PoroTomo Subtask 3.2 Data files from the Distributed Acoustic Sensing experiment at Garner Valley, California

DOE Data Explorer

Chelsea Lancelle

2013-09-11

In September 2013, an experiment using Distributed Acoustic Sensing (DAS) was conducted at Garner Valley, a test site of the University of California Santa Barbara (Lancelle et al., 2014). This submission includes all DAS data recorded during the experiment. The sampling rate for all files is 1000 samples per second. Any files with the same filename but ending in _01, _02, etc. represent sequential files from the same test. Locations of the sources are plotted on the basemap in GDR submission 481, titled: "PoroTomo Subtask 3.2 Sample data from a Distributed Acoustic Sensing experiment at Garner Valley, California (PoroTomo Subtask 3.2)." Lancelle, C., N. Lord, H. Wang, D. Fratta, R. Nigbor, A. Chalari, R. Karaulanov, J. Baldwin, and E. Castongia (2014), Directivity and Sensitivity of Fiber-Optic Cable Measuring Ground Motion using a Distributed Acoustic Sensing Array (abstract # NS31C-3935), AGU Fall Meeting. 
https://agu.confex.com/agu/fm1/meetingapp.cgi#Paper/19828 The e-poster is available at: https://agu.confex.com/data/handout/agu/fm14/Paper_19828_handout_696_0.pdf

Antebrachial fractures in four captive polar bears (Ursus maritimus).

PubMed

Lin, Rebecca C; Engeli, Emmanuel; Prowten, Allan W; Erb, Hollis N; Ducharme, Norm G; Goodrich, Laurie R

2005-01-01

To identify common risk factors for antebrachial fractures of captive polar bears and to evaluate outcome after fracture repair. Retrospective study. Four captive polar bears. United States zoological collections were surveyed to determine the prevalence of fractures in captive polar bears. Medical records of captive polar bears that had antebrachial fractures were reviewed for signalment, history, physical and radiographic findings, fracture management, postoperative care, and outcome. Serum samples from healthy bears and bears with antebrachial fractures were assayed for 25-hydroxyvitamin D (25-OHD) concentrations. Nineteen fractures (12 polar bears) occurred from 1974 to 2002; 12 fractures involved the antebrachium. Management of 4 antebrachial fractures was reviewed; 3 were repaired by internal fixation and 1 by external coaptation. Fractures healed and bears were returned to exhibit on average 3 months postfracture. Of 11 serum samples assayed for 25-OHD concentrations, 6 were below normal, 1 was low normal and 4 were within normal reference intervals. The 7 bears with subnormal or low normal values were housed in 2 zoos. Subnormal vitamin D concentrations were identified in 2 of 3 bears with fractures. Fracture disease is not uncommon in captive polar bears. Additional research is necessary to explore the role of nutrition in polar bear fracture disease. Internal fixation of antebrachial fractures is feasible and reasonably well tolerated in captive polar bears.

Flexible Regenerative Nanoelectronics for Advanced Peripheral Neural Interfaces

DTIC Science & Technology

2017-10-01

these materials will be developed based on 3D printing . Page 4 Task 3. Construct nerve guidance scaffolds comprising of embedded mesh electrodes with...Develop photo mask patterning methods. 1-9 In progress 50% Subtask 2.2.2. Develop 3D printing patterning methods. 9-18 9/1/2017 Milestone(s...research into patterning techniques, we found that 10% gelatin methacrylate (GelMA) base gel was the best for performing 3D printing of the gels

Reappraisal of Pediatric Diastatic Skull Fractures in the 3-Dimensional CT Era: Clinical Characteristics and Comparison of Diagnostic Accuracy of Simple Skull X-Ray, 2-Dimensional CT, and 3-Dimensional CT.

PubMed

Sim, Sook Young; Kim, Hyun Gi; Yoon, Soo Han; Choi, Jong Wook; Cho, Sung Min; Choi, Mi Sun

2017-12-01

Diastatic skull fractures (DSFs) in children are difficult to detect in skull radiographs before they develop into growing skull fractures; therefore, little information is available on this topic. However, recent advances in 3-dimensional (3D) computed tomography (CT) imaging technology have enabled more accurate diagnoses of almost all forms of skull fracture. The present study was undertaken to document the clinical characteristics of DSFs in children and to determine whether 3D CT enhances diagnostic accuracy. Two hundred and ninety-two children younger than 12 years with skull fractures underwent simple skull radiography, 2-dimensional (2D) CT, and 3DCT. Results were compared with respect to fracture type, location, associated lesions, and accuracy of diagnosis. DSFs were diagnosed in 44 (15.7%) of children with skull fractures. Twenty-two patients had DSFs only, and the other 22 had DSFs combined with compound or mixed skull fractures. The most common fracture locations were the occipitomastoid (25%) and lambdoid (15.9%). Accompanying lesions consisted of subgaleal hemorrhages (42/44), epidural hemorrhages (32/44), pneumocephalus (17/44), and subdural hemorrhages (3/44). A total of 17 surgical procedures were performed on 15 of the 44 patients. Fourteen and 19 patients were confirmed to have DSFs by skull radiography and 2D CT, respectively, but 3D CT detected DSFs in 43 of the 44 children (P < 0.001). 3D CT was found to be markedly superior to skull radiography or 2D CT for detecting DSFs. This finding indicates that 3D CT should be used routinely rather than 2D CT for the assessment of pediatric head trauma. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of the Diagnostic Accuracy of Conventional 2-Dimensional and 3-Dimensional Computed Tomography for Assessing Canine Sacral and Pelvic Fractures by Radiologists, Orthopedic Surgeons, and Veterinary Medical Students.

PubMed

Stieger-Vanegas, Susanne M; Senthirajah, Sri Kumar Jamie; Nemanic, Sarah; Baltzer, Wendy; Warnock, Jennifer; Hollars, Katelyn; Lee, Scott S; Bobe, Gerd

2015-08-01

To determine, using 3 groups of evaluators of varying experience reading orthopedic CT studies, if 3-dimensional computed tomography (3D-CT) provides a more accurate and time efficient method for diagnosis of canine sacral and pelvic fractures, and displacements of the sacroiliac and coxofemoral joints compared with 2-dimensional computed tomography (2D-CT). Retrospective clinical and prospective study. Dogs (n = 23): 12 dogs with traumatic pelvic fractures, 11 canine cadavers with pelvic trauma induced by a lateral impactor. All dogs had a 2D-CT exam of the pelvis and subsequent 3D-CT reconstructions from the 2D-CT images. Both 2D-CT and 3D-CT studies were anonymized and randomly presented to 2 veterinary radiologists, 2 veterinary orthopedic surgeons, and 2 veterinary medical students. Evaluators classified fractures using a confidence scale and recorded the duration of evaluation for each modality and case. 3D-CT was a more time-efficient technique for evaluation of traumatic sacral and pelvic injuries compared with 2D-CT in all evaluator groups irrespective of experience level reading orthopedic CT studies. However, for radiologists and surgeons, 2D-CT was the more accurate technique for evaluating sacral and pelvic fractures. 3D-CT improves sacral and pelvic fracture diagnosis when added to 2D-CT; however, 3D-CT has a reduced accuracy for evaluation of sacral and pelvic fractures if used without concurrent evaluation of 2D-CT images. © Copyright 2014 by The American College of Veterinary Surgeons.

3D printing-assisted osteotomy treatment for the malunion of lateral tibial plateau fracture.

PubMed

Yang, Peng; Du, Di; Zhou, Zhibin; Lu, Nan; Fu, Qiang; Ma, Jun; Zhao, Liangyu; Chen, Aimin

2016-12-01

Osteotomy and internal fixation are usually the most effective way to treat the malunion of lateral tibial plateau fractures, and the accuracy of the osteotomy is still a challenge for surgeons. This is a report of a series of prospectively study of osteotomy treatment for the malunion of lateral plateau fractures with the aid of 3D printing technology. A total of 7 patients with malunion of lateral tibial plateau fractures were enrolled in the study between September 2012 to September 2014 and completed follow up. CT image data were used for 3D reconstruction, and individually 3D printed models were used for accurate measurements and detail osteotomy procedures planning. Under the premeditated operation plan, the osteotomy operations were performed. Patients were invited for follow-up examinations at 2 and 6 weeks and then at intervals of 6 to 8 weeks until 12 months or more. Mean age of the patients was 44 years (range 30-52 years), 3 cases were result of fall injuries, 2 were traffic accidents and 2 were sports injuries. Among the cases, one accompanied with craniocerebra trauma, one with pelvic fracture, one accompanied with both. According to the Schatzker Tibial Plateau classification, the original fracture type were 3 type I, 1 type II and 3 type III. The lateral tibial plateau collapse ranges from 4 mm-12mm, with an average of 9.4mm. All the operations were successfully completed, the average operation time was 77.1min (range 70-90 min), the average intraoperative blood loss was 121.4ml (range 90-180ml), the mean follow-up time was 14.4 months (range 12-18 months), and the average healing time of the osteotomy fragments was 12 weeks (range 11-13 weeks). The difference between preoperative and postoperative Rasmussen scores were statistically significant (P<0.05). All the patients were obtained functional recovery, with no complications. 3D printing technology is helpful to accurately design osteotomy operation, reduce the risk of postoperative deformity, decrease intraoperative blood loss, shorten the operation time, and can effectively improve the treatment effect. Copyright © 2016. Published by Elsevier Ltd.

Orbit transfer rocket engine technology program: Advanced engine study

NASA Technical Reports Server (NTRS)

Erickson, C. M.

1992-01-01

In Task D.6 of the Advanced Engine Study, three primary subtasks were accomplished: (1) design of parametric data; (2) engine requirement variation studies; and (3) vehicle study/engine study coordination. Parametric data were generated for vacuum thrusts ranging from 7500 lbf to 50,000 lbf, nozzle expansion ratios from 600 to 1200, and engine mixture ratios from 5:1 to 7:1. Failure Modes and Effects Analysis (FMEA) was used as a departure point for these parametric analyses. These data are intended to assist in definition and trade studies. In the Engine Requirements Variation Studies, the individual effects of increasing the throttling ratio from 10:1 to 20:1 and requiring the engine to operate at a maximum mixture ratio of 12:1 were determined. Off design engine balances were generated at these extreme conditions and individual component operating requirements analyzed in detail. Potential problems were identified and possible solutions generated. In the Vehicle Study/Engine Study coordination subtask, vehicle contractor support was provided as needed, addressing a variety of issues uncovered during vehicle trade studies. This support was primarily provided during Technical Interchange Meetings (TIM) in which Space Exploration Initiative (SEI) studies were addressed.

Early Detection of NSCLC Using Stromal Markers in Peripheral Blood

DTIC Science & Technology

2015-09-01

post- surgery patients, and COPD patients Subtask 2: Flow cytometry sorting of circulating myeloid cells. Subtask 3: RNA-Sequencing Subtask 4: RNA...recruitment including pre- and post- surgery patients, and COPD patients During this reporting period, we have recruited 23 NSCLC patients and collected

Positive Effects of a Sufficient Pre-fracture Serum Vitamin D Level on the Long-Term Survival of Hip Fracture Patients in Finland: A Minimum 11-Year Follow-Up.

PubMed

Nurmi-Lüthje, Ilona; Lüthje, Peter; Kaukonen, Juha-Pekka; Kataja, Matti

2015-06-01

Several studies have shown that the mortality of elderly hip fracture patients is higher than that in the general population, and is higher in male than in female hip fracture patients. The objective of this study was to investigate factors affecting overall mortality at a minimum of 11 years following a new hip fracture. The sex, age, pre-fracture serum 25-hydroxyvitamin D level, American Society of Anesthesiologists physical status classification (ASA class), 1- to 12-month mortality, and 2- to 11-year mortality of hip fracture patients were collected. The use of anti-osteoporotic medication and prescribed calcium and vitamin D supplements during the first 3 post-operative years were checked. The survival of the patients was analyzed using both the Bayesian multivariate analysis and the life table method. The mean age of females at the time of the index hip fracture was 80.5 years and of males was 73 years. The protective factors were age <80 years; ASA class 1-2; serum 25-hydroxyvitamin level ≥ 50 nmol/L; post-fracture use of calcium and vitamin D supplementation; post-fracture concomitant use of calcium and vitamin D supplementation and anti-osteoporotic drugs; and male sex. The excess mortality was higher among women than men. Survival was highest among patients with a vitamin D level of ≥ 50 nmol/L. Post-fracture concomitant use of calcium and vitamin D and anti-osteoporotic drugs was positively associated with survival. Our results indicate a positive relationship between a sufficient pre-fracture vitamin D serum concentration (≥ 50 nmol/L) and survival, and a potential relationship between reduced mortality and the concomitant post-fracture use of prescribed calcium plus vitamin D supplementation and anti-osteoporotic medication.

Identification and characterisation of individual Fractures in 3D fracture-network of shale reservoir rocks from microtomography

NASA Astrophysics Data System (ADS)

Qi, C.; Liu, J.

2017-12-01

Fractures are essential for unconventional hydrocarbon production. However, the observation of fractures in three-dimensional (3D) space is very difficult except using microtomography to obtain 3D fracture structures at micro-scales. Twelve shale samples taken from a specimen are analyzed in this study: six of them were isobarically and five were isothermally processed in experiments of simulating hydrocarbon generation and expulsion and one is unprocessed. The resolutions of microtomographic images are in the range from 5.83 to 9.12 μm. Fractures developed in different complexities: some samples have mostly parallel fractures, some have major parallel fractures plus irregular fractures forming crack-network and some samples have fully intersected fractures of various directions. To identify individual fractures in 3D network is crucial for the characterization of fractures and it needs to separate each fractures or disconnect intersections of fractures. For those samples with fewer intersections, it is not difficult to disconnect intersections manually slice by slice using Avizo®. For those samples with complex intersections, it is impractical to process manually. A patented method and corresponding programs are used to separate, identify and characterize individual fractures. By procedures of filtering, smoothing, thinning, separating and combining, intersected cracks are separated, the segments of a broken elongated cracks are identified as one crack, and the thinned thickness is restored, finally the shape, orientation and dimensions of individual fractures are characterized. Our results show that: 1) relatively large fractures are very thin, showing typical fracture morphology, while small fractures may have various shapes; 2) isothermal processed samples have stronger anisotropy, which implies that the fractures in isothermal series are thinner or flatter than in isobaric series; 3) the fractal dimension exists in the samples and there is good correlation between the fractal dimension and temperature/pressure. This study is a first trial of the characterization of individual cracks in 3D network. It lays a foundation for future research on the prediction of large-scale fractures in tight reservoirs.

Rapid Response Research and Development (R&D) for the Aerospace Systems Directorate. Delivery Order 0021: Engineering Research and Technical Analyses of Advanced Airbreathing Propulsion Fuels, Subtask: Engine and Pump Studies Utilizing JP-8 and Alcohol-to-Jet (ATJ) Blends

DTIC Science & Technology

2014-08-01

41 Figure A-21. Lubricant Soot Accumulation...ASTM D4739 Total Base Number ASTM D664 Total Acid Number ASTM D445 Kinematic Viscosity @ 100°C ASTM D4052 Density ASTM TGA SOOT TGA Soot ASTM E168...118.85 134.01 145.47 169.22 187.43 342.42 Nitration (Abs./cm) E168 FTIR 0 6.67 10.91 16.54 19.04 25.79 35.12 24.03 23.75 52.31 93.9 Soot (%) Soot TGA

Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS.

PubMed

Svedbom, Axel; Borgström, Fredrik; Hernlund, Emma; Ström, Oskar; Alekna, Vidmantas; Bianchi, Maria Luisa; Clark, Patricia; Curiel, Manuel Díaz; Dimai, Hans Peter; Jürisson, Mikk; Uusküla, Anneli; Lember, Margus; Kallikorm, Riina; Lesnyak, Olga; McCloskey, Eugene; Ershova, Olga; Sanders, Kerrie M; Silverman, Stuart; Tamulaitiene, Marija; Thomas, Thierry; Tosteson, Anna N A; Jönsson, Bengt; Kanis, John A

2018-03-01

The International Costs and Utilities Related to Osteoporotic fractures Study is a multinational observational study set up to describe the costs and quality of life (QoL) consequences of fragility fracture. This paper aims to estimate and compare QoL after hip, vertebral, and distal forearm fracture using time-trade-off (TTO), the EuroQol (EQ) Visual Analogue Scale (EQ-VAS), and the EQ-5D-3L valued using the hypothetical UK value set. Data were collected at four time-points for five QoL point estimates: within 2 weeks after fracture (including pre-fracture recall), and at 4, 12, and 18 months after fracture. Health state utility values (HSUVs) were derived for each fracture type and time-point using the three approaches (TTO, EQ-VAS, EQ-5D-3L). HSUV were used to estimate accumulated QoL loss and QoL multipliers. In total, 1410 patients (505 with hip, 316 with vertebral, and 589 with distal forearm fracture) were eligible for analysis. Across all time-points for the three fracture types, TTO provided the highest HSUVs, whereas EQ-5D-3L consistently provided the lowest HSUVs directly after fracture. Except for 13-18 months after distal forearm fracture, EQ-5D-3L generated lower QoL multipliers than the other two methods, whereas no equally clear pattern was observed between EQ-VAS and TTO. On average, the most marked differences between the three approaches were observed immediately after the fracture. The approach to derive QoL markedly influences the estimated QoL impact of fracture. Therefore the choice of approach may be important for the outcome and interpretation of cost-effectiveness analysis of fracture prevention.

Targeting a Novel Androgen Receptor-Repressed Pathway in Prostate Cancer Therapy

DTIC Science & Technology

2017-09-01

AURKA and CENPE. [ Study is on - going] Major Task 3: Test the hypothesis that androgen deprivation-induced PKD1 expression. Major Task 4: Test the...Subtask 3: Conduct detail analysis of the pathway identified in Subtask 2 and assessing its impact on PKD1 expression. This study is on -going. We...enzalutamide, in androgen-sensitivity PrCa cells. We have completed this subtask. In this study , although PKD2 overexpression had little impact on LNCaP

Treatment of Intercondylar Humeral Fractures With 3D-Printed Osteosynthesis Plates

PubMed Central

Shuang, Feng; Hu, Wei; Shao, Yinchu; Li, Hao; Zou, Hongxing

2016-01-01

Abstract The aim of the study was to evaluate the efficacy custom 3D-printed osteosynthesis plates in the treatment of intercondylar humeral fractures. Thirteen patients with distal intercondylar humeral fractures were randomized to undergo surgery using either conventional plates (n = 7) or 3D-printed plates (n = 6) at our institution from March to October 2014. Both groups were compared in terms of operative time and elbow function at 6 month follow-up. All patients were followed-up for a mean of 10.6 months (range: 6–13 months). The 3D-printing group had a significantly shorter mean operative time (70.6 ± 12.1 min) than the conventional plates group (92.3 ± 17.4 min). At the last follow-up period, there was no significant difference between groups in the rate of patients with good or excellent elbow function, although the 3D-printing group saw a slightly higher rate of good or excellent evaluations (83.1%) compared to the conventional group (71.4%). Custom 3D printed osteosynthesis plates are safe and effective for the treatment of intercondylar humeral fractures and significantly reduce operative time. PMID:26817880

High prevalence of vitamin D deficiency in Asian-Indian patients with fragility hip fracture: a pilot study.

PubMed

Khadgawat, Rajesh; Brar, Krishnendra Singh; Brar, Kiraninder Singh; Gahlo, Monita; Yadav, Chandra Shekhar; Malhotra, Rajesh; Guptat, Nandita; Tandon, Nikhil

2010-09-01

To assess vitamin D nutrition status in Asian-Indian patients with fragility hip fracture. The study subjects included patients with non-traumatic hip fracture with age more than 50 years. Any patient who sustained fracture after road side accident of any severity was excluded. The other exclusion criteria were history of previous non-traumatic fracture or history of intake of systemic steroids, anti-osteoporotic medication, anti-tubercular or antiepileptic drugs. Routine biochemistry, serum 25-hydroxy vitamin D [25(OH)D] and BMD (DXA) were measured in all patients. Diagnosis of vitamin D deficiency (VDD) was considered when serum 25(OH)D levels were < 20 ng/ml. Age and sex matched apparently healthy subjects (without history of fracture at any site) were selected from general population. All controls under went BMD measurement at spine. Final analysis included 43 patients, 9 men (20.9%) and 34 women (79.0%, all postmenopausal). The mean age of patients was 62.2 +/- 12.3 years (range 50.5 to 74.2 years, men--62 +/- 13.4 years; women--62.3 +/- 12.4 years; p 0.73). History of adequate sun exposure was obtained in 34.8% cases only. Fracture occurred while patients were outside home in 10/43 (23.25%) while 33/43 (76.7%) patients sustained fracture at home. Of all fractures occurring at home, 51.5% patients sustained fracture consequent to fall/slip in the bathroom. The mean serum 25(OH)D level was 9.9 +/- 4.8 ng/ml (range 5-21.5 ng/ml). All patients except one (96.7%) had VDD. No significant difference in serum 25(OH)D levels was observed between patients with and without adequate sun exposure. BMD of patients with fragility fractures were significantly low in comparison to BMD of healthy controls. (cases --0.790 +/- 0.1 gm/sq cm vs controls 0.924 +/- 0.1 gm/sq cm; p 0.000). The mean Z-score of spine BMD of cases was -1.13 +/- 1.4. No significant difference was observed in the BMD of patients with or without adequate sun exposure and with or without calcium and vitamin D supplementation at the time of fracture. Similarly, no significant difference was noted in BMD of patients with severe VDD and patients with mild to moderate VDD. All patients were contacted by telephone one year after the surgery (mean 12.3 months, range 9 to 13 months). Out of total 43 patients, 26 patients/families could be contacted, 11 (42.3%) died within one year of surgery, of which 8 patients died within first 6 months after surgery. Two patients died within 72 hours after discharge from hospital. Of 15 patients alive one year after surgery, two were able to walk without any support while 13 were able to walk with some support (stick or walker). Our study shows very high prevalence (96.7%) of vitamin D deficiency in Asian-Indian patients with fragility hip fracture. The BMD of these patients is significantly low in comparison to age and sex matched healthy controls. More fractures occurred at home than outside, with a majority of fall being in the bathroom.

Vitamin D Use and Health Outcomes After Surgery for Hip Fracture.

PubMed

Sprague, Sheila; Slobogean, Gerard P; Bogoch, Earl; Petrisor, Brad; Garibaldi, Alisha; O'Hara, Nathan; Bhandari, Mohit

2017-10-01

Daily administration of vitamin D is important for maintaining bone homeostasis. The orthopedic community has shown increased interest in vitamin D supplementation and patient outcomes after fracture. The current study used data from a large hip fracture trial to determine the proportion of patients who consistently used vitamin D after hip fracture surgery and to determine whether supplementation was associated with improved health-related quality of life and reduced reoperation rates. The FAITH study is a multicenter trial of elderly patients with femoral neck fracture treated with internal fixation. The current study asked a subset of patients included in the FAITH study about vitamin D supplementation and categorized them as consistent users, inconsistent users, or nonusers. This study also evaluated whether supplementation was associated with improved quality of life and reduced reoperation rates. The final analysis included 573 patients (mean age, 74.1 years; female, 66.3%; nondis-placed fractures, 72.4%). A total of 18.7% of participants reported no use of vitamin D, 35.6% reported inconsistent use, and 45.7% reported consistent use. Adjusted analysis found that consistent supplementation was associated with a 2.42 increase of the Short Form-12 physical component score 12 months postoperatively (P=.033). However, supplementation was not associated with reduced reoperation rates (P=.386). Despite guidelines recommending vitamin D supplementation, a low proportion of elderly patients with hip fracture use vitamin D consistently, suggesting a need for additional strategies to promote compliance. This study found that the use of vitamin D was associated with a statistically significant but not clinically significant improvement in health-related quality of life after hip fracture. Further research is needed to confirm these findings. [Orthopedics. 2017; 40(5):e868-e875.]. Copyright 2017, SLACK Incorporated.

Onboard Inert Gas Generation System/Onboard Oxygen Gas Generation System (OBIGGS/OBOGS) Study. Part 1; Aircraft System Requirements

NASA Technical Reports Server (NTRS)

Reynolds, Thomas L.; Bailey, Delbert B.; Lewinski, Daniel F.; Roseburg, Conrad M.; Palaszewski, Bryan (Technical Monitor)

2001-01-01

The purpose of this technology assessment is to define a multiphase research study program investigating Onboard Inert Gas Generation Systems (OBIGGS) and Onboard Oxygen Generation Systems (OBOGS) that would identify current airplane systems design and certification requirements (Subtask 1); explore state-of-the-art technology (Subtask 2); develop systems specifications (Subtask 3); and develop an initial system design (Subtask 4). If feasible, consideration may be given to the development of a prototype laboratory test system that could potentially be used in commercial transport aircraft (Subtask 5). These systems should be capable of providing inert nitrogen gas for improved fire cargo compartment fire suppression and fuel tank inerting and emergency oxygen for crew and passenger use. Subtask I of this research study, presented herein, defines current production aircraft certification requirements and design objectives necessary to meet mandatory FAA certification requirements and Boeing design and performance specifications. These requirements will be utilized for baseline comparisons for subsequent OBIGGS/OBOGS application evaluations and assessments.

An informal analysis of flight control tasks

NASA Technical Reports Server (NTRS)

Andersen, George J.

1991-01-01

Issues important in rotorcraft flight control are discussed. A perceptual description is suggested of what is believed to be the major issues in flight control. When the task is considered of a pilot controlling a helicopter in flight, the task is decomposed in several subtasks. These subtasks include: (1) the control of altitude, (2) the control of speed, (3) the control of heading, (4) the control of orientation, (5) the control of flight over obstacles, and (6) the control of flight to specified positions in the world. The first four subtasks can be considered to be primary control tasks as they are not dependent on any other subtasks. However, the latter two subtasks can be considered hierarchical tasks as they are dependent on other subtasks. For example, the task of flight control over obstacles can be decomposed as a task requiring the control of speed, altitude, and heading. Thus, incorrect control of altitude should result in poor control of flight over an obstacle.

Quality of life following hip fractures: results from the Norwegian hip fracture register.

PubMed

Gjertsen, Jan-Erik; Baste, Valborg; Fevang, Jonas M; Furnes, Ove; Engesæter, Lars Birger

2016-07-07

Patient-reported health-related quality of life is an important outcome measure when assessing the quality of hip fracture surgery. The frequently used EQ-5D index score has unfortunately important limitations. One alternative can be to assess the distribution of each of the five dimensions of the patients' descriptive health profile. The objective of this paper was to investigate health-related quality of life (HRQoL) after hip fractures. Data from hip fracture operations from 2005 through 2012 were obtained from The Norwegian Hip Fracture Register. Patient reported HRQoL, (EQ-5D-3L) was collected from patients preoperatively and at four and twelve months postoperatively n = 10325. At each follow-up the distribution of the EQ-5D-3L and mean pain VAS was calculated. Generally, a higher proportion of patients reported problems in all 5 dimensions of the EQ-5D-3L at all follow-ups compared to preoperative. Also a high proportion of patients with no preoperative problems reported problems after surgery; At 4 and 12 months follow-ups 71 % and 58 % of the patients reported walking problems, and 65 % and 59 % of the patients reported pain respectively. Patients with femoral neck fractures and the youngest patients (age < 70 years) reported least problems both preoperatively and at all follow-ups. A hip fracture has a dramatic impact on the patients' HRQoL, and the deterioration in HRQoL sustained also one year after the fracture. Separate use of the descriptive profile of the EQ-5D is informative when assessing quality of life after hip fracture surgery.

Vitamin D status and falls, frailty, and fractures among postmenopausal Japanese women living in Hawaii.

PubMed

Pramyothin, P; Techasurungkul, S; Lin, J; Wang, H; Shah, A; Ross, P D; Puapong, R; Wasnich, R D

2009-11-01

Vitamin D status and its relationship to physical performance, falls, and fractures in 495 postmenopausal women of Japanese ancestry in Hawaii were investigated. The mean 25-hydroxyvitamin D (25-OHD) was 31.94 ng/mL. No significant association of 25-OHD was demonstrated with most outcomes, possibly due to higher 25-OHD levels in this population. In this study, we investigated vitamin D status and its relationship to physical performance, muscle strength, falls, and fractures in postmenopausal Japanese females living in Hawaii. Of 510 community-dwelling women who participated in the eighth examination of the Hawaii Osteoporosis Study, 495 were included in these analyses. Multivariate regression models were used to evaluate the relationship of 25-OHD (D(3) and total) to eight performance-based measurements, 12 activities of daily living (ADLs), and muscle strength (grip, triceps, and quadriceps). Logistic regression analyses were performed to evaluate the relationship of 25-OHD to falls, vertebral fractures, and non-vertebral fractures. The mean total 25-OHD was 31.94 +/- 9.46 ng/mL; 44% of subjects had values <30 ng/mL, while none had values <10-12 ng/mL. There was little evidence of seasonal variation. Among performance-based measures, ADLs, and strength tests, only quadriceps strength was significantly associated with total 25-OHD (p = 0.0063) and 25-OHD(3) (p = 0.0001). No significant association of 25-OHD was found with vertebral or non-vertebral fractures, or incidence of one or more falls. Lack of serum 25-OHD relationship with falls and fractures or most physical performance measures in this study may be related to the low prevalence of very low 25-OHD levels in this population.

Before and after hip fracture, vitamin D deficiency may not be treated sufficiently.

PubMed

Maier, S; Sidelnikov, E; Dawson-Hughes, B; Egli, A; Theiler, R; Platz, A; Staehelin, H B; Simmen, H-P; Meier, C; Dick, W; Grob, D; von Eckardstein, A; Bischoff-Ferrari, H A

2013-11-01

Our findings show that only about 20% of seniors receive vitamin D supplementation prior to their index hip fracture or after the event. We further confirm the high prevalence of severe vitamin D deficiency in this population and show that those who receive supplementation have significantly higher 25-hydroxyvitamin D (25(OH)D) status. The aim of this study is to assess current practice in pre- and post-hip fracture care practice with respect to vitamin D supplementation. We surveyed 1,090 acute hip fracture patients age 65 and older admitted to acute care for hip fracture repair; 844 had serum 25-hydroxyvitamin D levels measured upon admission to acute care, and 362 agreed to be followed at 12 month after their hip fracture. Prevalence of vitamin D supplementation was assessed upon admission to acute care (at the time of hip fracture), upon discharge from acute care, and at 6 and 12 months follow-up. Of 1,090 acute hip fracture patients (mean age 85 years, 78% women, 59 % community-dwelling), 19% had received any dose of vitamin D prior to the index hip fracture, 27% (of 854 assessed) at discharge from acute care, 22 % (of 321 assessed) at 6 month, and 21% (of 285 assessed) at 12 month after their hip fracture. At the time of fracture, 45% had 25(OH)D levels below 10 ng/ml, 81% had levels below 20 ng/ml, and 96% had levels below 30 ng/ml. Notably, 25(OH)D levels did not differ by season or gender but were significantly higher among 164 hip fracture patients, with any vitamin D supplementation compared with 680 without supplementation (19.9 versus 10.8 ng/ml; p < 0.0001). Only about 20% of seniors receive vitamin D at the time of their fracture and after the event. This is despite the documented 81% prevalence of vitamin D deficiency. Interdisciplinary efforts may be warranted to improve vitamin D supplementation in seniors both before a hip fracture occurs and after.

Development of Less Toxic Treatment Strategies for Metastatic and Drug-Resistant Breast Cancer Using Noninvasive Optical Monitoring

DTIC Science & Technology

2017-09-01

models has been evaluated, with one good option, the Py230 cell lines, as our choice for use in future studies . We have conducted the first study ... Study of Progressive Resistance Major Task 6: dDOS fabrication Subtask 15: Design /Fabricate dDOS system and new custom dDOS probe 6-24 Dr...until year 3 of the study , based on current accrual trends with our clinical collaborators at the Boston Medical Center for different projects, the

Increasing Severity of Malnutrition Is Associated With Poorer 30-Day Outcomes in Patients Undergoing Hip Fracture Surgery.

PubMed

Chung, Andrew S; Hustedt, Joshua W; Walker, Robert; Jones, Clifford; Lowe, Jason; Russell, George V

2018-04-01

Low serum albumin levels (hypoalbuminemia) have classically been used to identify malnutrition. The effect of increasing severity of malnutrition on postoperative outcomes in patients undergoing hip fracture surgery has not been well delineated on a large scale. Retrospective. Multicenter. A total of 12,373 patients undergoing hip fracture surgery from 2006 to 2013 National Surgery Quality Improvement Project data were identified. Patient demographic, comorbidity, and preoperative laboratory data and complication, reoperation, and readmission data were collected. Multivariate logistic regression was used to determine the effect of increasing severity of malnutrition on rates of 30-day postoperative complications, readmissions, and reoperations. A total of 12,373 hip fractures met inclusion criteria. A total of 6506 (52.6%) patients had normal albumin levels (albumin ≥3.5 g/dL), 3205 (25.9%) patients were mildly malnourished (albumin 3.1-3.49 g/dL), 2265 (18.3%) were moderately malnourished (albumin 2.4-3.1 g/dL), and 397 (3.2%) patients were severely malnourished (albumin <2.4 g/dL). Mean age was similar between the 4 cohorts (P < 0.001). Severe malnutrition was associated with a 2-fold increase in the odds of postoperative complications and mortality when compared with mild malnutrition (P < 0.001). Increasing severity of malnutrition was associated with significantly longer lengths of stay and higher odds of experiencing a related readmission (P < 0.001). Increasing severity of hypoalbuminemia is independently associated with poorer outcomes in the 30 days after hip fracture surgery. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Validity of height loss as a predictor for prevalent vertebral fractures, low bone mineral density, and vitamin D deficiency.

PubMed

Mikula, A L; Hetzel, S J; Binkley, N; Anderson, P A

2017-05-01

Many osteoporosis-related vertebral fractures are unappreciated but their detection is important as their presence increases future fracture risk. We found height loss is a useful tool in detecting patients with vertebral fractures, low bone mineral density, and vitamin D deficiency which may lead to improvements in patient care. This study aimed to determine if/how height loss can be used to identify patients with vertebral fractures, low bone mineral density, and vitamin D deficiency. A hospital database search in which four patient groups including those with a diagnosis of osteoporosis-related vertebral fracture, osteoporosis, osteopenia, or vitamin D deficiency and a control group were evaluated for chart-documented height loss over an average 3 1/2 to 4-year time period. Data was retrieved from 66,021 patients (25,792 men and 40,229 women). A height loss of 1, 2, 3, and 4 cm had a sensitivity of 42, 32, 19, and 14% in detecting vertebral fractures, respectively. Positive likelihood ratios for detecting vertebral fractures were 1.73, 2.35, and 2.89 at 2, 3, and 4 cm of height loss, respectively. Height loss had lower sensitivities and positive likelihood ratios for detecting low bone mineral density and vitamin D deficiency compared to vertebral fractures. Specificity of 1, 2, 3, and 4 cm of height loss was 70, 82, 92, and 95%, respectively. The odds ratios for a patient who loses 1 cm of height being in one of the four diagnostic groups compared to a patient who loses no height was higher for younger and male patients. This study demonstrated that prospective height loss is an effective tool to identify patients with vertebral fractures, low bone mineral density, and vitamin D deficiency although a lack of height loss does not rule out these diagnoses. If significant height loss is present, the high positive likelihood ratios support a further workup.

Orbit transfer rocket engine integrated control and health monitoring system technology readiness assessment

NASA Technical Reports Server (NTRS)

Bickford, R. L.; Collamore, F. N.; Gage, M. L.; Morgan, D. B.; Thomas, E. R.

1992-01-01

The objectives of this task were to: (1) estimate the technology readiness of an integrated control and health monitoring (ICHM) system for the Aerojet 7500 lbF Orbit Transfer Vehicle engine preliminary design assuming space based operations; and (2) estimate the remaining cost to advance this technology to a NASA defined 'readiness level 6' by 1996 wherein the technology has been demonstrated with a system validation model in a simulated environment. The work was accomplished through the conduct of four subtasks. In subtask 1 the minimally required functions for the control and monitoring system was specified. The elements required to perform these functions were specified in Subtask 2. In Subtask 3, the technology readiness level of each element was assessed. Finally, in Subtask 4, the development cost and schedule requirements were estimated for bringing each element to 'readiness level 6'.

Syndecan-1 and Metastasis Dormancy

DTIC Science & Technology

2015-09-01

Sdc1 WT vs Sdc1 KO mice (p = 0.36). - 5 - Major Task 2: Optimize 3D lung microenvironment assay Subtask 1: Transduce HMVEC-L with E4ORF1 and mCherry...micro-channel devices (see below) but have not yet transduced them with E4ORF1 nor labeled them. If we succeed in generating defined vascular

Detection of Brain Reorganization in Pediatric Multiple Sclerosis Using Functional MRI

DTIC Science & Technology

2015-10-01

accomplish this, we apply comparative assessments of fMRI mappings of language, memory , and motor function, and performance on clinical neurocognitive...community at a target rate of 13 volunteers per quarter period; acquire fMRI data for language, memory , and visual-motor functions (months 3-12). c...consensus fMRI activation maps for language, memory , and visual-motor tasks (months 8-12). f) Subtask 1f. Prepare publication to disseminate our

Hip fractures in the elderly in Israel-possible impact of preventable conditions.

PubMed

Segal, Elena; Raichlin, Valentina; Rimbrot, Sophia; Zinman, Chaim; Raz, Batia; Ish-Shalom, Sophia

2009-01-01

In the present study we evaluated the possible contribution of different factors to the occurrence of hip fractures in Israel. We assessed medical history, physical activity, body mass index, smoking status, bone turnover markers and calcium regulating hormones levels of 142 consecutive elderly hip fracture patients (HFP), and compared them to 96 community dwelling elderly people without a history of hip fracture. Age and female gender were the strongest predictors of hip fracture, p<0.001 and 0.013. Stepwise logistic regression demonstrated that HFP had higher PTH and lower 25(OH)D(3) levels, p=0.002, p<0.001; they were less physically active, p<0.001, and had higher rate of vitamin D insufficiency during winter-spring, compared to summer-autumn, p=0.033. Diabetics had higher risk for hip fracture, p=0.06, OR=3.9 (95% CI 1.50-10.4). Deoxypyridinoline (DPD) cross links levels were 19.35+/-10.58mg/mg creatinine in HFP and 9.12+/-3.52 in controls, p<0.0001. Bone alkaline phosphatase (BAP)/DPD ratio was 1.5 in controls compared to 0.53 in HFP. We conclude that age and female gender were the strongest predictors for hip fracture. Diabetic patients had threefold risk for hip fracture. Bone formation/bone resorption ratio was lower in HFP. Vitamin D deficiency and physical inactivity are important preventable risk factors for hip fracture.

Targeting Transcription Elongation Machinery for Breast Cancer Therapy

DTIC Science & Technology

2017-04-01

activation of EMT genes in breast cancer cells. 6-30 H. Lu (Zhou) 80% Subtask 2: Determine the molecular basis underlying high sensitivity of EMT and...interaction with the molecular chaperone heat shock protein HSP90 upon the KD. Fig. 1. Knockdown (KD) of HEXIM1 in T47D cells enhances breast cancer EMT...that the observed increase in EMT in ELL2-overexpressing cells was due to the elevated P-TEFb activity. Subtask 2: Determine the molecular basis

Remarkable improvement in serum 25-hydroxyvitamin levels among hip fracture patients over a 12-year period: a prospective study in South-eastern Finland.

PubMed

Nurmi-Lüthje, I; Tiihonen, R; Paattiniemi, E-L; Naboulsi, H; Pigg, S; Sarkkinen, H; Kaukonen, J-P; Toivanen, A; Salmio, K; Kataja, M; Lüthje, P

2018-04-01

Hypovitaminosis D is a problem among hip fracture patients. In a 1-year cohort study comprising 245 hip fracture patients (mean age of females 81 years and males 78 years) from south-eastern Finland, the mean 25-hydroxyvitamin D [S-25(OH)D] concentration was 73(SD 31) nmol/L. Vitamin D supplementation has been integrated into our current practice. The objectives of this study are to verify vitamin D levels among hip fracture patients and to compare the results with a similar study conducted in the same two hospitals covering the same geographic area 12 years ago. A prospective cohort comprising 245 Caucasian hip fracture patients was enrolled in the study in two acute hospitals in south-eastern Finland (61° N) over a 12-month period in 2015-2016. The S-25(OH)D was measured using 25-hydroxyvitamin D electrochemiluminescence binding assay. The S-25(OH)D concentrations were compared with the corresponding concentrations of a similar cohort analyzed in the same two hospitals 12 years ago. Of the 245 patients, 70% were women with a mean age of 81 (SD 10) years, while the men had a mean age of 78 (SD 12) years (p < 0.01). The total mean S-25(OH)D concentration was 73 (SD 31.3) nmol/L. Regional differences were found: 15% in hospital A and 36% in hospital B had a S-25(OH(D level < 50 nmol/L, and the mean S-25(OH)D level was 79.2 (SD 31.7) nmol/L in hospital A and 62.4 (SD 27.5) nmol/L in hospital B (p < 0.001). No differences were found in S-25(OH)D concentrations by either the place of residence or the time of year. Overall, the percentage of patients with a sufficient vitamin D level (> 50 nmol/L) was remarkably higher in 2015-2016 (77%) than in 2003-2004 (22%). Our results indicate that vitamin D supplementation has been widely integrated into our current practice. However, regional differences were found in the S-25(OH)D concentrations for which the reasons are unknown.

Radiographic evaluation of acute distal radius fracture stability: A comparative cadaveric study between a thermo-formable bracing system and traditional fiberglass casting.

PubMed

Santoni, Brandon G; Aira, Jazmine R; Diaz, Miguel A; Kyle Stoops, T; Simon, Peter

2017-08-01

Distal radius fractures are common musculoskeletal injuries and many can be treated non-operatively with cast immobilization. A thermo-formable brace has been developed for management of such fractures, but no data exist regarding its comparative stabilizing efficacy to fiberglass casting. A worst-case distal radius fracture was created in 6 cadaveric forearms. A radiolucent loading fixture was created to apply cantilever bending/compression loads ranging from 4.5N to 66.7N across the simulated fracture in the: (1) non-stabilized, (2) braced; and (3) casted forearms, each forearm serving as its own control. Fracture fragment translations and rotations were measured radiographically using orthogonal radiographs and a 2D-3D, CT-based transformation methodology. Under 4.5N of load in the non-stabilized condition, average sagittal plane rotation and 3D center of mass translation of the fracture fragment were 12.3° and 5.3mm, respectively. At the 4.5N load step, fragment rotation with the brace (avg. 0.0°) and cast (0.1°) reduced sagittal plane rotation compared to the non-stabilized forearm (P<0.001). There were no significant differences in measured sagittal plane fracture fragment rotations or 3D fragment translations between the brace or cast at any of the four load steps (4.5N, 22.2N, 44.5N, and 66.7N, P≥0.138). In this in vitro radiographic study utilizing 6 cadaveric forearms with simulated severe-case, unstable and comminuted distal radius fractures, the thermo-formable brace stabilized the fracture in a manner that was not radiographically or biomechanically different from traditional fiberglass casting. Study results support the use of the thermo-formable brace clinically. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fracture-network 3D characterization in a deformed chalk reservoir analogue -- the Laegerdorf case

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

Koestler, A.G.; Reksten, K.

1995-09-01

Quantitative descriptions of 3D fracture networks in terms of fracture characteristics and connectivity are necessary for reservoir evaluation, management, and EOR programs of fractured reservoirs. The author`s research has focused on an analogue to North Sea fractured chalk reservoirs that is excellently exposed near Laegerdorf, northwest Germany. An underlying salt diapir uplifted and deformed Upper Cretaceous chalk; the cement industry now exploits it. The fracture network in the production wall of the quarry was characterized and mapped at different scales, and 12 profiles of the 230-m wide and 35-m high production wall were investigated as the wall receded 25 m.more » In addition, three wells were drilled into the chalk volume. The wells were cored and the wellbores were imaged with both the resistivity formation micro scanner (FMS) and the sonic circumferential borehole image logger (CBIL). The large amount of fracture data was analyzed with respect to parameters, such as fracture density distribution, orientation, and length distribution, and in terms of the representativity and predictability of data sets collected from restricted rock volumes.« less

An Embedded 3D Fracture Modeling Approach for Simulating Fracture-Dominated Fluid Flow and Heat Transfer in Geothermal Reservoirs

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

Johnston, Henry; Wang, Cong; Winterfeld, Philip

An efficient modeling approach is described for incorporating arbitrary 3D, discrete fractures, such as hydraulic fractures or faults, into modeling fracture-dominated fluid flow and heat transfer in fractured geothermal reservoirs. This technique allows 3D discrete fractures to be discretized independently from surrounding rock volume and inserted explicitly into a primary fracture/matrix grid, generated without including 3D discrete fractures in prior. An effective computational algorithm is developed to discretize these 3D discrete fractures and construct local connections between 3D fractures and fracture/matrix grid blocks of representing the surrounding rock volume. The constructed gridding information on 3D fractures is then added tomore » the primary grid. This embedded fracture modeling approach can be directly implemented into a developed geothermal reservoir simulator via the integral finite difference (IFD) method or with TOUGH2 technology This embedded fracture modeling approach is very promising and computationally efficient to handle realistic 3D discrete fractures with complicated geometries, connections, and spatial distributions. Compared with other fracture modeling approaches, it avoids cumbersome 3D unstructured, local refining procedures, and increases computational efficiency by simplifying Jacobian matrix size and sparsity, while keeps sufficient accuracy. Several numeral simulations are present to demonstrate the utility and robustness of the proposed technique. Our numerical experiments show that this approach captures all the key patterns about fluid flow and heat transfer dominated by fractures in these cases. Thus, this approach is readily available to simulation of fractured geothermal reservoirs with both artificial and natural fractures.« less

Small Engine Technology (SET) - Task 13 ANOPP Noise Prediction for Small Engines: Jet Noise Prediction Module, Wing Shielding Module, and System Studies Results

NASA Technical Reports Server (NTRS)

Lieber, Lysbeth; Golub, Robert (Technical Monitor)

2000-01-01

This Final Report has been prepared by AlliedSignal Engines and Systems, Phoenix, Arizona, documenting work performed during the period May 1997 through June 1999, under the Small Engines Technology Program, Contract No. NAS3-27483, Task Order 13, ANOPP Noise Prediction for Small Engines. The report specifically covers the work performed under Subtasks 4, 5 and 6. Subtask 4 describes the application of a semi-empirical procedure for jet noise prediction, subtask 5 describes the development of a procedure to predict the effects of wing shielding, and subtask 6 describes the results of system studies of the benefits of the new noise technology on business and regional aircraft.

Celiac Disease Does Not Influence Fracture Risk in Young Patients with Type 1 Diabetes

PubMed Central

Reilly, Norelle R; Lebwohl, Benjamin; Mollazadegan, Kaziwe; Michaëlsson, Karl; Green, Peter HR; Ludvigsson, Jonas F

2015-01-01

Objectives To examine the risk of any fractures in patients with both type 1 diabetes (T1D) and celiac disease (CD) vs patients with T1D only. Study design We performed a population-based cohort study. We defined T1D as individuals aged ≤30 years who had a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964–2009. Individuals with CD were identified through biopsy report data between 1969–2008 from any of Sweden’s 28 pathology departments. Some 958 individuals had both T1D and CD and were matched for sex, age and calendar period with 4,598 reference individuals with T1D only. We then used a stratified Cox regression analysis, where CD was modeled as a time-dependent covariate, to estimate the risk of any fractures and osteoporotic fractures (hip, distal forearm, thoracic and lumbar spine, and proximal humerus) in patients with both T1D and CD compared with that in patients with T1D only. Results During follow-up, 12 patients with T1D and CD had a fracture (1 osteoporotic fracture). CD did not influence the risk of any fracture (adjusted Hazard Ratio=0.77; 95%CI=0.42–1.41) or osteoporotic fractures (adjusted Hazard Ratio=0.46; 95%CI=0.06–3.51) in patients with T1D. Stratification for time since CD diagnosis did not affect risk estimates. Conclusion Having a diagnosis of CD does not seem to influence fracture risk in young patients with T1D. Follow-up in this study was, however, too short to ascertain osteoporotic fractures which traditionally occur in old age. PMID:26589343

Soldier Mobility: Innovations in Load Carriage System Design and Evaluation (la Mobilite du combattant: innovations dans la conception et l’evaluation des gilets d’intervention)

DTIC Science & Technology

2001-05-01

sweating and inappropriate foot care. Metatarsalgia, stress fractures and knee problems are related primarily to load mass and duration of marching...Stress Fracture 0 1 0 1 1 Other 8 3 1 12 12 Total 68 17 17 102 100 aFrom physician’s assistances at fixed medical sites along the march bFrom medical...feet through physical training and road march practice 2. Reduce load mass Stress Fractures Persistent, boney pain 1. Smoking/tobacco cessation 2. Pre

The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet.

PubMed

Eschler, Anica; Röpenack, Paula; Herlyn, Philipp K E; Roesner, Jan; Pille, Kristin; Büsing, Kirsten; Vollmar, Brigitte; Mittlmeier, Thomas; Gradl, Georg

2015-10-01

Vertebral compression fractures (VCFs) are one of the most common injuries in the aging population presenting with an annual incidence of 1.4 million new cases in Europe. Current treatment strategies focus on cement-associated solutions (kyphoplasty/vertebroplasty techniques). Specific cement-associated problems as leakage, embolism and the adjacent fracture disease are reported adding to open questions like general fracture healing properties of the osteoporotic spine. In order to analyze those queries animal models are of great interest; however, both technical difficulties in the induction of experimental osteoporosis in animal as well as the lack of a standardized fracture model impede current and future in vivo studies. This study introduces a standardized animal model of an osteoporotic VCF type A3.1 that may enable further in-depth analysis of the afore mentioned topics. Twenty-four 5-year-old female Merino sheep (mean body weight: 67 kg; range 57-79) were ovariectomized (OP1) and underwent 5.5 months of weekly corticosteroid injections (dexamethasone and dexamethasone-sodium-phosphate), adding to a calcium/phosphorus/vitamin D-deficient diet. Osteoporosis induction was documented by pQCT and micro-CT BMD (bone mineral density) as well as 3D histomorphometric analysis postoperatively of the sheep distal radius and spine. Non osteoporotic sheep served as controls. Induction of a VCF of the second lumbar vertebra was performed via a mini-lumbotomy surgical approach with a standardized manual compression mode (OP2). PQCT analysis revealed osteoporosis of the distal radius with significantly reduced BMD values (0.19 g/cm(3), range 0.13-0.22 vs. 0.27 g/cm(3), range 0.23-0.32). Micro-CT documented significant lowering of BMD values for the second lumbar vertebrae (0.11 g/cm(3), range 0.10-0.12) in comparison to the control group (0.14 g/cm(3), range 0.12-0.17). An incomplete burst fracture type A3.1 was achieved in all cases and resulted in a significant decrease in body angle and vertebral height (KA 4.9°, range: 2-12; SI 4.5%, range: 2-12). With OP1, one minor complication (lesion of small bowel) occurred, while no complications occurred with OP2. A suitable spinal fracture model for creation of VCFs in osteoporotic sheep was developed. The technique may promote the development of improved surgical solutions for VCF treatment in the experimental and clinical setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

Calcination/dissolution chemistry development Fiscal year 1995

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

Delegard, C.H.

1995-09-01

The task {open_quotes}IPC Liaison and Chemistry of Thermal Reconstitution{close_quotes} is a $300,000 program that was conducted in Fiscal Year (FY) 1995 with U.S. Department of Energy (DOE) Office of Research and Development (EM-53) Efficient Separations and Processing Crosscutting Program supported under technical task plan (TTP) RL4-3-20-04. The principal investigator was Cal Delegard of the Westinghouse Hanford Company (WHC). The task encompassed the following two subtasks related to the chemistry of alkaline Hanford Site tank waste: (1) Technical Liaison with the Institute of Physical Chemistry of the Russian Academy of Science (IPC/RAS) and its research into the chemistry of transuranic elementsmore » (TRU) and technetium (Tc) in alkaline media. (2) Laboratory investigation of the chemistry of calcination/dissolution (C/D) (or thermal reconstitution) as an alternative to the present reference Hanford Site tank waste pretreatment flowsheet, Enhanced Sludge Washing (ESW). This report fulfills the milestone for the C/D subtask to {open_quotes}Provide End-of-Year Report on C/D Laboratory Test Results{close_quotes} due 30 September 1995. A companion report, fulfilling the milestone to provide an end-of-year report on the IPC/RAS liaison, also has been prepared.« less

Orbit Transfer Rocket Engine Technology Program, Advanced Engine Study Task D.6

DTIC Science & Technology

1992-02-28

l!J~iliiJl 1. Report No. 2. Government Accession No. 3 . Recipient’s Catalog No. NASA 187215 4. Title and Subtitle 5. Report Date ORBIT TRANSFER ROCKET...Engine Study, three primary subtasks were accomplished: 1) Design and Parametric Data, 2) Engine Requirement Variation Studies, and 3 ) Vehicle Study...Mixture Ratio Parametrics 18 3 . Thrust Parametrics Off-Design Mixture Ratio Scans 22 4. Expansion Area Ratio Parametrics 24 5. OTV 20 klbf Engine Off

Propulsion and Power Rapid Response Research and Development (R&D) Support. Delivery Order 0011: Advanced Propulsion Fuels R&D, Subtask: Evaluation of 50/50 Hydroprocessed Renewable Jet Fuel and JP8 in the Ford 6.7L High-Pressure Common Rail Design Engine

DTIC Science & Technology

2012-12-01

treated with 9ppm of a QPL-25017 additive. Testing was completed using a Ford 6.7L V8 turbocharged diesel engine. Testing was completed following a...Installation ................................................................................. 3 2. Ford 6.7L Fuel Injection Pump, Rail, & Injector ...5 4. Fuel Injector Component Break-Out

Air Force Research Initiation Program. 1986 Technical Report. Volume 3

DTIC Science & Technology

1988-04-01

functions quickly. b. Knowledgeable intermittent users retain the operation- al concepts. c. Error messages are rarely needed. d. Users can see...Motions," AIAA J., Vol. 23, No. 11, November 1985, pp. 1653-1659. 83-16 3.0 BEGINNING OF REGION OF FAST DYNAMIC STALL VORTEX GROWTH INITIATION OF DYNAMIC...19E6. Observations of the oil/water separator conducted during firetraining excercise March 1, 1986. Memorandum Subtask 4.31. Dynamac Corporation

[Application of three-dimensional printing in the operation of distal tibia fracture involving epiphyseal plate injury for teenagers].

PubMed

Zhao, Jingxin; Ma, Yachang; Han, Dong; Jin, Yu

2017-10-01

To investigate the application value of three-dimensional (3-D) printing technology in the operation of distal tibia fracture involving epiphyseal plate injury for teenagers. The retrospective analysis was conducted on the clinical data of 16 cases of children patients with distal tibia fracture involving epiphyseal plate injury undergoing the operation by using of 3-D printing technology between January 2014 and December 2015. There were 12 males and 4 females with an age of 9-14 years (mean, 12.8 years). The causes of injury included traffic accident injury in 9 cases, heavy pound injury in 3 cases, and sport injury in 4 cases. The time from injury to operation was 3-92 hours (mean, 25.8 hours). According to Salter-Harris typing standard, the typing for epiphyseal injury was classified as type Ⅱ in 11 cases, type Ⅲ in 4 cases, and type Ⅳ in 1 case. The thin slice CT scan on the affected limb was performed before operation, and the Mimics14.0 medical software was applied for the design and the 1∶1 fracture model was printed by the 3-D printer; the stimulation of operative reduction was made in the fracture model, and bone plate, Kirschner wire, and hollow screw with the appropriate size were chosen, then the complete operative approach and method were designed and the internal fixator regimen was chosen, then the practical operation was performed based on the preoperative design regimen. The operation time was 40-68 minutes (mean, 59.1 minutes); the intraoperative blood loss was 5-102 mL (mean, 35 mL); the intraoperative fluoroscopy times was 2-6 times (mean, 2.8 times). All the patiens were followed up 12-24 months (mean, 15 months). The fracture of 15 cases reached anatomic reduction, and 1 cases had no anatomic reduction with the displaced end less than 1 mm. All the fractures reached bony union with the healing time of 2-4 months (mean, 2.6 months). There was no deep vein thrombosis, premature epiphyseal closure and oblique, or uneven ankle surface occurred, and there was no complication such as osteomyelitis, varus or valgus of ankle joint, joint stiffness, traumatic arthritis. Helfet scores of ankle function were measured at 12 months after operation, the results were excellent in 15 cases and good in 1 case. The angulation of introversion and extroversion for the affected limb was (6.56±2.48)°, and the growth length was (4.44±2.31) mm, and there was no significant difference ( t =0.086, P =0.932; t =0.392, P =0.697) when compared with the uninjured side [(6.50±1.51)°, (4.69±1.08) mm]. As the assistive technology, 3-D printing technology has a certain clinical application value in improving the effectiveness of distal tibia fracture involving epiphyseal plate injury.

Development of Thermoacoustic Sensors for Sodium-cooled Fast Reactors

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

Heibel, Michael D.; Carvajal, Jorge V.; Ferroni, Paolo

This Final Report refers to the project “Development of Thermoacoustic Sensors for Sodium-cooled Fast Reactor Systems”, which was led by Westinghouse Electric Company (Westinghouse) and carried out in collaboration with Argonne National Laboratory (ANL) and University of Pittsburgh. Thermo-acoustic Power Sensors (TAPS) are self-powered, wireless sensors envisioned for measuring key parameters, such as local temperature and neutron flux, in a nuclear reactor core. This project was intended to specifically investigate their applicability to Sodium-cooled Fast Reactors (SFR). TAPS are non-invasive (wireless) and passive (self-powered) devices. The passivity derives from their ability to use conditions that “naturally” exist in a nuclearmore » reactor, such as gamma and neutron flux, as power sources. They generate oscillating pressure waves (i.e., sound waves) which, with a frequency and amplitude dependent upon these conditions, can travel through the core and associated structures, and reach the outside of the reactor vessel where a properly designed network of receivers can detect and interpret them. These receivers require a very small amount of power which, during loss of power events, can be provided for example by harvesting gamma radiation energy, thus resulting in a monitoring system that can function both during normal operation and during loss of power events. The project aimed at TAPS development through a series of tasks which are listed and briefly discussed as follows. TASK 1 – Sensor hardware design Subtask 1a: Assessment of sensor applications to SFRs Subtask 1b: Development of sensor functional requirements Subtask 1c: Definition of sensor hardware design specifications Task description: TAPS design was informed by considerations on their application (Subtask 1a), both the ultimate one in an SFR and the actual one in the ANL testing facilities that was intended to be used in support of the project. Considerations were made to identify optimum sensor design features that optimize the sensor size, materials, and output signal, for installation inside an SFR core. These considerations led to the development of Functional Requirements (Subtask 1b) and Design Requirements (Subtask 1c). TASK 2 – Sensor Hardware Manufacture Subtask 2a: Sensor hardware construction drawing development Subtask 2b: Sensor manufacture and assembly Task description: TAPS technical drawings were developed (Subtask 2a) using the Design Requirements established under Task 1. Subsequently, in spite of some problems which ultimately caused the program to be delayed, TAPS manufacturing was completed based on drawings (Subtask 2b). TASK 3 – Development of TAPS Signal Measurement System and TAPS Testing in Water Subtask 3a: Design, assembly and testing of signal measurement system, and TAPS testing in water Subtask 3b: Signal prediction-correction methodology development Task description: An assessment was performed on the techniques that can potentially be used to detect the signals emitted by the TAPS, e.g. a fiber-optic based acoustic signal measurement system, a laser vibrometer system, or an accelerometer-based system. The most suited technology, i.e. the accelerometer-based system, was developed further, and tested in water (Subtask 3a). Moreover, efforts were made to develop the methodology required to determine the actual system temperature and neutron flux distribution using differences between the measured and predicted TAPS responses (Subtask 3b). TASK 4 – Sensor System Testing in Sodium Subtask 4a: Test plan development Subtask 4b: Design, assembly and testing in small-scale sodium facility Subtask 4c: Design, assembly and testing in large-scale sodium and structures facility Task description: Upon proper test plan development (Subtask 4a), the fabricated TAPS was planned to be tested in sodium, by using two sodium facilities at ANL having different size and different purpose. The Under Sodium Viewing (USV) small-scale facility was intended to be used to investigate the effect of sodium on the sensor and its performance (Subtask 4b). The Mechanism Engineering Test Loop (METL) large-scale facility was instead intended to be used to assess the additional effect of prototypical SFR structures, such as fuel assembly mockup or parts of the core restrain structure, on sensor performance (Subtask 4c). As discussed in Section 3.2.2.7, unexpected issues during the TAPS manufacturing process resulted in some activities being delayed, with the TAPS and USV facility developed to the point to be ready for testing in sodium, however without the possibility to actually perform such testing (including the testing in METL) due to the end of the program’s performance period. Overall, through the development and testing (in water only) of two TAPS devices (a First-Generation TAPS followed by an optimized Second-Generation TAPS), the project confirmed the capability of this technology to generate acoustic signals proportional to temperature, which can be detected through a network of accelerometers identified as the best-suited type of receivers for acoustic signal detection. Moreover, the project also developed a computational model to predict the characteristics of the acoustic signals being generated, which combines thermal analysis of the TAPS with Finite Element Modeling (FEM)-aided acoustic characterization of the system. This model was benchmarked against experimental data collected during the project and, although general agreement was obtained, some limitations of the modeling methods were identified, which require additional development. Additional testing is needed in order to assess the effect, on TAPS operation and performance, of environmental changes resulting from the transition from water to liquid sodium. Such testing, which is suggested to be performed in the future, should look specifically at 1) both the effect resulting from the different thermoacoustic behavior of sodium (relative to water) and the effects of higher temperature on TAPS performance, and 2) the performance of the sensor-receiver system when multiple TAPS are used simultaneously and prototypical reactor structures are positioned in the testing environment. The latter testing is needed to assess the effects that potential signal attenuation/ distortion phenomena, as well as potential interference between signals emitted simultaneously, have on the performance of the technology for ultimate application in a nuclear reactor.« less

FROMS3D: New Software for 3-D Visualization of Fracture Network System in Fractured Rock Masses

NASA Astrophysics Data System (ADS)

Noh, Y. H.; Um, J. G.; Choi, Y.

2014-12-01

A new software (FROMS3D) is presented to visualize fracture network system in 3-D. The software consists of several modules that play roles in management of borehole and field fracture data, fracture network modelling, visualization of fracture geometry in 3-D and calculation and visualization of intersections and equivalent pipes between fractures. Intel Parallel Studio XE 2013, Visual Studio.NET 2010 and the open source VTK library were utilized as development tools to efficiently implement the modules and the graphical user interface of the software. The results have suggested that the developed software is effective in visualizing 3-D fracture network system, and can provide useful information to tackle the engineering geological problems related to strength, deformability and hydraulic behaviors of the fractured rock masses.

Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly.

PubMed

Shinkov, Alexander; Borissova, Anna-Maria; Dakovska, Lilia; Vlahov, Jordan; Kassabova, Lidia; Svinarov, Dobrin; Krivoshiev, Stefan

2016-02-23

To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.

Hip fracture patients in India have vitamin D deficiency and secondary hyperparathyroidism.

PubMed

Dhanwal, D K; Sahoo, S; Gautam, V K; Saha, R

2013-02-01

This study evaluated the parameters of bone mineral homeostasis including 25(OH)D and PTH in 90 Indian patients with hip fracture and 90 controls. Hypovitaminosis D, secondary hyperparathyroidism, and biochemical osteomalacia was present in 77, 69, and 50 % patients, respectively, significantly higher compared to controls. Vitamin D deficiency is an important risk factor for hip fracture. The prevalence of vitamin D deficiency is not well known in hip fracture patients from India. Therefore, the present study was conducted to evaluate the parameters of bone mineral homeostasis including 25(OH)D and intact PTH in hip fracture from North India. Ninety consecutive patients with hip fracture and similar number of age- and sex-matched controls were enrolled in the study. The fasting venous samples were analyzed for 25-hydroxyvitamin D (25-OHD), intact parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, and phosphorus. Vitamin D deficiency was defined as serum 25-OHD of <20 ng/dl. The mean age of hip fracture subjects was 65.9 ± 12.6 which was comparable in men and women. Majority of study subjects were women (70 women and 20 men). The serum 25(OH)D and calcium levels were significantly lower, whereas the intact PTH and ALP levels were significantly higher in patients compared to controls. There was significant negative correlation between serum 25(OH)D and PTH. In the hip fracture group, 76.7 % of the subjects had vitamin D deficiency, and 68.9 % had secondary hyperparathyroidism. In the control group, vitamin D deficiency and elevated PTH levels were seen in 32.3 and 42.2 %, respectively. About three fourths of hip fracture patients have vitamin D deficiency, and two thirds have secondary hyperparathyroidism. Therefore, the serum 25-OHD level may be a useful index for the assessment of risk of hip fracture in India.

Associations between Quantitative Mobility Measures Derived from Components of Conventional Mobility Testing and Parkinsonian Gait in Older Adults

PubMed Central

Buchman, Aron S.; Leurgans, Sue E.; Weiss, Aner; VanderHorst, Veronique; Mirelman, Anat; Dawe, Robert; Barnes, Lisa L.; Wilson, Robert S.; Hausdorff, Jeffrey M.; Bennett, David A.

2014-01-01

Objective To provide objective measures which characterize mobility in older adults assessed in the community setting and to examine the extent to which these measures are associated with parkinsonian gait. Methods During conventional mobility testing in the community-setting, 351 ambulatory non-demented Memory and Aging Project participants wore a belt with a whole body sensor that recorded both acceleration and angular velocity in 3 directions. We used measures derived from these recordings to quantify 5 subtasks including a) walking, b) transition from sit to stand, c) transition from stand to sit, d) turning and e) standing posture. Parkinsonian gait and other mild parkinsonian signs were assessed with a modified version of the original Unified Parkinson’s Disease Rating Scale (mUPDRS). Results In a series of separate regression models which adjusted for age and sex, all 5 mobility subtask measures were associated with parkinsonian gait and accounted for 2% to 32% of its variance. When all 5 subtask measures were considered in a single model, backward elimination showed that measures of walking sit to stand and turning showed independent associations with parkinsonian gait and together accounted for more than 35% of its variance. Cross-validation using data from a 2nd group of 258 older adults showed similar results. In similar analyses, only walking was associated with bradykinesia and sway with tremor. Interpretation Quantitative mobility subtask measures vary in their associations with parkinsonian gait scores and other parkinsonian signs in older adults. Quantifying the different facets of mobility has the potential to facilitate the clinical characterization and understanding the biologic basis for impaired mobility in older adults. PMID:24465997

Consequences of Fluid Lag in Three-Dimensional Hydraulic Fractures

NASA Astrophysics Data System (ADS)

Advani (Deceased), S. H.; Lee, T. S.; Dean, R. H.; Pak, C. K.; Avasthi, J. M.

1997-04-01

Research investigations on three-dimensional (3-D) rectangular hydraulic fracture configurations with varying degrees of fluid lag are reported. This paper demonstrates that a 3-D fracture model coupled with fluid lag (a small region of reduced pressure) at the fracture tip can predict very large excess pressure measurements for hydraulic fracture processes. Predictions of fracture propagation based on critical stress intensity factors are extremely sensitive to the pressure profile at the tip of a propagating fracture. This strong sensitivity to the pressure profile at the tip of a hydraulic fracture is more strongly pronounced in 3-D models versus 2-D models because 3-D fractures are clamped at the top and bottom, and pressures in the 3-D fractures that are far removed from the fracture tip have little effect on the stress intensity factor at the fracture tip. This rationale for the excess pressure mechanism is in marked contrast to the crack tip process damage zone assumptions and attendant high rock fracture toughness value hypotheses advanced in the literature. A comparison with field data is presented to illustrate the proposed fracture fluid pressure sensitivity phenomenon. This paper does not attempt to calculate the length of the fluid lag region in a propagating fracture but instead attempts to show that the pressure profile at the tip of the propagating fracture plays a major role in fracture propagation, and this role is magnified in 3-D models. Int. J. Numer. Anal. Meth. Geomech., vol. 21, 229-240 (1997).

Vitamin D insufficiency over 5 years is associated with increased fracture risk-an observational cohort study of elderly women.

PubMed

Buchebner, D; McGuigan, F; Gerdhem, P; Malm, J; Ridderstråle, M; Akesson, K

2014-12-01

This study of elderly Swedish women investigated the association between chronic vitamin D insufficiency and osteoporotic fractures occurring between ages 80-90. The incidence and risk of hip and major osteoporotic fractures was significantly higher in elderly women with low vitamin D levels maintained over 5 years. Vitamin D insufficiency among the elderly is common; however, relatively little is known about the effects of long-term hypovitaminosis D on fracture. We investigated sequential assessment of serum 25(OH)D at age 75 and 80 to determine if continuously low 25(OH)D levels are associated with increased 10-year fracture incidence. One thousand forty-four Swedish women from the population-based OPRA cohort, all 75 years old, attended at baseline (BL); 715 attended at 5 years. S-25(OH)D was available in 987 and 640, respectively and categorized as: <50 (Low), 50-75 (Intermediate), and >75 nmol/L (High). Incident fracture data was collected with maximum follow-up to 90 years of age. Hip fracture incidence between age 80-85 was higher in women who had low 25(OH)D at both baseline and 5 years (22.2 % (Low) vs. 6.6 % (High); p = 0.003). Between age 80-90, hip fracture incidence was more than double that of women in the high category (27.9 vs. 12.3 %; p = 0.006). Within 5-years, 50 % of women in the continuously low group compared to 34 % in the continuously high 25(OH)D group had an osteoporotic fracture (p = 0.004) while 10-year incidence was higher compared to the intermediate (p = 0.020) but not the high category (p = 0.053). The 10-year relative risk of hip fracture was almost three times higher and osteoporotic fracture risk almost doubled for women in the lowest 25(OH)D category compared to the high category (HR 2.7 and 1.7; p = 0.003 and 0.023, respectively). In these elderly women, 25(OH)D insufficiency over 5-years was associated with increased 10-year risk of hip and major osteoporotic fractures.

Evaluation of malrotation following intramedullary nailing in a femoral shaft fracture model: Can a 3D c-arm improve accuracy?

PubMed

Ramme, Austin J; Egol, Jonathan; Chang, Gregory; Davidovitch, Roy I; Konda, Sanjit

2017-07-01

Difficulty determining anatomic rotation following intramedullary (IM) nailing of the femur continues to be problematic for surgeons. Clinical exam and fluoroscopic imaging of the hip and knee have been used to estimate femoral version, but are inaccurate. We hypothesize that 3D c-arm imaging can be used to accurately measure femoral version following IM nailing of femur fractures to prevent rotational malreduction. A midshaft osteotomy was created in a femur Sawbone to simulate a transverse diaphyseal fracture. An intramedullary (IM) nail was inserted into the Sawbone femur without locking screws or cephalomedullary fixation. A goniometer was used to simulate four femoral version situations after IM nailing: 20° retroversion, 0° version, 15° anteversion, and 30° anteversion. In each simulated position, 3D c-arm imaging and, for comparison purposes, perfect lateral radiographs of the knee and hip were performed. The femoral version of each simulated 3D and fluoroscopic case was measured and the results were tabulated. The measured version from the 3D c-arm images was 22.25° retroversion, 0.66° anteversion, 19.53° anteversion, and 25.15° anteversion for the simulated cases of 20° retroversion, 0° version, 15° anteversion, and 30° anteversion, respectively. The lateral fluoroscopic views were measured to be 9.66° retroversion, 12.12° anteversion, 20.91° anteversion, and 18.77° anteversion for the simulated cases, respectively. This study demonstrates the utility of a novel intraoperative method to evaluate femur rotational malreduction following IM nailing. The use of 3D c-arm imaging to measure femoral version offers accuracy and reproducibility. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Effect of Guided Imagery and Internal Visualization on Learning

DTIC Science & Technology

1987-01-01

existance) of - . memory traces, and how retrival cues operate, to name a few. The lack of a single theory or a coherent approach has not deterred movement...and function (Subtask 3) to a 31% gain over the control group for information emphasizing the rote memory of sequential data (Subtask 1). Overall, the

Implementation of the Western Australian Osteoporosis Model of Care: a fracture liaison service utilising emergency department information systems to identify patients with fragility fracture to improve current practice and reduce re-fracture rates: a 12-month analysis.

PubMed

Inderjeeth, C A; Raymond, W D; Briggs, A M; Geelhoed, E; Oldham, D; Mountain, D

2018-04-27

Fracture liaison service linked to an emergency department database effectively identifies patients with OP, improves best practice care, reduces recurrent fractures, and improves quality of life (QoL). The next step is to establish cost-effectiveness. This should be seen as the standard model of care. The Western Australian Osteoporosis Model of Care recommends implementation of a fracture liaison service (FLS) to manage patients with minimal trauma fractures (MTFs). This study evaluates the efficacy of a FLS linked to a tertiary hospital emergency department information system (EDIS) in reducing recurrent fractures. Patients aged ≥ 50 years with MTF identified from EDIS were invited to the FLS. Patient outcomes were compared to routine care (retrospective group-same hospital, and prospective group-other hospital) at 3- and 12-month follow-up. Two hundred forty-one of 376 (64.1%) eligible patients participated in the FLS with 12 months of follow-up. Absolute risk of recurrent MTF at 12 months was reduced by 9.2 and 10.2% compared with the prospective and retrospective controls, respectively. After age/sex adjustment, FLS participants had less MTF at 12 months vs. the retrospective controls, OR 0.38 (95%CI 0.18-0.79), but not the prospective controls, OR 0.40 (95%CI 0.16-1.01). FLS patients were more likely to receive the 'best practice' care, i.e. awareness of osteoporosis, investigations, and treatment (all p < 0.05). 'Fallers' (OR 0.48 (95%CI 0.24, 0.96)) and fall rates were lower in the FLS (p = 0.001) compared to the prospective control. FLS experienced the largest improvement in QoL from 3 to 12 months as measured by the EuroQoL 5-domain (EQ-5D) UK weighted score (+ 15 vs. - 11 vs. - 16%, p < 0.001) and EQ-5D Health State visual analogue scale (+ 29 vs. - 2 vs. + 1%, p < 0.001). Patients managed in a linked EDIS-FLS were more likely to receive the 'best practice' care and had lower recurrent MTF and improved QoL.

Hierarchical Bayesian Models of Subtask Learning

ERIC Educational Resources Information Center

Anglim, Jeromy; Wynton, Sarah K. A.

2015-01-01

The current study used Bayesian hierarchical methods to challenge and extend previous work on subtask learning consistency. A general model of individual-level subtask learning was proposed focusing on power and exponential functions with constraints to test for inconsistency. To study subtask learning, we developed a novel computer-based booking…

Improving the mechanical properties of nano-hydroxyapatite

NASA Astrophysics Data System (ADS)

Khanal, Suraj Prasad

Hydroxyapatite (HAp) is an ideal bioactive material that is used in orthopedics. Chemical composition and crystal structure properties of HAp are similar to the natural bone hence it promotes bone growth. However, its mechanical properties of synthetic HAp are not sufficient for major load-bearing bone replacement. The potential of improving the mechanical properties of synthetic hydroxyapatite (HAp) by incorporating carboxyl functionalized single walled carbon nanotubes (CfSWCNT) and polymerized epsilon-caprolactam (nylon) is studied. The fracture toughness, tensile strength, Young's modulus, stiffness and fracture energy were studied for a series of HAp samples with CfSWCNT concentrations varying from 0 to 1.5 wt. % without, and with nylon addition. X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM) and Differential Scanning Calorimetry (DSC) were used to characterize the samples. The fracture toughness and tensile test was performed under the standard protocol of ASTM D5045 and ASTM D638-02a respectively. Reproducible maximum values of (3.60 +/- 0.3) MPa.m1/2 for fracture toughness and 65.38 MPa for tensile strength were measured for samples containing 1 wt. % CfSWCNT and nylon. The Young's modulus, stiffness and fracture energy of the samples are 10.65 GPa, 1482.12 N/mm, and 644 J/m2 respectively. These values are comparable to those of the cortical bone. Further increase of the CfSWCNT content results to a decreased fracture toughness and tensile strength and formation of a secondary phase.

A Resident-led Initiative Improves Screening and Treatment for Vitamin D Deficiency in Patients with Hip Fractures.

PubMed

Lansdown, Drew A; Whitaker, Amanda; Wustrack, Rosanna; Sawyer, Aenor; Hansen, Erik N

2017-01-01

Acute hip fractures carry a high risk of morbidity and are associated with low vitamin D levels. Improvements in screening and treating low vitamin D levels may lead to lower fall rates and a lower likelihood of additional fragility fractures. However, patients with low vitamin D levels often remain unassessed and untreated, even after they experience these fractures. We wished to determine whether a resident-led initiative can improve (1) screening for and (2) treatment of vitamin D deficiency in patients with acute hip fractures. Our department initiated a housestaff-led, quality improvement project focused on screening and treating vitamin D deficiency in patients with acute hip fractures. Screening encompassed checking serum 25-hydroxyvitamin D level during the acute hospitalization, and treating was defined as starting supplementation before discharge when the serum 25-hydroxyvitamin D level was less than 30 ng/mL. To evaluate the efficacy of this program, an administrative database identified 283 patients treated surgically for an acute hip fracture between July 2010 and June 2014. This period included 2 years before program initiation (Year 1, n = 65 patients; Year 2, n = 61 patients), the initial program year (Year 3, n = 66 patients), and the subsequent program year (Year 4, n = 91 patients). Followup was extended to 6 weeks after treatment with 9.2% (26/282) of patients lost to followup. Eight patients were excluded owing to documented intolerance of vitamin D supplementation. There were no differences regarding patient demographics, fracture type, or treatment rendered across these 4 years. The primary endpoints were the proportion of patients screened and treated for vitamin D deficiency. The secondary endpoint was the continuation of vitamin D supplementation at the patient's 6 week followup, according to the patient's medication list at that visit. This analysis included all patients, assuming those lost to followup had not continued supplementation. ANOVA and chi-square tests were used to evaluate the differences in demographic data and in screening and treating rates. Screening for vitamin D deficiency improved after initiation of the resident-led quality improvement program, with screening performed for 31% of patients in Year 1 (20/65; odds ratio [OR], 0.44; 95% CI, 0.26-0.75), 20% of patients in Year 2 (12/61; OR, 0.24; 95% CI, 0.13-0.46), 46% of patients in Year 3 (30/66; OR, 0.83; 95% CI, 0.51-1.35), and 88% of patients in Year 4 (80/91; OR, 7.27; 95% CI, 3.87-13.7) (p < 0.001). Vitamin D supplementation was initiated for 33% of patients in Year 1 (21/63; OR, 0.5; 95% CI, 0.30-0.84), 28% in Year 2 (17/61; OR, 0.39; 95% CI, 0.22-0.68), 50% in Year 3 (32/64; OR,1.00; 95% CI, 0.61-1.63), and 76% in Year 4 (65/86; OR, 3.10; 95% CI, 1.89-5.06) (p < 0.001). At early postoperative followup, we saw substantial improvement in the proportion of patients who continued receiving vitamin D supplementation: Year 1, 12% (8/64; OR, 0.14; 95% CI, 0.07-0.30); Year 2, 15% (9/61; OR, 0.17; 95% CI, 0.09-0.35); Year 3, 26% (16/64; OR, 0.33; 95% CI, 0.19-0.59); and Year 4, 46% (40/86; OR, 0.87; 95% CI, 0.57-1.33) (p < 0.001). Implementation of a resident-led quality improvement program resulted in higher rates of screening and treating vitamin D deficiency for patients with acute hip fractures. Housestaff-based initiatives may be an effective way to improve care processes that target improvements in bone health.

[Manipulative reduction and percutaneous Kirschner wire internal fixation for grade IV supination-external rotation ankle fractures].

