy was performed in both patients, and pathological examinations revealed hippocampal sclerosis. The "hush" sign no longer occurred after seizures were controlled. They were seizure free as of 30 and 31 months of follow-up, respectively. We believe that the "hush" sign may be supportive of a diagnosis of TLE originating from the nondominant hemisphere. This sign may occur as a result of ictal activation of a specific brain region in this hemisphere.

  1. Influence of Functional Knee Bracing on the Isokinetic and Functional Tests of Anterior Cruciate Ligament Deficient Patients

    PubMed Central

    Mortaza, Niyousha; Abu Osman, Noor Azuan; Jamshidi, Ali Ashraf; Razjouyan, Javad

    2013-01-01

    Use of functional knee braces has been suggested to provide protection and to improve kinetic performance of the knee in Anterior cruciate ligament(ACL)-injured patients. However, many athletes might refrain from wearing the braces because of the fear of performance hindrance in the playing field. The aim of this study was to examine the effect of three functional knee brace/sleeves upon the isokinetic and functional performance of ACL-deficient and healthy subjects. Six anterior cruciate ligament deficient (29.0±5.3 yrs., 175.2±5.4 cm, and 73.0±10.0 kg) and six healthy male subjects (27.2±3.7 yrs., 176.4±6.4 cm, and 70.3±6.9 kg) were selected. The effect of a custom-made functional knee brace, and two neoprene knee sleeves, one with four metal supports and one without support were examined via the use of isokinetic and functional tests in four sets (non-braced,wearing functional knee brace,and wearing the sleeves). Cross-over hop and single leg vertical jump test were performed and jump height, and hop distance were recorded. Peak torque to body weight ratio and average power in two isokinetic velocities(60°.s−1,180°.s−1) were recorded and the brace/sleeves effect was calculated as the changes in peak torque measured in the brace/sleeves conditions, expressed as a percentage of peak torque measured in non-braced condition. Frequency content of the isokinetic torque-time curves was also analyzed. Wilcoxon signed rank test was used to compare the measured values in four test conditions within each control and ACL-deficient group,and Mann-Whitney U test was used for the comparison between the two groups. No significant differences in peak torque, average power, torque-time curve frequency content, vertical-jump and hop measurements were found within the experimental and the non-braced conditions (p>0.05). Although the examined functional knee brace/sleeves had no significant effect on the knee muscle performance, there have been some enhancement regarding

  2. Perception of symmetry and asymmetry in individuals with anterior cruciate ligament reconstruction.

    PubMed

    Roper, Jaimie A; Terza, Matthew J; Hass, Chris J

    2016-12-01

    Changes in the quantity, quality and integration of sensory information are thought to persist long after anterior cruciate ligament reconstruction and completion of physical therapy. Our purpose was to investigate the ability of individuals with anterior cruciate ligament reconstruction to perceive imposed asymmetry and symmetry while walking. Twenty participants with anterior cruciate ligament reconstruction and 20 controls walked on a split-belt treadmill while we assessed the ability to detect symmetry and asymmetry at fast and slow speeds. Detection scores and spatiotemporal data during asymmetric and symmetric tasks in which the belts were coupled or decoupled over time were recorded. The ability to detect symmetry and asymmetry was not altered in individuals with anterior cruciate ligament reconstruction compared to healthy young adults. The belt-speed ratio at detection also correlated to asymmetry for step length, stride length, double support time, and stance time. However, the anterior cruciate ligament reconstruction group appeared to utilize unique information to determine detection. When asked to detect symmetry at a fast speed, no asymmetry scores significantly correlated with belt-speed ratio in the anterior cruciate ligament reconstruction group. Conversely, asymmetry in stride length, step length, and stance time all significantly correlated with belt-speed ratio at detection in the control group. Specific sensory cues arising from the speed of the leg may also augment perception of symmetry. This strategy may be necessary in order to successfully execute the motor task, and could develop due to altered sensory information from the reconstructed knee at faster walking speeds. Published by Elsevier Ltd.