PubMed

Li, Jia; Sun, Jin-Ke; Wang, Chen-Lin

2017-06-25

To investigate surgical skills and clinical effects of manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures. From May 2013 to October 2016, 35 patients with grade IV supination-external rotation ankle fractures were treated with percutaneous Kirschner wire internal fixation, involving 22 males and 13 females with an average age of 38.2 years ranged from 18 to 65 years old. The time from injury to operation ranged from 2 h to 10 d with an average of 5 d. Reduction quality was assessed by Burwell-Charnley radiological criteria. Baird-Jackson ankle scoring system was used to assess clinical effects. Thirty-three patients were followed up from 10 to 28 months with an average of 14 months. Fracture healing time ranged from 10 to 18 weeks with an average of 12 weeks. According to Burwell-Charnley radiological criteria, 30 cases were obtained anatomic reduction, 3 cases moderate. According to Baird-Jackson ankle scoring system, total score was 93.8±5.4, 17 cases got excellent result, 12 good, 2 fair and 2 poor. Manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures has advantages of reliable efficacy, less complications. But higher require techniques were required for closed reduction. It is not suitable for severe crushed fracture and compressive articular surface fracture.

Pelvic fracture in the patient with multiple injuries: factors and lesions associated with mortality.

PubMed

Martínez, Fernando; Alegret, Núria; Carol, Federico; Laso, M Jesús; Zancajo, Juanjo; García, Esteban; Ros, Vanesa

2018-01-01

The main objective of this study was to identify demographic, clinical, analytical factors or injuries associated with 30-day mortality in patients with pelvic fractures. Prospective observational study of patients with multiple injuries including pelvic fractures between January 2009 and January 2017. We recorded demographic, clinical, and laboratory data on arrival at the emergency department; type of pelvic fracture; treatments; associated lesions; and 30-day mortality. Univariable and multivariable models were used to analyze the data. A total of 2061 multiple-injury patients were attended; 118 had pelvic fractures. Fifteen of the patients with pelvic fractures (12.7%) died within 30 days. Arterial blood pressure on admission was less than 90 mm Hg in 23.7%, heart rate was over 100 beats per minute in 41.52%, lactic acid level was 20 mg/dL or higher in 67.6%, and base excess of -6 or less was recorded for 26.3%. The mean Injury Severity Score was 20 points. Angiographic embolization was required in 80.6% and preperitoneal packing in 3.4%. The main associated lesions were rib fractures (35.6%), hemo-pneumothorax (31.3%), spinal injuries (35.6%), and head injuries (30%). The 6 independent variables associated with risk of death in multiple-injury patients with pelvic fractures are age, female sex, complex fractures (Tile type C), lactic acid level of 20 mg/dL or more, base excess of -6 or less, and bowel perforation.

Discovery of a New Cellular Motion and Its Relevance to Breast Cancer and Involution

DTIC Science & Technology

2014-02-01

motion (CAMo), live cell imaging , confocal microscopy Overall Project Summary: During this first year of funding we have concentrated our work to...cell types in 3D cultures and in vivo. Subtask 1.1a: Real time live cell imaging using confocal microscopy will be used to image cellular movement...exciting as they are important steps in understanding behavior of normal myoepithelial cells using live cell imaging in physiologically

[Midterm follow-up results on Asian femoral intramedullary nail for the treatment of segmental and comminuted femoral fractures].

PubMed

Li, Lang; Gao, Feng; Huang, Qi; Li, Qiang; Xie, Lin; Zhang, Bin

2016-06-01

To investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and comminuted femoral fractures. Between June 2011 and October 2012,16 patients with segmental and comminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them, there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old; the time from injury to operation ranged from 3 to 24 d with an average of 9.1 d. There were 6 cases were type C1,2 cases were type C2 and 8 cases were type C3 according to AO classification. X-ray of femoral segment at 3,6 and 12 months after operation were applied for evaluating fracture healing. Harris score of hip joint and HSS score of knee joint were used to evaluate postoperative function. All patients were followed up from 24 to 36 months with an average of 28.4 months. Operative time was from 88 to 112 min with an average of 90.7 min; blood loss ranged from 150 to 200 ml with an average of 188.75 ml; the time of fracture healing was from 5 to 9 months with an average of 5.4 months. All incision were healed at stage I. No loosening, breakage of internal fixation and displacement of fracture were occurred. There were no significant differences in Harris score of hip joint at 3, 6 and 12 months after operation (F = 0.07, P = 0.893 > 0.05), 10 cases obtained excellent results, 5 good and 1 moderate. There was no obvious meaning in HSS score of knee joint (F = 0.08,P = 0.876 > 0.05), 9 cases obtained excellent results, 6 good and 1 poor. Asian femoral intramedullary nail could treat segmental and comminuted femoral fractures by using variety of less invasive ways,which has advantages of less trauma, quick recovery of function and satisfied midterm following-up results. But long term following-up effects remains to be seen.

Differences in Multitask Resource Reallocation After Change in Task Values.

PubMed

Matton, Nadine; Paubel, Pierre; Cegarra, Julien; Raufaste, Eric

2016-12-01

The objective was to characterize multitask resource reallocation strategies when managing subtasks with various assigned values. When solving a resource conflict in multitasking, Salvucci and Taatgen predict a globally rational strategy will be followed that favors the most urgent subtask and optimizes global performance. However, Katidioti and Taatgen identified a locally rational strategy that optimizes only a subcomponent of the whole task, leading to detrimental consequences on global performance. Moreover, the question remains open whether expertise would have an impact on the choice of the strategy. We adopted a multitask environment used for pilot selection with a change in emphasis on two out of four subtasks while all subtasks had to be maintained over a minimum performance. A laboratory eye-tracking study contrasted 20 recently selected pilot students considered as experienced with this task and 15 university students considered as novices. When two subtasks were emphasized, novices focused their resources particularly on one high-value subtask and failed to prevent both low-value subtasks falling below minimum performance. On the contrary, experienced people delayed the processing of one low-value subtask but managed to optimize global performance. In a multitasking environment where some subtasks are emphasized, novices follow a locally rational strategy whereas experienced participants follow a globally rational strategy. During complex training, trainees are only able to adjust their resource allocation strategy to subtask emphasis changes once they are familiar with the multitasking environment. © 2016, Human Factors and Ergonomics Society.

Rush Fracture Liaison Service for capturing "missed opportunities" to treat osteoporosis in patients with fragility fractures.

PubMed

Gupta, M J; Shah, S; Peterson, S; Baim, S

2018-06-04

In spite of being a public health problem of pandemic proportions, osteoporosis continues to be underdiagnosed and undertreated especially in older adults with fragility fractures. Confirmation of this hypothesis resulted in the development of a novel Fracture Liaison Service (Rush FLS). Results of the first 12 months of operation revealed that patients with confirmed fragility fracture do not have a timely diagnosis at fracture occurrence or treatment of their disease. The Rush FLS is an effective fracture liaison model. Determining the prevalence of undiagnosed and untreated osteoporosis in fragility fracture patients, either admitted to an academic tertiary care center or treated and discharged from the center's emergency department to be followed in the endocrinology bone clinic, using an innovative, educational, low-cost, physician-run Fracture Liaison Service (FLS). An automated alert was integrated into the electronic medical record at Rush University Medical Center (RUMC), triggered by historical and/or acute fracture(s) in patients 50 years or older, in patients that were either admitted to the hospital or in patients evaluated in the emergency department and discharged to be followed in the endocrinology bone clinic. We report the results of the first 12 months of operation in patients admitted to the hospital. First acute fragility fracture(s) were identified in 36% (80/223), only historical fragility fracture(s) in 28% (63/223) and both acute and historical fragility fracture(s) in 36% (80/223). The cumulative subgroup with historical fragility fractures with/without new fractures included 67% (96/143) without a previous diagnosis of osteoporosis. First acute fragility fracture group included 83.8% (67/80) without a previous diagnosis of osteoporosis. Rush FLS "captured missed opportunities" in 73.1% (163/223) of previously undiagnosed and 77.1% (172/223) of previously untreated osteoporosis patients. Dual-energy x-ray absorptiometry (DXA) prior to FLS consult was confirmed in 30% (67/223). Vitamin D deficiency (25-hydroxy vitamin D < 20 ng/ml) in 41.9% (78/186) including undetectable levels in 16.6% (31/186) and secondary hyperparathyroidism in 43.3% (78/180) were the most common laboratory confirmed secondary etiologies for bone loss. This study reported undiagnosed, uninvestigated, and untreated osteoporosis in the majority of fragility fracture patients seen by the Rush FLS in the first 12 months of operation.

Morphology of the posteromedial fragment in pertrochanteric fractures: A three-dimensional computed tomography analysis.

PubMed

Sharma, Gaurav; Gn, Kiran Kumar; Khatri, Kavin; Singh, Ravijot; Gamanagatti, Shivanand; Sharma, Vijay

2017-02-01

In this study we describe the morphology of the posteromedial fragment in pertrochanteric fractures using 3D CT scans and answer two questions 1) Do differences exist between the 3D CT appearances of posteromedial fragments and the depictions made in the AO classification 2) Does the posteromedial fragment affect stability in pertrochanteric fractures, in terms of fracture collapse? Preoperative CT scans of eight 31-A1 and fifty 31-A2 fractures were analysed. The presence of PM fragment, its fragmentation, greater trochanter (GT) involvement, lesser trochanter (LT) fragment size (in terms of its posterior and medial extent as well as LT length), LT fragment displacement (in terms of medial displacement and rotation) were determined. All fractures were treated with a DHS. Fracture collapse was determined on postoperative radiographs. The relationship between fracture collapse and patient factors including age, gender, fracture type (A1 versus A2), characteristics of the posteromedial fragment, and the presence of a lateral wall fracture were determined. Three out of eight 31-A1 fractures demonstrated a separate GT fragment (three part fracture). Out of the 50 31-A2 fractures, 12 had a single PM fragment, which included the LT and GT in continuity. The more common four part fractures seem to form by further fragmentation of this basic form. In A2 fractures, the GT was almost always broken and the broken fragment comprised a mean 56% of normal GT. The LT fragment involved an average of 74% of the posterior wall, and an average of 36% of the medial wall of the proximal femur. Larger LT fragments were less displaced as compared to smaller fragments. Univariate regression analyses revealed that fracture collapse was significantly correlated with fracture type (A1 versus A2, p 0.036), GT size (p 0.002) and the presence of a lateral wall fracture (p<0.001). This study revealed some important differences between the 3D CT appearances and AO classification of pertrochanteric fractures. Further, neither fragmentation of the posteromedial fragment, nor the size of the lesser trochanter fragment was found to predict stability in pertrochanteric fractures. A perioperative lateral wall fracture is the main determinant of stability in these fractures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Palaeopermeability anisotropies of a strike-slip fault damage zone: 3D Insights of quantitative fluid flow from µCT analysis.

NASA Astrophysics Data System (ADS)

Gomila, R.; Arancibia, G.; Nehler, M.; Bracke, R.; Morata, D.

2017-12-01

Fault zones and their related structural permeability are a key aspect in the migration of fluids through the continental crust. Therefore, the estimation of the hydraulic properties (palaeopermeability conditions; k) and the spatial distribution of the fracture mesh within the damage zone (DZ) are critical in the assessment of fault zones behavior for fluids. The study of the real spatial distribution of the veinlets of the fracture mesh (3D), feasible with the use of µCT analyses, is a first order factor to unravel both, the real structural permeability conditions of a fault-zone, and the validation of previous (and classical) estimations made in 2D analyses in thin-sections. This work shows the results of a fault-related fracture mesh and its 3D spatial distribution in the damage-zone of the Jorgillo Fault (JF), an ancient subvertical left-lateral strike-slip fault exposed in the Atacama Fault System in northern Chile. The JF is a ca. 20 km long NNW-striking strike-slip fault with sinistral displacement of ca. 4 km. The methodology consisted of drilling 5 mm vertically oriented plugs at several locations within the JF damage zone. Each specimen was scanned with an X-Ray µCT scanner, to assess the fracture mesh, with a voxel resolution of ca. 4.5 µm in the 3D reconstructed data. Tensor permeability modeling, using Lattice-Boltzmann Method, through the segmented microfracture mesh show GMkmin (geometric mean values) of 2.1x10-12 and 9.8x10-13 m2, and GMkmax of 6.4x10-12 and 2.1x10-12 m2. A high degree of anisotropy of the DZ permeability tensor both sides of the JF (eastern and western side, respectively) is observed, where the k values in the kmax plane are 2.4 and 1.9 times higher than the kmin direction at the time of fracture sealing. This style of anisotropy is consistent with the obtained for bedded sandstones supporting the idea that damage zones have an analogous effect - but vertically orientated - on bulk permeability (in low porosity rocks) as stratigraphic layering, where across-strike khorizontal of a fault is lower when compared with the kvertical and kfault parallel. Acknowledgements: This work is a contribution to FONDAP-CONICYT Project 15090013 and CONICYT- BMBF International Scientific Collaborative Research Program Project PCCI130025/FKZ01DN14033. R.G. Ph.D. is funded by CONICYT Scholarship 21140021.

Organizational and operational models for certificate management entities as part of the connected vehicle program : revised working paper (task 2).

DOT National Transportation Integrated Search

1997-01-01

This report summarizes the efforts performed under subtasks D&E of the ATIS Communications Technology Alternatives Task for the FHWA Turner Fairbank Highway Research Center. Tasks D & E were to facilitate further examination of wireless communication...

NRA8-21 Cycle 2 RBCC Turbopump Risk Reduction

NASA Technical Reports Server (NTRS)

Ferguson, Thomas V.; Williams, Morgan; Marcu, Bogdan

2004-01-01

This project was composed of three sub-tasks. The objective of the first task was to use the CFD code INS3D to generate both on- and off-design predictions for the consortium optimized impeller flowfield. The results of the flow simulations are given in the first section. The objective of the second task was to construct a turbomachinery testing database comprised of measurements made on several different impellers, an inducer and a diffuser. The data was in the form of static pressure measurements as well as laser velocimeter measurements of velocities and flow angles within the stated components. Several databases with this information were created for these components. The third subtask objective was two-fold: first, to validate the Enigma CFD code for pump diffuser analysis, and secondly, to perform steady and unsteady analyses on some wide flow range diffuser concepts using Enigma. The code was validated using the consortium optimized impeller database and then applied to two different concepts for wide flow diffusers.

[Internal fixation treatment of multiple rib fractures with absorbable rib-connecting-pins].

PubMed

Liu, Jinliang; Li, Keyao; He, Jianning

2011-01-01

To study the indications, methods, and therapeutic effect of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures. Between March 2007 and September 2009, 40 patients with multiple rib fractures received internal fixation with absorbable rib-connecting-pins, including 8 one-side flail chest and 1 two-side flail chest. There were 32 males and 8 females with an average age of 39.8 years (range, 25-72 years). The injury was caused by traffic accident in 32 cases, falling from height in 6 cases, and blunt hitting in 2 cases. Preoperatively, imaging data of the chest X-ray or spiral CT three-dimensional (3D) examination showed that all patients had multiple ribs fractures and displacement. The number of fractured ribs was 4-10 (median, 6), and the fracture location ranged from the 2nd to the 10th ribs. Of them, 28 cases were accompanied by hemathorax, pneumothorax or hemopneumothorax; 5 cases by thoracic organ injury; and 10 cases by other part trauma. The time from injury to hospitalization was less than 1 day in 26 cases, 1-3 days in 12 cases, and 3-6 days in 2 cases, and the time from hospitalization to operation was 3 hours to 3 days (mean, 1.2 days). The median fixation rib number was 5 (range, 3-8). The mean operative time, the time in bed, and hospitalization days were 32 minutes (range, 15-50 minutes), 4.5 days (range, 2-7 days), and 11.2 days (range, 5-18 days), respectively. All incisions healed by first intention. No pulmonary infection, pulmonary atelectasis, intrathoracic infection or other complications occurred. All cases were followed up 6-12 months (mean, 8 months). PaO2 [(86.6 +/- 2.2) mmHg (1 mm Hg = 0.133 kPa)] and SpO2 (97.2% +/- 0.6%) at 2 hours after operation were obviously improved when compared with preoperative ones (PaO2 (53.6 + 4.7) mm Hg and SpO2 (86.2% + 1.8%)], showing significant differences (t = 2.971, P = 0.005; t = 2.426, P = 0.020). The chest X-ray films or spiral CT 3D indicated that fracture of rib healed within 3-6 months (mean, 4.5 months) after operation. Severe collapsed chest wall or flail chest caused by fracture of multiple ribs should be treated by absorbable rib-connecting-pins, which is a simple, firm, and effective method.

Relationships among diet, physical activity, and dual plane dual-energy X-ray absorptiometry bone outcomes in pre-pubertalgirls.

PubMed

Ren, Jie; Brann, Lynn S; Bruening, Kay S; Scerpella, Tamara A; Dowthwaite, Jodi N

2017-12-01

In pre-pubertal girls, nutrient intakes and non-aquatic organized activity were evaluated as factors in vertebral body bone mass, structure, and strength. Activity, vitamin B 12 , and dietary fiber predicted bone outcomes most consistently. Exercise and vitamin B 12 appear beneficial, whereas high fiber intake appears to be adverse for vertebral body development. Childhood development sets the baseline for adult fracture risk. Most studies evaluate development using postero-anterior (PA) dual-energy X-ray absorptiometry (DXA) areal bone mineral density, bone mineral content, and bone mineral apparent density. In a prior analysis, we demonstrated that PA DXA reflects posterior element properties, rather than vertebral body fracture sites, such that loading is associated with subtle differences in vertebral body geometry, not 3D density. The current analysis is restricted to pre-pubertal girls, for a focused exploration of key nutrient intakes and physical activity as factors in dual plane indices of vertebral body geometry, density, and strength. This cross-sectional analysis used paired PA and supine lateral (LAT) lumbar spine DXA scans to assess "3D" vertebral body bone mineral apparent density (PALATBMAD), "3D" index of structural strength in axial compression (PALATIBS), and fracture risk index (PALATFRI). Diet data were collected using the Youth/Adolescent Questionnaire (YAQ, 1995); organized physical activity was recorded via calendar-based form. Pearson correlations and backward stepwise multiple linear regression analyzed associations among key nutrients, physical activity, and bone outcomes. After accounting for activity and key covariates, fiber, unsupplemented vitamin B 12 , zinc, carbohydrate, vitamin C, unsupplemented magnesium, and unsupplemented calcium intake explained significant variance for one or more bone outcomes (p < 0.05). After adjustment for influential key nutrients and covariates, activity exposure was associated with postero-anterior (PA) areal bone mineral density, PA bone mineral content, PA width, lateral (LAT) BMC, "3D" bone cross-sectional area (coronal plane), "3D" PALATIBS, and PALATFRI benefits (p < 0.05). Physical activity, fiber intake, and unsupplemented B 12 intake appear to influence vertebral body bone mass, density, geometry, and strength in well-nourished pre-pubertal girls; high fiber intakes may adversely affect childhood vertebral body growth.

Compositional Reservoir Simulation of Highly Heterogeneous and Anisotropic Fractured Media in 2D and 3D Unstructured Gridding

NASA Astrophysics Data System (ADS)

Zidane, A.; Firoozabadi, A.

2017-12-01

We present an efficient and accurate numerical model for multicomponent compressible single-phase flow in 2D and 3D fractured media based on higher-order discretization. The numerical model accounts for heterogeneity and anisotropy in unstructured gridding with low mesh dependency. The efficiency of our model is demonstrated by having comparable CPU time between fractured and unfractured media. The fracture cross-flow equilibrium approach (FCFE) is applied on triangular finite elements (FE) in 2D. This allows simulating fractured reservoirs with all possible orientations of fractures as opposed to rectangular FE. In 3D we apply the FCFE approach on the prism FE. The prism FE with FCFE allows simulating realistic fractured domains compared to hexahedron FE. In addition, when using FCFE on triangular and prism FE there is no limitation on the number of intersecting fractures, whereas in rectangular and hexahedron FE the number is limited to 2 in 2D and 3 in 3D. To generate domains with complicated boundaries, we have developed a computer-aided design (CAD) interface in our model. The advances introduced in this work are demonstrated through various examples.

Occult Intertrochanteric Fracture Mimicking the Fracture of Greater Trochanter.

PubMed

Chung, Phil Hyun; Kang, Suk; Kim, Jong Pil; Kim, Young Sung; Lee, Ho Min; Back, In Hwa; Eom, Kyeong Soo

2016-06-01

Occult intertrochanteric fractures are misdiagnosed as isolated greater trochanteric fractures in some cases. We investigated the utility of three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) in the diagnosis and outcome management of occult intertrochanteric fractures. This study involved 23 cases of greater trochanteric fractures as diagnosed using plain radiographs from January 2004 to July 2013. Until January 2008, 9 cases were examined with 3D-CT only, while 14 cases were screened with both 3D-CT and MRI scans. We analyzed diagnostic accuracy and treatment results following 3D-CT and MRI scanning. Nine cases that underwent 3D-CT only were diagnosed with isolated greater trochanteric fractures without occult intertrochanteric fractures. Of these, a patient with displacement received surgical treatment. Of the 14 patients screened using both CT and MRI, 13 were diagnosed with occult intertrochanteric fractures. Of these, 11 were treated with surgical intervention and 2 with conservative management. Three-dimensional CT has very low diagnostic accuracy in diagnosing occult intertrochanteric fractures. For this reason, MRI is recommended to confirm a suspected occult intertrochanteric fracture and to determine the most appropriate mode of treatment.

Occult Intertrochanteric Fracture Mimicking the Fracture of Greater Trochanter

PubMed Central

Chung, Phil Hyun; Kang, Suk; Kim, Jong Pil; Kim, Young Sung; Back, In Hwa; Eom, Kyeong Soo

2016-01-01

Purpose Occult intertrochanteric fractures are misdiagnosed as isolated greater trochanteric fractures in some cases. We investigated the utility of three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) in the diagnosis and outcome management of occult intertrochanteric fractures. Materials and Methods This study involved 23 cases of greater trochanteric fractures as diagnosed using plain radiographs from January 2004 to July 2013. Until January 2008, 9 cases were examined with 3D-CT only, while 14 cases were screened with both 3D-CT and MRI scans. We analyzed diagnostic accuracy and treatment results following 3D-CT and MRI scanning. Results Nine cases that underwent 3D-CT only were diagnosed with isolated greater trochanteric fractures without occult intertrochanteric fractures. Of these, a patient with displacement received surgical treatment. Of the 14 patients screened using both CT and MRI, 13 were diagnosed with occult intertrochanteric fractures. Of these, 11 were treated with surgical intervention and 2 with conservative management. Conclusion Three-dimensional CT has very low diagnostic accuracy in diagnosing occult intertrochanteric fractures. For this reason, MRI is recommended to confirm a suspected occult intertrochanteric fracture and to determine the most appropriate mode of treatment. PMID:27536653

INTRODUCTION TO PHARMACEUTICALS AND PERSONAL ...

EPA Pesticide Factsheets

There is no abstract for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. Subtask 3: T

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS ...

EPA Pesticide Factsheets

There is no abstract for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. Subtask 3: T

MONITORING SYNTHETIC MUSK COMPOUNDS IN ...

EPA Pesticide Factsheets

Synthetic musk compounds are manufactured as fragrance materials for consumer products and are consumed in very large quantities worldwide. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. Subtask 3: To apply state-of-the-art envir

CORRELATION OF CHEMICAL MARKERS - NITRATE AND ...

EPA Pesticide Factsheets

Giving public water authorities another tool to monitor and measure levels of human waste contamination of waters simply and rapidly would enhance public protection. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. Subtask 3: To ap

Methods, apparatus and system for selective duplication of subtasks

DOEpatents

Andrade Costa, Carlos H.; Cher, Chen-Yong; Park, Yoonho; Rosenburg, Bryan S.; Ryu, Kyung D.

2016-03-29

A method for selective duplication of subtasks in a high-performance computing system includes: monitoring a health status of one or more nodes in a high-performance computing system, where one or more subtasks of a parallel task execute on the one or more nodes; identifying one or more nodes as having a likelihood of failure which exceeds a first prescribed threshold; selectively duplicating the one or more subtasks that execute on the one or more nodes having a likelihood of failure which exceeds the first prescribed threshold; and notifying a messaging library that one or more subtasks were duplicated.

New software for 3D fracture network analysis and visualization

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

Extending Topological Approaches to Microseismic-Derived 3D Fracture Networks

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Estimation of the optimum dose of vitamin D for disease prevention in older people: rationale, design and baseline characteristics of the BEST-D trial.

PubMed

Clarke, Robert; Newman, Connie; Tomson, Joseph; Hin, Harold; Kurien, Rijo; Cox, Jolyon; Lay, Michael; Sayer, Jenny; Hill, Michael; Emberson, Jonathan; Armitage, Jane

2015-04-01

Previous large trials of vitamin D for prevention of fractures and other disease outcomes have reported conflicting results, possibly because the doses tested were insufficient to maintain optimum blood levels of vitamin D (25[OH]D) predicted by the observational studies. This report describes the design and baseline characteristics of the BEST-D (Biochemical Efficacy and Safety Trial of vitamin D) trial which aims to establish the best dose of vitamin D to assess in a future large outcome trial. The BEST-D trial will compare the biochemical and other effects of daily dietary supplementation with 100 μg or 50 μg vitamin D3 or placebo, when administered for 12 months, in 305 ambulant community-dwelling older people living in Oxfordshire, England. The primary analyses will compare 12-month mean plasma concentrations of 25(OH)D as well as the proportion of participants with a 12-month concentration >90 nmol/L between participants allocated 100 μg and participants allocated 50 μg daily. Secondary analyses will compare the two active doses (both separately and when combined) with placebo. Additional end-points include biochemical assessments of safety, blood pressure, arterial stiffness, falls, fractures, heel and wrist bone density, grip strength and physical performance and echocardiographic assessments of cardiac function in a random sample of participants. About one-third of eligible participants agreed to participate in the trial. The mean age was 72 (SD 6) years with equal numbers of men and women. About one third reported a prior history of fracture or hypertension, one-fifth reported a prior cardiovascular event, and one tenth reported diabetes or a fall in the previous 6 months. The results of this trial will help determine the optimum dose of vitamin D to test in a larger trial investigating whether vitamin D supplementation can reduce the risk of fractures, cardiovascular disease or cancer. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

FBI fingerprint identification automation study. AIDS 3 evaluation report. Volume 2: Technical feasibility

NASA Technical Reports Server (NTRS)

Mulhall, B. D. L.

1980-01-01

The results of this effort are presented in a manner for use by both the AIDS 3 Operational and Economic Feasibility subtasks as well as the Development of Alternative subtask. The approach taken was to identify the major functions that appear in AIDS 3 and then to determine which technologies would be needed for support. The technologies were then examined from the point of view of reliability, throughput, security, availability, cost and possible future trends. Whenever possible graphs are given to indicate projected costs of rapidly changing technologies.

Bone health in long-term gastric cancer survivors: A prospective study of high-dose vitamin D supplementation using an easy administration scheme.

PubMed

Climent, Marta; Pera, Manuel; Aymar, Isabel; Ramón, José M; Grande, Luis; Nogués, Xavier

2018-07-01

Bone disease in long-term survivors after gastric cancer resection has received little research attention. This study aimed to investigate bone health after curative resection of gastric cancer and the consequences of high-dose vitamin D supplementation in patients with low levels of 25-(OH)-vitamin D. Disease-free patients at least 24 months after gastric cancer resection represented the study cohort. Serum markers of bone metabolism were assessed at baseline and at 3 and 12 months. Bone mineral density and presence of fractures were assessed by X-ray at baseline. Patients with 25-(OH)-vitamin D ≤30 ng/mL at baseline received 16,000 IU of vitamin D3 every 10 days during the 1-year follow-up. Forty patients were included in the study. Mean time from surgery was 48.9 (24-109) months. Vitamin D insufficiency and secondary hyperparathyroidism were observed in 38 and 20 patients, respectively. Densitometry showed osteoporosis in 14 women and seven men and prevalent fractures in 12 women and six men at baseline. After 3 months of vitamin D supplementation, 35 patients reached values of 25-(OH)-vitamin D over 30 ng/mL. After 12 months, 38 patients were in the normal range of 25-(OH)-vitamin D. At the same time, iPTH levels and markers of bone turnover (C-terminal cross-linked telopeptide of type-I collagen, serum concentrations of bone-specific alkaline phosphatase and osteocalcin) significantly decreased after vitamin D intervention. Oral administration of high doses of vitamin D is easily implemented and restored 25-(OH)-vitamin D and iPTH values, which are frequently disturbed after gastric cancer resection.

Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men.

PubMed

Avenell, Alison; Mak, Jenson C S; O'Connell, Dianne

2014-04-14

Vitamin D and related compounds have been used to prevent osteoporotic fractures in older people. This is the third update of a Cochrane review first published in 1996. To determine the effects of vitamin D or related compounds, with or without calcium, for preventing fractures in post-menopausal women and older men. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (to December 2012), the Cochrane Central Register of Controlled Trials (2012, Issue 12), MEDLINE (1966 to November Week 3 2012), EMBASE (1980 to 2012 Week 50), CINAHL (1982 to December 2012), BIOSIS (1985 to 3 January 2013), Current Controlled Trials (December 2012) and reference lists of articles. Randomised or quasi-randomised trials that compared vitamin D or related compounds, alone or with calcium, against placebo, no intervention or calcium alone, and that reported fracture outcomes in older people. The primary outcome was hip fracture. Two authors independently assessed trial risk of selection bias and aspects of methodological quality, and extracted data. Data were pooled, where possible, using the fixed-effect model, or the random-effects model when heterogeneity between studies appeared substantial. We included 53 trials with a total of 91,791 participants. Thirty-one trials, with sample sizes ranging from 70 to 36,282 participants, examined vitamin D (including 25-hydroxy vitamin D) with or without calcium in the prevention of fractures in community, nursing home or hospital inpatient populations. Twelve of these 31 trials had participants with a mean or median age of 80 years or over.Another group of 22 smaller trials examined calcitriol or alfacalcidol (1-alphahydroxyvitamin D3), mostly with participants who had established osteoporosis. These trials were carried out in the setting of institutional referral clinics or hospitals.In the assessment of risk of bias for random sequence generation, 21 trials (40%) were deemed to be at low risk, 28 trials (53%) at unclear risk and four trials at high risk (8%). For allocation concealment, 22 trials were at low risk (42%), 29 trials were at unclear risk (55%) and two trials were at high risk (4%).There is high quality evidence that vitamin D alone, in the formats and doses tested, is unlikely to be effective in preventing hip fracture (11 trials, 27,693 participants; risk ratio (RR) 1.12, 95% confidence intervals (CI) 0.98 to 1.29) or any new fracture (15 trials, 28,271 participants; RR 1.03, 95% CI 0.96 to 1.11).There is high quality evidence that vitamin D plus calcium results in a small reduction in hip fracture risk (nine trials, 49,853 participants; RR 0.84, 95% confidence interval (CI) 0.74 to 0.96; P value 0.01). In low-risk populations (residents in the community: with an estimated eight hip fractures per 1000 per year), this equates to one fewer hip fracture per 1000 older adults per year (95% CI 0 to 2). In high risk populations (residents in institutions: with an estimated 54 hip fractures per 1000 per year), this equates to nine fewer hip fractures per 1000 older adults per year (95% CI 2 to 14). There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures. However, there is only moderate quality evidence of an absence of a statistically significant preventive effect on clinical vertebral fractures. There is high quality evidence that vitamin D plus calcium reduces the risk of any type of fracture (10 trials, 49,976 participants; RR 0.95, 95% CI 0.90 to 0.99).In terms of the results for adverse effects: mortality was not adversely affected by either vitamin D or vitamin D plus calcium supplementation (29 trials, 71,032 participants, RR 0.97, 95% CI 0.93 to 1.01). Hypercalcaemia, which was usually mild (2.6 to 2.8 mmol/L), was more common in people receiving vitamin D or an analogue, with or without calcium (21 trials, 17,124 participants, RR 2.28, 95% CI 1.57 to 3.31), especially for calcitriol (four trials, 988 participants, RR 4.41, 95% CI 2.14 to 9.09), than in people receiving placebo or control. There was also a small increased risk of gastrointestinal symptoms (15 trials, 47,761 participants, RR 1.04, 95% CI 1.00 to 1.08), especially for calcium plus vitamin D (four trials, 40,524 participants, RR 1.05, 95% CI 1.01 to 1.09), and a significant increase in renal disease (11 trials, 46,548 participants, RR 1.16, 95% CI 1.02 to 1.33). Other systematic reviews have found an increased association of myocardial infarction with supplemental calcium; and evidence of increased myocardial infarction and stroke, but decreased cancer, with supplemental calcium plus vitamin D, without an overall effect on mortality. Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people. Supplements of vitamin D and calcium may prevent hip or any type of fracture. There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium. This review found that there was no increased risk of death from taking calcium and vitamin D.

Aerospace engineering design by systematic decomposition and multilevel optimization

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, J.; Barthelemy, J. F. M.; Giles, G. L.

1984-01-01

A method for systematic analysis and optimization of large engineering systems, by decomposition of a large task into a set of smaller subtasks that is solved concurrently is described. The subtasks may be arranged in hierarchical levels. Analyses are carried out in each subtask using inputs received from other subtasks, and are followed by optimizations carried out from the bottom up. Each optimization at the lower levels is augmented by analysis of its sensitivity to the inputs received from other subtasks to account for the couplings among the subtasks in a formal manner. The analysis and optimization operations alternate iteratively until they converge to a system design whose performance is maximized with all constraints satisfied. The method, which is still under development, is tentatively validated by test cases in structural applications and an aircraft configuration optimization.

Hand grip strength and its correlation with vitamin D in Indian patients with hip fracture.

PubMed

Dhanwal, Dinesh K; Dharmshaktu, Pramila; Gautam, V K; Gupta, N; Saxena, Alpana

2013-01-01

This case-control study was performed to evaluate 25-hydroxyvitamin D [25(OH)D] deficiency and its correlation with hand grip strength in 95 Indian hip fracture subjects and 95 controls. 25(OH)D deficiency was found in 88.4 % of hip fracture subjects that was significantly higher as compared to controls. Hand grip strength as measured by hand held dynamometer was significantly lower in patients, and there was a significant positive correlation between 25(OH)D and hand grip strength. The present study was conducted to assess correlation between 25(OH) D and hand grip strength in hip fracture subjects residing in North India. Ninety-five patients with hip fracture and similar number of controls were enrolled in the study. Fasting venous samples were analyzed for 25(OH)D, intact parathyroid hormone (PTH), alkaline phosphatase, calcium, and phosphate. Hand grip strength of study subjects was measured using Jamar dynamometer. Correlation between vitamin D levels and hand grip strength was analyzed in study population. The mean age of hip fracture subjects was 61.4 ± 12.6 years which was comparable in men and women. Out of 95 subjects, 57 were men and 38 were women. Mean 25(OH)D levels were significantly lower whereas intact PTH levels were significantly higher in patient group compared controls (10.29 ± 6.53 vs 13.6 ± 4.01 ng/ml; 62.6 ± 59.3 vs 37.7 ± 28.8 pg/ml, respectively). The number of subjects with 25(OH)D deficiency and secondary hyperparathyroidism was significantly higher in hip fracture group. The mean hand grip strength among hip fracture subjects was significantly lower compared to that of controls (16.57 ± 5.74 vs 26.74 ± 5.23 kg). There was a significant positive correlation between 25(OH)D and hand grip strength ( r = 0.482, p value <0.01) in hip fracture population. Majority of hip fracture patients in India have vitamin D deficiency, secondary hyperparathyroidism, and lower hand grip strength compared to controls. Further, there is significant positive correlation between 25(OH)D and hand grip strength.

Floor-Fractured Craters on Ceres and Implications for Internal Composition and Processes

NASA Astrophysics Data System (ADS)

Buczkowski, D.; Schenk, P.; Scully, J. E. C.; Park, R. S.; Preusker, F.; Raymond, C. A.; Russell, C. T.

2016-12-01

Several of the impact craters on Ceres have patterns of fractures on their floors. These fractures appear similar to those found within a class of lunar craters referred to as Floor-Fractured Craters (FFCs) [1]. Lunar FFCs are characterized by anomalously shallow floors cut by radial, concentric, and/or polygonal fractures, and have been classified into crater classes, Types 1 through 6, based on their morphometric properties [1,2]. Models for their formation have included both floor uplift due to magmatic intrusion below the crater or floor shallowing due to viscous relaxation. However, the observation that the depth versus diameter (d/D) relationship of the FFCs is distinctly shallower than the same association for other lunar craters supports the hypotheses that the floor fractures form due to shallow magmatic intrusion under the crater [2]. We have cataloged the Ceres FFCs according to the classification scheme designed for the Moon. Large (>50 km) Ceres FFCs are most consistent with Type 1 lunar FFCs, having deep floors, central peaks, wall terraces, and radial and/or concentric fractures. Smaller craters on Ceres are more consistent with Type 4 lunar FFCs, having less-pronounced floor fractures and v-shaped moats separating the wall scarp from the crater interior. An analysis of the d/D ratio for Ceres craters shows that, like lunar FFCs, the Ceres FFCs are anomalously shallow. This suggests that the fractures on the floor of Ceres FFCs may be due the intrusion of a low-density material below the craters that is uplifting their floors. While on the Moon the intrusive material is hypothesized to be silicate magma, this is unlikely for Ceres. However, a cryovolcanic extrusive edifice has been identified on Ceres [3], suggesting that cryomagmatic intrusions could be responsible for the formation of the Ceres FFCs. References: [1] Schultz P. (1976) Moon, 15, 241-273 [2] Jozwiak L.M. et al (2015) JGR 117, doi: 10.1029/2012JE004134 [3] Ruesch O. et al (2016) Science

Computer-assisted virtual preoperative planning in orthopedic surgery for acetabular fractures based on actual computed tomography data.

PubMed

Wang, Guang-Ye; Huang, Wen-Jun; Song, Qi; Qin, Yun-Tian; Liang, Jin-Feng

2016-12-01

Acetabular fractures have always been very challenging for orthopedic surgeons; therefore, appropriate preoperative evaluation and planning are particularly important. This study aimed to explore the application methods and clinical value of preoperative computer simulation (PCS) in treating pelvic and acetabular fractures. Spiral computed tomography (CT) was performed on 13 patients with pelvic and acetabular fractures, and Digital Imaging and Communications in Medicine (DICOM) data were then input into Mimics software to reconstruct three-dimensional (3D) models of actual pelvic and acetabular fractures for preoperative simulative reduction and fixation, and to simulate each surgical procedure. The times needed for virtual surgical modeling and reduction and fixation were also recorded. The average fracture-modeling time was 45 min (30-70 min), and the average time for bone reduction and fixation was 28 min (16-45 min). Among the surgical approaches planned for these 13 patients, 12 were finally adopted; 12 cases used the simulated surgical fixation, and only 1 case used a partial planned fixation method. PCS can provide accurate surgical plans and data support for actual surgeries.

Application of 3D Printing in the Surgical Planning of Trimalleolar Fracture and Doctor-Patient Communication.

PubMed

Yang, Long; Shang, Xian-Wen; Fan, Jian-Nan; He, Zhi-Xu; Wang, Jian-Ji; Liu, Miao; Zhuang, Yong; Ye, Chuan

2016-01-01

To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication, thirty patients with trimalleolar fractures were randomly divided into the 3D printing assisted-design operation group (Group A) and the no-3D printing assisted-design group (Group B). In Group A, 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment. All patients underwent open reduction and internal fixation. A questionnaire was designed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype. Meanwhile, the operation time and the intraoperative blood loss were compared between the two groups. The fracture prototypes were accurately printed, and the average overall score of the verisimilitude and effectiveness of the 3D-printed prototypes was relatively high. Both the operation time and the intraoperative blood loss in Group A were less than those in Group B (P < 0.05). Patient satisfaction using the 3D-printed prototype and the communication score were 9.3 ± 0.6 points. A 3D-printed prototype can faithfully reflect the anatomy of the fracture site; it can effectively help the doctors plan the operation and represent an effective tool for physician-patient communication.

3-D Mixed Mode Delamination Fracture Criteria - An Experimentalist's Perspective

NASA Technical Reports Server (NTRS)

Reeder, James R.

2006-01-01

Many delamination failure criteria based on fracture toughness have been suggested over the past few decades, but most only covered the region containing mode I and mode II components of loading because that is where toughness data existed. With new analysis tools, more 3D analyses are being conducted that capture a mode III component of loading. This has increased the need for a fracture criterion that incorporates mode III loading. The introduction of a pure mode III fracture toughness test has also produced data on which to base a full 3D fracture criterion. In this paper, a new framework for visualizing 3D fracture criteria is introduced. The common 2D power law fracture criterion was evaluated to produce unexpected predictions with the introduction of mode III and did not perform well in the critical high mode I region. Another 2D criterion that has been shown to model a wide range of materials well was used as the basis for a new 3D criterion. The new criterion is based on assumptions that the relationship between mode I and mode III toughness is similar to the relation between mode I and mode II and that a linear interpolation can be used between mode II and mode III. Until mixed-mode data exists with a mode III component of loading, 3D fracture criteria cannot be properly evaluated, but these assumptions seem reasonable.

[Detection of tibial condylar fractures using 3D imaging with a mobile image amplifier (Siemens ISO-C-3D): Comparison with plain films and spiral CT].

PubMed

Kotsianos, D; Rock, C; Wirth, S; Linsenmaier, U; Brandl, R; Fischer, T; Euler, E; Mutschler, W; Pfeifer, K J; Reiser, M

2002-01-01

To analyze a prototype mobile C-arm 3D image amplifier in the detection and classification of experimental tibial condylar fractures with multiplanar reconstructions (MPR). Human knee specimens (n = 22) with tibial condylar fractures were examined with a prototype C-arm (ISO-C-3D, Siemens AG), plain films (CR) and spiral CT (CT). The motorized C-arm provides fluoroscopic images during a 190 degrees orbital rotation computing a 119 mm data cube. From these 3D data sets MP reconstructions were obtained. All images were evaluated by four independent readers for the detection and assessment of fracture lines. All fractures were classified according to the Müller AO classification. To confirm the results, the specimens were finally surgically dissected. 97 % of the tibial condylar fractures were easily seen and correctly classified according to the Müller AO classification on MP reconstruction of the ISO-C-3D. There is no significant difference between ISO-C and CT in detection and correct classification of fractures, but ISO-CD-3D is significant by better than CR. The evaluation of fractures with the ISO-C is better than with plain films alone and comparable to CT scans. The three-dimensional reconstruction of the ISO-C can provide important information which cannot be obtained from plain films. The ISO-C-3D may be useful in planning operative reconstructions and evaluating surgical results in orthopaedic surgery of the limbs.

Relationship between vitamin D, parathyroid hormone, bone mineral density, fracture and antiretroviral therapy in HIV patients.

PubMed

Das, Satyajit; Bopitya, Shyamalie; Taha, Huda; David, Loay

2014-01-01

Vitamin D deficiency and abnormal bone mineral density (BMD) have been reported in HIV patients. We aimed to find out the effects of antiretroviral therapy (ART) on serum vitamin D, parathyroid hormone (PTH) levels, BMD changes and fragility fracture rates in HIV patients. We collected information about baseline demography, risk factors for fracture, viral load (VL), CD4 count, serum 25-OH vitamin D (n=357), PTH (n=277), phosphate, ionised calcium, creatinine and BMD of spine and hip by DEXA scan (hologic, n=142). Statistical analysis used one-way ANOVA followed by Dunn's multiple comparison tests. Results Table 1: Total 357 patients, mean age 41.1 (+/- 11.9) years, 249 (66%) black African, 197(52%) females, baseline CD4 count 451 (+/- 184) cells/dl, VL 1.4 log (+/- 1.2) copies/ml, duration of ART 52 (+/- 35) months were included in the analysis. Serum vitamin D was 15.3 (+/- 11.0) ng/ml, PTH (intact) 5.5 (+/- 3.9) pmol/l, corrected calcium 2.13 (+/- 0.9), phosphate 1.0 (+/- 0.2) and creatinine was 73.4 (+/- 21.1) mmol/l. Ninety four (66%) patients had abnormal BMD (T-score of spine or hip or both ≤ 1.0). Vitamin D levels were deficient (< 30 ng/ml) in 297 (78.7%) and PTH was high (>4.1 pmol/l) in 177 (64.8%) patients. Of 91 (30.9%) patients who had vitamin D levels below 10.0 ng/mL, PTH was high in 70 (n=91, 76.9%) and abnormal BMD in 50 (n=61, 75.4%) patients. Thirteen patients (3.2%) had possible fragility fractures. Tenofovir (TDF) users had higher PTH (P=0.002) and lower BMD of spine (0.01) and hip (0.002) and efavirenz (EFV) users had lower vitamin D (0.01) levels. On multivariate analysis including all significant variables, female sex (OR 1.5 CI 1.3-5.9), age over 40 years (OR 1.2 CI 0.9-5.1) and TDF use (OR 1.9 CI 1.6-6.9) were associated with abnormal BMD of hip but not spine. Female patients over 40 years old on tenofovir containing regimens may have increased risk of BMD loss from hip. Whether Vitamin D replacement will prevent further bone loss needs further work.

The National Shipbuilding Research Program. Environmental Studies and Testing (Phase V)

DTIC Science & Technology

2000-11-20

development of an analytical procedure for toxic organic compounds, including TBT ( tributyltin ), whose turnaround time would be in the order of minutes...Cost of the Subtask was $20,000. Subtask #33 - Turnaround Analytical Method for TBT This Subtask performed a preliminary investigation leading to the...34Quick TBT Analytical Method" that will yield reliable results in 15 minutes, a veritable breakthrough in sampling technology. The Subtask was managed by

Investigation of Bone Health Subsequent to Vitamin D Supplementation in Children Following Burn Injury.

PubMed

Mayes, Theresa; Gottschlich, Michele M; Khoury, Jane; Kagan, Richard J

2015-12-01

The effect of supplemental vitamin D on fracture occurrence following burn injuries is unclear. The objective of this study was to evaluate postintervention incidence of fractures in children during the rehabilitative phase postburn (PB) following participation in a randomized clinical trial of vitamin D supplementation. Follow-up for fracture evaluation was obtained in 39 of 50 patients randomized to daily enteral vitamin D2, D3, or placebo throughout the acute burn course. Serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, D2, D3, calcitonin, and bone alkaline phosphatase (BAP) measurements were obtained PB day 7, midpoint, discharge, and 1-year PB. Urinary calcium was obtained PB day 7 and midpoint. Dual-energy x-ray absorptiometry (DXA) was performed at discharge and 1-year PB. Fractures were reported in 6 of 39 respondents. Four fractures occurred in the placebo group, 2 in the D2 group, and none in the D3 group. Serum vitamin D, calcitonin, BAP, and urinary calcium were similar between fracture groups. The group with fracture morbidity had larger burn size (83.8% ± 4.9% vs 53.0% ± 2.9%, P < .0001), greater full-thickness burn (69.7% ± 9.4% vs 39.4% ± 4.1%, P = .02), and increased incidence of inhalation injury (33% vs 6%, P = .04). Decreased bone mineral density z score was noted at discharge in the placebo fracture compared with no-fracture group (P < .05). This preliminary report suggests there may be benefit of vitamin D3 in reducing postdischarge fracture risk. Results reaffirm the importance of monitoring bone health in pediatric patients postburn. © 2015 American Society for Parenteral and Enteral Nutrition.

Fracture network created by 3D printer and its validation using CT images

NASA Astrophysics Data System (ADS)

Suzuki, A.; Watanabe, N.; Li, K.; Horne, R. N.

2017-12-01

Understanding flow mechanisms in fractured media is essential for geoscientific research and geological development industries. This study used 3D printed fracture networks in order to control the properties of fracture distributions inside the sample. The accuracy and appropriateness of creating samples by the 3D printer was investigated by using a X-ray CT scanner. The CT scan images suggest that the 3D printer is able to reproduce complex three-dimensional spatial distributions of fracture networks. Use of hexane after printing was found to be an effective way to remove wax for the post-treatment. Local permeability was obtained by the cubic law and used to calculate the global mean. The experimental value of the permeability was between the arithmetic and geometric means of the numerical results, which is consistent with conventional studies. This methodology based on 3D printed fracture networks can help validate existing flow modeling and numerical methods.

Spinal Cord Injury-Induced Dysautonomia via Plasticity in Paravertebral Sympathetic Postganglionic

DTIC Science & Technology

2015-10-01

for future study Data analysis and publications Major Task 3: Data analysis and publications months % completion/ Completion dates Subtask 1...Data analysis 6-36 25% Subtask 2: Manuscript writing and submission 24-36 10% Milestone(s) Achieved: Dissemination of scientific results. b. What...ganglia by computational simulation and dynamic-clamp analysis . Journal of neurophysiology 92, 2659- 2671, doi:10.1152/jn.00470.2004 (2004). 14 Llewellyn

Structured Analysis and Structured Design for the Logistic Support Analysis (LSA) Task 303 Evaluation of Alternatives and Trade-Off Analysis, LSA Subtask 303.2.2, Trade-Off Between Support System Alternatives and System/Equipment Alternatives

DTIC Science & Technology

1991-01-01

Field 3. Training and Training Devices: a. Factory training b. Instructor and key personnel training c. New equipment training plan d. New equipment...12345678901234567990123456789012345678901234567890123456789� 1. 0016 10 SUPPOR2AILITY ALTEIIIVE TRADE-OFF ANALISIS . 4. + 4" + 4. 4. 4 2. C1.0 111.0 N2.0 1.0 INITIATE

SOURCES & ORIGINS OF PPCPS: A COMPLEX ISSUE ...

EPA Pesticide Factsheets

There is no abstract for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. Subtask 3: T

Transcranial direct current stimulation facilitates cognitive multi-task performance differentially depending on anode location and subtask

PubMed Central

Scheldrup, Melissa; Greenwood, Pamela M.; McKendrick, Ryan; Strohl, Jon; Bikson, Marom; Alam, Mahtab; McKinley, R. Andy; Parasuraman, Raja

2014-01-01

There is a need to facilitate acquisition of real world cognitive multi-tasks that require long periods of training (e.g., air traffic control, intelligence analysis, medicine). Non-invasive brain stimulation—specifically transcranial Direct Current Stimulation (tDCS)—has promise as a method to speed multi-task training. We hypothesized that during acquisition of the complex multi-task Space Fortress, subtasks that require focused attention on ship control would benefit from tDCS aimed at the dorsal attention network while subtasks that require redirection of attention would benefit from tDCS aimed at the right hemisphere ventral attention network. We compared effects of 30 min prefrontal and parietal stimulation to right and left hemispheres on subtask performance during the first 45 min of training. The strongest effects both overall and for ship flying (control and velocity subtasks) were seen with a right parietal (C4, reference to left shoulder) montage, shown by modeling to induce an electric field that includes nodes in both dorsal and ventral attention networks. This is consistent with the re-orienting hypothesis that the ventral attention network is activated along with the dorsal attention network if a new, task-relevant event occurs while visuospatial attention is focused (Corbetta et al., 2008). No effects were seen with anodes over sites that stimulated only dorsal (C3) or only ventral (F10) attention networks. The speed subtask (update memory for symbols) benefited from an F9 anode over left prefrontal cortex. These results argue for development of tDCS as a training aid in real world settings where multi-tasking is critical. PMID:25249958

Transcranial direct current stimulation facilitates cognitive multi-task performance differentially depending on anode location and subtask.

PubMed

Scheldrup, Melissa; Greenwood, Pamela M; McKendrick, Ryan; Strohl, Jon; Bikson, Marom; Alam, Mahtab; McKinley, R Andy; Parasuraman, Raja

2014-01-01

There is a need to facilitate acquisition of real world cognitive multi-tasks that require long periods of training (e.g., air traffic control, intelligence analysis, medicine). Non-invasive brain stimulation-specifically transcranial Direct Current Stimulation (tDCS)-has promise as a method to speed multi-task training. We hypothesized that during acquisition of the complex multi-task Space Fortress, subtasks that require focused attention on ship control would benefit from tDCS aimed at the dorsal attention network while subtasks that require redirection of attention would benefit from tDCS aimed at the right hemisphere ventral attention network. We compared effects of 30 min prefrontal and parietal stimulation to right and left hemispheres on subtask performance during the first 45 min of training. The strongest effects both overall and for ship flying (control and velocity subtasks) were seen with a right parietal (C4, reference to left shoulder) montage, shown by modeling to induce an electric field that includes nodes in both dorsal and ventral attention networks. This is consistent with the re-orienting hypothesis that the ventral attention network is activated along with the dorsal attention network if a new, task-relevant event occurs while visuospatial attention is focused (Corbetta et al., 2008). No effects were seen with anodes over sites that stimulated only dorsal (C3) or only ventral (F10) attention networks. The speed subtask (update memory for symbols) benefited from an F9 anode over left prefrontal cortex. These results argue for development of tDCS as a training aid in real world settings where multi-tasking is critical.

Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures

PubMed Central

Hawkes, W. G.; Glowacki, J.; Yu-Yahiro, J.; Hurwitz, S.; Magaziner, J.

2008-01-01

Summary We determined the prevalence of vitamin D deficiency and lower extremity function in women with hip fractures. Women with extremely low vitamin D levels had reduced lower extremity muscle function and increased falls 1 year later. Ensuring vitamin D sufficiency after a hip fracture may improve function and reduce falls. Introduction Hip fractures are the most devastating of fractures, commonly leading to loss of independent ambulation and living. In this retrospective analysis we determined the prevalence of vitamin D deficiency in women with hip fractures and the association between 25-hydroxyvitamin D [25(OH)D] levels and functional impairment one year later. Methods One hundred ten community-dwelling women with hip fractures were recruited from Boston, MA (n= 30) and Baltimore, MD (n=80) before 1998 and 25(OH)D levels were measured by radioimmunoassay. In a subset of women from Baltimore, a performance measure of the lower extremities using the lower extremity gain scale (LEGS) was measured at 2, 6, and 12 months. Falls, grip strength, chair rise time, walking speed, and balance were also determined. Results Vitamin D insufficiency defined as a 25(OH)D ≤32 ng/mL was present in 96% of the women with hip fractures and 38% had extremely low levels ≤9 ng/mL. At 1 year post-fracture, compared to women with a 25(OH) D >9 ng/mL, those with 25(OH)D ≤9 ng/mL had poorer LEGS performance (p<0.0001) and higher fall rates, without group differences in grip strength or balance. Conclusion Vitamin D sufficiency may have important effects on lower extremity function following hip fractures, without excessive healthcare costs. PMID:18373057

3D Simulation of Multiple Simultaneous Hydraulic Fractures with Different Initial Lengths in Rock

NASA Astrophysics Data System (ADS)

Tang, X.; Rayudu, N. M.; Singh, G.

2017-12-01

Hydraulic fracturing is widely used technique for extracting shale gas. During this process, fractures with various initial lengths are induced in rock mass with hydraulic pressure. Understanding the mechanism of propagation and interaction between these induced hydraulic cracks is critical for optimizing the fracking process. In this work, numerical results are presented for investigating the effect of in-situ parameters and fluid properties on growth and interaction of multi simultaneous hydraulic fractures. A fully coupled 3D fracture simulator, TOUGH- GFEM is used for simulating the effect of different vital parameters, including in-situ stress, initial fracture length, fracture spacing, fluid viscosity and flow rate on induced hydraulic fractures growth. This TOUGH-GFEM simulator is based on 3D finite volume method (FVM) and partition of unity element method (PUM). Displacement correlation method (DCM) is used for calculating multi - mode (Mode I, II, III) stress intensity factors. Maximum principal stress criteria is used for crack propagation. Key words: hydraulic fracturing, TOUGH, partition of unity element method , displacement correlation method, 3D fracturing simulator

Parathyroid hormone response to two levels of vitamin D deficiency is associated with high risk of medical problems during hospitalization in patients with hip fracture.

PubMed

Alarcón, T; González-Montalvo, J I; Hoyos, R; Diez-Sebastián, J; Otero, A; Mauleon, J L

2015-10-01

Vitamin D and the parathyroid hormone (PTH) response play an important role in hip fracture patients. This study was carried out to determine the factors associated with the PTH response to different levels of vitamin D deficiency during hospitalization. This was a cross-sectional study of patients over 64 years of age admitted with an acute fragility hip fracture between March 1st 2009 and November 30th 2012. Demographic, clinical, functional, and cognitive function were evaluated at admission and during hospitalization. Levels of 25-hydroxyvitamin D (25-OHD) and PTH were analyzed. Two 25-OHD cut-off points were considered, <12 ng/ml and 12-20 ng/ml. Multivariate logistic regression analysis was used. Mean age of the 607 patients included was 84.7 years (SD 7.10), and 81.9 % were women. The mean 25-OHD level in the total sample was 13.2 (SD 11.1) ng/ml. Levels of 25-OHD <12 ng/ml were present in 347 patients (57.2 %), of whom 158 (45.5 %) had secondary hyperparathyroidism (SHPT) (PTH >65 pg/ml). 25-OHD levels of 12-20 ng/ml were present in 168 (27.7 %) patients, of whom 47 (28 %) had SHPT. Following logistic regression, SHPT was associated in both groups (25-OHD <12 and 12-20 ng/ml) with a greater number of medical problems during hospitalization. In the 25-OHD group <12 ng/ml, SHPT was also associated with poorer glomerular filtration rates. The PTH response to vitamin D deficiency in hip fracture patients may be a marker for patients with higher risk of developing multiple medical problems, both when considering severe (<12 ng/ml) and moderate (12-20 ng/ml) vitamin D deficiency.

Use of a real-size 3D-printed model as a preoperative and intraoperative tool for minimally invasive plating of comminuted midshaft clavicle fractures.

PubMed

Kim, Hyong Nyun; Liu, Xiao Ning; Noh, Kyu Cheol

2015-06-10

Open reduction and plate fixation is the standard operative treatment for displaced midshaft clavicle fracture. However, sometimes it is difficult to achieve anatomic reduction by open reduction technique in cases with comminution. We describe a novel technique using a real-size three dimensionally (3D)-printed clavicle model as a preoperative and intraoperative tool for minimally invasive plating of displaced comminuted midshaft clavicle fractures. A computed tomography (CT) scan is taken of both clavicles in patients with a unilateral displaced comminuted midshaft clavicle fracture. Both clavicles are 3D printed into a real-size clavicle model. Using the mirror imaging technique, the uninjured side clavicle is 3D printed into the opposite side model to produce a suitable replica of the fractured side clavicle pre-injury. The 3D-printed fractured clavicle model allows the surgeon to observe and manipulate accurate anatomical replicas of the fractured bone to assist in fracture reduction prior to surgery. The 3D-printed uninjured clavicle model can be utilized as a template to select the anatomically precontoured locking plate which best fits the model. The plate can be inserted through a small incision and fixed with locking screws without exposing the fracture site. Seven comminuted clavicle fractures treated with this technique achieved good bone union. This technique can be used for a unilateral displaced comminuted midshaft clavicle fracture when it is difficult to achieve anatomic reduction by open reduction technique. Level of evidence V.

Municipal resources and patient outcomes through the first year after a hip fracture.

PubMed

Ruths, Sabine; Baste, Valborg; Bakken, Marit Stordal; Engesæter, Lars Birger; Lie, Stein Atle; Haugland, Siren

2017-02-16

Hip fractures represent major critical events for older people, and put huge demands on economic and personnel resources. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery. The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life. We conducted a nationwide cohort study on people experiencing a hip fracture in 2011-2012 in Norway, with a 1-year follow-up. We obtained data on date of hip fracture, demographics, total morbidity (ASA) score, health-related quality of life (EQ-5D-3 L), date of death if applicable, municipality of residence (Norwegian Hip Fracture Register), date of hospital readmission due to complications (Norwegian Patient Register), and information on municipalities' characteristics (Municipality-State-Reporting). The study population comprised 15,757 patients, mean age 80.8 years, 68.6% women. All-cause mortality was 8.6% at 30 days, and 25.3% at 12 months. Mortality was lower in the municipalities with the highest overall staff time for rehabilitation. A high proportion of the population aged 80+, was associated with low rates of self-reported anxiety/depression 12 months after surgery, as well as higher general health scores (EQ-5D VAS). There were no other differences in outcome according to rehabilitation resources, when comparing municipalities with the highest and lowest staffing. The study revealed no substantial impact of municipal resources on survival and health-related quality of life through the first year after a hip fracture. To evaluate major organizational changes and allocate resources according to best practice, there is a need to monitor health outcomes and use of resources over time through reliable measures, including variables related to coordination between services.

Strategic avionics technology definition studies. Subtask 3-1A: Electrical Actuation (ELA) systems

NASA Technical Reports Server (NTRS)

Lum, Ben T. F.; Pond, Charles; Dermott, William

1993-01-01

This interim report presents the preliminary results of an electrical actuation (ELA) system study (subtask TA3-1A) to support the NASA strategic avionics technology definition studies. The final report of this ELA study is scheduled for September 30, 1993. The topics are presented in viewgraph form and include the following ELA technology demonstration testing; ELA system baseline; power and energy requirements for shuttle effector systems; power efficiency and losses of ELA effector systems; and power and energy requirements for ELA power sources.

Prevention of hip fractures by correcting calcium and vitamin D insufficiencies in elderly people.

PubMed

Meunier, P

1996-01-01

For a 50-year old caucasian woman today, the risk of a hip fracture over her remaining lifetime is about 17%. Tomorrow the situation will clearly be worse because the continual increase in life expectancy will cause a 3-fold rise in worldwide fracture incidence over the next 60 years, particularly in women, but also in men. In addition, a secular increase in the incidence of hip fractures in individuals of the same age has been noted in both sexes by several investigators, and the cost of hip fractures is expected to dramatically increase in the next decades. Consequently, preventive strategies are urgently required. A great deal has been learned in recent years about the risk factors for hip fracture, the pathophysiology of this fracture, and the prediction of fracture risk, particularly through bone mass measurements on the hip and biochemical evaluations of parathyroid and vitamin D status. The two main determinants of hip fractures are falls and bone loss leading to an intrinsic femoral fragility. A substantial femoral bone loss continues throughout the old age, with a continuous and exponential increase in the risk of hip fracture, and any reduction or arrest of this loss will induce an important reduction in the incidence of hip fractures. A preventive effect on the risk of hip fracture may be partly achieved by using long term estrogen replacement therapy after menopause, but also by using vitamin D and calcium supplements for a late prevention in elderly people. Vitamin D insufficiency and deficit in calcium intake are very common in elderly people living either in institutions or at home, particularly in Europe where dairy products are not fortified with vitamin D. The cumulative response to this deficit in calcium intake and low vitamin D status is a negative calcium balance which stimulates parathyroid hormone secretion. In 300 residents of nursing homes, we recently found a significant negative correlation between serum 25 OHD and log serum PTH after age-adjustment. In addition, in 446 elderly women living at home in 5 French cities and selected from the voting lists, we also found an age-adjusted relationship between serum 25 OHD and PTH concentrations. This senile secondary hyperparathyroidism is one of the determinants of femoral bone loss and can be reversed by calcium and vitamin D supplements. We have shown in a 3-year controlled prospective study that the daily use of these supplements (1.2 g of calcium and 800 IU of vitamin D3) given in a large population of 3270 elderly ambulatory women living in nursing homes reduced of 23% (intention-to-treat analysis) the number of hip fractures and other non vertebral fractures. In parallel, serum perathyroid hormone concentration was reduced of 28% and low serum 25-hydroxyvitamin D concentration returned to normal values. After 18 months of treatment the bone density of the total proximal femoral region had increased 2.7% the vitamin D3-calcium group and decreased 4.6% in the placebo group (p < 0.001). This prevention is safe and can be recommended in people living in institutions. It could be also useful in other elderly subjects particularly at risk because of a low calcium intake, an absence of solar exposure and a previous history of falls. From the data of our study we assessed the economic consequences in terms of medical cost of this prevention. In case of treatment of all women living in nursing homes in France, this would saved FF 150000000 per year, the economic balance of prevention becoming positive as soon as the age of the beginning of the prevention reaches 73.5 years. It is now possible to partly stop bone loss in elderly people and it is never too late to prevent hip fractures with calcium and vitamin D supplements.

Navigation system for robot-assisted intra-articular lower-limb fracture surgery.

PubMed

Dagnino, Giulio; Georgilas, Ioannis; Köhler, Paul; Morad, Samir; Atkins, Roger; Dogramadzi, Sanja

2016-10-01

In the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction. 3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. The navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture. Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.

Serum of 25-Hydroxyvitamin D and Intact Parathyroid Hormone Levels in Postmenopausal Women with Hip and Upper Limb Fractures.

PubMed

Lv, Jiang-Tao; Zhang, Ying-Ying; Tian, Shao-Qi; Sun, Kang

2016-05-01

To assess the serum of 25-hydroxyvitamin D (25(OH)D) and intact parathyroid hormone (iPTH) levels in postmenopausal women from northern China with hip and upper limb fractures. Case-control. Affiliated Hospital of Qingdao University. Postmenopausal women diagnosed with hip fracture (n = 335) and matched controls without fracture (n = 335). Between 2011 and 2013, fasting venous samples were analyzed for 25(OH)D, iPTH, alkaline phosphatase (ALP), calcium, and phosphorus. All women completed a standardized questionnaire designed to document putative risk factors for fractures. Eight percent of participants had vitamin D deficiency, and 66.0% had secondary hyperparathyroidism. Serum 25(OH)D levels were significantly (P < .001) lower in women with hip fracture than in controls. Multivariate logistic regression analysis adjusted for common risk factors showed that serum 25(OH)D of 20 ng/mL or less was an independent indicator of hip fracture (odds ratio (OR) = 2.98, 95% confidence interval (CI) = 2.11-4.20) and concomitant upper limb fracture in those with existing hip fractures (OR = 4.77, 95% CI = 1.60-10.12). The area under the receiver operating characteristic curve of 25(OH)D was 0.77 (95% CI = 0.68-0.84) for hip fracture and 0.80 (95% CI = 0.72-0.89) for hip and upper limb fractures. Vitamin D insufficiency and secondary hyperparathyroidism were a common problem in postmenopausal women who presented with concomitant hip and upper limb fractures, suggesting that they might contribute to the pathophysiology of fractures in postmenopausal women. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Solid State Compressor

DTIC Science & Technology

1984-01-20

Air Products and Chemicals , Inc . CONTRACT NO.: N00014-83-C-0394...performed by Air Products and Chemicals , Inc . 2.0 TASK 2. MECHANICAL SIMULATOR: SUBTASK 2.1, ONE CELL SIMULATOR 2.1 Purpose The overall goal of this...refrigerant 12 (Freon 12) • 4.5 Test final system, ten cell compressor, and cryostat APCI ., ’ APCI - Air Products and Chemicals , Inc . CPI -

Development of a new software for analyzing 3-D fracture network

NASA Astrophysics Data System (ADS)

Um, Jeong-Gi; Noh, Young-Hwan; Choi, Yosoon

2014-05-01

A new software is presented to analyze fracture network in 3-D. Recently, we completed the software package based on information given in EGU2013. The software consists of several modules that play roles in management of borehole data, stochastic modelling of fracture network, construction of analysis domain, visualization of fracture geometry in 3-D, calculation of equivalent pipes and production of cross-section diagrams. Intel Parallel Studio XE 2013, Visual Studio.NET 2010 and the open source VTK library were utilized as development tools to efficiently implement the modules and the graphical user interface of the software. A case study was performed to analyze 3-D fracture network system at the Upper Devonian Grosmont Formation in Alberta, Canada. The results have suggested that the developed software is effective in modelling and visualizing 3-D fracture network system, and can provide useful information to tackle the geomechanical problems related to strength, deformability and hydraulic behaviours of the fractured rock masses. This presentation describes the concept and details of the development and implementation of the software.

Should 25-hydroxyvitamin D and bone density using DXA be tested in adolescents with lumbar stress fractures of the pars interarticularis?

PubMed

McClellan, John W; Vernon, Brian A; White, Michael A; Stamm, Sarah; Ryschon, Kay L

2012-12-01

Retrospective study. To determine if 25-hydroxyvitamin D (25[OH]D) level measurement and bone mineral density (BMD) using dual-energy x-ray absorptiometry (DXA) are indicated in children with a history of stress fracture of the pars interarticularis. Healing rates of 4%-25% for bilateral and unilateral pars fractures, respectively, have previously been reported. Factors that may contribute to osteomalacia, rickets, and poor bone healing include low (25[OH]D) and low BMD. Patients were seen at the Nebraska Spine Center between 2008 and 2010. Selection criteria included a diagnosis of pars fracture with DXA Z-score values (lumbar and hip) and pretreatment serum (25[OH]D) level measurement. Twenty-four patients were included. Vitamin D was defined as sufficient when ≥ 32 ng/mL, insufficient when 20 to < 32 ng/mL, and deficient when < 20 ng/mL. BMD was interpreted from DXA Z-scores using reference intervals defined in the literature. A Z-score <-2.0 was considered low for chronological age. The mean (± SD) vitamin D level was 29.9 ng/mL ± 10.8 (range, 9-56 ng/mL). Values were ≤ 10 ng/mL in 1 patient (4%), 11-20 ng/mL in 4 patients (17%), 21-30 ng/mL in 8 patients (33%), 31-50 ng/mL in 10 patients (42%), and > 50 ng/mL in 1 patient (4%). This correlated to 3 (13%) patients with deficient vitamin D (≤ 15 ng/mL), 12 (50%) patients with insufficient levels, and 9 (38%) with sufficient levels of vitamin D. The mean Z-scores were 0.43 ± 0.93 (lumbar, range, -1.3 to 2.8) and 1.0 ± 1.11 (hip, range, -0.5 to 3.0). All scores were consistent with normal bony mineralization for age. On the basis of these data, we recommend routine vitamin D testing and do not recommend routine DXA in adolescents with lumbar stress fractures of the pars interarticularis.

Origins and nature of non-Fickian transport through fractures

NASA Astrophysics Data System (ADS)

Wang, L.; Cardenas, M. B.

2014-12-01

Non-Fickian transport occurs across all scales within fractured and porous geological media. Fundamental understanding and appropriate characterization of non-Fickian transport through fractures is critical for understanding and prediction of the fate of solutes and other scalars. We use both analytical and numerical modeling, including direct numerical simulation and particle tracking random walk, to investigate the origin of non-Fickian transport through both homogeneous and heterogeneous fractures. For the simple homogenous fracture case, i.e., parallel plates, we theoretically derived a formula for dynamic longitudinal dispersion (D) within Poiseuille flow. Using the closed-form expression for the theoretical D, we quantified the time (T) and length (L) scales separating preasymptotic and asymptotic dispersive transport, with T and L proportional to aperture (b) of parallel plates to second and fourth orders, respectively. As for heterogeneous fractures, the fracture roughness and correlation length are closely associated with the T and L, and thus indicate the origin for non-Fickian transport. Modeling solute transport through 2D rough-walled fractures with continuous time random walk with truncated power shows that the degree of deviation from Fickian transport is proportional to fracture roughness. The estimated L for 2D rough-walled fractures is significantly longer than that derived from the formula within Poiseuille flow with equivalent b. Moreover, we artificially generated normally distributed 3D fractures with fixed correlation length but different fracture dimensions. Solute transport through 3D fractures was modeled with a particle tracking random walk algorithm. We found that transport transitions from non-Fickian to Fickian with increasing fracture dimensions, where the estimated L for the studied 3D fractures is related to the correlation length.

Treatment of trochanteric fractures with the gamma3 nail - methodology and early results of a prospective consecutive monitored clinical case series.

PubMed

A C, Unger; E, Wilde; B, Kienast; C, Jürgens; A P, Schulz

2014-01-01

There is only sparse data on clinical results and complications of the third-generation Gamma nailing system (Gamma3, Stryker). Therefore, we started a large multi-centre case series in 2008. The aim of this paper is to present the study design and early results of a single arm of a prospective, consecutive, monitored, post-market follow-up evaluation of Gamma3 nails. From September 2009 to January 2012, 154 consecutive patients with an average age of 80 ± 1.43 years (50-99 years) and a trochanteric femoral fracture were included in the local arm of the trial. All patients that fulfilled the inclusion criteria were treated with a Gamma3 nail. Preoperative variables included age, gender, fracture classification, walking ability (Merle d'Aubigné score), daily activity level (retrospective Zuckerman score), ASA rating of operative risk, waiting time for operation, use of walker or crutches and body mass index (BMI). Skin-to-skin time, fluoroscopy time, blood loss, intraoperative complications and device information were recorded for each patient. Follow-up postoperative assessment was undertaken at 4, 12 and 24 months. Hip range of motion, pain around the hip and the tight, walking ability (Merle d'Aubigné score, Sahlgrenska mobility score) and management of daily life (Zuckerman score) were used to evaluate the outcome. The descriptive data of age, gender, BMI, ASA classification, fracture type and skin-to-skin time is similar to other studies. Median fluoroscopy time was 62 seconds (range: 4-225 seconds) and significantly shorter in closed reductions. No intraoperative implant-related complication was recorded. A cut-out of the leg-screw during assessment period occurred in 2.6% patients (n = 4). At the 12-month assessment two (1.8%) non-unions were identified and two patients (1.8%) had broken the femoral shaft below the 180 mm nail after a fall. Analysis of the scores showed significantly declined mobility and activity in daily life four months after operation which increased significantly from four to 12 months and increased slightly between 12 and 24 months after fracture. A low implant-associated complication rate was achieved in geriatric patients with trochanteric femoral fractures using the Gamma3 nail. A better outcome concerning mobility, activity in daily life and complications compared to the Gamma2 nail could not be found in comparison to historic data.

30-Second bound and pore water concentration mapping of cortical bone using 2D UTE with optimized half-pulses.

PubMed

Manhard, Mary Kate; Harkins, Kevin D; Gochberg, Daniel F; Nyman, Jeffry S; Does, Mark D

2017-03-01

MRI of cortical bone has the potential to offer new information about fracture risk. Current methods are typically performed with 3D acquisitions, which suffer from long scan times and are generally limited to extremities. This work proposes using 2D UTE with half pulses for quantitatively mapping bound and pore water in cortical bone. Half-pulse 2D UTE methods were implemented on a 3T Philips Achieva scanner using an optimized slice-select gradient waveform, with preparation pulses to selectively image bound or pore water. The 2D methods were quantitatively compared with previously implemented 3D methods in the tibia in five volunteers. The mean difference between bound and pore water concentration acquired from 3D and 2D sequences was 0.6 and 0.9 mol 1 H/L bone (3 and 12%, respectively). While 2D pore water methods tended to slightly overestimate concentrations relative to 3D methods, differences were less than scan-rescan uncertainty and expected differences between healthy and fracture-prone bones. Quantitative bound and pore water concentration mapping in cortical bone can be accelerated by 2 orders of magnitude using 2D protocols with optimized half-pulse excitation. Magn Reson Med 77:945-950, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Severe vitamin D deficiency in Swiss hip fracture patients.

PubMed

Bischoff-Ferrari, H A; Can, U; Staehelin, H B; Platz, A; Henschkowski, J; Michel, B A; Dawson-Hughes, B; Theiler, R

2008-03-01

Most clinical guidelines for the prevention of hip fractures recommend 800 IU vitamin D per day. This dose shifted serum 25-hydroxyvitamin D levels (25(OH)D) in previous studies to between 60 and 100 nmol/l. To measure 25(OH)D levels and prevalence of vitamin D supplementation in individuals age 65+ with acute hip fracture. 222 consecutive hip fracture patients were investigated over a 12 month period. Mean age of patients was 86 years and 77% were women. Mean serum 25(OH)D levels were low among hip fracture patients admitted from home (34.6 nmol/l), from assisted living (27.7 nmol/l), and from nursing homes (24 nmol/l). Severe vitamin D deficiency below 30 nmol/l was present in 60%, 80% were below 50 nmol/l, and less than 4% reached desirable levels of at least 75 nmol/l. Consistently, only 10% of hip fracture patients had any vitamin D supplementation on admission to acute care with significantly higher 25(OH)D levels among individuals supplemented with 800-880 IU/day (63.5 nmol/l). Controlling for age and gender, vitamin D supplementation, type of dwelling, and season were independently and significantly associated with 25(OH)D levels. These data provide evidence that current guidelines for the prevention of hip fractures need further effort to be translated into clinical practice.

Three-Dimensional Modeling of Fracture Clusters in Geothermal Reservoirs

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

Ghassemi, Ahmad

The objective of this is to develop a 3-D numerical model for simulating mode I, II, and III (tensile, shear, and out-of-plane) propagation of multiple fractures and fracture clusters to accurately predict geothermal reservoir stimulation using the virtual multi-dimensional internal bond (VMIB). Effective development of enhanced geothermal systems can significantly benefit from improved modeling of hydraulic fracturing. In geothermal reservoirs, where the temperature can reach or exceed 350oC, thermal and poro-mechanical processes play an important role in fracture initiation and propagation. In this project hydraulic fracturing of hot subsurface rock mass will be numerically modeled by extending the virtual multiplemore » internal bond theory and implementing it in a finite element code, WARP3D, a three-dimensional finite element code for solid mechanics. The new constitutive model along with the poro-thermoelastic computational algorithms will allow modeling the initiation and propagation of clusters of fractures, and extension of pre-existing fractures. The work will enable the industry to realistically model stimulation of geothermal reservoirs. The project addresses the Geothermal Technologies Office objective of accurately predicting geothermal reservoir stimulation (GTO technology priority item). The project goal will be attained by: (i) development of the VMIB method for application to 3D analysis of fracture clusters; (ii) development of poro- and thermoelastic material sub-routines for use in 3D finite element code WARP3D; (iii) implementation of VMIB and the new material routines in WARP3D to enable simulation of clusters of fractures while accounting for the effects of the pore pressure, thermal stress and inelastic deformation; (iv) simulation of 3D fracture propagation and coalescence and formation of clusters, and comparison with laboratory compression tests; and (v) application of the model to interpretation of injection experiments (planned by our industrial partner) with reference to the impact of the variations in injection rate and temperature, rock properties, and in-situ stress.« less

Residual Strength Predictions with Crack Buckling

NASA Technical Reports Server (NTRS)

Dawicke, D. S.; Gullerud, A. S.; Dodds, R. H., Jr.; Hampton, R. W.

1999-01-01

Fracture tests were conducted on middle crack tension, M(T), and compact tension, C(T), specimens of varying widths, constructed from 0.063 inch thick sheets of 2024-T3 aluminum alloy. Guide plates were used to restrict out-of-plane displacements in about half of the tests. Analyses using the three-dimensional, elastic-plastic finite element code WARP3D simulated the tests with and without guide plates using a critical CTOA fracture criterion. The experimental results indicate that crack buckling reduced the failure loads by up to 40%. Using a critical CTOA value of 5.5 deg., the WARP3D analyses predicted the failure loads for the tests with guide plates within +/- 10% of the experimentally measured values. For the M(T) tests without guide plates, the WARP3D analyses predicted the failure loads for the 12 and 24 inch tests within 10%, while over predicting the failure loads for the 40 inch wide tests by about 20%.

Prevalence and risk factors for nonvertebral bone fractures in kidney transplant recipients - a single-center retrospective analysis.

PubMed

Jerman, Alexander; Lindič, Jelka; Škoberne, Andrej; Borštnar, Špela; Martinuč Bergoč, Maja; Godnov, Uroš; Kovač, Damjan

Complex and longstanding bone disease superimposed by harmful influences of immunosuppression is the reason for increased risk of bone fracture in kidney transplant recipients. The aim of our study was to analyze the incidence and prevalence of nonvertebral bone fractures and early (in the first post-transplant year) clinical and laboratory risk factors for suffering bone fracture in the long-term post-transplant period. Clinical and laboratory data as well as bone mineral density (BMD) measurements of 507 first kidney transplant recipients who were transplanted in the period from 1976 to 2011 were analyzed. The mean age of included patients was 54.3 ± 12.0 years, there were 45% females, and mean time on renal replacement treatment prior to transplantation was 63.4 ± 43.6 months. The average observation time post-transplant was 9.7 years (1.4 - 36.3 years). Post-transplant, 64 (12.6%) patients suffered 89 nonvertebral fractures (44 patients suffered 1 fracture, 15 patients 2 fractures, and 5 patients 3 fractures). Patients with fractures had significantly lower late BMD of femoral neck in the period of 1 - 10 years post-transplant, had osteopenia and osteoporosis more frequently in the same time period, and higher serum alkaline phosphatase in the first year post-transplant. 13 patients (13/64, 20.3%) had major fractures. Patients with major fractures were significantly older than patients with no major fractures and had lower serum albumin. Frequency of treatment with bisphosphonate, calcium, or phosphate did not differ between the groups. Vitamin D supplement (active form in 98% of cases) was prescribed more frequently in the group without fractures, but this was not statistically significant. Fracture rate in our transplant patient population was comparable to that reported in the literature. Except for a higher level of serum total alkaline phosphatase in the fracture group, we found no other early laboratory risk factors for bone fractures. BMD at the femoral region 1 - 10 years after kidney transplantation but not BMD at the time of transplantation was a risk factor for nonvertebral fractures. Osteopenia and osteoporosis in the post-transplant period were found to be a fracture risk factor.
.

Open Scenario Study: IDA Open Scenario Repository User’s Manual

DTIC Science & Technology

2010-01-01

Thomason, Study Co-Lead Zachary S. Rabold, Sub-Task Lead Ylli Bajraktari Rachel D. Dubin Mary Catherine Flythe Open Scenario Study: IDA Open Scenario... Bajraktari Rachel D. Dubin Mary Catherine Flythe Open Scenario Study: IDA Open Scenario Repository User’s Manual iii Preface This document reports the...vii Appendices A. Identifying Scenario Components...........................................................A-1 B . Acronyms

Vertically-Integrated Dual-Continuum Models for CO2 Injection in Fractured Aquifers

NASA Astrophysics Data System (ADS)

Tao, Y.; Guo, B.; Bandilla, K.; Celia, M. A.

2017-12-01

Injection of CO2 into a saline aquifer leads to a two-phase flow system, with supercritical CO2 and brine being the two fluid phases. Various modeling approaches, including fully three-dimensional (3D) models and vertical-equilibrium (VE) models, have been used to study the system. Almost all of that work has focused on unfractured formations. 3D models solve the governing equations in three dimensions and are applicable to generic geological formations. VE models assume rapid and complete buoyant segregation of the two fluid phases, resulting in vertical pressure equilibrium and allowing integration of the governing equations in the vertical dimension. This reduction in dimensionality makes VE models computationally more efficient, but the associated assumptions restrict the applicability of VE model to formations with moderate to high permeability. In this presentation, we extend the VE and 3D models for CO2 injection in fractured aquifers. This is done in the context of dual-continuum modeling, where the fractured formation is modeled as an overlap of two continuous domains, one representing the fractures and the other representing the rock matrix. Both domains are treated as porous media continua and can be modeled by either a VE or a 3D formulation. The transfer of fluid mass between rock matrix and fractures is represented by a mass transfer function connecting the two domains. We have developed a computational model that combines the VE and 3D models, where we use the VE model in the fractures, which typically have high permeability, and the 3D model in the less permeable rock matrix. A new mass transfer function is derived, which couples the VE and 3D models. The coupled VE-3D model can simulate CO2 injection and migration in fractured aquifers. Results from this model compare well with a full-3D model in which both the fractures and rock matrix are modeled with 3D models, with the hybrid VE-3D model having significantly reduced computational cost. In addition to the VE-3D model, we explore simplifications of the rock matrix domain by using sugar-cube and matchstick conceptualizations and develop VE-dual porosity and VE-matchstick models. These vertically-integrated dual-permeability and dual-porosity models provide a range of computationally efficient tools to model CO2 storage in fractured saline aquifers.

Quantifying fracture geometry with X-ray tomography: Technique of Iterative Local Thresholding (TILT) for 3D image segmentation

DOE PAGES

Deng, Hang; Fitts, Jeffrey P.; Peters, Catherine A.

2016-02-01

This paper presents a new method—the Technique of Iterative Local Thresholding (TILT)—for processing 3D X-ray computed tomography (xCT) images for visualization and quantification of rock fractures. The TILT method includes the following advancements. First, custom masks are generated by a fracture-dilation procedure, which significantly amplifies the fracture signal on the intensity histogram used for local thresholding. Second, TILT is particularly well suited for fracture characterization in granular rocks because the multi-scale Hessian fracture (MHF) filter has been incorporated to distinguish fractures from pores in the rock matrix. Third, TILT wraps the thresholding and fracture isolation steps in an optimized iterativemore » routine for binary segmentation, minimizing human intervention and enabling automated processing of large 3D datasets. As an illustrative example, we applied TILT to 3D xCT images of reacted and unreacted fractured limestone cores. Other segmentation methods were also applied to provide insights regarding variability in image processing. The results show that TILT significantly enhanced separability of grayscale intensities, outperformed the other methods in automation, and was successful in isolating fractures from the porous rock matrix. Because the other methods are more likely to misclassify fracture edges as void and/or have limited capacity in distinguishing fractures from pores, those methods estimated larger fracture volumes (up to 80 %), surface areas (up to 60 %), and roughness (up to a factor of 2). In conclusion, these differences in fracture geometry would lead to significant disparities in hydraulic permeability predictions, as determined by 2D flow simulations.« less

Genetic Variations in SLCO Transporter Genes Contributing to Racial Disparity in Aggressiveness of Prostate Cancer

DTIC Science & Technology

2015-10-01

situ RNA hybridization staining of a TMA set and tissue sections from Roswell Park Cancer Institute (RPCI) and PCaP, respectively; 2) completion of...Facility at Roswell Park Cancer Institute (RPCI). Three Subtasks were proposed: Subtask 1 (months 1-3): Obtain approval for IRB protocol and request...Resource Network (PRN) at Roswell Park Cancer Institute (RPCI). The predominantly expressed SLCO transporters in AA or EA, and the transporters with

Multiple paths in complex tasks

NASA Technical Reports Server (NTRS)

Galanter, Eugene; Wiegand, Thomas; Mark, Gloria

1987-01-01

The relationship between utility judgments of subtask paths and the utility of the task as a whole was examined. The convergent validation procedure is based on the assumption that measurements of the same quantity done with different methods should covary. The utility measures of the subtasks were obtained during the performance of an aircraft flight controller navigation task. Analyses helped decide among various models of subtask utility combination, whether the utility ratings of subtask paths predict the whole tasks utility rating, and indirectly, whether judgmental models need to include the equivalent of cognitive noise.

Effects of protein-rich supplementation and nandrolone in lean elderly women with femoral neck fractures.

PubMed

Tidermark, Jan; Ponzer, Sari; Carlsson, Pronoti; Söderqvist, Anita; Brismar, Kerstin; Tengstrand, Birgitta; Cederholm, Tommy

2004-08-01

To evaluate the effects of a protein-rich liquid supplementation, alone or in combination with the anabolic steroid nandrolone decanoate, on body composition, activities of daily living (ADL) status and the health-related quality of life (HRQoL) after a femoral neck fracture. Sixty women, aged 83 +/- 5 years (mean +/- SD), BMI < 24 kg/m2 (20.4 +/- 2 kg/m2 ) and capable of co-operating, with a femoral neck fracture treated with internal fixation, were randomised to open treatment during 6 months with a protein-rich liquid formula alone (PR, Fortimel, 200 ml/day, 20 g protein/day) or in combination with nandrolone decanoate (PR/N, Deca-Durabol 25 mg i.m./3 weeks) or to a control group (C). The patients were re-examined after 6 and 12 months regarding body weight (BW), lean body mass (LBM, DXA), ADL status according to Katz, HRQoL according to EQ 5-D and fracture healing. LBM decreased in the C (-1.2 +/- 2 kg) and PR groups (-1.2 +/- 1 kg) but remained the same in the PR/N group (0.3 +/- 1 kg) (P < 0.05 between groups). ADL remained at a high level in the two intervention groups but declined significantly in the C group (P < 0.005 between groups). The decline in HRQoL was least pronounced in the PR/N group at 6 months (P < 0.05 between groups). Patients with fracture healing complications lost more BW (P < 0.05) and LBM (P < 0.01) than patients with uneventful fracture healing. Protein-rich liquid supplementation in combination with nandrolone given for 6 months to lean elderly women after a femoral neck fracture may positively affect LBM, ADL and HRQoL. Copyright 2003 Elsevier Ltd.

Hyponatremia Is Associated With Increased Osteoporosis and Bone Fractures in a Large US Health System Population.

PubMed

Usala, Rachel L; Fernandez, Stephen J; Mete, Mihriye; Cowen, Laura; Shara, Nawar M; Barsony, Julianna; Verbalis, Joseph G

2015-08-01

The significance of studies suggesting an increased risk of bone fragility fractures with hyponatremia through mechanisms of induced bone loss and increased falls has not been demonstrated in large patient populations with different types of hyponatremia. This matched case-control study evaluated the effect of hyponatremia on osteoporosis and fragility fractures in a patient population of more than 2.9 million. Osteoporosis (n = 30 517) and fragility fracture (n = 46 256) cases from the MedStar Health database were matched on age, sex, race, and patient record length with controls without osteoporosis (n = 30 517) and without fragility fractures (n = 46 256), respectively. Cases without matched controls or serum sodium (Na(+)) data or with Na(+) with a same-day blood glucose greater than 200 mg/dL were excluded. Incidence of diagnosis of osteoporosis and fragility fractures of the upper or lower extremity, pelvis, and vertebrae were the outcome measures. Multivariate conditional logistic regression models demonstrated that hyponatremia was associated with osteoporosis and/or fragility fractures, including chronic [osteoporosis: odds ratio (OR) 3.97, 95% confidence interval (CI) 3.59-4.39; fracture: OR 4.61, 95% CI 4.15-5.11], recent (osteoporosis: OR 3.06, 95% CI 2.81-3.33; fracture: OR 3.05, 95% CI 2.83-3.29), and combined chronic and recent hyponatremia (osteoporosis: OR 12.09, 95% CI 9.34-15.66; fracture: OR 11.21, 95% CI 8.81-14.26). Odds of osteoporosis or fragility fracture increased incrementally with categorical decrease in median serum Na(+). These analyses support the hypothesis that hyponatremia is a risk factor for osteoporosis and fracture. Additional studies are required to evaluate whether correction of hyponatremia will improve patient outcomes.

3D Modeling and Characterization of Hydraulic Fracture Efficiency Integrated with 4D/9C Time-Lapse Seismic Interpretations in the Niobrara Formation, Wattenberg Field, Denver Basin

NASA Astrophysics Data System (ADS)

Alfataierge, Ahmed

Hydrocarbon recovery rates within the Niobrara Shale are estimated as low as 2-8%. These recovery rates are controlled by the ability to effectively hydraulic fracture stimulate the reservoir using multistage horizontal wells. Subsequent to any mechanical issues that affect production from lateral wells, the variability in production performance and reserve recovery along multistage lateral shale wells is controlled by the reservoir heterogeneity and its consequent effect on hydraulic fracture stimulation efficiency. Using identical stimulation designs on a number of wells that are as close as 600ft apart can yield variable production and recovery rates due to inefficiencies in hydraulic fracture stimulation that result from the variability in elastic rock properties and in-situ stress conditions. As a means for examining the effect of the geological heterogeneity on hydraulic fracturing and production within the Niobrara Formation, a 3D geomechanical model is derived using geostatistical methods and volumetric calculations as an input to hydraulic fracture stimulation. The 3D geomechanical model incorporates the faults, lithological facies changes and lateral variation in reservoir properties and elastic rock properties that best represent the static reservoir conditions pre-hydraulic fracturing. Using a 3D numerical reservoir simulator, a hydraulic fracture predictive model is generated and calibrated to field diagnostic measurements (DFIT) and observations (microseismic and 4D/9C multicomponent time-lapse seismic). By incorporating the geological heterogeneity into the 3D hydraulic fracture simulation, a more representative response is generated that demonstrate the variability in hydraulic fracturing efficiency along the lateral wells that will inevitability influence production performance. Based on the 3D hydraulic fracture simulation results, integrated with microseismic observations and 4D/9C time-lapse seismic analysis (post-hydraulic fracturing & post production), the variability in production performance within the Niobrara Shale wells is shown to significantly be affected by the lateral variability in reservoir quality, well and stage positioning relative to the target interval, and the relative completion efficiency. The variation in reservoir properties, faults, rock strength parameters, and in-situ stress conditions are shown to influence and control the hydraulic fracturing geometry and stimulation efficiency resulting in complex and isolated induced fracture geometries to form within the reservoir. This consequently impacts the effective drainage areas, production performance and recovery rates from inefficiently stimulated horizontal wells. The 3D simulation results coupled with the 4D seismic interpretations illustrate that there is still room for improvement to be made in optimizing well spacing and hydraulic fracturing efficiency within the Niobrara Formation. Integrated analysis show that the Niobrara reservoir is not uniformly stimulated. The vertical and lateral variability in rock properties control the hydraulic fracturing efficiency and geometry. Better production is also correlated to higher fracture conductivity. 4D seismic interpretation is also shown to be essential for the validation and calibration hydraulic fracture simulation models. The hydraulic fracture modeling also demonstrations that there is bypassed pay in the Niobrara B chalk resulting from initial Niobrara C chalk stimulation treatments. Forward modeling also shows that low pressure intervals within the Niobrara reservoir influence hydraulic fracturing and infill drilling during field development.

Neonatal vitamin D status from archived dried blood spots and future risk of fractures in childhood: results from the D-tect study, a population-based case-cohort study.

PubMed

Händel, Mina Nicole; Frederiksen, Peder; Cohen, Arieh; Cooper, Cyrus; Heitmann, Berit Lilienthal; Abrahamsen, Bo

2017-07-01

Background: Whether antenatal and neonatal vitamin D status have clinical relevance in fracture prevention has not been examined extensively, although observational studies indicate that fetal life may be a sensitive period in relation to bone growth and mineralization during childhood. Objective: We examined whether 25-hydroxyvitamin D 3 [25(OH)D 3 ] concentrations in stored neonatal dried blood spot (DBS) samples are associated with pediatric fracture risk. We hypothesized that in particular, low neonatal vitamin D status may be a risk factor for fracture incidence among children. Design: In a register-based case-cohort study design, the case group was composed of 1039 individuals who were randomly selected from a total of 82,154 individuals who were born during 1989-1999 and admitted to a Danish hospital with a fracture of the forearm, wrist, scaphoid bone, clavicle, or ankle at age 6-13 y. The subcohort was composed of 1600 individuals randomly selected from all Danish children born during 1989-1999. The neonatal 25(OH)D 3 concentrations in DBS samples were assessed by using highly sensitive chromatography-tandem mass spectrometry. Results: The mean ± SD 25(OH)D 3 concentration for all subjects was 27.7 ± 18.9 nmol/L [median (IQR): 23.5 nmol/L (13.3, 37.3 nmol/L)] and showed significant monthly variation ( P < 0.0001) with the highest values in July and August. Individuals in the middle quintile of neonatal 25(OH)D 3 had lower odds of sustaining a fracture than did those in the lowest quintile (adjusted OR: 0.75; 95% CI: 0.58, 0.96), but a global test did not show any significant overall association (adjusted P = 0.13). Conclusions: This study suggested that neonatal vitamin D status does not influence subsequent fracture risk in childhood. This is in accordance with studies that report no association between antenatal maternal vitamin D status and childhood fractures. Further studies are needed to examine fracture risk in relation to prenatal vitamin D status in a randomized controlled setting. © 2017 American Society for Nutrition.

Haptic computer-assisted patient-specific preoperative planning for orthopedic fractures surgery.

PubMed

Kovler, I; Joskowicz, L; Weil, Y A; Khoury, A; Kronman, A; Mosheiff, R; Liebergall, M; Salavarrieta, J

2015-10-01

The aim of orthopedic trauma surgery is to restore the anatomy and function of displaced bone fragments to support osteosynthesis. For complex cases, including pelvic bone and multi-fragment femoral neck and distal radius fractures, preoperative planning with a CT scan is indicated. The planning consists of (1) fracture reduction-determining the locations and anatomical sites of origin of the fractured bone fragments and (2) fracture fixation-selecting and placing fixation screws and plates. The current bone fragment manipulation, hardware selection, and positioning processes based on 2D slices and a computer mouse are time-consuming and require a technician. We present a novel 3D haptic-based system for patient-specific preoperative planning of orthopedic fracture surgery based on CT scans. The system provides the surgeon with an interactive, intuitive, and comprehensive, planning tool that supports fracture reduction and fixation. Its unique features include: (1) two-hand haptic manipulation of 3D bone fragments and fixation hardware models; (2) 3D stereoscopic visualization and multiple viewing modes; (3) ligaments and pivot motion constraints to facilitate fracture reduction; (4) semiautomatic and automatic fracture reduction modes; and (5) interactive custom fixation plate creation to fit the bone morphology. We evaluate our system with two experimental studies: (1) accuracy and repeatability of manual fracture reduction and (2) accuracy of our automatic virtual bone fracture reduction method. The surgeons achieved a mean accuracy of less than 1 mm for the manual reduction and 1.8 mm (std [Formula: see text] 1.1 mm) for the automatic reduction. 3D haptic-based patient-specific preoperative planning of orthopedic fracture surgery from CT scans is useful and accurate and may have significant advantages for evaluating and planning complex fractures surgery.

An initial loading-dose vitamin D versus placebo after hip fracture surgery: baseline characteristics of a randomized controlled trial (REVITAHIP).

PubMed

Mak, Jenson C D; Klein, Linda A; Finnegan, Terry; Mason, Rebecca S; Cameron, Ian D

2014-09-09

Hypovitaminosis D is particularly common among older people with a proximal femoral (hip) fracture. There are currently no agreed strategies for vitamin D replenishment after hip fracture surgery. The REVITAHIP Study is a multisite, double-blinded randomized-controlled trial investigating the effects of an oral vitamin D loading dose on gait velocity after hip fracture surgery. We describe the baseline characteristics of participants, aiming to document hypovitaminosis D and its associations after hip fracture. Participants, over 65, recruited within 7 days following hip fracture surgery from 3 Australia hospitals, were randomly allocated to receive a loading dose of vitamin D3 (250,000IU) or placebo, followed by oral maintenance vitamin D3/calcium (800 IU/500 mg) and the usual hip fracture rehabilitation pathway. Demographic and clinical data were collected, including surgical procedure, pre-fracture functional status, Mini Mental State Examination (MMSE) score, serum 25-hydroxyvitamin D (25-OHD), Verbal Rating Scale (VRS) for pain, grip strength and gait velocity. The associations of baseline 25-OHD levels with demographic and clinical data were assessed using Pearson's correlation, ANOVA and regression analyses. Two-hundred-and-eighteen people with hip fracture participated in the study. Mean age was 83.9+/-7.2 years, 77% were women and 82% lived in private homes. Fifty-six percent had a subcapital fracture. Mean comorbidity count was 3.13+/-2.0. Mean MMSE was 26.1+/-3.9. Forty-seven percent of participants had hypovitaminosis D (<50 nmol/L). Multivariate regression models demonstrated higher baseline vitamin D levels were significantly associated with higher premorbid Barthel index scores, lower post-operative VRS pain levels and use of vitamin D. This study cohort shared similar demographic characteristics and comorbidities with other cohorts of people with hip fracture, with the probable exception of less cognitive impairment. Hypovitaminosis D was not as prevalent as previously documented. Patients taking vitamin D supplements and with higher premorbid Barthel index, reflecting greater independence and activity, tended to have higher 25-OHD levels at baseline. Further, lower VRS pain ratings following surgery were associated with higher vitamin D levels. Such associations will need further investigation to determine causation. (ANZCTR number, ACTRN12610000392066). The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry ANZCTRN ACTRN12610000392066.

Treatment of protrusio fractures of the acetabulum in patients 70 years and older.

PubMed

Archdeacon, Michael T; Kazemi, Namdar; Collinge, Cory; Budde, Bradley; Schnell, Scott

2013-05-01

To present clinical, radiographic, and functional outcomes in patients 70 years and older with a protrusio-type acetabulum fracture. Retrospective case series. Two level 1 trauma centers. Between November 2000 and December 2009, 39 consecutive patients older than 70 years with protrusio acetabulum fractures were enrolled. Open reduction internal fixation using a combination of pelvic brim and infrapectineal plates. Clinical, radiographic, and functional outcomes as assessed with the modified Merle d'Aubigné score. Twelve patients were lost to follow-up (<12 months), and one patient was excluded from analysis because he was treated with a percutaneous technique. The remaining 26 (67%) had a mean follow-up of 34 months (12-127 months). At the final follow-up, radiographic grades were excellent in 15, good in 3, poor in 3, and 5 patients had a total hip arthroplasty (19%) at an average of 18 months after the index procedure .The average modified Merle d'Aubigné score was 16 (9-18); categorized as excellent in 10, very good in 4, good in 7, fair in 2, and poor in 3. In the senior patient with a protrusio acetabulum fracture, a treatment strategy that optimizes preoperative conditions, minimizes operative time and blood loss, achieves a stable concentric hip joint, and encourages immediate postoperative ambulation can result in reasonable clinical, radiographic, and functional outcomes with acceptable morbidity. This appears to remain true even in the face of a less than anatomic reduction. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Characterization of the 3-D fracture setting of an unstable rock mass: From surface and seismic investigations to numerical modeling

NASA Astrophysics Data System (ADS)

Colombero, C.; Baillet, L.; Comina, C.; Jongmans, D.; Vinciguerra, S.

2017-08-01

The characterization of the fracturing state of a potentially unstable rock cliff is a crucial requirement for stability assessments and mitigation purposes. Classical measurements of fracture location and orientation can however be limited by inaccessible rock exposures. The steep topography and high-rise morphology of these cliffs, together with the widespread presence of fractures, can additionally condition the success of geophysical prospecting on these sites. In order to mitigate these limitations, an innovative approach combining noncontact geomechanical measurements, active and passive seismic surveys, and 3-D numerical modeling is proposed in this work to characterize the 3-D fracture setting of an unstable rock mass, located in NW Italian Alps (Madonna del Sasso, VB). The 3-D fracture geometry was achieved through a combination of field observations and noncontact geomechanical measurements on oriented pictures of the cliff, resulting from a previous laser-scanning and photogrammetric survey. The estimation of fracture persistence within the rock mass was obtained from surface active seismic surveys. Ambient seismic noise and earthquakes recordings were used to assess the fracture control on the site response. Processing of both data sets highlighted the resonance properties of the unstable rock volume decoupling from the stable massif. A finite element 3-D model of the site, including all the retrieved fracture information, enabled both validation and interpretation of the field measurements. The integration of these different methodologies, applied for the first time to a complex 3-D prone-to-fall mass, provided consistent information on the internal fracturing conditions, supplying key parameters for future monitoring purposes and mitigation strategies.

Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis

PubMed Central

Ma, Jun; Wang, Ce; Zhou, Xuhui; Zhou, Shengyuan; Jia, Lianshun

2015-01-01

Abstract The present study aimed to explore surgical treatments and assess the effects based on the features of cervical spine fracture in patients with ankylosing spondylitis (AS) and to summarize the experiences in perioperative management. Retrospective analysis was performed in 25 AS patients with cervical spine fracture treated in our hospital from January 2011 to December 2013. The patients were divided according to fracture segments, including 4 cases at C4 to C5, 8 cases at C5 to C6, and 13 cases at C6 to C7. Among them, 12 belonged to I type, 5 to II type, and 8 to III type based on the improved classification method for AS cervical spine fracture. The Subaxial Cervical Spine Injury Classification score for these patients was 7.2 ± 1.3, and the assessment of their neurological function states showed 6 patients (24%) were in American Spinal Injury Association (ASIA) A grade, 1 (4%) in ASIA B grade, 3 (12%) in ASIA C grade, 12 (48%) in ASIA D grade, and 3 (12%) in ASIA E grade. Surgical methods contained simple anterior approach alone, posterior approach alone, and combined posterior–anterior or anterior–posterior approach. The average duration of patients’ hospital stay was 38.6 ± 37.6, and the first surgical methods were as follows: anterior approach alone on 6 cases, posterior surgery alone on 9 cases, and combined posterior–anterior or anterior–posterior approach on 10 patients. The median segments of fixation and fusion were 4.1 ± 1.4 sections. Thirteen patients developed complications. During 2 to 36 months of postoperative follow-up, 1 patient died of respiratory failure caused by pulmonary infections 2 months after leaving hospital. At the end of the follow-up, bone graft fusion was achieved in the rest of patients, and obvious looseness or migration of internal fixation was not observed. In addition, the preoperative neurological injury in 12 patients (54.5%) was also alleviated in different levels. AS cervical spine fracture, an unstable fracture, should be treated with operation, and satisfactory effects will be achieved after the individualized surgical treatment according to the improved classification method for AS cervical spine fracture. PMID:26554765

Aerospace engineering design by systematic decomposition and multilevel optimization

NASA Technical Reports Server (NTRS)

Sobieszczanski-Sobieski, J.; Giles, G. L.; Barthelemy, J.-F. M.

1984-01-01

This paper describes a method for systematic analysis and optimization of large engineering systems, e.g., aircraft, by decomposition of a large task into a set of smaller, self-contained subtasks that can be solved concurrently. The subtasks may be arranged in many hierarchical levels with the assembled system at the top level. Analyses are carried out in each subtask using inputs received from other subtasks, and are followed by optimizations carried out from the bottom up. Each optimization at the lower levels is augmented by analysis of its sensitivity to the inputs received from other subtasks to account for the couplings among the subtasks in a formal manner. The analysis and optimization operations alternate iteratively until they converge to a system design whose performance is maximized with all constraints satisfied. The method, which is still under development, is tentatively validated by test cases in structural applications and an aircraft configuration optimization. It is pointed out that the method is intended to be compatible with the typical engineering organization and the modern technology of distributed computing.

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

NASA Astrophysics Data System (ADS)

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

2015-04-01

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

The design, production and clinical application of 3D patient-specific implants with drilling guides for acetabular surgery.

PubMed

Merema, B J; Kraeima, J; Ten Duis, K; Wendt, K W; Warta, R; Vos, E; Schepers, R H; Witjes, M J H; IJpma, F F A

2017-11-01

An innovative procedure for the development of 3D patient-specific implants with drilling guides for acetabular fracture surgery is presented. By using CT data and 3D surgical planning software, a virtual model of the fractured pelvis was created. During this process the fracture was virtually reduced. Based on the reduced fracture model, patient-specific titanium plates including polyamide drilling guides were designed, 3D printed and milled for intra-operative use. One of the advantages of this procedure is that the personalised plates could be tailored to both the shape of the pelvis and the type of fracture. The optimal screw directions and sizes were predetermined in the 3D model. The virtual plan was translated towards the surgical procedure by using the surgical guides and patient-specific osteosynthesis. Besides the description of the newly developed multi-disciplinary workflow, a clinical case example is presented to demonstrate that this technique is feasible and promising for the operative treatment of complex acetabular fractures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Task partitioning in a robot swarm: object retrieval as a sequence of subtasks with direct object transfer.

PubMed

Pini, Giovanni; Brutschy, Arne; Scheidler, Alexander; Dorigo, Marco; Birattari, Mauro

2014-01-01

We study task partitioning in the context of swarm robotics. Task partitioning is the decomposition of a task into subtasks that can be tackled by different workers. We focus on the case in which a task is partitioned into a sequence of subtasks that must be executed in a certain order. This implies that the subtasks must interface with each other, and that the output of a subtask is used as input for the subtask that follows. A distinction can be made between task partitioning with direct transfer and with indirect transfer. We focus our study on the first case: The output of a subtask is directly transferred from an individual working on that subtask to an individual working on the subtask that follows. As a test bed for our study, we use a swarm of robots performing foraging. The robots have to harvest objects from a source, situated in an unknown location, and transport them to a home location. When a robot finds the source, it memorizes its position and uses dead reckoning to return there. Dead reckoning is appealing in robotics, since it is a cheap localization method and it does not require any additional external infrastructure. However, dead reckoning leads to errors that grow in time if not corrected periodically. We compare a foraging strategy that does not make use of task partitioning with one that does. We show that cooperation through task partitioning can be used to limit the effect of dead reckoning errors. This results in improved capability of locating the object source and in increased performance of the swarm. We use the implemented system as a test bed to study benefits and costs of task partitioning with direct transfer. We implement the system with real robots, demonstrating the feasibility of our approach in a foraging scenario.

A combination of three-dimensional printing and computer-assisted virtual surgical procedure for preoperative planning of acetabular fracture reduction.

PubMed

Zeng, Canjun; Xing, Weirong; Wu, Zhanglin; Huang, Huajun; Huang, Wenhua

2016-10-01

Treatment of acetabular fractures remains one of the most challenging tasks that orthopaedic surgeons face. An accurate assessment of the injuries and preoperative planning are essential for an excellent reduction. The purpose of this study was to evaluate the feasibility, accuracy and effectiveness of performing 3D printing technology and computer-assisted virtual surgical procedures for preoperative planning in acetabular fractures. We hypothesised that more accurate preoperative planning using 3D printing models will reduce the operation time and significantly improve the outcome of acetabular fracture repair. Ten patients with acetabular fractures were recruited prospectively and examined by CT scanning. A 3-D model of each acetabular fracture was reconstructed with MIMICS14.0 software from the DICOM file of the CT data. Bone fragments were moved and rotated to simulate fracture reduction and restore the pelvic integrity with virtual fixation. The computer-assisted 3D image of the reduced acetabula was printed for surgery simulation and plate pre-bending. The postoperative CT scan was performed to compare the consistency of the preoperative planning with the surgical implants by 3D-superimposition in MIMICS14.0, and evaluated by Matta's method. Computer-based pre-operations were precisely mimicked and consistent with the actual operations in all cases. The pre-bent fixation plates had an anatomical shape specifically fit to the individual pelvis without further bending or adjustment at the time of surgery and fracture reductions were significantly improved. Seven out of 10 patients had a displacement of fracture reduction of less than 1mm; 3 cases had a displacement of fracture reduction between 1 and 2mm. The 3D printing technology combined with virtual surgery for acetabular fractures is feasible, accurate, and effective leading to improved patient-specific preoperative planning and outcome of real surgery. The results provide useful technical tips in planning pelvic surgeries. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Comparative effectiveness of surgical and non-surgical treatment for pediatric mandibular condylar fractures].

PubMed

Hu, Min; Wang, Yanyi; Zhang, Lihai; Yao, Jun

2010-12-01

To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of clinical therapy. The clinical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) with non-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbling in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospitalization; and 5 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 3 cases as bilateral condylar fractures complicated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by falling from height in 4 cases, by tumbling in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospitalization; and 12 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 5 cases as bilateral condylar fractures (1 complicated by mental fracture). Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or limited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P > 0.05). During centric occlusion, mental point located at the midline with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had slight snap when opening their mouths. Mandible deviation was observed in 3 patients of 2 groups, respectively when gaping. The X-ray films showed healing of fracture and condylar remodeling at 3-6 months. Mandibular ramus were symmetric in cephalometry. Good effectiveness can be obtained by surgical or non-surgical treatment in pediatric mandibular condylar fractures. Considering the pediatric mandibular condyle having powerful healing and reconstructing potency and avoiding secondary injury on the temporomandibular joint from surgery, non-surgical treatment should be first selected for the pediatric mandibular condylar fractures in patients under 7 years.

Vitamin D supplementation is required to normalize serum level of 25OH-vitamin D in older adults: an observational study of 974 hip fracture inpatients.

PubMed

Lauretani, F; Frondini, C; Davoli, M L; Martini, E; Pellicciotti, F; Zagatti, A; Giordano, A; Zurlo, A; Pioli, G

2012-11-01

Vitamin D deficiency is highly prevalent in older adults in all continents. In this study we assessed the vitamin D status of hip fracture subjects across different hospitals in a real word situation using the data from a multicenter cohort study on outcomes in orthogeriatric units. We performed a prospective cohort study on 974 consecutive patients 75 yr or older admitted with fragility hip fracture over a 12 months period at 4 general hospitals of different districts in Emilia Romagna Region, Italy. Data collected included comorbidity, cognitive impairment, prefracture functional status, walking ability, living arrangement along with the use of antiosteoporotic drugs, serum intact PTH and serum 25-hydroxyvitamin D [25(OH)D]. Mean 25(OH)D serum levels were 12.2±9.4 ng/ml and 84.2% of patients had levels below recommended values. Male had a higher probability to have values within the reference range [odds ratio (OR): 1.74 (1.13-2.67); p=0.012] while living in nursing resulted negatively related even if only close to statistical significance [OR: 0.24 (0.06-1.02); p=0.051]. Vitamin D supplementation appeared to be the strongest factor associated with adequate level of vitamin D levels [OR: 4.50 (2.57-7.88); p<0.001). This study confirmed the very high rate of severe vitamin D deficiency in Italian subjects admitted with hip fracture. Our study also showed that supplementation of vitamin D is the strongest determinant influencing serum 25(OH)D level of older persons with hip fracture and these results should be taken into account when planning treatment in older persons.

Motion Predicts Clinical Callus Formation

PubMed Central

Elkins, Jacob; Marsh, J. Lawrence; Lujan, Trevor; Peindl, Richard; Kellam, James; Anderson, Donald D.; Lack, William

2016-01-01

Background: Mechanotransduction is theorized to influence fracture-healing, but optimal fracture-site motion is poorly defined. We hypothesized that three-dimensional (3-D) fracture-site motion as estimated by finite element (FE) analysis would influence callus formation for a clinical series of supracondylar femoral fractures treated with locking-plate fixation. Methods: Construct-specific FE modeling simulated 3-D fracture-site motion for sixty-six supracondylar femoral fractures (OTA/AO classification of 33A or 33C) treated at a single institution. Construct stiffness and directional motion through the fracture were investigated to assess the validity of construct stiffness as a surrogate measure of 3-D motion at the fracture site. Callus formation was assessed radiographically for all patients at six, twelve, and twenty-four weeks postoperatively. Univariate and multivariate linear regression analyses examined the effects of longitudinal motion, shear (transverse motion), open fracture, smoking, and diabetes on callus formation. Construct types were compared to determine whether their 3-D motion profile was associated with callus formation. Results: Shear disproportionately increased relative to longitudinal motion with increasing bridge span, which was not predicted by our assessment of construct stiffness alone. Callus formation was not associated with open fracture, smoking, or diabetes at six, twelve, or twenty-four weeks. However, callus formation was associated with 3-D fracture-site motion at twelve and twenty-four weeks. Longitudinal motion promoted callus formation at twelve and twenty-four weeks (p = 0.017 for both). Shear inhibited callus formation at twelve and twenty-four weeks (p = 0.017 and p = 0.022, respectively). Titanium constructs with a short bridge span demonstrated greater longitudinal motion with less shear than did the other constructs, and this was associated with greater callus formation (p < 0.001). Conclusions: In this study of supracondylar femoral fractures treated with locking-plate fixation, longitudinal motion promoted callus formation, while shear inhibited callus formation. Construct stiffness was found to be a poor surrogate of fracture-site motion. Future implant design and operative fixation strategies should seek to optimize 3-D fracture-site motion rather than rely on surrogate measures such as axial stiffness. PMID:26888675

The Feasibility of 3D Printing Technology on the Treatment of Pilon Fracture and Its Effect on Doctor-Patient Communication.

PubMed

Zheng, Wenhao; Chen, Chunhui; Zhang, Chuanxu; Tao, Zhenyu; Cai, Leyi

2018-01-01

The aim of this study was to assess the feasibility and effectiveness of the three-dimensional (3D) printing technology in the treatment of Pilon fractures. 100 patients with Pilon fractures from March 2013 to December 2016 were enrolled in our study. They were divided randomly into 3D printing group ( n = 50) and conventional group ( n = 50). The 3D models were used to simulate the surgery and carry out the surgery according to plan in 3D printing group. Operation time, blood loss, fluoroscopy times, fracture union time, and fracture reduction as well as functional outcomes including VAS and AOFAS score and complications were recorded. To examine the feasibility of this approach, we invited surgeons and patients to complete questionnaires. 3D printing group showed significantly shorter operation time, less blood loss volume and fluoroscopy times, higher rate of anatomic reduction and rate of excellent and good outcome than conventional group ( P < 0.001, P < 0.001, P < 0.001, P = 0.040, and P = 0.029, resp.). However, no significant difference was observed in complications between the two groups ( P = 0.510). Furthermore, the questionnaire suggested that both surgeons and patients got high scores of overall satisfaction with the use of 3D printing models. Our study indicated that the use of 3D printing technology to treat Pilon fractures in clinical practice is feasible.

The Feasibility of 3D Printing Technology on the Treatment of Pilon Fracture and Its Effect on Doctor-Patient Communication

PubMed Central

Zheng, Wenhao; Chen, Chunhui; Zhang, Chuanxu; Tao, Zhenyu

2018-01-01

Purpose The aim of this study was to assess the feasibility and effectiveness of the three-dimensional (3D) printing technology in the treatment of Pilon fractures. Methods 100 patients with Pilon fractures from March 2013 to December 2016 were enrolled in our study. They were divided randomly into 3D printing group (n = 50) and conventional group (n = 50). The 3D models were used to simulate the surgery and carry out the surgery according to plan in 3D printing group. Operation time, blood loss, fluoroscopy times, fracture union time, and fracture reduction as well as functional outcomes including VAS and AOFAS score and complications were recorded. To examine the feasibility of this approach, we invited surgeons and patients to complete questionnaires. Results 3D printing group showed significantly shorter operation time, less blood loss volume and fluoroscopy times, higher rate of anatomic reduction and rate of excellent and good outcome than conventional group (P < 0.001, P < 0.001, P < 0.001, P = 0.040, and P = 0.029, resp.). However, no significant difference was observed in complications between the two groups (P = 0.510). Furthermore, the questionnaire suggested that both surgeons and patients got high scores of overall satisfaction with the use of 3D printing models. Conclusion Our study indicated that the use of 3D printing technology to treat Pilon fractures in clinical practice is feasible. PMID:29581985

Modelling of 3D fractured geological systems - technique and application

NASA Astrophysics Data System (ADS)

Cacace, M.; Scheck-Wenderoth, M.; Cherubini, Y.; Kaiser, B. O.; Bloecher, G.

2011-12-01

All rocks in the earth's crust are fractured to some extent. Faults and fractures are important in different scientific and industry fields comprising engineering, geotechnical and hydrogeological applications. Many petroleum, gas and geothermal and water supply reservoirs form in faulted and fractured geological systems. Additionally, faults and fractures may control the transport of chemical contaminants into and through the subsurface. Depending on their origin and orientation with respect to the recent and palaeo stress field as well as on the overall kinematics of chemical processes occurring within them, faults and fractures can act either as hydraulic conductors providing preferential pathways for fluid to flow or as barriers preventing flow across them. The main challenge in modelling processes occurring in fractured rocks is related to the way of describing the heterogeneities of such geological systems. Flow paths are controlled by the geometry of faults and their open void space. To correctly simulate these processes an adequate 3D mesh is a basic requirement. Unfortunately, the representation of realistic 3D geological environments is limited by the complexity of embedded fracture networks often resulting in oversimplified models of the natural system. A technical description of an improved method to integrate generic dipping structures (representing faults and fractures) into a 3D porous medium is out forward. The automated mesh generation algorithm is composed of various existing routines from computational geometry (e.g. 2D-3D projection, interpolation, intersection, convex hull calculation) and meshing (e.g. triangulation in 2D and tetrahedralization in 3D). All routines have been combined in an automated software framework and the robustness of the approach has been tested and verified. These techniques and methods can be applied for fractured porous media including fault systems and therefore found wide applications in different geo-energy related topics including CO2 storage in deep saline aquifers, shale gas extraction and geothermal heat recovery. The main advantage is that dipping structures can be integrated into a 3D body representing the porous media and the interaction between the discrete flow paths through and across faults and fractures and within the rock matrix can be correctly simulated. In addition the complete workflow is captured by open-source software.

A CNN Regression Approach for Real-Time 2D/3D Registration.

PubMed

Shun Miao; Wang, Z Jane; Rui Liao

2016-05-01

In this paper, we present a Convolutional Neural Network (CNN) regression approach to address the two major limitations of existing intensity-based 2-D/3-D registration technology: 1) slow computation and 2) small capture range. Different from optimization-based methods, which iteratively optimize the transformation parameters over a scalar-valued metric function representing the quality of the registration, the proposed method exploits the information embedded in the appearances of the digitally reconstructed radiograph and X-ray images, and employs CNN regressors to directly estimate the transformation parameters. An automatic feature extraction step is introduced to calculate 3-D pose-indexed features that are sensitive to the variables to be regressed while robust to other factors. The CNN regressors are then trained for local zones and applied in a hierarchical manner to break down the complex regression task into multiple simpler sub-tasks that can be learned separately. Weight sharing is furthermore employed in the CNN regression model to reduce the memory footprint. The proposed approach has been quantitatively evaluated on 3 potential clinical applications, demonstrating its significant advantage in providing highly accurate real-time 2-D/3-D registration with a significantly enlarged capture range when compared to intensity-based methods.

A 3-dimensional-printed patient-specific guide system for minimally invasive plate osteosynthesis of a comminuted mid-diaphyseal humeral fracture in a cat.

PubMed

Oxley, Bill

2018-04-01

To report the use of a 3-dimensional (3D)-printed patient-specific reduction guide system to facilitate minimally invasive plate osteosynthesis (MIPO) of a humeral fracture in a cat. Case report. A 9-year-old male neutered domestic short hair cat weighing 4.4 kg. A 9-year-old male domestic short hair cat was presented with a comminuted, mid-diaphyseal left humeral fracture. Computed tomographic data were processed to yield 3D mesh representations of both humeri and subsequently manipulated in computer-aided design software. The mirrored, intact humerus was used as a template for appropriate spatial orientation of the major proximal and distal fracture fragments. Patient-specific Ellis pin orientation guides and a reduction guide were designed and 3D printed. The guide system was used intraoperatively to align the major fracture fragments before application of locking internal fixation via standard MIPO surgical portals. Internal fixation of the fracture resulted in appropriate bone alignment. Recovery was uncomplicated, with early return to normal limb function and radiographic evidence of advanced fracture healing after 4 months. A 3D-printed patient-specific reduction guide system facilitated accurate alignment of a comminuted humeral fracture during MIPO without intraoperative imaging. © 2018 The American College of Veterinary Surgeons.

3D convection in a fractured porous medium : influence of fracture network parameters and comparison to homogeneous approach.

NASA Astrophysics Data System (ADS)

Mezon, Cécile; Mourzenko, Valeri; François Thovert, Jean; Antoine, Raphael; Fontaine, Fabrice; Finizola, Anthony; Adler, Pierre Michel

2016-04-01

In the crust, fractures/faults can provide preferential pathways for fluid flow or act as barriers preventing the flow across these structures. In hydrothermal systems (usually found in fractured rock masses), these discontinuities may play a critical role at various scales, controlling fluid flows and heat transfer. The thermal convection is numerically computed in 3D fluid satured isotropically fractured porous media. Fractures are inserted as 2D convex polygons, which are randomly located. The fluid is assumed to satisfy 2D and 3D Darcy's law in the fractures and in the porous medium, respectively; exchanges take place between these two structures. First, checks were performed on an unfractured porous medium and the convection cells do start for the theoretical value of Ra, namely 4pi². 2D convection was verified up to Ra=800. Second, all fractured simulations were made for Rayleigh numbers (Ra) < 150, cubic boxes and closed-top conditions. The influence of parameters such as fracture aperture (or fracture transmissivity) and fracture density on the heat released by the whole system is studied. Then, the effective permeability of each fractured system is calculated. This last calculation enables the comparison between all fractured models and models of homogeneous medium with the same macroscopic properties. First, the heat increase released by the system as a function of fracture transmissivity and fracture density is determined. Second, results show that the effective approach is valid for low Ra (< 70), and that the mismatch between the full calculations and the effective medium approach for Ra higher than 70 depends on the fracture density in a crucial way. Third, the study also reveals that equivalent properties could be deduced from these computations in order to estimate the heat released by a fractured system from an homogeneous approach.

Treatment of Die-Punch Fractures with 3D Printing Technology.

PubMed

Chen, Chunhui; Cai, Leyi; Zhang, Chuanxu; Wang, Jianshun; Guo, Xiaoshan; Zhou, Yifei

2017-07-19

We evaluated the feasibility, accuracy and effectiveness of applying three-dimensional (3D) printing technology for preoperative planning for die-punch fractures. A total of 107 patients who underwent die-punch fracture surgery were enrolled in the study. They were randomly divided into two groups: 52 cases in the 3D model group and 55 cases in the routine group. A 3D digital model of each die-punch fracture was reconstructed in the 3D group. The 3D digital model was imported to a 3D printer to build the full solid model. The operation time, blood loss volume, and the number of intraoperative fluoroscopy were recorded. Follow-up was performed to evaluate the patients' surgical outcomes. Treatment of die-punch fractures using the 3D printing approach reduced the number of intraoperative fluoroscopy, blood loss volume, and operation time, but did not improve wrist function compared to those in the routine group. The patients wanted the doctor to use the 3D model to introduce the condition and operative plan because it was easier for them to understand. The orthopedic surgeons thought that the 3D model was useful for communicating with their patients, but their satisfaction with the preoperative plan was much lower than the benefit of using the 3D model to communicate with their patients. 3D printing technology produced more accurate morphometric information for orthopedists to provide personalized surgical planning and communicate better with their patients. However, it is difficult to use widely in the department of orthopedics.

[3-D finite element modeling of internal fixation of mandibular mental fracture and the design of boundary constraints].

PubMed

Luo, Xiaohui; Wang, Hang; Fan, Yubo

2007-04-01

This study was aimed to develop a 3-D finite element (3-D FE) model of the mental fractured mandible and design the boundary constrains. The CT images from a health volunteer were used as the original information and put into ANSYS program to build a 3-D FE model. The model of the miniplate and screw which were used for the internal fixation was established by Pro/E. The boundary constrains of different muscle loadings were used to simulate the 3 functional conditions of the mandible. A 3-D FE model of mental fractured mandible under the miniplate-screw internal fixation system was constructed. And by the boundary constraints, the 3 biting conditions were simulated and the model could serve as a foundation on which to analyze the biomechanical behavior of the fractured mandible.

Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL: a prospective observational study of 46 complex tibial fractures treated with a ring fixator.

PubMed

Elsoe, Rasmus; Larsen, Peter; Petruskevicius, Juozas; Kold, Søren

2018-04-01

The long-term outcomes following complex fractures of the tibia are reported to carry a risk of knee pain, malalignment, articular injury and post-traumatic osteoarthritis. The main objective of this study was to account for the patient-reported quality of life (QOL) 12 months after ring fixator removal in patients with a complex tibial fracture. Secondary objectives included a review of the socio-economic characteristics of the patient group and the rate of return to work in the study period. A prospective follow-up study was conducted of 60 patients with complex fractures of the tibia treated with ring external fixation. Patient-reported outcomes, radiological outcomes and socio-economic status including employment status of the patients were obtained 12 months after frame removal. Forty-six patients completed the assessment 12 months after frame removal (77%). The mean age of the patient at the time of fracture was 54.6 years (range 31-86). There were 19 males and 27 females. At 12 months after frame removal, the mean EQ5D-5L index was 0.66 (CI 0.60-0.72). The mean EQ5D-5L VAS was 69 (CI 61-76). When this was compared to the established reference population from Denmark, the study population showed a significantly worse EQ5D-5L index. The majority of patients (87%) were in the lower social classes suggesting a higher degree of social deprivation in the study population. Twenty-seven per cent of patients who were employed prior to injury had returned to employment at approximately 19 months following fracture. The onset of post-traumatic osteoarthritis was present in the knee joint in 29% of patients following a proximal intra-articular fracture, whereas osteoarthritis was present at the ankle joint in 35% of patients following a distal intra-articular fracture 12 months after frame removal. This study indicates that at 12 months after frame removal there are poorer patient-reported QOL as when compared to reference populations. Furthermore, this study suggests that complex tibial fractures are associated with lower social classes and that only 27% of patients in this sample, who prior to injury were employed, had returned to employment at approximately 19 months after the injury.

[The clinical effect of anti-rotation reduction internal fixator on the treatment of fresh thoracolumbar spine fracture].

PubMed

Pan, Xianming; Quan, Yi; Tan, Yingjun; Zhang, Bo; Wang, Yuanshan; Huang, Tong; Ma, Zehui; Liao, Dongfa; Li, Ting; Liu, Jinbiao

2005-03-15

To evaluate the effect of self-designed anti-rotation reduction internal fixator (ARRIF) on treating different spine segment fracture. From August 1999 to March 2003, 76 patients(48 males and 28 females, aged from 22 to 59 with an average of 34.1) with thoracolumbar fracture were operatively treated by ARRIF. The follow-up period ranged from 6 to 21 months (15 months in average). Classification according to injury segment: flexion compression fracture 27 cases, burst fracture 42 cases, flexion distraction injury 3 cases, flexion revolving type fracture dislocation 2 cases, shear force type dislocation 2 cases. Classification according Frankel's grade: A grade 16 cases, B grade 15 cases, C grade 27 cases, D grade 10 cases, E grade 8 cases. Operation duration, volume of bleeding, incidence post-operation complication and effect of reduction-fixation were observed. The operation duration of ARRIF was 1.2 h in average, and there was about 200 ml volume of bleeding during operation. The nerve function showed one Frankel's grade improvement after operation were as follows: A grade 8 cases (50%), B grade 11 cases (73.3%), C grade 20 cases (74.1%), D grade 3 cases (30%); 2 Frankel's E cases have no nerve function changes. The nerve function damage have no aggravation in all the patients, the postoperation Cobb's angle was averagely corrected 22 degrees. The horizontal displacement of dislocation vertebrae was averagely corrected 28% in sagittal plane, the statistical analysis had significant variance (P < 0.01). ARRIF had no complications of the breakage of screws and rods. ARRIF proves to be a valid internal fixator in reducing and fixing different thoracic lumbar segment spine fracture.

Surgical management of C-type subaxial cervical fractures using cervical traction followed by anterior cervical discectomy and fusion within 12 h after the trauma.

PubMed

Donnarumma, Pasquale; Bozzini, Vincenzo; Rizzi, Gaetano; Berardi, Arturo; Merlicco, Gaetano

2017-01-01

This was a retrospective cohort study. To report our 10-year experience of closed reduction using Crutchfield traction followed by anterior cervical discectomy and fusion within 12 h from injury for C-type subaxial cervical fractures (according to the AOSpine classification system). Clinical records and neuroimaging were retrospectively reviewed. Surgical details were provided. A total of 22 patients were included in the study. The cervical fracture was diagnosed after whole-body computed tomography scan on admission in all cases. Crutchfield traction was applied within 1-5 h from the diagnosis. Surgery consisting of anterior microdiscectomy and fusion with interbody cage and plating was performed 6-12 h after traction positioning. Most patients (19, 86%) had spinal cord injury: 7 were Frankel A (31%), 3 Frankel B (14%), 6 Frankel C (27%), 3 Frankel D (14%), and 3 Frankel E (14%). No neurologic deterioration was observed after the treatment. In 10 cases (45%), neurological symptoms improved 1 year after the trauma. Two patients (10%) died for complication related to spinal cord transition or other organ damage. Early reduction gives the best chance of recovery for patients affected by C-type subaxial cervical fracture. Rapid traction is more often successful and safer than manipulation under anesthesia. After close reduction achieving, anterior microdiscectomy, cage, and plating implant seem to be safe and effective with a low rate of complications.

Study of the X-Ray Diagnosis of Unstable Pelvic Fracture Displacements in Three-Dimensional Space and its Application in Closed Reduction.

PubMed

Shi, Chengdi; Cai, Leyi; Hu, Wei; Sun, Junying

2017-09-19

ABSTRACTS Objective: To study the method of X-ray diagnosis of unstable pelvic fractures displaced in three-dimensional (3D) space and its clinical application in closed reduction. Five models of hemipelvic displacement were made in an adult pelvic specimen. Anteroposterior radiographs of the pelvis were analyzed in PACS. The method of X-ray diagnosis was applied in closed reductions. From February 2012 to June 2016, 23 patients (15 men, 8 women; mean age, 43.4 years) with unstable pelvic fractures were included. All patients were treated by closed reduction and percutaneous cannulate screw fixation of the pelvic ring. According to Tile's classification, the patients were classified into type B1 in 7 cases, B2 in 3, B3 in 3, C1 in 5, C2 in 3, and C3 in 2. The operation time and intraoperative blood loss were recorded. Postoperative images were evaluated by Matta radiographic standards. Five models of displacement were made successfully. The X-ray features of the models were analyzed. For clinical patients, the average operation time was 44.8 min (range, 20-90 min) and the average intraoperative blood loss was 35.7 (range, 20-100) mL. According to the Matta standards, 7 cases were excellent, 12 cases were good, and 4 were fair. The displacements in 3D space of unstable pelvic fractures can be diagnosed rapidly by X-ray analysis to guide closed reduction, with a satisfactory clinical outcome.

Application of 3D printed customized external fixator in fracture reduction.

PubMed

Qiao, Feng; Li, Dichen; Jin, Zhongmin; Gao, Yongchang; Zhou, Tao; He, Jinlong; Cheng, Li

2015-01-01

Long bone fracture is common in traumatic osteopathic patients. Good reduction is beneficial for bone healing, preventing the complications such as delayed union, nonunion, malunion, but is hard to achieve. Repeated attempts during the surgery would increase the operation time, cause new damage to the fracture site and excessive exposure to radiation. Robotic and navigation techniques can help improve the reduction accuracy, however, the high cost and complexity of operation have limited their clinical application. We combined 3D printing with computer-assisted reduction technique to develop a customised external fixator with the function of fracture reduction. The original CT data obtained by scanning the fracture was imported to computer for reconstructing and reducing the 3D image of the fracture, based on which the external fixator (named as Q-Fixator) was designed and then fabricated by 3D printing techniques. The fracture reduction and fixation was achieved by connecting the pins inserted in the bones with the customised Q-Fixator. Experiments were conducted on three fracture models to demonstrate the reduction results. Good reduction results were obtained on all three fractured bone models, with an average rotation of 1.21°(± 0.24), angulation of 1.84°(± 0.28), and lateral displacement of 2.22 mm(± 0.62). A novel customised external fixator for long bone fracture reduction was readily developed using 3D printing technique. The customised external fixator had the advantages of easy manipulation, accurate reduction, minimally invasion and experience-independence. Future application of the customised external fixator can be extended to include the fixation function with stress adjustment and potentially optimise the fracture healing process. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Application of three-dimensional printing personalized acetabular wing-plate in treatment of complex acetabular fractures via lateral-rectus approach].

PubMed

Mai, J G; Gu, C; Lin, X Z; Li, T; Huang, W Q; Wang, H; Tan, X Y; Lin, H; Wang, Y M; Yang, Y Q; Jin, D D; Fan, S C

2017-03-01

Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month's follow-up, who didn't accept any treatment because the patient didn't feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all patients had achieved bone union. According to the modified Merle D'Aubigné and Postel scoring system, 5 cases were excellent, 2 cases were good, 1 case was fair. Conclusions: Surgical management of complex acetabular fracture via lateral-rectus approach combine with 3D printing personalized acetabular wing-plate can effectively improve reduction quality and fixation effect. It will be truly accurate, personalized and minimally invasive.

High Incidence of Vertebral Fractures in Children with Acute Lymphoblastic Leukemia 12 Months After the Initiation of Therapy

PubMed Central

Alos, Nathalie; Grant, Ronald; Ramsay, Timothy; Halton, Jacqueline; Cummings, Elizabeth A.; Miettunen, Paivi M.; Abish, Sharon; Atkinson, Stephanie; Barr, Ronald; Cabral, David A.; Cairney, Elizabeth; Couch, Robert; Dix, David B.; Fernandez, Conrad V.; Hay, John; Israels, Sara; Laverdière, Caroline; Lentle, Brian; Lewis, Victor; Matzinger, MaryAnn; Rodd, Celia; Shenouda, Nazih; Stein, Robert; Stephure, David; Taback, Shayne; Wilson, Beverly; Williams, Kathryn; Rauch, Frank; Siminoski, Kerry; Ward, Leanne M.

2014-01-01

Purpose Vertebral fractures due to osteoporosis are a potential complication of childhood acute lymphoblastic leukemia (ALL). To date, the incidence of vertebral fractures during ALL treatment has not been reported. Patient and Methods We prospectively evaluated 155 children with ALL during the first 12 months of leukemia therapy. Lateral thoracolumbar spine radiographs were obtained at baseline and 12 months. Vertebral bodies were assessed for incident vertebral fractures using the Genant semi-quantitative method, and relevant clinical indices such as spine bone mineral density (BMD), back pain and the presence of vertebral fractures at baseline were analyzed for association with incident vertebral fractures. Results Of the 155 children, 25 (16%, 95% Confidence Interval (CI) 11% to 23%) had a total of 61 incident vertebral fractures, of which 32 (52%) were moderate or severe. Thirteen of the 25 children with incident vertebral fractures (52%) also had fractures at baseline. Vertebral fractures at baseline increased the odds of an incident fracture at 12 months by an odds ratio of 7.3 (95% CI 2.3 to 23.1, p = 0.001). In addition, for every one standard deviation reduction in spine BMD Z-score at baseline, there was 1.8-fold increased odds of incident vertebral fracture at 12 months (95% CI 1.2 to 2.7, p = 0.006). Conclusion Children with ALL have a high incidence of vertebral fractures after 12 months of chemotherapy, and the presence of vertebral fractures and reductions in spine BMD Z-scores at baseline are highly associated clinical features. PMID:22734031

Vitamin D status and bone turnover in women with acute hip fracture.

PubMed

Nuti, Ranuccio; Martini, Giuseppe; Valenti, Roberto; Gambera, Dario; Gennari, Luigi; Salvadori, Stefania; Avanzati, Annalisa

2004-05-01

Hypovitaminosis D is common in elderly women. Few data are available on vitamin D status and bone turnover in women with acute hip fracture. The aims of this study were to determine whether elderly Italian women with an acute hip fracture also had low vitamin D levels and an increase of bone turnover compared with elderly women with osteoporosis but without fractures. Seventy-four women with acute osteoporotic hip fracture and 73 women with postmenopausal osteoporosis were studied. All women were self-sufficient and had adequate sunlight exposure. To exclude the effect of trauma on serum 25-hydroxycolecalciferol levels and bone markers (bone alkaline phosphatase and C-terminal telopeptides of Type I collagen as indices of bone formation and bone resorption), blood samples were drawn within 24 hours of the fracture. Current data indicated that in our patients the prevalence of hypovitaminosis D is common although to a lesser extent than in women who are housebound. Women with acute hip fractures had a higher prevalence of vitamin deficiency defined as serum 25-hydroxycolecalciferol lower than 12 ng/mL, compared with women with osteoporosis. Moreover, the presence of fracture did not influence the rate of bone formation, whereas the increase in bone resorption could be attributed to an older age of women with acute hip fracture because of similar values of parathyroid hormone levels in the two groups.

Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures.

PubMed

Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

2015-09-01

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3-12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1 week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact.

Outcomes and secondary prevention strategies for male hip fractures.

PubMed

Riley, Rebecca L; Carnes, Molly L; Gudmundsson, Adalsteinn; Elliott, Mary E

2002-01-01

To assess clinical outcomes and determine whether osteoporosis assessment and secondary prevention strategies were performed for male veterans hospitalized for hip fractures. Retrospective chart review for male veterans hospitalized for hip fracture from January 1993 through July 1999. The Veterans Affairs Medical Center, Madison, WI. Medical charts were available for 46 of 53 male patients admitted for hip fracture during the study period. Three subjects were excluded because hip fracture was associated with high-impact trauma. Mean age of the 43 study patients was 72 years (range 43-91 y), and mean length of hospitalization was 16 days (median 11 d, range 3-108 d). Thirty-two (82%) of 39 veterans whose disposition was documented were discharged to a nursing home. Eleven (26%) of 43 men died within 12 months after fracture. Twelve (28%) had fractured previously. Four (10%) subsequently had another fracture. Three of 9 patients with documented ambulation status were ambulatory at 1 year. Three patients received a bone mass measurement within a prespecified time interval of 6 months subsequent to fracture. No patient's records included a diagnosis of osteoporosis either before or within 6 months after fracture. One-third of the patients had documentation of calcium or multivitamin supplementation at discharge. One patient was receiving calcitonin at the time of fracture and continued to receive it afterward. No other patient was prescribed antiresorptive therapy by the time of hospital discharge. Male veterans with hip fractures received inadequate evaluation and treatment for osteoporosis, although a substantial portion had documentation of recurrent fractures. Education of clinicians and creation of algorithms for management of established osteoporosis may improve outcomes for these individuals.

Using a System Identification Approach to Investigate Subtask Control during Human Locomotion

PubMed Central

Logan, David; Kiemel, Tim; Jeka, John J.

2017-01-01

Here we apply a control theoretic view of movement to the behavior of human locomotion with the goal of using perturbations to learn about subtask control. Controlling one's speed and maintaining upright posture are two critical subtasks, or underlying functions, of human locomotion. How the nervous system simultaneously controls these two subtasks was investigated in this study. Continuous visual and mechanical perturbations were applied concurrently to subjects (n = 20) as probes to investigate these two subtasks during treadmill walking. Novel application of harmonic transfer function (HTF) analysis to human motor behavior was used, and these HTFs were converted to the time-domain based representation of phase-dependent impulse response functions (ϕIRFs). These ϕIRFs were used to identify the mapping from perturbation inputs to kinematic and electromyographic (EMG) outputs throughout the phases of the gait cycle. Mechanical perturbations caused an initial, passive change in trunk orientation and, at some phases of stimulus presentation, a corrective trunk EMG and orientation response. Visual perturbations elicited a trunk EMG response prior to a trunk orientation response, which was subsequently followed by an anterior-posterior displacement response. This finding supports the notion that there is a temporal hierarchy of functional subtasks during locomotion in which the control of upper-body posture precedes other subtasks. Moreover, the novel analysis we apply has the potential to probe a broad range of rhythmic behaviors to better understand their neural control. PMID:28123365

A patient specific finite element simulation of intramedullary nailing to predict the displacement of the distal locking hole.

PubMed

Mortazavi, Javad; Farahmand, Farzam; Behzadipour, Saeed; Yeganeh, Ali; Aghighi, Mohammad

2018-05-01

Distal locking is a challenging subtask of intramedullary nailing fracture fixation due to the nail deformation that makes the proximally mounted targeting systems ineffective. A patient specific finite element model was developed, based on the QCT data of a cadaveric femur, to predict the position of the distal hole of the nail postoperatively. The mechanical interactions of femur and nail (of two sizes) during nail insertion was simulated using ABAQUS in two steps of dynamic pushing and static equilibrium, for the intact and distally fractured bone. Experiments were also performed on the same specimen to validate the simulation results. A good agreement was found between the model predictions and the experimental observations. There was a three-point contact pattern between the nail and medullary canal, only on the proximal fragment of the fractured bone. The nail deflection was much larger in the sagittal plane and increased for the larger diameter nail, as well as for more distally fractured or intact femur. The altered position of the distal hole was predicted by the model with an acceptable error (mean: 0.95; max: 1.5 mm, in different tests) to be used as the compensatory information for fine tuning of proximally mounted targeting systems. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Thermal convection in three-dimensional fractured porous media

NASA Astrophysics Data System (ADS)

Mezon, C.; Mourzenko, V. V.; Thovert, J.-F.; Antoine, R.; Fontaine, F.; Finizola, A.; Adler, P. M.

2018-01-01

Thermal convection is numerically computed in three-dimensional (3D) fluid saturated isotropically fractured porous media. Fractures are randomly inserted as two-dimensional (2D) convex polygons. Flow is governed by Darcy's 2D and 3D laws in the fractures and in the porous medium, respectively; exchanges take place between these two structures. Results for unfractured porous media are in agreement with known theoretical predictions. The influence of parameters such as the fracture aperture (or fracture transmissivity) and the fracture density on the heat released by the whole system is studied for Rayleigh numbers up to 150 in cubic boxes with closed-top conditions. Then, fractured media are compared to homogeneous porous media with the same macroscopic properties. Three major results could be derived from this study. The behavior of the system, in terms of heat release, is determined as a function of fracture density and fracture transmissivity. First, the increase in the output flux with fracture density is linear over the range of fracture density tested. Second, the increase in output flux as a function of fracture transmissivity shows the importance of percolation. Third, results show that the effective approach is not always valid, and that the mismatch between the full calculations and the effective medium approach depends on the fracture density in a crucial way.

[Early total care pattern for intertrochanteric fracture of femur in the elderly].

PubMed

Gu, Jie; Kang, Xin-yong; Xu, Hong-wei; Li, Yong-fu; Zahng, Bin; Guo, Jian; He, Zhen-nian

2016-06-01

To evaluate clinical results of early total care (ETC) treatment for elderly patients with intertrochanteric femur fractures. Clinical data of 106 elderly patients with intertrochanteric fracture treated from January 2012 and February 2015 were retrospectively studied. According to whether receiving the early total care mode, the patients were divided into 2 groups, 34 cases were diagnosed and treated with early total care pattern (ETC group), including 14 males and 20 females with an average age of (74.88 ± 4.38) years old ranging from 70 to 86. According to Evans types, 4 cases were type I, 5 cases were type II, 13 cases were type III, 11 cases were type IV, 1 case was type V. Seventy-two patients were treated with conventional trauma method (conventional group), including 35 males and 37 females with an average age of (74.46 ± 3.63) years old ranging from 70 to 85. According to Evans type, 8 cases were type I ,13 cases were type II, 25 cases were type III, 25 cases were type IV, and 1 case was type V. All fractures were treated with proximal femoral nails anti-rotation (PFNA). Operative time, hospital stays, leaving bed time, complications, cases of death at 1 year after operation, postoperative Harris score at 12 months were observed and compared. All patients were followed up, the time of ETC group ranged from 9 to 18 months with an average of 13.29 ± 1.51, and the time in conventional group ranged from 12 to 16 months with an average 12.93 ± 1.15, while there was no significant difference between two groups in time of following-up (t = 1.368, P = 0.174). There was no significant meaning in cases of death between ETC group (2 cases) and conventional group (8 cases). Three cases occurred complications in ETC group, and 20 cases in conventional group,there was obvious meaning between two groups (χ² = 0.739, P = 0.318). Operative time,hospital stays,leaving bed time in ETC group respectively was (2.03 ± 0.67) d, (15.41 ± 2.87) d and (3.62 ± 0.74) d; while in conventional group respectively was (4.17 ± 1.59) d, (20.11 ± 4.24) d and (5.35 ± 1.22) d; there were significant differences between two groups in operative time, hospital stays, leaving bed time. Postoperative Harris scores at 12 months in ETC group was (82.32 ± 4.56), and (79.24 ± 5.52) in conventional group, there was obvious meaning between two groups (t = 2.833, P = 0.006). ETC pattern is a novel method for diagnosis and treatment of intertrochanteric femur fractures in elderly, it could shorten operative time, hospital stays, leaving bed time, decrease complications and promote recovery of function.

Epidural analgesia for traumatic rib fractures is associated with worse outcomes: a matched analysis.

PubMed

McKendy, Katherine M; Lee, Lawrence F; Boulva, Kerianne; Deckelbaum, Dan L; Mulder, David S; Razek, Tarek S; Grushka, Jeremy R

2017-06-15

The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded. Patients who were treated with epidural analgesia (EPI) were compared with those were not treated with epidural analgesia (NEPI) using coarsened exact matching. Primary outcomes were respiratory complications (pneumonia, deep vein thrombosis/pulmonary embolus, and respiratory failure) and 30-d in-hospital mortality. Secondary outcomes were total hospital and intensive care unit length of stay, and duration of ventilator support. About 1360 patients (EPI: 329 and NEPI: 1031) met inclusion criteria (mean age: 54.2 y; standard deviation [SD]: 19.7; 68% male). The mean number of rib fractures was 4.8 (SD: 3.3; 21% bilateral) with a high total burden of injury (mean Injury Severity Score: 19.9 [SD: 8.9]). The overall incidence of respiratory complications was 13% and mortality was 4%. After matching, 204 EPI patients were compared with 204 NEPI patients, with no differences in baseline characteristics. EPI patients experienced more respiratory complications (19% versus 10%, P = 0.009), but no differences in 30-d mortality (5% versus 2%, P = 0.159), duration of mechanical ventilation (EPI: 148 h [SD: 167] versus NEPI: 117 h [SD: 187], P = 0.434), or duration of intensive care unit length of stay (6.5 d [SD: 7.6] versus 5.8 d [SD: 9.1], P = 0.626). Hospital stay was higher in the EPI group (16.6 d [SD: 19.6] vs 12.7 d [SD: 15.2], P = 0.026). Epidural analgesia is associated with increased respiratory complications without providing mortality benefit after traumatic rib fractures. Alternate analgesic strategies should be investigated to treat these severely injured patients. Copyright © 2017 Elsevier Inc. All rights reserved.

3D surgical printing and pre contoured plates for acetabular fractures.

PubMed

Chana-Rodríguez, Francisco; Mañanes, Rubén Pérez; Rojo-Manaute, José; Gil, Pablo; Martínez-Gómiz, José María; Vaquero-Martín, Javier

2016-11-01

We describe the methodical and possibilities of 3D surgical printing in preoperative planning of acetabular fractures showing a case of a 45-year-old with an associated transverse fracture of the left acetabulum with posterior wall fracture, with multiple fragments, and posterior ipsilateral hip dislocation, defending the do it your-self mode. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Biomechanical analysis on healing process of sagittal fracture of the mandibular condyle after rigid fixation].

PubMed

Jing, Jie; Qu, Ai-li; Ding, Xiao-mei; Hei, Yu-na

2015-04-01

To analyze the biomechanical healing process on rigid fixation of sagittal fracture of the mandibular condyle (SFMC), and to provide guidelines for surgical treatment. Three-dimensional finite element model (3D-FEAM) of mandible and condyle was established. The right condyle was simulated as SFMC with 0.1 mm space across the condyle length ways. The 3D-FEAM of rigid fixation was established. The biomechanical factors such as stress distribution of condylar surface, displacement around fracture, stress on the plate and stress shielding were calculated during 0, 4, 8 and 12-week after rigid fixation. The maximum equivalent stress of normal condyle was located at the area of middle 1/3 of condylar neck. The maximum equivalent stress at 0-week after fixation was 23 times than that on normal condyle. They were located at the condylar stump and the plate near inferior punctual areas of fracture line. There were little stress on the other areas. The maximum equivalent stress at 4, 8 and 12-week was approximately 6 times than that on normal condyle. They were located at the areas same as the area at 0-week. There were little stress on the other areas at the condyle. The maximum total displacement and maximum total corner were increased 0.57-0.75 mm and 0.01-0.09° respectively during healing process. The maximum equivalent stress at 0-week on the condylar trump was 5-6 times compared with that at 4, 8, and 12-week. The maximum equivalent stress, maximum total displacement and maximum total corner on the fractured fragment were not changed significantly during healing process. The maximum equivalent stress at 0-week on the plate was 7-9 times compared with that at 4, 8, 12-week. The stress of the condyle and stress shielding of the plate may be the reasons of absorbing and rebuilding on the condyle in healing process of SFMC. The biomechanical parameters increase obviously at 4-week after fixation. Elastic intermaxillary traction is necessary to decrease total displacement and total corner of the condyle, and liquid diet is necessary to decrease equivalent stress within 4 weeks. Rehabilitation training should be used to recover TMJ functions after 4 weeks because the condyle and mandible have the ability to carry out normal functions.

Evaluation of the Effectiveness of Training Devices: Elaboration and Application of the Predictive Model

DTIC Science & Technology

1976-07-01

consider a two-subtask case where subtask I is difficult, while subtask 2 Is easy. rurther, suppose there are two training devices designed to teach the...extra cures an which he rrMeS to rely hut whikh ire’ not ava llableF whein he Lhanqe%" frrae training to thew actual Job. Iip Ir IL.AlI -. efl ~elleont

Minimally invasive fixation in tibial plateau fractures using an pre-operative and intra-operative real size 3D printing.

PubMed

Giannetti, Silvio; Bizzotto, Nicola; Stancati, Andrea; Santucci, Attilio

2017-03-01

The purpose of our study was to compare the outcome after minimally invasive reconstruction and internal fixation with and without the use of pre- and intra-operative real size 3D printing for patients with displaced tibial plateau fractures (TPFs). We prospectively followed up 40 consecutive adult patients with closed TPF who underwent surgical treatment of reconstruction of the tibial plateau with the use of minimally invasive fixation. Sixteen patients (group 1) were operated using a pre-operative and intra-operative real size 3D-model, while 24 patients (group 2) were operated without 3D-model printing, but using only pre-operative and intra-operative 3D Tc-scan images. The mean operating time was 148.2±15.9min for group 1 and 174.5±22.2min for group 2 (p=0.041). In addition, the mean intraoperative blood loss was less in group 1 (520mL) than in group 2 (546mL) (p=0.534). After discharge, all patients were followed up at 6 weeks, 12 weeks, 6 months, 1year and then every year post surgically and radiographic evaluation was carried out each time using clinical and radiological Rasmussen's score, with no significant differences between the two groups. Two patients (group 2) developed infection which resolved within 3 weeks after usage of antibiotics. Neither superficial nor deep infections were present in group 1. In all patients, no non-union occurred. No intraoperative, perioperative, or postoperative complications, such as loss of valgus correction, bone fractures, or metallic plate failures were detected at follow-up. In patients operated with the use of 3D-model printing, we found a significant reduction in surgical time. Moreover, the technique without a 3D-model increased the patient's and the surgeon's exposure to radiation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Polyaxial stress-dependent permeability of a three-dimensional fractured rock layer

NASA Astrophysics Data System (ADS)

Lei, Qinghua; Wang, Xiaoguang; Xiang, Jiansheng; Latham, John-Paul

2017-12-01

A study about the influence of polyaxial (true-triaxial) stresses on the permeability of a three-dimensional (3D) fractured rock layer is presented. The 3D fracture system is constructed by extruding a two-dimensional (2D) outcrop pattern of a limestone bed that exhibits a ladder structure consisting of a "through-going" joint set abutted by later-stage short fractures. Geomechanical behaviour of the 3D fractured rock in response to in-situ stresses is modelled by the finite-discrete element method, which can capture the deformation of matrix blocks, variation of stress fields, reactivation of pre-existing rough fractures and propagation of new cracks. A series of numerical simulations is designed to load the fractured rock using various polyaxial in-situ stresses and the stress-dependent flow properties are further calculated. The fractured layer tends to exhibit stronger flow localisation and higher equivalent permeability as the far-field stress ratio is increased and the stress field is rotated such that fractures are preferentially oriented for shearing. The shear dilation of pre-existing fractures has dominant effects on flow localisation in the system, while the propagation of new fractures has minor impacts. The role of the overburden stress suggests that the conventional 2D analysis that neglects the effect of the out-of-plane stress (perpendicular to the bedding interface) may provide indicative approximations but not fully capture the polyaxial stress-dependent fracture network behaviour. The results of this study have important implications for understanding the heterogeneous flow of geological fluids (e.g. groundwater, petroleum) in subsurface and upscaling permeability for large-scale assessments.

Assessing the Capabilities of Training Simulations: A Method and Simulation Networking (SIMNET) Application

DTIC Science & Technology

1990-06-01

Comments: Platoon cannot prepare for crossing the area or conduct decontamination in SIMNET. A-27 PLATOON ARTEP 17-237-10-MTP PERFORM CHEMICAL ... Chemical warfare is not represented in SIMNET. COMPANY TEAM ARTEP 71-1-MTP PERFORM LOCAL RADIOLOGICAL RECONNAISSANCE (03-2-C032) Task Rating: N Subtask... CHEMICAL ATTACK (03-2-C013) Task Ri#ting: N Subtask/Standard Ratings: +1 N aO bN 2 M aO bH 3 N aO bN Comments: Chemical warfare is not represented in the

High-Performance Agent-Based Modeling Applied to Vocal Fold Inflammation and Repair.

PubMed

Seekhao, Nuttiiya; Shung, Caroline; JaJa, Joseph; Mongeau, Luc; Li-Jessen, Nicole Y K

2018-01-01

Fast and accurate computational biology models offer the prospect of accelerating the development of personalized medicine. A tool capable of estimating treatment success can help prevent unnecessary and costly treatments and potential harmful side effects. A novel high-performance Agent-Based Model (ABM) was adopted to simulate and visualize multi-scale complex biological processes arising in vocal fold inflammation and repair. The computational scheme was designed to organize the 3D ABM sub-tasks to fully utilize the resources available on current heterogeneous platforms consisting of multi-core CPUs and many-core GPUs. Subtasks are further parallelized and convolution-based diffusion is used to enhance the performance of the ABM simulation. The scheme was implemented using a client-server protocol allowing the results of each iteration to be analyzed and visualized on the server (i.e., in-situ ) while the simulation is running on the same server. The resulting simulation and visualization software enables users to interact with and steer the course of the simulation in real-time as needed. This high-resolution 3D ABM framework was used for a case study of surgical vocal fold injury and repair. The new framework is capable of completing the simulation, visualization and remote result delivery in under 7 s per iteration, where each iteration of the simulation represents 30 min in the real world. The case study model was simulated at the physiological scale of a human vocal fold. This simulation tracks 17 million biological cells as well as a total of 1.7 billion signaling chemical and structural protein data points. The visualization component processes and renders all simulated biological cells and 154 million signaling chemical data points. The proposed high-performance 3D ABM was verified through comparisons with empirical vocal fold data. Representative trends of biomarker predictions in surgically injured vocal folds were observed.

High-Performance Agent-Based Modeling Applied to Vocal Fold Inflammation and Repair

PubMed Central

Seekhao, Nuttiiya; Shung, Caroline; JaJa, Joseph; Mongeau, Luc; Li-Jessen, Nicole Y. K.

2018-01-01

Fast and accurate computational biology models offer the prospect of accelerating the development of personalized medicine. A tool capable of estimating treatment success can help prevent unnecessary and costly treatments and potential harmful side effects. A novel high-performance Agent-Based Model (ABM) was adopted to simulate and visualize multi-scale complex biological processes arising in vocal fold inflammation and repair. The computational scheme was designed to organize the 3D ABM sub-tasks to fully utilize the resources available on current heterogeneous platforms consisting of multi-core CPUs and many-core GPUs. Subtasks are further parallelized and convolution-based diffusion is used to enhance the performance of the ABM simulation. The scheme was implemented using a client-server protocol allowing the results of each iteration to be analyzed and visualized on the server (i.e., in-situ) while the simulation is running on the same server. The resulting simulation and visualization software enables users to interact with and steer the course of the simulation in real-time as needed. This high-resolution 3D ABM framework was used for a case study of surgical vocal fold injury and repair. The new framework is capable of completing the simulation, visualization and remote result delivery in under 7 s per iteration, where each iteration of the simulation represents 30 min in the real world. The case study model was simulated at the physiological scale of a human vocal fold. This simulation tracks 17 million biological cells as well as a total of 1.7 billion signaling chemical and structural protein data points. The visualization component processes and renders all simulated biological cells and 154 million signaling chemical data points. The proposed high-performance 3D ABM was verified through comparisons with empirical vocal fold data. Representative trends of biomarker predictions in surgically injured vocal folds were observed. PMID:29706894

Mineral metabolism disorders, vertebral fractures and aortic calcifications in stable kidney transplant recipients: The role of gender (EMITRAL study).

PubMed

Torres, Armando; Torregrosa, Vicens; Marcen, Roberto; Campistol, Josep María; Arias, Manuel; Hernández, Domingo; Fernández, Constantino; Esforzado, Nuria; Paschoalin, Raphael; Pérez, Nuria; García, Ana Isabel; Del Amo, Montserrat; Pomés, Jaume; González Rinne, Ana; Marrero, Domingo; Pérez, Estefanía; Henríquez, Fernando; Díaz, Juan Manuel; Silva, Irene; López, Verónica; Perello, Manuel; Ramos, David; Beneyto, Isabel; Cruzado, José María; Martínez Castelao, Alberto; Bravo, Juan; Rodríguez, Minerva; Díaz, Carmen; Crespo, Josep; Anaya, Fernando; Rodríguez, María Luisa; Cubero, Juan José; Pascual, Pilar; Romero, Rafael; Andrés Belmonte, Amado; Checa, María Dolores; Jiménez, Carlos; Escuin, Fernando; Crespo, Marta; Mir, Marisa; Gómez, Gonzalo; Bayes, Beatriz; González, María José; Gutiérrez, Alex; Cuberes, Marta; Rodríguez Benoit, Alberto; García, Teresa; Llamas, Francisco; Ortega, Agustín; Conde, José Luis; Gómez Alamillo, Carlos

2016-01-01

The relationship between mineral metabolism disorders, bone fractures and vascular calcifications in kidney transplant recipients has not been established. We performed a cross-sectional study in 727 stable recipients from 28 Spanish transplant clinics. Mineral metabolism parameters, the semi-quantification of vertebral fractures and abdominal aortic calcifications were determined centrally. Vitamin D deficiency (25OHD3<15ng/ml) was more common in female recipients at CKD-T stages I-III (29.6% vs 44.4%; p=0.003). The inverse and significant correlation between 25OHD3 and PTH was gender-specific and women exhibited a steeper slope than men (p=0.01). Vertebral fractures (VFx) with deformity grade ≥2 were observed in 15% of recipients. Factors related to VFx differed by gender; in males, age (OR 1.04; 95% CI 1.01-1.06) and CsA treatment (OR: 3.2; 95% CI: 1.6-6.3); in females, age (OR 1.07; 95% CI: 1.03-1.12) and PTH levels (OR per 100pg/ml increase: 1.27; 95% CI: 1.043-1.542). Abdominal aortic calcifications were common (67.2%) and related to classical risk factors but not to mineral metabolism parameters. Vitamin D deficiency is more common among female kidney transplant recipients at earlier CKD-T stages, and it contributes to secondary hyperparathyroidism. Prevalent vertebral fractures are only related to high serum PTH levels in female recipients. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Fracture probability assessed using FRAX® in elderly women with benign paroxysmal positional vertigo.