  3. Different roles of the medial and lateral hamstrings in unloading the anterior cruciate ligament.

    PubMed

    Guelich, David R; Xu, Dali; Koh, Jason L; Nuber, Gordon W; Zhang, Li-Qun

    2016-01-01

    Anterior cruciate ligament injuries are closely associated with excessive loading and motion about the off axes of the knee, i.e. tibial rotation and knee varus/valgus. However, it is not clear about the 3-D mechanical actions of the lateral and medial hamstring muscles and their differences in loading the ACL. The purpose of this study was to investigate the change in anterior cruciate ligament strain induced by loading the lateral and medial hamstrings individually. Seven cadaveric knees were investigated using a custom testing apparatus allowing for six degree-of-freedom tibiofemoral motion induced by individual muscle loading. With major muscles crossing the knee loaded moderately, the medial and lateral hamstrings were loaded independently to 200N along their lines of actions at 0°, 30°, 60° and 90° of knee flexion. The induced strain of the anterior cruciate ligament was measured using a differential variable reluctance transducer. Tibiofemoral kinematics was monitored using a six degrees-of-freedom knee goniometer. Loading the lateral hamstrings induced significantly more anterior cruciate ligament strain reduction (mean 0.764 [SD 0.63] %) than loading the medial hamstrings (mean 0.007 [0.2] %), (P=0.001 and effect size=0.837) across the knee flexion angles. The lateral and medial hamstrings have significantly different effects on anterior cruciate ligament loadings. More effective rehabilitation and training strategies may be developed to strengthen the lateral and medial hamstrings selectively and differentially to reduce anterior cruciate ligament injury and improve post-injury rehabilitation. The lateral and medial hamstrings can potentially be strengthened selectively and differentially as a more focused rehabilitation approach to reduce ACL injury and improve post-injury rehabilitation. Different ACL reconstruction procedures with some of them involving the medial hamstrings can be compared to each other for their effect on ACL loading. Copyright

  4. [Intra- and extra-articular hamstring reconstruction of anterior cruciate ligament tears].

    PubMed

    Buscayret, C; Buscayret, F; Farenq, C

    2001-05-01

    We examined a reconstruction technique for tears of the anterior cruciate ligament using the hamstring tendons. The tendons were harvested en bloc, leaving the tibial insertion intact. Three intra-articular strands (two semitendinous and one gracilis) and lateral tenodesis were used with continuity via the gracilis. The intra-articular procedure was performed arthroscopically with tunneling laterally to medially to achieve the best position. Ligamentoplasty was performed in 262 cases. Outcome was satisfactory. This method preserves the lateral iliotibial sheath and spares the extensors apparatus. It is particularly interesting for reconstruction of anterior cruciate ligament tears when a lateral tenodesis appears to be necessary.

  5. Experimental and Numerical Analysis of Screw Fixation in Anterior Cruciate Ligament Reconstruction

    NASA Astrophysics Data System (ADS)

    Chizari, Mahmoud; Wang, Bin; Snow, Martyn; Barrett, Mel

    2008-09-01

    This paper reports the results of an experimental and finite element analysis of tibial screw fixation in anterior cruciate ligament (ACL) reconstruction. The mechanical properties of the bone and tendon graft are obtained from experiments using porcine bone and bovine tendon. The results of the numerical study are compared with those from mechanical testing. Analysis shows that the model may be used to establish the optimum placement of the tunnel in anterior cruciate ligament reconstruction by predicting mechanical parameters such as stress, strain and displacement at regions in the tunnel wall.

  6. Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis.