PubMed

Nakada, Takafumi; Teranishi, Masaaki; Ueda, Yukio; Sone, Michihiko

2018-05-18

Patients with benign paroxysmal positional vertigo (BPPV) can have vitamin D deficiency, which is a cause of abnormal bone turnover. Several studies have established a relationship between osteoporosis and BPPV. The World Health Organization Fracture Risk Assessment Tool, widely known as FRAX ® (http://www.shef.ac.uk/FRAX), is a computer-based algorithm for assessing fracture risk. No direct comparison has been made between the FRAX scores of patients with BPPV and controls. The purpose of this study was to determine whether women with BPPV are at high risk of fracture as assessed using FRAX. The study involved 40 postmenopausal women diagnosed with BPPV between July 2015 and April 2016, and 40 postmenopausal women as controls. The 10-year major osteoporotic and hip fracture risks were calculated using FRAX and were compared between BPPV patients and controls using Welch's t test and a general linear model. The 10-year major osteoporotic fracture risk was 20.4%±12.1% for BPPV patients (aged 72.4±8.6years) and 14.3%±6.5% for controls (aged 71.2±6.3years). The 10-year hip fracture risk was 9.0%±9.8% for BPPV patients and 5.0%±3.9% for controls. The BPPV group had significantly higher 10-year major risks of osteoporotic fracture (p=0.0069) and hip fracture (p=0.0202) compared with controls. Similarly, after adjustment for age, the BPPV group had significantly higher 10-year risks of major osteoporotic fracture (p=0.0007) and hip fracture (p=0.0092) compared with controls. Fracture risk calculated using FRAX was significantly higher in the BPPV group than in controls. Women with BPPV may need early intervention to prevent future fractures. Copyright © 2018 Elsevier B.V. All rights reserved.

[Effect of 3D printing technology on pelvic fractures:a Meta-analysis].

PubMed

Zhang, Yu-Dong; Wu, Ren-Yuan; Xie, Ding-Ding; Zhang, Lei; He, Yi; Zhang, Hong

2018-05-25

To evaluate the effect of 3D printing technology applied in the surgical treatment of pelvic fractures through the published literatures by Meta-analysis. The PubMed database, EMCC database, CBM database, CNKI database, VIP database and Wanfang database were searched from the date of database foundation to August 2017 to collect the controlled clinical trials in wich 3D printing technology was applied in preoperative planning of pelvic fracture surgery. The retrieved literatures were screened according to predefined inclusion and exclusion criteria, and quality evaluation were performed. Then, the available data were extracted and analyzed with the RevMan5.3 software. Totally 9 controlled clinical trials including 638 cases were chosen. Among them, 279 cases were assigned to the 3D printing technology group and 359 cases to the conventional group. The Meta-analysis results showed that the operative time[SMD=-2.81, 95%CI(-3.76, -1.85)], intraoperative blood loss[SMD=-3.28, 95%CI(-4.72, -1.85)] and the rate of complication [OR=0.47, 95%CI(0.25, 0.87)] in the 3D printing technology were all lower than those in the conventional group;the excellent and good rate of pelvic fracture reduction[OR=2.09, 95%CI(1.32, 3.30)] and postoperative pelvic functional restoration [OR=1.94, 95%CI(1.15, 3.28) in the 3D printing technology were all superior to those in the conventional group. 3D printing technology applied in the surgical treatment of pelvic fractures has the advantage of shorter operative time, less intraoperative blood loss and lower rate of complication, and can improve the quality of pelvic fracture reduction and the recovery of postoperative pelvic function. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

Naturalistic Assessment of Executive Function and Everyday Multitasking in Healthy Older Adults

PubMed Central

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2013-01-01

Everyday multitasking and its cognitive correlates were investigated in an older adult population using a naturalistic task, the Day Out Task. Fifty older adults and 50 younger adults prioritized, organized, initiated and completed a number of subtasks in a campus apartment to prepare for a day out (e.g., gather ingredients for a recipe, collect change for a bus ride). Participants also completed tests assessing cognitive constructs important in multitasking. Compared to younger adults, the older adults took longer to complete the everyday tasks and more poorly sequenced the subtasks. Although they initiated, completed, and interweaved a similar number of subtasks, the older adults demonstrated poorer task quality and accuracy, completing more subtasks inefficiently. For the older adults, reduced prospective memory abilities were predictive of poorer task sequencing, while executive processes and prospective memory were predictive of inefficiently completed subtasks. The findings suggest that executive dysfunction and prospective memory difficulties may contribute to the age-related decline of everyday multitasking abilities in healthy older adults. PMID:23557096

Postoperative Evaluation of Reduction Loss in Proximal Humeral Fractures: A Comparison of Plain Radiographs and Computed Tomography.

PubMed

Jia, Xiao-Yang; Chen, Yan-Xi; Qiang, Min-Fei; Zhang, Kun; Li, Hao-Bo; Jiang, Yu-Chen; Zhang, Yi-Jie

2017-05-01

To compare postoperative CT images with plain radiographs for measuring prognostic factors of reduction loss of fractures of the proximal part of the humerus. A total of 65 patients who sustained fractures of the proximal humerus treated with locking plates from June 2012 to October 2015 were retrospectively analyzed. There were 24 men and 41 women, with a mean age of 60.0 years (range, 22-76 years). According to the Neer classification system of proximal humeral fracture, there were 26 two-part, 27 three-part and 12 four-part fractures of the proximal part of the humerus, and all fractures were treated with open reduction and internal fixation (ORIF) using locked plating. All postoperative CT images and plain radiographs of the patients were obtained. Prognostic factors of the reduction loss were the change of neck shaft angle (NSA) and the change of humeral head height (HHH). The change of NSA and HHH were evaluated by the difference between postoperative initial and final follow-up measurement. Reduction loss was defined as the change ≥10° for NSA or ≥5 mm for HHH. The NSA and HHH were measured using plain radiographs and 3-D CT images, both initially and at final follow-up. The paired t-test was used for comparison of NSA, change of NSA, HHH, and change of HHH between two image modalities. The differences between two image modalities in the assessment of reduction loss were examined using the χ 2 -test (McNemar test). Intraclass correlation coefficients (ICC) were used to assess the intra-observer and inter-observer reliability. 3-D CT images (ICC range, 0.834-0.967) were more reliable in all parameters when compared with plain radiographs (ICC range, 0.598-0.915). Significant differences were found between the two image modalities in all parameters (plain radiographs: initial NSA = 133.6° ± 3.8°, final NSA = 130.0° ± 1.9°, initial HHH = 17.9 ± 0.9 mm, final HHH = 15.8 ± 1.5 mm; 3-D CT: initial NSA = 131.4° ± 3.4°, final NSA = 128.8° ± 1.7°, initial HHH = 16.8 ± 1.2 mm, final HHH = 14.5 ± 1.1 mm; all P < 0.05). In the assessment of reduction loss, the percentage was 16.9% (11/65) for the plain radiographs and 7.7% (5/65) for the 3-D CT scans (P < 0.05). For the 5 patients with reduction loss, which were observed by two imaging modalities, the mean Constant-Murley score was 61.0 ± 1.6. The patients with reduction loss, observed only in plain radiographs but not CT images, had good shoulder function (Constant-Murley score: 82.7 ± 1.0). Our data reveal that 3-D CT images are more reliable than plain radiographs in the assessment of the prognostic factors of reduction loss of fractures of the proximal part of the humerus with treatment of locking plates; this reliable CT technique can serve as an effective guideline for the subsequent clinical management of patients. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Maternal vitamin D status and offspring bone fractures: prospective study over two decades in Aarhus City, Denmark.

PubMed

Petersen, Sesilje Bondo; Olsen, Sjurdur Frodi; Mølgaard, Christian; Granström, Charlotta; Cohen, Arieh; Vestergaard, Peter; Strøm, Marin

2014-01-01

Studies investigating the association between maternal vitamin D status and offspring bone mass measured by dual-energy X-ray absorptiometry (DXA) during childhood have shown conflicting results. We used occurrence of bone fractures up to the age of 18 as a measure reflecting offspring bone mass and related that to maternal vitamin D status. The Danish Fetal Origins 1988 Cohort recruited 965 pregnant women during 1988-89 at their 30th gestation week antenatal midwife visit. A blood sample was drawn and serum was stored, which later was analyzed for the concentration of 25-hydroxyvitamin D (25(OH)D) by the liquid chromatography coupled with a tandem mass spectrometric method (LC-MS/MS). Outcome was diagnosis of first time bone fractures extracted from the Danish National Patient Register. Vitamin D status was available for 850 women. The median (5th-95th percentile) 25(OH)D was 76.2 (23.0-152.1) nmol/l. During follow up 294 children were registered with at least one bone fracture diagnosis. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between maternal vitamin D status and first time bone fractures. However, there was a significantly increased hazard ratio (HR) during childhood for those who had maternal blood drawn in Dec/Jan/Feb compared with Jun/Jul/Aug (HR: 1.75, 95%CI: 1.11-2.74). Adjustment for vitamin D status strengthened this association (1.82, 1.12-2.97), which indicated a potential seasonal impact on offspring fractures independent of maternal vitamin D status. In a sensitivity analysis we found a borderline significant inverse association between continuous concentrations of 25(OH)D and offspring forearm fractures (P = 0.054). Overall, our results did not substantiate an association between maternal vitamin D status and offspring bone fractures. Further studies on this subject are needed, but the study populations must be large enough to allow for subdivision of fractures.

Carbohydrate crops as a renewable resource for fuels production. Volume III. Juice preservation

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

Fink, D.J.; Allen, B.R.; Litchfield, J.H.

1980-01-29

The objective of this study was to evaluate a process to preserve sugar crop juices. The process is energy conserving in that concentrated sugar solutions are produced with little evaporation of water. A preliminary investigation was conducted of polysaccharide hydrolysis as a means for preserving mixed sugar solutions obtained from crops such as sweet sorghum. Four subtasks have been addressed during this report period: I. Concentration of Pure Sugar Solutions by Hydrolysis of Purified Starch; II. Concentration of Genuine Sugar Crop Juice by Hydrolysis of Purified Starch; III. Concentration of Pure Sugar Solutions by Hydrolysis of Genuine Biomass Starch; andmore » IV. Concentration of Pure Sugar Solutions by Hydrolysis of Cellulosic Materials. The results obtained from the experiments conducted in Subtasks I and II included the following: (1) Concentrated sucrose-glucose-fructose solutions (greater than 50 percent) can be prepared from simulated or actual sweet sorghum juice using enzymatic thinning and saccharification of pure starch-sugar solution mixtures. (2) Enzymatic saccharification of corn meal and cracked wheat in simulated sorghum juice was also demonstrated. (3) Concentration of sugar solutions also can be accomplished by saccharification of cellulosic materials. In our experiments, inhibition of the cellobiase component of the cellulase preparation was observed. The hydrolysis studies were directed to the demonstration of the feasibility of one approach to the preparation of concentrated, microbiologically stable sugar syrups starting with sweet sorghum juice. Future work on Subtask V of this program will continue the investigations already underway and will consider other approaches to the stabilization of juices. Subtask VI of this program will consider the process economics of the Subtask I to IV approaches, or combinations of two or more methods, that are considered to be most feasible for juice preservation.« less

Advanced thermally stable jet fuels: Technical progress report, October 1994--December 1994

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

Schobert, H.H.; Eser, S.; Song, C.

There are five tasks within this project on thermally stable coal-based jet fuels. Progress on each of the tasks is described. Task 1, Investigation of the quantitative degradation chemistry of fuels, has 5 subtasks which are described: Literature review on thermal stability of jet fuels; Pyrolytic and catalytic reactions of potential endothermic fuels: cis- and trans-decalin; Use of site specific {sup 13}C-labeling to examine the thermal stressing of 1-phenylhexane: A case study for the determination of reaction kinetics in complex fuel mixtures versus model compound studies; Estimation of critical temperatures of jet fuels; and Surface effects on deposit formation inmore » a flow reactor system. Under Task 2, Investigation of incipient deposition, the subtask reported is Uncertainty analysis on growth and deposition of particles during heating of coal-derived aviation gas turbine fuels; under Task 3, Characterization of solid gums, sediments, and carbonaceous deposits, is subtask, Studies of surface chemistry of PX-21 activated carbon during thermal degradation of jet A-1 fuel and n-dodecane; under Task 4, Coal-based fuel stabilization studies, is subtask, Exploratory screening and development potential of jet fuel thermal stabilizers over 400 C; and under Task 5, Exploratory studies on the direct conversion of coal to high quality jet fuels, are 4 subtasks: Novel approaches to low-severity coal liquefaction and coal/resid co-processing using water and dispersed catalysts; Shape-selective naphthalene hydrogenation for production of thermally stable jet fuels; Design of a batch mode and a continuous mode three-phase reactor system for the liquefaction of coal and upgrading of coal liquids; and Exploratory studies on coal liquids upgrading using mesopores molecular sieve catalysts. 136 refs., 69 figs., 24 tabs.« less

3D Experimental Measurement of Lattice Strain and Fracture Behavior of Sand Particles Using Synchrotron X-Ray Diffraction and Tomography

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

Cil, Mehmet B.; Alshibli, Khalid A.; Kenesei, Peter

3D synchrotron X-ray diffraction (3DXRD) and synchrotron micro-computed tomography (SMT) techniques were used to measure and monitor the lattice strain evolution and fracture behavior of natural Ottawa sand particles subjected to 1D compression loading. The particle-averaged lattice strain within sand particles was measured using 3DXRD and then was used to calculate the corresponding lattice stress tensor. In addition, the evolution and mode of fracture of sand particles was investigated using high-resolution 3D SMT images. The results of diffraction data analyses revealed that the major principal component of the lattice strain or stress tensor increased in most of the particles asmore » the global applied compressive load increased until the onset of fracture. Particle fracture and subsequent rearrangements caused significant variation and fluctuations in measured lattice strain/stress values from one particle to another and from one load step to the next one. SMT image analysis at the particle-scale showed that cracks in fractured sand particles generally initiate and propagate along the plane that connects the two contact points. Fractured particles initially split into two or three major fragments followed by disintegration into multiple smaller fragments in some cases. In conclusion, microscale analysis of fractured particles showed that particle position, morphology, the number and location of contact points play a major role in the occurrence of particle fracture in confined comminution of the sand assembly.« less

3D Experimental Measurement of Lattice Strain and Fracture Behavior of Sand Particles Using Synchrotron X-Ray Diffraction and Tomography

DOE PAGES

Cil, Mehmet B.; Alshibli, Khalid A.; Kenesei, Peter

2017-05-27

3D synchrotron X-ray diffraction (3DXRD) and synchrotron micro-computed tomography (SMT) techniques were used to measure and monitor the lattice strain evolution and fracture behavior of natural Ottawa sand particles subjected to 1D compression loading. The particle-averaged lattice strain within sand particles was measured using 3DXRD and then was used to calculate the corresponding lattice stress tensor. In addition, the evolution and mode of fracture of sand particles was investigated using high-resolution 3D SMT images. The results of diffraction data analyses revealed that the major principal component of the lattice strain or stress tensor increased in most of the particles asmore » the global applied compressive load increased until the onset of fracture. Particle fracture and subsequent rearrangements caused significant variation and fluctuations in measured lattice strain/stress values from one particle to another and from one load step to the next one. SMT image analysis at the particle-scale showed that cracks in fractured sand particles generally initiate and propagate along the plane that connects the two contact points. Fractured particles initially split into two or three major fragments followed by disintegration into multiple smaller fragments in some cases. In conclusion, microscale analysis of fractured particles showed that particle position, morphology, the number and location of contact points play a major role in the occurrence of particle fracture in confined comminution of the sand assembly.« less

Engineering and Physics Optimization of Breed and Burn Fast Reactor Systems

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

Michael J. Driscoll; Pavel Hejzlar; Peter Yarsky

2005-12-09

This project is organized under four major tasks (each of which has two or more subtasks) with contributions among the three collaborating organizations (MIT, INEEL and ANL-West): Task A: Core Physics and Fuel Cycle; Task B: Core Thermal Hydraulics; Task C: Plant Design Task; and D: Fuel Design.

Fracture analysis of an Eocene reservoir in Eastern Tunisia by coupling Terrestrial Laser Scanning with GigaPan Technology and seismic attribute

NASA Astrophysics Data System (ADS)

Mastouri, Raja; Guerin, Antoine; Marchant, Robin; Derron, Marc-Henri; Boulares, Achref; Lazzez, Marzouk; Marillier, François; Jaboyedoff, Michel; Bouaziz, Samir

2015-04-01

It is usually not possible to study in situ fractures and faults of oil reservoirs. Then outcropping reservoir analogues are used instead. For this purpose, Terrestrial Laser Scanning (TLS) has been increasingly used for some years in the petroleum sector. The formations El Garia and Reineche make the Eocene oil reservoir of Eastern Tunisia. The fracturing of these formations has been analyzed on the surface by TLS on a reservoir analogue outcrop and in the depth by 3D seismic data. TLS datasets provide clear information on fracture geometry distribution (spacing and persistence), connectivity and joint orientation. These results were then compared to structures observed in depth with seismic data. The reservoir analogues are the Ousselat cliff (formation El Garia) and the Damous quarry (formation Reineche). Those two sites are made of marine limestone rich in large foraminifers, gastropods and nummulites. Fieldwork, TLS acquisitions and high-resolution GigaPan panoramas were put together to create digital outcrop models. A total of 9 scans at 3 different survey positions were carried out. Firstly, the data processing (cleaning, alignment and georeferencing of the raw point clouds) was carried out using the Polyworks software. Secondly, we draped Gigapixel pictures on the triangular mesh generated with 3DReshaper to produce relief shading. This process produces a photorealistic model that gives a 3D representation of the outcrop. Finally, Coltop3D was used to identify the different sets of discontinuities and to measure their orientations. Furthermore, we used some 3D seismic attribute data to interpret approximately 60 fractures and faults at the top of the Eocene reservoir. The Coltop3D analysis of the Ousselat cliff shows 5 sets of joints and fractures, with different dips and dip directions. They all strike in directions NW-SE, NNE-SSW, NE-SW and ENE-WSW. Using the photorealistic model, we measured approximately 120 fracture spacings ranging from 1.75m to 10m. For Reineche formation outcrop, the structural analog indicates 8 sets of joints and fractures. In Total, we measured 150 fracture spacings. The most part of fracture spacings range from 0.05m to 1m. The results show that many joints of the quarry rocks are interconnected with other small-scale fractures. The comparison between the stereonets obtained by Coltop3D and the seismic attributes indicated that fractures striking NW-SE to NNW-SSE and NE-SW to NNE-SSW are represented in all surveys position. The majority of the faults and fractures observed in TLS data and 3D seismic data can be explained by a combination of extension and shear. Moreover, in this study, we found that there is no correlation between fractures density or fracture distribution and lithology. Finally, the density and the geometry of the fractures have been also interpreted at the outcrop level and in depth, this comparison allows to better characterize the relationship between permeability, secondary porosity and fracture density of the Eocene reservoir.

Useful field of view test performance throughout adulthood in subjects without ocular disorders.

PubMed

Woutersen, Karlijn; van den Berg, Albert V; Boonstra, F Nienke; Theelen, Thomas; Goossens, Jeroen

2018-01-01

Previous research has shown an age-related decline in Useful Field of View (UFOV) test performance, which measures the duration required to extract relevant information from a scene in three subtasks. However, these results are mostly based on data that may have been confounded by (age-related) ocular diseases. We examined UFOV performance in subjects aged 19.5 to 70.3 years to investigate how UFOV performance changes throughout adulthood. All subjects underwent a thorough ophthalmological examination to exclude ocular disorders. We also examined some elementary visual functions, i.e., near and far visual acuity, crowding and contrast sensitivity. We investigated whether these functions were related to age and whether they could explain a possible age-related decline in UFOV performance. The subjects (n = 41) performed very well on almost every measure and reached far better UFOV and visual acuity scores than those reported by other studies that relied on self-reported absence of ocular pathology. We did not find significant relationships between age and any of the elementary visual functions or the first two UFOV subtasks (R2UFOV1 = 0.03, p = 0.25; R2UFOV2 = 0.07, p = 0.10). However, we found an age-related decline in performance on the third UFOV subtask (R2UFOV3 = 0.36, p < 0.001), which was unrelated to performance on the elementary visual function tasks. Our results show that performance on the first two UFOV subtasks as well as central elementary visual functions may remain high in the absence of obvious ophthalmological pathology.

Incidence of infection following internal fixation of open and closed tibia fractures in India (INFINITI): a multi-centre observational cohort study.

PubMed

Doshi, Prakash; Gopalan, Hitesh; Sprague, Sheila; Pradhan, Chetan; Kulkarni, Sunil; Bhandari, Mohit

2017-04-14

Trauma is a major public health problem, particularly in India due to the country's rapid urbanization. Tibia fractures are a common and often complicated injury that is at risk of infection following surgical fixation. The primary objectives of this cohort study were to determine the incidence of infection within one year of surgery and to describe the distribution of infections by location and time of diagnosis for tibia fractures in India. We conducted a multi-center, prospective cohort study. Patients who presented with an open or closed tibia fracture treated with internal fixation to one of the participating hospitals in India were invited to participate in the study. Participants attended follow-up visits at 3, 6, and 12 months post-surgery, where they were assessed for infections, fracture healing, and health-related quality of life as measured by the EurQol-5 Dimensions (EQ-5D). Seven hundred eighty-seven participants were included in the study and 768 participants completed the 12 month follow-up. The overall incidence of infection was 2.9% (23 infections). The incidence of infection was 1.6% (10 infections) in closed and 8.0% (13 infections) in open fractures. There were 7 deep and 16 superficial infections, with 5 being early, 7 being delayed, and 11 being late infections. Intra-operative antibiotics were given to 92.1% of participants and post-operative antibiotics were given to 96.8% of participants. Antibiotics were prescribed for an average of 8.3 days for closed fractures and 9.1 days for open fractures. Infected fractures took significantly longer to heal, and participants who had an infection had significantly lower EQ-5D scores. The incidence of infection within this cohort is similar to those seen in developed countries. The duration of prophylactic antibiotic use was longer than standard practice in North America, raising concern for the potential development of antibiotic resistant microbes within Indian orthopaedic settings. Future research should aim to identify the best practice for antibiotic use in India to ensure that antibiotic usage patterns do not lead to unnecessary overuse, while maintaining a low incidence of infection. NCT01691599 , September 17, 2012.

A Development Testbed for ALPS-Based Systems

DTIC Science & Technology

1988-10-01

alloted to tile application because of size or power constraints). Given an underlying support ALPS architecture such as the d-ALPS architecture, a...resource on which it is assigned at runtime. A second representation problem is that most graph analysis algorithms treat either graphs with weighted links...subtask) associated with it but is treated like other links. In d-ALPS, as a priority precedence link, it would cause the binding of a pro- cessor: as a

Fractures in the men of a Veterans Administration Nursing Home: relation to 1,25-dihydroxyvitamin D.

PubMed

Rudman, D; Rudman, I W; Mattson, D E; Nagraj, H S; Caindec, N; Jackson, D L

1989-08-01

One hundred fifty-three men, age 48-96, 86% white, had resided in this Nursing Home for an average of 6.3 years (range 1.3-36) as of August 1984. At that time, we reviewed their medical charts to record the numbers and sites of fractures which had been diagnosed during the preceding 1 to 5 years of Nursing Home residence, the duration of this period depending on the duration of institutionalization. In addition, a clinical database was compiled comprising 70 attributes, including diagnoses, drugs, plasma (serum) chemistries, and measures of hematologic, nutritional, and functional status. Fractures during the studied period of Nursing Home residence had occurred in 24 of 153 men; six residents had experienced two or more fractures. Fracture rates in hip, spine, and wrist were 2564, 366, and 549 per 100,000 patient years, respectively. The total fracture rate, hip fracture rate, and limb fracture rate were five to 11 times higher than in the age-matched general population of white men in the United States; in Rochester, MN; in Dundee, England; in Oxford, England; or in Finland. Univariate statistical analysis showed that the rates for hip fracture or for fracture at any site were significantly associated with 13 attributes: directly with age, plasma somatomedin C, blood urea N, serum creatinine, serum uric acid, serum 25-hydroxyvitamin D (25-OH-D), degree of functional impairment, and chronic urinary tract infection, and inversely with serum 1,25-dihydroxyvitamin D [1,25-(OH)2-D], serum albumin, hematocrit, and hemoglobin. There was not a significant correlation with the number of falls/month which occurred during the 7 months after August 1984. After the effect of age was partialed out, somatomedin C, 25-OH-D, 1,25-(OH)2-D, and the diagnosis of urinary tract infection were still significantly related to the occurrence of fractures. The fact that Nursing Home fracture cases had significantly higher blood urea nitrogen and 25-OH-D, and significantly lower 1,25-(OH)2-D, than their non-fracture counterparts suggests that impaired renal production of the latter vitamin D metabolite contributed to the excessive rate of fractures.

Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures

PubMed Central

Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

2014-01-01

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3–12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1 week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact. PMID:26269728

Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation.

PubMed

Dos Santos, Denise Takehana; Costa e Silva, Adriana Paula Andrade; Vannier, Michael Walter; Cavalcanti, Marcelo Gusmão Paraiso

2004-12-01

The purpose of this study was to demonstrate the sensitivity and specificity of multislice computerized tomography (CT) for diagnosis of maxillofacial fractures following specific protocols using an independent workstation. The study population consisted of 56 patients with maxillofacial fractures who were submitted to a multislice CT. The original data were transferred to an independent workstation using volumetric imaging software to generate axial images and simultaneous multiplanar (MPR) and 3-dimensional (3D-CT) volume rendering reconstructed images. The images were then processed and interpreted by 2 examiners using the following protocols independently of each other: axial, MPR/axial, 3D-CT images, and the association of axial/MPR/3D images. The clinical/surgical findings were considered the gold standard corroborating the diagnosis of the fractures and their anatomic localization. The statistical analysis was carried out using validity and chi-squared tests. The association of axial/MPR/3D images indicated a higher sensitivity (range 95.8%) and specificity (range 99%) than the other methods regarding the analysis of all regions. CT imaging demonstrated high specificity and sensitivity for maxillofacial fractures. The association of axial/MPR/3D-CT images added important information in relationship to other CT protocols.

The National Shipbuilding Research Program. Environmental Studies and Testing (Phase IV)

DTIC Science & Technology

2000-11-15

Subtask responded to the action taken by the State of Virginia to incorporate limitations of 50 parts per trillion TBT ( tributyltin ) in shipyard...Funds actually expended totaled $6,750. Subtask #22 - Document Technologies Available to Clean Brackish Waters to 50 parts per trillion TBT Levels. This...Subtask concluded that there were NO technologies extant to achieve a reduction in shipyard effluent TBT to below 50 ppt. This has become an

Recovery Act. Development and Validation of an Advanced Stimulation Prediction Model for Enhanced Geothermal System

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

Gutierrez, Marte

The research project aims to develop and validate an advanced computer model that can be used in the planning and design of stimulation techniques to create engineered reservoirs for Enhanced Geothermal Systems. The specific objectives of the proposal are to: 1) Develop a true three-dimensional hydro-thermal fracturing simulator that is particularly suited for EGS reservoir creation. 2) Perform laboratory scale model tests of hydraulic fracturing and proppant flow/transport using a polyaxial loading device, and use the laboratory results to test and validate the 3D simulator. 3) Perform discrete element/particulate modeling of proppant transport in hydraulic fractures, and use the resultsmore » to improve understand of proppant flow and transport. 4) Test and validate the 3D hydro-thermal fracturing simulator against case histories of EGS energy production. 5) Develop a plan to commercialize the 3D fracturing and proppant flow/transport simulator. The project is expected to yield several specific results and benefits. Major technical products from the proposal include: 1) A true-3D hydro-thermal fracturing computer code that is particularly suited to EGS, 2) Documented results of scale model tests on hydro-thermal fracturing and fracture propping in an analogue crystalline rock, 3) Documented procedures and results of discrete element/particulate modeling of flow and transport of proppants for EGS applications, and 4) Database of monitoring data, with focus of Acoustic Emissions (AE) from lab scale modeling and field case histories of EGS reservoir creation.« less

The Anterior Intrapelvic Approach for Acetabular Fractures Using Approach-Specific Instruments and an Anatomical-Preshaped 3-Dimensional Suprapectineal Plate.

PubMed

Gras, Florian; Marintschev, Ivan; Grossterlinden, Lars; Rossmann, Markus; Graul, Isabel; Hofmann, Gunther O; Rueger, Johannes M; Lehmann, Wolfgang

2017-07-01

Anatomical acetabular plates the anterior intrapelvic approach (AIP) were recently introduced to fix acetabular fractures through the intrapelvic approach. Therefore, we asked the following: (1) Does the preshaped 3-dimensional suprapectineal plate interfere with or even impair the fracture reduction quality? (2) How often does the AIP approach need to be extended by the first (lateral) window of the ilioinguinal approach? Observational case series. Two Level 1 trauma centers. Patients with unstable acetabular fractures in 2014. Fracture fixation with anatomical-preshaped, 3-dimensional suprapectineal plates through the AIP approach ± the first window of the ilioinguinal approach. Fracture reduction results were measured in computed tomography scans and graded according to the Matta quality of reduction. Intraoperative parameters and perioperative complications were recorded. Radiological results (according to Matta) and functional outcome (modified Merle d'Aubigné score) were evaluated at 1-year follow-up. Thirty patients (9 women + 21 men; mean age ± SE: 64 ± 8 years) were included. The intrapelvic approach was solely used in 19 cases, and in 11 cases, an additional extension with the first window of the ilioinguinal approach (preferential for 2-column fractures) was performed. The mean operating time was 202 ± 59 minutes; the fluoroscopic time was 66 ± 48 seconds. Fracture gaps and steps in preoperative versus postoperative computed tomography scans were 12.4 ± 9.8 versus 2.0 ± 1.5 and 6.0 ± 5.5 versus 1.3 ± 1.7 mm, respectively. At 13.4 ± 2.9 months follow-up, the Matta grading was excellent in 50%, good in 25%, fair in 11%, and poor in 14% of cases. The modified Merle d'Aubigné score was excellent in 17%, good in 37%, fair in 33%, and poor in 13% of cases. The AIP approach using approach-specific instruments and an anatomical-preshaped, 3-dimensional suprapectineal plate became the standard procedure in our departments. Radiological and functional early results justify joint preserving surgery in most cases. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Association of serum bicarbonate with bone fractures in hemodialysis patients: the mineral and bone disorder outcomes study for Japanese CKD stage 5D patients (MBD-5D).

PubMed

Kato, Akihiko; Kido, Ryo; Onishi, Yoshihiro; Kurita, Noriaki; Fukagawa, Masafumi; Akizawa, Tadao; Fukuhara, Shunichi

2014-01-01

Bone fracture is often complicated in hemodialysis (HD) patients. Metabolic acidosis is related to bone disease and muscle wasting, but it is not known whether acid-base disturbance is associated with the risk of bone fractures. The aim of this study was to clarify the association of serum bicarbonate level with bone fracture in HD patients. Using a subcohort of the Mineral and Bone Disorder Outcomes Study for Japanese CKD Stage 5D Patients (MBD-5D), 890 prevalent HD patients (age: 62 years old, male: 62.8%, duration of dialysis: 8.3 years) with secondary hyperparathyroidism were studied. After measuring predialysis serum bicarbonate at a 2-day interdialytic interval, we prospectively followed them every 3 months, and examined the occurrence of any type of bone fracture or hospitalization due to fracture over a 3-year observation period. Seventy-four bone fractures and 47 hospitalizations due to fracture were observed during the follow-up period. HD patients with serum bicarbonate <20 mmol/l had a 1.93 (95% CI 1.01-3.71)-fold higher risk for all-cause fractures than those with serum bicarbonate of 20.0-21.9 mmol/l. A higher bicarbonate level (≥22 mmol/l) was also related to an increased risk of bone fracture. A restricted cubic regression spline disclosed that the higher or the lower than 21.0 mmol/l of serum bicarbonate, the greater the risk for bone fracture. Both a lower level and a higher level of predialysis bicarbonate concentration were associated with risk of bone fracture in HD patients with secondary hyperparathyroidism. © 2014 S. Karger AG, Basel.

[Application of 3D printing and computer-assisted surgical simulation in preoperative planning for acetabular fracture].

PubMed

Liu, Xin; Zeng, Can-Jun; Lu, Jian-Sen; Lin, Xu-Chen; Huang, Hua-Jun; Tan, Xin-Yu; Cai, Dao-Zhang

2017-03-20

To evaluate the feasibility and effectiveness of using 3D printing and computer-assisted surgical simulation in preoperative planning for acetabular fractures. A retrospective analysis was performed in 53 patients with pelvic fracture, who underwent surgical treatment between September, 2013 and December, 2015 with complete follow-up data. Among them, 19 patients were treated with CT three-dimensional reconstruction, computer-assisted virtual reset internal fixation, 3D model printing, and personalized surgery simulation before surgery (3D group), and 34 patients underwent routine preoperative examination (conventional group). The intraoperative blood loss, transfusion volume, times of intraoperative X-ray, operation time, Matta score and Merle D' Aubigne & Postel score were recorded in the 2 groups. Preoperative planning and postoperative outcomes in the two groups were compared. All the operations were completed successfully. In 3D group, significantly less intraoperative blood loss, transfusion volume, fewer times of X-ray, and shortened operation time were recorded compared with those in the conventional group (P<0.05). According to the Matta scores, excellent or good fracture reduction was achieved in 94.7% (18/19) of the patients in 3D group and in 82.4% (28/34) of the patients in conventional group; the rates of excellent and good hip function at the final follow-up were 89.5% (17/19) in the 3D group and 85.3% (29/34) in the conventional group (P>0.05). In the 3D group, the actual internal fixation well matched the preoperative design. 3D printing and computer-assisted surgical simulation for preoperative planning is feasible and accurate for management of acetabular fracture and can effectively improve the operation efficiency.

A Novel Method of Orbital Floor Reconstruction Using Virtual Planning, 3-Dimensional Printing, and Autologous Bone.

PubMed

Vehmeijer, Maarten; van Eijnatten, Maureen; Liberton, Niels; Wolff, Jan

2016-08-01

Fractures of the orbital floor are often a result of traffic accidents or interpersonal violence. To date, numerous materials and methods have been used to reconstruct the orbital floor. However, simple and cost-effective 3-dimensional (3D) printing technologies for the treatment of orbital floor fractures are still sought. This study describes a simple, precise, cost-effective method of treating orbital fractures using 3D printing technologies in combination with autologous bone. Enophthalmos and diplopia developed in a 64-year-old female patient with an orbital floor fracture. A virtual 3D model of the fracture site was generated from computed tomography images of the patient. The fracture was virtually closed using spline interpolation. Furthermore, a virtual individualized mold of the defect site was created, which was manufactured using an inkjet printer. The tangible mold was subsequently used during surgery to sculpture an individualized autologous orbital floor implant. Virtual reconstruction of the orbital floor and the resulting mold enhanced the overall accuracy and efficiency of the surgical procedure. The sculptured autologous orbital floor implant showed an excellent fit in vivo. The combination of virtual planning and 3D printing offers an accurate and cost-effective treatment method for orbital floor fractures. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The use of 3D-printed titanium mesh tray in treating complex comminuted mandibular fractures

PubMed Central

Ma, Junli; Ma, Limin; Wang, Zhifa; Zhu, Xiongjie; Wang, Weijian

2017-01-01

Abstract Rationale: Precise bony reduction and reconstruction of optimal contour in treating comminuted mandibular fractures is very difficult using traditional techniques and devices. The aim of this report is to introduce our experiences in using virtual surgery and three-dimensional (3D) printing technique in treating this clinical challenge. Patient concerns: A 26-year-old man presented with severe trauma in the maxillofacial area due to fall from height. Diagnosis: Computed tomography images revealed middle face fractures and comminuted mandibular fracture including bilateral condyles. Interventions and outcomes: The computed tomography data was used to construct the 3D cranio-maxillofacial models; then the displaced bone fragments were virtually reduced. On the basis of the finalized model, a customized titanium mesh tray was designed and fabricated using selective laser melting technology. During the surgery, a submandibular approach was adopted to repair the mandibular fracture. The reduction and fixation were performed according to preoperative plan, the bone defects in the mental area were reconstructed with iliac bone graft. The 3D-printed mesh tray served as an intraoperative template and carrier of bone graft. The healing process was uneventful, and the patient was satisfied with the mandible contour. Lessons: Virtual surgical planning combined with 3D printing technology enables surgeon to visualize the reduction process preoperatively and guide intraoperative reduction, making the reduction less time consuming and more precise. 3D-printed titanium mesh tray can provide more satisfactory esthetic outcomes in treating complex comminuted mandibular fractures. PMID:28682875

Particle Swarm Transport across the Fracture-Matrix Interface

NASA Astrophysics Data System (ADS)

Malenda, M. G.; Pyrak-Nolte, L. J.

2016-12-01

A fundamental understanding of particle transport is required for many diverse applications such as effective proppant injection, for deployment of subsurface imaging micro-particles, and for removal of particulate contaminants from subsurface water systems. One method of particulate transport is the use of particle swarms that act as coherent entities. Previous work found that particle swarms travel farther and faster in single fractures than individual particles when compared to dispersions and emulsions. In this study, gravity-driven experiments were performed to characterize swarm transport across the fracture-matrix interface. Synthetic porous media with a horizontal fracture were created from layers of square-packed 3D printed (PMMA) spherical grains (12 mm diameter). The minimum fracture aperture ranged from 0 - 10 mm. Swarms (5 and 25 µL) were composed of 3.2 micron diameter fluorescent polystryene beads (1-2% by mass). Swarms were released into a fractured porous medium that was submerged in water and was illuminated with a green (528 nm) LED array. Descending swarms were imaged with a CCD camera (2 fps). Whether an intact swarm was transported across a fracture depended on the volume of the swarm, the aperture of the fracture, and the alignment of pores on the two fracture walls. Large aperture fractures caused significant deceleration of a swarm because the swarm was free to expand laterally in the fracture. Swarms tended to remain intact when the pores on the two fracture walls were vertically aligned and traveled in the lower porous medium with speeds that were 30%-50% of their original speed in the upper matrix. When the pores on opposing walls were no longer aligned, swarms were observed to bifurcate around the grain into two smaller slower-moving swarms. Understanding the physics of particle swarms in fractured porous media has important implications for enhancing target particulate injection into the subsurface as well as for contaminant particulate transport. Acknowledgment: This material is based upon work supported by the U.S. Department of Energy, Office of Science, Office of Basic Energy Sciences, Geosciences Research Program under Award Number (DE-FG02-09ER16022) and by National Science Foundation REU program under Award Number (PHY-1460899) at Purdue University.

Association between Caregiver Role and Short- and Long-Term Functional Recovery after Hip Fracture: A Prospective Study.

PubMed

Nardi, Marlis; Fischer, Karina; Dawson-Hughes, Bess; Orav, Endel J; Meyer, Otto W; Meyer, Ursina; Beck, Sacha; Simmen, Hans-Peter; Pape, Hans-Christoph; Egli, Andreas; Willett, Walter C; Theiler, Robert; Bischoff-Ferrari, Heike A

2018-02-01

After a hip fracture, 50% of senior patients are left with permanent functional decline and 30% lose their autonomy. The aim of this prospective study was to evaluate whether seniors who are in a caregiver role have better functional recovery after hip fracture compared with noncaregivers. Prospective observational study. A total of 107 Swiss patients with acute hip fracture age 65 years and older (84% women; 83.0 ± 6.9 years; 87% community-dwelling). At baseline, participants were asked if they were caregivers for a person, a pet, or a plant. Lower-extremity mobility was measured using the Timed Up and Go (TUG) test at baseline during acute care (day 1-12 after hip fracture surgery) and at 6 and 12 months follow-up. Subjective physical functioning (SPF) was rated for prefracture values and at 6 and 12 months follow-up using the Short Form 36 Health Survey questionnaire. Differences in TUG performance or SPF between caregivers and noncaregivers at 6 and 12 months were assessed using multivariable repeated-measures analysis adjusted for age, sex, body mass index, Charlson comorbidity index, Mini-Mental State Examination, living condition, baseline TUG, and treatment (vitamin D, home exercise program as part of the original trial). At baseline, adjusted TUG performance was better in caregivers of any kind compared with noncaregivers (40.9 vs 84.4 seconds, P < .0001). At 6 months, and after adjustment for baseline TUG performance and other covariates, TUG was better in caregivers of any kind (-6.4 seconds, P = .007) and caregivers of plants (-6.6 seconds, P = .003) compared with noncaregivers. At 12 months, only caregivers of persons had better TUG performance compared with noncaregivers (-7.3 seconds, P = .009). Moreover, at 12 months, SPF was better in caregivers of persons (58.9 vs 45.6, P = .01) and caregivers of any kind (50.8 vs 39.3, P = .02) compared with noncaregivers. Senior hip fracture patients who have a caregiver role of any kind, and especially of plants, had better short-term recovery after hip fracture assessed with the TUG. For long-term recovery, senior hip fracture patients who are caregivers for other persons appeared to have a significant benefit. These benefits were independent of baseline function and all other covariates. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

3D characterization of the fracture network in a deformed chalk reservoir analogue: The Lagerdorf case

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

Koestler, A.G.; Reksten, K.

1994-12-31

Quantitative descriptions of the 3D fracture networks in terms of connectivity, fracture types, fracture surface roughness and flow characteristics are necessary for reservoir evaluation, management, and enhanced oil recovery programs of fractured reservoirs. For a period of 2 years, a research project focused on an analogue to fractured chalk reservoirs excellently exposed near Laegerdorf, NW Germany. Upper Cretaceous chalk has been uplifted and deformed by an underlying salt diapir, and is now exploited for the cement industry. In the production wall of a quarry, the fracture network of the deformed chalk was characterized and mapped at different scales. The wallmore » was scraped off as chalk exploitation proceeded, continuously revealing new sections through the faulted and fractured chalk body. A 230 m long part of the 35m high production wall was investigated during its recess of 25m. The large amount of fracture data were analyzed with respect to parameters such as fracture density distribution, orientation- and length distribution, and in terms of the representativity of data sets collected from restricted rock volumes. This 3D description and analysis of a fracture network revealed quantitative generic parameters of importance for modeling chalk reservoirs with less data and lower data quality.« less

Early Versus Late Weight-Bearing Protocols for Surgically Managed Posterior Wall Acetabular Fractures.

PubMed

Heare, Austin; Kramer, Nicholas; Salib, Christopher; Mauffrey, Cyril

2017-07-01

Despite overall improved outcomes with open reduction and internal fixation of acetabular fractures, posterior wall fractures show disproportionately poor results. The effect of weight bearing on outcomes of fracture management has been investigated in many lower extremity fractures, but evidence-based recommendations in posterior wall acetabular fractures are lacking. The authors systematically reviewed the current literature to determine if a difference in outcome exists between early and late postoperative weight-bearing protocols for surgically managed posterior wall acetabular fractures. PubMed and MEDLINE were searched for posterior wall acetabular fracture studies that included weight-bearing protocols and Merle d'Aubigné functional scores. Twelve studies were identified. Each study was classified as either early or late weight bearing. Early weight bearing was defined as full, unrestricted weight bearing at or before 12 weeks postoperatively. Late weight bearing was defined as restricted weight bearing for greater than 12 weeks postoperatively. The 2 categories were then compared by functional score using a 2-tailed t test and by complication rate using chi-square analysis. Six studies (152 fractures) were placed in the early weight-bearing category. Six studies (302 fractures) were placed in the late weight-bearing category. No significant difference in Merle d'Aubigné functional scores was found between the 2 groups. No difference was found regarding heterotopic ossification, avascular necrosis, superficial infections, total infections, or osteoarthritis. This systematic review found no difference in functional outcome scores or complication rates between early and late weight-bearing protocols for surgically treated posterior wall fractures. [Orthopedics. 2017: 40(4):e652-e657.]. Copyright 2017, SLACK Incorporated.

Beam and Plasma Physics Research

DTIC Science & Technology

1990-06-01

La di~raDy in high power microwave computations and thi-ory and high energy plasma computations and theory. The HPM computations concentrated on...2.1 REPORT INDEX 7 2.2 TASK AREA 2: HIGH-POWER RF EMISSION AND CHARGED- PARTICLE BEAM PHYSICS COMPUTATION , MODELING AND THEORY 10 2.2.1 Subtask 02-01...Vulnerability of Space Assets 22 2.2.6 Subtask 02-06, Microwave Computer Program Enhancements 22 2.2.7 Subtask 02-07, High-Power Microwave Transvertron Design 23

Adaptive Nonlinear Tracking Control of Kinematically Redundant Robot Manipulators with Sub-Task Extensions

DTIC Science & Technology

2005-01-01

C. Hughes, Spacecraft Attitude Dynamics, New York, NY: Wiley, 1994. [8] H. K. Khalil, “Adaptive Output Feedback Control of Non- linear Systems...Closed-Loop Manipulator Control Using Quaternion Feedback ”, IEEE Trans. Robotics and Automation, Vol. 4, No. 4, pp. 434-440, (1988). [23] E...full-state feedback quaternion based controller de- veloped in [5] and focuses on the design of a general sub-task controller. This sub-task controller

The effects of extracorporeal shockwave on acute high-energy long bone fractures of the lower extremity.

PubMed

Wang, Ching-Jen; Liu, Hao-Chen; Fu, Te-Hu

2007-02-01

High-energy long bone fractures of the lower extremity are at risk of poor fracture healing and high rate of non-union. Extracorporeal shockwave was shown effective to heal non-union of long bone fracture. However, the effect of shockwave on acute fractures is unknown. The purpose of this study was to investigate the effects of shockwave on acute high-energy fractures of the lower extremity. Between January and October 2004, 56 patients with 59 acute high-energy fractures were enrolled in this study. Patients were randomly divided into two groups with 28 patients with 28 fractures in the study group and 28 patients with 31 fractures in the control group. Both groups showed similar age, gender, type of fracture and follow-up time. Patients in the study group received open reduction and internal fixation and shockwave treatment immediately after surgery on odd-numbered days of the week, whereas, patients in the control group received open reduction and internal fixation without shockwave treatment on even-numbered days of the week. Postoperative managements were similarly performed in both groups including crutch walking with non-weight bearing on the affected limb until fracture healing shown on radiographs. The evaluation parameters included clinical assessments of pain score and weight bearing status of the affected leg and serial radiographs at 3, 6 and 12 months. The primary end-point is the rate of non-union at 12 months, and the secondary end point is the rate of fracture healing at 3, 6 and 12 months. At 12 months, the rate of non-union was 11% for the study group versus 20% for the control group (P < 0.001). Significantly, better rate of fracture healing was noted in the study group than the control group at 3, 6 and 12 months (P < 0.001). Extracorporeal shockwave is effective on promoting fracture healing and decreasing the rate of non-union in acute high-energy fractures of the lower extremity.

Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW).

PubMed

Roux, C; Wyman, A; Hooven, F H; Gehlbach, S H; Adachi, J D; Chapurlat, R D; Compston, J E; Cooper, C; Díez-Pérez, A; Greenspan, S L; Lacroix, A Z; Netelenbos, J C; Pfeilschifter, J; Rossini, M; Saag, K G; Sambrook, P N; Silverman, S; Siris, E S; Watts, N B; Boonen, S

2012-12-01

Among 50,461 postmenopausal women, 1,822 fractures occurred (57% minor non-hip, non-vertebral [NHNV], 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D, followed by major NHNV and hip fractures. Decreases in physical function and health status were greatest for spine or hip fractures. There is growing evidence that NHNV fractures result in substantial morbidity and healthcare costs. The aim of this prospective study was to assess the effect of these NHNV fractures on quality of life. We analyzed the 1-year incidences of hip, spine, major NHNV (pelvis/leg, shoulder/arm) and minor NHNV (wrist/hand, ankle/foot, rib/clavicle) fractures among women from the Global Longitudinal study of Osteoporosis in Women (GLOW). Health-related quality of life (HRQL) was analyzed using the EuroQol EQ-5D tool and the SF-36 health survey. Among 50,461 women analyzed, there were 1,822 fractures (57% minor NHNV, 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D summary scores, followed by major NHNV and hip fractures. The number of women with mobility problems increased most for those with major NHNV and spine fractures (both +8%); spine fractures were associated with the largest increases in problems with self care (+11%), activities (+14%), and pain/discomfort (+12%). Decreases in physical function and health status were greatest for those with spine or hip fractures. Multivariable modeling found that EQ-5D reduction was greatest for spine fractures, followed by hip and major/minor NHNV. Statistically significant reductions in SF-36 physical function were found for spine fractures, and were borderline significant for major NHNV fractures. This prospective study shows that NHNV fractures have a detrimental effect on HRQL. Efforts to optimize the care of osteoporosis patients should include the prevention of NHNV fractures.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-03-01

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

Fortification of Yogurts with Vitamin D and Calcium Enhances the Inhibition of Serum Parathyroid Hormone and Bone Resorption Markers: A Double Blind Randomized Controlled Trial in Women over 60 Living in a Community Dwelling Home.

PubMed

Bonjour, J-P; Benoit, V; Atkin, S; Walrand, S

2015-05-01

To evaluate whether fortification of yogurts with vitamin D and calcium exerts an additional lowering effect on serum parathyroid hormone (PTH) and bone resorption markers (BRM) as compared to iso-caloric and iso-protein dairy products in aged white women at risk of fragility fractures. A randomized double-blind controlled trial. A community dwelling home. Forty-eight women over 60 years (mean age 73.4). Consumption during 84 days of two 125 g servings of either vitamin D and calcium-fortified yogurts (FY) at supplemental levels of 10 µg vitamin D3/d and 520 mg/d of calcium (total=800 mg/d), or non fortified control yogurts (CY) providing 280 mg/d of calcium. Serum changes from baseline (D0) to D28, D56 and D84 in 25OHD, PTH and in two BRM: Tartrate-resistant-acid-phosphatase-isoform-5b (TRAP5b) and carboxy-terminal-cross-linked-telopeptide of type-I-collagen (CTX). The 10 years risk of major and hip fractures were 13.1 and 5.0%, and 12.9 and 4.2 %, in FY and CY groups, respectively. From D0 to D84, serum 25OHD increased (mean±SE) from 34.3±2.4 to 56.3±2.4 nmol/L in FY (n=24) and from 35.0±2.5 to 41.3±3.0 nmol/L in CY (n=24), (P=0.00001). The corresponding changes in PTH were from 64.1±5.1 to 47.4±3.8 ng/L in FY and from 63.5±4.6 to 60.7±4.2 ng/L in CY (P=0.0011). After D84, TRAP5b was reduced significantly (P=0.0228) and CTX fell though not significantly (P=0.0773) in FY compared to CY. This trial in aged white women living in a community dwelling home at risk for osteoporotic fractures confirms that fortification of dairy products with vitamin D3 and calcium should provide a greater prevention of secondary hyperparathyroidism and accelerated bone resorption as compared to non-fortified equivalent foods.

Studies of Coronae and Large Volcanoes on Venus: Constraining the Diverse Outcomes of Small-Scale Mantle Upwellings on Venus

NASA Technical Reports Server (NTRS)

Stofan, Ellen R.

2005-01-01

Proxemy Research had a grant from NASA to perform science research on upwelling and volcanism on Venus. This was a 3 year Planetary Geology and Geophysics grant to E. Stofan, entitled Coronae and Large volcanoes on Venus. This grant closes on 12/31/05. Here we summarize the scientific progress and accomplishments of this grant. Scientific publications and abstracts of presentations are indicated in the final section. This was a very productive grant and the progress that was made is summarized. Attention is drawn to the publications and abstracts published in each year. The proposal consisted of two tasks, one examining coronae and one studying large volcanoes. The corona task (Task 1) consisted of three parts: 1) a statistical study of the updated corona population, with Sue Smrekar, Lori Glaze, Paula Martin and Steve Baloga; 2) geologic analysis of several specific groups of coronae, with Sue Smrekar and others; and 3) determining the histories and significance of a number of coronae with extreme amounts of volcanism, with Sue Smrekar. Task 2, studies of large volcanoes, consisted of two subtasks. In the first, we studied the geologic history of several volcanoes, with John Guest, Peter Grindrod, Antony Brian and Steve Anderson. In the second subtask, I analyzed a number of Venusian volcanoes with evidence of summit diking along with Peter Grindrod and Francis Nimmo.

Does age of fracture affect the outcome of vertebroplasty? Results from data from a prospective multicenter FDA IDE study.

PubMed

Syed, Mubin I; Shaikh, Azim

2012-11-01

To evaluate whether the age of a fracture is a variable that can identify patients for whom vertebroplasty would be most beneficial. Data from 256 patients with painful osteoporotic vertebral compression fractures (VCFs) who underwent vertebroplasty were examined to assess the effect of fracture age on outcomes. Patients ranged in age from 34-76 years, and the age of fractures ranged from 6 weeks or less (n = 117) to more than 52 weeks (n = 3). Most patients had a fracture age of 12 weeks or less (n = 207), with only 17% having a fracture age greater than 12 weeks. The duration of back pain was used as a surrogate for fracture age and was confirmed by edema on magnetic resonance (MR) imaging, abnormal bone scans, and the presence of central pain over the spinous process The primary outcome was pain reduction as determined by the change in the visual analog scale (VAS) pain score from baseline and at 1, 3, 6, and 24 months after vertebroplasty. A fracture age of 12 weeks or less versus greater than 12 weeks did not affect outcomes, with patients in both groups achieving equivalent benefit after vertebroplasty. Patients with a fracture age of 6 weeks or less had a slightly improved benefit at 3 months after vertebroplasty compared with those having a fracture age of greater than 6 weeks, but the benefit beyond 3 months was the same. Results of the study showed that the age of a fracture does not independently affect the outcomes of vertebroplasty. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Application of 3D-printing technology in the treatment of humeral intercondylar fractures.

PubMed

Zheng, W; Su, J; Cai, L; Lou, Y; Wang, J; Guo, X; Tang, J; Chen, H

2018-02-01

This study was aimed to compare conventional surgery and surgery assisted by 3D-printing technology in the treatment of humeral intercondylar fractures. In addition, we also investigated the effect of 3D-printing technology on the communication between doctors and patients. A total of 91 patients with humeral intercondylar fracture were enrolled in the study from March 2013 to August 2015. They were divided into two groups: 43 cases of 3D-printing group, 48 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan. Operation duration, blood loss volume, fluoroscopy times and time to fracture union were recorded. The final functional outcomes, including the motion of the elbow, MEPS and DASH were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. The operation duration, blood loss volume and fluoroscopy times for 3D-printing group was 76.6±7.9minutes, 231.1±18.1mL and 5.3±1.9 times, and for conventional group was 92.0±10.5minutes, 278.6±23.0mL and 8.7±2.7 times respectively. There was statistically significant difference between the conventional group and 3D-printing group (p<0.05). However, No significant difference was noted in the final functional outcomes between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D-printing model. This study suggested the clinical feasibility of 3D-printing technology in treatment of humeral intercondylar fractures. Level II prospective randomized study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force.

PubMed

Kahwati, Leila C; Weber, Rachel Palmieri; Pan, Huiling; Gourlay, Margaret; LeBlanc, Erin; Coker-Schwimmer, Manny; Viswanathan, Meera

2018-04-17

Osteoporotic fractures result in significant morbidity and mortality. To update the evidence for benefits and harms of vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults to inform the US Preventive Services Task Force. PubMed, EMBASE, Cochrane Library, and trial registries through March 21, 2017; references; and experts. Surveillance continued through February 28, 2018. English-language randomized clinical trials (RCTs) or observational studies of supplementation with vitamin D, calcium, or both among adult populations; studies of populations that were institutionalized or had known vitamin D deficiency, osteoporosis, or prior fracture were excluded. Dual, independent review of titles/abstracts and full-text articles and study quality rating using predefined criteria. Random-effects meta-analysis used when at least 3 similar studies were available. Incident fracture, mortality, kidney stones, cardiovascular events, and cancer. Eleven RCTs (N = 51 419) in adults 50 years and older conducted over 2 to 7 years were included. Compared with placebo, supplementation with vitamin D decreased total fracture incidence (1 RCT [n = 2686]; absolute risk difference [ARD], -2.26% [95% CI, -4.53% to 0.00%]) but had no significant association with hip fracture (3 RCTs [n = 5496]; pooled ARD, -0.01% [95% CI, -0.80% to 0.78%]). Supplementation using vitamin D with calcium had no effect on total fracture incidence (1 RCT [n = 36 282]; ARD, -0.35% [95% CI, -1.02% to 0.31%]) or hip fracture incidence (2 RCTs [n = 36 727]; ARD from the larger trial, -0.14% [95% CI, -0.34% to 0.07%]). The evidence for calcium alone was limited, with only 2 studies (n = 339 total) and very imprecise results. Supplementation with vitamin D alone or with calcium had no significant effect on all-cause mortality or incident cardiovascular disease; ARDs ranged from -1.93% to 1.79%, with CIs consistent with no significant differences. Supplementation using vitamin D with calcium was associated with an increased incidence of kidney stones (3 RCTs [n = 39 213]; pooled ARD, 0.33% [95% CI, 0.06% to 0.60%]), but supplementation with calcium alone was not associated with an increased risk (3 RCTs [n = 1259]; pooled ARD, 0.00% [95% CI, -0.87% to 0.87%]). Supplementation with vitamin D and calcium was not associated with an increase in cancer incidence (3 RCTs [n = 39 213]; pooled ARD, -1.48% [95% CI, -3.32% to 0.35%]). Vitamin D supplementation alone or with calcium was not associated with reduced fracture incidence among community-dwelling adults without known vitamin D deficiency, osteoporosis, or prior fracture. Vitamin D with calcium was associated with an increase in the incidence of kidney stones.

3D printing-based minimally invasive cannulated screw treatment of unstable pelvic fracture.

PubMed

Cai, Leyi; Zhang, Yingying; Chen, Chunhui; Lou, Yiting; Guo, Xiaoshan; Wang, Jianshun

2018-04-04

Open reduction and internal fixation of pelvic fractures could restore the stability of the pelvic ring, but there were several problems. Minimally invasive closed reduction cannulated screw treatment of pelvic fractures has lots advantages. However, how to insert the cannulated screw safely and effectively to achieve a reliable fixation were still hard for orthopedist. Our aim was to explore the significance of 3D printing technology as a new method for minimally invasive cannulated screw treatment of unstable pelvic fracture. One hundred thirty-seven patients with unstable pelvic fractures from 2014 to 2016 were retrospectively analyzed. Based on the usage of 3D printing technology for preoperative simulation surgery, they were assigned to 3D printing group (n = 65) and control group (n = 72), respectively. These two groups were assessed in terms of operative time, intraoperative fluoroscopy, postoperative reduction effect, fracture healing time, and follow-up function. The effect of 3D printing technology was evaluated through minimally invasive cannulated screw treatment. There was no significant difference in these two groups with respect to general conditions, such as age, gender, fracture type, time from injury to operation, injury cause, and combined injury. Length of surgery and average number of fluoroscopies were statistically different for 3D printing group and the control group (p < 0.01), i.e., 58.6 vs. 72.3 min and 29.3 vs. 37 min, respectively. Using the Matta radiological scoring systems, the reduction was scored excellent in 21/65 cases (32.3%) and good in 30/65 cases (46.2%) for the 3D printing group, versus 22/72 cases (30.6%) scored as excellent and 36/72 cases (50%) as good for the control group. On the other hand, using the Majeed functional scoring criteria, there were 27/65 (41.5%) excellent and 26/65 (40%) good cases for the 3D printing group in comparison to 30/72 (41.7%) and 28/72 (38.9%) cases for the control group, respectively. This suggests no significant difference between these two groups about the function outcomes. Full reduction and proper fixation of the pelvic ring and reconstruction of anatomical morphology are of great significance to patients' early functional exercise and for the reduction of long-term complications. This retrospective study has demonstrated the 3D printing technology as a potential approach for improving the diagnosis and treatment of pelvic fractures. The study was retrospectively registered at the Chinese Clinical Trial Registry, number: ChiCTR-TRC-17012798, trial registration date: 26 Sept. 2017.

Perioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation.

PubMed

Warner, Stephen J; Garner, Matthew R; Nguyen, Joseph T; Lorich, Dean G

2016-03-01

Hypovitaminosis D is common in patients undergoing orthopaedic trauma surgery. While previous studies have shown that vitamin D levels correlate with functional outcome after hip fracture surgery, the significance of vitamin D levels on outcomes after surgery in other orthopaedic trauma patients is unknown. The purpose of this study was to determine if vitamin D levels correlated with outcomes in ankle fracture patients. We reviewed a prospective registry of patients who underwent operative treatment for ankle fractures from 2003 to 2012. Preoperative serum 25-hydroxyvitamin D (25[OH]D) levels were measured, and the primary and secondary outcomes included foot and ankle outcome scores (FAOS) and ankle range of motion. Data were also collected on patient comorbidities, articular malreductions, and wound complications. Included patients had at least 12 months of clinical outcome data. Ninety-eight patients operatively treated for ankle fractures met our inclusion criteria. Of these 98 patients, 36 (37%) were deficient in vitamin D (<20 ng/ml) and 31 (32%) had vitamin D insufficiency (<30 ng/ml, ≥20 mg/ml). Patients with vitamin D deficiency were similar with regard to age, gender, and comorbidities compared to patients with vitamin D levels ≥20. Univariate analysis revealed that patients with vitamin D deficiency had significantly worse FAOS with regard to symptoms (P = 0.017) and quality of life (P = 0.040) domains than patients with vitamin D levels ≥20. Multivariate regression analysis suggested that vitamin D deficiency was a factor in inferior FAOS with regard to symptoms, activities of daily living, and quality of life. In our group of patients with operative treated ankle fractures, preoperative vitamin D deficiency correlated with inferior clinical outcomes at a minimum of 1 year follow-up. Our study suggests that deficient vitamin D levels may result in worse outcomes in orthopaedic trauma patients recovering from fracture fixation.

Hormonal and biochemical parameters and osteoporotic fractures in elderly men.

PubMed

Center, J R; Nguyen, T V; Sambrook, P N; Eisman, J A

2000-07-01

Low testosterone has been associated with hip fracture in men in some studies. However, data on other hormonal parameters and fracture outcome in men is minimal. This study examined the association between free testosterone (free T) estradiol (E2), sex hormone-binding globulin (SHBG), 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), insulin-like growth factor I (IGF-I), and fracture in 437 elderly community-dwelling men. Age, height, weight, quadriceps strength, femoral neck bone mineral density (FN BMD), and fracture data (1989-1997) also were obtained. Fractures were classified as major (hip, pelvis, proximal tibia, multiple rib, vertebral, and proximal humerus) or minor (remaining distal upper and lower limb fractures). Fifty-four subjects had a fracture (24 major and 30 minor). There was no association between minor fractures and any hormonal parameter. Risk of major fracture was increased 2-fold for each SD increase in age, decrease in weight and height, and increase in SHBG, and risk of major fracture was increased 3-fold for each SD decrease in quadriceps strength, FN BMD, and 25(OH)D (univariate logistic regression). Independent predictors of major fracture were FN BMD, 2.7 (1.5-4.7; odds ratio [OR]) and 95% confidence interval [CI]); 25(OH)D, 2.8 (1.5-5.3); and SHBG, 1.7 (1.2-2.4). An abnormal value for three factors resulted in a 30-fold increase in risk but only affected 2% of the population. It is not immediately apparent how 25(OH)D and SHBG, largely independently of BMD, may contribute to fracture risk. They may be markers for biological age or health status not measured by methods that are more traditional and as such may be useful in identifying those at high risk of fracture.

[Finite element analysis of the maxillary central incisor with crown lengthening surgery and post-core restoration in management of crown-root fracture].

PubMed

Zhen, Min; Hu, Wen-jie; Rong, Qi-guo

2015-12-18

To construct the finite element models of maxillary central incisor and the simulations with crown lengthening surgery and post-core restoration in management of different crown-root fracture types, to investigate the stress intensity and distributions of these models mentioned above, and to analyze the indications of crown lengthening from the point of view of mechanics. An extracted maxillary central incisor and alveolar bone plaster model were scanned by Micro-CT and dental impression scanner (3shape D700) respectively. Then the 3D finite element models of the maxillary central incisor and 9 simulations with crown lengthening surgery and post-core restoration were constructed by Mimics 10.0, Geomagic studio 9.0 and ANSYS 14.0 software. The oblique static force (100 N) was applied to the palatal surface (the junctional area of the incisal 1/3 and middle 1/3), at 45 degrees to the longitudinal axis, then the von Mises stress of dentin, periodontal ligament, alveolar bone, post and core, as well as the periodontal ligament area, were calculated. A total of 10 high-precision three-dimensional finite element models of maxillary central incisor were established. The von Mises stress of models: post>dentin>alveolar bone>core>periodontal ligament, and the von Mises stress increased linearly with the augmentation of fracture degree (besides the core). The periodontal ligament area of the crown lengthening was reduced by 12% to 33%. The von Mises stress of periodontal ligament of the B2L2c, B2L3c, B3L1c, B3L2c, B3L3c models exceeded their threshold limit value, respectively. The maxillary central incisors with the labial fracture greater than three-quarter crown length and the palatal fracture deeper than 1 mm below the alveolar crest are not the ideal indications of the crown lengthening surgery.

Efficacy of 3-Dimensional plates over Champys miniplates in mandibular anterior fractures

PubMed Central

Barde, Dhananjay H; Mudhol, Anupama; Ali, Fareedi Mukram; Madan, R S; Kar, Sanjay; Ustaad, Farheen

2014-01-01

Background: Mandibular fractures are treated surgically by either rigid or semi-rigid fixation, two techniques that reflect almost opposite concept of craniomaxillofacial osteosynthesis. The shortcomings of these fixations led to the development of 3 dimensional (3D) miniplates. This study was designed with the aim of evaluating the efficiency of 3D miniplate over Champys miniplate in anterior mandibular fractures. Materials & Methods: This study was done in 40 patients with anterior mandibular fractures. Group I consisting of 20 patients in whom 3D plates were used for fixation while in Group II consisting of other 20 patients, 4 holes straight plates were used. The efficacy of 3D miniplate over Champy’s miniplate was evaluated in terms of operating time, average pain, post operative infection, occlusion, wound dehiscence, post operative mobility and neurological deficit. Results: The mean operation time for Group II was more compared to Group I (statistically significant).There was significantly greater pain on day of surgery and at 2nd week for Group II patients but there was no significant difference between the two groups at 4th week. The post operative infection, occlusal disturbance, wound dehiscence, post operative mobility at facture site, neurological deficit was statistically insignificant (chi square test). Conclusion: The results of this study suggest that fixation of anterior mandibular fractures with 3D plates provides three dimensional stability and carries low morbidity and infection rates. The only probable limitation of these 3D plates may be excessive implant material, but they seem to be easy alternative to champys miniplate. How to cite the article: Barde DH, Mudhol A, Ali FM, Madan RS, Kar S, Ustaad F. Efficacy of 3-Dimensional plates over Champys miniplates in mandibular anterior fractures. J Int Oral Health 2014;6(1):20-6. PMID:24653598

Vertebral fractures assessed with dual-energy X-ray absorptiometry in patients with Addison's disease on glucocorticoid and mineralocorticoid replacement therapy.

PubMed

Camozzi, Valentina; Betterle, Corrado; Frigo, Anna Chiara; Zaccariotto, Veronica; Zaninotto, Martina; De Caneva, Erica; Lucato, Paola; Gomiero, Walter; Garelli, Silvia; Sabbadin, Chiara; Salvà, Monica; Costa, Miriam Dalla; Boscaro, Marco; Luisetto, Giovanni

2018-02-01

to assess bone damage and metabolic abnormalities in patients with Addison's disease given replacement doses of glucocorticoids and mineralocorticoids. A total of 87 patients and 81 age-matched and sex-matched healthy controls were studied. The following parameters were measured: urinary cortisol, serum calcium, phosphorus, creatinine, 24-h urinary calcium excretion, bone alkaline phosphatase, parathyroid hormone, serum CrossLaps, 25 hydroxyvitamin D, and 1,25 dihydroxyvitamin D. Clear vertebral images were obtained with dual-energy X-ray absorptiometry in 61 Addison's disease patients and 47 controls and assessed using Genant's classification. Nineteen Addison's disease patients (31.1%) had at least one morphometric vertebral fracture, as opposed to six controls (12.8%, odds ratio 3.09, 95% confidence interval 1.12-8.52). There were no significant differences in bone mineral density parameters at any site between patients and controls. In Addison's disease patients, there was a positive correlation between urinary cortisol and urinary calcium excretion. Patients with fractures had a longer history of disease than those without fractures. Patients taking fludrocortisone had a higher bone mineral density than untreated patients at all sites except the lumbar spine. Addison's disease patients have more fragile bones irrespective of any decrease in bone mineral density. Supra-physiological doses of glucocorticoids and longer-standing disease (with a consequently higher glucocorticoid intake) might be the main causes behind patients' increased bone fragility. Associated mineralocorticoid treatment seems to have a protective effect on bone mineral density.

Pressurized fluidized-bed hydroretorting of Eastern oil shales -- Sulfur control. Topical report for Subtask 3.1, In-bed sulfur capture tests; Subtask 3.2, Electrostatic desulfurization; Subtask 3.3, Microbial desulfurization and denitrification

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

Roberts, M.J.; Abbasian, J.; Akin, C.

1992-05-01

This topical report on ``Sulfur Control`` presents the results of work conducted by the Institute of Gas Technology (IGT), the Illinois Institute of Technology (IIT), and the Ohio State University (OSU) to develop three novel approaches for desulfurization that have shown good potential with coal and could be cost-effective for oil shales. These are (1) In-Bed Sulfur Capture using different sorbents (IGT), (2) Electrostatic Desulfurization (IIT), and (3) Microbial Desulfurization and Denitrification (OSU and IGT). The objective of the task on In-Bed Sulfur Capture was to determine the effectiveness of different sorbents (that is, limestone, calcined limestone, dolomite, and siderite)more » for capturing sulfur (as H{sub 2}S) in the reactor during hydroretorting. The objective of the task on Electrostatic Desulfurization was to determine the operating conditions necessary to achieve a high degree of sulfur removal and kerogen recovery in IIT`s electrostatic separator. The objectives of the task on Microbial Desulfurization and Denitrification were to (1) isolate microbial cultures and evaluate their ability to desulfurize and denitrify shale, (2) conduct laboratory-scale batch and continuous tests to improve and enhance microbial removal of these components, and (3) determine the effects of processing parameters, such as shale slurry concentration, solids settling characteristics, agitation rate, and pH on the process.« less

Modelling DC responses of 3D complex fracture networks

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

Beskardes, Gungor Didem; Weiss, Chester Joseph

Here, the determination of the geometrical properties of fractures plays a critical role in many engineering problems to assess the current hydrological and mechanical states of geological media and to predict their future states. However, numerical modeling of geoelectrical responses in realistic fractured media has been challenging due to the explosive computational cost imposed by the explicit discretizations of fractures at multiple length scales, which often brings about a tradeoff between computational efficiency and geologic realism. Here, we use the hierarchical finite element method to model electrostatic response of realistically complex 3D conductive fracture networks with minimal computational cost.

Modelling DC responses of 3D complex fracture networks

DOE PAGES

Beskardes, Gungor Didem; Weiss, Chester Joseph

2018-03-01

Here, the determination of the geometrical properties of fractures plays a critical role in many engineering problems to assess the current hydrological and mechanical states of geological media and to predict their future states. However, numerical modeling of geoelectrical responses in realistic fractured media has been challenging due to the explosive computational cost imposed by the explicit discretizations of fractures at multiple length scales, which often brings about a tradeoff between computational efficiency and geologic realism. Here, we use the hierarchical finite element method to model electrostatic response of realistically complex 3D conductive fracture networks with minimal computational cost.

HRT and Vit D in prevention of non-vertebral fractures in postmenopausal women; a 5 year randomized trial.

PubMed

Komulainen, Marja H; Kröger, Heikki; Tuppurainen, Marjo T; Heikkinen, Anna-Mari; Alhava, Esko; Honkanen, Risto; Saarikoski, Seppo

2008-01-01

We investigated the incidence of new non-vertebral fractures during HRT or low-dose vitamin (Vit) D3 supplementation in a 5-year prospective trial. A total of 464 early postmenopausal women, (a subgroup of the Kuopio Osteoporosis Study, n = 13100) were randomized to four groups: (1) HRT, a sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate; (2) Vit D (300 IU/day and 100 IU/day during the fifth year); (3) HRT + Vit D; and (4) placebo. Lumbar (L2-4) and femoral neck bone mineral densities (BMD) were determined by dual X-ray absorptiometry (DXA) at baseline, after 2.5 and 5 years of treatment. All new symptomatic non-vertebral, radiographically defined fractures were recorded. Altogether, 368 women (79%) completed the 5 year treatment. In all, 32 women had 39 non-vertebral fractures during a mean of 4.3 year follow-up (HRT 4, Vit D 10, HRT + Vit D 8 and placebo 17). The reduction in the incidence of new non-verterbral fractures was significant in women with HRT alone (P = 0.032) when adjusted by baseline BMD and previous fractures; observed also with the intention-to-treat principle (P = 0.048). When the HRT groups were pooled, HRT showed a significantly lower incidence of new non-vertebral fractures (P = 0.042) than women receiving placebo and also after adjusting as above (P = 0.016); both in valid-case and in the intention-to-treat analysis. In the Vit D group, the fracture incidence was non-significantly decreased (P = 0.229) in comparison with the placebo group. The estimated risk of new non-vertebral fractures among women treated with HRT alone was 0.29 (95% CI, 0.10-0.90) and with Vit D 0.47 (95% CI, 0.20-1.14) and with HRT + Vit D 0.44 (95% CI, 0.17-1.15), in comparison with the placebo group (adjusted by femoral BMD and previous fractures). This study is the first prospective trial confirming the beneficial effect of HRT on prevention of peripheral fractures in non-osteoporotic postmenopausal women. The effect of low-dose Vit D remains to be proved.

Measurement of fracture stress for 6000-series extruded aluminum alloy tube using multiaxial tube expansion testing method

NASA Astrophysics Data System (ADS)

Nagai, Keisuke; Kuwabara, Toshihiko; Ilinich, Andrey; Luckey, George

2018-05-01

A servo-controlled tension-internal pressure testing machine with an optical 3D digital image correlation system (DIC) is used to measure the multiaxial deformation behavior of an extruded aluminum alloy tube for a strain range from initial yield to fracture. The outer diameter of the test sample is 50.8 mm and wall thickness 2.8 mm. Nine linear stress paths are applied to the specimens: σɸ (axial true stress component) : σθ (circumferential true stress component) = 1:0, 4:1, 2:1, 4:3, 1:1, 3:4, 1:2, 1:4, and 0:1. The equivalent strain rate is approximately 5 × 10-4 s-1 constant. The forming limit curve (FLC) and forming limit stress curve (FLSC) are also measured. Moreover, the average true stress components inside a localized necking area are determined for each specimen from the thickness strain data for the localized necking area and the geometry of the fracture surface.

Low serum 25-hydroxyvitamin D is associated with increased risk of stress fracture during Royal Marine recruit training.

PubMed

Davey, T; Lanham-New, S A; Shaw, A M; Hale, B; Cobley, R; Berry, J L; Roch, M; Allsopp, A J; Fallowfield, J L

2016-01-01

The aim of this study was to investigate vitamin D status and stress fracture risk during Royal Marine military training. Poor vitamin D status was associated with an increased risk of stress fracture. Vitamin D supplementation may help to reduce stress fracture risk in male military recruits with low vitamin D status. Stress fracture is a common overuse injury in military recruits, including Royal Marine (RM) training in the UK. RM training is recognised as one of the most arduous basic training programmes in the world. Associations have been reported between serum 25-hydroxyvitamin D (25(OH)D) and risk of stress fracture, but the threshold of 25(OH)D for this effect remains unclear. We aimed to determine if serum 25(OH)D concentrations were associated with stress fracture risk during RM training. We prospectively followed 1082 RM recruits (males aged 16-32 years) through the 32-week RM training programme. Troops started training between September and July. Height, body weight and aerobic fitness were assessed at week 1. Venous blood samples were drawn at weeks 1, 15 and 32. Serum samples were analysed for 25(OH)D and parathyroid hormone (PTH). Seventy-eight recruits (7.2 %) suffered a total of 92 stress fractures. Recruits with a baseline serum 25(OH)D concentration below 50 nmol L(-1) had a higher incidence of stress fracture than recruits with 25(OH)D concentration above this threshold (χ(2) (1) = 3.564, p = 0.042; odds ratio 1.6 (95 % confidence interval (CI) 1.0-2.6)). Baseline serum 25(OH)D varied from 47.0 ± 23.7 nmol L(-1) in February, to 97.3 ± 24.6 nmol L(-1) in July (overall mean 69.2 ± 29.2 nmol L(-1), n = 1016). There were weak inverse correlations between serum 25(OH)D and PTH concentrations at week 15 (r = -0.209, p < 0.001) and week 32 (r = -0.214, p < 0.001), but not at baseline. Baseline serum 25(OH)D concentration below 50 nmol L(-1) was associated with an increased risk of stress fracture. Further studies into the effects of vitamin D supplementation on stress fracture risk are certainly warranted.

Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW)

PubMed Central

Roux, C.; Wyman, A.; Hooven, F. H.; Gehlbach, S. H.; Adachi, J. D.; Chapurlat, R. D.; Compston, J. E.; Cooper, C.; Díez-Pérez, A.; Greenspan, S. L.; LaCroix, A. Z.; Netelenbos, J. C.; Pfeilschifter, J.; Rossini, M.; Saag, K. G.; Sambrook, P. N.; Silverman, S.; Siris, E. S.; Watts, N. B.; Boonen, S.

2016-01-01

Purpose Most fracture studies have focused on hip and vertebral fractures, but there is growing evidence that non-hip, non-vertebral (NHNV) fractures also result in substantial morbidity and healthcare costs. We sought to assess the effect of NHNV fractures on quality of life. Methods We analyzed 1-year incidences of hip, spine, major NHNV (pelvis/leg, shoulder/arm) and minor NHNV (wrist/hand, ankle/foot, rib/clavicle) fractures among women from the GLOW registry, a prospective, multinational, observational cohort study. Health-related quality of life (HRQL) was analyzed using EuroQol EQ-5D and the SF-36 health survey. Results Among 50,461 women analyzed, there were 1,822 fractures (57% minor NHNV, 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D summary scores, followed by major NHNV and hip fractures. The amount of women with mobility problems increased most for those with major NHNV and spine fractures (both +8%); spine fractures were associated with the largest increases in problems with self care (+11%), activities (+14%), and pain/discomfort (+12%). Decreases in physical function and health status were greatest for women with spine or hip fractures. Multivariable modeling found that EQ-5D reduction was greatest for spine fractures, followed by hip and major/minor NHNV. Significant reductions in SF-36 physical function were found only for spine and major NHNV fractures. Conclusion This prospective study shows that NHNV fractures have a detrimental effect on HRQL. As NHNV fractures account for >80% of incident fractures, efforts to optimize osteoporosis care should include prevention of NHNV fractures. PMID:22398855

Maternal Vitamin D Status and Offspring Bone Fractures: Prospective Study over Two Decades in Aarhus City, Denmark

PubMed Central

Petersen, Sesilje Bondo; Olsen, Sjurdur Frodi; Mølgaard, Christian; Granström, Charlotta; Cohen, Arieh; Vestergaard, Peter; Strøm, Marin

2014-01-01

Background Studies investigating the association between maternal vitamin D status and offspring bone mass measured by dual-energy X-ray absorptiometry (DXA) during childhood have shown conflicting results. Purpose We used occurrence of bone fractures up to the age of 18 as a measure reflecting offspring bone mass and related that to maternal vitamin D status. Methods The Danish Fetal Origins 1988 Cohort recruited 965 pregnant women during 1988–89 at their 30th gestation week antenatal midwife visit. A blood sample was drawn and serum was stored, which later was analyzed for the concentration of 25-hydroxyvitamin D (25(OH)D) by the liquid chromatography coupled with a tandem mass spectrometric method (LC-MS/MS). Outcome was diagnosis of first time bone fractures extracted from the Danish National Patient Register. Results Vitamin D status was available for 850 women. The median (5th–95th percentile) 25(OH)D was 76.2 (23.0–152.1) nmol/l. During follow up 294 children were registered with at least one bone fracture diagnosis. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between maternal vitamin D status and first time bone fractures. However, there was a significantly increased hazard ratio (HR) during childhood for those who had maternal blood drawn in Dec/Jan/Feb compared with Jun/Jul/Aug (HR: 1.75, 95%CI: 1.11–2.74). Adjustment for vitamin D status strengthened this association (1.82, 1.12–2.97), which indicated a potential seasonal impact on offspring fractures independent of maternal vitamin D status. In a sensitivity analysis we found a borderline significant inverse association between continuous concentrations of 25(OH)D and offspring forearm fractures (P = 0.054). Conclusion Overall, our results did not substantiate an association between maternal vitamin D status and offspring bone fractures. Further studies on this subject are needed, but the study populations must be large enough to allow for subdivision of fractures. PMID:25474409

Earth resources data analysis program, phase 2

NASA Technical Reports Server (NTRS)

1974-01-01

The efforts and findings of the Earth Resources Data Analysis Program are summarized. Results of a detailed study of the needs of EOD with respect to an applications development system (ADS) for the analysis of remotely sensed data, including an evaluation of four existing systems with respect to these needs are described. Recommendations as to possible courses for EOD to follow to obtain a viable ADS are presented. Algorithmic development comprised of several subtasks is discussed. These subtasks include the following: (1) two algorithms for multivariate density estimation; (2) a data smoothing algorithm; (3) a method for optimally estimating prior probabilities of unclassified data; and (4) further applications of the modified Cholesky decomposition in various calculations. Little effort was expended on task 3, however, two reports were reviewed.

Intra-operative 3D imaging system for robot-assisted fracture manipulation.

PubMed

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

2015-01-01

Reduction is a crucial step in the treatment of broken bones. Achieving precise anatomical alignment of bone fragments is essential for a good fast healing process. Percutaneous techniques are associated with faster recovery time and lower infection risk. However, deducing intra-operatively the desired reduction position is quite challenging due to the currently available technology. The 2D nature of this technology (i.e. the image intensifier) doesn't provide enough information to the surgeon regarding the fracture alignment and rotation, which is actually a three-dimensional problem. This paper describes the design and development of a 3D imaging system for the intra-operative virtual reduction of joint fractures. The proposed imaging system is able to receive and segment CT scan data of the fracture, to generate the 3D models of the bone fragments, and display them on a GUI. A commercial optical tracker was included into the system to track the actual pose of the bone fragments in the physical space, and generate the corresponding pose relations in the virtual environment of the imaging system. The surgeon virtually reduces the fracture in the 3D virtual environment, and a robotic manipulator connected to the fracture through an orthopedic pin executes the physical reductions accordingly. The system is here evaluated through fracture reduction experiments, demonstrating a reduction accuracy of 1.04 ± 0.69 mm (translational RMSE) and 0.89 ± 0.71 ° (rotational RMSE).

Development of Game-Like Simulations for Procedural Knowledge in Healthcare Education

ERIC Educational Resources Information Center

Torrente, Javier; Borro-Escribano, Blanca; Freire, Manuel; del Blanco, Ángel; Marchiori, Eugenio J.; Martinez-Ortiz, Iván; Moreno-Ger, Pablo; Fernández-Manjón, Baltasar

2014-01-01

We present EGDA, an educational game development approach focused on the teaching of procedural knowledge using a cost-effective approach. EGDA proposes four tasks: analysis, design, implementation, and quality assurance that are subdivided in a total of 12 subtasks. One of the benefits of EGDA is that anyone can apply it to develop a game since…

Integration of computer-assisted fracture reduction system and a hybrid 3-DOF-RPS mechanism for assisting the orthopedic surgery

NASA Astrophysics Data System (ADS)

Irwansyah; Sinh, N. P.; Lai, J. Y.; Essomba, T.; Asbar, R.; Lee, P. Y.

2018-02-01

In this paper, we present study to integrate virtual fracture bone reduction simulation tool with a novel hybrid 3-DOF-RPS external fixator to relocate back bone fragments into their anatomically original position. A 3D model of fractured bone was reconstructed and manipulated using 3D design and modeling software, PhysiGuide. The virtual reduction system was applied to reduce a bilateral femoral shaft fracture type 32-A3. Measurement data from fracture reduction and fixation stages were implemented to manipulate the manipulator pose in patient’s clinical case. The experimental result presents that by merging both of those techniques will give more possibilities to reduce virtual bone reduction time, improve facial and shortest healing treatment.

Health state utility values and patient-reported outcomes before and after vertebral and non-vertebral fractures in an osteoporosis clinical trial.

PubMed

Imai, T; Tanaka, S; Kawakami, K; Miyazaki, T; Hagino, H; Shiraki, M

2017-06-01

We assessed the health state utility value (HSUV) reductions associated with vertebral fractures using data collected in the Japanese Osteoporosis Intervention Trial-03 (JOINT-03). Our analysis revealed that assessment of HSUVs after morphometric vertebral fracture is important to capture the burden of vertebral fractures. Evaluation of the HSUV after fracture is important to calculate the quality-adjusted life years (QALYs) of osteoporosis patients, which is essential information in the context of health economic evaluation. JOINT-03 study patients were aged ≥65 years and treated with risedronate and vitamin K 2 or risedronate alone. Radiographic information and patient-reported outcomes measured by EQ-5D and a visual analogue scale (VAS) were assessed at registration and followed up after 6, 12, and 24 months. According to differences among the dates of these assessments and the radiographic information, we classified the follow-up HSUVs calculated based on EQ-5D results into before or after fracture categories regardless of clinical symptoms. Among 2922 follow-up HSUVs, 201 HSUVs were categorized as HSUVs that were observed after incident vertebral fractures on X-ray films. The median time from the detection of an incident vertebral fracture until the EQ-5D assessment was 53 days (25th percentile, 0 day; 75th percentile, 357 days). The impact of incident vertebral fractures on HSUVs was quantified as -0.03. Among the five health profile domains on the EQ-5D, an incident vertebral fracture had significant effects on anxiety/depression, self-care, and usual activities. The results suggest that incident morphometric vertebral fracture was associated with impairment of the HSUV for patients with osteoporosis not only immediately but also several months after the fracture.

DUAL-ENERGY X-RAY ABSORPTIOMETRY AND CALCULATED FRAX RISK SCORES MAY UNDERESTIMATE OSTEOPOROTIC FRACTURE RISK IN VITAMIN D-DEFICIENT VETERANS WITH HIV INFECTION.

PubMed

Stephens, Kelly I; Rubinsztain, Leon; Payan, John; Rentsch, Chris; Rimland, David; Tangpricha, Vin

2016-04-01

We evaluated the utility of the World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX) in assessing fracture risk in patients with human immunodeficiency virus (HIV) and vitamin D deficiency. This was a retrospective study of HIV-infected patients with co-existing vitamin D deficiency at the Atlanta Veterans Affairs Medical Center. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DEXA), and the 10-year fracture risk was calculated by the WHO FRAX algorithm. Two independent radiologists reviewed lateral chest radiographs for the presence of subclinical vertebral fractures. We identified 232 patients with HIV and vitamin D deficiency. Overall, 15.5% of patients met diagnostic criteria for osteoporosis on DEXA, and 58% had low BMD (T-score between -1 and -2.5). The median risk of any major osteoporotic and hip fracture by FRAX score was 1.45 and 0.10%, respectively. Subclinical vertebral fractures were detected in 46.6% of patients. Compared to those without fractures, those with fractures had similar prevalence of osteoporosis (15.3% versus 15.7%; P>.999), low BMD (53.2% versus 59.3%; P = .419), and similar FRAX hip scores (0.10% versus 0.10%; P = .412). While the FRAX major score was lower in the nonfracture group versus fracture group (1.30% versus 1.60%; P = .025), this was not clinically significant. We found a high prevalence of subclinical vertebral fractures among vitamin D-deficient HIV patients; however, DEXA and FRAX failed to predict those with fractures. Our results suggest that traditional screening tools for fragility fractures may not be applicable to this high-risk patient population.

Application of computer-aided three-dimensional skull model with rapid prototyping technique in repair of zygomatico-orbito-maxillary complex fracture.

PubMed

Li, Wei Zhong; Zhang, Mei Chao; Li, Shao Ping; Zhang, Lei Tao; Huang, Yu

2009-06-01

With the advent of CAD/CAM and rapid prototyping (RP), a technical revolution in oral and maxillofacial trauma was promoted to benefit treatment, repair of maxillofacial fractures and reconstruction of maxillofacial defects. For a patient with zygomatico-facial collapse deformity resulting from a zygomatico-orbito-maxillary complex (ZOMC) fracture, CT scan data were processed by using Mimics 10.0 for three-dimensional (3D) reconstruction. The reduction design was aided by 3D virtual imaging and the 3D skull model was reproduced using the RP technique. In line with the design by Mimics, presurgery was performed on the 3D skull model and the semi-coronal incision was taken for reduction of ZOMC fracture, based on the outcome from the presurgery. Postoperative CT and images revealed significantly modified zygomatic collapse and zygomatic arch rise and well-modified facial symmetry. The CAD/CAM and RP technique is a relatively useful tool that can assist surgeons with reconstruction of the maxillofacial skeleton, especially in repairs of ZOMC fracture.

Resorbable poly(D,L)lactide plates and screws for osteosynthesis of condylar neck fractures in sheep.

PubMed

Rasse, Michael; Moser, Doris; Zahl, Christian; Gerlach, Klaus Louis; Eckelt, Uwe; Loukota, Richard

2007-01-01

We made osteotomies in the condylar neck in 12 adult sheep to simulate fractures, and joined the two ends with 2 poly(D,L)lactide (PDLLA) plates and 8 PDLLA screws 2mm in diameter. The animals were killed after 2, 6, and 12 months and bony healing was assessed macroscopically and histologically. The plates and screws remained intact and there was no displacement of the bony ends. The degrading plates, which were still visible in the specimens after 6 months, had been replaced by bone. At 12 months the PDLLA had been resorbed with no foreign body reaction and no resorption of underlying bone. The articular discs showed no signs of degeneration.

Decreased Levels of Circulating Carboxylated Osteocalcin in Children with Low Energy Fractures: A Pilot Study.

PubMed

Popko, Janusz; Karpiński, Michał; Chojnowska, Sylwia; Maresz, Katarzyna; Milewski, Robert; Badmaev, Vladimir; Schurgers, Leon J

2018-06-06

In the past decades, an increased interest in the roles of vitamin D and K has become evident, in particular in relation to bone health and prevention of bone fractures. The aim of the current study was to evaluate vitamin D and K status in children with low-energy fractures and in children without fractures. The study group of 20 children (14 boys, 6 girls) aged 5 to 15 years old, with radiologically confirmed low-energy fractures was compared with the control group of 19 healthy children (9 boys, 10 girls), aged 7 to 17 years old, without fractures. Total vitamin D (25(OH)D3 plus 25(OH)D2), calcium, BALP (bone alkaline phosphatase), NTx (N-terminal telopeptide), and uncarboxylated (ucOC) and carboxylated osteocalcin (cOC) serum concentrations were evaluated. Ratio of serum uncarboxylated osteocalcin to serum carboxylated osteocalcin ucOC:cOC (UCR) was used as an indicator of bone vitamin K status. Logistic regression models were created to establish UCR influence for odds ratio of low-energy fractures in both groups. There were no statistically significant differences in the serum calcium, NTx, BALP, or total vitamin D levels between the two groups. There was, however, a statistically significant difference in the UCR ratio. The median UCR in the fracture group was 0.471 compared with the control group value of 0.245 ( p < 0.0001). In the logistic regression analysis, odds ratio of low-energy fractures for UCR was calculated, with an increased risk of fractures by some 78.3 times. In this pilot study, better vitamin K status expressed as the ratio of ucOC:cOC-UCR—is positively and statistically significantly correlated with lower rate of low-energy fracture incidence.

Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study.

PubMed

Racine, Samuel; Émond, Marcel; Audette-Côté, Jean-Sébastien; Le Sage, Natalie; Guimont, Chantal; Moore, Lynne; Chauny, Jean-Marc; Bergeron, Éric; Vanier, Laurent

2016-09-01

The aim of this study was to determine the incidence of delayed complications, specifically hemothorax, and functional outcome in patients with isolated sternal fracture discharged from the emergency department (ED) compared to patients with other minor thoracic trauma. This prospective cohort study was conducted in four university-affiliated Canadian EDs. Patients ages 16 and older discharged from the ED with an isolated minor thoracic injury were included and categorized as isolated sternal fracture, rib fracture, or no fracture. A standardized clinical and radiological follow-up was performed at 7 and 14 days as well as a phone follow-up at 30 and 90 days post-injury. Functional outcome was determined using the Medical Outcome Short-Form Health Survey (SF-12). A total of 969 patients were included, of whom 32 (3.3%) had an isolated sternal fracture, 304 (31.3%) had rib fracture, and 633 (65.3%) had no fracture. Within 14 days, 112 patients presented with a delayed hemothorax: 12.5% of sternal fracture patients, 23% of rib fracture(s) patients, and 6% of minor thoracic injury patients without fracture (p<0.05). At 90 days, 57.1% of patients with sternal fracture had moderate to severe disability compared to 25.4% and 21.2% for both of the other groups, respectively (p<0.001). In this prospective study, we found that 12.5% (n=4, p<0.05) of patients with sternal fracture developed a delayed hemothorax, but the clinical significance of this remains questionable. The proportion of patients with sternal fracture who had moderate to severe disability was significantly higher than that of patients with other minor thoracic trauma.

Evaluation of Shear Strength of RC Beams with Multiple Interfaces Formed before Initial Setting Using 3D Printing Technology

PubMed Central

Kim, Kyeongjin; Park, Sangmin; Jeong, Yoseok; Lee, Jaeha

2017-01-01

With the recent development of 3D printing technology, concrete materials are sometimes used in 3D printing. Concrete structures based on 3D printing have been characterized to have the form of multiple layer build-up. Unlike general concrete structures, therefore, the 3D-printed concrete can be regarded as an orthotropic material. The material property of the 3D-printed concrete’s interface between layers is expected to be far different from that of general concrete bodies since there are no aggregate interlocks and weak chemical bonding. Such a difference finally affects the structural performance of concrete structures even though the interfaces are formed before initial setting of the concrete. The current study mainly reviewed the changes in fracture energy (toughness) with respect to various environmental conditions of such interface. Changes in fracture energies of interfaces between concrete layers were measured using low-speed Crack Mouth Opening Displacement (CMOD) closed loop concrete fracture test. The experimental results indicated reduction in fracture energy as well as tensile strengths. To improve the tensile strength of interfaces, the use of bridging materials is suggested. Since it was assumed that reduction in fracture energy could be a cause of shear strength, to evaluate the reduced structural performance of concrete structure constructed with multiple interfaces by 3D printing technology, the shear strength of RC beam by 3D printing technology was predicted and compared with that of plain RC beam. Based on the fracture energy measured in this study, Modified Compression Field Theory (MCFT) theory-applied Vector 2 program was employed to predict the degree of reduction in shear strength without considering stirrups. Reduction factors were presented based on the obtained results to predict the reduction in shear strength due to interfaces before initial setting of the concrete.

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

Robinson, Judith; Johnson, Timothy C.; Slater, Lee D.

There is an increasing need to characterize discrete fractures away from boreholes to better define fracture distributions and monitor solute transport. We performed a 3D evaluation of static and time-lapse cross-borehole electrical resistivity tomography (ERT) data sets from a limestone quarry in which flow and transport are controlled by a bedding-plane feature. Ten boreholes were discretized using an unstructured tetrahedral mesh, and 2D panel measurements were inverted for a 3D distribution of conductivity. We evaluated the benefits of 3D versus 2.5D inversion of ERT data in fractured rock while including the use of borehole regularization disconnects (BRDs) and borehole conductivitymore » constraints. High-conductivity halos (inversion artifacts) surrounding boreholes were removed in static images when BRDs and borehole conductivity constraints were implemented. Furthermore, applying these constraints focused transient changes in conductivity resulting from solute transport on the bedding plane, providing a more physically reasonable model for conductivity changes associated with solute transport at this fractured rock site. Assuming bedding-plane continuity between fractures identified in borehole televiewer data, we discretized a planar region between six boreholes and applied a fracture regularization disconnect (FRD). Although the FRD appropriately focused conductivity changes on the bedding plane, the conductivity distribution within the discretized fracture was nonunique and dependent on the starting homogeneous model conductivity. Synthetic studies performed to better explain field observations showed that inaccurate electrode locations in boreholes resulted in low-conductivity halos surrounding borehole locations. These synthetic studies also showed that the recovery of the true conductivity within an FRD depended on the conductivity contrast between the host rock and fractures. Our findings revealed that the potential exists to improve imaging of fractured rock through 3D inversion and accurate modeling of boreholes. However, deregularization of localized features can result in significant electrical conductivity artifacts, especially when representing features with a high degree of spatial uncertainty.« less

VITAL-Bone Health: rationale and design of two ancillary studies evaluating the effects of vitamin D and/or omega-3 fatty acid supplements on incident fractures and bone health outcomes in the VITamin D and OmegA-3 TriaL (VITAL).

PubMed

LeBoff, Meryl S; Yue, Amy Y; Copeland, Trisha; Cook, Nancy R; Buring, Julie E; Manson, JoAnn E

2015-03-01

Although vitamin D is widely used to promote skeletal health, definitive data on benefits and risks of supplemental vitamin D alone on bone are lacking. Results from large, randomized controlled trials in the general population are sparse. Data on the effects of supplemental omega-3 fatty acids (FAs) on bone are also limited. The VITamin D and OmegA-3 TriaL (VITAL) is a double-blind, placebo-controlled trial assessing the role of vitamin D3 (2000 IU/d) and omega-3 FA (1g/d) supplements in reducing risks of cancer and cardiovascular disease among U.S. men aged ≥50 and women aged ≥55. To comprehensively test effects of supplemental vitamin D and/or omega-3 FAs on skeletal health, the VITAL: Effects on Fractures ancillary study is determining the effects of these supplements on incident fractures among 25,875 participants enrolled in the parent trial. Study investigators adjudicate fractures through a detailed review of medical records and radiological images (hip and femur). In a complementary ancillary, VITAL: Effects on Structure and Architecture is determining the effects of supplemental vitamin D and/or omega-3 FAs on bone with detailed phenotyping during in-person visits. Comprehensive assessments of bone density, turnover, structure/architecture, body composition, and physical performance are being performed at baseline and 2 years post-randomization. Results from these studies will clarify the relationship between supplemental vitamin D and/or omega-3 FAs on bone health outcomes, and inform clinical care and public health guidelines on the use of supplemental vitamin D for the primary prevention of fractures in women and men. Copyright © 2015 Elsevier Inc. All rights reserved.

VITAL-Bone Health: rationale and design of two ancillary studies evaluating the effects of vitamin D and/or omega-3 fatty acid supplements on incident fractures and bone health outcomes in the VITamin D and OmegA-3 TriaL (VITAL)

PubMed Central

LeBoff, Meryl S.; Yue, Amy Y.; Copeland, Trisha; Cook, Nancy R.; Buring, Julie E.; Manson, JoAnn E.

2015-01-01

Rationale Although vitamin D is widely used to promote skeletal health, definitive data on benefits and risks of supplemental vitamin D alone on bone are lacking. Results from large, randomized controlled trials in the general population are sparse. Data on the effects of supplemental omega-3 fatty acids (FAs) on bone are also limited. Design The VITamin D and OmegA-3 TriaL (VITAL) is a double-blind, placebo-controlled trial assessing the role of vitamin D3 (2000 IU/d) and omega-3 FA (1 g/d) supplements in reducing risks of cancer and cardiovascular disease among U.S. men aged ≥50 and women aged ≥55. To comprehensively test effects of supplemental vitamin D and/or omega-3 FAs on skeletal health, the VITAL: Effects on Fractures ancillary study is determining the effects of these supplements on incident fractures among 25,875 participants enrolled in the parent trial. Study investigators adjudicate fractures through detailed review of medical records and radiological images (hip and femur). In a complementary ancillary, VITAL: Effects on Structure and Architecture is determining the effects of supplemental vitamin D and/or omega-3 FAs on bone with detailed phenotyping during in-person visits. Comprehensive assessments of bone density, turnover, structure/architecture, body composition, and physical performance are being performed at baseline and 2 years post-randomization. Conclusion Results from these studies will clarify the relationship between supplemental vitamin D and/or omega-3 FAs on bone health outcomes, and inform clinical care and public health guidelines on the use of supplemental vitamin D for the primary prevention of fractures in women and men. PMID:25623291

Comparative evaluation of cyclic fatigue resistance of D-RaCe and ProTaper retreatment instruments in curved artificial canals.

PubMed

Topçuoğlu, H S; Topçuoğlu, G; Aktı, A

2016-06-01

To compare the cyclic fatigue resistance of D-RaCe and ProTaper rotary nickel-titanium (NiTi) retreatment files when used in curved artificial canals. A total of 120 new D-RaCe DR2 and ProTaper D3 retreatment files were tested in stainless steel artificial canals having 45° and 60° angles of curvature. Thirty instruments of each of the file systems were tested in both angles of curvature (n = 30). The retreatment instruments were rotated until fracture to calculate the number of cycles to failure. The length of each fractured fragment was recorded. Data were analysed by independent sample t-test. Fractured surfaces of the instruments were analysed by scanning electron microscopy. In the canal with 45° angle of curvature, no significant difference was observed between the retreatment systems (P > 0.05); on the other hand, in the canal with 60° angle of curvature, D-RaCe DR2 instruments had greater cyclic fatigue resistance than ProTaper D3 (P < 0.05). No difference was observed between the retreatment instruments regarding the lengths of fractured fragments (P > 0.05). The fracture surfaces of the instruments had morphologic characteristics of ductile fracture. D-RaCe DR2 instrument exhibited greater cyclic fatigue resistance than ProTaper D3 only in root canals with 60° angle of curvature. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Concurrent Path Planning with One or More Humanoid Robots

NASA Technical Reports Server (NTRS)

Reiland, Matthew J. (Inventor); Sanders, Adam M. (Inventor)

2014-01-01

A robotic system includes a controller and one or more robots each having a plurality of robotic joints. Each of the robotic joints is independently controllable to thereby execute a cooperative work task having at least one task execution fork, leading to multiple independent subtasks. The controller coordinates motion of the robot(s) during execution of the cooperative work task. The controller groups the robotic joints into task-specific robotic subsystems, and synchronizes motion of different subsystems during execution of the various subtasks of the cooperative work task. A method for executing the cooperative work task using the robotic system includes automatically grouping the robotic joints into task-specific subsystems, and assigning subtasks of the cooperative work task to the subsystems upon reaching a task execution fork. The method further includes coordinating execution of the subtasks after reaching the task execution fork.

Recovery Act. Development and Validation of an Advanced Stimulation Prediction Model for Enhanced Geothermal Systems

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

Gutierrez, Marte

2013-12-31

This research project aims to develop and validate an advanced computer model that can be used in the planning and design of stimulation techniques to create engineered reservoirs for Enhanced Geothermal Systems. The specific objectives of the proposal are to; Develop a true three-dimensional hydro-thermal fracturing simulator that is particularly suited for EGS reservoir creation; Perform laboratory scale model tests of hydraulic fracturing and proppant flow/transport using a polyaxial loading device, and use the laboratory results to test and validate the 3D simulator; Perform discrete element/particulate modeling of proppant transport in hydraulic fractures, and use the results to improve understandmore » of proppant flow and transport; Test and validate the 3D hydro-thermal fracturing simulator against case histories of EGS energy production; and Develop a plan to commercialize the 3D fracturing and proppant flow/transport simulator. The project is expected to yield several specific results and benefits. Major technical products from the proposal include; A true-3D hydro-thermal fracturing computer code that is particularly suited to EGS; Documented results of scale model tests on hydro-thermal fracturing and fracture propping in an analogue crystalline rock; Documented procedures and results of discrete element/particulate modeling of flow and transport of proppants for EGS applications; and Database of monitoring data, with focus of Acoustic Emissions (AE) from lab scale modeling and field case histories of EGS reservoir creation.« less

Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method.

PubMed

Milenković, Sasa; Mitković, Milorad; Micić, Ivan; Mladenović, Desimir; Najman, Stevo; Trajanović, Miroslav; Manić, Miodrag; Mitković, Milan

2013-09-01

Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF) and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60) years. The average follow-up was 21.86 (from 12 to 48) months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20) weeks. There were 4 (12.19%) infections around the pins of the external skeletal fixator and one (3.22%) deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90%) patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for treating all types of inta-articular pilon fractures. In fractures types B and C dynamic external skeletal fixation allows early mobility in the ankle joint.

[Application of anterior percutaneous screw fixation in treatment of odontoid process fractures in aged people].

PubMed

Luo, Peng; Dou, Hai-cheng; Ni, Wen-fei; Huang, Qi-shan; Wang, Xiang-yang; Xu, Hua-zi; Chi, Yong-long

2011-03-01

To explore the efficacy of anterior percutaneous screw fixation in the treatment of odontoid process fractures in aged people. From February 2001 to April 2009, 15 elderly patients with odontoid fracture were treated with anterior percutaneous screw fixation,including 13 males and 2 females; the average age was 69.3 years (ranged, 60 to 86 years). According to Anderson classification, there were 10 patients with type II fractures (type II A in 7 cases, type II B in 3 cases, based on Eysel and Roosen classification), 4 patients with shallow type III fractures, 1 patient with deep type III fractures. Thirteen patients were fresh fractures, 2 patients were obsolete fractures. All patients had varying degrees of neck or shoulder pain, and limit activity of neck. There were 4 patients with neural symptoms including 2 grade D and 2 grade C according to Frankel classification. All the patients were followed up and were assessed by radiology. Clinical examination included neck activity, neurological function and the degree of neck pain. Radiology examinations including anteroposterior, lateral, open mouth position and flexion-extension radiographs of cervical vertebra were performed. After surgery, all patients were followed up,and the duration ranged from 6 to 60 months (averaged 31.3 months). Two patients died of other diseases during the follow-up period (18 and 22 months after surgery respectively). All patients got satisfactory results, and all screws were in good position. As the screw was too long, esophagus was compressed by screw tail in one case. One case showed fibrous union, 12 cases had achieved solid bony union, 2 cases showed nonunion without clinical symptoms. The rotation of neck in 3 cases was mildly limited,the neck function of the remaining patients were normal. Four patients with symptoms nerve injuries improved after operation (Frankel E in 3 cases, Frankel D in 1 case). The symptom of neck pain had a significant improvement after surgery (P < 0.001). The VAS score decreased from preoperative (6.07 +/- 1.44) (4 to 8 scores),to postoperative (1.13 +/- 0.92) (0 to 3 scores). And there were no severe postoperative complications. The anterior percutaneous screw fixation is less traumatic than conventional approaches for aged people in dealing with odontoid process fractures. Most patients will achieve satisfactory clinical results, as long as the general conditions of them are comprehensively assess. However, this procedure should not be used in patients with comminuted odontoid fractures or severe osteoporosis.

Analysis of bone healing in flail chest injury: do we need to fix both fractures per rib?

PubMed

Marasco, Silvana; Liew, Susan; Edwards, Elton; Varma, Dinesh; Summerhayes, Robyn

2014-09-01

Surgical rib fixation (SRF) for severe rib fracture injuries is generating increasing interest in the medical literature. It is well documented that poorly healed fractured ribs can lead to chronic pain, disability, and deformity. An unanswered question in SRF for flail chest injury is whether it is sufficient to fix one fracture per rib, on successive ribs, thus converting a flail chest injury into simple fractured ribs, or whether both ends of the floating segment of the chest wall should be fixed. This study aimed to analyze SRF in flail chest injury, assessing 3-month outcomes for nonfixed fractured rib ends in the flail segment. This is a retrospective review (2005-2013) of 60 consecutive patients who underwent SRF for flail chest injury admitted to the Alfred Hospital, Melbourne, Australia. Imaging by three-dimensional computed tomography (3D CT) of the chest at admission was compared with follow-up 3D CT at 3 months after injury. The 3-month CT scans were assessed for degree of healing and presence of residual deformity at the fracture fixation site. Follow-up CT was performed in 52 of the 60 patients. At 3 months after surgery, 86.5% of the patients had at least partial healing with good alignment and adequate fracture stabilization. Hardware failure was noted in five patients (9.6%) and occurred with the absorbable prostheses only. Six patients who had preoperative overlapping or displacement showed no improvement in deformity despite fixing the lateral fractures. Callus formation and bony bridging between adjacent ribs was often noted in the rib fractures not fixed (28 of 52 patients, 54%) This retrospective review of 3D CT chest at 3 months after rib fixation indicates that a philosophy of fixing only one fracture per rib in a flail segment does not avoid deformity and displacement, particularly in posterior rib fractures. Therapeutic study, level V; epidemiologic study, level V.

3D printing application and numerical simulations in a fracture system

NASA Astrophysics Data System (ADS)

Yoon, H.; Martinez, M. J.

2017-12-01

The hydrogeological and mechanical properties in fractured and porous media are fundamental to predicting coupled multiphysics processes in the subsurface. Recent advances in experimental methods and multi-scale imaging capabilities have revolutionized our ability to quantitatively characterize geomaterials and digital counterparts are now routinely used for numerical simulations to characterize petrophysical and mechanical properties across scales. 3D printing is a very effective and creative technique that reproduce the digital images in a controlled way. For geoscience applications, 3D printing can be co-opted to print reproducible porous and fractured structures derived from CT-imaging of actual rocks and theoretical algorithms for experimental testing. In this work we used a stereolithography (SLA) method to create a single fracture network. The fracture in shale was first scanned using a microCT system and then the digital fracture network was printed into two parts and assembled. Aperture ranges from 0.3 to 1 mm. In particular, we discuss the design of single fracture network and the progress of printing practices to reproduce the fracture network system. Printed samples at different scales are used to measure the permeability and surface roughness. Various numerical simulations including (non-)reactive transport and multiphase flow cases are performed to study fluid flow characterization. We will also discuss the innovative advancement of 3D printing techniques applicable for coupled processes in the subsurface. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology & Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

Conventional plate fixation method versus pre-operative virtual simulation and three-dimensional printing-assisted contoured plate fixation method in the treatment of anterior pelvic ring fracture.

PubMed

Hung, Chun-Chi; Li, Yuan-Ta; Chou, Yu-Ching; Chen, Jia-En; Wu, Chia-Chun; Shen, Hsain-Chung; Yeh, Tsu-Te

2018-05-03

Treating pelvic fractures remains a challenging task for orthopaedic surgeons. We aimed to evaluate the feasibility, accuracy, and effectiveness of three-dimensional (3D) printing technology and computer-assisted virtual surgery for pre-operative planning in anterior ring fractures of the pelvis. We hypothesized that using 3D printing models would reduce operation time and significantly improve the surgical outcomes of pelvic fracture repair. We retrospectively reviewed the records of 30 patients with pelvic fractures treated by anterior pelvic fixation with locking plates (14 patients, conventional locking plate fixation; 16 patients, pre-operative virtual simulation with 3D, printing-assisted, pre-contoured, locking plate fixation). We compared operative time, instrumentation time, blood loss, and post-surgical residual displacements, as evaluated on X-ray films, among groups. Statistical analyses evaluated significant differences between the groups for each of these variables. The patients treated with the virtual simulation and 3D printing-assisted technique had significantly shorter internal fixation times, shorter surgery duration, and less blood loss (- 57 minutes, - 70 minutes, and - 274 ml, respectively; P < 0.05) than patients in the conventional surgery group. However, the post-operative radiological result was similar between groups (P > 0.05). The complication rate was less in the 3D printing group (1/16 patients) than in the conventional surgery group (3/14 patients). The 3D simulation and printing technique is an effective and reliable method for treating anterior pelvic ring fractures. With precise pre-operative planning and accurate execution of the procedures, this time-saving approach can provide a more personalized treatment plan, allowing for a safer orthopaedic surgery.

Effective matrix diffusion in kilometer‐scale transport in fractured crystalline rock

USGS Publications Warehouse

Shapiro, Allen M.

2001-01-01

Concentrations of tritium (3H) and dichlorodifluoromethane (CFC‐12) in water samples taken from glacial drift and fractured crystalline rock over 4 km2 in central New Hampshire are interpreted to identify a conceptual model of matrix diffusion and the magnitude of the diffusion coefficient. Dispersion and mass transfer to and from fractures has affected the 3H concentration to the extent that the peak 3H concentration of the 1960s is no longer distinguishable. Because of heterogeneity in the bedrock the sparsely distributed chemical data do not warrant a three‐dimensional transport model. Instead, a one‐dimensional model of CFC‐12 and 3H migration along flow lines in the glacial drift and bedrock is used to place bounds on the processes affecting kilometer‐scale transport, arid model parameters are varied to reproduce the measured relation between 3H and CFC‐12, rather than their spatial distributions. A model of mass exchange to and from fractures that is dependent on the time‐varying concentration gradient at fracture surfaces qualitatively reproduces the measured relation between 3H and CFC‐12 with an upper bound for the fracture dispersivity approximately equal to 250 m and a lower bound for the effective matrix diffusion coefficient equal to 1 m2 yr−1. The diffusion coefficient at the kilometer scale is at least 3 orders of magnitude greater than laboratory estimates of diffusion in crystalline rock. The large diffusion coefficient indicates that diffusion into an immobile fluid phase (rock matrix) is masked at the kilometer scale by advective mass exchange between fractures with large contrasts in trarismissivity. The measured transmissivity of fractures in the study area varies over more than 6 orders of magnitude. Advective mass exchange from high‐permeability fractures to low‐permeability fractures results in short migration distances of a chemical constituent in low‐permeability fractures over an extended period of time before reentering high‐permeability fractures; viewed at the kilometer scale, this process is analogous to the chemical constituent diffusing into and out of an immobile fluid phase.

Poststroke Hip Fracture: Prevalence, Clinical Characteristics, Mineral-Bone Metabolism, Outcomes, and Gaps in Prevention

PubMed Central

Fisher, Alexander; Srikusalanukul, Wichat; Davis, Michael; Smith, Paul

2013-01-01

Objective. To assess the prevalence, clinical and laboratory characteristics, and short-term outcomes of poststroke hip fracture (HF). Methods. A cross-sectional study of 761 consecutive patients aged ≥60 years (82.3 ± 8.8 years; 75% females) with osteoporotic HF. Results. The prevalence of poststroke HF was 13.1% occurring on average 2.4 years after the stroke. The poststroke group compared to the rest of the cohort had a higher proportion of women, subjects with dementia, history of TIA, hypertension, coronary artery disease, secondary hyperparathyroidism, higher serum vitamin B12 levels (>350 pmol/L), walking aid users, and living in residential care facilities. The majority of poststroke HF patients had vitamin D insufficiency (68%) and excess bone resorption (90%). This group had a 3-fold higher incidence of postoperative myocardial injury and need for institutionalisation. In multivariate analysis, independent indicators of poststroke HF were female sex (OR 3.6), history of TIA (OR 5.2), dementia (OR 4.1), hypertension (OR 3.2), use of walking aid (OR 2.5), and higher vitamin B12 level (OR 2.3). Only 15% of poststroke patients received antiosteoporotic therapy prior to HF. Conclusions. Approximately one in seven HFs occurs in older stroke survivors and are associated with poorer outcomes. Early implementation of fracture prevention strategies is needed. PMID:24187647

[CHANGES OF SEMAPHORIN 3A EXPRESSION IN HEALING OF TIBIA FRACTURE AFTER TRAUMATIC BRAIN INJURY].

PubMed

Li, Zhengzheng; Zhao, Junwei; Yi, Zhigang; Luo, Wei; Li, Kang; Wang, Yuliang; Wang, Jing; An, Liping; Ma, Jinglin

2016-10-08

To investigate the mechanism of Semaphorin 3A (Sema3A) in fracture healing after nerve injury by observing the expression of Sema3A in the tibia fracture healing after traumatic brain injury (TBI). A total of 192 Wistar female rats, 8-10 weeks old and weighing 220-250 g, were randomly divided into tibia fracture group (group A, n =48), TBI group (group B, n =48), TBI with tibia fracture group (group C, n =48), and control group (group D, n =48). The tibia fracture model was established at the right side of group A; TBI model was made in group B by the improved Feeney method; the TBI and tibia fracture model was made in group C; no treatment was given in group D. The tissue samples were respectively collected at 3, 5, 7, 14, 21, and 28 days after operation; HE staining, immunohistochemistry staining, and Western blot method were used for the location and quantitative detection of Sema3A in callus tissue. HE staining showed that no obvious changes were observed at each time point in groups B and D. At 3 and 5 days, there was no obvious callus growth at fracture site with inflammatory cells and fibrous tissue filling in groups A and C. At 7 and 14 days, fibrous tissue grew from periosteum to fracture site in groups A and C; the proliferation of chondrocytes in exterior periosteum gradually formed osteoid callus at fracture site in groups A and C. The chondrocyte had bigger size, looser arrangement, and more osteoid in group C than group A. Group B had disorder periosteum, slight subperiosteal bone hyperplasia, and no obvious change of bone trabecula in group B when compared with group D. At 21 and 28 days, cartilage callus was gradually replaced by new bone trabecula in groups A and C. Group C had loose arrange, disorder structure, and low density of bone trabecula, big callus area and few chondrocyte and osteoid when compared with group A; group B was similar to Group D. Immunohistochemistry staining showed that Sema3A expression in chondrocytes in group C was higher than that in group A, particularly at 7, 14, and 21 day. Sema3A was significantly higher in osteoblasts of new bone trabecula in group A than group C, especially at 14 and 21 days ( P <0.05). Western blot results showed that the Sema3A had the same expression trend during fracture healing in groups A and C. However, the expression of Sema3A protein was significantly higher in group C than group A ( P <0.05) and in group B than group D ( P <0.05) at 7, 14, 21, and 28 days. Abnormal expression of Sema3A may play a role in fracture healing after nerve injury by promoting the chondrocytes proliferation and reducing the distribution of sensory nerve fibers and osteoblast differentiation.

Syndrome naviculo-capital de Fenton (à propos d’un nouveau cas)

PubMed Central

Bennis, Azzelarab; Benabbouha, Abdellatif; Ouzaa, Mohammed Reda; Lamkhanter, Adil; Benchakroun, Mohammed; Jaafar, Abdelouahab

2017-01-01

La fracture scapho-capitale ou syndrome naviculo-capital de Fenton, est une lésion très rare, souvent méconnue. Elle résulte d'un traumatisme du poignet de haute énergie. Son mécanisme est controversé. Les auteurs rapportent l'observation d'un patient,qui a présenté dans les suites d’un accident de la voie publique une fracture du scaphoïde associée à une fracture du capitatum, du triquetrum et de la styloïde cubitale. La voie d'abord dorsale, a permis une réduction et une contention par embrochage de la première rangée, indépendamment de la deuxième rangée. Les ligaments interosseux scapho-lunaire et lunaro-triquétral étaient intacts. Une immobilisation plâtrée antébrachio-palmaire a été mise en place pour 12 semaines. La rééducation a durée six mois. A deux ans de recul, le score fonctionnel de Cooney était bon et l'ensemble des fractures a consolidé sans aucune désaxation intracarpienne. La reprise du travail était au huitième mois après l’accident. Scapho-capitate fracture or Fenton’s naviculo-capitate fracture syndrome is a very rare and often ignored lesion. It is caused by a high-energy traumatic injury to the wrist. Its mechanism is controversial. This study reports the case of a patient with scaphoid fracture associated with fracture of the capitatum, triquetrum and ulnar styloid due to public road accident. Dorsal approach allowed reduction and containment by internal fixation in the first row, regardless the second row. Scapholunate interosseous ligaments and luno-triquetral were intact. The patient underwent antebrachial-palmar plaster immobilization for 12 weeks. Rehabilitation program lasted for six months. Cooney’s wrist function score was good and all fractures consolidated without intracarpal malalignment at 2 years follow up. The patient resumed work in the eighth month after the road accident. PMID:28690721

Patterns of Pediatric Mandible Fractures in the United States.

PubMed

Owusu, James A; Bellile, Emily; Moyer, Jeffrey S; Sidman, James D

2016-01-01

The mandible is arguably the most frequently fractured facial bone in children. However, facial fractures are rare in children compared with adults, resulting in few large studies on patterns of pediatric facial fractures. To report the patterns, demographics, and cause of pediatric mandible fractures across the United States. A retrospective analysis was conducted of the Healthcare Cost and Utilization Project's National Emergency Department Sample from January 1 to December 31, 2012, using the International Classification of Disease, Ninth Revision, codes for mandible fractures (802.20-802.39) among patients 18 years and younger who presented to emergency departments. Demographics, fracture site, and fracture mechanism were analyzed to identify factors associated with fractures. Analysis was conducted from July 9 to July 28, 2015. There were 1984 records, representing a weighted estimate of 8848 cases of pediatric mandible fracture. The mean patient age was 14.0 years (95% CI, 13.6-14.3). The male to female ratio was 4:1 and females were comparatively younger, with a mean age of 12.5 years (95% CI, 11.8-13.1; P < .001). The most frequently fractured sites were the condyle, in 1288 patients (14.6% [95% CI, 12.6%-16.5%]), and the angle, in 1252 patients (14.1% [12.4%-15.9%]). Associated intracranial injuries occurred in 756 patients (8.5% [7.1%-10.0%]), and cervical spine fractures occurred in 393 (4.4% [3.5%-5.4%]). The fracture site and mechanism of injury varied with age and sex. For patients 12 years and younger, the most frequent fracture site was the condyle, accounting for 636 fractures (27.9% [24.2%-31.6%]), and the most frequent cause was falls, accounting for 692 fractures (30.3% [25.9%-34.8%]). In teenaged patients (13-18 years), the angle was the most frequent fracture site, accounting for 1157 fractures (17.6% [15.6%-19.6%]), and the most frequent cause was assault, accounting for 2619 fractures (39.9% [36.4%-43.3%]). For male patients, the angle was the predominant site, accounting for 1053 fractures (15.0% [13.1%-16.8%]), and the leading cause was assault, accounting for 2360 fractures (33.5% [30.2%-36.9%]). For female patients, the condyle was the most frequent site, accounting for 369 fractures (20.3% [16.0%-24.6%]), and the leading cause was falls, accounting for 422 fractures (23.2% [18.6%-28.0%]). In this study, age and sex disparities among pediatric mandible fractures were identified. Younger patients and female patients tend to have condyle fractures caused more commonly by falls while older patients and male patients tend to have angle fractures caused by assault. NA.

Natural thermal convection in fractured porous media

NASA Astrophysics Data System (ADS)

Adler, P. M.; Mezon, C.; Mourzenko, V.; Thovert, J. F.; Antoine, R.; Finizola, A.

2015-12-01

In the crust, fractures/faults can provide preferential pathways for fluid flow or act as barriers preventing the flow across these structures. In hydrothermal systems (usually found in fractured rock masses), these discontinuities may play a critical role at various scales, controlling fluid flows and heat transfer. The thermal convection is numerically computed in 3D fluid satured fractured porous media. Fractures are inserted as discrete objects, randomly distributed over a damaged volume, which is a fraction of the total volume. The fluid is assumed to satisfy Darcy's law in the fractures and in the porous medium with exchanges between them. All simulations were made for Rayleigh numbers (Ra) < 150 (hence, the fluid is in thermal equilibrium with the medium), cubic boxes and closed-top conditions. Checks were performed on an unfractured porous medium and the convection cells do start for the theoretical value of Ra, namely 4p². 2D convection was verified up to Ra=800. The influence of parameters such as fracture aperture (or fracture transmissivity), fracture density and fracture length is studied. Moreover, these models are compared to porous media with the same macroscopic permeability. Preliminary results show that the non-uniqueness associated with initial conditions which makes possible either 2D or 3D convection in porous media (Schubert & Straus 1979) is no longer true for fractured porous media (at least for 50

Effects of foot posture on fifth metatarsal fracture healing: a finite element study.

PubMed

Brilakis, Emmanuel; Kaselouris, Evaggelos; Xypnitos, Frank; Provatidis, Christopher G; Efstathopoulos, Nicolas

2012-01-01

The goal of this study was to evaluate the effects of maintaining different foot postures during healing of proximal fifth metatarsal fractures for each of 3 common fracture types. A 3-dimensional (3D) finite element model of a human foot was developed and 3 loading situations were evaluated, including the following: (1) normal weightbearing, (2) standing with the affected foot in dorsiflexion at the ankle, and (3) standing with the affected foot in eversion. Three different stages of the fracture-healing process were studied, including: stage 1, wherein the material interposed between the fractured edges was the initial connective tissue; stage 2, wherein connective tissue had been replaced by soft callus; and stage 3, wherein soft callus was replaced by mature bone. Thus, 30 3D finite element models were analyzed that took into account fracture type, foot posture, and healing stage. Different foot postures did not statistically significantly affect the peak-developed strains on the fracture site. When the fractured foot was everted or dorsiflexed, it developed a slightly higher strain within the fracture than when it was in the normal weightbearing position. In Jones fractures, eversion of the foot caused further torsional strain and we believe that this position should be avoided during foot immobilization during the treatment of fifth metatarsal base fractures. Tuberosity avulsion fractures and Jones fractures seem to be biomechanically stable fractures, as compared with shaft fractures. Our understanding of the literature and experience indicate that current clinical observations and standard therapeutic options are in accordance with the results that we observed in this investigation, with the exception of Jones fractures. Copyright © 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Vitamin D insufficiency in osteoporotic hip fracture patients: rapid substitution therapy with high dose oral cholecalciferol (vitamin D3).

PubMed

de Jong, Andy; Woods, Kate; Van Gestel, Lise; Suresh, Mohanraj; Porteous, Matthew

2013-10-01

Assessment and treatment of osteoporosis are recommended following hip fracture. Osteoporosis treatment assumes an adequate calcium intake and a normal vitamin D plasma level. The authors conducted a study in three phases. Phase I: circulating 25-hydroxyvitamin D levels were retrospectively recorded from in the case records of 381 consecutive patients with 387 hip fractures, between March 2010 and September 2011. Only 27 patients had sufficient (> 75 nmol/L) circulating vitamin D, and of these 22 were taking vitamin D supplements. The remainder, 354 patients, had abnormally low vitamin D levels, with a mean value of 26.4 nmol/L. These findings confirmed literature data, and gave rise to the prospective Phase II (October 2011): 14 consecutive patients with a hip fracture received rapid substitution therapy with 50,000 IU cholecalciferol (vitamin D3) daily for 3 days. Patients with corrected calcium level (calcium level based on the serum albumin level) > 2.60 mmol/L were excluded from phase II (and phase III), in order to avoid hypercalcemia. Substitution resulted in an increase in vitamin D plasma levels from +/- 29.6 nmol/L to +/- 81.4 nmol/L (p < 0.0001), after +/- 14 days. However, vitamin D level remained below the desired threshold of 75 nmol/L in 29%. Therefore it was decided to increase the treatment period from 3 days to 7 days in the next 54 patients with a hip fracture in a prospective phase III (October 2011-January 2012). This time rapid substitution resulted in an increase from +/-31.4 nmol/L to +/-131.1 nmol/L (p < 0.0001), after +/- 16 days, and 100% of treated patients achieved plasma levels above the desired threshold of 75 nmol/L. virtually all patients with a hip fracture have low vitamin D plasma levels; substitution with 50,000 IU oral cholecalciferol daily for 7 days increases vitamin D plasma levels rapidly, safely and consistently.

Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures.

PubMed

Yoshii, Yuichi; Kusakabe, Takuya; Akita, Kenichi; Tung, Wen Lin; Ishii, Tomoo

2017-12-01

A three-dimensional (3D) digital preoperative planning system for the osteosynthesis of distal radius fractures was developed for clinical practice. To assess the usefulness of the 3D planning for osteosynthesis, we evaluated the reproducibility of the reduction shapes and selected implants in the patients with distal radius fractures. Twenty wrists of 20 distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. The 3D preoperative planning was performed prior to each surgery. Four surgeons conducted the surgeries. The surgeons performed the reduction and the placement of the plate while comparing images between the preoperative plan and fluoroscopy. Preoperative planning and postoperative reductions were compared by measuring volar tilt and radial inclination of the 3D images. Intra-class correlation coefficients (ICCs) of the volar tilt and radial inclination were evaluated. For the implant choices, the ICCs for the screw lengths between the preoperative plan and the actual choices were evaluated. The ICCs were 0.644 (p < 0.01) and 0.625 (p < 0.01) for the volar tilt and radial inclination in the 3D measurements, respectively. The planned size of plate was used in all of the patients. The ICC for the screw length between preoperative planning and actual choice was 0.860 (p < 0.01). Good reproducibility for the reduction shape and excellent reproducibility for the implant choices were achieved using 3D preoperative planning for distal radius fracture. Three-dimensional digital planning was useful to visualize the reduction process and choose a proper implant for distal radius fractures. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2646-2651, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Three dimensional printing technology and materials for treatment of elbow fractures.

PubMed

Yang, Long; Grottkau, Brian; He, Zhixu; Ye, Chuan

2017-11-01

3D printing is a rapid prototyping technology that uses a 3D digital model to physically build an object. The aim of this study was to evaluate the peri-operative effect of 3D printing in treating complex elbow fractures and its role in physician-patient communication and determine which material is best for surgical model printing. Forty patients with elbow fractures were randomly divided into a 3D printing-assisted surgery group (n = 20) and a conventional surgery group (n = 20). Surgery duration, intra-operative blood loss, anatomic reduction rate, incidence of complications and elbow function score were compared between the two groups. The printing parameters, the advantages and the disadvantages of PLA and ABS were also compared. The independent-samples t-test was used to compare the data between groups. A questionnaire was designed for orthopaedic surgeons to evaluate the verisimilitude, the appearance of being true or real, and effectiveness of the 3D printing fracture model. Another questionnaire was designed to evaluate physician-patient communication effectiveness. The 3D group showed shorter surgical duration, lower blood loss and higher elbow function score, compared with the conventional group. PLA is an environmentally friendly material, whereas ABS produce an odour in the printing process. Curling edges occurred easily in the printing process with ABS and were observed in four of ten ABS models but in only one PLA model. The overall scores given by the surgeons about the verisimilitude and effectiveness of the 3D model were relatively high. Patient satisfaction scores for the 3D model were higher than those for the 2D imaging data during physician-patient discussions. 3D-printed models can accurately depict the anatomic characteristics of fracture sites, help surgeons determine a surgical plan and represent an effective tool for physician-patient communication. PLA is more suitable for desktop fused deposition printing in surgical modeling applications.

An assessment of commercial motor vehicle driver distraction using naturalistic driving data.

PubMed

Hickman, Jeffrey S; Hanowski, Richard J

2012-01-01

This study analyzed naturalistic driving data from commercial trucks (3-axle and tractor-trailer/tanker) and buses (transit and motorcoach) during a 3-month period. The data set contained 183 commercial truck and bus fleets comprising 13,306 vehicles and included 1085 crashes, 8375 near crashes, 30,661 crash-relevant conflicts, and 211,171 baseline events. Study results documented the prevalence of tertiary tasks and the risks associated with performing these tasks while driving. Results indicated the odds of involvement in a safety-critical event differed as a function of performing different cell phone-related subtasks while driving. Although the odds ratio for talking/listening on a cell phone while driving was found to not significantly increase the likelihood of involvement in a safety-critical event, other cell phone subtasks (e.g., texting, dialing, reaching) were found to significantly increase the odds of involvement in a safety-critical event. The results suggest that cell phone use while driving should not be considered a simple dichotomous task (yes/no). Consideration should instead be made for a set of discrete cell phone subtasks that are each associated with varying levels of risk. Several hypotheses are presented to explain why cell phone use while driving was found to not increase the likelihood of involvement in a safety-critical event.

Three-dimensional computer simulation of radiostereometric analysis (RSA) in distal radius fractures.

PubMed

Madanat, Rami; Moritz, Niko; Aro, Hannu T

2007-01-01

Physical phantom models have conventionally been used to determine the accuracy and precision of radiostereometric analysis (RSA) in various orthopaedic applications. Using a phantom model of a fracture of the distal radius it has previously been shown that RSA is a highly accurate and precise method for measuring both translation and rotation in three-dimensions (3-D). The main shortcoming of a physical phantom model is its inability to mimic complex 3-D motion. The goal of this study was to create a realistic computer model for preoperative planning of RSA studies and to test the accuracy of RSA in measuring complex movements in fractures of the distal radius using this new model. The 3-D computer model was created from a set of tomographic scans. The simulation of the radiographic imaging was performed using ray-tracing software (POV-Ray). RSA measurements were performed according to standard protocol. Using a two-part fracture model (AO/ASIF type A2), it was found that for simple movements in one axis, translations in the range of 25microm-2mm could be measured with an accuracy of +/-2microm. Rotations ranging from 16 degrees to 2 degrees could be measured with an accuracy of +/-0.015 degrees . Using a three-part fracture model the corresponding values of accuracy were found to be +/-4microm and +/-0.031 degrees for translation and rotation, respectively. For complex 3-D motion in a three-part fracture model (AO/ASIF type C1) the accuracy was +/-6microm for translation and +/-0.120 degrees for rotation. The use of 3-D computer modelling can provide a method for preoperative planning of RSA studies in complex fractures of the distal radius and in other clinical situations in which the RSA method is applicable.

Internal Fixation of Complicated Acetabular Fractures Directed by Preoperative Surgery with 3D Printing Models.

PubMed

Liu, Zhao-Jie; Jia, Jian; Zhang, Yin-Guang; Tian, Wei; Jin, Xin; Hu, Yong-Cheng

2017-05-01

The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed. A 3D printing pelvic model was established using CT digital imaging and communications in medicine (DICOM) data preoperatively, with which surgical procedures were simulated in preoperative surgery to confirm the sequence of the reduction and fixation as well as the position and length of the implants. Open reduction with internal fixation (ORIF) of the acetabular fracture using modified ilioinguinal and Kocher-Langenbeck approaches was performed 25 days after injury. Plates that had been pre-bent in the preoperative surgery were positioned and screws were tightened in the directions determined in the preoperative planning following satisfactory reduction. The duration of the operation was 170 min and blood loss was 900 mL. Postoperative X-rays showed that anatomical reduction of the acetabulum was achieved and the hip joint was congruous. The position and length of the implants were not different when compared with those in preoperative surgery on 3D printing models. We believe that preoperative surgery using 3D printing models is beneficial for confirming the reduction and fixation sequence, determining the reduction quality, shortening the operative time, minimizing preoperative difficulties, and predicting the prognosis for complicated fractures of acetabulam. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Visualizing 3D Fracture Morphology in Granular Media

NASA Astrophysics Data System (ADS)

Dalbe, M. J.; Juanes, R.

2015-12-01

Multiphase flow in porous media plays a fundamental role in many natural and engineered subsurface processes. The interplay between fluid flow, medium deformation and fracture is essential in geoscience problems as disparate as fracking for unconventional hydrocarbon production, conduit formation and methane venting from lake and ocean sediments, and desiccation cracks in soil. Recent work has pointed to the importance of capillary forces in some relevant regimes of fracturing of granular materials (Sandnes et al., Nat. Comm. 2011), leading to the term hydro-capillary fracturing (Holtzman et al., PRL 2012). Most of these experimental and computational investigations have focused, however, on 2D or quasi-2D systems. Here, we develop an experimental set-up that allows us to observe two-phase flow in a 3D granular bed, and control the level of confining stress. We use an index matching technique to directly visualize the injection of a liquid in a granular media saturated with another, immiscible liquid. We determine the key dimensionless groups that control the behavior of the system, and elucidate different regimes of the invasion pattern. We present result for the 3D morphology of the invasion, with particular emphasis on the fracturing regime.

Primary stenting for TASC C and D femoropopliteal lesions: one-year results from a multicentric trial on 203 patients.

PubMed

Brouillet, Julie; Deloose, Koen; Goueffic, Yann; Poirier, Mathieu; Midy, Dominique; Caradu, Caroline; Ducasse, Eric

2018-06-01

Recent advances in endovascular techniques have made it a seductive choice in the management of TASC C and D lesions. Currently, this tendency remains controversial, despite high success rates. The aim of the study was to regroup and harmonize the results of three surgical teams in 5 centers in order to obtain the largest series ever published on TASC C and D femoro-popliteal lesions primary stenting. Two hundred and three patients and 209 lower limbs were included from March 2008 to October 2013. Each patient underwent primary stenting for TASC C or D femoro-popliteal lesions. Mean age was 70±10; 71.4% were male with a 39.8% rate of coronary heart disease, 20.1% of renal insufficiency and 35.9% of diabetes; 57,4% suffered from claudication and 42.6% from critical limb ischemia (CLI); 61.8% of the 144 limbs analyzed for run-off presented with 3 patent infra-popliteal arteries. Four hundred and three stents were implanted in the 209 limbs included. Median stented length was 252 mm. Associated procedures were performed in 35 patients (17.0%) including 4.3% minor amputations. The 30-day mortality rate was 1.4% (3 patients). Major complications occurred in 19 patients (9.3%) including 7 patients (3.4%) presented with early in-stent thrombosis. Median follow-up duration was 12 months (range 9.5-17.2 months). The 12-month mortality rate was 11.8% (24 patients). The 3, 6 and 12 months primary patency rates according to Kaplan Meier estimates were 98.1±0.9, 85.2±2.5 and 67.0±3.3% respectively. Secondary patency rates were 96.1±1.9, 89.3±3.0 and 75.7±4.2% respectively. A subgroup analysis reported significantly higher patency rates for TASC C lesions compared to TASC D lesions (82.1% vs. 44% respectively, P=0.009). The 12-month in-stent thrombosis and restenosis rates were 19.6% and 13.9% respectively. A subgroup analysis showed higher rates of in-stent restenosis for TASC D lesions compared to TASC C lesions (35% vs. 10% respectively, P=0.005). The stent fracture rate was equal to 10.2% (30 stents). Occurrence of in-stent thrombosis and restenosis were associated with 3 and 5 cases of stent fracture (type II to IV) respectively. Freedom from TLR was 70.5%. Rutherford class decreased from 3.7 to 0.9 (3.52±1.06 to 0.75±1.24) (P<0.0001). At 12 months 61.3% were asymptomatic, 33.3% suffered from claudication (21.3% Rutherford 1) and 5.4% suffered from CLI. Healing rates were 63.9% with a limb salvage rate of 95.5% and a major amputation rate of 3.8%. This is the largest series of TASC C and D femoro-popliteal lesions primary stenting to our knowledge. The results are encouraging with acceptable primary patency and clinical improvement at 12 months. Results from mid- to long-term follow-up are awaited.

Time to initial operative treatment following open fracture does not impact development of deep infection: a prospective cohort study of 736 subjects.

PubMed

Weber, Donald; Dulai, Sukhdeep K; Bergman, Joseph; Buckley, Richard; Beaupre, Lauren A

2014-11-01

To evaluate the association between time to surgery, antibiotic administration, Gustilo grade, fracture location, and development of deep infection in open fractures. Prospective cohort between 2001 and 2009. Three Level 1 Canadian trauma centers. A total of 736 (791 fractures) subjects were enrolled and 686 subjects (93%; 737 fractures) provided adequate follow-up data (1-year interview and/or clinical follow-up >90 days). Demographics, injury information, time to surgery, and antibiotics were recorded. Subjects were evaluated using standardized data forms until the fracture(s) healed. Phone interviews were undertaken 1 year after the fracture. Infection requiring unplanned surgical debridement and/or sustained antibiotic therapy. Tibia/fibula fractures were most common (n = 413, 52%), followed by upper extremity (UE) (n = 285, 36%), and femoral (n = 93, 12%) fractures. Infection developed in 46 fractures (6%). The median time to surgery was 9 hours 4 minutes (interquartile range, 6 hours 39 minutes to 12 hours 33 minutes) and 7 hours 39 minutes (interquartile range, 6 hours 10 minutes to 9 hours 54 minutes) for those without and with infection, respectively (P = 0.04). Gustilo grade 3B/3C fractures accounted for 17 of 46 infections (37%) (P < 0.001). Four UE (1.5%), 7 femoral (8%), and 35 tibia/fibula (9%) fractures developed infections (P = 0.001). Multivariate regression found no association between infection and time to surgery [odds ratio (OR), 0.97; 95% confidence interval (95% CI), 0.90-1.06] or antibiotics (OR, 1.0; 95% CI, 0.90-1.05). Grades 3A (OR, 6.37; 95% CI, 1.37-29.56) and 3B/3C (OR, 12.87; 95% CI, 2.72-60.95) relative to grade 1 injuries and tibia/fibula (OR, 3.91; 95% CI, 1.33-11.53) relative to UE fractures were significantly associated with infection. Infection after open fracture was associated with increasing Gustilo grade or tibia/fibula fractures but not time to surgery or antibiotics. Prognostic level I. See instructions for authors for a complete description of levels of evidence.

Effects of intra-operative fluoroscopic 3D-imaging on peri-operative imaging strategy in calcaneal fracture surgery.

PubMed

Beerekamp, M S H; Backes, M; Schep, N W L; Ubbink, D T; Luitse, J S; Schepers, T; Goslings, J C

2017-12-01

Previous studies demonstrated that intra-operative fluoroscopic 3D-imaging (3D-imaging) in calcaneal fracture surgery is promising to prevent revision surgery and save costs. However, these studies limited their focus to corrections performed after 3D-imaging, thereby neglecting corrections after intra-operative fluoroscopic 2D-imaging (2D-imaging). The aim of this study was to assess the effects of additional 3D-imaging on intra-operative corrections, peri-operative imaging used, and patient-relevant outcomes compared to 2D-imaging alone. In this before-after study, data of adult patients who underwent open reduction and internal fixation (ORIF) of a calcaneal fracture between 2000 and 2014 in our level-I Trauma center were collected. 3D-imaging (BV Pulsera with 3D-RX, Philips Healthcare, Best, The Netherlands) was available as of 2007 at the surgeons' discretion. Patient and fracture characteristics, peri-operative imaging, intra-operative corrections and patient-relevant outcomes were collected from the hospital databases. Patients in whom additional 3D-imaging was applied were compared to those undergoing 2D-imaging alone. A total of 231 patients were included of whom 107 (46%) were operated with the use of 3D-imaging. No significant differences were found in baseline characteristics. The median duration of surgery was significantly longer when using 3D-imaging (2:08 vs. 1:54 h; p = 0.002). Corrections after additional 3D-imaging were performed in 53% of the patients. However, significantly fewer corrections were made after 2D-imaging when 3D-imaging was available (Risk difference (RD) -15%; 95% Confidence interval (CI) -29 to -2). Peri-operative imaging, besides intra-operative 3D-imaging, and patient-relevant outcomes were similar between groups. Intra-operative 3D-imaging provides additional information resulting in additional corrections. Moreover, 3D-imaging probably changed the surgeons' attitude to rely more on 3D-imaging, hence a 15%-decrease of corrections performed after 2D-imaging when 3D imaging was available. No substantiation for cost reduction was found through reduction in peri-operative imaging or in terms of improved patient-relevant outcomes.

Comparison of the Conventional Surgery and the Surgery Assisted by 3d Printing Technology in the Treatment of Calcaneal Fractures.

PubMed

Zheng, Wenhao; Tao, Zhenyu; Lou, Yiting; Feng, Zhenhua; Li, Hang; Cheng, Liang; Zhang, Hui; Wang, Jianshun; Guo, Xiaoshan; Chen, Hua

2017-09-19

This study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of calcaneal fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients. we enrolled 75 patients with calcaneal fracture from April 2014 to August 2016. They were divided randomly into two groups: 35 cases of 3D printing group, 40 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan in 3D printing group. Operation duration, blood loss volume during the surgery, number of intraoperative fluoroscopy and fracture union time were recorded. The radiographic outcomes Böhler angle, Gissane angle, calcaneal width and calcaneal height and final functional outcomes including VAS and AOFAS score as well as the complications were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. The operation duration, blood loss volume and number of intraoperative fluoroscopy for 3D printing group was 71.4 ± 6.8 minutes, 226.1 ± 22.6 ml and 5.6 ± 1.9 times, and for conventional group was 91.3 ± 11.2 minutes, 288.7 ± 34.8 ml and 8.6 ± 2.7 times respectively. There was statistically significant difference between the conventional group and 3D printing group (p < 0.05). Additionally, 3D printing group achieved significantly better radiographic results than conventional group both postoperatively and at the final follow-up (p < 0.05). However, No significant difference was noted in the final functional outcomes between the two groups. As for complications, there was no significant difference between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D printing model. This study suggested the clinical feasibility of 3D printing technology in treatment of calcaneal fractures.

Causes and treatment of mandibular and condylar fractures in children and adolescents: a review of 104 cases.

PubMed

Shi, Jun; Chen, Zhibiao; Xu, Bing

2014-03-01

There are no uniform treatments, standards, and specifications for conservative and surgical management of mandibular fractures in children and adolescents. To review the management of mandibular fractures in children and adolescents at our institution. The medical records of 104 children and adolescents (60 male and 44 female) treated for mandibular fractures from 2005 to 2012 at the Ninth People's Hospital, Shanghai, China, were retrospectively reviewed. The participants were classified as having deciduous dentition (age ≤6 years), mixed dentition (age >6 but <12 years), and permanent dentition (age ≥12 but ≤16 years). Conservative treatment and surgical management. Helkimo clinical dysfunction and anamnestic indices. Condylar process fractures accounted for 55.7% of the fractures (112 fractures of 201 total fracture sites), and symphysis fractures, parasymphysis fractures, fractures of the body, and fractures of the angle accounted for 20.9%, 11.9%, 7.0%, and 3.5% of the fractures, respectively. A total of 83 cases with 159 fracture sites with complete follow-up data were included in the treatment analysis. In these 83 patients, 77 fractures were dentigerous bone fractures, 46 were intracapsular fractures, and 36 were extracapsular fractures. Dentigerous bone fractures of the mandible were managed by closed or open reduction in children younger than 12 years and were managed more often by open reduction and fixation in those between ages 12 and 16 years. Closed treatment was performed for 22 condylar process fractures (28.6%), and open reduction was carried out for 55 condylar process fractures (71.4%). In patients with intracapsular fractures, there was no significant relationship between dentation age and treatment method (P = .06). Most patients with extracapsular fractures with permanent dentition underwent surgical fixation (73.3%), whereas most with deciduous dentition received conservative treatment (87.5%). In patients with condylar process fractures, there was no significant difference in Ai and Di based on treatment method (P = .49 and P = .76, respectively). The treatment of mandibular fractures in children and adolescents should be determined by clinical factors including age, location, and type of fracture.

3D reconstruction of highly fragmented bone fractures

NASA Astrophysics Data System (ADS)

Willis, Andrew; Anderson, Donald; Thomas, Thad; Brown, Thomas; Marsh, J. Lawrence

2007-03-01

A system for the semi-automatic reconstruction of highly fragmented bone fractures, developed to aid in treatment planning, is presented. The system aligns bone fragment surfaces derived from segmentation of volumetric CT scan data. Each fragment surface is partitioned into intact- and fracture-surfaces, corresponding more or less to cortical and cancellous bone, respectively. A user then interactively selects fracture-surface patches in pairs that coarsely correspond. A final optimization step is performed automatically to solve the N-body rigid alignment problem. The work represents the first example of a 3D bone fracture reconstruction system and addresses two new problems unique to the reconstruction of fractured bones: (1) non-stationary noise inherent in surfaces generated from a difficult segmentation problem and (2) the possibility that a single fracture surface on a fragment may correspond to many other fragments.

New concept of 3D printed bone clip (polylactic acid/hydroxyapatite/silk composite) for internal fixation of bone fractures.

PubMed

Yeon, Yeung Kyu; Park, Hae Sang; Lee, Jung Min; Lee, Ji Seung; Lee, Young Jin; Sultan, Md Tipu; Seo, Ye Bin; Lee, Ok Joo; Kim, Soon Hee; Park, Chan Hum

Open reduction with internal fixation is commonly used for the treatment of bone fractures. However, postoperative infection associated with internal fixation devices (intramedullary nails, plates, and screws) remains a significant complication, and it is technically difficult to fix multiple fragmented bony fractures using internal fixation devices. In addition, drilling in the bone to install devices can lead to secondary fracture, bone necrosis associated with postoperative infection. In this study, we developed bone clip type internal fixation device using three- dimensional (3D) printing technology. Standard 3D model of the bone clip was generated based on computed tomography (CT) scan of the femur in the rat. Polylacticacid (PLA), hydroxyapatite (HA), and silk were used for bone clip material. The purpose of this study was to characterize 3D printed PLA, PLA/HA, and PLA/HA/Silk composite bone clip and evaluate the feasibility of these bone clips as an internal fixation device. Based on the results, PLA/HA/Silk composite bone clip showed similar mechanical property, and superior biocompatibility compared to other types of the bone clip. PLA/HA/Silk composite bone clip demonstrated excellent alignment of the bony segments across the femur fracture site with well-positioned bone clip in an animal study. Our 3D printed bone clips have several advantages: (1) relatively noninvasive (drilling in the bone is not necessary), (2) patient-specific design (3) mechanically stable device, and (4) it provides high biocompatibility. Therefore, we suggest that our 3D printed PLA/HA/Silk composite bone clip is a possible internal fixation device.

Vitamin D serum levels are associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture.

PubMed

Gumieiro, David Nicoletti; Murino Rafacho, Bruna Paola; Buzati Pereira, Bruna Letícia; Cavallari, Karelin Alvisi; Tanni, Suzana Erico; Azevedo, Paula Schmidt; Polegato, Bertha Furlan; Mamede Zornoff, Leonardo Antonio; Dinhane, Daniel Innocenti; Innocenti Dinhane, Kandir Genésio; Cação Pereira, Gilberto José; de Paiva, Sergio Alberto Rupp; Minicucci, Marcos Ferreira

2015-01-01

The aim of this study was to evaluate the association between serum levels of 25(OH) vitamin D3 with midupper arm muscle circumference (MUAMC), handgrip strength and length of hospital stay (LOS) after hip fracture. In total, 102 consecutive patients with hip fracture over the age of 65 were admitted to the orthopedic unit and prospectively evaluated. All of the patients were treated according to specific protocols depending on the type of fracture. Anthropometric measurements and handgrip strength were performed, and blood samples were taken for serum biochemistry and 25(OH) vitamin D3 analysis within the first 72 h of admission. All of the patients were followed during their hospital stay, and the length of stay was recorded. Of the patients, two were excluded because of pathologic fractures. In total, 100 patients with a mean age of 80 ± 7 y were included in the analysis. Among these patients, 73% were female, and 37% had vitamin D deficiency. The median LOS was 7 (5-11) d. Patients with vitamin D deficiency had lower handgrip strength in univariate analysis. In the multiple linear regression analysis with robust standard error, serum vitamin D levels adjusted by age and sex were associated with handgrip strength but not with MUAMC and LOS after hip fracture. In conclusion, vitamin D serum levels were associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture. Copyright © 2015 Elsevier Inc. All rights reserved.

Finite element generation of arbitrary 3-D fracture networks for flow analysis in complicated discrete fracture networks

NASA Astrophysics Data System (ADS)

Zhang, Qi-Hua

2015-10-01

Finite element generation of complicated fracture networks is the core issue and source of technical difficulty in three-dimensional (3-D) discrete fracture network (DFN) flow models. Due to the randomness and uncertainty in the configuration of a DFN, the intersection lines (traces) are arbitrarily distributed in each face (fracture and other surfaces). Hence, subdivision of the fractures is an issue relating to subdivision of two-dimensional (2-D) domains with arbitrarily-distributed constraints. When the DFN configuration is very complicated, the well-known approaches (e.g. Voronoi Delaunay-based methods and advancing-front techniques) cannot operate properly. This paper proposes an algorithm to implement end-to-end connection between traces to subdivide 2-D domains into closed loops. The compositions of the vertices in the common edges between adjacent loops (which may belong to a single fracture or two connected fractures) are thus ensured to be topologically identical. The paper then proposes an approach for triangulating arbitrary loops which does not add any nodes to ensure consistency of the meshes at the common edges. In addition, several techniques relating to tolerance control and improving code robustness are discussed. Finally, the equivalent permeability of the rock mass is calculated for some very complicated DFNs (the DFN may contain 1272 fractures, 633 connected fractures, and 16,270 closed loops). The results are compared with other approaches to demonstrate the veracity and efficiency of the approach proposed in this paper.

Vegetarian diets and bone status.

PubMed

Tucker, Katherine L

2014-07-01

Osteoporosis is a common chronic condition associated with progressive loss of bone mineral density (BMD) and compromised bone strength, with increasing risk of fracture over time. Vegetarian diets have been shown to contain lower amounts of calcium, vitamin D, vitamin B-12, protein, and n-3 (ω-3) fatty acids, all of which have important roles in maintaining bone health. Although zinc intakes are not necessarily lower quantitatively, they are considerably less bioavailable in vegetarian diets, which suggests the need for even higher intakes to maintain adequate status. At the same time, healthy vegetarian diets tend to contain more of several protective nutrients, including magnesium, potassium, vitamin K, and antioxidant and anti-inflammatory phytonutrients. On balance, there is evidence that vegetarians, and particularly vegans, may be at greater risk of lower BMD and fracture. Attention to potential shortfall nutrients through the careful selection of foods or fortified foods or the use of supplements can help ensure healthy bone status to reduce fracture risk in individuals who adhere to vegetarian diets. © 2014 American Society for Nutrition.

The Comprehensive AOCMF Classification System: Mandible Fractures-Level 3 Tutorial

PubMed Central

Cornelius, Carl-Peter; Audigé, Laurent; Kunz, Christoph; Rudderman, Randal; Buitrago-Téllez, Carlos H.; Frodel, John; Prein, Joachim

2014-01-01

This tutorial outlines the details of the AOCMF image-based classification system for fractures of the mandibular arch (i.e. the non-condylar mandible) at the precision level 3. It is the logical expansion of the fracture allocation to topographic mandibular sites outlined in level 2, and is based on three-dimensional (3D) imaging techniques/computed tomography (CT)/cone beam CT). Level 3 allows an anatomical description of the individual conditions of the mandibular arch such as the preinjury dental state and the degree of alveolar atrophy. Trauma sequelae are then addressed: (1) tooth injuries and periodontal trauma, (2) fracture involvement of the alveolar process, (3) the degree of fracture fragmentation in three categories (none, minor, and major), and (4) the presence of bone loss. The grading of fragmentation needs a 3D evaluation of the fracture area, allowing visualization of the outer and inner mandibular cortices. To document these fracture features beyond topography the alphanumeric codes are supplied with distinctive appendices. This level 3 tutorial is accompanied by a brief survey of the peculiarities of the edentulous atrophic mandible. Illustrations and a few case examples serve as instruction and reference to improve the understanding and application of the presented features. PMID:25489389

SHOCKS Impulse-Jerk(I-J) Plasticity/Fracture Burst Acoustic-Emission(BAE) NON:``1''/ ω -``Noise'' Power-Law; Universality Power-Spectrum is I-J Time-Series Fourier-Transform: 1687 < < < 1988: VERY-LONG PRE-``Bak''!!!

NASA Astrophysics Data System (ADS)

Chavira, Aldo; Gregson, Victor, Jr.; Green, Sidney; Siegel, Edward

2011-06-01

SHOCKS impulse-jerk(I-J) [apply strain/impulse to get stress/jerk ],{VS. NON-shocks[apply stress to get strain]}, plasticity/fracture BAE[E. S.: MSE 8.,310(71); PSS: (a) 5, 601/607(71); Xl..-Latt. Defects 5, 277(74); Scripta Met.: 6, 785(72); 8, 587/617(74); 3rd Tokyo A.-E. Symp. (76);Acta Met.25,383(77); JMMM 7, 312(78)] NON: ``1''/ ω -``Noise'' Zipf(NON-Pareto); power-law ; universality power-spectrum is manifestly-demonstrated in ONLY ``PURE''-MATHS way to be nothing but d[F(t)=m(t)a(t)=Newton's (3rd) Law of Motion=(I-J)]/dt I-Jderivative d(I-J)/dt=dF(t)/dt=[m(t)da(t)/dt+a(t)dm(t)/dt] REdiscovery!!! A/Siegel NON-shock PHYSICS derivation fails!!!; ''PURE''-MATHS: dF(t)/dt=d2p(t)/dt2=[m(t)da(t)/dt+a(t)dm(t)/dt] TRIPLE-integral [VS. NON -shocks F = ma time-series DOUBLE-integral] Dichotomy: s(t) = [v0+(1/2)a(t)t2+EXTRA-TERM(S)], {VS. s(t) = [v0t+(1/2) at2]}, integral-transform formally defines power-spectrum Dichotomy:

Monovision techniques for telerobots

NASA Technical Reports Server (NTRS)

Goode, P. W.; Carnils, K.

1987-01-01

The primary task of the vision sensor in a telerobotic system is to provide information about the position of the system's effector relative to objects of interest in its environment. The subtasks required to perform the primary task include image segmentation, object recognition, and object location and orientation in some coordinate system. The accomplishment of the vision task requires the appropriate processing tools and the system methodology to effectively apply the tools to the subtasks. The functional structure of the telerobotic vision system used in the Langley Research Center's Intelligent Systems Research Laboratory is discussed as well as two monovision techniques for accomplishing the vision subtasks.

Evolution of stress and strain during 3D folding: application to orthogonal fracture systems in folded turbidites, SW Portugal

NASA Astrophysics Data System (ADS)

Reber, J. E.; Schmalholz, S. M.; Lechmann, S. M.

2009-04-01

We present field data and numerical modeling results which show the evolution of stress and strain patterns during 3D folding resulting in an orthogonal fracture system. The field area is located near Almograve, SW Portugal. The area is part of the Mira Formation which itself is part of the South Portuguese Zone (SPZ). The structural development of the SPZ is characterized by southwest vergent folding and thrust displacement. The metamorphism in the SPZ increases from diagenetic conditions in the southwest to greenschist-facies conditions to the northeast. The Mira Formation is composed of turbiditic layers of Carboniferous age with low sandstone to shale ratio. The data was gathered at three outcrops which show structures similar to chocolate tablet structures in the folded sandstone layers. Chocolate tablet structures are generated under simultaneous extension in two directions and show two fracture systems of the same age which are perpendicular to each other. However, the Mira Formation is located in a convergent area. Also, the outcrops near Almograve show two fracture systems of different age. The fractures orthogonal to the fold axis and the bedding are crosscut by fractures parallel to the fold axis and orthogonal to the bedding. Our hypothesis for the evolution of the observed fracture systems is as follows; the older fractures which are now orthogonal to the fold axis and to the bedding plane were generated during compression while the layers were still approximately horizontal. They are parallel to σ1(i.e. mode 1 fractures). The second and younger fracture family was generated in a phase where there is local extension in the fold limbs. These fractures are orthogonal to the far-field σ1, parallel to the fold axis and perpendicular to the bedding. The shortening direction is constant during the entire folding process. We test our hypothesis with numerical modeling. We use 2D and 3D finite element codes with a mixed formulation for incompressible flow and a viscous rheology. The stress and strain tensor components are calculated at each numerical nodal point. The stress and strain fields are visualized through ellipses and ellipsoids which are calculated using the eigenvalues of the respective tensors. The shortest main axis represents the direction of the smallest stress σ3 and the longest main axis represents the direction of the largest stress σ1. To generate two orthogonal fracture systems in the fold limbs we expect a relatively rapid change of the stress field in the fold limbs during folding. With a relatively slow change of the stress field we would expect to see more than two fracture systems with a wide range of fracture orientation which we did not observe in the field. The preliminary 2D results show, as expected, a sudden flip of the main axes of the stress ellipse which corresponds to a change from limb-parallel compression to extension. For the 3D model we expect similar results and we will investigate the impact of different deformation boundary conditions on the evolution of the 3D stress and strain fields.