    PubMed

    Verra, Wiebe C; van den Boom, Lennard G H; Jacobs, Wilco; Clement, Darren J; Wymenga, Ate A B; Nelissen, Rob G H H

    2013-10-11

    The functional and clinical basis on which to choose whether or not to retain the posterior cruciate ligament during total knee arthroplasty surgery remained unclear after a Cochrane systematic review and meta-analysis in 2005, which contained eight clinical trials. Several new trials have been conducted since then. Hence, an update of the review was performed. Our aim was to assess the benefits and harms of retention compared to sacrifice of the posterior cruciate ligament in total knee arthroplasty in patients with osteoarthritis of the knee. An extensive search was conducted in CENTRAL, MEDLINE (PubMed), EMBASE, Web of Science, CINAHL, Academic Search Premier, Current Contents Connect and Science Direct. All databases were searched, without any limitations, up to 6 December 2012. References of the articles were checked and citation tracking was performed. Randomised and quasi-randomised controlled trials comparing retention with sacrifice of the posterior cruciate ligament in primary total knee arthroplasty in patients with osteoarthritis of the knee. Data were collected with a pre-developed form. Risk of bias was assessed independently by two authors (WV, LB). The level of evidence was graded using the GRADE approach. Meta-analysis was performed by pooling the results of the selected studies, when possible. Subgroup analyses were performed for posterior cruciate ligament retention versus sacrifice using the same total knee arthroplasty design, and for studies using a posterior cruciate ligament retaining or posterior stabilised design, and when sufficient studies were available subgroup analyses were performed for the same brand. Seventeen randomised controlled trials (with 1810 patients and 2206 knees) were found, described in 18 articles. Ten of these were new studies compared to the previous Cochrane Review. One study from the original Cochrane review was excluded. Most new studies compared a posterior cruciate ligament retaining design with a posterior

  7. Dynamic knee joint mechanics after anterior cruciate ligament reconstruction.

    PubMed

    Clarke, Sarah B; Kenny, Ian C; Harrison, Andrew J

    2015-01-01

    There is scarcity of information on the long-term adaptations in lower limb biomechanics during game-specific movements after anterior cruciate ligament (ACL) reconstruction. Particularly, variables such as knee abduction moments and transverse plane knee motion have not been studied during a game-specific landing and cutting task after ACL reconstruction. The purpose of this study was to compare the hip and knee mechanics between the ACL-reconstructed (ACLr) group and a healthy control group. Thirty-eight reconstructed athletes (18 ACLr, 18 control) participated in the study. Three-dimensional hip, knee, and ankle angles were calculated during a maximal drop jump land from a 0.30-m box and unanticipated cutting task at 45°. During the landing phase, ACLr participants had increased hip flexion (P < 0.003) and transverse plane knee range of motion (P = 0.027). During the cutting phase, the ACLr participant's previously injured limb had increased internal knee abduction moment compared with that of the control group (P = 0.032). No significant differences were reported between the previously injured and contralateral uninjured limb. Previously injured participants demonstrated higher knee abduction moment and transverse plane range of motion when compared with those of control participants during a game-specific landing and cutting task.

  8. Ring-shaped lateral meniscus with hypoplasic anterior cruciate ligament.

    PubMed

    Esteves, Cátia; Castro, Ricardo; Cadilha, Rui; Raposo, Frederico; Melão, Lina

    2015-12-01

    Knee joint lesions can be solitary or occur concomitantly with other lower limb abnormalities. Ring-shaped lateral meniscus (RSM) and hypoplasic anterior cruciate ligament (ACL) are two rare malformations. The therapeutic management of such abnormalities is not consensual, and highly depends on clinical symptomatology. We report a case of a 25-year-old girl with progressive knee pain whose MRI demonstrated a continuous segment of lateral meniscus situated along the medial aspect of the lateral compartment, continuous with the otherwise normal-appearing lateral meniscus, compatible with an RSM. This anatomic variant can be mistaken by a displaced meniscal fragment, like a bucket-handle tear, a central tear of a discoid meniscus, or incomplete discoid meniscus, as previously reported. Her MRI examination also showed a thinned ACL with anomalous lateral course. This abnormality may be mistaken for an ACL rupture and/or a meniscofemoral ligament with agenesis of ACL. Multiple images in different planes as well as following the course of meniscal and ligaments are critical clues to avoid misdiagnosis. As a result, the diagnosis of an RSM along with hypoplasic ACL with abnormal attachment was assumed based on MRI and confirmed during arthroscopy. The patient was treated conservatively with clinical outcome improvement.