Severe hypoglycemia is associated with high risk for falls in adults with type 1 diabetes.

PubMed

Shah, Viral N; Wu, Mengdi; Foster, Nicole; Dhaliwal, Ruban; Al Mukaddam, Mona

2018-06-12

We evaluated fall frequency and factors affecting falls among middle-aged and older adults with type 1 diabetes (T1D) from T1D Exchange Registry. Twenty-nine percent of T1D participants reported falls within the past 12 months. Severe hypoglycemia, diabetic peripheral neuropathy, and depression were associated with falls in adults with T1D. Fall is an important risk factor for osteoporotic fracture; we evaluated fall frequency and factors affecting falls among middle-aged and older adults with type 1 diabetes (T1D). Participants aged ≥ 55 years with T1D completed an email-based questionnaire on falls in the prior 12 months. Demographic, clinical, and fall-related information were gathered from the questionnaire; HbA1c was recorded from medical record data extraction. Four hundred and thirty five adults with T1D completed the fall questionnaire (mean age 64 ± 7 years, 57% females, and 97% were non-Hispanic whites). The mean diabetes duration was 36 years with mean HbA1c of 7.3%. Among the 435 participants, 126 reported at least one fall in the prior 12 months (29%). The fall frequency values in adults (55-64 years) with T1D and older adults (> 65 years) were 26 and 32%, respectively (p = 0.16). There was no significant difference in frequency of fall between female and male participants (31 vs. 26%, p = 0.33). Of 126 participants who had a fall, 44% had injuries due to fall, 24% required medical attention, and 13 participants reported fracture (10%). Severe hypoglycemia (odds ratio (OR) 3.6), diabetic peripheral neuropathy (OR 2.2), and depression (OR 1.7) were associated with falls in adults with T1D. Forty-one percent of participants were fearful of falls. This is the first study on prevalence and risk factors for falls suggesting that falls are common in T1D and severe hypoglycemia is a unique diabetes-related factor associated with threefold higher risk for falls.

The prevention of hip fracture with menatetrenone and risedronate plus calcium supplementation in elderly patients with Alzheimer disease: a randomized controlled trial.

PubMed

Sato, Yoshihiro; Honda, Yoshiaki; Umeno, Kazuo; Hayashida, Norimasa; Iwamoto, Jun; Takeda, Tsuyoshi; Matsumoto, Hideo

2011-01-01

A high incidence of fractures, particularly of the hip, represents an important problem in patients with Alzheimer disease (AD), who are prone to falls and have osteoporosis. We previously found that vitamin K deficiency and low 25-hydroxyvitamin D (25-OHD) with compensatory hyperparathyroidism cause reduced bone mineral density (BMD) in female patients with AD. This may modifiable by intervention with menatetrenone (vitamin K2) and risedronate sodium; we address the possibility that treatment with menatetrenone, risedronate and calcium may reduce the incidence of nonvertebral fractures in elderly patients with AD. A total of 231 elderly patients with AD were randomly assigned to daily treatment with 45 mg of menatetrenone or a placebo combined with once weekly risedronate sodium, and followed up for 12 months. At baseline, patients of both groups showed high undercarboxylated osteocalcin (ucOC) and low 25-OHD insufficiency with compensatory hyperparathyroidism. During the study period, BMD in the treatment group increased by 5.7% and increased by 2.1% in the control group. Nonvertebral fractures occurred in 15 patients (10 hip fractures) in the control group and 5 patients (2 hip fractures) in the treatment group. The relative risk in the treatment group compared with the control group was 0.31 (95% confidence interval, 0.12-0.81). Elderly AD patients with hypovitaminosis K and D are at increased risk for hip fracture. The study medications were well tolerated with relatively few adverse events and effective in reducing the risk of a fracture in elderly patients with AD.

Advanced Glycation Endproducts and Bone Material Properties in Type 1 Diabetic Mice

PubMed Central

Rubin, Mishaela R.; Paschalis, Eleftherios P.; Poundarik, Atharva; Sroga, Gyna E.; McMahon, Donald J.; Gamsjaeger, Sonja; Klaushofer, Klaus; Vashishth, Deepak

2016-01-01

Fractures, particularly at the lower extremities and hip, are a complication of diabetes. In both type 1 (T1D) and type 2 diabetes (T2D), fracture risk is disproportionately worse than that predicted from the measurement of bone mineral density. Although an explanation for this discrepancy is the presence of organic matrix abnormalities, it has not been fully elucidated how advanced glycation endproducts (AGEs) relate to bone deterioration at both the macroscopic and microscopic levels. We hypothesized that there would be a relationship between skeletal AGE levels (determined by Raman microspectroscopy at specific anatomical locations) and bone macroscopic and microscopic properties, as demonstrated by the biomechanical measures of crack growth and microindentation respectively. We found that in OVE26 mice, a transgenic model of severe early onset T1D, AGEs were increased by Raman (carboxymethyl-lysine [CML] wildtype (WT): 0.0143 ±0.0005 vs T1D: 0.0175 ±0.0002, p = 0.003) at the periosteal surface. These differences were associated with less tough bone in T1D by fracture mechanics (propagation toughness WT: 4.73 ± 0.32 vs T1D: 3.39 ± 0.24 NM/m1/2, p = 0.010) and by reference point indentation (indentation distance increase WT: 6.85 ± 0.44 vs T1D: 9.04 ± 0.77 μm; p = 0.043). Within T1D, higher AGEs by Raman correlated inversely with macroscopic bone toughness. These data add to the existing body of knowledge regarding AGEs and the relationship between skeletal AGEs with biomechanical indices. PMID:27140650

Diagnostic tools in maxillofacial fractures: Is there really a need of three-dimensional computed tomography?

PubMed Central

Shah, Sheerin; Uppal, Sanjeev K.; Mittal, Rajinder K.; Garg, Ramneesh; Saggar, Kavita; Dhawan, Rishi

2016-01-01

Introduction: Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly. Materials and Methods: Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed. Results: CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall. Conclusion: 3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT. PMID:27833286

Diagnostic tools in maxillofacial fractures: Is there really a need of three-dimensional computed tomography?

PubMed

Shah, Sheerin; Uppal, Sanjeev K; Mittal, Rajinder K; Garg, Ramneesh; Saggar, Kavita; Dhawan, Rishi

2016-01-01

Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly. Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed. CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall. 3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT.

A new multiple trauma model of the mouse.

PubMed

Fitschen-Oestern, Stefanie; Lippross, Sebastian; Klueter, Tim; Weuster, Matthias; Varoga, Deike; Tohidnezhad, Mersedeh; Pufe, Thomas; Rose-John, Stefan; Andruszkow, Hagen; Hildebrand, Frank; Steubesand, Nadine; Seekamp, Andreas; Neunaber, Claudia

2017-11-21

Blunt trauma is the most frequent mechanism of injury in multiple trauma, commonly resulting from road traffic collisions or falls. Two of the most frequent injuries in patients with multiple trauma are chest trauma and extremity fracture. Several trauma mouse models combine chest trauma and head injury, but no trauma mouse model to date includes the combination of long bone fractures and chest trauma. Outcome is essentially determined by the combination of these injuries. In this study, we attempted to establish a reproducible novel multiple trauma model in mice that combines blunt trauma, major injuries and simple practicability. Ninety-six male C57BL/6 N mice (n = 8/group) were subjected to trauma for isolated femur fracture and a combination of femur fracture and chest injury. Serum samples of mice were obtained by heart puncture at defined time points of 0 h (hour), 6 h, 12 h, 24 h, 3 d (days), and 7 d. A tendency toward reduced weight and temperature was observed at 24 h after chest trauma and femur fracture. Blood analyses revealed a decrease in hemoglobin during the first 24 h after trauma. Some animals were killed by heart puncture immediately after chest contusion; these animals showed the most severe lung contusion and hemorrhage. The extent of structural lung injury varied in different mice but was evident in all animals. Representative H&E-stained (Haematoxylin and Eosin-stained) paraffin lung sections of mice with multiple trauma revealed hemorrhage and an inflammatory immune response. Plasma samples of mice with chest trauma and femur fracture showed an up-regulation of IL-1β (Interleukin-1β), IL-6, IL-10, IL-12p70 and TNF-α (Tumor necrosis factor- α) compared with the control group. Mice with femur fracture and chest trauma showed a significant up-regulation of IL-6 compared to group with isolated femur fracture. The multiple trauma mouse model comprising chest trauma and femur fracture enables many analogies to clinical cases of multiple trauma in humans and demonstrates associated characteristic clinical and pathophysiological changes. This model is easy to perform, is economical and can be used for further research examining specific immunological questions.

Printed three-dimensional anatomic templates for virtual preoperative planning before reconstruction of old pelvic injuries: initial results.

PubMed

Wu, Xin-Bao; Wang, Jun-Qiang; Zhao, Chun-Peng; Sun, Xu; Shi, Yin; Zhang, Zi-An; Li, Yu-Neng; Wang, Man-Yi

2015-02-20

Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures. First, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8-17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure. The accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6-9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3-29 months (median: 5 months). The fracture healing time was 9-17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The results were excellent in two cases, good in five, and poor in two based on the Majeed score. The 3D printing planning technique for pelvic surgery was successfully integrated into a clinical workflow to improve patient-specific preoperative planning by providing a visual and haptic model of the injury and allowing patient-specific adaptation of each osteosynthesis implant to the virtually reduced pelvis.

FracPaQ: a MATLAB™ Toolbox for the Quantification of Fracture Patterns

NASA Astrophysics Data System (ADS)

Healy, D.; Rizzo, R. E.; Cornwell, D. G.; Timms, N.; Farrell, N. J.; Watkins, H.; Gomez-Rivas, E.; Smith, M.

2016-12-01

The patterns of fractures in deformed rocks are rarely uniform or random. Fracture orientations, sizes, shapes and spatial distributions often exhibit some kind of order. In detail, there may be relationships among the different fracture attributes e.g. small fractures dominated by one orientation, larger fractures by another. These relationships are important because the mechanical (e.g. strength, anisotropy) and transport (e.g. fluids, heat) properties of rock depend on these fracture patterns and fracture attributes. This presentation describes an open source toolbox to quantify fracture patterns, including distributions in fracture attributes and their spatial variation. Software has been developed to quantify fracture patterns from 2-D digital images, such as thin section micrographs, geological maps, outcrop or aerial photographs or satellite images. The toolbox comprises a suite of MATLAB™ scripts based on published quantitative methods for the analysis of fracture attributes: orientations, lengths, intensity, density and connectivity. An estimate of permeability in 2-D is made using a parallel plate model. The software provides an objective and consistent methodology for quantifying fracture patterns and their variations in 2-D across a wide range of length scales. Our current focus for the application of the software is on quantifying the fracture patterns in and around fault zones. There is a large body of published work on the quantification of relatively simple joint patterns, but fault zones present a bigger, and arguably more important, challenge. The method presented is inherently scale independent, and a key task will be to analyse and integrate quantitative fracture pattern data from micro- to macro-scales. Planned future releases will incorporate multi-scale analyses based on a wavelet method to look for scale transitions, and combining fracture traces from multiple 2-D images to derive the statistically equivalent 3-D fracture pattern.

Multi-scale Fracture Patterns Associated with a Complex Anticline Structure: Insights from Field Outcrop Analogues of the Jebel Hafit Pericline, Al Ain-UAE

NASA Astrophysics Data System (ADS)

Kokkalas, S.; Jones, R. R.; Long, J. J.; Zampos, M.; Wilkinson, M. W.; Gilment, S.

2017-12-01

The formation of folds and their associated fracture patterns plays an important role in controlling the migration and concentration of fluids within the upper crust. Prediction of fracture patterns from various fold shapes and kinematics still remains poorly understood in terms of spatial and temporal distribution of fracture sets. Thus, a more detailed field-based multi scale approach is required to better constrain 3D models of fold-fracture relationships, which are critical for reservoir characterization studies. In order to generate reservoir-scale fracture models representative fracture properties across a wider range of scales are needed. For this reason we applied modern geospatial technologies, including terrestrial LiDAR, photogrammetry and satellite images in the asymmetric, east verging, four-way closure Jebel Hafit anticline, in the eastern part of the United Arab Emirates. The excellent surface outcrops allowed the rapid acquisition of extensive areas of fracture data from both limbs and fold hinge area of the anticline, even from large areas of steep exposure that are practically inaccessible on foot. The digital outcrops provide longer 1D transects, and 2D or 3D surface datasets and give more robust data, particularly for fracture heights, lengths, spacing, clustering, termination and connectivity. The fracture patterns across the folded structure are more complex than those predicted from conceptual models and geomechanical fracture modeling. Mechanical layering, pre-existing structures and sedimentation during fold growth seem to exert a critical influence in the development of fracture systems within Jebel Hafit anticline and directly affect fracture orientations, spacing/intensity, segmentation and connectivity. Seismic and borehole data provide additional constraints on the sub-surface fold geometry and existence of large-scale thrusting in the core of the anticline. The complexity of the relationship between fold geometry and fracture intensity is presented and the implications for prediction of fracture networks in naturally fractured reservoirs are discussed.

Modeling of Hydraulic Fracture Propagation at the kISMET Site Using a Fully Coupled 3D Network-Flow and Quasi- Static Discrete Element Model

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

Zhou, Jing; Huang, Hai; Mattson, Earl

Aimed at supporting the design of hydraulic fracturing experiments at the kISMET site, ~1500 m below ground in a deep mine, we performed pre-experimental hydraulic fracturing simulations in order to estimate the breakdown pressure, propagation pressure, fracture geometry, and the magnitude of induced seismicity using a newly developed fully coupled three-dimensional (3D) network flow and quasi-static discrete element model (DEM). The quasi-static DEM model, which is constructed by Delaunay tessellation of the rock volume, considers rock fabric heterogeneities by using the “disordered” DEM mesh and adding random perturbations to the stiffness and tensile/shear strengths of individual DEM elements and themore » elastic beams between them. A conjugate 3D flow network based on the DEM lattice is constructed to calculate the fluid flow in both the fracture and porous matrix. One distinctive advantage of the model is that fracturing is naturally described by the breakage of elastic beams between DEM elements. It is also extremely convenient to introduce mechanical anisotropy into the model by simply assigning orientation-dependent tensile/shear strengths to the elastic beams. In this paper, the 3D hydraulic fracturing model was verified against the analytic solution for a penny-shaped crack model. We applied the model to simulate fracture propagation from a vertical open borehole based on initial estimates of rock mechanical properties and in-situ stress conditions. The breakdown pressure and propagation pressure are directly obtained from the simulation. In addition, the released elastic strain energies of individual fracturing events were calculated and used as a conservative estimate for the magnitudes of the potential induced seismic activities associated with fracturing. The comparisons between model predictions and experimental results are still ongoing.« less

Internal fixation of complex fractures of the tarsal navicular with locking plates. A report of 10 cases.

PubMed

Cronier, P; Frin, J-M; Steiger, V; Bigorre, N; Talha, A

2013-06-01

Tarsal navicular fractures are rare and treatment of comminuted fractures is especially difficult. Since 2007, the authors have had access to 3D reconstruction from CT scan images and specific locking plates, and they decided to evaluate whether these elements improved management of these severe cases. Between 2007 and 2011, 10 comminuted tarsal navicular fractures were treated in a prospective study. All of the fractures were evaluated by 3D reconstruction from CT scan images, with suppression of the posterior tarsal bones. The surgical approach was chosen according to the type of lesion. Reduction was achieved with a mini-distractor when necessary, and stabilized by AO locking plate fixation (Synthes™). Patient follow-up included a clinical and radiological evaluation (Maryland Foot score, AOFAS score). Eight patients underwent postoperative CT scan. All patients were followed up after a mean 20.5 months. Union was obtained in all patients and arthrodesis was not necessary in any of them. The mean Maryland Foot score was 92.8/100, and the AOFAS score 90.6/100. One patient with an associated comminuted calcaneal fracture had minimal sequella from a compartment syndrome of the foot. The authors did not find any series in the literature that reported evaluating tarsal navicular fractures by 3D reconstruction from CT scan images. The images obtained after suppression of the posterior tarsal bones systematically showed a lateral plantar fragment attached to the plantar calcaneonavicular ligament, which is essential for stability, and which helped determine the reduction technique. Locking plate fixation of these fractures has never been reported. Comminuted fractures of the tarsal navicular were successfully treated with specific imaging techniques in particular 3D reconstructions of CT scan images to choose the surgical approach and the reduction technique. Locking plate fixation of the navicular seems to be a satisfactory solution for the treatment of these particularly difficult fractures. Level IV. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The risk of a safety-critical event associated with mobile device use in specific driving contexts.

PubMed

Fitch, Gregory M; Hanowski, Richard J; Guo, Feng

2015-01-01

We explored drivers' mobile device use and its associated risk of a safety-critical event (SCE) in specific driving contexts. Our premise was that the SCE risk associated with mobile device use increases when the driving task becomes demanding. Data from naturalistic driving studies involving commercial motor vehicle drivers and light vehicle drivers were partitioned into subsets representative of specific driving contexts. The subsets were generated using data set attributes that included level of service and relation to junction. These attributes were selected based on exogenous factors known to alter driving task demands. The subsets were analyzed using a case-cohort approach, which was selected to complement previous investigations of mobile device SCE risk using naturalistic driving data. Both commercial motor vehicle and light vehicle drivers varied as to how much they conversed on a mobile device but did not vary their engagement in visual-manual subtasks. Furthermore, commercial motor vehicle drivers conversed less frequently as the driving task demands increased, whereas light vehicle drivers did not. The risk of an SCE associated with mobile device use was dependent on the subtask performed and the driving context. Only visual-manual subtasks were associated with an increased SCE risk, whereas conversing was associated with a decreased risk in some driving contexts. Drivers' engagement in mobile device subtasks varies by driving context. The SCE risk associated with mobile device use is dependent on the types of subtasks performed and the driving context. The findings of this exploratory study can be applied to the design of driver-vehicle interfaces that mitigate distraction by preventing visual-manual subtasks while driving.

Vitamin D Insufficiency Among Professional Basketball Players: A Relationship to Fracture Risk and Athletic Performance.

PubMed

Grieshober, Jason A; Mehran, Nima; Photopolous, Christos; Fishman, Matthew; Lombardo, Stephen J; Kharrazi, F Daniel

2018-05-01

Vitamin D is believed to play a role in influencing fracture risk and athletic performance. Insufficiency of vitamin D affects an estimated three-quarters of the United States population. Hypovitaminosis D has also been demonstrated to be quite common among professional basketball players in the National Basketball Association (NBA). To determine whether a relationship exists between vitamin D levels and fracture risk and athletic performance (as measured by NBA draft status) among elite basketball players. Descriptive epidemiology study. Data were obtained from the NBA regarding combine participants from 2009 through 2013. This information included vitamin D level, demographic information, fracture history, and NBA draft status. The data were analyzed to determine associations between vitamin D level and fracture risk and NBA draft status. Vitamin D levels were measured for 279 players at the NBA Combine from 2009 through 2013. Vitamin D deficiency (<20 ng/mL) was seen in 32.3% of athletes, vitamin D insufficiency (20-30 ng/mL) was seen in 41.2%, and sufficient levels of vitamin D (>30 ng/mL) were present in only 26.5%. A total of 118 players had a history of at least 1 fracture. Vitamin D level was not predictive of fracture risk. Contrary to our hypothesis, players with a history of stress fracture had a significantly greater mean vitamin D level than those without such history (30.7 vs 25.1 ng/mL; P = .04). A majority (79.6%) of participants were selected in the NBA draft. Players with deficient vitamin D levels had a significantly lower rate of being drafted into the NBA ( P = .027). The NBA draft rate was found to increase with increasing levels of vitamin D ( P = .007). Hypovitaminosis D is quite common among NBA Combine participants, affecting 73.5%. While no significant relationship was found between vitamin D level and fracture history, patients with a history of stress fracture had significantly greater mean vitamin D levels. Additionally, participants with greater vitamin D levels were more likely to be drafted into the NBA. This information supports the potential role of vitamin D in influencing athletic performance.

Analytic crack solutions for tilt fields around hydraulic fractures

NASA Astrophysics Data System (ADS)

Warpinski, Norman R.

2000-10-01

The recent development of downhole tiltmeter arrays for monitoring hydraulic fractures has provided new information on fracture growth and geometry. These downhole arrays offer the significant advantages of being close to the fracture (large signal) and being unaffected by the free surface. As with surface tiltmeter data, analysis of these measurements requires the inversion of a crack or dislocation model. To supplement the dislocation models of Davis [1983], Okada [1992], and others, this work has extended several elastic crack solutions to provide tilt calculations. The solutions include constant-pressure two-dimensional (2-D), penny-shaped, and 3-D-elliptic cracks and a 2-D-variable-pressure crack. Equations are developed for an arbitrary inclined fracture in an infinite elastic space. Effects of fracture height, fracture length, fracture dip, fracture azimuth, fracture width, and monitoring distance on the tilt distribution are given, as well as comparisons with the dislocation model. The results show that the tilt measurements are very sensitive to the fracture dimensions but also that it is difficult to separate the competing effects of the various parameters.

Analytic crack solutions for tilt fields around hydraulic fractures

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

Warpinski, N.R.

The recent development of downhole tiltmeter arrays for monitoring hydraulic fractures has provided new information on fracture growth and geometry. These downhole arrays offer the significant advantages of being close to the fracture (large signal) and being unaffected by the free surface. As with surface tiltmeter data, analysis of these measurements requires the inversion of a crack or dislocation model. To supplement the dislocation models of Davis [1983], Okada [1992] and others, this work has extended several elastic crack solutions to provide tilt calculations. The solutions include constant-pressure 2D, penny-shaped, and 3D-elliptic cracks and a 2D-variable-pressure crack. Equations are developedmore » for an arbitrary inclined fracture in an infinite elastic space. Effects of fracture height, fracture length, fracture dip, fracture azimuth, fracture width and monitoring distance on the tilt distribution are given, as well as comparisons with the dislocation model. The results show that the tilt measurements are very sensitive to the fracture dimensions, but also that it is difficult to separate the competing effects of the various parameters.« less

Fabrication of a customized bone scaffold using a homemade medical 3D printer for comminuted fractures

NASA Astrophysics Data System (ADS)

Yoon, Do-Kun; Jung, Joo-Young; Shin, Han-Back; Kim, Moo-Sub; Choe, Bo-Young; Kim, Sunmi; Suh, Tae Suk; Lee, Keum Sil; Xing, Lei

2016-09-01

The purpose of this study was to show a 3D printed reconstruction model of a bone destroyed by a comminuted fracture. After a thoracic limb of a cow with a comminuted fracture was scanned by using computed tomography, a scaffold was designed by using a 3D modeling tool for its reconstruction and fabricated by using a homemade medical 3D printer. The homemade medical 3D printer was designed for medical use. In order to reconstruct the geometry of the destroyed bone, we use the geometry of a similar section (reference geometry) of normal bone in the 3D modeling process. The missing part between the destroyed ridge and the reference geometry was filled with an effective space by using a manual interpolation. Inexpensive materials and free software were used to construct the medical 3D printer system. The fabrication of the scaffold progressed according to the design of reconstructed bone by using this medical 3D printer. The material of the scaffold was biodegradable material, and could be transplanted into the human body. The fabricated scaffold was correctly inserted into the fractured bone in place of the destroyed portion, with good agreement. According to physical stress test results, the performance of printing resolution was 0.1 mm. The average geometrical error of the scaffold was below 0.3 mm. The reconstructed bone by using the fabricated scaffold was able to support the weight of the human body. No process used to obtain the result was complex or required many resources. The methods and results in this study show several possible clinical applications in fields such as orthopedics or oncology without a need to purchase high-price instruments for 3D printing.

Fluid lavage of open wounds (FLOW): design and rationale for a large, multicenter collaborative 2 x 3 factorial trial of irrigating pressures and solutions in patients with open fractures.

PubMed

2010-05-06

Open fractures frequently result in serious complications for patients, including infections, wound healing problems, and failure of fracture healing, many of which necessitate subsequent operations. One of the most important steps in the initial management of open fractures is a thorough wound irrigation and debridement to remove any contaminants. There is, however, currently no consensus regarding the optimal approach to irrigating open fracture wounds during the initial operative procedure. The selection of both the type of irrigating fluid and the pressure of fluid delivery remain controversial. The primary objective of this study is to investigate the effects of irrigation solutions (soap vs. normal saline) and pressure (low vs. high; gravity flow vs. high; low vs. gravity flow) on re-operation within one year among patients with open fractures. The FLOW study is a multi-center, randomized controlled trial using a 2 x 3 factorial design. Surgeons at clinical sites in North America, Europe, Australia, and Asia will recruit 2 280 patients who will be centrally randomized into one of the 6 treatment arms (soap + low pressure; soap + gravity flow pressure; soap + high pressure; saline + low pressure; saline + gravity flow pressure; saline + high pressure). The primary outcome of the study is re-operation to promote wound or bone healing, or to treat an infection. This composite endpoint of re-operation includes a narrow spectrum of patient-important procedures: irrigation and debridement for infected wound, revision and closure for wound dehiscence, wound coverage procedures for infected or necrotic wound, bone grafts or implant exchange procedures for established nonunion in patients with postoperative fracture gaps less than 1 cm, intramedullary nail dynamizations in the operating room, and fasciotomies for compartment syndrome. Patients, outcome adjudicators, and data analysts will be blinded. We will compare rates of re-operation at 12 months across soap vs. saline, low pressure vs. high pressure, gravity flow pressure vs. high pressure, and low pressure vs. gravity flow pressure. We will measure function and quality of life with the Short Form-12 (SF-12) and the EuroQol-5 Dimensions (EQ-5D) at baseline, 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months after initial surgical management, and measure patients' illness beliefs with the Somatic Pre-Occupation and Coping (SPOC) questionnaire at 1 and 6 weeks. We will also compare non-operatively managed infections, wound healing, and fracture healing problems at 12 months after initial surgery. This study represents a major international effort to identify a simple and easily applicable strategy for emergency wound management. The importance of the question and the potential to identify a low cost treatment strategy argues strongly for global participation, especially in low and middle income countries such as India and China where disability from traumatic injuries is substantial. This trial is registered at ClinicalTrials.gov (NCT00788398).

Effects of medication reviews performed by a physician on treatment with fracture-preventing and fall-risk-increasing drugs in older adults with hip fracture-a randomized controlled study.

PubMed

Sjöberg, Christina; Wallerstedt, Susanna M

2013-09-01

To investigate whether medication reviews increase treatment with fracture-preventing drugs and decrease treatment with fall-risk-increasing drugs. Randomized controlled trial (1:1). Departments of orthopedics, geriatrics, and medicine at Sahlgrenska University Hospital, Gothenburg, Sweden. One hundred ninety-nine consecutive individuals with hip fracture aged 65 and older. Medication reviews, based on assessments of risks of falls and fractures, regarding fracture-preventing and fall-risk-increasing drugs, performed by a physician, conveyed orally and in written form to hospital physicians during the hospital stay, and to general practitioners after discharge. Primary outcomes were changes in treatment with fracture-preventing and fall-risk-increasing drugs 12 months after discharge. Secondary outcomes were falls, fractures, deaths, and physicians' attitudes toward the intervention. At admission, 26% of intervention and 29% of control participants were taking fracture-preventing drugs, and 12% and 11%, respectively, were taking bone-active drugs, predominantly bisphosphonates. After 12 months, 77% of intervention and 58% of control participants were taking fracture-preventing drugs (P = .01), and 29% and 15%, respectively, were taking bone-active drugs (P = .04). Mean number of fall-risk-increasing drugs per participants was 3.1 (intervention) and 3.1 (control) at admission and 2.9 (intervention) and 3.1 (control) at 12 months (P = .62). No significant differences in hard endpoints were found. The responding physicians (n = 65) appreciated the intervention; on a scale from 1 (very bad) to 6 (very good), the median rating was 5 (interquartile range (IQR) 4-6) for the oral part and 5 (IQR 4-5.5) for the text part. Medication reviews performed and conveyed by a physician increased treatment with fracture-preventing drugs but did not significantly decrease treatment with fall-risk-increasing drugs in older adults with hip fracture. Prescribing physicians appreciated this intervention. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Effect of Measured Welding Residual Stresses on Crack Growth

NASA Technical Reports Server (NTRS)

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

1998-01-01

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

Intelligent Engine Systems Work Element 1.3: Sub System Health Management

NASA Technical Reports Server (NTRS)

Ashby, Malcolm; Simpson, Jeffrey; Singh, Anant; Ferguson, Emily; Frontera, mark

2005-01-01

The objectives of this program were to develop health monitoring systems and physics-based fault detection models for engine sub-systems including the start, lubrication, and fuel. These models will ultimately be used to provide more effective sub-system fault identification and isolation to reduce engine maintenance costs and engine down-time. Additionally, the bearing sub-system health is addressed in this program through identification of sensing requirements, a review of available technologies and a demonstration of a demonstration of a conceptual monitoring system for a differential roller bearing. This report is divided into four sections; one for each of the subtasks. The start system subtask is documented in section 2.0, the oil system is covered in section 3.0, bearing in section 4.0, and the fuel system is presented in section 5.0.

Percolation Laws of a Fractal Fracture-Pore Double Medium

NASA Astrophysics Data System (ADS)

Zhao, Yangsheng; Feng, Zengchao; Lv, Zhaoxing; Zhao, Dong; Liang, Weiguo

2016-12-01

The fracture-pore double porosity medium is one of the most common media in nature, for example, rock mass in strata. Fracture has a more significant effect on fluid flow than a pore in a fracture-pore double porosity medium. Hence, the fracture effect on percolation should be considered when studying the percolation phenomenon in porous media. In this paper, based on the fractal distribution law, three-dimensional (3D) fracture surfaces, and two-dimensional (2D) fracture traces in rock mass, the locations of fracture surfaces or traces are determined using a random function of uniform distribution. Pores are superimposed to build a fractal fracture-pore double medium. Numerical experiments were performed to show percolation phenomena in the fracture-pore double medium. The percolation threshold can be determined from three independent variables (porosity n, fracture fractal dimension D, and initial value of fracture number N0). Once any two are determined, the percolation probability exists at a critical point with the remaining parameter changing. When the initial value of the fracture number is greater than zero, the percolation threshold in the fracture-pore medium is much smaller than that in a pore medium. When the fracture number equals zero, the fracture-pore medium degenerates to a pore medium, and both percolation thresholds are the same.

Geologic setting, petrophysical characteristics, and regional heterogeneity patterns of the Smackover in southwest Alabama. Draft topical report on Subtasks 2 and 3

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

Kopaska-Merkel, D.C.; Mann, S.D.; Tew, B.H.

1992-06-01

This is the draft topical report on Subtasks 2 and 3 of DOE contract number DE-FG22-89BC14425, entitled ``Establishment of an oil and gas database for increased recovery and characterization of oil and gas carbonate reservoir heterogeneity.`` This volume constitutes the final report on Subtask 3, which had as its primary goal the geological modeling of reservoir heterogeneity in Smackover reservoirs of southwest Alabama. This goal was interpreted to include a thorough analysis of Smackover reservoirs, which was required for an understanding of Smackover reservoir heterogeneity. This report is divided into six sections (including this brief introduction). Section two, entitled ``Geologicmore » setting,`` presents a concise summary of Jurassic paleogeography, structural setting, and stratigraphy in southwest Alabama. This section also includes a brief review of sedimentologic characteristics and stratigraphic framework of the Smackover, and a summary of the diagenetic processes that strongly affected Smackover reservoirs in Alabama. Section three, entitled ``Analytical methods,`` summarizes all nonroutine aspects of the analytical procedures used in this project. The major topics are thin-section description, analysis of commercial porosity and permeability data, capillary-pressure analysis, and field characterization. ``Smackover reservoir characteristics`` are described in section four, which begins with a general summary of the petrographic characteristics of porous and permeable Smackover strata. This is followed by a more-detailed petrophysical description of Smackover reservoirs.« less

Propulsion and Power Rapid Response Research and Development (R&D) Support. Task Order 0004: Advanced Propulsion Fuels R&D, Subtask: Optimization of Lipid Production and Processing of Microalgae for the Development of Biofuels

DTIC Science & Technology

2013-02-01

Purified cultures are tested for optimized production under heterotrophic conditions with several organic carbon sources like beet and sorghum juice using ...Moreover, AFRL support sponsored the Master’s in Chemical Engineering project titled “Cost Analysis Of Local Bio- Products Processing Plant Using ...unlimited. 2.5 Screening for High Lipid Production Mutants Procedure: A selection of 84 single colony cultures was analyzed in this phase using the

Efficient computation of aerodynamic influence coefficients for aeroelastic analysis on a transputer network

NASA Technical Reports Server (NTRS)

Janetzke, David C.; Murthy, Durbha V.

1991-01-01

Aeroelastic analysis is multi-disciplinary and computationally expensive. Hence, it can greatly benefit from parallel processing. As part of an effort to develop an aeroelastic capability on a distributed memory transputer network, a parallel algorithm for the computation of aerodynamic influence coefficients is implemented on a network of 32 transputers. The aerodynamic influence coefficients are calculated using a 3-D unsteady aerodynamic model and a parallel discretization. Efficiencies up to 85 percent were demonstrated using 32 processors. The effect of subtask ordering, problem size, and network topology are presented. A comparison to results on a shared memory computer indicates that higher speedup is achieved on the distributed memory system.

Fully Coupled 3D Finite Element Model of Hydraulic Fracturing in a Permeable Rock Formation

NASA Astrophysics Data System (ADS)

Salimzadeh, S.; Paluszny, A.; Zimmerman, R. W.

2015-12-01

Hydraulic fracturing in permeable rock formations is a complex three-dimensional multi-physics phenomenon. Numerous analytical models of hydraulic fracturing processes have been proposed that typically simplify the physical processes, or somehow reduce the problem from three dimensions to two dimensions. Moreover, although such simplified models are able to model the growth of a single hydraulic fracture into an initially intact, homogeneous rock mass, they are generally not able to model fracturing of heterogeneous rock formations, or to account for interactions between multiple induced fractures, or between an induced fracture and pre-existing natural fractures. We have developed a numerical finite-element model for hydraulic fracturing that does not suffer from any of the limitations mentioned above. The model accounts for fluid flow within a fracture, the propagation of the fracture, and the leak-off of fluid from the fracture into the host rock. Fluid flow through the permeable rock matrix is modelled using Darcy's law, and is coupled with the laminar flow within the fracture. Fractures are discretely modelled in the three-dimensional mesh. Growth of a fracture is modelled using the concepts of linear elastic fracture mechanics (LEFM), with the onset and direction of growth based on stress intensity factors that are computed for arbitrary tetrahedral meshes. The model has been verified against several analytical solutions available in the literature for plane-strain (2D) and penny-shaped (3D) fractures, for various regimes of domination: viscosity, toughness, storage and leak-off. The interaction of the hydraulically driven fracture with pre-existing fractures and other fluid-driven fractures in terms of fluid leak-off, stress interaction and fracture arrest is investigated and the results are presented. Finally, some preliminary results are presented regarding the interaction of a hydraulically-induced fracture with a set of pre-existing natural fractures.

Selective control of gait subtasks in robotic gait training: foot clearance support in stroke survivors with a powered exoskeleton

PubMed Central

2013-01-01

Background Robot-aided gait training is an emerging clinical tool for gait rehabilitation of neurological patients. This paper deals with a novel method of offering gait assistance, using an impedance controlled exoskeleton (LOPES). The provided assistance is based on a recent finding that, in the control of walking, different modules can be discerned that are associated with different subtasks. In this study, a Virtual Model Controller (VMC) for supporting one of these subtasks, namely the foot clearance, is presented and evaluated. Methods The developed VMC provides virtual support at the ankle, to increase foot clearance. Therefore, we first developed a new method to derive reference trajectories of the ankle position. These trajectories consist of splines between key events, which are dependent on walking speed and body height. Subsequently, the VMC was evaluated in twelve healthy subjects and six chronic stroke survivors. The impedance levels, of the support, were altered between trials to investigate whether the controller allowed gradual and selective support. Additionally, an adaptive algorithm was tested, that automatically shaped the amount of support to the subjects’ needs. Catch trials were introduced to determine whether the subjects tended to rely on the support. We also assessed the additional value of providing visual feedback. Results With the VMC, the step height could be selectively and gradually influenced. The adaptive algorithm clearly shaped the support level to the specific needs of every stroke survivor. The provided support did not result in reliance on the support for both groups. All healthy subjects and most patients were able to utilize the visual feedback to increase their active participation. Conclusion The presented approach can provide selective control on one of the essential subtasks of walking. This module is the first in a set of modules to control all subtasks. This enables the therapist to focus the support on the subtasks that are impaired, and leave the other subtasks up to the patient, encouraging him to participate more actively in the training. Additionally, the speed-dependent reference patterns provide the therapist with the tools to easily adapt the treadmill speed to the capabilities and progress of the patient. PMID:23336754

3D Printing and Digital Rock Physics for Geomaterials

NASA Astrophysics Data System (ADS)

Martinez, M. J.; Yoon, H.; Dewers, T. A.

2015-12-01

Imaging techniques for the analysis of porous structures have revolutionized our ability to quantitatively characterize geomaterials. Digital representations of rock from CT images and physics modeling based on these pore structures provide the opportunity to further advance our quantitative understanding of fluid flow, geomechanics, and geochemistry, and the emergence of coupled behaviors. Additive manufacturing, commonly known as 3D printing, has revolutionized production of custom parts with complex internal geometries. For the geosciences, recent advances in 3D printing technology may be co-opted to print reproducible porous structures derived from CT-imaging of actual rocks for experimental testing. The use of 3D printed microstructure allows us to surmount typical problems associated with sample-to-sample heterogeneity that plague rock physics testing and to test material response independent from pore-structure variability. Together, imaging, digital rocks and 3D printing potentially enables a new workflow for understanding coupled geophysical processes in a real, but well-defined setting circumventing typical issues associated with reproducibility, enabling full characterization and thus connection of physical phenomena to structure. In this talk we will discuss the possibilities that these technologies can bring to geosciences and present early experiences with coupled multiscale experimental and numerical analysis using 3D printed fractured rock specimens. In particular, we discuss the processes of selection and printing of transparent fractured specimens based on 3D reconstruction of micro-fractured rock to study fluid flow characterization and manipulation. Micro-particle image velocimetry is used to directly visualize 3D single and multiphase flow velocity in 3D fracture networks. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

Initial varus displacement of proximal humerus fractures results in similar function but higher complication rates.

PubMed

Capriccioso, Christina E; Zuckerman, Joseph D; Egol, Kenneth A

2016-04-01

To investigate the effect of initial varus or valgus surgical neck alignment on outcomes of patients who sustained proximal humerus fractures treated with open reduction and internal fixation (ORIF). An institutional review board approved database of proximal humerus fractures treated with locked plates was reviewed. Of 185 fractures in the database, 101 fractures were identified and met inclusion criteria. Initial varus displacement was seen in 47 fractures (OTA types 11.A2.2, A3.1, A3.3, B1.2, B2.2, C1.2, C2.2, or C2.3) and initial valgus displacement was observed in 54 fractures (OTA types 11.A2.3, B1.1, C1.1, or C2.1). All patients were treated in a similar manner and examined by the treating physician at standard intervals. Functional outcomes were quantified via the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and physical examination data at 12 months. Radiographs were reviewed for complications of healing. Additionally, complication rate and reoperation rate were investigated. Patients who presented with initial varus displacement had an average age of 59.3 years, while patients in the valgus group had an average age of 62.4 years. Overall, there was no statistically significant difference in age, sex distribution, BMI, fracture parts, screws used, or implant plate type between the two groups. At a minimum 12 months follow up, there was no significant difference in DASH scores between those presenting with varus versus valgus fracture patterns. In addition, no significant differences were seen in final shoulder range of motion in any plane. Overall, 30 patients included in this study developed a complication. A significantly greater number of patients in the initial varus cohort developed complications (40.4%), as compared to 20.3% of patients in the initial valgus cohort (P=0.03). Fourteen patients in this study underwent reoperation. Nine of these patients were in the varus cohort, while 5 were in the valgus cohort (P=0.15). In this study, initial surgical neck displacement in varus or valgus was found to not significantly affect functional outcome. Based upon our findings, patients with varus displaced proximal humerus fractures are at a greater risk of developing postoperative complications than those who present with initial valgus displaced fracture patterns. Copyright © 2016 Elsevier Ltd. All rights reserved.

Three-dimensional to two-dimensional transition in mode-I fracture microbranching in a perturbed hexagonal close-packed lattice

NASA Astrophysics Data System (ADS)

Heizler, Shay I.; Kessler, David A.

2017-06-01

Mode-I fracture exhibits microbranching in the high velocity regime where the simple straight crack is unstable. For velocities below the instability, classic modeling using linear elasticity is valid. However, showing the existence of the instability and calculating the dynamics postinstability within the linear elastic framework is difficult and controversial. The experimental results give several indications that the microbranching phenomenon is basically a three-dimensional (3D) phenomenon. Nevertheless, the theoretical effort has been focused mostly on two-dimensional (2D) modeling. In this paper we study the microbranching instability using three-dimensional atomistic simulations, exploring the difference between the 2D and the 3D models. We find that the basic 3D fracture pattern shares similar behavior with the 2D case. Nevertheless, we exhibit a clear 3D-2D transition as the crack velocity increases, whereas as long as the microbranches are sufficiently small, the behavior is pure 3D behavior, whereas at large driving, as the size of the microbranches increases, more 2D-like behavior is exhibited. In addition, in 3D simulations, the quantitative features of the microbranches, separating the regimes of steady-state cracks (mirror) and postinstability (mist-hackle) are reproduced clearly, consistent with the experimental findings.

A Computational/Experimental Platform for Investigating Three-Dimensional Puzzle Solving of Comminuted Articular Fractures

PubMed Central

Thomas, Thaddeus P.; Anderson, Donald D.; Willis, Andrew R.; Liu, Pengcheng; Frank, Matthew C.; Marsh, J. Lawrence; Brown, Thomas D.

2011-01-01

Reconstructing highly comminuted articular fractures poses a difficult surgical challenge, akin to solving a complicated three-dimensional (3D) puzzle. Pre-operative planning using CT is critically important, given the desirability of less invasive surgical approaches. The goal of this work is to advance 3D puzzle solving methods toward use as a pre-operative tool for reconstructing these complex fractures. Methodology for generating typical fragmentation/dispersal patterns was developed. Five identical replicas of human distal tibia anatomy, were machined from blocks of high-density polyetherurethane foam (bone fragmentation surrogate), and were fractured using an instrumented drop tower. Pre- and post-fracture geometries were obtained using laser scans and CT. A semi-automatic virtual reconstruction computer program aligned fragment native (non-fracture) surfaces to a pre-fracture template. The tibias were precisely reconstructed with alignment accuracies ranging from 0.03-0.4mm. This novel technology has potential to significantly enhance surgical techniques for reconstructing comminuted intra-articular fractures, as illustrated for a representative clinical case. PMID:20924863

[Features of dual--postural and calculation--task performance in patients with consequences of traumatic brain injury].

PubMed

Zharikova, A V; Zhavoronkova, L A; Maksakova, O A; Kuptsova, S V

2012-01-01

Dual tasks with voluntary postural control and calculation have been done by 14 patients (25.7 +/- 4.7 yo.) after traumatic brain injury and 40 healthy volunteers (29.8 +/- 2.5 y.o.). Complex clinical (MMSE, FIM, MPAI-3 and Berg scales) and stabilographic evaluation has been performed. According to clinical evaluation 8 patients were included into group 1 with less severe functional deficit and 6 patients formed group 2 with more severe deficit. Parameters of motor and especially cognitive sub-tasks in patients were lower than in healthy subjects in both separate and dual tasks. In group 2 these parameters were lower than in group 1. Certain types of dual task where the quality of sub-tasks, especially of the motor-one increased in healthy subjects and patients of the first group were revealed. The complex of stabilographic parameters which could be used for estimation of quality of sub-tasks performance has been revealed. Dual tasks could be an additional method of evaluation of patients' adaptive possibilities and certain type of dual task could become a promising approach to recovery at late period of rehabilitation.

Vitamin D profile in National Football League players.

PubMed

Maroon, Joseph C; Mathyssek, Christina M; Bost, Jeffrey W; Amos, Austin; Winkelman, Robert; Yates, Anthony P; Duca, Mark A; Norwig, John A

2015-05-01

By maintaining phosphate and calcium homeostasis, vitamin D is critical for bone health and possibly physical performance. Hence, vitamin D is important to athletes. Few studies have investigated vitamin D levels in relation to fractures and performance in athletes, and no published study has included a multiracial sample of professional American football players. To assess vitamin D levels, including the prevalence of vitamin D deficiency/insufficiency, in professional American football players and to evaluate the association of vitamin D levels with race, fracture history, and the ability to obtain a contract position, which may be a marker for athletic performance. Cohort study; Level of evidence, 3. Serum vitamin D levels of 80 professional football players from a single team in the National Football League were obtained during the 2011 off-season (mean age, 26.5±3.7 years; black, n=67 [84%]). These levels were used to compare injury reports from the 2011-2012 and 2012-2013 seasons. Statistical analyses were performed to test if vitamin D levels were related to race, fracture history, and the ability to obtain a contract position. Mean vitamin D level was 27.4±11.7 ng/mL, with significantly lower levels for black players (25.6±11.3 ng/mL) versus white players (37.4±8.6 ng/mL; F 1,78=13.00, P=.001). All athletes who were vitamin D deficient were black. When controlling for number of professional years played, vitamin D levels were significantly lower in players with at least 1 bone fracture when compared with no fractures. Players who were released during the preseason because of either injury or poor performance had significantly lower vitamin D levels than did players who played in the regular season. Black professional football players have a higher rate of vitamin D deficiency than do white players. Furthermore, professional football players with higher vitamin D levels were more likely to obtain a contract position in the National Football League. Professional football players deficient in vitamin D levels may be at greater risk of bone fractures. © 2015 The Author(s).

A Review of Computational Spinal Injury Biomechanics Research and Recommendations for Future Efforts

DTIC Science & Technology

2011-09-01

wedge vertebral fractures . The approximate degree of height reduction determines the assignment of grade to the fractured verte- bra (reproduced with...permission of Mary Ann Liebert, Inc.). (b) Lateral radiograph of lumbar spine shows a mild wedge fracture (grade 1) of L3 vertebra. (c) Lateral ra...diograph of lumbar spine shows moderate wedge fracture (grade 2) of L3 vertebra and moderate crush fracture (grade 2) of L2 vertebra. (d) Lateral

The seismogenic Gole Larghe Fault Zone (Italian Southern Alps): quantitative 3D characterization of the fault/fracture network, mapping of evidences of fluid-rock interaction, and modelling of the hydraulic structure through the seismic cycle

NASA Astrophysics Data System (ADS)

Bistacchi, A.; Mittempergher, S.; Di Toro, G.; Smith, S. A. F.; Garofalo, P. S.

2016-12-01

The Gole Larghe Fault Zone (GLFZ) was exhumed from 8 km depth, where it was characterized by seismic activity (pseudotachylytes) and hydrous fluid flow (alteration halos and precipitation of hydrothermal minerals in veins and cataclasites). Thanks to glacier-polished outcrops exposing the 400 m-thick fault zone over a continuous area > 1.5 km2, the fault zone architecture has been quantitatively described with an unprecedented detail, providing a rich dataset to generate 3D Discrete Fracture Network (DFN) models and simulate the fault zone hydraulic properties. The fault and fracture network has been characterized combining > 2 km of scanlines and semi-automatic mapping of faults and fractures on several photogrammetric 3D Digital Outcrop Models (3D DOMs). This allowed obtaining robust probability density functions for parameters of fault and fracture sets: orientation, fracture intensity and density, spacing, persistency, length, thickness/aperture, termination. The spatial distribution of fractures (random, clustered, anticlustered…) has been characterized with geostatistics. Evidences of fluid/rock interaction (alteration halos, hydrothermal veins, etc.) have been mapped on the same outcrops, revealing sectors of the fault zone strongly impacted, vs. completely unaffected, by fluid/rock interaction, separated by convolute infiltration fronts. Field and microstructural evidence revealed that higher permeability was obtained in the syn- to early post-seismic period, when fractures were (re)opened by off-fault deformation. We have developed a parametric hydraulic model of the GLFZ and calibrated it, varying the fraction of faults/fractures that were open in the post-seismic, with the goal of obtaining realistic fluid flow and permeability values, and a flow pattern consistent with the observed alteration/mineralization pattern. The fraction of open fractures is very close to the percolation threshold of the DFN, and the permeability tensor is strongly anisotropic, resulting in a marked channelling of fluid flow in the inner part of the fault zone. Amongst possible seismological applications of our study, we will discuss the possibility to evaluate the coseismic fracture intensity due to off-fault damage, a fundamental mechanical parameter in the energy balance of earthquakes.

Intramedullary nail fixation versus locking plate fixation for adults with a fracture of the distal tibia: the UK FixDT RCT.

PubMed

Costa, Matthew L; Achten, Juul; Hennings, Susie; Boota, Nafisa; Griffin, James; Petrou, Stavros; Maredza, Mandy; Dritsaki, Melina; Wood, Thomas; Masters, James; Pallister, Ian; Lamb, Sarah E; Parsons, Nick R

2018-05-01

The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. This was a multicentre randomised trial. The trial was conducted in 28 UK acute trauma centres from April 2013 to final follow-up in February 2017. In total, 321 adult patients were recruited. Participants were excluded if they had open fractures, fractures involving the ankle joint, contraindication to nailing or inability to complete questionnaires. IM nail fixation ( n  = 161), in which a metal rod is inserted into the hollow centre of the tibia, versus locking plate fixation ( n  = 160), in which a plate is attached to the surface of the tibia with fixed-angle screws. The primary outcome measure was the Disability Rating Index (DRI) score, which ranges from 0 points (no disability) to 100 points (complete disability), at 6 months with a minimum clinically important difference of 8 points. The DRI score was also collected at 3 and 12 months. The secondary outcomes were the Olerud-Molander Ankle Score (OMAS), quality of life as measured using EuroQol-5 Dimensions (EQ-5D), complications such as infection, and further surgery. Resource use was collected to inform the health economic evaluation. Participants had a mean age of 45 years (standard deviation 16.2 years), were predominantly male (61%, 197/321) and had experienced traumatic injury after a fall (69%, 223/321). There was no statistically significant difference in DRI score at 6 months [IM nail fixation group, mean 29.8 points, 95% confidence interval (CI) 26.1 to 33.7 points; locking plate group, mean 33.8 points, 95% CI 29.7 to 37.9 points; adjusted difference, 4.0 points, 95% CI -1.0 to 9.0 points; p  = 0.11]. There was a statistically significant difference in DRI score at 3 months in favour of IM nail fixation (IM nail fixation group, mean 44.2 points, 95% CI 40.8 to 47.6 points; locking plate group, mean 52.6 points, 95% CI 49.3 to 55.9 points; adjusted difference 8.8 points, 95% CI 4.3 to 13.2 points; p  < 0.001), but not at 12 months (IM nail fixation group, mean 23.1 points, 95% CI 18.9 to 27.2 points; locking plate group, 24.0 points, 95% CI 19.7 to 28.3 points; adjusted difference 1.9 points, 95% CI -3.2 to 6.9 points; p  = 0.47). Secondary outcomes showed the same pattern, including a statistically significant difference in mean OMAS and EQ-5D scores at 3 and 6 months in favour of IM nail fixation. There were no statistically significant differences in complications, including the number of postoperative infections (13% in the locking plate group and 9% in the IM nail fixation group). Further surgery was more common in the locking plate group (12% in locking plate group and 8% in IM nail fixation group at 12 months). The economic evaluation showed that IM nail fixation provided a slightly higher quality of life in the 12 months after injury and at lower cost and, therefore, it was cost-effective compared with locking plate fixation. The probability of cost-effectiveness for IM nail fixation exceeded 90%, regardless of the value of the cost-effectiveness threshold. As wound dressings after surgery are clearly visible, it was not possible to blind the patients to their treatment allocation. This evidence does not apply to intra-articular (pilon) fractures of the distal tibia. Among adults with an acute fracture of the distal tibia who were randomised to IM nail fixation or locking plate fixation, there were similar disability ratings at 6 months. However, recovery across all outcomes was faster in the IM nail fixation group and costs were lower. The potential benefit of IM nail fixation in several other fractures requires investigation. Research is also required into the role of adjuvant treatment and different rehabilitation strategies to accelerate recovery following a fracture of the tibia and other long-bone fractures in the lower limb. The patients in this trial will remain in longer-term follow-up. Current Controlled Trials ISRCTN99771224 and UKCRN 13761. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 22, No. 25. See the NIHR Journals Library website for further project information.

Design issues for grid-connected photovoltaic systems

NASA Astrophysics Data System (ADS)

Ropp, Michael Eugene

1998-08-01

Photovoltaics (PV) is the direct conversion of sunlight to electrical energy. In areas without centralized utility grids, the benefits of PV easily overshadow the present shortcomings of the technology. However, in locations with centralized utility systems, significant technical challenges remain before utility-interactive PV (UIPV) systems can be integrated into the mix of electricity sources. One challenge is that the needed computer design tools for optimal design of PV systems with curved PV arrays are not available, and even those that are available do not facilitate monitoring of the system once it is built. Another arises from the issue of islanding. Islanding occurs when a UIPV system continues to energize a section of a utility system after that section has been isolated from the utility voltage source. Islanding, which is potentially dangerous to both personnel and equipment, is difficult to prevent completely. The work contained within this thesis targets both of these technical challenges. In Task 1, a method for modeling a PV system with a curved PV array using only existing computer software is developed. This methodology also facilitates comparison of measured and modeled data for use in system monitoring. The procedure is applied to the Georgia Tech Aquatic Center (GTAC) FV system. In the work contained under Task 2, islanding prevention is considered. The existing state-of-the- art is thoroughly reviewed. In Subtask 2.1, an analysis is performed which suggests that standard protective relays are in fact insufficient to guarantee protection against islanding. In Subtask 2.2. several existing islanding prevention methods are compared in a novel way. The superiority of this new comparison over those used previously is demonstrated. A new islanding prevention method is the subject under Subtask 2.3. It is shown that it does not compare favorably with other existing techniques. However, in Subtask 2.4, a novel method for dramatically improving this new islanding prevention method is described. It is shown, both by computer modeling and experiment, that this new method is one of the most effective available today. Finally, under Subtask 2.5, the effects of certain types of loads; on the effectiveness of islanding prevention methods are discussed.

[Intraoperative virtual implant planning for volar plate osteosynthesis of distal radius fractures].

PubMed

Franke, J; Vetter, S Y; Reising, K; Herrmann, S; Südkamp, N P; Grützner, P A; von Recum, J

2016-01-01

Digital planning of implants is in most cases conducted prior to surgery. The virtual implant planning system (VIPS) is an application developed for mobile C-arms, which assists the virtual planning of screws close to the joint line during surgery for treatment of distal radius fractures with volar plate osteosynthesis. The aim of this prospective randomized study was to acquire initial clinical experiences and to compare the VIPS method with the conventional technique. The study included 10 patients for primary testing and 30 patients with distal radius fractures of types A3, C1 and C2, divided in 2 groups. In the VIPS group, after placement of the plate and fracture reduction, a virtual 3D model of the plate was matched with the image of the plate from the fluoroscopic acquisition. Next, the length and position of the screws close to the joint line were planned on the virtual plate. The control group was treated with the same implant in the conventional way. Data were collected regarding screw replacement, fluoroscopy and operating room (OR) times. The VIPS group included six A3, one C1 and eight C2 fractures, while the control group consisted of six A3 and nine C2 fractures. Three screws were replaced in the VIPS group and two in the control group (p = 0.24). The mean intraoperative fluoroscopy time of the VIPS group amounted to 2.58 ± 1.38 min, whereas it was 2.12 ± 0.73 min in the control group (p = 0.26). The mean OR time in the VIPS group was 53.3 ± 34.5 minutes and 42.3 ± 8.8 min (p = 0.23) in the control group. The VIPS enables a precise positioning of screws close to joint line in the treatment of distal radius fractures; however, for routine use, further development of the system is necessary.

Structure and Content in Social Cognition: Conceptual and Empirical Analyses.

ERIC Educational Resources Information Center

Edelstein, Wolfgang; And Others

1984-01-01

Conceptual analysis of two perspective-taking tasks identified a number of subtasks calling for equivalent operations of social reasoning within tasks of different content. Subtasks hypothetically formed a logical and developmental sequence of abilities required for decentering. The developmental significance of the hierarchy was tested among 121…

Numerical modeling of the fracture process in a three-unit all-ceramic fixed partial denture.

PubMed

Kou, Wen; Kou, Shaoquan; Liu, Hongyuan; Sjögren, Göran

2007-08-01

The main objectives were to examine the fracture mechanism and process of a ceramic fixed partial denture (FPD) framework under simulated mechanical loading using a recently developed numerical modeling code, the R-T(2D) code, and also to evaluate the suitability of R-T(2D) code as a tool for this purpose. Using the recently developed R-T(2D) code the fracture mechanism and process of a 3U yttria-tetragonal zirconia polycrystal ceramic (Y-TZP) FPD framework was simulated under static loading. In addition, the fracture pattern obtained using the numerical simulation was compared with the fracture pattern obtained in a previous laboratory test. The result revealed that the framework fracture pattern obtained using the numerical simulation agreed with that observed in a previous laboratory test. Quasi-photoelastic stress fringe pattern and acoustic emission showed that the fracture mechanism was tensile failure and that the crack started at the lower boundary of the framework. The fracture process could be followed both in step-by-step and step-in-step. Based on the findings in the current study, the R-T(2D) code seems suitable for use as a complement to other tests and clinical observations in studying stress distribution, fracture mechanism and fracture processes in ceramic FPD frameworks.

Two Dimensional Linear Elastic Analysis of Fracture Specimens User’s Manual of a Finite Element Computer Program.

DTIC Science & Technology

1980-02-01

8 d. Data Set 4 8 e. Data Set 5 9 f. Data Set 6 9 g. Data Set 7 10 h. Data Set 8 10 i. Data Set 9 11 J. Data Set 10 12 k. Data...Coordinates NODE X Y NODE X Y NODE X Y 1 4.0 0.5 7 3.50 1.0 13 1.50 1.5 2 4.0 1.0 8 3.50 1.5 14 1.25 0.5 3 4.0 1.5 9 2.50 0.5 15 1.25 1.5 4 3.75 0.5 10 ...4 1+5 1+6 1+7 1 1 3 8 6 2 5 7 4 2 8 13 11 6 10 12 9 7 3 16 11 13 18 14 12 15 17 Note that I can be chosen to be any corner node. 6. PLOTTING THE

Predictors of fracture while on treatment with oral bisphosphonates: a population-based cohort study.

PubMed

Prieto-Alhambra, Daniel; Pagès-Castellà, Aina; Wallace, Gemma; Javaid, M Kassim; Judge, Andrew; Nogués, Xavier; Arden, Nigel K; Cooper, Cyrus; Diez-Perez, Adolfo

2014-01-01

Although oral bisphosphonates (BPs) are highly effective in preventing fractures, some patients will fracture while on treatment. We identified predictors of such fractures in a population-based cohort of incident users of oral BPs. We screened the Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària (SIDIAP) database to identify new users of oral BPs in 2006-2007. SIDIAP includes pharmacy invoice data and primary care electronic medical records for a representative 5 million people in Catalonia (Spain). Exclusion criteria were the following: Paget disease; <40 years of age; and any antiosteoporosis treatment in the previous year. A priori defined risk factors included age, gender, body mass index, vitamin D deficiency, smoking, alcohol drinking, preexisting comorbidities, and medications. Fractures were considered if they appeared at least 6 months after treatment initiation. "Fractures while on treatment" were defined as those occurring among participants persisting for at least 6 months and with an overall high compliance (medication possession ratio ≥80%). Fine and Gray survival models accounting for competing risk with therapy discontinuation were fitted to identify key predictors. Only 7449 of 21,385 (34.8%) participants completed >6 months of therapy. Incidence of fracture while on treatment was 3.4/100 person-years (95% confidence interval [CI], 3.1-3.7). Predictors of these among patients persisting and adhering to treatment included: older age (subhazard ratio [SHR] for 60 to <80 years, 2.18 [95% CI, 1.70-2.80]; for ≥80 years, 2.5 [95% CI, 1.82-3.43]); previous fracture (1.75 [95% CI, 1.39-2.20] and 2.49 [95% CI, 1.98-3.13], in the last 6 months and longer, respectively); underweight, 2.11 (95% CI, 1.14-3.92); inflammatory arthritis, 1.46 (95% CI, 1.02-2.10); use of proton pump inhibitors (PPIs), 1.22 (95% CI, 1.02-1.46); and vitamin D deficiency, 2.69 (95% CI, 1.27-5.72). Even among high compliers, 3.4% of oral BP users will fracture every year. Older age, underweight, vitamin D deficiency, PPI use, previous fracture, and inflammatory arthritides increase risk. Monitoring strategies and/or alternative therapies should be considered for these patients. © 2014 American Society for Bone and Mineral Research.

Contributors to secondary osteoporosis and metabolic bone diseases in patients presenting with a clinical fracture.

PubMed

Bours, Sandrine P G; van Geel, Tineke A C M; Geusens, Piet P M M; Janssen, Marcel J W; Janzing, Heinrich M J; Hoffland, Ge A; Willems, Paul C; van den Bergh, Joop P W

2011-05-01

Previously undetected contributors to secondary osteoporosis and metabolic bone diseases (SECOB) are frequently found in patients with osteoporosis, but the prevalence in patients at the time they present with a clinical fracture is unknown. All consecutive patients with a recent clinical vertebral or nonvertebral fracture, who were able and willing to be investigated (n = 626: 482 women, 144 men, age range 50-97 yr) had bone mineral density and laboratory investigations (serum calcium, inorganic phosphate, 25-hydroxyvitamin D, creatinine, intact PTH, TSH, free T(4), serum and urine protein electrophoresis, and in men also serum testosterone). Known SECOB contributors were present in 23.0% of patients and newly diagnosed SECOB contributors in 26.5%: monoclonal proteinemia (14 of 626), renal insufficiency grade III or greater (54 of 626), primary (17 of 626) and secondary (64 of 626) hyperparathyroidism, hyperthyroidism (39 of 626), and hypogonadism in men (12 of 144). Newly diagnosed SECOBs, serum 25-hydroxyvitamin D less than 50 nmol/liter (in 63.9%), and dietary calcium intake less than 1200 mg/d (in 90.6%) were found at any age, in both sexes, after any fracture (except SECOB in men with finger and toe fractures) and at any level of bone mineral density. At presentation with a fracture, 26.5% of patients have previously unknown contributors to SECOB, which are treatable or need follow-up, and more than 90% of patients have an inadequate vitamin D status and/or calcium intake. Systematic screening of patients with a recent fracture identifies those in whom potentially reversible contributors to SECOB and calcium and vitamin D deficiency are present.

Applications of 3D orbital computer-assisted surgery (CAS).

PubMed

Scolozzi, P

2017-09-01

The purpose of the present report is to describe the indications for use of 3D orbital computer-assisted surgery (CAS). We analyzed the clinical and radiological data of all patients with orbital deformities treated using intra-operative navigation and CAD/CAM techniques at the Hôpitaux Universitaires de Genève, Switzerland, between 2009 and 2016. We recorded age and gender, orbital deformity, technical and surgical procedure and postoperative complications. One hundred and three patients were included. Mean age was 39.5years (range, 5 to 84years) and 85 (87.5%) were men. Of the 103 patients, 96 had intra-operative navigation (34 for primary and 3 for secondary orbito-zygomatic fractures, 15 for Le Fort fractures, 16 for orbital floor fractures, 10 for combined orbital floor and medial wall fractures, 7 for orbital medial wall fractures, 3 for NOE (naso-orbito-ethmoidal) fractures, 2 for isolated comminuted zygomatic arch fractures, 1 for enophthalmos, 3 for TMJ ankylosis and 2 for fibrous dysplasia bone recontouring), 8 patients had CAD/CAM PEEK-PSI for correction of residual orbital bone contour following craniomaxillofacial trauma, and 1 patient had CAD/CAM surgical splints and cutting guides for correction of orbital hypertelorism. Two patient (1.9%) required revision surgery for readjustment of an orbital mesh. The 1-year follow-up examination showed stable cosmetic and dimensional results in all patients. This study demonstrated that the application of 3D orbital CAS with regards to intra-operative navigation and CAD/CAM techniques allowed for a successful outcome in the patients presented in this series. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Effect of monthly high-dose vitamin D supplementation on falls and non-vertebral fractures: secondary and post-hoc outcomes from the randomised, double-blind, placebo-controlled ViDA trial.

PubMed

Khaw, Kay-Tee; Stewart, Alistair W; Waayer, Debbie; Lawes, Carlene M M; Toop, Les; Camargo, Carlos A; Scragg, Robert

2017-06-01

Adults with low concentrations of 25-hydroxyvitamin D (25[OH]D) in blood have an increased risk of falls and fractures, but randomised trials of vitamin D supplementation have had inconsistent results. We aimed to assess the effect of high-dose vitamin D supplementation on fractures and falls. The Vitamin D Assessment (ViDA) Study was a randomised, double-blind, placebo-controlled trial of healthy volunteers aged 50-84 years conducted at one centre in Auckland, New Zealand. Participants were randomly assigned to receive either an initial oral dose of 200 000 IU (5·0 mg) colecalciferol (vitamin D 3 ) followed by monthly 100 000 IU (2·5 mg) colecalciferol or equivalent placebo dosing. The prespecified primary outcome was cardiovascular disease and secondary outcomes were respiratory illness and fractures. Here, we report secondary outcome data for fractures and post-hoc outcome data for falls. Cox proportional hazards models were used to estimate hazard ratios (HRs) for time to first fracture or time to first fall in individuals allocated vitamin D compared with placebo. The analysis of fractures included all participants who gave consent and was by intention-to-treat; the analysis of falls included all individuals who returned one or more questionnaires. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000402943. Between April 5, 2011, and Nov 6, 2012, 5110 participants were recruited and randomly assigned either colecalciferol (n=2558) or placebo (n=2552). Two participants allocated placebo withdrew consent after randomisation; thus, a total of 5108 individuals were included in the analysis of fractures. The mean age of participants was 65·9 years (SD 8·3) and 2971 (58%) were men. The mean concentration of 25(OH)D in blood was 63 nmol/L (SD 24) at baseline, with 1534 (30%) having 25(OH)D concentrations lower than 50 nmol/L. Follow-up was until July 31, 2015, with a mean treatment duration of 3·4 years (SD 0·4, range 2·5-4·2). During follow-up, 2638 participants reported having a fall, 1312 (52%) of 2539 in the vitamin D group compared with 1326 (53%) of 2517 in the placebo group. The HR for falls-adjusted for age, sex, ethnic origin, history of recent fall, physical activity, and baseline 25(OH)D-was 0·99 (95% CI 0·92-1·07; p=0·82) for vitamin D compared with placebo. Non-vertebral fractures were reported in 292 individuals, 156 (6%) of 2558 in the vitamin D group and 136 (5%) of 2550 in the placebo group. The adjusted HR for fractures was 1·19 (95% CI 0·94-1·50; p=0·15) for vitamin D compared with placebo. 123 (2%) people died during the trial, 65 assigned vitamin D and 58 allocated placebo; the difference between treatment groups was not significant. High-dose bolus vitamin D supplementation of 100 000 IU colecalciferol monthly over 2·5-4·2 years did not prevent falls or fractures in this healthy, ambulatory, adult population. Further research is needed to ascertain the effects of daily vitamin D dosing, with or without calcium. Health Research Council of New Zealand and Accident Compensation Corporation of New Zealand. Copyright © 2017 Elsevier Ltd. All rights reserved.

FracPaQ: a MATLAB™ toolbox for the quantification of fracture patterns

NASA Astrophysics Data System (ADS)

Healy, David; Rizzo, Roberto; Farrell, Natalie; Watkins, Hannah; Cornwell, David; Gomez-Rivas, Enrique; Timms, Nick

2017-04-01

The patterns of fractures in deformed rocks are rarely uniform or random. Fracture orientations, sizes, shapes and spatial distributions often exhibit some kind of order. In detail, there may be relationships among the different fracture attributes e.g. small fractures dominated by one orientation, larger fractures by another. These relationships are important because the mechanical (e.g. strength, anisotropy) and transport (e.g. fluids, heat) properties of rock depend on these fracture patterns and fracture attributes. This presentation describes an open source toolbox to quantify fracture patterns, including distributions in fracture attributes and their spatial variation. Software has been developed to quantify fracture patterns from 2-D digital images, such as thin section micrographs, geological maps, outcrop or aerial photographs or satellite images. The toolbox comprises a suite of MATLAB™ scripts based on published quantitative methods for the analysis of fracture attributes: orientations, lengths, intensity, density and connectivity. An estimate of permeability in 2-D is made using a parallel plate model. The software provides an objective and consistent methodology for quantifying fracture patterns and their variations in 2-D across a wide range of length scales. Our current focus for the application of the software is on quantifying crack and fracture patterns in and around fault zones. There is a large body of published work on the quantification of relatively simple joint patterns, but fault zones present a bigger, and arguably more important, challenge. The methods presented are inherently scale independent, and a key task will be to analyse and integrate quantitative fracture pattern data from micro- to macro-scales. New features in this release include multi-scale analyses based on a wavelet method to look for scale transitions, support for multi-colour traces in the input file processed as separate fracture sets, and combining fracture traces from multiple 2-D images to derive the statistically equivalent 3-D fracture pattern expressed as a 2nd rank crack tensor.

Mortality and Readmissions After Cervical Fractures From Falls In Older Adults: A Comparison To Hip Fractures Using National Medicare Data

PubMed Central

Cooper, Zara; Mitchell, Susan L.; Lipsitz, Stuart; Ayanian, John Z.; Bernacki, Rachelle E.; Harris, Mitchel B.; Jha, Ashish K.

2015-01-01

Background Cervical fractures from falls are a potentially lethal injury in older patients. Little is known about their epidemiology and outcomes. Objectives To examine the prevalence of cervical spine fractures after falls among older Americans and show changes in recent years. Further, to compare 12-month outcomes in patients with cervical and hip fracture after falls. Design, Setting, and Participants A retrospective study of Medicare data from 2007–2011 including patients ≥65 with cervical fracture and hip fracture after falls treated at acute care hospitals. Measurements Rates of cervical fracture, 12-month mortality and readmission rates after injury. Results Rates of cervical fracture increased from 4.6/10,000 in 2007 to 5.3/10,000 in 2011, whereas rates of hip fracture decreased from 77.3/10,000 in 2007 to 63.5/10,000 in 2011. Patients with cervical fracture without and with spinal cord injury (SCI) were more likely than patients with hip fracture, respectively, to receive treatment at large hospitals (54.1%, 59.4% vs. 28.1%, p< 0.001), teaching hospitals (40.0%, 49.3% vs. 13.4%, p< 0.001), and regional trauma centers (38.5%, 46.3% vs. 13.0%, p< 0.001). Patients with cervical fracture, particularly those with SCI, had higher risk-adjusted mortality rates at one year than those with hip fracture (24.5%, 41.7% vs. 22.7%, p<0.001). By one year, more than half of patients with cervical and hip fracture died or were readmitted to the hospital (59.5%, 73.4% vs. 59.3%, p<0.001). Conclusion Cervical spine fractures occur in one of every 2,000 Medicare beneficiaries annually and appear to be increasing over time. Patients with cervical fractures had higher mortality than those with hip fractures. Given the increasing prevalence and the poor outcomes of this population, hospitals need to develop processes to improve care for these vulnerable patients. PMID:26456855

Multitasking 3-D forward modeling using high-order finite difference methods on the Cray X-MP/416

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

Terki-Hassaine, O.; Leiss, E.L.

1988-01-01

The CRAY X-MP/416 was used to multitask 3-D forward modeling by the high-order finite difference method. Flowtrace analysis reveals that the most expensive operation in the unitasked program is a matrix vector multiplication. The in-core and out-of-core versions of a reentrant subroutine can perform any fraction of the matrix vector multiplication independently, a pattern compatible with multitasking. The matrix vector multiplication routine can be distributed over two to four processors. The rest of the program utilizes the microtasking feature that lets the system treat independent iterations of DO-loops as subtasks to be performed by any available processor. The availability ofmore » the Solid-State Storage Device (SSD) meant the I/O wait time was virtually zero. A performance study determined a theoretical speedup, taking into account the multitasking overhead. Multitasking programs utilizing both macrotasking and microtasking features obtained actual speedups that were approximately 80% of the ideal speedup.« less

Multiphase fluid-solid coupled analysis of shock-bubble-stone interaction in shockwave lithotripsy.

PubMed

Wang, Kevin G

2017-10-01

A novel multiphase fluid-solid-coupled computational framework is applied to investigate the interaction of a kidney stone immersed in liquid with a lithotripsy shock wave (LSW) and a gas bubble near the stone. The main objective is to elucidate the effects of a bubble in the shock path to the elastic and fracture behaviors of the stone. The computational framework couples a finite volume 2-phase computational fluid dynamics solver with a finite element computational solid dynamics solver. The surface of the stone is represented as a dynamic embedded boundary in the computational fluid dynamics solver. The evolution of the bubble surface is captured by solving the level set equation. The interface conditions at the surfaces of the stone and the bubble are enforced through the construction and solution of local fluid-solid and 2-fluid Riemann problems. This computational framework is first verified for 3 example problems including a 1D multimaterial Riemann problem, a 3D shock-stone interaction problem, and a 3D shock-bubble interaction problem. Next, a series of shock-bubble-stone-coupled simulations are presented. This study suggests that the dynamic response of a bubble to LSW varies dramatically depending on its initial size. Bubbles with an initial radius smaller than a threshold collapse within 1 μs after the passage of LSW, whereas larger bubbles do not. For a typical LSW generated by an electrohydraulic lithotripter (p max  = 35.0MPa, p min  =- 10.1MPa), this threshold is approximately 0.12mm. Moreover, this study suggests that a noncollapsing bubble imposes a negative effect on stone fracture as it shields part of the LSW from the stone. On the other hand, a collapsing bubble may promote fracture on the proximal surface of the stone, yet hinder fracture from stone interior. Copyright © 2016 John Wiley & Sons, Ltd.

49 CFR 195.111 - Fracture propagation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation. [Amdt. 195-45, 56 FR 26926, June 12, 1991] ...

49 CFR 195.111 - Fracture propagation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation. [Amdt. 195-45, 56 FR 26926, June 12, 1991] ...

49 CFR 195.111 - Fracture propagation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation. [Amdt. 195-45, 56 FR 26926, June 12, 1991] ...

49 CFR 195.111 - Fracture propagation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation. [Amdt. 195-45, 56 FR 26926, June 12, 1991] ...

49 CFR 195.111 - Fracture propagation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation. [Amdt. 195-45, 56 FR 26926, June 12, 1991] ...

A Preprocessor for Modeling Nonpoint Sources in Fractured Media using MODFLOW and MT3D

NASA Astrophysics Data System (ADS)

Mun, Y.; Uchrin, C. G.

2002-05-01

There are a multitude of fractures in the geological structure of fractured media which act as conduits for subsurface fluid flow. The hydraulic properties of this flow are very heterogeneous even within a single unit and this heterogeneity is very localized. As a result, modeling flow in fractured media is difficult due to this heterogeneity. There are two major approaches to simulate the flow and transport of fluid flow in fractured media: the discrete fracture approach and the continuum approach. Precise characteristics such as geometry are required to use the discrete fracture approach. It, however, is difficult to determine the fluid flow through the fractures because of inaccessibility. In the continuum approach, although head distributions can match to well data, chemical concentration distributions are hard to match well sample concentration observations, because some aquifers are dominated by advective transport and others are likely to serve as reservoirs for immobile solutes. The MODFLOW preprocessor described in this paper has been developed and applied to the Cranberry Lake system in Northwestern New Jersey. Cranberry Lake has exhibited eutrophic characteristics for some time by nonpoint sources including surface water runoff, leaching from local septic systems and direct deposition. It has been estimated that 70% of the nutrient loading to the lake flows through fractured media from septic systems. The preprocessor presented in this paper utilizes percolation theory, which is concerned with the existence of ­ropen paths­_. The percolation threshold of a body-centered cubic lattice (3D), a square lattice (2D) and several other percolation numbers are applied to make the model system represent the fractured media. The distribution of hydraulic head within groundwater is simulated by MODFLOW and the advection-dispersion equation of nitrate transport is solved by MT3D. This study also simulates boron transport as an indicator.

Application of an innovative computerized virtual planning system in acetabular fracture surgery: A feasibility study.

PubMed

Wang, Huixiang; Wang, Fang; Newman, Simon; Lin, Yanping; Chen, Xiaojun; Xu, Lu; Wang, Qiugen

2016-08-01

Acetabular fracture surgery is amongst the most challenging tasks in the field of trauma surgery and careful preoperative planning is crucial for success. The aim of this paper is to describe the preliminary outcome of the utilization of an innovative computerized virtual planning system for acetabular fractures. 3D models of acetabular fractures and surrounding soft tissues from six patients were constructed from preoperative CT scans. A novel highly-automatic segmentation technique was performed on the 3D model to separate each fracture fragment, then 3D virtual reduction was performed. Additionally, the models were used to assess potential surgical approaches with reference to both the fracture and the surrounding soft tissues. The time required for virtual planning was recorded. After surgery, the virtual plan was compared to the real surgery with respect to surgical approach and reduction sequence. A Likert scale questionnaire was completed by the surgeons to evaluate their satisfaction with the system. Virtual planning was successfully completed in all cases. The planned surgical approach was followed in all cases with the planned reduction sequence followed completely in five cases and partially in one. The mean time required for virtual planning was 38.7min (range 21-57, SD=15.5). The mean time required for planning of B-type fractures was 25.0min (range 21-30, SD=4.6), of C-type fracture 52.3min (range 49-57, SD=4.2). The results of the questionnaire demonstrated a high level of satisfaction with the planning system. This study demonstrates that the virtual planning system is feasible in clinical settings with high satisfaction and acceptability from the surgeons. It provides a viable option for the planning of acetabular fracture surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Early results of proximal femoral fractures treated with FENIX modular hemiarthroplasty].

PubMed

Görski, Radosław; Górecki, Andrzej; Olszewski, Paweł; Biedrzycki, Jerzy; Skowronek, Paweł

2010-01-01

The article discusses preliminary clinical results in patients with proximal femoral fractures treated with hemiarthroplasty using a FENIX implant. The study group comprised 41 subjects aged 69 to 97 (median age 82.3 year). The follow-up study provided data on 26 subjects (63.4%), among which 15 attended the check-up, 5 subjects refused to visit at the Department and 6 subjects were reported as deceased. Median follow-up period amounted to 6.8 month (1 to 22 months). General hospitalization-related complications occurred in 8 patients (19.5%). During hospitalization no deaths occurred, in the deceased group 3 patients died within 12 months after surgery, while another 3 died after the twelve-month postoperative period (median of 13.3%). According to Merle d'Aubigne-Postel score favorable long-term results were observed in 9 patients (59.9%), 13 patients regained the level of motor function similar to the functional ability prior to fracture. The need to postpone the surgery due to general health status and impaired pre-operative motor function are significant negative prognostic factors. The results obtained were compared with previous efficacy studies on femoral fracture treatment using an Austin-Moore implant. Functional ability and self-reliance was higher in the FENIX group. FENIX arthroplasty effectively helps patients regain self-reliance and motor function thanks to its modular characteristics and anatmoical construction.

Vitamin D Insufficiency Among Professional Basketball Players: A Relationship to Fracture Risk and Athletic Performance

PubMed Central

Grieshober, Jason A.; Mehran, Nima; Photopolous, Christos; Fishman, Matthew; Lombardo, Stephen J.; Kharrazi, F. Daniel

2018-01-01

Background: Vitamin D is believed to play a role in influencing fracture risk and athletic performance. Insufficiency of vitamin D affects an estimated three-quarters of the United States population. Hypovitaminosis D has also been demonstrated to be quite common among professional basketball players in the National Basketball Association (NBA). Purpose: To determine whether a relationship exists between vitamin D levels and fracture risk and athletic performance (as measured by NBA draft status) among elite basketball players. Study Design: Descriptive epidemiology study. Methods: Data were obtained from the NBA regarding combine participants from 2009 through 2013. This information included vitamin D level, demographic information, fracture history, and NBA draft status. The data were analyzed to determine associations between vitamin D level and fracture risk and NBA draft status. Results: Vitamin D levels were measured for 279 players at the NBA Combine from 2009 through 2013. Vitamin D deficiency (<20 ng/mL) was seen in 32.3% of athletes, vitamin D insufficiency (20-30 ng/mL) was seen in 41.2%, and sufficient levels of vitamin D (>30 ng/mL) were present in only 26.5%. A total of 118 players had a history of at least 1 fracture. Vitamin D level was not predictive of fracture risk. Contrary to our hypothesis, players with a history of stress fracture had a significantly greater mean vitamin D level than those without such history (30.7 vs 25.1 ng/mL; P = .04). A majority (79.6%) of participants were selected in the NBA draft. Players with deficient vitamin D levels had a significantly lower rate of being drafted into the NBA (P = .027). The NBA draft rate was found to increase with increasing levels of vitamin D (P = .007). Conclusion: Hypovitaminosis D is quite common among NBA Combine participants, affecting 73.5%. While no significant relationship was found between vitamin D level and fracture history, patients with a history of stress fracture had significantly greater mean vitamin D levels. Additionally, participants with greater vitamin D levels were more likely to be drafted into the NBA. This information supports the potential role of vitamin D in influencing athletic performance. PMID:29845086

Celiac disease is not increased in women with hip fractures and low vitamin D levels.

PubMed

Leboff, M S; Cobb, H; Gao, L Y; Hawkes, W; Yu-Yahiro, J; Kolatkar, N S; Magaziner, J

2013-01-01

Celiac disease is associated with decreased bone density; however, the risk of fractures in celiac disease patients is unclear. We compared the prevalence of celiac disease between a group of women with hip fractures and a group of women undergoing elective joint replacement surgery and the association between celiac disease and vitamin D levels. Two hundred eight community dwelling and postmenopausal women were recruited from Boston, MA (n=81) and Baltimore, MD (n=127). We measured tissue transglutaminase IgA by ELISA to diagnose celiac disease and 25-hydroxyvitamin D (25(OH)D) levels by radioimmunoassay in both women with hip fractures (n=157) and a control group (n=51) of total hip replacement subjects from Boston. Subjects were excluded if they took any medications or had medical conditions that might affect bone. Median serum 25(OH)D levels were significantly lower (p< 0.0001) in the hip fracture cohorts compared to the elective joint replacement cohort (14.1 ng/ml vs. 21.3 ng/ml, respectively). There were no differences in the percentage of subjects with a positive tissue transglutaminase in the women with hip fractures versus the control group (1.91% vs. 1.96%, respectively). Vitamin D levels are markedly reduced in women with hip fractures, however hip fracture patients did not show a higher percentage of positive tissue transglutaminase levels compared with controls. These data suggest that routine testing for celiac disease among hip fracture patients may not be necessary in the absence of clinical signs and symptoms, although data from larger studies among hip fracture subjects are needed.

Recent Advances in Clinical Natural Language Processing in Support of Semantic Analysis.

PubMed

Velupillai, S; Mowery, D; South, B R; Kvist, M; Dalianis, H

2015-08-13

We present a review of recent advances in clinical Natural Language Processing (NLP), with a focus on semantic analysis and key subtasks that support such analysis. We conducted a literature review of clinical NLP research from 2008 to 2014, emphasizing recent publications (2012-2014), based on PubMed and ACL proceedings as well as relevant referenced publications from the included papers. Significant articles published within this time-span were included and are discussed from the perspective of semantic analysis. Three key clinical NLP subtasks that enable such analysis were identified: 1) developing more efficient methods for corpus creation (annotation and de-identification), 2) generating building blocks for extracting meaning (morphological, syntactic, and semantic subtasks), and 3) leveraging NLP for clinical utility (NLP applications and infrastructure for clinical use cases). Finally, we provide a reflection upon most recent developments and potential areas of future NLP development and applications. There has been an increase of advances within key NLP subtasks that support semantic analysis. Performance of NLP semantic analysis is, in many cases, close to that of agreement between humans. The creation and release of corpora annotated with complex semantic information models has greatly supported the development of new tools and approaches. Research on non-English languages is continuously growing. NLP methods have sometimes been successfully employed in real-world clinical tasks. However, there is still a gap between the development of advanced resources and their utilization in clinical settings. A plethora of new clinical use cases are emerging due to established health care initiatives and additional patient-generated sources through the extensive use of social media and other devices.

Recent Advances in Clinical Natural Language Processing in Support of Semantic Analysis

PubMed Central

Mowery, D.; South, B. R.; Kvist, M.; Dalianis, H.

2015-01-01

Summary Objectives We present a review of recent advances in clinical Natural Language Processing (NLP), with a focus on semantic analysis and key subtasks that support such analysis. Methods We conducted a literature review of clinical NLP research from 2008 to 2014, emphasizing recent publications (2012-2014), based on PubMed and ACL proceedings as well as relevant referenced publications from the included papers. Results Significant articles published within this time-span were included and are discussed from the perspective of semantic analysis. Three key clinical NLP subtasks that enable such analysis were identified: 1) developing more efficient methods for corpus creation (annotation and de-identification), 2) generating building blocks for extracting meaning (morphological, syntactic, and semantic subtasks), and 3) leveraging NLP for clinical utility (NLP applications and infrastructure for clinical use cases). Finally, we provide a reflection upon most recent developments and potential areas of future NLP development and applications. Conclusions There has been an increase of advances within key NLP subtasks that support semantic analysis. Performance of NLP semantic analysis is, in many cases, close to that of agreement between humans. The creation and release of corpora annotated with complex semantic information models has greatly supported the development of new tools and approaches. Research on non-English languages is continuously growing. NLP methods have sometimes been successfully employed in real-world clinical tasks. However, there is still a gap between the development of advanced resources and their utilization in clinical settings. A plethora of new clinical use cases are emerging due to established health care initiatives and additional patient-generated sources through the extensive use of social media and other devices. PMID:26293867

[Application of three-dimensional printing technology in treatment of internal or external ankle distal avulsed fracture].

PubMed

Shi, Weixiang; Luo, Xiaozhong; Wu, Gang; Ding, Yong; Zhou, Xin

2018-02-01

To explore the effectiveness and advantage of three-dimensional (3D) printing technology in treatment of internal or external ankle distal avulsed fracture. Between January 2015 and January 2017, 20 patients with distal avulsed fracture of internal or external ankle were treated with the 3D guidance of shape-blocking steel plate fixation (group A), and 18 patients were treated with traditional plaster external fixation (group B). There was no significant difference in gender, age, injury cause, disease duration, fracture side, and fracture type between 2 groups ( P >0.05). Recording the fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, residual ankle pain, and evaluating ankle function recovery of both groups by the American Orthopaedic Foot and Ankle Society (AOFAS) score. All patients were followed up 8-24 months, with an average of 15.5 months. In group A: all incisions healed by first intention, the time of starting to ankle functional exercise was (14±3) days, fracture healing rate was 100%, and the fracture healing time was (10.15±2.00) weeks. At 6 months, the AOFAS score was 90.35±4.65. Among them, 13 patients were excellent and 7 patients were good. All patients had no post-operative incision infection, residual ankle pain, or dysfunction during the follow-up. In group B: the time of starting to ankle functional exercise was (40±10) days, the fracture healing rate was 94.44%, and the fracture healing time was (13.83±7.49) weeks. At 6 months, the AOFAS score was 79.28±34.28. Among them, 15 patients were good, 2 patients were medium, and 1 patient was poor. During the follow-up, 3 patients (16.67%) had pain of ankle joint with different degrees. There were significant differences in the postoperative fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, and postoperative AOFAS score between 2 groups ( P <0.05). Application of 3D printing technology in treatment of internal or external ankle distal avulsed fracture is simple, safe, reliable, and effective. In particular, it is an ideal treatment for avulsed fracture.

Comprehensive nutritional status in sarco-osteoporotic older fallers.

PubMed

Huo, Y R; Suriyaarachchi, P; Gomez, F; Curcio, C L; Boersma, D; Gunawardene, P; Demontiero, O; Duque, G

2015-04-01

In older persons, the combination of osteoporosis and sarcopenia has been proposed as a subset of frailer individuals at higher risk of falls and fractures. However, the particular nutritional status of the sarco-osteoporotic (SOP) patients remains unknown. The goal of this study was to obtain a comprehensive picture of nutritional status in SOP patients. Cross-sectional study. Falls and Fractures Clinic, Nepean Hospital (Penrith, Australia). 680 subjects (mean age=79, 65% female) assessed between 2008-2013. Assessment included medical history, mini-nutritional assessment, physical examination, bone densitometry and body composition by DXA, and blood tests for nutritional status (albumin, creatinine, hemoglobin, vitamin D, vitamin B-12, calcium, phosphate and folate). Patients were divided in 4 groups: 1) osteopenia/osteoporosis (BMD<-1.0 SD); 2) sarcopenia; 3) SOP; and 4) normal (no sarcopenia/no osteoporosis). Difference between groups was assessed with one-way ANOVA and chi square analysis. Multivariable linear regression evaluated the association between the groups and measures of nutritional parameters. Sarcopenia was present in 47.4% of those with osteopenia (167/352) and 62.7% in those with osteoporosis (91/145). Mean age of the SOP was 80.4±7 years. SOP patients showed significantly higher prevalence of falls and fractures. Univariate analyses showed that SOP were more likely than normal to have a BMI< 25 (OR 2.42 95%CI 1.45-4.041, p<0.001), a MNA score <12 (OR 2.0, 95%CI 1.15-3.49, p<0.05), serum folate <20 nmol/L (OR 4.0 95%CI 1.35-11.87, p<0.01) and hemoglobin <120g/L (OR 2.0 95%CI 1.28-3.30, p<0.01). Multivariate analysis showed that a MNA score <12 was independently associated with SOP compared to normal when adjusted for age and gender. Hemoglobin <120g/L, BMI <25, and GDS >6 remained independently associated with SOP after adjustment for all variables including inflammatory conditions. Hypoalbuminemia (<35 g/L) was associated with just osteopenia/osteoporosis (OR: 2.03, 95%CI 1.08-3.81, p<0.01) and just sarcopenia (OR: 1.77, 95%CI 1.0-3.0, p<0.01) compared to normal. No differences in vitamin D, glomerular filtration rate, albumin, corrected calcium, phosphate, red blood cells folate or vitamin B12 levels were found between the subgroups. In approaching SOP patients, early prevention protocols directed to optimize their nutritional status would be a key strategy to prevent poor outcomes such as falls and fractures in this high risk population. Therefore, nutritional assessment and early nutritional supplementation should be essential domains in this strategy.

Optimizing the Terzaghi Estimator of the 3D Distribution of Rock Fracture Orientations

NASA Astrophysics Data System (ADS)

Tang, Huiming; Huang, Lei; Juang, C. Hsein; Zhang, Junrong

2017-08-01

Orientation statistics are prone to bias when surveyed with the scanline mapping technique in which the observed probabilities differ, depending on the intersection angle between the fracture and the scanline. This bias leads to 1D frequency statistical data that are poorly representative of the 3D distribution. A widely accessible estimator named after Terzaghi was developed to estimate 3D frequencies from 1D biased observations, but the estimation accuracy is limited for fractures at narrow intersection angles to scanlines (termed the blind zone). Although numerous works have concentrated on accuracy with respect to the blind zone, accuracy outside the blind zone has rarely been studied. This work contributes to the limited investigations of accuracy outside the blind zone through a qualitative assessment that deploys a mathematical derivation of the Terzaghi equation in conjunction with a quantitative evaluation that uses fractures simulation and verification of natural fractures. The results show that the estimator does not provide a precise estimate of 3D distributions and that the estimation accuracy is correlated with the grid size adopted by the estimator. To explore the potential for improving accuracy, the particular grid size producing maximum accuracy is identified from 168 combinations of grid sizes and two other parameters. The results demonstrate that the 2° × 2° grid size provides maximum accuracy for the estimator in most cases when applied outside the blind zone. However, if the global sample density exceeds 0.5°-2, then maximum accuracy occurs at a grid size of 1° × 1°.

Smart roadside initiative gap analysis : trucking technology utilization.

DOT National Transportation Integrated Search

2014-04-01

This technical memorandum synthesizes and summarizes the American Transportation Research Institutes (ATRI) findings for Subtask 2.3 of the Smart Roadside Initiative (SRI) Gap Analysis. As part of this task, ATRI: 1. completed a technical literatu...

Numerical Analysis of AHSS Fracture in a Stretch-bending Test

NASA Astrophysics Data System (ADS)

Luo, Meng; Chen, Xiaoming; Shi, Ming F.; Shih, Hua-Chu

2010-06-01

Advanced High Strength Steels (AHSS) are increasingly used in the automotive industry due to their superior strength and substantial weight reduction advantage. However, their limited ductility gives rise to numerous manufacturing issues. One of them is the so-called `shear fracture' often observed on tight radii during stamping processes. Since traditional approaches, such as the Forming Limit Diagram (FLD), are unable to predict this type of fracture, efforts have been made to develop failure criteria that can predict shear fractures. In this paper, a recently developed Modified Mohr-Coulomb (MMC) ductile fracture criterion[1] is adopted to analyze the failure behavior of a Dual Phase (DP) steel sheet during stretch bending operations. The plasticity and ductile fracture of the present sheet are fully characterized by the Hill'48 orthotropic model and the MMC fracture model respectively. Finite Element models with three different element types (3D, shell and plane strain) were built for a Stretch Forming Simulator (SFS) test and numerical simulations with four different R/t ratios (die radius normalized by sheet thickness) were performed. It has been shown that the 3D and shell element models can accurately predict the failure location/mode, the upper die load-displacement responses as well as the wall stress and wrap angle at the onset of fracture for all R/t ratios. Furthermore, a series of parametric studies were conducted on the 3D element model, and the effects of tension level (clamping distance) and tooling friction on the failure modes/locations were investigated.

Modem transmission of data for 3D fracture modeling

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

Chaudhary, S.A.; Rodgerson, J.L.; Martinez, A.D.

1996-06-01

Hydraulic fracturing treatments require measurement of numerous parameters, including surface rates and pressures, to quantify fluids, proppant, and additives. Computers are used to acquire data for the purpose of calculating bottomhole pressure (BHP), compiling quality-control data, generating diagnostic plots, and, often, for modeling fracture geometry in real time. In the recent past, modems have been routinely used in conjunction with cellular phone systems to transmit field-monitored data to a remote office. More recently, these data have been used at the remote site to perform 3D fracture modeling for design verification and adjustment. This paper describes data-transmission technology and discusses themore » related cost and reliability.« less

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

Baker, Scott E.; Bruno, Kenneth S.; Butcher, Mark G.

In 2009, we continued to address barriers to fungal fermentation in the primary areas of morphology control, genomics, proteomics, fungal hyperproductivity, biomass-to-products via fungal based consolidated bioprocesses, and filamentous fungal ethanol. “Alternative renewable fuels from fungi” was added as a new subtask. Plans were also made to launch a new advanced strain development subtask in FY2010.

Strategic adaptation to performance objectives in a dual-task setting.

PubMed

Janssen, Christian P; Brumby, Duncan P

2010-11-01

How do people interleave attention when multitasking? One dominant account is that the completion of a subtask serves as a cue to switch tasks. But what happens if switching solely at subtask boundaries led to poor performance? We report a study in which participants manually dialed a UK-style telephone number while driving a simulated vehicle. If the driver were to exclusively return his or her attention to driving after completing a subtask (i.e., using the single break in the xxxxx-xxxxxx representational structure of the number), then we would expect to see a relatively poor driving performance. In contrast, our results show that drivers choose to return attention to steering control before the natural subtask boundary. A computational modeling analysis shows that drivers had to adopt this strategy to meet the required performance objective of maintaining an acceptable lateral position in the road while dialing. Taken together these results support the idea that people can strategically control the allocation of attention in multitask settings to meet specific performance criteria. Copyright © 2010 Cognitive Science Society, Inc.

Adhesion at Entangled Polymer Interfaces: A Unified Approach..

NASA Astrophysics Data System (ADS)

Wool, Richard

2006-03-01

A unified theory of fracture of polymer interfaces was developed which was based on the Rigidity Percolation model of fracture [R.P. Wool, J.Polym.Sci. Part A: Polym Phys., 43,168(2005)]. The polymer fractured critically when the normalized entanglement density p, approached the percolation threshold pc. The fracture energy was found to be G1c ˜ [p-pc]. When applied to interfaces of width X, containing an areal density σ of chains, each contributing L chain entanglements, the percolation term p ˜ σL/X and the percolation threshold was related to σc, Lc, or Xc. For welding of A/A symmetric interfaces, p = σL/X, and pc Lc/M 0, such that when σ/X ˜1/M for randomly distributed chain ends, p˜L ˜ (t/M)^1/2, G/G* = (t/τ*)^1/2, where the weld time τ* ˜ M. When the chain ends are segregated to the surface, σ is constant with time and G/G* = [t/τ*]^1/4. For sub-Tg welding, there exists a surface mobile layer (due to the critical Lindemann Atom fraction) of depth X ˜ 1/δT^ν such that G ˜ δT-2ν, where the critical exponent v = 0.8. For incompatible A/B interfaces of Helfand width d, normalized width w = d/Rge, and entanglement density Nent ˜ d/Le, p ˜ d such that, G1c ˜ [d-dc], G1c ˜ [w-1], and G ˜ [Nent-Nc]. For incompatible A/B interfaces reinforced by an areal density σ of compatibilizer chains, L and X are constant, p ˜ σ, pc ˜σc, such that G1c ˜ [σ-σc], which is in excellent agreement with experimental data.

Defining hip fracture with claims data: outpatient and provider claims matter.

PubMed

Berry, S D; Zullo, A R; McConeghy, K; Lee, Y; Daiello, L; Kiel, D P

2017-07-01

Medicare claims are commonly used to identify hip fractures, but there is no universally accepted definition. We found that a definition using inpatient claims identified fewer fractures than a definition including outpatient and provider claims. Few additional fractures were identified by including inconsistent diagnostic and procedural codes at contiguous sites. Medicare claims data is commonly used in research studies to identify hip fractures, but there is no universally accepted definition of fracture. Our purpose was to describe potential misclassification when hip fractures are defined using Medicare Part A (inpatient) claims without considering Part B (outpatient and provider) claims and when inconsistent diagnostic and procedural codes occur at contiguous fracture sites (e.g., femoral shaft or pelvic). Participants included all long-stay nursing home residents enrolled in Medicare Parts A and B fee-for-service between 1/1/2008 and 12/31/2009 with follow-up through 12/31/2011. We compared the number of hip fractures identified using only Part A claims to (1) Part A plus Part B claims and (2) Part A and Part B claims plus discordant codes at contiguous fracture sites. Among 1,257,279 long-stay residents, 40,932 (3.2%) met the definition of hip fracture using Part A claims, and 41,687 residents (3.3%) met the definition using Part B claims. 4566 hip fractures identified using Part B claims would not have been captured using Part A claims. An additional 227 hip fractures were identified after considering contiguous fracture sites. When ascertaining hip fractures, a definition using outpatient and provider claims identified 11% more fractures than a definition with only inpatient claims. Future studies should publish their definition of fracture and specify if diagnostic codes from contiguous fracture sites were used.

Fracture resistance and marginal discrepancy of porcelain laminate veneers influenced by preparation design and restorative material in vitro.

PubMed

Lin, Tai-Min; Liu, Perng-Ru; Ramp, Lance C; Essig, Milton E; Givan, Daniel A; Pan, Yu-Hwa

2012-03-01

The purpose of this investigation is to evaluate marginal discrepancy and fracture resistance of two veneering materials using two preparation designs. Two veneer preparation designs (full and traditional) were restored with leucite-reinforced ceramic (ProCAD, Ivoclar Vivadent, Amherst, NY) milled by CAD/CAM (Cerec 3D milling system, Serona Dental Systems), and conventional sintered feldspathic porcelain (Noritake Super Porcelain EX3, Noritake Dental Supply Co). Forty-eight specimens were analysed with a sample size of n=12 per group. The thickness of each veneer was measured on four specific surfaces. Marginal discrepancy was evaluated with a replica technique and cross-sectional view using a digital microscope. The fracture resistance of veneers cemented on standardised composite resin dies was evaluated using a universal testing machine. Results were analysed with ANOVA, Tukey-Kramer post hoc testing, and linear regression. The results of this investigation revealed no correlation between the thickness and marginal discrepancy of the veneers. The full preparation design with ProCAD and the traditional preparation design with feldspathic porcelain manifested smaller gap. Fracture resistance was decreased for the full preparation design with feldspathic porcelain. In terms of marginal discrepancy and fracture resistance, the most favourable combination was a traditional veneer preparation design with conventional sintered feldspathic porcelain. For the full veneer preparation, a stronger ceramic material such as ProCAD is suggested. Published by Elsevier Ltd.

Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2018-04-17

Because of the aging population, osteoporotic fractures are an increasingly important cause of morbidity and mortality in the United States. Approximately 2 million osteoporotic fractures occurred in the United States in 2005, and annual incidence is projected to increase to more than 3 million fractures by 2025. Within 1 year of experiencing a hip fracture, many patients are unable to walk independently, more than half require assistance with activities of daily living, and 20% to 30% of patients will die. To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on vitamin D supplementation, with or without calcium, to prevent fractures. The USPSTF reviewed the evidence on vitamin D, calcium, and combined supplementation for the primary prevention of fractures in community-dwelling adults (defined as not living in a nursing home or other institutional care setting). The review excluded studies conducted in populations with a known disorder related to bone metabolism (eg, osteoporosis or vitamin D deficiency), taking medications known to be associated with osteoporosis (eg, long-term steroids), or with a previous fracture. The USPSTF found inadequate evidence to estimate the benefits of vitamin D, calcium, or combined supplementation to prevent fractures in community-dwelling men and premenopausal women. The USPSTF found adequate evidence that daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of calcium has no benefit for the primary prevention of fractures in community-dwelling, postmenopausal women. The USPSTF found inadequate evidence to estimate the benefits of doses greater than 400 IU of vitamin D or greater than 1000 mg of calcium to prevent fractures in community-dwelling postmenopausal women. The USPSTF found adequate evidence that supplementation with vitamin D and calcium increases the incidence of kidney stones. The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of vitamin D and calcium supplementation, alone or combined, for the primary prevention of fractures in community-dwelling, asymptomatic men and premenopausal women. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of daily supplementation with doses greater than 400 IU of vitamin D and greater than 1000 mg of calcium for the primary prevention of fractures in community-dwelling, postmenopausal women. (I statement) The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of calcium for the primary prevention of fractures in community-dwelling, postmenopausal women. (D recommendation) These recommendations do not apply to persons with a history of osteoporotic fractures, increased risk for falls, or a diagnosis of osteoporosis or vitamin D deficiency.

Mineral crystal alignment in mineralized fracture callus determined by 3D small-angle X-ray scattering

NASA Astrophysics Data System (ADS)

Liu, Yifei; Manjubala, Inderchand; Roschger, Paul; Schell, Hanna; Duda, Georg N.; Fratzl, Peter

2010-10-01

Callus tissue formed during bone fracture healing is a mixture of different tissue types as revealed by histological analysis. But the structural characteristics of mineral crystals within the healing callus are not well known. Since two-dimensional (2D) scanning small-angle X-ray scattering (sSAXS) patterns showed that the size and orientation of callus crystals vary both spatially and temporally [1] and 2D electron microscopic analysis implies an anisotropic property of the callus morphology, the mineral crystals within the callus are also expected to vary in size and orientation in 3D. Three-dimensional small-angle X-ray scattering (3D SAXS), which combines 2D SAXS patterns collected at different angles of sample tilting, has been previously applied to investigate bone minerals in horse radius [2] and oim/oim mouse femur/tibia [3]. We implement a similar 3D SAXS method but with a different way of data analysis to gather information on the mineral alignment in fracture callus. With the proposed accurate yet fast assessment of 3D SAXS information, it was shown that the plate shaped mineral particles in the healing callus were aligned in groups with their predominant orientations occurring as a fiber texture.

The effect of a single early high-dose vitamin D supplement on fracture union in patients with hypovitaminosis D: a prospective randomised trial.

PubMed

Haines, N; Kempton, L B; Seymour, R B; Bosse, M J; Churchill, C; Hand, K; Hsu, J R; Keil, D; Kellam, J; Rozario, N; Sims, S; Karunakar, M A

2017-11-01

To evaluate the effect of a single early high-dose vitamin D supplement on fracture union in patients with hypovitaminosis D and a long bone fracture. Between July 2011 and August 2013, 113 adults with a long bone fracture were enrolled in a prospective randomised double-blind placebo-controlled trial. Their serum vitamin D levels were measured and a total of 100 patients were found to be vitamin D deficient (< 20 ng/ml) or insufficient (< 30 ng/mL). These were then randomised to receive a single dose of vitamin D 3 orally (100 000 IU) within two weeks of injury (treatment group, n = 50) or a placebo (control group, n = 50). We recorded patient demographics, fracture location and treatment, vitamin D level, time to fracture union and complications, including vitamin D toxicity. Outcomes included union, nonunion or complication requiring an early, unplanned secondary procedure. Patients without an outcome at 15 months and no scheduled follow-up were considered lost to follow-up. The t -test and cross tabulations verified the adequacy of randomisation. An intention-to-treat analysis was carried out. In all, 100 (89%) patients had hypovitaminosis D. Both treatment and control groups had similar demographics and injury characteristics. The initial median vitamin D levels were 16 ng/mL (interquartile range 5 to 28) in both groups (p = 0.885). A total of 14 patients were lost to follow-up (seven from each group), two had fixation failure (one in each group) and one control group patient developed an infection. Overall, the nonunion rate was 4% (two per group). No patient showed signs of clinical toxicity from their supplement. Despite finding a high level of hypovitaminosis D, the rate of union was high and independent of supplementation with vitamin D 3 . Cite this article: Bone Joint J 2017;99-B:1520-5. ©2017 The British Editorial Society of Bone & Joint Surgery.

a Predictive Model of Permeability for Fractal-Based Rough Rock Fractures during Shear

NASA Astrophysics Data System (ADS)

Huang, Na; Jiang, Yujing; Liu, Richeng; Li, Bo; Zhang, Zhenyu

This study investigates the roles of fracture roughness, normal stress and shear displacement on the fluid flow characteristics through three-dimensional (3D) self-affine fractal rock fractures, whose surfaces are generated using the modified successive random additions (SRA) algorithm. A series of numerical shear-flow tests under different normal stresses were conducted on rough rock fractures to calculate the evolutions of fracture aperture and permeability. The results show that the rough surfaces of fractal-based fractures can be described using the scaling parameter Hurst exponent (H), in which H = 3 - Df, where Df is the fractal dimension of 3D single fractures. The joint roughness coefficient (JRC) distribution of fracture profiles follows a Gauss function with a negative linear relationship between H and average JRC. The frequency curves of aperture distributions change from sharp to flat with increasing shear displacement, indicating a more anisotropic and heterogeneous flow pattern. Both the mean aperture and permeability of fracture increase with the increment of surface roughness and decrement of normal stress. At the beginning of shear, the permeability increases remarkably and then gradually becomes steady. A predictive model of permeability using the mean mechanical aperture is proposed and the validity is verified by comparisons with the experimental results reported in literature. The proposed model provides a simple method to approximate permeability of fractal-based rough rock fractures during shear using fracture aperture distribution that can be easily obtained from digitized fracture surface information.

Mortality Rates Following Posterior C1-2 Fusion for Displaced Type II Odontoid Fractures in Octogenarians.

PubMed

Clark, Stephen; Nash, Alysa; Shasti, Mark; Brown, Luke; Jauregui, Julio J; Mistretta, Katherine; Koh, Eugene; Banagan, Kelley; Ludwig, Steven; Gelb, Daniel

2018-03-13

Retrospective cohort study OBJECTIVE.: To assess 30-day and one-year mortality rates as well as the most common complications associated with posterior C1-2 fusion in an octogenarian cohort. Treatment of unstable type II odontoid fractures in elderly patients can present challenges. Recent evidence indicates in patients older than 80 years, posterior C1-2 fusion results in improved survival as compared to other modes of treatment. Retrospective analysis of 43 consecutive patients (25 F and 18 M; mean age 84.3y, range 80-89y; mean Charlson Comorbidities Index 1.4, (range 1-6); mean BMI 24.8 ± 4.2 kg/m2, who underwent posterior C1-C2 fusion for management of unstable type II odontoid fracture by 4 fellowship trained spine surgeons at a single institution between January 2006-June 2016. Mean fracture displacement was 5.1 ± 3.6 mm and mean absolute value of angulation was 19.93 ± 12.93°. The most common complications were altered mental status (41.9%, n = 18), dysphagia (27.9%, n = 12) with 50% of those patients (6 of 12) requiring a feeding tube, and emergency reintubation (9.3%, n = 4). To the date of review completion, 25 of 43 patients expired (58.1%), median survival of 1.76 years from the date of surgery. Thirty-day and one-year mortality rates were 2.3% and 18.6%, respectively. Patients who developed dysphagia were 14.5 times more likely to have expired at 1 year; dysphagia was also found to be significantly associated with degree of displacement. Fracture displacement was found to be associated with increased odds for 1-year mortality when accounting for age and requirement of a feeding tube. Posterior C1-2 fusion results in acceptably low mortality rates in octogenarians with unstable type II odontoid fractures when compared to non-operative management mortality rates in current literature. Initial fracture displacement is associated with higher mortality rate in this patient population. 4.

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

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation: Case report and literature review.

PubMed

Li, Suyun; Li, Zhi; Hua, Wenbin; Wang, Kun; Li, Shuai; Zhang, Yunkun; Ye, Zhewei; Shao, Zengwu; Wu, Xinghuo; Yang, Cao

2017-12-01

Thoracic-lumbar vertebral fracture is very common in clinic, and late post-traumatic kyphosis is the main cause closely related to the patients' life quality, which has evocated extensive concern for the surgical treatment of the disease. This study aimed to analyze the clinical outcomes and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation. All patients presented back pain with kyphotic apex vertebrae between T12 and L3. According to Frankel classification grading system, among them, 3 patients were classified as grade D, with the ability to live independently. A systematic review of 12 case series of post-traumatic kyphosis after failed thoracolumbar fracture operation was involved. Wedge osteotomy was performed as indicated-posterior closing osteotomy correction in 5 patients and anterior open-posterior close correction in 7 patients.Postoperatively, thoracolumbar x-rays were obtained to evaluate the correction of kyphotic deformity, visual analog scales (VAS) and Frankel grading system were used for access the clinical outcomes. All the patients were followed up, with the average period of 38.5 months (range 24-56 months). The Kyphotic Cobb angle was improved from preoperative (28.65 ± 11.41) to postoperative (1.14 ± 2.79), with the correction rate of 96.02%. There was 1 case of intraoperative dural tear, without complications such as death, neurological injury, and wound infection. According to Frankel grading system, no patient suffered deteriorated neurological symptoms after surgery, and 2 patients (2/3) experienced significant relief after surgery. The main VAS score of back pain was improved from preoperative (4.41 ± 1.08) to postoperative (1.5 ± 0.91) at final follow-up, with an improvement rate of 65.89%. Surgical treatment of late post-traumatic kyphosis after failed thoracolumbar fracture operation can obtain good radiologic and clinical outcomes by kyphosis correction, decompression, and posterior stability.

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation

PubMed Central

Li, Suyun; Li, Zhi; Hua, Wenbin; Wang, Kun; Li, Shuai; Zhang, Yunkun; Ye, Zhewei; Shao, Zengwu; Wu, Xinghuo; Yang, Cao

2017-01-01

Abstract Rationale: Thoracic-lumbar vertebral fracture is very common in clinic, and late post-traumatic kyphosis is the main cause closely related to the patients’ life quality, which has evocated extensive concern for the surgical treatment of the disease. This study aimed to analyze the clinical outcomes and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation. Patient concerns: All patients presented back pain with kyphotic apex vertebrae between T12 and L3. According to Frankel classification grading system, among them, 3 patients were classified as grade D, with the ability to live independently. Diagnoses: A systematic review of 12 case series of post-traumatic kyphosis after failed thoracolumbar fracture operation was involved. Interventions: Wedge osteotomy was performed as indicated—posterior closing osteotomy correction in 5 patients and anterior open-posterior close correction in 7 patients.Postoperatively, thoracolumbar x-rays were obtained to evaluate the correction of kyphotic deformity, visual analog scales (VAS) and Frankel grading system were used for access the clinical outcomes. Outcomes: All the patients were followed up, with the average period of 38.5 months (range 24–56 months). The Kyphotic Cobb angle was improved from preoperative (28.65 ± 11.41) to postoperative (1.14 ± 2.79), with the correction rate of 96.02%. There was 1 case of intraoperative dural tear, without complications such as death, neurological injury, and wound infection. According to Frankel grading system, no patient suffered deteriorated neurological symptoms after surgery, and 2 patients (2/3) experienced significant relief after surgery. The main VAS score of back pain was improved from preoperative (4.41 ± 1.08) to postoperative (1.5 ± 0.91) at final follow-up, with an improvement rate of 65.89%. Lessons: Surgical treatment of late post-traumatic kyphosis after failed thoracolumbar fracture operation can obtain good radiologic and clinical outcomes by kyphosis correction, decompression, and posterior stability. PMID:29245233

Type 2 Diabetes and Metformin Influence on Fracture Healing in an Experimental Rat Model.

PubMed

La Fontaine, Javier; Chen, Chris; Hunt, Nathan; Jude, Edward; Lavery, Lawrence

2016-01-01

Persons with diabetes have a greater incidence of fractures compared with persons without diabetes. However, very little published information is available concerning the deleterious effect of late-stage diabetes on osseous structure and bone healing. The purpose of the present study was to evaluate the role of diabetes on fracture healing in a rat femur repair model. Thirty-six lean and diabetic Zucker rats were subdivided into 3 groups: (1) 12 lean rats as the control group; (2) 12 diabetic rats without blood glucose control (DM group); and (3) 12 diabetic rats treated with 300 mg/kg metformin to reduce the blood glucose levels (DM + Met group). Radiographs were taken every week to determine the incidence of bone repair and delayed union. All the rats were killed at 6 weeks after surgery. In both the sham-operated and the fractured and repaired femurs, significant decreases in the fracture-load/weight and marginal decreases in the fracture-load between the lean and DM groups were found. Metformin treatment significantly reduced the blood glucose and body weight 12 days postoperatively. Furthermore, a decrease in the fracture-load and fracture-load/weight in the repaired femurs was found in the DM + Met group. Diabetes impairs bone fracture healing. Metformin treatment reduces the blood glucose and body weight but had an adverse effect on fracture repair in diabetic rats. Further investigations are needed to reveal the mechanisms responsible for the effects of type 2 diabetes mellitus on bone and bone quality and the effect of medications such as metformin might have in diabetic bone in the presence of neuropathy and vascular disease. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Validating Human Behavioral Models for Combat Simulations Using Techniques for the Evaluation of Human Performance

DTIC Science & Technology

2004-01-01

Cognitive Task Analysis Abstract As Department of Defense (DoD) leaders rely more on modeling and simulation to provide information on which to base...capabilities and intent. Cognitive Task Analysis (CTA) Cognitive Task Analysis (CTA) is an extensive/detailed look at tasks and subtasks performed by a...Domain Analysis and Task Analysis: A Difference That Matters. In Cognitive Task Analysis , edited by J. M. Schraagen, S.

Eliminating Late Recurrence to Eradicate Breast Cancer

DTIC Science & Technology

2015-09-01

induction of autophagy and antioxidant responses in Drosophila melanogaster . PLoS Genet. 9, e1003664 34 Rouschop, K.M. et al. (2010) The unfolded protein... genomic editing in human cells [8]. In contrast to RNA interference, CRISPR results in stable genetic changes in cell lines. We have generated the ...upcoming year. Since subtask 1d was delayed to pursue studies in the   Fig 2. CRISP/Cas9-Mediated Genomic Deletion of cATGs. Top: Construct

Skill Assessment in the Interpretation of 3D Fracture Patterns from Radiographs

PubMed Central

Rojas-Murillo, Salvador; Hanley, Jessica M; Kreiter, Clarence D; Karam, Matthew D; Anderson, Donald D

2016-01-01

Abstract Background Interpreting two-dimensional radiographs to ascertain the three-dimensional (3D) position and orientation of fracture planes and bone fragments is an important component of orthopedic diagnosis and clinical management. This skill, however, has not been thoroughly explored and measured. Our primary research question is to determine if 3D radiographic image interpretation can be reliably assessed, and whether this assessment varies by level of training. A test designed to measure this skill among orthopedic surgeons would provide a quantitative benchmark for skill assessment and training research. Methods Two tests consisting of a series of online exercises were developed to measure this skill. Each exercise displayed a pair of musculoskeletal radiographs. Participants selected one of three CT slices of the same or similar fracture patterns that best matched the radiographs. In experiment 1, 10 orthopedic residents and staff responded to nine questions. In experiment 2, 52 residents from both orthopedics and radiology responded to 12 questions. Results Experiment 1 yielded a Cronbach alpha of 0.47. Performance correlated with experience; r(8) = 0.87, p<0.01, suggesting that the test could be both valid and reliable with a slight increase in test length. In experiment 2, after removing three non-discriminating items, the Cronbach coefficient alpha was 0.28 and performance correlated with experience; r(50) = 0.25, p<0.10. Conclusions Although evidence for reliability and validity was more compelling with the first experiment, the analyses suggest motivation and test duration are important determinants of test efficacy. The interpretation of radiographs to discern 3D information is a promising and a relatively unexplored area for surgical skill education and assessment. The online test was useful and reliable. Further test development is likely to increase test effectiveness. Clinical Relevance Accurately interpreting radiographic images is an essential clinical skill. Quantitative, repeatable techniques to measure this skill can improve resident training and improve patient safety. PMID:27528827

The management of humeral shaft fractures with associated radial nerve palsy: a review of 117 cases.

PubMed

Bumbasirević, Marko; Lesić, Aleksandar; Bumbasirević, Vesna; Cobeljić, Goran; Milosević, Ivan; Atkinson, Henry Dushan E

2010-04-01

This single center retrospective study reviews the management and outcomes of 117 consecutive patients with humeral shaft fractures and associated radial nerve palsy (RNP) treated over a 20-year period (1986-2006). A total of 101 fractures were managed conservatively and 16 fractures underwent external fixation for poor bony alignment. Sixteen grade 1 and 2 open fractures underwent wound toileting alone. No patients underwent initial radial nerve exploration or opening of the fracture sites. All patients achieved clinical and radiological bony union at a mean of 8 weeks (range 7-12 weeks). There were no complications or pin tract infections in the operated patients. A total of 111 cases had initial spontaneous RNP recovery at a mean of 6 weeks (range 3-24 weeks) with full RNP recovery at a mean of 17 weeks (range 3-70 weeks) post-injury. Fourteen patients had no clinical/EMG signs of nerve activity at 12 weeks and 6 subsequently failed to regain any radial nerve recovery; 2 had late explorations and the lacerated nerves underwent sural nerve cable neurorraphy; and 4 patients underwent delayed tendon transposition 2-3 years after initial injury, with good/excellent functional outcomes. Humeral fractures with associated RNP may be treated expectantly. With low rates of humeral nonunion, 95% spontaneous nerve recovery in closed fractures and 94% in grade 1 and 2 open fractures, one has the opportunity of waiting. If at 10-12 weeks there are no clinical/EMG signs of recovery, then nerve exploration/secondary reconstruction is indicated. Late tendon transfers may also give good/excellent functional results.

High resolution monitoring of strain fields in concrete during hydraulic fracturing processes.

PubMed

Chen, Rongzhang; Zaghloul, Mohamed A S; Yan, Aidong; Li, Shuo; Lu, Guanyi; Ames, Brandon C; Zolfaghari, Navid; Bunger, Andrew P; Li, Ming-Jun; Chen, Kevin P

2016-02-22

We present a distributed fiber optic sensing scheme to image 3D strain fields inside concrete blocks during laboratory-scale hydraulic fracturing. Strain fields were measured by optical fibers embedded during casting of the concrete blocks. The axial strain profile along the optical fiber was interrogated by the in-fiber Rayleigh backscattering with 1-cm spatial resolution using optical frequency domain reflectometry (OFDR). The 3D strain fields inside the cubes under various driving pressures and pumping schedules were measured and used to characterize the location, shape, and growth rate of the hydraulic fractures. The fiber optic sensor detection method presented in this paper provides scientists and engineers an unique laboratory tool to understand the hydraulic fracturing processes via internal, 3D strain measurements with the potential to ascertain mechanisms related to crack growth and its associated damage of the surrounding material as well as poromechanically-coupled mechanisms driven by fluid diffusion from the crack into the permeable matrix of concrete specimens.

High resolution monitoring of strain fields in concrete during hydraulic fracturing processes

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

Chen, Rongzhang; Zaghloul, Mohamed A. S.; Yan, Aidong

Here, we present a distributed fiber optic sensing scheme to image 3D strain fields inside concrete blocks during laboratory-scale hydraulic fracturing. Strain fields were measured by optical fibers embedded during casting of the concrete blocks. The axial strain profile along the optical fiber was interrogated by the in-fiber Rayleigh backscattering with 1-cm spatial resolution using optical frequency domain reflectometry (OFDR). The 3D strain fields inside the cubes under various driving pressures and pumping schedules were measured and used to characterize the location, shape, and growth rate of the hydraulic fractures. The fiber optic sensor detection method presented in this papermore » provides scientists and engineers an unique laboratory tool to understand the hydraulic fracturing processes via internal, 3D strain measurements with the potential to ascertain mechanisms related to crack growth and its associated damage of the surrounding material as well as poromechanically-coupled mechanisms driven by fluid diffusion from the crack into the permeable matrix of concrete specimens.« less

High resolution monitoring of strain fields in concrete during hydraulic fracturing processes

DOE PAGES

Chen, Rongzhang; Zaghloul, Mohamed A. S.; Yan, Aidong; ...

2016-02-17

Here, we present a distributed fiber optic sensing scheme to image 3D strain fields inside concrete blocks during laboratory-scale hydraulic fracturing. Strain fields were measured by optical fibers embedded during casting of the concrete blocks. The axial strain profile along the optical fiber was interrogated by the in-fiber Rayleigh backscattering with 1-cm spatial resolution using optical frequency domain reflectometry (OFDR). The 3D strain fields inside the cubes under various driving pressures and pumping schedules were measured and used to characterize the location, shape, and growth rate of the hydraulic fractures. The fiber optic sensor detection method presented in this papermore » provides scientists and engineers an unique laboratory tool to understand the hydraulic fracturing processes via internal, 3D strain measurements with the potential to ascertain mechanisms related to crack growth and its associated damage of the surrounding material as well as poromechanically-coupled mechanisms driven by fluid diffusion from the crack into the permeable matrix of concrete specimens.« less

A three-dimensional FEM-DEM technique for predicting the evolution of fracture in geomaterials and concrete

NASA Astrophysics Data System (ADS)

Zárate, Francisco; Cornejo, Alejandro; Oñate, Eugenio

2018-07-01

This paper extends to three dimensions (3D), the computational technique developed by the authors in 2D for predicting the onset and evolution of fracture in a finite element mesh in a simple manner based on combining the finite element method and the discrete element method (DEM) approach (Zárate and Oñate in Comput Part Mech 2(3):301-314, 2015). Once a crack is detected at an element edge, discrete elements are generated at the adjacent element vertexes and a simple DEM mechanism is considered in order to follow the evolution of the crack. The combination of the DEM with simple four-noded linear tetrahedron elements correctly captures the onset of fracture and its evolution, as shown in several 3D examples of application.

Review of potential EGS sites and possible EGS demonstration scenarios

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

None

1999-09-01

Review of potential sites for Enhanced Geothermal Systems (EGS) and development of reference scenarios for EGS demonstration projects are two sub-tasks included in the FY 1999 EGS Research and Development (R&D) Management Task (DOE Task Order Number DE-AT07-99ID60365, included in the Appendix of this report). These sub-tasks are consistent with the EGS Strategic Plan, which includes milestones relating to EGS site selection (Milestone 4, to be completed in 2004) and development of a cost-shared, pilot-scale demonstration project (Milestone 5, to be completed in 2008). The purpose of the present work is to provide some reference points for discussing what typemore » of EGS projects might be undertaken, where they might be located, and what the associated benefits are likely to be. The review of potential EGS sites is presented in Chapter 2 of this report. It draws upon site-selection criteria (and potential project sites that were identified using those criteria) developed at a mini-workshop held at the April 1998 DOE Geothermal Program Review to discuss EGS R&D issues. The criteria and the sites were the focus of a paper presented at the 4th International Hot Dry Rock Forum in Strasbourg in September 1998 (Sass and Robertson-Tait, 1998). The selection criteria, project sites and possible EGS developments discussed in the workshop and paper are described in more detail herein. Input from geothermal operators is incorporated, and water availability and transmission-line access are emphasized. The reference scenarios for EGS demonstration projects are presented in Chapter 3. Three alternative scenarios are discussed: (1) a stand-alone demonstration plant in an area with no existing geothermal development; (2) a separate generating facility adjacent to an existing geothermal development; and (3) an EGS project that supplies an existing geothermal power plant with additional generating capacity. Furthermore, information potentially useful to DOE in framing solicitations and selecting projects for funding is discussed objectively. Although defined as separate sub-tasks, the EGS site review and reference scenarios are closely related. The incremental approach to EGS development that has recently been adopted could logically be expected to yield proposals for studies that lead up to and include production-enhancement experiments in producing geothermal fields in the very near future. However, the strategic plan clearly calls for the development of a more comprehensive demonstration project that can generate up to perhaps 10 MW (gross). It is anticipated that a series of small-scale experiments will define what realistically may be achieved in the near future, thus setting the stage for a successful pilot demonstration. This report continues the process of presenting information on EGS sites and experiments, and begins the process of defining what a demonstration project might be.« less

Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries.

PubMed

Dunham, C Michael; Hileman, Barbara M; Ransom, Kenneth J; Malik, Rema J

2015-01-01

We hypothesized that lung injury and rib cage fracture quantification would be associated with adverse outcomes. Consecutive admissions to a trauma center with Injury Severity Score ≥ 9, age 18-75, and blunt trauma. CT scans were reviewed to score rib and sternal fractures and lung infiltrates. Sternum and each anterior, lateral, and posterior rib fracture was scored 1 = non-displaced and 2 = displaced. Rib cage fracture score (RCFS) = total rib fracture score + sternal fracture score + thoracic spine Abbreviated Injury Score (AIS). Four lung regions (right upper/middle, right lower, left upper, and left lower lobes) were each scored for % of infiltrate: 0% = 0; ≤ 20% = 1, ≤ 50% = 2, > 50% = 3; total of 4 scores = lung infiltrate score (LIS). Of 599 patients, 193 (32%) had 854 rib fractures. Rib fracture patients had more abdominal injuries (p < 0.001), hemo/pneumothorax (p < 0.001), lung infiltrates (p < 0.001), thoracic spine injuries (p = 0.001), sternal fractures (p = 0.0028) and death or need for mechanical ventilation ≥ 3 days (Death/Vdays ≥ 3) (p < 0.001). Death/Vdays ≥ 3 was independently associated with RCFS (p < 0.001), LIS (p < 0.001), head AIS (p < 0.001) and abdominal AIS (p < 0.001). Of the 193 rib fracture patients, Glasgow Coma Score 3-12 or head AIS ≥ 2 occurred in 43%. A lung infiltrate or hemo/pneumothorax occurred in 55%. Thoracic spine injury occurred in 23%. RCFS was 6.3 ± 4.4 and Death/Vdays ≥ 3 occurred in 31%. Death/Vdays ≥ 3 rates correlated with RCFS values: 19% for 1-3; 24% for 4-6; 42% for 7-12 and 65% for ≥ 13 (p < 0.001). Death/Vdays ≥ 3 was independently associated with RCFS (p = 0.02), LIS (p = 0.001), head AIS (p < 0.001) and abdominal AIS (p < 0.001). Death/Vdays ≥ 3 association was better for RCFS (p = 0.005) than rib fracture score (p = 0.08) or number of fractured ribs (p = 0.80). Rib fracture patients have increased risk for truncal injuries and adverse outcomes. Adverse outcomes are independently associated with rib cage fracture burden. Severity of head, abdominal, and lung injuries also influence rib fracture outcomes.

Avalanche weak layer shear fracture parameters from the cohesive crack model

NASA Astrophysics Data System (ADS)

McClung, David

2014-05-01

Dry slab avalanches release by mode II shear fracture within thin weak layers under cohesive snow slabs. The important fracture parameters include: nominal shear strength, mode II fracture toughness and mode II fracture energy. Alpine snow is not an elastic material unless the rate of deformation is very high. For natural avalanche release, it would not be possible that the fracture parameters can be considered as from classical fracture mechanics from an elastic framework. The strong rate dependence of alpine snow implies that it is a quasi-brittle material (Bažant et al., 2003) with an important size effect on nominal shear strength. Further, the rate of deformation for release of an avalanche is unknown, so it is not possible to calculate the fracture parameters for avalanche release from any model which requires the effective elastic modulus. The cohesive crack model does not require the modulus to be known to estimate the fracture energy. In this paper, the cohesive crack model was used to calculate the mode II fracture energy as a function of a brittleness number and nominal shear strength values calculated from slab avalanche fracture line data (60 with natural triggers; 191 with a mix of triggers). The brittleness number models the ratio of the approximate peak value of shear strength to nominal shear strength. A high brittleness number (> 10) represents large size relative to fracture process zone (FPZ) size and the implications of LEFM (Linear Elastic Fracture Mechanics). A low brittleness number (e.g. 0.1) represents small sample size and primarily plastic response. An intermediate value (e.g. 5) implies non-linear fracture mechanics with intermediate relative size. The calculations also implied effective values for the modulus and the critical shear fracture toughness as functions of the brittleness number. The results showed that the effective mode II fracture energy may vary by two orders of magnitude for alpine snow with median values ranging from 0.08 N/m (non-linear) to 0.18 N/m (LEFM) for median slab density around 200 kg/m3. Schulson and Duval (2009) estimated the fracture energy of solid ice (mode I) to be about 0.22-1 N/m which yields rough theoretical limits of about 0.05- 0.2 N/m for density 200 kg/m3 when the ice volume fraction is accounted for. Mode I results from lab tests (Sigrist, 2006) gave 0.1 N/m (200 kg/m3). The median effective mode II shear fracture toughness was calculated between 0.31 to 0.35 kPa(m)1/2 for the avalanche data. All the fracture energy results are much lower than previously calculated from propagation saw tests (PST) results for a weak layer collapse model (1.3 N/m) (Schweizer et al., 2011). The differences are related to model assumptions and estimates of the effective slab modulus. The calculations in this paper apply to quasi-static deformation and mode II weak layer fracture whereas the weak layer collapse model is more appropriate for dynamic conditions which follow fracture initiation (McClung and Borstad, 2012). References: Bažant, Z.P. et al. (2003) Size effect law and fracture mechanics of the triggering of dry snow slab avalanches, J. Geophys. Res. 108(B2): 2119, doi:10.1029/2002JB))1884.2003. McClung, D.M. and C.P. Borstad (2012) Deformation and energy of dry snow slabs prior to fracture propagation, J. Glaciol. 58(209), 2012 doi:10.3189/2012JoG11J009. Schulson, E.M and P. Duval (2009) Creep and fracture of ice, Cambridge University Press, 401 pp. Schweizer, J. et al. (2011) Measurements of weak layer fracture energy, Cold Reg. Sci. and Tech. 69: 139-144. Sigrist, C. (2006) Measurement of fracture mechanical properties of snow and application to dry snow slab avalanche release, Ph.D thesis: 16736, ETH, Zuerich: 139 pp.

[Effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture].

PubMed

Yan, Rongliang; Qu, Jiafu; Cao, Lihai; Liu, Hongda; Chen, Jianghua; Gao, Yan; Peng, Yi

2018-05-01

To summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture. Between January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days (mean, 5 days). The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale (VAS) score, and the function by the American Orthopaedic Foot & Ankle Society (AOFAS) score. All incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months. Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks (mean, 9.4 weeks). At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 92%. The procedure of mini locking plate combined with Kirschner wire for comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.

Effects of Long-Term Low-Molecular-Weight Heparin on Fractures and Bone Density in Non-Pregnant Adults: A Systematic Review With Meta-Analysis.

PubMed

Gajic-Veljanoski, Olga; Phua, Chai W; Shah, Prakesh S; Cheung, Angela M

2016-08-01

Adults who require long-term anticoagulation with low-molecular-weight heparin (LMWH) such as cancer patients or the elderly may be at increased risk of fractures. To determine the effects of LMWH therapy of at least 3 months' duration on fractures and bone mineral density (BMD) in non-pregnant adult populations. We systematically reviewed electronic databases (e.g., MEDLINE, EMBASE), conferences and bibliographies until June 2015 and included comparative studies in non-pregnant adult populations that examined the effects of LMWH (≥3 months) on fractures and BMD. We synthesized evidence qualitatively and used random-effects meta-analysis to quantify the effect of LMWH on fractures. Sixteen articles reporting 14 studies were included: 10 clinical trials (n = 4865 participants) and four observational cohort studies (3 prospective, n = 221; 1 retrospective, n = 30). BMD and fractures were secondary outcomes in the majority of trials, while they were primary outcomes in the majority of observational studies. In participants with venous thromboembolism and underlying cardiovascular disease or cancer (5 RCTs, n = 2280), LMWH for 3-6 months did not increase the relative risk of all fractures at 6-12 months compared to unfractionated heparin, oral vitamin K antagonists or placebo [pooled risk ratio (RR) = 0.58, 95 % CI: 0.23-1.43; I(2) = 12.5 %]. No statistically significant increase in the risk of fractures at 6-12 months was found for cancer patients (RR = 1.08, 95 % CI: 0.31-3.75; I(2) = 4.4 %). Based on the data from two prospective cohort studies (n = 166), LMWH for 3-24 months decreased mean BMD by 2.8-4.8 % (depending on the BMD site) compared to mean BMD decreases of 1.2-2.5 % with oral vitamin K antagonists. LMWH for 3-6 months may not increase the risk of fractures, but longer exposure for up to 24 months may adversely affect BMD. Clinicians should consider monitoring BMD in adults on long-term LMWH who are at increased risk of bone loss or fracture.

Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women.

PubMed

Yusuf, Akeem A; Cummings, Steven R; Watts, Nelson B; Feudjo, Maurille Tepie; Sprafka, J Michael; Zhou, Jincheng; Guo, Haifeng; Balasubramanian, Akhila; Cooper, Cyrus

2018-03-21

Studies examining real-world effectiveness of osteoporosis therapies are beset by limitations due to confounding by indication. By evaluating longitudinal changes in fracture incidence, we demonstrated that osteoporosis therapies are effective in reducing fracture risk in real-world practice settings. Osteoporosis therapies have been shown to reduce incidence of vertebral and non-vertebral fractures in placebo-controlled randomized clinical trials. However, information on the real-world effectiveness of these therapies is limited. We examined fracture risk reduction in older, post-menopausal women treated with osteoporosis therapies. Using Medicare claims, we identified 1,278,296 women age ≥ 65 years treated with zoledronic acid, oral bisphosphonates, denosumab, teriparatide, or raloxifene. Fracture incidence rates before and after treatment initiation were described to understand patients' fracture risk profile, and fracture reduction effectiveness of each therapy was evaluated as a longitudinal change in incidence rates. Fracture incidence rates increased during the period leading up to treatment initiation and were highest in the 3-month period most proximal to treatment initiation. Fracture incidence rates following treatment initiation were significantly lower than before treatment initiation. Compared with the 12-month pre-index period, there were reductions in clinical vertebral fractures for denosumab (45%; 95% confidence interval [CI] 39-51%), zoledronic acid (50%; 95% CI 47-52%), oral bisphosphonates (24%; 95% CI 22-26%), and teriparatide (72%; 95% CI 69-75%) during the subsequent 12 months. Relative to the first 3 months after initiation, clinical vertebral fractures were reduced for denosumab (51%; 95% CI 42-59%), zoledronic acid (25%; 95% CI 17-32%), oral bisphosphonates (23%; 95% CI 20-26%), and teriparatide (64%; 95% CI 58-69%) during the subsequent 12 months. In summary, reductions in fracture incidence over time were observed in cohorts of patients treated with osteoporosis therapies.

Classroom evaluation of the Arlyn Arm robotic workstation.

PubMed

Eberhardt, S P; Osborne, J; Rahman, T

2000-01-01

High school and junior high school students with neuromuscular weakness and other disorders of the arms evaluated a recently commercialized robotic workstation, the Arlyn Arm, to carry out art projects and science experiments. These tasks were designed for independent execution with the workstation using standard or custom-designed tools. Each task was divided into subtasks, and the execution time of each subtask was determined as a measure of efficiency. Special attention was given to the causes of required experimenter intervention. While subjects easily accomplished some subtasks, others required considerable intervention. Most of these interventions could be avoided by further customizing accessories. It is concluded that the Arlyn Arm workstation could be of considerable benefit in a classroom setting to persons with severe neuromuscular disorders.

Impact of malnutrition on 12-month mortality following acute hip fracture.

PubMed

Bell, Jack J; Pulle, Ranjeev C; Crouch, Alisa M; Kuys, Suzanne S; Ferrier, Rebecca L; Whitehouse, Sarah L

2016-03-01

Studies investigating the relationship between malnutrition and post-discharge mortality following acute hip fracture yield conflicting results. This study aimed to determine whether malnutrition independently predicted 12-month post-fracture mortality after adjusting for clinically relevant covariates. An ethics approved, prospective, consecutive audit was undertaken for all surgically treated hip fracture inpatients admitted to a dedicated orthogeriatric unit (November 2010-October 2011). The 12-month mortality data were obtained by a dual search of the mortality registry and Queensland Health database. Malnutrition was evaluated using the Subjective Global Assessment. Demographic (age, gender, admission residence) and clinical covariates included fracture type, time to surgery, anaesthesia type, type of surgery, post-surgery time to mobilize and post-operative complications (delirium, pulmonary and deep vein thrombosis, cardiac complications, infections). The Charlson Comorbidity Index was retrospectively applied. All diagnoses were confirmed by the treating orthogeriatrician. A total of 322 of 346 patients were available for audit. Increased age (P = 0.004), admission from residential care (P < 0.001), Charlson Comorbidity Index (P = 0.007), malnutrition (P < 0.001), time to mobilize >48 h (P < 0.001), delirium (P = 0.003), pulmonary embolism (P = 0.029) and cardiovascular complication (P = 0.04) were associated with 12-month mortality. Logistic regression analysis demonstrated that malnutrition (odds ratio (OR) 2.4 (95% confidence interval (CI) 1.3-4.7, P = 0.007)), in addition to admission from residential care (OR 2.6 (95% CI 1.3-5.3, P = 0.005)) and pulmonary embolism (OR 11.0 (95% CI 1.5-78.7, P = 0.017)), independently predicted 12-month mortality. Findings substantiate malnutrition as an independent predictor of 12-month mortality in a representative sample of hip fracture inpatients. Effective strategies to identify and treat malnutrition in hip fracture should be prioritized. © 2016 Royal Australasian College of Surgeons.

Dietary Intake and Stress Fractures Among Elite Male Combat Recruits

DTIC Science & Technology

2012-03-13

groups that can be analyzed for nutrient and food group intake, such as: 1) eggs, milk , and milk products; 2) fats (including sauces); 3) chicken...intake of proteins , carbohydrates, total fat , iron, folate, vitamins (D, B6, and B12), calcium, zinc, and magnesium. Our study referred to the MDRI and...included body weight, height, body fat percentage and calculation of body mass index (BMI). Height (cm) was measured using a stadiometer (±1cm) and

User-only design to assess drug effectiveness in clinical practice: application to bisphosphonates and secondary prevention of fractures.

PubMed

Corrao, Giovanni; Ghirardi, Arianna; Segafredo, Giulia; Zambon, Antonella; Della Vedova, Gianluca; Lapi, Francesco; Cipriani, Francesco; Caputi, Achille; Vaccheri, Alberto; Gregori, Dario; Gesuita, Rosaria; Vestri, Annarita; Staniscia, Tommaso; Mazzaglia, Giampiero; Di Bari, Mauro

2014-08-01

Different strategies applicable to control for confounding by indication in observational studies were compared in a large population-based study regarding the effect of bisphosphonates (BPs) for secondary prevention of fractures. The cohort was drawn from healthcare utilization databases of 13 Italian territorial units. Patients aged 55 years or more who were hospitalized for fracture during 2003-2005 entered into the cohort. A nested case-control design was used to compare BPs use in cohort members who did (cases) and who did not experience (controls) a new fracture until 2007 (outcome). Three designs were employed: conventional-matching (D1 ), propensity score-matching (D2 ), and user-only (D3 ) designs. They differed for (i) cohort composition, restricted to patients who received BPs straight after cohort entry (D3 ); (ii) using propensity score for case-control matching (D2 ); and (iii) compared groups of BPs users versus no users (D1 and D2 ) and long-term versus short-term users (D3 ). Bisphosphonate users had odds ratios (95% confidence interval) of 1.20 (1.01 to 1.44) and 0.95 (0.74 to 1.24) by applying D1 and D2 designs, respectively. Statistical evidence that long-term BPs use protects the outcome onset with respect to short-term use was observed for user-only design (D3 ) being the corresponding odds ratio (95% confidence interval) 0.64 (0.44 to 0.93). User-only design yielded closer results to those seen in RCTs. This approach is one possible strategy to account for confounding by indication. Copyright © 2014 John Wiley & Sons, Ltd.

Effects of metal binder on the microstructure and mechanical properties of Al2O3-based micro-nanocomposite ceramic tool material

NASA Astrophysics Data System (ADS)

Ni, Xiu-ying; Zhao, Jun; Sun, Jia-lin; Gong, Feng; Li, Zuo-li

2017-07-01

The Al2O3-(W,Ti)C composites with Ni and Mo additions varying from 0vol% to 12vol% were prepared via hot pressing sintering under 30 MPa. The microstructure was investigated via X-ray diffraction (XRD) and scanning electron microscopy (SEM) equipped with energy dispersive spectrometry (EDS). Mechanical properties such as flexural strength, fracture toughness, and Vickers hardness were also measured. Results show that the main phases A12O3 and (W,Ti)C were detected by XRD. Compound MoNi also existed in sintered nanocomposites. The fracture modes of the nanocomposites were both intergranular and transgranular fractures. The plastic deformation of metal particles and crack bridging were the main toughening mechanisms. The maximum flexural strength and fracture toughness were obtained for 9vol% and 12vol% additions of Ni and Mo, respectively. The hardness of the composites reduced gradually with increasing content of metals Ni and Mo.

A Comparative Study of 3-Dimensional Titanium Versus 2-Dimensional Titanium Miniplates for Open Reduction and Fixation of Mandibular Parasymphysis Fracture.

PubMed

Mittal, Yogesh; Varghese, K George; Mohan, S; Jayakumar, N; Chhag, Somil

2016-03-01

Three dimensional titanium plating system was developed by Farmand in 1995 to meet the requirements of semi rigid fixation with lesser complication. The purpose of this in vivo prospective study was to evaluate and compare the clinical effectiveness of three dimensional and two dimensional Titanium miniplates for open reduction and fixation of mandibular parasymphysis fracture. Thirty patients with non-comminuted mandibular parasymphysis fractures were divided randomly into two equal groups and were treated with 2 mm 3D and 2D miniplate system respectively. All patients were systematically monitored at 1st, 2nd, 3rd, 6th week, 3rd and 6th month postoperatively. The outcome parameters recorded were severity of pain, infection, mobility, occlusion derangement, paresthesia and implant failure. The data so collected was analyzed using independent t test and Chi square test (α = .05). The results showed that one patient in each group had post-operative infection, occlusion derangement and mobility (p > .05). In Group A, one patient had paresthesia while in Group B, two patients had paresthesia (p > .05). None of the patients in both the groups had implant failure. There was no statistically significant difference between 3D and 2D miniplate system in all the recorded parameters at all the follow-ups (p > .05). 3D miniplates were found to be better than 2D miniplates in terms of cost, ease of surgery and operative time. However, 3D miniplates were unfavorable for cases where fracture line was oblique and in close proximity to mental foramen, where they were difficult to adapt and more chances for tooth-root damage and inadvertent injury to the mental nerve due to traction.

Information Presentation

NASA Technical Reports Server (NTRS)

Holden, Kritina L.; Thompson, Shelby G.; Sandor, Aniko; McCann, Robert S.; Kaiser, Mary K.; Adelstein, Barnard D.; Begault, Durand R.; Beutter, Brent R.; Stone, Leland S.; Godfroy, Martine

2009-01-01

The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. In addition to addressing display design issues associated with information formatting, style, layout, and interaction, the Information Presentation DRP is also working toward understanding the effects of extreme environments encountered in space travel on information processing. Work is also in progress to refine human factors-based design tools, such as human performance modeling, that will supplement traditional design techniques and help ensure that optimal information design is accomplished in the most cost-efficient manner. The major areas of work, or subtasks, within the Information Presentation DRP for FY10 are: 1) Displays, 2) Controls, 3) Procedures and Fault Management, and 4) Human Performance Modeling. The poster will highlight completed and planned work for each subtask.

[Treatment of pediatric distal femur fractures by external fixator combined with limited internal fixation].

PubMed

Wei, Sheng-wang; Shi, Zhan-ying; Hu, Ju-zheng; Wu, Hao

2016-03-01

To discuss the clinical effects of external fixator combined with limited internal fixation in the treatment of pediatric distal femur fractures. From January 2008 to June 2014, 17 children of distal femur fractures were treated by external fixator combined with limited internal fixation. There were 12 males and 5 females, aged from 6 to 13 years old with an average of 10.2 years, ranged in the course of disease from 1 h to 2 d. Preoperative diagnoses were confirmed by X-ray films in all children. There were 11 patients with supracondylar fracture , and 6 patients with intercondylar comminuted fracture. According to AO/ASIF classification, 9 fractures were type A1, 5 cases were type A2,and 3 cases were type C1. The intraoperative and postoperative complications, postoperative radiological examination, lower limbs length and motion of knee joints were observed. Knee joint function was assessed by KSS score. All the patients were followed up from 6 to 38 months with an average of 24.4 months. No nerve or blood vessel injury was found. One case complicated with the external fixation loosening, 2 cases with the infection of pin hole and 3 cases with the leg length discrepancy. Knee joint mobility and length measurement (compared with the contralateral), the average limited inflexion was 10 degrees (0 degrees to 20 degrees), the average limited straight was 4 degrees (0 degrees to 10), the average varus or valgus angle was 3 degrees (0 degrees to 5 degrees). KSS of the injured side was (96.4 +/- 5.0) points at final follow-up, 16 cases got excellent results and 1 good. All fractures obtained healing and no epiphyseal closed early was found. External fixator combined with limited internal fixation has advantages of simple operation, reliable fixation, early functional exercise in treating pediatric distal femurs fractures.

Clinical risk factors for osteoporosis are common among elderly people in Nuuk, Greenland.

PubMed

Jakobsen, Anna; Laurberg, Peter; Vestergaard, Peter; Andersen, Stig

2013-01-01

Osteoporosis is a debilitating condition characterized by fractures, pain and premature death. Risk factors for osteoporosis predict the risk of fragility fractures. To describe the occurrence of risk factors for osteoporosis among populations in Nuuk, the capital of Greenland. A random sample of women born in 1934-42, 1945-47, 1956, and men born in 1956 were selected from the national civil registry. A questionnaire was sent out in Greenlandic and Danish on risk factors for osteoporosis: family history, smoking habits, alcohol intake, presence of disease, sun exposure, intake of dairy products, age at menopause (women) and number of falls. Additional questions included the frequency of back pain, previous fractures, intake of vitamin D and calcium supplements, use of anti-osteoporotic drugs, steroids and other drugs. The questionnaire was sent to 317 subjects confirmed to be living at an address in Nuuk and 181 (57.1%) responded. More young women than older women were smokers (60.6% vs. 35.0%; p=0.022) while limited sun exposure was reported by more of the old women (37.2% vs. 5.6%; p=0.003). Family history of osteoporosis was reported by 15.0%, without difference between groups. Alcohol and milk intake did not differ between groups. Premature menopause was reported by 17.9% of the women. Falls within the last year were reported by 42.4% with fewer falls in the oldest age group (21.9% vs. 50.0%; p=0.005). Frequency of fragility fractures increased with age (5.7% vs. 24.3% vs. 30.4%; p=0.02) and the risk of a fragility fracture increased with age (p=0.004; OR, 95% CI: 4.5, 1.6-12.2, reference: below 70 years), when adjusted for smoking, gender and falls. The use of anti-osteoporotic drugs was low (3.4%) while 28.8% took calcium and vitamin D supplements. Age is a dominating risk factor for fragility fractures in Greenland. The use of anti-osteoporotic drugs is low in Greenland, even if osteoporotic fractures are common in old age.

Short uncemented stems allow greater femoral flexibility and may reduce peri-prosthetic fracture risk: a dry bone and cadaveric study.

PubMed

Jones, Christopher; Aqil, Adeel; Clarke, Susannah; Cobb, Justin P

2015-09-01

Short femoral stems for uncemented total hip arthroplasty have been introduced as a safe alternative to traditional longer stem designs. However, there has been little biomechanical examination of the effects of stem length on complications of surgery. This study aims to examine the effect of femoral stem length on torsional resistance to peri-prosthetic fracture. We tested 16 synthetic and two paired cadaveric femora. Specimens were implanted and then rapidly rotated until fracture to simulate internal rotation on a planted foot, as might occur during stumbling. 3D planning software and custom-printed 3D cutting guides were used to enhance the accuracy and consistency of our stem insertion technique. Synthetic femora implanted with short stems fractured at a significantly higher torque (27.1 vs. 24.2 Nm, p = 0.03) and angle (30.3° vs. 22.3°, p = 0.002) than those implanted with long stems. Fracture patterns of the two groups were different, but showed remarkable consistency within each group. These characteristic fracture patterns were closely replicated in the pair of cadaveric femora. This new short-stemmed press-fit femoral component allows more femoral flexibility and confers a higher resistance to peri-prosthetic fracture from torsional forces than long stems.

DoD Military Injury Prevention Priorities Working Group: Leading Injuries, Causes and Mitigation Recommendations

DTIC Science & Technology

2006-02-01

Based upon conservative estimates, lower extremity overuse injuries (e.g. pain , inflammation, and stress fractures) alone resulted in over three million...Injury Freq 1 Lower Extremity Overuse ( Pain , inflammation, & stress fractures) 3,803,512 34.5% 240,796 2 Torso Overuse ( Pain , inflammation, & stress...fractures) 2,165,562 19.6% 154,683 3 Upper Extremity Overuse ( Pain , inflammation, & stress fractures) 1,314,330 11.9% 93,750 4 Unspecified Location

Calcium plus vitamin D supplementation and the risk of fractures.

PubMed

Jackson, Rebecca D; LaCroix, Andrea Z; Gass, Margery; Wallace, Robert B; Robbins, John; Lewis, Cora E; Bassford, Tamsen; Beresford, Shirley A A; Black, Henry R; Blanchette, Patricia; Bonds, Denise E; Brunner, Robert L; Brzyski, Robert G; Caan, Bette; Cauley, Jane A; Chlebowski, Rowan T; Cummings, Steven R; Granek, Iris; Hays, Jennifer; Heiss, Gerardo; Hendrix, Susan L; Howard, Barbara V; Hsia, Judith; Hubbell, F Allan; Johnson, Karen C; Judd, Howard; Kotchen, Jane Morley; Kuller, Lewis H; Langer, Robert D; Lasser, Norman L; Limacher, Marian C; Ludlam, Shari; Manson, JoAnn E; Margolis, Karen L; McGowan, Joan; Ockene, Judith K; O'Sullivan, Mary Jo; Phillips, Lawrence; Prentice, Ross L; Sarto, Gloria E; Stefanick, Marcia L; Van Horn, Linda; Wactawski-Wende, Jean; Whitlock, Evelyn; Anderson, Garnet L; Assaf, Annlouise R; Barad, David

2006-02-16

The efficacy of calcium with vitamin D supplementation for preventing hip and other fractures in healthy postmenopausal women remains equivocal. We recruited 36,282 postmenopausal women, 50 to 79 years of age, who were already enrolled in a Women's Health Initiative (WHI) clinical trial. We randomly assigned participants to receive 1000 mg of elemental [corrected] calcium as calcium carbonate with 400 IU of vitamin D3 daily or placebo. Fractures were ascertained for an average follow-up period of 7.0 years. Bone density was measured at three WHI centers. Hip bone density was 1.06 percent higher in the calcium plus vitamin D group than in the placebo group (P<0.01). Intention-to-treat analysis indicated that participants receiving calcium plus vitamin D supplementation had a hazard ratio of 0.88 for hip fracture (95 percent confidence interval, 0.72 to 1.08), 0.90 for clinical spine fracture (0.74 to 1.10), and 0.96 for total fractures (0.91 to 1.02). The risk of renal calculi increased with calcium plus vitamin D (hazard ratio, 1.17; 95 percent confidence interval, 1.02 to 1.34). Censoring data from women when they ceased to adhere to the study medication reduced the hazard ratio for hip fracture to 0.71 (95 percent confidence interval, 0.52 to 0.97). Effects did not vary significantly according to prerandomization serum vitamin D levels. Among healthy postmenopausal women, calcium with vitamin D supplementation resulted in a small but significant improvement in hip bone density, did not significantly reduce hip fracture, and increased the risk of kidney stones. (ClinicalTrials.gov number, NCT00000611.). Copyright 2006 Massachusetts Medical Society

Energy Harvesting and Storage Systems for Future AF Vehicles

DTIC Science & Technology

2012-05-18

mechanical testing setup/procedures to determine the Young’s modulus and fracture strength of solar energy harvesting modules. Figure D1 SEM micrograph of...failure modes. (4 configurations; 2 repetitions) Table D3. Summary of mechanical testing activity The goal of the test is to determine the fracture ...

Hearing and Mortality Outcomes following Temporal Bone Fractures.

PubMed

Honeybrook, Adam; Patki, Aniruddha; Chapurin, Nikita; Woodard, Charles

2017-12-01

The aim of this article is to determine hearing and mortality outcomes following temporal bone fractures. Retrospective chart review was performed of 152 patients diagnosed with a temporal bone fracture presenting to the emergency room at a tertiary care referral center over a 10-year period. Utilizing Patients' previously obtained temporal bone computed tomographic scans and audiograms, fractures were classified based on several classification schemes. Correlations between fracture patterns, mortality, and hearing outcomes were analyzed using χ 2 tests. Ossicular chain disruption was seen in 11.8% of patients, and otic capsule violation was seen in 5.9%; 22.7% of patients presented for audiologic follow-up. Seventeen patients with conductive hearing loss had air-bone gaps of 26 ± 7.5 dB (500 Hz), 27 ± 6.8 dB (1,000 Hz), 18 ± 6.2 dB (2,000 Hz), and 32 ± 7.7 dB (4,000 Hz). Two cases of profound sensorineural hearing loss were associated with otic capsule violation. No fracture classification scheme was predictive of hearing loss, although longitudinal fractures were statistically associated with ossicular chain disruption ( p  < 0.01). Temporal bone fractures in patients older than 60 years carried a relative risk of death of 3.15 compared with those younger than 60 years. The average magnitude of conductive hearing loss resulting from temporal bone fracture ranged from 18 to 32 dB in this cohort. Classification of fracture type was not predictive of hearing loss, despite the statistical association between ossicular chain disruption and longitudinal fractures. This finding may be due to the low follow-up rates of this patient population. Physicians should make a concerted effort to ensure that audiological monitoring is executed to prevent and manage long-term hearing impairment.

Graphene Foam: Uniaxial Tension Behavior and Fracture Mode Based on a Mesoscopic Model.

PubMed

Pan, Douxing; Wang, Chao; Wang, Tzu-Chiang; Yao, Yugui

2017-09-26

Because of the combined advantages of both porous materials and two-dimensional (2D) graphene sheets, superior mechanical properties of three-dimensional (3D) graphene foams have received much attention from material scientists and energy engineers. Here, a 2D mesoscopic graphene model (Modell. Simul. Mater. Sci. Eng. 2011, 19, 054003), was expanded into a 3D bonded graphene foam system by utilizing physical cross-links and van der Waals forces acting among different mesoscopic graphene flakes by considering the debonding behavior, to evaluate the uniaxial tension behavior and fracture mode based on in situ SEM tensile testing (Carbon 2015, 85, 299). We reasonably reproduced a multipeak stress-strain relationship including its obvious yielding plateau and a ductile fracture mode near 45° plane from the tensile direction including the corresponding fracture morphology. Then, a power scaling law of tensile elastic modulus with mass density and an anisotropic strain-dependent Poisson's ratio were both deduced. The mesoscopic physical mechanism of tensile deformation was clearly revealed through the local stress state and evolution of mesostructure. The fracture feature of bonded graphene foam and its thermodynamic state were directly navigated to the tearing pattern of mesoscopic graphene flakes. This study provides an effective way to understand the mesoscopic physical nature of 3D graphene foams, and hence it may contribute to the multiscale computations of micro/meso/macromechanical performances and optimal design of advanced graphene-foam-based materials.

Serum 25-Hydroxyvitamin D Levels and Stress Fractures in Military Personnel: A Systematic Review and Meta-analysis.

PubMed

Dao, Dyda; Sodhi, Sukhmani; Tabasinejad, Rasam; Peterson, Devin; Ayeni, Olufemi R; Bhandari, Mohit; Farrokhyar, Forough

2015-08-01

Low serum 25-hydroxyvitamin D (25(OH)D) levels have been associated with stress fractures in various physically active populations such as the military. To examine the association between serum 25(OH)D levels and stress fractures in the military. Systematic review and meta-analysis. Relevant studies were identified through searching multiple databases and manually screening reference lists. Two reviewers independently selected the included studies by applying the eligibility criteria to the title, abstract, and/or full text of the articles yielded in the search. Two reviewers also independently conducted the methodological quality assessment and data extraction. A random-effects model was used to calculate the mean difference (MD) with 95% CI in serum 25(OH)D levels between stress fracture cases and controls. Nine observational studies on lower extremity stress fractures were eligible, and 1 was excluded due to inadequate data. A total of 2634 military personnel (age, 18-30 years; 44% male) with 761 cases (16% male) and 1873 controls (61% male) from 8 studies were included in the analysis. Three of the 8 studies measured serum 25(OH)D levels at the time of stress fracture diagnosis, and the 5 remaining studies measured serum 25(OH)D levels at the time of entry into basic training. The mean serum 25(OH)D level was lower in stress fracture cases than in controls at the time of entry into basic training (MD, -2.63 ng/mL; 95% CI, -5.80 to 0.54; P = .10; I(2) = 65%) and at the time of stress fracture diagnosis (MD, -2.26 ng/mL; 95% CI, -3.89 to -0.63; P = .007; I(2) = 42%). Despite the inherent limitations of the included studies, the study results suggest some association between low serum 25(OH)D levels and lower extremity stress fractures in military personnel. Given the rigorous training of military personnel, implementing strategies to ensure sufficient 25(OH)D levels may be beneficial for reducing the risk of stress fractures. © 2014 The Author(s).

Work Plan for an Inpatient Rehabilitation Prospective Payment System

DTIC Science & Technology

2000-01-01

through 4.23 5 Nontraumatic spinal cord 4.1,4.11 through 4.13 6 Neurological 3.1,3.2,3.3,3.5,3.8,3.9 7 Hip fracture 8.11 through 8.4 8 Replacement of...Eilertsen, C. A. Hrincevich, D. A. Tropea, L. A. Ahmad, and D. G. Eckhoff, "Outcomes and Costs After Hip Fracture and Stroke: A Comparison of...Teaching Costs 53 Low Income Patients 55 Other Factors Affecting Cost 58 Multivariate Regression Analysis 59 8. SIMULATIONS AND IMPACT ANALYSES 60 Data

Prediction of extravasation in pelvic fracture using coagulation biomarkers.