  9. Adolescent Segond fracture with an intact anterior cruciate ligament.

    PubMed

    Reddy, Deepak; Alexander, Reginald; Hussain, Waqas M; Leland, J Martin

    2012-07-01

    Segond fractures, or avulsion fractures of the proximal lateral tibial plateau, have been well documented and studied since their original description in 1878. Segond fractures have a widely recognized pathognomonic association with anterior cruciate ligament (ACL) injuries and often prompt orthopedic surgeons to consider reconstruction following radiographic and clinical evaluation. Adolescent patients are particularly vulnerable to these fractures due to the relative weakness of their physeal growth plates compared with the strength of their accompanying ligamentous structures. This article describes a case of a 13-year-old boy who sustained a Segond fracture that was not coupled with an ACL avulsion or tear. The patient sustained a twisting injury to his knee. He presented to the emergency room with an effusion and radiographic findings consistent with a Segond fracture. On follow-up examination 1 week after injury, the ACL was intact. The patient was followed for 5 months of conservative treatment. At final follow-up, the patient had reestablished his previous level of activity. This article describes the history, physical examination, and radiographic findings necessary to care for patients who present with a Segond fracture. Although considered pathognomonic for an associated ACL injury, this article describes a Segond fracture that occurred in isolation.

  10. Graft selection in arthroscopic anterior cruciate ligament reconstruction.

    PubMed

    Romanini, Emilio; D'Angelo, Franca; De Masi, Salvatore; Adriani, Ezio; Magaletti, Massimiliano; Lacorte, Eleonora; Laricchiuta, Paola; Sagliocca, Luciano; Morciano, Cristina; Mele, Alfonso

    2010-12-01

    anterior cruciate ligament (ACL) surgical reconstruction is performed with the use of an autogenic, allogenic or synthetic graft. The document issued by the Italian National Guidelines System (SNLG, Sistema Nazionale Linee Guida) at the National Institute of Health aims to guide orthopaedic surgeons in selecting the optimal graft for ACL reconstruction using an evidence-based approach. A monodisciplinary panel was formed to define a restricted number of clinical questions, develop specific search strategies and critically appraise the literature using the grading of recommendations assessment, development, and evaluation (GRADE) method. The final draft was shared by the panel and then sent to four external referees to assess its readability and clarity, its clinical relevance and the feasibility of recommendations. autograft shows moderate superiority compared with allograft, in relation to the relevant outcomes and the quality of selected evidence, after an appropriate risk-benefit assessment. Allograft shows higher failure rate and higher risk of infection. The panel recommends use of autografts; patellar tendon should be the first choice, due to its higher stability, while use of hamstring is indicated for subjects for whom knee pain can represent a particular problem (e.g., some categories of workers). autograft shows better performance compared with allograft and no significant heterogeneity in relation to relevant outcomes. The GRADE method allowed collation of all the information needed to draw up the recommendations, and to highlight the core points for discussion.

  11. Ruptures of the anterior cruciate ligament in soccer.

    PubMed

    Rochcongar, P; Laboute, E; Jan, J; Carling, C

    2009-05-01

    Ruptures of the anterior cruciate ligament (ACL) are serious, common and costly injuries. The present 12-year investigation was undertaken to examine the frequency of ACL ruptures and identify the game events that may have contributed to the cause of these injuries in male soccer players across a French district. A retrospective questionnaire was used to record the players' age at the time of injury, laterality, standard of play, playing position and injured side. The characteristics of the injury situations were described in detail to investigate the game events involved in each case. A total of 934 ruptures was reported. Significantly more ruptures were sustained in a non-contact versus a contact situation (p<0.01). Of the total number of lesions, 34.5% occurred during a pivot action. The right knee was affected more than the left knee (p<0.001), irrespective of the dominant side of the player. Certain game events reported in the injury situations were shown to be related to player's age, standard and position. While these results have confirmed observations from previous investigations on ACL ruptures in soccer, the analysis of a considerably larger number of injury cases has brought new findings to the literature as well as recommendations for future research.

  12. Extracellular matrix content of ruptured anterior cruciate ligament tissue.

    PubMed

    Young, Kate; Samiric, Tom; Feller, Julian; Cook, Jill

    2011-08-01

    Anterior cruciate ligaments (ACLs) can rupture with simple movements, suggesting that structural changes in the ligament may reduce the loading capacity of the ligament. We aimed to investigate if proteoglycan and collagen levels were different between ruptured and non-ruptured ACLs. We also compared changes in ruptured tissue over time. During arthroscopic knee reconstruction surgery 24 ruptured ACLs were collected from participants (10 females; 14 males; mean age 24 years). Four non-ruptured ACLs were obtained from participants undergoing total knee replacement surgery (one female, three males; mean age 66 years). Western blot analysis was used to characterise core proteins of aggrecan, versican, decorin and biglycan and glycosaminoglycan assays were also conducted. Collagen levels were measured by hydroxyproline (OHPr) assays. Significantly lower levels of collagen, were found in ruptured ACL compared to non-ruptured ACL (p=0.004). Lower levels of both small and large proteoglycans were found in ruptured than non-ruptured ACLs. No correlation was found between time since rupture and proteoglycan or collagen levels. Ruptured ACLs had less collagen and proteoglycans than non-ruptured ACLs. These changes indicate either extracellular matrix protein levels were reduced prior to rupture or levels decreased immediately after rupture. It is possible that the composition and structure of ACLs that rupture are different to normal ACLs, potentially reducing the tissue's ability to withstand loading. An enhanced understanding of the aetiology of ACL injury could help identify individuals who may be predisposed to rupture.

  13. Sport-specific outcomes after anterior cruciate ligament reconstruction.

    PubMed

    Warner, Stephen J; Smith, Matthew V; Wright, Rick W; Matava, Matthew J; Brophy, Robert H

    2011-08-01

    Although anterior cruciate ligament (ACL) reconstruction has been studied extensively in the literature, sport-specific outcomes have not been well-documented. The purpose of this systematic review was to assess sport-specific outcomes after ACL reconstruction in the literature. We performed a systematic review of the literature to identify studies reporting sport-specific outcomes after primary ACL reconstruction. Included studies were required to have reported standardized outcomes after primary ACL reconstruction for a single sport or comparing between different sports. In total 8 studies conformed to all inclusion criteria: 2 Level II studies, 1 Level III study, and 5 Level IV case series. Only 1 study reported comparisons of standardized outcomes between different sports, whereas 7 studies reported standardized outcomes in a single sport. Return to activity was the most common sport-specific outcome reported and varied from 19% (soccer) to 100% (bicycling and rugby), although the methods of measuring this outcome differed. Whereas return to activity after ACL reconstruction appears more likely for bicycling and jogging than for cutting and pivoting sports such as soccer and football, the literature on sport-specific outcomes from ACL reconstruction is limited with minimal data. Further studies are needed to report sport-specific outcomes and return to play after ACL reconstruction. Level IV, systematic review of Level II, III, and IV studies. Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. FEMORAL INSERTION OF THE POSTERIOR CRUCIATE LIGAMENT: AN ANATOMICAL STUDY

    PubMed Central

    de Paula Leite Cury, Ricardo; Severino, Nilson Roberto; Camargo, Osmar Pedro Arbix; Aihara, Tatsuo; Neto, Leopoldo Viana Batista; Goarayeb, Dedley Nelson

    2015-01-01

    Objective: To identify objective parameters to guide correct location of the posterior cruciate ligament (PCL) in the femur. Methods: The PCLs of 20 human cadavers were resected. The following portions were measured: distance from the most distal portion of the PCL, close to the roof, to the most anterior edge of the cartilage (AB); distance from the most proximal portion of the PCL, close to the roof, to the most anterior cartilage (AC); distance between the two parts of the ligament close to the roof (BC); distance from the distal edge in its posterior portion, to the more posterior joint edge (DE); distance from the distal edge of the ligament in its posterior portion, to the intercondylar roof (DF); and finally, the format of the ligament insertion and area of coverage on the femoral condyle. Results: The PCL has the shape of a quarter ellipse, with an average area of 153.5mm2. The mean distances found were: AB of 2.1mm, AC of 10.7mm, BC of 8.6mm DE of 12.4mm and DF of 16.8mm. Conclusions: The edge close to the roof of the anterolateral bundle is closer to the joint cartilage (2.1mm) than the posteromedial bundle is, which is 12.4mm from the edge proximal to the cartilage. These references should assist in better and more accurate positioning of femoral tunnels in PCL reconstruction. PMID:27027059

  15. Nonmodifiable risk factors for anterior cruciate ligament injury.

    PubMed

    Price, Meghan J; Tuca, Maria; Cordasco, Frank A; Green, Daniel W

    2017-02-01

    As anterior cruciate ligament (ACL) injury is becoming increasingly prevalent in the population of active children and young adolescents, it is crucial to be aware of both the modifiable and nonmodifiable factors that place this population at increased ACL injury risk. Historically, there has not been a definitive consensus on all of these risk factors-particularly the nonmodifiable ones. The present review has accumulated the most recent evidence for the nonmodifiable risk factors in ACL injury focusing particularly on female gender, generalized joint laxity, knee recurvatum, increased lateral tibial slope, decreased intercondylar notch width, structural lower extremity valgus, limb length discrepancy, family history, and history of contralateral knee ACL injury. Physicians should be aware of the nonmodifiable risk factors for ACL tears in active children and adolescents and should also encourage avoidance of modifiable risk factors in this population. Young athletes with nonmodifiable risk factors are at a particularly increased risk of recurrent injury following ACL reconstruction (ACLR). We believe that a primary extra-articular augmentation via iliotibial band tenodesis at the same time of ACLR may decrease the rate of reinjury for the high risk athlete with multiple nonmodifiable risk factors.

  16. Partial tearing of the anterior cruciate ligament: diagnosis and treatment.

    PubMed

    Temponi, Eduardo Frois; de Carvalho Júnior, Lúcio Honório; Sonnery-Cottet, Bertrand; Chambat, Pierre

    2015-01-01

    Partial tears of the anterior cruciate ligament (ACL) are common and represent 10-27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process. There is controversy regarding the definition of these injuries, which is based on anatomy, clinical examination, translation measurements, imaging examinations and arthroscopy. The way in which it is treated will depend on the existing laxity and instability. Conservative treatment is optional for cases without instability, with a focus on motor rehabilitation. Surgical treatment is a challenge, since it requires correct positioning of the bone tunnels and conservation of the remnants of the torn bundle. The pivot shift test under anesthesia, the magnetic resonance findings, the previous level and type of sports activity and the arthroscopic appearance and mechanical properties of the remnants will aid the orthopedist in the decision-making process between conservative treatment, surgical treatment with strengthening of the native ACL (selective reconstruction) and classical (anatomical) reconstruction.

  17. Partial tearing of the anterior cruciate ligament: diagnosis and treatment

    PubMed Central

    Temponi, Eduardo Frois; de Carvalho Júnior, Lúcio Honório; Sonnery-Cottet, Bertrand; Chambat, Pierre

    2015-01-01

    Partial tears of the anterior cruciate ligament (ACL) are common and represent 10–27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process. There is controversy regarding the definition of these injuries, which is based on anatomy, clinical examination, translation measurements, imaging examinations and arthroscopy. The way in which it is treated will depend on the existing laxity and instability. Conservative treatment is optional for cases without instability, with a focus on motor rehabilitation. Surgical treatment is a challenge, since it requires correct positioning of the bone tunnels and conservation of the remnants of the torn bundle. The pivot shift test under anesthesia, the magnetic resonance findings, the previous level and type of sports activity and the arthroscopic appearance and mechanical properties of the remnants will aid the orthopedist in the decision-making process between conservative treatment, surgical treatment with strengthening of the native ACL (selective reconstruction) and classical (anatomical) reconstruction. PMID:26229890

  18. Factors informing fear of reinjury after anterior cruciate ligament reconstruction.

    PubMed

    Ross, Cheryl A; Clifford, Amanda; Louw, Quinette A

    2017-02-01

    Fear of reinjury is associated with cessation of sport after anterior cruciate ligament (ACL) reconstruction despite normal postoperative knee function. The objective of this study is to describe factors informing athletes' experience of fear of reinjury post ACL reconstruction, in athletes who cited fear as the sole reason for not returning to their pre-injury level of sport. Mixed-methods study design of qualitative and a preliminary quantitative component. A conveniently selected private hospital. Ten male and two female athletes, aged between 19 and 45 years, were eligible for the interview from 68 male and 32 female potential participants (age range 17-50) who underwent an ACL reconstruction using any graft type, excluding revision or multi-ligament surgery. To explore factors informing fear of reinjury in participants citing fear of reinjury as the sole reason for not returning to sport, albeit normal knee function. From the participant interview, four themes emerged: undergoing the surgery and recovery again, nature of the pre-injury sport imposing risk of reinjury, personality traits, and social priorities. Clinicians should be aware of factors informing fear of reinjury post ACL reconstruction. Modifiable fears including pain, mode and length of rehabilitation and psychological factors should be considered during rehabilitation to potentially improve the return to sport rate.

  19. Basic science of anterior cruciate ligament injury and repair

    PubMed Central

    Kiapour, A. M.; Murray, M. M.

    2014-01-01

    Injury to the anterior cruciate ligament (ACL) is one of the most devastating and frequent injuries of the knee. Surgical reconstruction is the current standard of care for treatment of ACL injuries in active patients. The widespread adoption of ACL reconstruction over primary repair was based on early perception of the limited healing capacity of the ACL. Although the majority of ACL reconstruction surgeries successfully restore gross joint stability, post-traumatic osteoarthritis is commonplace following these injuries, even with ACL reconstruction. The development of new techniques to limit the long-term clinical sequelae associated with ACL reconstruction has been the main focus of research over the past decades. The improved knowledge of healing, along with recent advances in tissue engineering and regenerative medicine, has resulted in the discovery of novel biologically augmented ACL-repair techniques that have satisfactory outcomes in preclinical studies. This instructional review provides a summary of the latest advances made in ACL repair. Cite this article: Bone Joint Res 2014;3:20–31. PMID:24497504

  20. Osteonecrosis of the Knee After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Lansdown, Drew A.; Shaw, Jeremy; Allen, Christina R.; Ma, C. Benjamin

    2015-01-01

    Background: Anterior cruciate ligament (ACL) reconstruction is performed commonly, with a low risk of complication. Osteonecrosis of the knee is a potentially devastating condition and has been observed both spontaneously and after meniscectomy, although osteonecrosis has not been described as a complication after ACL reconstruction. Purpose: To describe the development of osteonecrosis of the knee in 5 patients after arthroscopic ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: This study involved 5 patients (mean age, 33.2 years) who developed osteonecrosis of the knee after ACL reconstruction. A retrospective chart review was performed to identify clinical characteristics and surgical factors present in each of the 5 cases. Results: In 4 cases, the pathologic changes were present in both the medial and lateral femoral condyles, with isolated lateral condyle changes in the other case. The mean time to diagnosis was 11.6 months. These patients underwent an average of 1.8 additional surgical procedures after the diagnosis of osteonecrosis. Conclusion: Osteonecrosis of the knee is a rare outcome after ACL reconstruction. We are unable to identify clear risk factors for the development of this complication, although we hope the presentation of these cases will help promote the identification of other cases in future studies. PMID:26665035