PubMed

Aoki, Makoto; Hagiwara, Shuichi; Tokue, Hiroyuki; Shibuya, Kei; Kaneko, Minoru; Murata, Masato; Nakajima, Jun; Sawada, Yusuke; Isshiki, Yuta; Ichikawa, Yumi; Oshima, Kiyohiro

2016-08-01

To evaluate the usefulness of coagulation biomarkers, which are easy and quick to analyze in emergency settings, for prediction of arterial extravasation due to pelvic fracture. The medical records of pelvic fracture patients transferred to the emergency department of Gunma University Hospital between December 2009 and May 2015 were reviewed. Patients were divided into two groups, those with (Extra(+)) and without (Extra(-)) arterial extravasation on enhanced CT or angiography. Levels of fibrin degradation products (FDP), D-dimer, fibrinogen, the ratio of FDP to fibrinogen, the ratio of D-dimer to fibrinogen, systolic blood pressure, heart rate, the Glasgow Coma Scale, pH, base excess, hemoglobin and lactate levels, the pattern of pelvic injury, and injury severity score were measured at hospital admission, and compared between the two groups. Parameters with a significant difference between the two groups were used to construct receiver operating characteristic (ROC) curves. The study included 29 patients with pelvic fracture. FDP, D-dimer, the ratio of FDP to fibrinogen and the ratio of D-dimer to fibrinogen were the most useful parameters for predicting arterial extravasation due to pelvic fracture. FDP, D-dimer, the ratio of FDP to fibrinogen, the ratio of D-dimer to fibrinogen, and hemoglobin and lactate levels were significantly higher in the Extra(+) group than in the Extra(-) group (FDP, 354.8μg/mL [median] versus 96.6μg/mL; D-dimer, 122.3μg/mL versus 42.1μg/mL; the ratio of FDP to fibrinogen, 3.39 versus 0.42; the ratio of D-dimer to fibrinogen, 1.14 versus 0.18; hemoglobin, 10.5g/dL versus 13.5g/dL; lactate, 3.5mmol/L versus 1.7mmol/L). The area under the ROC curves for FDP, D-dimer, the ratio of FDP to fibrinogen, the ratio of D-dimer to fibrinogen, hemoglobin and lactate levels were 0.900, 0.882, 0.918, 0.900, 0.815 and 0.765, respectively. Coagulation biomarkers, and hemoglobin and lactate levels could be useful to predict the existence of arterial extravasation due to pelvic fracture. The ratio of FDP to fibrinogen and the ratio of D-dimer to fibrinogen were the most accurate markers. Coagulation biomarkers may enable more rapid and specific treatment for pelvic fracture. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Gait characteristics before hardware removal in patients operated upon for tibial plateau fractures.

PubMed

Deleanu, Bogdan; Prejbeanu, Radu; Crisan, Dan; Predescu, Vlad; Popa, Iulian; Poenaru, Dan V

2015-07-01

The reporting of gait analysis data on operated fractures of the tibial plateau, while extensive for studies of knee osteoarthritis of mostly undisclosed aetiology and ACL deficient knees, is rather limited in literature. In the present study we investigated 25 tibial plateau fractures classified as Schatzker II, IV, V and VI that underwent operative reduction and lateral plate osteosynthesis. Apart from routine radiographic exploration and patient completed (KOOS) scores at three (mean of 3.2 months), six (mean of 5.6 months) and 12 months (mean of 11.3 months) postoperatively, gait analysis was performed at these intervals as well. Cadence, step time and knee flexion were the gait parameters that were selected for the comparison at six and 12 months postoperatively. The analysed gait parameters were significantly improved between the six and the 12-month session and statistically significant differences were found between the two groups of values. Cadence had a mean value of 41 steps/minute at six months and 45 steps/minute at 12 months (p = 0.99). Step time was a mean of 0.74 seconds at six months while at 12 months the median value was 0.66 seconds (p = 0.94). Knee flexion angles evolved in a similar manner with mean values of 58° at six months and 69° at 12 months (p = 0.95). The mean KOOS scores were 42.4, 56.3 and 67.99 at three, six and 12 months postoperatively, respectively. Complex intra-articular fractures, classified as Schatzker IV, V and VI, had a higher impact on joint function than Schatzker II fractures treated with similar techniques and implants. There were statistically significant improvements in the recovery status at 12 months postoperatively compared to six months with extended chances for improvement.

Expected Time to Return to Athletic Participation After Stress Fracture in Division I Collegiate Athletes.

PubMed

Miller, Timothy L; Jamieson, Marissa; Everson, Sonsecharae; Siegel, Courtney

2017-12-01

Few studies have documented expected time to return to athletic participation after stress fractures in elite athletes. Time to return to athletic participation after stress fractures would vary by site and severity of stress fracture. Retrospective cohort study. Level 3. All stress fractures diagnosed in a single Division I collegiate men's and women's track and field/cross-country team were recorded over a 3-year period. Site and severity of injury were graded based on Kaeding-Miller classification system for stress fractures. Time to return to full unrestricted athletic participation was recorded for each athlete and correlated with patient sex and site and severity grade of injury. Fifty-seven stress fractures were diagnosed in 38 athletes (mean age, 20.48 years; range, 18-23 years). Ten athletes sustained recurrent or multiple stress fractures. Thirty-seven injuries occurred in women and 20 in men. Thirty-three stress fractures occurred in the tibia, 10 occurred in the second through fourth metatarsals, 3 occurred in the fifth metatarsal, 6 in the tarsal bones (2 navicular), 2 in the femur, and 5 in the pelvis. There were 31 grade II stress fractures, 11 grade III stress fractures, and 2 grade V stress fractures (in the same patient). Mean time to return to unrestricted sport participation was 12.9 ± 5.2 weeks (range, 6-27 weeks). No significant differences in time to return were noted based on injury location or whether stress fracture was grade II or III. The expected time to return to full unrestricted athletic participation after diagnosis of a stress fracture is 12 to 13 weeks for all injury sites. Athletes with grade V (nonunion) stress fractures may require more time to return to sport.

The effect of vehicle protection on spine injuries in military conflict.

PubMed

Possley, Daniel R; Blair, James A; Freedman, Brett A; Schoenfeld, Andrew J; Lehman, Ronald A; Hsu, Joseph R

2012-09-01

To evaluate the effect of critical time periods in vehicle protection on spine injuries in the Global War on Terror. To characterize the effect of method of movement on and around the battlefield during Operation Enduring Freedom and Operation Iraqi Freedom from 2001 to 2009 in terms of its impact on the incidence and severity of spinal fractures sustained in combat. Retrospective study. Mounted and dismounted American servicemembers who were injured during combat. Extracted medical records of servicemembers identified in the Joint Theater Trauma Registry from October 2001 to December 2009. Methods of movement were defined as mounted or dismounted. Two time periods were compared. Cohorts were created for 2×2 analysis based on method of movement and the time period in which the injury occurred. Time period 1 and 2 were separated by April 1, 2007, which correlates with the initial fielding of the modern class of uparmored fighting vehicles with thickened underbelly armor and a V-shaped hull. Our four comparison groups were Dismounted in Time Period 1 (D1), Dismounted in Time Period 2 (D2), Mounted in Time Period 1 (M1), and Mounted in Time Period 2 (M2). In total, 1,819 spine fractures occurred over the entire study period. Four hundred seventy-two fractures (26%) were sustained in 145 servicemembers who were mounted at the time of injury, and 1,347 (74%) were sustained by 404 servicemembers who were dismounted (p<.0005). The incidence of fractures in the dismounted cohort (D1+D2) was significantly higher than in the mounted cohort (M1+M2) in both time periods (D1 vs. M1, 13.75 vs. 3.95/10,000 warrior-years [p<.001] and D2 vs. M2, 11.15 vs. 4.89/10,000 warrior-years [p<.0001]). In both the mounted and dismounted groups, the thoracolumbar (TL) junction was the most common site of injury (36.1%). Fractures to the TL junction (T10-L3) increased significantly from Time Period 1 to 2 (34% vs. 40% of all fractures, respectively, p=.03). Thoracolumbar fractures were significantly more severe in that there were more Arbeitsgemeinschaft fur Osteosynthesefragen/Magerl Type A injuries versus all TL fractures, 1.75 versus 2.68/10,000 or 27% of all spine fractures in Time Period 1 versus 40% in Time Period 2 (p=.007). Furthermore, there were significantly fewer minor fractures (spinous process and transverse process fractures) (p<.0001). In Time Period 2, significantly more TL spine fractures were classified as major fractures, according to the Denis classification system, in both the mounted and dismounted groups; M1 group, 61 of 226 (27%) versus the M2 group, 86 of 246 (34%) (p<.0005) and 173 of 786 (22%) in the D1 group versus 193 of 561 (34%) in the D2 group. The spinal cord injury (SCI) incidence did not change in the mounted groups in Time Period 1 (7 of 71, 9.9%) versus Time Period 2 (7 of 74, 9.5%) (p=.935). In the dismounted groups, SCI actually decreased from D1 (55 of 228, 24%) to D2 (28 of 176, 16%) (p=.0428). The incidence of spine fractures and SCI is significantly higher in dismounted operations. The data suggest that current uparmored vehicles convey greater protection against spinal fracture compared with dismounted operations in which servicemembers are engaged on foot, outside their vehicles. The TL junction is at greatest risk for spine fractures sustained in mounted and dismounted combat operations. Recently, the incidence of TL fractures, especially severe fractures, has significantly increased in mounted operations. Although there has been an increased incidence of TL spine fractures, in context of the number of servicemembers deployed in support of Operation Enduring Freedom/Operation Iraqi Freedom, these severe fractures still represent a relatively rare event. Published by Elsevier Inc.

Surgical treatment of comminuted mandibular fractures using a low-profile locking mandibular reconstruction plate system

PubMed Central

Kanno, Takahiro; Sukegawa, Shintaro; Nariai, Yoshiki; Tatsumi, Hiroto; Ishibashi, Hiroaki; Furuki, Yoshihiko; Sekine, Joji

2014-01-01

Objective: The treatment of comminuted mandibular fractures is challenging due to the severity of associated injuries and the need for a careful diagnosis with adequate treatment planning. Recently, open reduction and stable internal fixation (OR-IF) with a load-bearing reconstruction plate have been advocated for reliable clinical outcomes with minimal complications. This clinical prospective study evaluated OR-IF in the surgical management of comminuted mandibular fractures with a new low-profile, thin, mandibular locking reconstruction plate. Materials and Methods: We prospectively assessed OR-IF of comminuted mandibular fractures with a low-profile locking mandibular reconstruction plate in 12 patients (nine men, three women; mean age 32.2 [range 16-71] years) between April 2010 and December 2011. The clinical characteristics and associated clinical parameters of patients were evaluated over a minimum follow-up period of 12 months. Results: Traffic accidents caused 50% of the fractures, followed by falls (25%). Four patients (33.3%) had associated midfacial maxillofacial fractures, while five patients had other mandibular fractures. Seven patients (58.3%) needed emergency surgery, mostly for airway management. Anatomical reduction of the comminuted segments re-established the mandibular skeleton in stable occlusion with rigid IF via extraoral (33.3%), intraoral (50%), or combined (16.7%) approaches. Immediate functional recovery was achieved. Sound bone healing was confirmed in all patients, with no complications such as malocclusion, surgical site infection, or malunion with a mean follow-up of 16.3 (range 12-24) months. Conclusions: OR-IF using a low-profile reconstruction plate system is a reliable treatment for comminuted mandibular fractures, enabling immediate functional recovery with good clinical results. PMID:25593862

[Operative treatment of sacroiliac joint fracture and dislocation in Tile C pelvic fracture with Colorado 2 system].

PubMed

Liu, Shuping; Zhou, Qing; Liu, Yuehong; Chen, Xi; Zhou, Yu; Zhang, Desheng; Fang, Zhi; Xu, Wei

2011-12-01

To explore the effectiveness of Colorado 2 system in the stability reconstruction of sacroiliac joint fracture and dislocation in Tile C pelvic fracture. Between February 2009 and January 2011, 8 cases of Tile C pelvic fracture were treated with Colorado 2 system. There were 3 males and 5 females with an average age of 34.4 years (range, 22-52 years). Fractures were caused by traffic accident in 3 cases, by falling from height in 3 cases, and by crash of heavy object in 2 cases. According to Tile classification, 5 cases were classified as C1-2, 2 cases as C1-3, and 1 case as C2. The time between injury and operation was 5-10 days (mean, 7 days). After skeletal traction reduction, Colorado 2 system was used to fix sacroiliac joint, and reconstruction plate or external fixation was selectively adopted. The postoperative X-ray films showed that the reduction of vertical and rotatory dislocation was satisfactory, posterior pelvic ring achieved effective stability. All the incisions healed by first intention, and no blood vessel or nerve injury occurred. Eight patients were followed up 6-24 months (mean, 12 months). No loosening or breakage of internal fixation was observed and no re-dislocation of sacroiliac joint occurred. The bone healing time was 6-12 months (mean, 9 months). According to Majeed's functional criterion, the results were excellent in 5 cases, good in 2 cases, and fair in 1 case at last follow-up. Colorado 2 system could provide immediate stability of pelvic posterior ring and good maintenance of reduction effect, which is an effective method in the therapy of sacroiliac joint fracture and dislocation in Tile C pelvic fracture.

An efficient quasi-3D particle tracking-based approach for transport through fractures with application to dynamic dispersion calculation.

PubMed

Wang, Lichun; Cardenas, M Bayani

2015-08-01

The quantitative study of transport through fractured media has continued for many decades, but has often been constrained by observational and computational challenges. Here, we developed an efficient quasi-3D random walk particle tracking (RWPT) algorithm to simulate solute transport through natural fractures based on a 2D flow field generated from the modified local cubic law (MLCL). As a reference, we also modeled the actual breakthrough curves (BTCs) through direct simulations with the 3D advection-diffusion equation (ADE) and Navier-Stokes equations. The RWPT algorithm along with the MLCL accurately reproduced the actual BTCs calculated with the 3D ADE. The BTCs exhibited non-Fickian behavior, including early arrival and long tails. Using the spatial information of particle trajectories, we further analyzed the dynamic dispersion process through moment analysis. From this, asymptotic time scales were determined for solute dispersion to distinguish non-Fickian from Fickian regimes. This analysis illustrates the advantage and benefit of using an efficient combination of flow modeling and RWPT. Copyright © 2015 Elsevier B.V. All rights reserved.

3D Numerical Modeling of the Propagation of Hydraulic Fracture at Its Intersection with Natural (Pre-existing) Fracture

NASA Astrophysics Data System (ADS)

Dehghan, Ali Naghi; Goshtasbi, Kamran; Ahangari, Kaveh; Jin, Yan; Bahmani, Aram

2017-02-01

A variety of 3D numerical models were developed based on hydraulic fracture experiments to simulate the propagation of hydraulic fracture at its intersection with natural (pre-existing) fracture. Since the interaction between hydraulic and pre-existing fractures is a key condition that causes complex fracture patterns, the extended finite element method was employed in ABAQUS software to simulate the problem. The propagation of hydraulic fracture in a fractured medium was modeled in two horizontal differential stresses (Δ σ) of 5e6 and 10e6 Pa considering different strike and dip angles of pre-existing fracture. The rate of energy release was calculated in the directions of hydraulic and pre-existing fractures (G_{{frac}} /G_{{rock}}) at their intersection point to determine the fracture behavior. Opening and crossing were two dominant fracture behaviors during the hydraulic and pre-existing fracture interaction at low and high differential stress conditions, respectively. The results of numerical studies were compared with those of experimental models, showing a good agreement between the two to validate the accuracy of the models. Besides the horizontal differential stress, strike and dip angles of the natural (pre-existing) fracture, the key finding of this research was the significant effect of the energy release rate on the propagation behavior of the hydraulic fracture. This effect was more prominent under the influence of strike and dip angles, as well as differential stress. The obtained results can be used to predict and interpret the generation of complex hydraulic fracture patterns in field conditions.

Outcome of nonoperative management of displaced oblique spiral fractures of the fifth metatarsal shaft.

PubMed

Aynardi, Michael; Pedowitz, David I; Saffel, Heather; Piper, Christine; Raikin, Steven M

2013-12-01

Nonoperative management has been the preferred treatment for displaced oblique spiral fractures of the fifth metatarsal shaft; yet a paucity of literature supports this claim. The purpose of this investigation was to report the incidence and long-term outcome in the largest cohort of these fractures reported to date. From 2006 through 2010, 2990 patients sustaining closed metatarsal fractures were seen and treated. Displaced, oblique, spiral fractures of the distal shaft of the fifth metatarsal were identified and follow-up was conducted. Only patients who were initially treated with nonoperative management were included. Patients were seen at 6 and 12 weeks, and a minimum 2-year follow-up was conducted. In addition, demographic information was obtained, and the Short Form-12 (SF-12) and Foot and Ankle Ability Measure (FAAM) were administered. Average follow-up was 3.5 years. In all, 142 acute fractures were managed for an incidence of 4.8% of all metatarsal fractures. There were 117 females and 25 males, average age was 55. FAAM activities of daily living subscale scores averaged 95.5 (±5.7), while FAAM sports subscales were 92.7 (±9.1). SF-12 physical and mental scores averaged 51.4 (±4.9) and 50.3 (±4.6), respectively. There were 2 delayed unions, 1 asymptomatic nonunion treated nonoperatively, and 2 painful nonunions that required open reduction internal fixation with bone grafting. This large cohort described the relative incidence and functional outcomes of displaced oblique fracture of shaft of the fifth metatarsal bone treated nonoperatively. Nonoperative management of these fractures resulted in excellent, long-term functional outcomes. Level II, prospective cohort study.

Hybrid-dimensional modelling of two-phase flow through fractured porous media with enhanced matrix fracture transmission conditions

NASA Astrophysics Data System (ADS)

Brenner, Konstantin; Hennicker, Julian; Masson, Roland; Samier, Pierre

2018-03-01

In this work, we extend, to two-phase flow, the single-phase Darcy flow model proposed in [26], [12] in which the (d - 1)-dimensional flow in the fractures is coupled with the d-dimensional flow in the matrix. Three types of so called hybrid-dimensional two-phase Darcy flow models are proposed. They all account for fractures acting either as drains or as barriers, since they allow pressure jumps at the matrix-fracture interfaces. The models also permit to treat gravity dominated flow as well as discontinuous capillary pressure at the material interfaces. The three models differ by their transmission conditions at matrix fracture interfaces: while the first model accounts for the nonlinear two-phase Darcy flux conservations, the second and third ones are based on the linear single phase Darcy flux conservations combined with different approximations of the mobilities. We adapt the Vertex Approximate Gradient (VAG) scheme to this problem, in order to account for anisotropy and heterogeneity aspects as well as for applicability on general meshes. Several test cases are presented to compare our hybrid-dimensional models to the generic equi-dimensional model, in which fractures have the same dimension as the matrix, leading to deep insight about the quality of the proposed reduced models.

Applying 3D Full Waveform Inversion in resolving fracture damage zones around a modelled geological disposal facility in granite

NASA Astrophysics Data System (ADS)

Bentham, H. L. M.; Morgan, J. V.; Angus, D. A.

2016-12-01

The UK has a large volume of high level and intermediate level radioactive waste and government policy is to dispose of this waste in a Geological Disposal Facility (GDF). This will be a highly-engineered facility capable of isolating radioactive waste within multiple protective barriers, deep underground, to ensure that no harmful quantities of radioactivity ever reach the surface environment. Although no specific GDF site in the UK has been chosen, granite is one of the candidate host rocks due to its strength, in engineering terms, and because of its low permeability in consideration of groundwater movement. We design time-lapse seismic surveys to characterise geological models of naturally fractured granite with GDF-related tunnel damage zones at a potential disposal depth of 1000 m (the UK GDF might be shallower). Additionally, we use effective medium models to calculate the velocity change when the fracture density is increased in the damage zones, and find a reduction of 60 m/s in P-wave velocity when the fracture density is doubled. Next, we simulate seismic surveys and apply 3D Full Waveform Inversion (FWI) to see how well we can recover the low-velocity damage zones. Furthermore we evaluate the effectiveness of using a survey design consisting of surface and tunnel receivers (a combined array) to resolve the target. After applying FWI we find the velocity anomaly within the damage zone can be resolved to within 2 m/s (3%) and the shape of the damage zone is resolved to 12.5 m (within a single grid cell). Using the combined array we are able to resolve the anomaly strength and shape more completely. When we add further complexity to the model by including tunnel infrastructure, we conclude the combined array is essential in recovering the tunnel damage zone. Our findings show that it is beneficial to use 3D FWI and novel survey designs for characterising subtle variations as may be present in granite, information that could assist in the GDF site selection process and also with GDF design.

Women’s Health Initiative Clinical Trials: Interaction of calcium plus vitamin D and Hormone Therapy

PubMed Central

Robbins, John A; Aragaki, Aaron; Crandall, Carolyn J; Manson, Joann E; Carbone, Laura; Jackson, Rebecca; Lewis, Cora E.; Johnson, Karen C.; Sarto, Gloria; Stefanick, Marcia L; Wactawski-Wende, Jean

2013-01-01

Objective To test the added value of Calcium and vitamin D (CaD) for fracture prevention among women taking postmenopausal hormone therapy (HT). Methods A prospective, partial-factorial design, randomized controlled double blind trial amongst Women’s Health Initiative post-menopausal participants, ages 50–79, at 40 centers in the US, with 7.1 years average follow-up. 27,347 women were randomized to HT (conjugated estrogen 0.625 mg alone, or CEE 0.625 mg daily plus medroxyprogesterone acetate 2.5mg) and 36,282 women randomized to either 1000mg elemental calcium (carbonate) plus 400 IU of vitamin D3 daily each compared to placebo. A total of 16,089 women were in both arms. The predefined outcomes were adjudicated hip fractures and measured bone mineral density. Results Interaction between HT and CaD on hip fracture (P-interaction = 0.01) was shown. The effect of CaD was stronger among women assigned to HT (HR, 0.59; 95%CI, 0.38–0.93) than placebo (HR, 1.20; 95%CI, 0.85, 1.69). The effect of HT on hip fracture was stronger among women assigned to active CaD (HR, 0.43; 0.28–0.66) than placebo (HR, 0.87; 95%CI, 0.60–1.26). CaD supplementation enhanced the anti-fracture effect of the HT at all levels of personal calcium intake. There was no interaction of HT and CaD on change in hip or spine BMD. Conclusions Postmenopausal women at normal risk of hip fracture on HT, supplementation with CaD significantly reduced incident hip fracture beyond HT alone; at all levels of personal baseline total calcium intake. PMID:23799356

Clodronate reduces the incidence of fractures in community-dwelling elderly women unselected for osteoporosis: results of a double-blind, placebo-controlled randomized study.

PubMed

McCloskey, Eugene V; Beneton, Monique; Charlesworth, Diane; Kayan, Karthik; deTakats, Dominic; Dey, Abhijit; Orgee, Jane; Ashford, Robert; Forster, Martin; Cliffe, Jennifer; Kersh, Linda; Brazier, John; Nichol, Jon; Aropuu, Sakari; Jalava, Tarja; Kanis, John A

2007-01-01

A 3-year prospective, randomized, placebo-controlled trial of oral clodronate 800 mg showed that the incidence of clinical fractures was decreased by 20% in 5596 elderly women unselected for osteoporosis. The effect occurred in the absence of systematic calcium and vitamin D supplementation and was observed across a wide range of BMDs. To date, most studies with bisphosphonates have reported on their use in individuals selected to be at high risk for fracture usually by the presence of low BMD or a prior fragility fracture, usually of the spine. We wished to determine the effect of the bisphosphonate, clodronate, on the rate of fractures in women > or =75 years of age living in the community. Women > or =75 years of age living in the general community in South Yorkshire and North Derbyshire, identified from general practice registers, were recruited by letter of invitation to a randomized, double-blind, controlled trial of 800 mg oral clodronate (Bonefos) or matching placebo daily over 3 years. The main outcomes were the incidences of hip and any clinical fracture. Of the 5579 elderly women included in the intention-to-treat analysis of efficacy, 114 had a new hip fracture during the 3-year treatment phase: 56 (2.0%) women in the clodronate group and 58 (2.1%) women in the placebo group (hazard ration [HR], 1.02; 95% CI, 0.71-1.47). Clodronate did, however, decrease the incidence of any clinical fracture by 20% (264 women [9.5%] versus 337 [12.1%] in the placebo group; HR, 0.80; 95% CI, 0.68-0.94). The incidence of osteoporosis-associated nonhip fractures was also significantly decreased by 29% (5.2% versus 7.4%; HR, 0.71; 95% CI, 0.57-0.87). The ability of clodronate to reduce the risk of osteoporotic fracture was independent of baseline BMD, but the number needed-to-treat was lower in the presence of osteoporosis. Oral daily clodronate can prevent fractures without significant adverse effects in elderly women living in the general community. The effect on hip fracture risk is not significant, but an effect similar to that at other nonvertebral sites cannot be excluded. This study suggests that antiresorptive therapies can reduce fracture incidence in high-risk individuals even in the presence of a normal or osteopenic BMD.

Spatiotemporal and Kinematic Parameters Relating to Oriented Gait and Turn Performance in Patients with Chronic Stroke

PubMed Central

Bonnyaud, Céline; Pradon, Didier; Vuillerme, Nicolas; Bensmail, Djamel; Roche, Nicolas

2015-01-01

Background The timed up and go test (TUG) is a functional test which is increasingly used to evaluate patients with stroke. The outcome measured is usually global TUG performance-time. Assessment of spatiotemporal and kinematic parameters during the Oriented gait and Turn sub-tasks of the TUG would provide a better understanding of the mechanisms underlying patients’ performance and therefore may help to guide rehabilitation. The aim of this study was thus to determine the spatiotemporal and kinematic parameters which were most related to the walking and turning sub-tasks of TUG performance in stroke patients. Methods 29 stroke patients carried out the TUG test which was recorded using an optoelectronic system in two conditions: spontaneous and standardized condition (standardized foot position and instructed to turn towards the paretic side). They also underwent a clinical assessment. Stepwise regression was used to determine the parameters most related to Oriented gait and Turn sub-tasks. Relationships between explanatory parameters of Oriented gait and Turn performance and clinical scales were evaluated using Spearman correlations. Results Step length and cadence explained 82% to 95% of the variance for the walking sub-tasks in both conditions. Percentage single support phase and contralateral swing phase (depending on the condition) respectively explained 27% and 56% of the variance during the turning sub-task in the spontaneous and standardized conditions. Discussion and Conclusion Step length, cadence, percentage of paretic single support phase and non-paretic swing phase, as well as dynamic stability were the main parameters related to TUG performance and they should be targeted in rehabilitation. PMID:26091555

[Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach].

PubMed

Schwabe, P; Märdian, S; Perka, C; Schaser, K-D

2016-04-01

Reconstruction/stable fixation of the acetabular columns to create an adequate periacetabular requirement for the implantation of a revision cup. Displaced/nondisplaced fractures with involvement of the posterior column. Resulting instability of the cup in an adequate bone stock situation. Periprosthetic acetabulum fractures with inadequate bone stock. Extended periacetabular defects with loss of anchorage options. Isolated periprosthetic fractures of the anterior column. Septic loosening. Dorsal approach. Dislocation of hip. Mechanical testing of inlaying acetabular cup. With unstable cup situation explantation of the cup, fracture fixation of acetabulum with dorsal double plate osteosynthesis along the posterior column. Cup revision. Hip joint reposition. Early mobilization; partial weight bearing for 12 weeks. Thrombosis prophylaxis. Clinical and radiological follow-ups. Periprosthetic acetabular fracture in 17 patients with 9 fractures after primary total hip replacement (THR), 8 after revision THR. Fractures: 12 due to trauma, 5 spontaneously; 7 anterior column fractures, 5 transverse fractures, 4 posterior column fractures, 1 two column fracture after hemiendoprosthesis. 5 type 1 fractures and 12 type 2 fractures. Operatively treated cases (10/17) received 3 reinforcement ring, 2 pedestal cup, 1 standard revision cup, cup-1 cage construct, 1 ventral plate osteosynthesis, 1 dorsal plate osteosynthesis, and 1 dorsal plate osteosynthesis plus cup revision (10-month Harris Hip Score 78 points). Radiological follow-up for 10 patients: consolidation of fractures without dislocation and a fixed acetabular cup. No revision surgeries during follow-up; 2 hip dislocations, 1 transient sciatic nerve palsy.

Incidence of fractures attributable to abuse in young hospitalized children: results from analysis of a United States database.

PubMed

Leventhal, John M; Martin, Kimberly D; Asnes, Andrea G

2008-09-01

The goal was to assess the proportion of children with fractures attributable to abuse and the incidence of fractures caused by abuse among children <36 months of age who were hospitalized in the United States. We used the Kids' Inpatient Database, which has discharge data on 80% of acute pediatric hospitalizations in the United States, for 3 time periods (1997, 2000, and 2003). Fractures attributable to abuse in children <36 months of age were identified by both an International Classification of Diseases, Ninth Revision, Clinical Modification code for fracture and a diagnosis external-cause-of-injury code for abuse. Weighted estimates of the incidence were calculated. Among children <36 months of age who were hospitalized with fractures, the proportions of cases attributable to abuse were 11.9% in 1997, 11.9% in 2000, and 12.1% in 2003. The proportions of cases attributable to abuse decreased with increasing age; for example, in 2003, the proportions attributable to abuse were 24.9% for children <12 months of age, 7.2% for children 12 to 23 months of age, and 2.9% for children 24 to 35 months of age. In 2003, the incidence of fractures caused by abuse was 15.3 cases per 100000 children <36 months of age. The incidence was 36.1 cases per 100000 among children <12 months of age; this decreased to 4.8 cases per 100000 among 12- to 23-month-old children and 4.8 cases per 100000 among 24- to 35-month-old children. The Kids' Inpatient Database can be used to provide reasonable estimates of the incidence of hospitalization with fractures attributable to child abuse. For children <12 months of age, the incidence was 36.1 cases per 100000, a rate similar to that of inflicted traumatic brain injury (25-32 cases per 100000).

A Response Surface Methodology for Bi-Level Integrated System Synthesis (BLISS)

NASA Technical Reports Server (NTRS)

Altus, Troy David; Sobieski, Jaroslaw (Technical Monitor)

2002-01-01

The report describes a new method for optimization of engineering systems such as aerospace vehicles whose design must harmonize a number of subsystems and various physical phenomena, each represented by a separate computer code, e.g., aerodynamics, structures, propulsion, performance, etc. To represent the system internal couplings, the codes receive output from other codes as part of their inputs. The system analysis and optimization task is decomposed into subtasks that can be executed concurrently, each subtask conducted using local state and design variables and holding constant a set of the system-level design variables. The subtasks results are stored in form of the Response Surfaces (RS) fitted in the space of the system-level variables to be used as the subtask surrogates in a system-level optimization whose purpose is to optimize the system objective(s) and to reconcile the system internal couplings. By virtue of decomposition and execution concurrency, the method enables a broad workfront in organization of an engineering project involving a number of specialty groups that might be geographically dispersed, and it exploits the contemporary computing technology of massively concurrent and distributed processing. The report includes a demonstration test case of supersonic business jet design.

BUILDING MATERIALS RECLAMATION PROGRAM

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

David C. Weggel; Shen-En Chen; Helene Hilger

2010-08-31

This report describes work conducted on the Building Materials Reclamation Program for the period of September 2008 to August 2010. The goals of the project included selecting materials from the local construction and demolition (C&D) waste stream and developing economically viable reprocessing, reuse or recycling schemes to divert them from landfill storage. Educational resources as well as conceptual designs and engineering feasibility demonstrations were provided for various aspects of the work. The project was divided into two distinct phases: Research and Engineering Feasibility and Dissemination. In the Research Phase, a literature review was initiated and data collection commenced, an advisorymore » panel was organized, and research was conducted to evaluate high volume C&D materials for nontraditional use; five materials were selected for more detailed investigations. In the Engineering Feasibility and Dissemination Phase, a conceptual study for a regional (Mecklenburg and surrounding counties) collection and sorting facility was performed, an engineering feasibility project to demonstrate the viability of recycling or reuse schemes was created, the literature review was extended and completed, and pedagogical materials were developed. Over the two-year duration of the project, all of the tasks and subtasks outlined in the original project proposal have been completed. The Final Progress Report, which briefly describes actual project accomplishments versus the tasks/subtasks of the original project proposal, is included in Appendix A of this report. This report describes the scientific/technical aspects (hypotheses, research/testing, and findings) of six subprojects that investigated five common C&D materials. Table 1 summarizes the six subprojects, including the C&D material studied and the graduate student and the faculty advisor on each subproject.« less

The Interrater and Intrarater Agreement of a Modified Neer Classification System and Associated Treatment Choice for Lateral Clavicle Fractures.

PubMed

Cho, Chul-Hyun; Oh, Joo Han; Jung, Gu-Hee; Moon, Gi-Hyuk; Rhyou, In Hyeok; Yoon, Jong Pil; Lee, Ho Min

2015-10-01

As there is substantial variation in the classification and diagnosis of lateral clavicle fractures, proper management can be challenging. Although the Neer classification system modified by Craig has been widely used, no study has assessed its validity through inter- and intrarater agreement. To determine the inter- and intrarater agreement of the modified Neer classification system and associated treatment choice for lateral clavicle fractures and to assess whether 3-dimensional computed tomography (3D CT) improves the level of agreement. Cohort study (diagnosis); Level of evidence, 3. Nine experienced shoulder specialists and 9 orthopaedic fellows evaluated 52 patients with lateral clavicle fractures, completing fracture typing according to the modified Neer classification system and selecting a treatment choice for each case. Web-based assessment was performed using plain radiographs only, followed by the addition of 3D CT images 2 weeks later. This procedure was repeated 4 weeks later. Fleiss κ values were calculated to estimate the inter- and intrarater agreement. Based on plain radiographs only, the inter- and intrarater agreement of the modified Neer classification system was regarded as fair (κ = 0.344) and moderate (κ = 0.496), respectively; the inter- and intrarater agreement of treatment choice was both regarded as moderate (κ = 0.465 and 0.555, respectively). Based on the plain radiographs and 3D CT images, the inter- and intrarater agreement of the classification system was regarded as fair (κ = 0.317) and moderate (κ = 0.508), respectively; the inter- and intrarater agreement of treatment choice was regarded as moderate (κ = 0.463) and substantial (κ = 0.623), respectively. There were no significant differences in the level of agreement between the plain radiographs only and plain radiographs plus 3D CT images for any κ values (all P > .05). The level of interrater agreement of the modified Neer classification system for lateral clavicle fractures was fair. Additional 3D CT did not improve the overall level of interrater or intrarater agreement of the modified Neer classification system or associated treatment choice. To eliminate a common source of disagreement among surgeons, a new classification system to focus on unclassifiable fracture types is needed. © 2015 The Author(s).

Use of integrated analogue and numerical modelling to predict tridimensional fracture intensity in fault-related-folds.

NASA Astrophysics Data System (ADS)

Pizzati, Mattia; Cavozzi, Cristian; Magistroni, Corrado; Storti, Fabrizio

2016-04-01

Fracture density pattern predictions with low uncertainty is a fundamental issue for constraining fluid flow pathways in thrust-related anticlines in the frontal parts of thrust-and-fold belts and accretionary prisms, which can also provide plays for hydrocarbon exploration and development. Among the drivers that concur to determine the distribution of fractures in fold-and-thrust-belts, the complex kinematic pathways of folded structures play a key role. In areas with scarce and not reliable underground information, analogue modelling can provide effective support for developing and validating reliable hypotheses on structural architectures and their evolution. In this contribution, we propose a working method that combines analogue and numerical modelling. We deformed a sand-silicone multilayer to eventually produce a non-cylindrical thrust-related anticline at the wedge toe, which was our test geological structure at the reservoir scale. We cut 60 serial cross-sections through the central part of the deformed model to analyze faults and folds geometry using dedicated software (3D Move). The cross-sections were also used to reconstruct the 3D geometry of reference surfaces that compose the mechanical stratigraphy thanks to the use of the software GoCad. From the 3D model of the experimental anticline, by using 3D Move it was possible to calculate the cumulative stress and strain underwent by the deformed reference layers at the end of the deformation and also in incremental steps of fold growth. Based on these model outputs it was also possible to predict the orientation of three main fractures sets (joints and conjugate shear fractures) and their occurrence and density on model surfaces. The next step was the upscaling of the fracture network to the entire digital model volume, to create DFNs.

Minimally invasive fixation of type B and C interprosthetic femoral fractures.

PubMed

Ehlinger, M; Czekaj, J; Adam, P; Brinkert, D; Ducrot, G; Bonnomet, F

2013-09-01

Interprosthetic femoral fractures are rare and raise unresolved treatment issues such as the length of the fixation material that best prevents secondary fractures. Awareness of the advantages of locked-plate fixation via a minimally invasive approach remains limited, despite the potential of this method for improving success rates. Femur-spanning (from the trochanters to the condyles) locked-plate fixation via a minimally invasive approach provides high healing rates with no secondary fractures. From January 2004 to May 2011, all eight patients seen for interprosthetic fractures were treated with minimally invasive locked-plate fixation. Mean time since hip arthroplasty was 47.5 months and mean time since knee arthroplasty was 72.6 months. There were 12 standard primary prostheses and four revision prostheses; 11 prostheses were cemented and a single prosthesis showed femoral loosening. Classification about the hip prostheses was Vancouver B in one patient and Vancouver C in seven patients; about the knee prosthesis, the fracture was SoFCOT B in three patients and SOFCOT C in five patients, and a single fracture was SoFCOT D. Minimally invasive locking-plate fixation was performed in all eight patients, with installation on a traction table in seven patients. Healing was obtained in all eight patients, after a mean of 14 weeks (range, 12-16 weeks). One patient had malalignment with more than 5° of varus. There were no general or infectious complications. One patient died, 32 months after surgery. The mean Parker-Palmer mobility score decreased from 6.2 pre-operatively to 2.5 at last follow-up. Early construct failure after 3 weeks in one patient required surgical revision. There was no change in implant fixation at last follow-up. No secondary fractures were recorded. In patients with type B or C interprosthetic fractures, femur-spanning fixation not only avoids complications related to altered bone stock and presence of prosthetic material, but also decreases the risk of secondary fractures by eliminating stress riser zones. The minimally invasive option enhances healing by preserving the fracture haematoma. Thus, healing was obtained consistently in our patients, with no secondary fractures, although the construct failed in one patient. Level IV. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Effect of Sunlight Exposure on Bone Mineral Density in Children with Severe Disability.

PubMed

Kanemura, Hideaki; Hatakeyama, Kazuo; Sano, Fumikazu; Yagasaki, Hideaki; Sugita, Kanji; Aihara, Masao

2016-08-01

The aim of this study was to determine the efficacy of sunlight exposure for increasing bone mineral density (BMD) in children with severe disability. The subjects were five children with severe disability, aged 6 to 8 years. BMD was measured at baseline and after 3, 6, 9, and 12 months of starting sunlight exposure. All caregivers of patients were instructed to create opportunities to stay outdoors. Daily sunlight exposure time was defined as hours of staying outdoors. Mean hours of sunbathing per day were calculated at baseline and after 3, 6, 9, and 12 months of starting sunlight exposure. Sunlight exposure tended to be longer after starting than before starting in all patients, but the difference was not significant (p = 0.052). Along with the increase in sunlight exposure, BMD increased significantly after the start of sunlight exposure in all patients (p < 0.01). The serum values of total alkaline phosphatase and intact parathyroid hormone were significantly decreased and that of 25-hydroxyvitamin D was significantly increased 12 months after starting sunlight exposure. No patients had bone fractures after the start of sunlight exposure. These results suggest that sunlight exposure increased BMD, and that this may reduce the risk of bone fracture in children with disability. Georg Thieme Verlag KG Stuttgart · New York.

Multiscale analysis of the fracture pattern in granite, example of Tamariu's granite, Catalunya.

NASA Astrophysics Data System (ADS)

Bertrand, L.; LeGarzic, E.; Géraud, Y.; Diraison, M.

2012-04-01

Crystalline rocks can be the host of important fluid flow and therefore they can provide a good reservoir potential. In this kind of rocks, the matrice porosity is in general low and a large part of the permeability is governed by the fracture pattern. Thus, they are the first interest of studies in order to characterize and model the fluid flows. Actual reservoirs are underground, and the only access to the fracture pattern is with boreholes and seismic lines. Those methods are investigating different scales and dimensions: seismic is in 3D at a global scale whereas boreholes are 1D at a localized scale. To make the link between the different data, it is necessary to study field analogues where such fractured rocks are outcropping. Tamariu's granite, in Catalunya, has recently been studied as a field analogue of a fractured reservoir. The previous studies have lead to define structural blocks at different scales, linked to the regional deformation. This study's aim is to characterize the internal fracturation of a single structural block with a statistical analysis. We used one dimension scan lines at the scale of a block and 2 dimensions mapping at a more precise scale until the grain scale. The data highlighted that the fracture and fault lengths have a power law relation in 8 orders of scales. So this power law is stretching between seismic and borehole scales. Therefore, the data fit with a very good trust in the power law exponent, which is very well defined. The link between the reservoir scale faults and the internal block fracturation has also been defined in term of the structures orientation. Finally, a comparison between the 1D and 2D measurement could be done. The 1D scan lines show correctly the different fractures families but samples incompletely a part the fracture pattern, whereas the 2D maps which show more the global trends of the fractures and could lose some minor trends orientations.

SUBTASK 6.1 – STRATEGIC STUDIES

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

Erickson, Thomas; Harju, John; Steadman, Edward

The Energy & Environmental Research Center (EERC) has recently completed 7 years of research through the Cooperative Agreement with the U.S. Department of Energy (DOE) National Energy Technology Laboratory (NETL) focused on fossil energy technology development and demonstration. To support a significant number of the different activities being considered within all of our research contracts with NETL, a subtask (6.1 – Strategic Studies) was created to focus on small research efforts that came up throughout the year that would support an existing EERC–NETL project or would help to develop a new concept for inclusion in future efforts. This subtask wasmore » funded through the EERC–DOE Joint Program on Research and Development for Fossil Energy-Related Resources Cooperative Agreement No. DE-FC26- 08NT43291« less

Physical and mechanical characterisation of 3D-printed porous titanium for biomedical applications.

PubMed

El-Hajje, Aouni; Kolos, Elizabeth C; Wang, Jun Kit; Maleksaeedi, Saeed; He, Zeming; Wiria, Florencia Edith; Choong, Cleo; Ruys, Andrew J

2014-11-01

The elastic modulus of metallic orthopaedic implants is typically 6-12 times greater than cortical bone, causing stress shielding: over time, bone atrophies through decreased mechanical strain, which can lead to fracture at the implantation site. Introducing pores into an implant will lower the modulus significantly. Three dimensional printing (3DP) is capable of producing parts with dual porosity features: micropores by process (residual pores from binder burnout) and macropores by design via a computer aided design model. Titanium was chosen due to its excellent biocompatibility, superior corrosion resistance, durability, osteointegration capability, relatively low elastic modulus, and high strength to weight ratio. The mechanical and physical properties of 3DP titanium were studied and compared to the properties of bone. The mechanical and physical properties were tailored by varying the binder (polyvinyl alcohol) content and the sintering temperature of the titanium samples. The fabricated titanium samples had a porosity of 32.2-53.4% and a compressive modulus of 0.86-2.48 GPa, within the range of cancellous bone modulus. Other physical and mechanical properties were investigated including fracture strength, density, fracture toughness, hardness and surface roughness. The correlation between the porous 3DP titanium-bulk modulus ratio and porosity was also quantified.

Synchrotron quantification of fracturing during maturation of shales

NASA Astrophysics Data System (ADS)

Figueroa Pilz, Fernando; Fauchille, Anne-Laure; Dowey, Patrick; Courtois, Loic; Bay, Brian; Ma, Lin; Taylor, Kevin; Mecklenburgh, Julian; Lee, Peter

2017-04-01

To understand both the hydrocarbon migration within and from shale rocks, and during hydraulic fracturing, is needed to evaluate and predict its environmental footprint. As a consequence, the time characterization of fracture networks in shale is particularly important. Time resolved synchrotron X-ray tomography was used to quantify the initiation and propagation of fractures during the simulated maturation of an organic-rich Kimmeridge Clay shale from the µm to mm scales. Scanning electron microscopy (SEM) observations were performed before and after maturation in order to compare the microstructure evolution and better understand the fracture location. Fracture and strain development during heating was quantified in 3D by Digital Volume Correlation (DVC) (Bay et al., 1999). The combination of DVC, X-Ray tomography and SEM obtained direct 4D strain measurements of the anisotropic mechanical behaviour of Kimmeridge shale with the temperature during an accelerated thermal maturation (Figueroa Pilz et al.). Such a combination has rarely been investigated in 4D at these scales in the past. In the study conditions, the results demonstrated the anisotropy in thermal expansion and the aperture fracture pathways through organic matter and clay matrix.

The predicted lifetime costs and health consequences of calcium and vitamin D supplementation for fracture prevention-the impact of cardiovascular effects.

PubMed

Hagen, G; Wisløff, T; Kristiansen, I S

2016-06-01

Some studies indicate that calcium supplementation increases cardiovascular risk. We assessed whether such effects could counterbalance the fracture benefits from supplementation. Accounting for cardiovascular outcomes, calcium may cause net harm and would not be cost-effective. Clinicians may do well considering cardiovascular effects when prescribing calcium supplementation. Accounting for possible cardiovascular effect of calcium and vitamin D supplementation (CaD), the aims of this study were to assess whether CaD on balance would improve population health and to evaluate the cost-effectiveness of such supplementation. We created a probabilistic Markov simulation model that was analysed at the individual patient level. We analysed 65-year-old Norwegian women with a 2.3 % 10-year risk of hip fracture and a 9.3 % risk of any major fracture according to the WHO fracture risk assessment tool (FRAX®). Consistent with a recent Cochrane review, we assumed that CaD reduces the risk of hip, vertebral, and wrist fractures by 16, 11, and 5 %, respectively. We included the increased risk of acute myocardial infarction (AMI) and stroke under a no-, medium-, and high-risk scenario. Assuming no cardiovascular effects, CaD supplementation produces improved health outcomes resulting in an incremental gain of 0.0223 quality-adjusted life years (QALYs) and increases costs by €322 compared with no treatment (cost-effectiveness ratio €14,453 per QALY gained). Assuming a Norwegian cost-effectiveness threshold of €60,000 per QALY, CaD is likely to be considered a cost-effective treatment alternative. In a scenario with a medium or high increased risk of cardiovascular events, CaD produces net health losses, respectively, -0.0572 and -0.0784 QALY at additional costs of €481 and €1033. We conclude that the magnitude of potential cardiovascular side effects is crucial for the effectiveness and cost-effectiveness of CaD supplementation in elderly women.

Reactor Pressure Vessel Fracture Analysis Capabilities in Grizzly

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

Spencer, Benjamin; Backman, Marie; Chakraborty, Pritam

2015-03-01

Efforts have been underway to develop fracture mechanics capabilities in the Grizzly code to enable it to be used to perform deterministic fracture assessments of degraded reactor pressure vessels (RPVs). Development in prior years has resulted a capability to calculate -integrals. For this application, these are used to calculate stress intensity factors for cracks to be used in deterministic linear elastic fracture mechanics (LEFM) assessments of fracture in degraded RPVs. The -integral can only be used to evaluate stress intensity factors for axis-aligned flaws because it can only be used to obtain the stress intensity factor for pure Mode Imore » loading. Off-axis flaws will be subjected to mixed-mode loading. For this reason, work has continued to expand the set of fracture mechanics capabilities to permit it to evaluate off-axis flaws. This report documents the following work to enhance Grizzly’s engineering fracture mechanics capabilities for RPVs: • Interaction Integral and -stress: To obtain mixed-mode stress intensity factors, a capability to evaluate interaction integrals for 2D or 3D flaws has been developed. A -stress evaluation capability has been developed to evaluate the constraint at crack tips in 2D or 3D. Initial verification testing of these capabilities is documented here. • Benchmarking for axis-aligned flaws: Grizzly’s capabilities to evaluate stress intensity factors for axis-aligned flaws have been benchmarked against calculations for the same conditions in FAVOR. • Off-axis flaw demonstration: The newly-developed interaction integral capabilities are demon- strated in an application to calculate the mixed-mode stress intensity factors for off-axis flaws. • Other code enhancements: Other enhancements to the thermomechanics capabilities that relate to the solution of the engineering RPV fracture problem are documented here.« less

Biocompatibility of Bespoke 3D-Printed Titanium Alloy Plates for Treating Acetabular Fractures.

PubMed

Lin, Xuezhi; Xiao, Xingling; Wang, Yimeng; Gu, Cheng; Wang, Canbin; Chen, Jiahui; Liu, Han; Luo, Juan; Li, Tao; Wang, Di; Fan, Shicai

2018-01-01

Treatment of acetabular fractures is challenging, not only because of its complicated anatomy but also because of the lack of fitting plates. Personalized titanium alloy plates can be fabricated by selective laser melting (SLM) but the biocompatibility of these three-dimensional printing (3D-printed) plates remains unknown. Plates were manufactured by SLM and their cytocompatibility was assessed by observing the metabolism of L929 fibroblasts incubated with culture medium extracts using a CCK-8 assay and their morphology by light microscopy. Allergenicity was tested using a guinea pig maximization test. In addition, acute systemic toxicity of the 3D-printed plates was determined by injecting extracts from the implants into the tail veins of mice. Finally, the histocompatibility of the plates was investigated by implanting them into the dorsal muscles of rabbits. The in vitro results suggested that cytocompatibility of the 3D-printed plates was similar to that of conventional plates. The in vivo data also demonstrated histocompatibility that was comparable between the two manufacturing techniques. In conclusion, both in vivo and in vitro experiments suggested favorable biocompatibility of 3D-printed titanium alloy plates, indicating that it is a promising option for treatment of acetabular fractures.

Biocompatibility of Bespoke 3D-Printed Titanium Alloy Plates for Treating Acetabular Fractures

PubMed Central

Xiao, Xingling; Wang, Yimeng; Gu, Cheng; Wang, Canbin; Chen, Jiahui; Liu, Han; Luo, Juan; Li, Tao

2018-01-01

Treatment of acetabular fractures is challenging, not only because of its complicated anatomy but also because of the lack of fitting plates. Personalized titanium alloy plates can be fabricated by selective laser melting (SLM) but the biocompatibility of these three-dimensional printing (3D-printed) plates remains unknown. Plates were manufactured by SLM and their cytocompatibility was assessed by observing the metabolism of L929 fibroblasts incubated with culture medium extracts using a CCK-8 assay and their morphology by light microscopy. Allergenicity was tested using a guinea pig maximization test. In addition, acute systemic toxicity of the 3D-printed plates was determined by injecting extracts from the implants into the tail veins of mice. Finally, the histocompatibility of the plates was investigated by implanting them into the dorsal muscles of rabbits. The in vitro results suggested that cytocompatibility of the 3D-printed plates was similar to that of conventional plates. The in vivo data also demonstrated histocompatibility that was comparable between the two manufacturing techniques. In conclusion, both in vivo and in vitro experiments suggested favorable biocompatibility of 3D-printed titanium alloy plates, indicating that it is a promising option for treatment of acetabular fractures. PMID:29682523

[Arthroscopically Assisted Minimally Invasive Fixation of a Type D2c Scapular Fracture].

PubMed

Kornherr, Patrick; Konerding, Christiane; Kovacevic, Mark; Wenda, Klaus

2018-06-12

Fractures of the scapula are rare and have an incidence of 1% of all fractures. Publications highlight glenoid rim fractures. Classification by Ideberg and Euler and Rüdi are accepted. Euler and Rüdi describe three extra-articular and two intra-articular fracture patterns. The indications for surgery are displaced glenoid fractures, scapula tilt of more than 40° and injuries to the superior shoulder suspensory complex. We describe a case of a 22 year old man, who while cycling collided with a moving car due to wet roads. After his admission to hospital as a polytraumatised patient, the trauma CT-Scan showed haemothorax with several associated rip fractures, displaced humeral shaft fracture and fractures of the acromion and glenoid, classified as type D2c according to Euler and Rüdi. Following damage control principles, drainage of the haemothorax was already performed in the ER and surgical treatment of the displaced humeral shaft fracture was performed on the day of admission. No peripheral neurological deficits were evident. After pulmonary stabilisation, surgery was performed 6 days later on the glenoid and acromion fracture, which in conjunction may be regarded as an injury to the superior shoulder suspensory complex. We performed an arthroscopically-assisted screw fixation of the glenoid fracture (type D2c according to Euler and Rüdi) and an ORIF procedure at the acromion. Postoperative rehabilitation was performed with passive abduction and elevation up to 90° for the first two weeks and active abduction an elevation up to 90° for weeks 3 to 6. Full ROM was allowed at week 7. Articular fractures of the glenoid are rare and mainly seen as rim fractures. The indications for surgery are displaced articular fractures and injury to the superior shoulder suspensory complex. As demonstrated by this article, type D2c fractures according to Euler and Rüdi can be treated effectively as an arthroscopically-assisted screw fixation procedure. Georg Thieme Verlag KG Stuttgart · New York.

Constitutive Model Constants for Al7075-T651 and Al7075-T6

NASA Astrophysics Data System (ADS)

Brar, Nachhatter; Joshi, Vasant; Harris, Bryan

2009-06-01

Aluminum 7075-T651 and 7075-T6 are characterized at quasi-static and high strain rates to determine Johnson-Cook (J-C) strength and fracture model constants. Constitutive model constants are required as input to computer codes to simulate projectile (fragment) impact or similar impact events on structural components made of these material. J-C strength model constants (A, B, n, C, and m) for the two alloys are determined from tension stress-strain data at room and high temperature to 250^oC. J-C strength model constants for Al7075-T651 are: A=527 MPa, B=676 MPa, n=0.71, C=0.017, and m=1.61 and for Al7075-T6: A = 546 MPa, B = 674 MPa, n = 0.72, C = 0.059, and m =1.56. J-C fracture model constants are determined form quasi-static and high strain rate/high temperature tests on notched and smooth tension specimens. J-C fracture model constants for the two alloys are: Al7075-T651; D1 = 0.110, D2 = 0.573, D3= -3.4446, D4 = 0.016, and D 5= 1.099 and Al7075-T6; D1= 0.451 D2= -0.952 D3= -.068, D4 =0.036, and D5 = 0.697.

Direct Observations of Fracture and the Damage Mechanics of Ceramics

DTIC Science & Technology

1988-10-31

microplasticity up to the fracture load. d. It shculd have low enough strength in tension and compression to enable strength measurements at easily accessible...15jm. SEM examination of the grains after large amounts of deformation indicated that the grains are brittle without any evidence of microplasticity . In...and microplasticity in polycrystalline alumina", J.Mater.Sci., 12(1977)791-796. 93. J Lankford, "Compressive microfracture and indentation damage in A1

Fatigue Failure in Extra-Articular Proximal Tibia Fractures: Locking Intramedullary Nail Versus Double Locking Plates-A Biomechanical Study.

PubMed

Kandemir, Utku; Herfat, Safa; Herzog, Mary; Viscogliosi, Paul; Pekmezci, Murat

2017-02-01

The goal of this study is to compare the fatigue strength of a locking intramedullary nail (LN) construct with a double locking plate (DLP) construct in comminuted proximal extra-articular tibia fractures. Eight pairs of fresh frozen cadaveric tibias with low bone mineral density [age: 80 ± 7 (SD) years, T-score: -2.3 ± 1.2] were used. One tibia from each pair was fixed with LN, whereas the contralateral side was fixed with DLP for complex extra-articular multifragmentary metaphyseal fractures (simulating OTA 41-A3.3). Specimens were cyclically loaded under compression simulating single-leg stance by staircase method out to 260,000 cycles. Every 2500 cycles, localized gap displacements were measured with a 3D motion tracking system, and x-ray images of the proximal tibia were acquired. To allow for mechanical settling, initial metrics were calculated at 2500 cycles. The 2 groups were compared regarding initial construct stiffness, initial medial and lateral gap displacements, stiffness at 30,000 cycles, medial and lateral gap displacements at 30,000 cycles, failure load, number of cycles to failure, and failure mode. Failure metrics were reported for initial and catastrophic failures. DLP constructs exhibited higher initial stiffness and stiffness at 30,000 cycles compared with LN constructs (P < 0.03). There were no significant differences between groups for loads at failure or cycles to failure. For the fixation of extra-articular proximal tibia fractures, a LN provides a similar fatigue performance to double locked plates. The locked nail could be safely used for fixation of proximal tibia fractures with the advantage of limited extramedullary soft tissue damage.

Intraoperative assessment of reduction and implant placement in acetabular fractures-limitations of 3D-imaging compared to computed tomography.

PubMed

Keil, Holger; Beisemann, Nils; Schnetzke, Marc; Vetter, Sven Yves; Swartman, Benedict; Grützner, Paul Alfred; Franke, Jochen

2018-04-10

In acetabular fractures, the assessment of reduction and implant placement has limitations in conventional 2D intraoperative imaging. 3D imaging offers the opportunity to acquire CT-like images and thus to improve the results. However, clinical experience shows that even 3D imaging has limitations, especially regarding artifacts when implants are placed. The purpose of this study was to assess the difference between intraoperative 3D imaging and postoperative CT regarding reduction and implant placement. Twenty consecutive cases of acetabular fractures were selected with a complete set of intraoperative 3D imaging and postoperative CT data. The largest detectable step and the largest detectable gap were measured in all three standard planes. These values were compared between the 3D data sets and CT data sets. Additionally, possible correlations between the possible confounders age and BMI and the difference between 3D and CT values were tested. The mean difference of largest visible step between the 3D imaging and CT scan was 2.0 ± 1.8 mm (0.0-5.8, p = 0.02) in the axial, 1.3 ± 1.4 mm (0.0-3.7, p = 0.15) in the sagittal and 1.9 ± 2.4 mm (0.0-7.4, p = 0.22) in the coronal views. The mean difference of largest visible gap between the 3D imaging and CT scan was 3.1 ± 3.6 mm (0.0-14.1, p = 0.03) in the axial, 4.6 ± 2.7 mm (1.2-8.7, p = 0.001) in the sagittal and 3.5 ± 4.0 mm (0.0-15.4, p = 0.06) in the coronal views. A positive correlation between the age and the difference in gap measurements in the sagittal view was shown (rho = 0.556, p = 0.011). Intraoperative 3D imaging is a valuable adjunct in assessing reduction and implant placement in acetabular fractures but has limitations due to artifacts caused by implant material. This can lead to missed malreduction and impairment of clinical outcome, so postoperative CT should be considered in these cases.

Bioactive glass granules: a suitable bone substitute material in the operative treatment of depressed lateral tibial plateau fractures: a prospective, randomized 1 year follow-up study.

PubMed

Heikkilä, Jouni T; Kukkonen, Juha; Aho, Allan J; Moisander, Susanna; Kyyrönen, Timo; Mattila, Kimmo

2011-04-01

Purpose of this study was to compare bioactive glass and autogenous bone as a bone substitute material in tibial plateau fractures. We designed a prospective, randomized study consisting of 25 consecutive operatively treated patients with depressed unilateral tibial comminuted plateau fracture (AO classification 41 B2 and B3).14 patients (7 females, 7 males, mean age 57 years, range 25-82) were randomized in the bioglass group (BG) and 11 patients (6 females, 5 males, mean age 50 years, range 31-82) served as autogenous bone control group (AB). Clinical examination of the patients was performed at 3 and 12 months, patients' subjective and functional results were evaluated at 12 months. Radiological analysis was performed preoperatively, immediately postoperatively and at 3 and 12 months. The postoperative redepression for both studied groups was 1 mm until 3 months and remained unchanged at 12 months. No differences were identified in the subjective evaluation, functional tests and clinical examination between the two groups during 1 year follow-up. We conclude that bioactive glass granules can be clinically used as filler material instead of autogenous bone in the lateral tibial plateau compression fractures.

Vacuum Brazing TC4 Titanium Alloy to 304 Stainless Steel with Cu-Ti-Ni-Zr-V Amorphous Alloy Foil

NASA Astrophysics Data System (ADS)

Dong, Honggang; Yang, Zhonglin; Wang, Zengrui; Deng, Dewei; Dong, Chuang

2014-10-01

Dissimilar metal vacuum brazing between TC4 titanium alloy and 304 stainless steel was conducted with newly designed Cu-Ti-Ni-Zr-V amorphous alloy foils as filler metals. Solid joints were obtained due to excellent compatibility between the filler metal and stainless steel substrate. Partial dissolution of stainless steel substrate occurred during brazing. The shear strength of the joint brazed with Cu43.75Ti37.5Ni6.25Zr6.25V6.25 foil was 105 MPa and that with Cu37.5Ti25Ni12.5Zr12.5V12.5 was 116 MPa. All the joints fractured through the gray layer in the brazed seam, revealing brittle fracture features. Cr4Ti, Cu0.8FeTi, Fe8TiZr3 and Al2NiTi3C compounds were found in the fractured joint brazed with Cu43.75Ti37.5Ni6.25Zr6.25V6.25 foil, and Fe2Ti, TiCu, Fe8TiZr3 and NiTi0.8Zr0.3 compounds were detected in the joint brazed with Cu37.5Ti25Ni12.5Zr12.5V12.5 foil. The existence of Cr-Ti, Fe-Ti, Cu-Fe-Ti, and Fe-Ti-V intermetallic compounds in the brazed seam caused fracture of the resultant joints.

[Pedicle flap transfer combined with external fixator to treat leg open fracture with soft tissue defect].

PubMed

Luo, Zhongchun; Lou, Hua; Jiang, Junwei; Song, Chunlin; Gong, Min; Wang, Yongcai

2008-08-01

To investigate the clinical results of treating leg open fracture with soft tissue defect by pedicle flap transfer in combination with external fixator. From May 2004 to June 2007, 12 cases of leg open fracture with soft tissue defect, 9 males and 3 females aged 18-75 years, were treated. Among them, 8 cases were caused by traffic accidents, 2 crush, 1 falling and 1 mechanical accident. According to the Gustilo Classification, there were 2 cases of type II, 5 of type IIIA and 5 of type IIIB. There were 2 cases of upper-tibia fracture, 3 of middle-tibia and 7 of middle-lower. The sizes of soft tissue defect ranged from 5 cm x 3 cm to 22 cm x 10 cm.The sizes of exposed bone ranged from 3 cm x 2 cm to 6 cm x 3 cm. The course of the disease was 1-12 hours. Fracture fixation was reached by external fixators or external fixators and limited internal fixation with Kirschner wire. The wounds with exposed tendons and bones were repaired by ipsilateral local rotation flap, sural neurocutaneous flap and saphenous nerve flap. The size of selected flap ranged from 5 cm x 4 cm to 18 cm x 12 cm. Granulation wounds were repaired by skin grafting or direct suture. All patients were followed up for 6 months to 2 years. All patients survived, among whom 2 with the wound edge infection and 1 with the distal necrosis were cured by changing the dressing, 8 with pin hole infection were treated by taking out the external fixator, 1 with nonunion received fracture healing after bone graft in comminuted fracture of lower tibia, 2 suffered delayed union in middle-lower tibia fracture. The ROM of ankle in 3 cases was mildly poor with surpass-joint fixation, with plantar extension of 0-10 degrees and plantar flexion of 10-30 degrees, while the others had plantar extension of 10-20 degrees and plantar flexion of 30-50 degrees. The method of pedicle flap transfer combined with external fixator is safe and effective for the leg open fracture with soft tissue defect.

Numerical analysis of standard and modified osteosynthesis in long bone fractures treatment.

PubMed

Sisljagić, Vladimir; Jovanović, Savo; Mrcela, Tomislav; Radić, Radivoje; Selthofer, Robert; Mrcela, Milanka

2010-03-01

The fundamental problem in osteoporotic fracture treatment is significant decrease in bone mass and bone tissue density resulting in decreased firmness and elasticity of osteoporotic bone. Application of standard implants and standard surgical techniques in osteoporotic bone fracture treatment makes it almost impossible to achieve stable osteosynthesis sufficient for early mobility, verticalization and load. Taking into account the form and the size of the contact surface as well as distribution of forces between the osteosynthetic materials and the bone tissue numerical analysis showed advantages of modified osteosynthesis with bone cement filling in the screw bed. The applied numerical model consisted of three sub-models: 3D model from solid elements, 3D cross section of the contact between the plate and the bone and the part of 3D cross section of the screw head and body. We have reached the conclusion that modified osteosynthesis with bone cement resulted in weaker strain in the part of the plate above the fracture fissure, more even strain on the screws, plate and bone, more even strain distribution along all the screws' bodies, significantly greater strain in the part of the screw head opposite to the fracture fissure, firm connection of the screw head and neck and the plate hole with the whole plate and more even bone strain around the screw.

A Clinically Realistic Large Animal Model of Intra-Articular Fracture

DTIC Science & Technology

2013-10-01

Model of Intra-Articular Fracture PRINCIPAL INVESTIGATOR: Jessica E. Goetz, Ph D CONTRACTING ORGANIZATION: The University of Iowa...5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Jessica E. Goetz, Ph D 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail...short-term survival study investigating the effects of therapeutic treatment which was initiated during PY3 will be completed. 15. SUBJECT TERMS post

Effect of Joint Scale and Processing on the Fracture of Sn-3Ag-0.5Cu Solder Joints: Application to Micro-bumps in 3D Packages

NASA Astrophysics Data System (ADS)

Talebanpour, B.; Huang, Z.; Chen, Z.; Dutta, I.

2016-01-01

In 3-dimensional (3D) packages, a stack of dies is vertically connected to each other using through-silicon vias and very thin solder micro-bumps. The thinness of the micro-bumps results in joints with a very high volumetric proportion of intermetallic compounds (IMCs), rendering them much more brittle compared to conventional joints. Because of this, the reliability of micro-bumps, and the dependence thereof on the proportion of IMC in the joint, is of substantial concern. In this paper, the growth kinetics of IMCs in thin Sn-3Ag-0.5Cu joints attached to Cu substrates were analyzed, and empirical kinetic laws for the growth of Cu6Sn5 and Cu3Sn in thin joints were obtained. Modified compact mixed mode fracture mechanics samples, with adhesive solder joints between massive Cu substrates, having similar thickness and IMC content as actual micro-bumps, were produced. The effects of IMC proportion and strain rate on fracture toughness and mechanisms were investigated. It was found that the fracture toughness G C decreased with decreasing joint thickness ( h Joint). In addition, the fracture toughness decreased with increasing strain rate. Aging also promoted alternation of the crack path between the two joint-substrate interfaces, possibly proffering a mechanism to enhance fracture toughness.

The subsurface impact of hydraulic fracturing in shales- Perspectives from the well and reservoir

NASA Astrophysics Data System (ADS)

ter Heege, Jan; Coles, Rhys

2017-04-01

It has been identified that the main risks of subsurface shale gas operations in the U.S.A. and Canada are associated with (1) drilling and well integrity, (2) hydraulic fracturing, and (3) induced seismicity. Although it is unlikely that hydraulic fracturing operations result in direct pathways of enhanced migration between stimulated fracture disturbed rock volume and shallow aquifers, operations may jeopardize well integrity or induce seismicity. From the well perspective, it is often assumed that fluid injection leads to the initiation of tensile (mode I) fractures at different perforation intervals along the horizontal sections of shale gas wells if pore pressure exceeds the minimum principal stress. From the reservoir perspective, rise in pore pressure resulting from fluid injection may lead to initiation of tensile fractures, reactivation of shear (mode II) fractures if the criterion for failure in shear is exceeded, or combinations of different fracturing modes. In this study, we compare tensile fracturing simulations using conventional well-based models with shear fracturing simulations using a fractured shale model with characteristic fault populations. In the fractured shale model, stimulated permeability is described by an analytical model that incorporates populations of reactivated faults and that combines 3D permeability tensors for layered shale matrix, damage zone and fault core. Well-based models applied to wells crosscutting the Posidonia Shale Formation are compared to generic fractured shale models, and fractured shale models are compared to micro-seismic data from the Marcellus Shale. Focus is on comparing the spatial distribution of permeability, stimulated reservoir volume and seismicity, and on differences in fracture initiation pressure and fracture orientation for tensile and shear fracturing end-members. It is shown that incorporation of fault populations (for example resulting from analysis of 3D seismics or outcrops) in hydraulic fracturing models provides better constraints on well pressures, stimulated fracture disturbed volume and induced seismicity. Thereby, it helps assessing the subsurface impact of hydraulic fracturing in shales and mitigating risks associated with loss of loss of well integrity, loss of fracture containment, and induced seismicity.

Effects of chemical alteration on fracture mechanical properties in hydrothermal systems

NASA Astrophysics Data System (ADS)

Callahan, O. A.; Eichhubl, P.; Olson, J. E.

2015-12-01

Fault and fracture networks often control the distribution of fluids and heat in hydrothermal and epithermal systems, and in related geothermal and mineral resources. Additional chemical influences on conduit evolution are well documented, with dissolution and precipitation of mineral species potentially changing the permeability of fault-facture networks. Less well understood are the impacts of chemical alteration on the mechanical properties governing fracture growth and fracture network geometry. We use double-torsion (DT) load relaxation tests under ambient air conditions to measure the mode-I fracture toughness (KIC) and subcritical fracture growth index (SCI) of variably altered rock samples obtained from outcrop in Dixie Valley, NV. Samples from southern Dixie Valley include 1) weakly altered granite, characterized by minor sericite in plagioclase, albitization and vacuolization of feldspars, and incomplete replacement of biotite with chlorite, and 2) granite from an area of locally intense propylitic alteration with chlorite-calcite-hematite-epidote assemblages. We also evaluated samples of completely silicified gabbro obtained from the Dixie Comstock epithermal gold deposit. In the weakly altered granite KIC and SCI are 1.3 ±0.2 MPam1/2 (n=8) and 59 ±25 (n=29), respectively. In the propylitic assemblage KIC is reduced to 0.6 ±0.1 MPam1/2 (n=11), and the SCI increased to 75 ±36 (n = 33). In both cases, the altered materials have lower fracture toughness and higher SCI than is reported for common geomechanical standards such as Westerly Granite (KIC ~1.7 MPam1/2; SCI ~48). Preliminary analysis of the silicified gabbro shows a significant increase in fracture toughness, 3.6 ±0.4 MPam1/2 (n=2), and SCI, 102 ±45 (n=19), compared to published values for gabbro (2.9 MPam1/2 and SCI = 32). These results suggest that mineralogical and textural changes associated with different alteration assemblages may result in spatially variable rates of fracture initiation and growth in different parts of hydrothermal systems. Contrasting fracture mechanical properties between alteration assemblages may constitute a new mechanism of chemical-mechanical feedback that contributes to the localization of conduits in hydrothermal systems.

3D Geological Model for "LUSI" - a Deep Geothermal System

NASA Astrophysics Data System (ADS)

Sohrabi, Reza; Jansen, Gunnar; Mazzini, Adriano; Galvan, Boris; Miller, Stephen A.

2016-04-01

Geothermal applications require the correct simulation of flow and heat transport processes in porous media, and many of these media, like deep volcanic hydrothermal systems, host a certain degree of fracturing. This work aims to understand the heat and fluid transport within a new-born sedimentary hosted geothermal system, termed Lusi, that began erupting in 2006 in East Java, Indonesia. Our goal is to develop conceptual and numerical models capable of simulating multiphase flow within large-scale fractured reservoirs such as the Lusi region, with fractures of arbitrary size, orientation and shape. Additionally, these models can also address a number of other applications, including Enhanced Geothermal Systems (EGS), CO2 sequestration (Carbon Capture and Storage CCS), and nuclear waste isolation. Fractured systems are ubiquitous, with a wide-range of lengths and scales, making difficult the development of a general model that can easily handle this complexity. We are developing a flexible continuum approach with an efficient, accurate numerical simulator based on an appropriate 3D geological model representing the structure of the deep geothermal reservoir. Using previous studies, borehole information and seismic data obtained in the framework of the Lusi Lab project (ERC grant n°308126), we present here the first 3D geological model of Lusi. This model is calculated using implicit 3D potential field or multi-potential fields, depending on the geological context and complexity. This method is based on geological pile containing the geological history of the area and relationship between geological bodies allowing automatic computation of intersections and volume reconstruction. Based on the 3D geological model, we developed a new mesh algorithm to create hexahedral octree meshes to transfer the structural geological information for 3D numerical simulations to quantify Thermal-Hydraulic-Mechanical-Chemical (THMC) physical processes.

Treatment of Displaced Intra-articular Calcaneal Fractures by Intramedullary Nail. Preliminary Report.

PubMed

Falis, Mirosław; Pyszel, Krystian

2016-03-23

Open reduction and plate stabilisation is a recognised method of treatment of intra-articular calcaneal fractures. The surgical approach to the calcaneal bone used in these procedures is associated with a high risk of complications. The aim of this paper is to present the author's experience with a new surgical method and analyse early outcomes of the treatment of calcaneal fractures by Calcanail intramedullary nailing. The study encompassed 17 patients (5 women and 12 men) with 18 calcaneal fractures (5 in the right foot and 13 in the left foot). The mean age of the patients was 47 years (range: 22-68 years). The mean time between the injury and surgery was 6 days (range: 3-14 days). The mean duration of follow-up was 12 months (range: 6-18 months). The fractures were classified according to the system presented by Guy Utheza. Bone union was achieved in all patients within 12 weeks of surgery. No infectious complications were observed. The mean AOFAS score was 82/100. Mean Bohler's angle was -3 degrees pre-operatively and +29 degrees post-operatively. 1. The use of Calcanail intramedullary nailing in the treatment of displaced intra-articular fractures is a minimally invasive procedure associated with a low risk of complications. 2. The innovative posterior approach allows for the intrafocal reduction of an articular surface fracture through the prepared intramedullary canal.

Coupled Thermo-Hydro-Chemical (THC) Modeling of Hypogene Karst Evolution in a Prototype Mountain Hydrologic System

NASA Astrophysics Data System (ADS)

Chaudhuri, A.; Rajaram, H.; Viswanathan, H. S.; Zyvoloski, G.

2011-12-01

Hypogene karst systems are believed to develop when water flowing upward against the geothermal gradient dissolves limestone as it cools. We present a comprehensive THC model incorporating time-evolving fluid flow, heat transfer, buoyancy effects, multi-component reactive transport and aperture/permeability change to investigate the origin of hypogene karst systems. Our model incorporates the temperature and pressure dependence of the solubility and dissolution kinetics of calcite. It also allows for rigorous representation of temperature-dependent fluid density and its influence on buoyancy forces at various stages of karstification. The model is applied to investigate karstification over geological time scales in a prototype mountain hydrologic system. In this system, a high water table maintained by mountain recharge, drives flow downward through the country rock and upward via a high-permeability fault/fracture. The pressure boundary conditions are maintained constant in time. The fluid flux through the fracture remains nearly constant even though the fracture aperture and permeability increase by dissolution, largely because the permeability of the country rock is not altered significantly due to slower dissolution rates. However, karstification by fracture dissolution is not impeded even though the fluid flux stays nearly constant. Forced and buoyant convection effects arise due to the increased permeability of the evolving fracture system. Since in reality the aperture varies significantly within the fracture plane, the initial fracture aperture is modeled as a heterogeneous random field. In such a heterogeneous aperture field, the water initially flows at a significant rate mainly through preferential flow paths connecting the relatively large aperture zones. Dissolution is more prominent at early time along these flow paths, and the aperture grows faster within these paths. With time, the aperture within small sub-regions of these preferential flow paths grows to a point where the permeability is large enough for the onset of buoyant convection. As a result, a multitude of buoyant convection cells form that take on a two-dimensional (2D) maze-like appearance, which could represent a 2D analog of the three-dimensional (3D) mazework pattern widely thought to be characteristic of hypogene cave systems. Although computational limitations limited us to 2D, we suggest that similar process interactions in a 3D network of fractures and faults could produce a 3D mazework.

De Novo Chromosome Copy Number Variation in Fanconi Anemia-Associated Hematopoietic Defects

DTIC Science & Technology

2012-04-01

Appendix 1. Expansion of monoclonal populations of FA-A hTERT and FA-A + FANCA hTERT cells Appendix 2. Expansion of monoclonal populations of FA...marrow failure (BMF) and pronounced cancer susceptibility. The FA proteins and the major breast cancer susceptibility gene products BRCA1 and BRCA2...Correction of FA-A, FA-C, and FA-D2 hTERT cells with pLenti6.2/V5- FANCA , -FANCC, and FANCD2, respectively. Sub-task 1. Selection and expansion of clonal

Engineering and Physics Optimization of Breed and Burn Fast Reactor Systems; NUCLEAR ENERGY RESEARCH INITIATIVE (NERI) QUARTERLY PROGRESS REPORT

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

Pavel Hejzlar, Peter Yarsky, Mike Driscoll, Dan Wachs, Kevan Weaver, Ken Czerwinski, Mike Pope, James Parry, Theron D. Marshall, Cliff B. Davis, Dustin Crawford, Thomas Hartmann, Pradip Saha; Hejzlar, Pavel; Yarsky, Peter

2005-01-31

This project is organized under four major tasks (each of which has two or more subtasks) with contributions among the three collaborating organizations (MIT, INEEL and ANL-West): Task A: Core Physics and Fuel Cycle; Task B: Core Thermal Hydraulics; Task C: Plant Design; Task D: Fuel Design The lead PI, Michael J. Driscoll, has consolidated and summarized the technical progress submissions provided by the contributing investigators from all sites, under the above principal task headings.

A Multidisciplinary Approach to Study the Role of the Gut Microbiome in Relapsing and Progressive MS

DTIC Science & Technology

2016-10-01

AWARD NUMBER: W81XWH-15-1-0654 TITLE: A Multidisciplinary Approach to Study the Role of the Gut Microbiome in Relapsing and Progressive MS...Multidisciplinary Approach to Study the Role of the Gut Microbiome in Relapsing and Progressive MS 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Major Tasks and subtasks: Aim#1: To compare the gut microbiome of subjects with RMS and PPMS. Major Task 1: To seek and obtain HRPO approval Major

A Multidisciplinary Approach to Study the Role of the Gut Microbiome in Relapsing and Progressive MS

DTIC Science & Technology

2016-10-01

AWARD NUMBER: W81XWH-15-1-0652 TITLE: A Multidisciplinary Approach to Study the Role of the Gut Microbiome in Relapsing and Progressive MS...0652 A Multidisciplinary Approach to Study the Role of the Gut Microbiome in Relapsing and Progressive MS 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...SOW, each Aim was subdivided into Major Tasks and subtasks: Aim#1: To compare the gut microbiome of subjects with RMS and PPMS. Major Task 1

Manufacturing Technology Support (MATES II) Task Order 0005: Manufacturing Integration and Technology Evaluation to Enable Technology Transition. Subtask Phase 0 Study Task: Manufacturing Technology (ManTech) and Systems Engineering For Quick Reaction Systems

DTIC Science & Technology

2014-10-01

Porosity from gas entrapment & shrinkage 4 Continuous Fiber Ti Metal Matrix Composites (Aircraft panels and rotor components) [14...process models for casting, forging, and welding , and software capability to integrate various independent models with design, thermal, and structural...Applications, Ph.D. Thesis, Queen’s College, University of Oxford, (2007). 14. S.A. Singerman and J.J. Jackson, Titanium Metal Matrix Composites for

Propulsion and Power Rapid Response Research and Development (R&D) Support. Delivery Order 0011: Advanced Propulsion Fuels Research and Development-Subtask: Framework and Guidance for Estimating Greenhouse Gas Footprints of Aviation Fuels

DTIC Science & Technology

2009-04-01

Uncertainties, Gaps , and Issues for the Use of GWP to Examine Emissions From Aviation That Impact Global Climate Change. (Wuebbles, Yang and Herman 2008...selecting time periods and spatial scales for data gathering, strategies for filling data gaps , and computational considerations for managing the...Fuels Assumptions, methodological choices, strategies for filling data gaps , and other factors throughout the life cycle substantially influence the

Cross-education for improving strength and mobility after distal radius fractures: a randomized controlled trial.

PubMed

Magnus, Charlene R A; Arnold, Cathy M; Johnston, Geoffrey; Dal-Bello Haas, Vanina; Basran, Jenny; Krentz, Joel R; Farthing, Jonathan P

2013-07-01

To evaluate the effects of cross-education (contralateral effect of unilateral strength training) during recovery from unilateral distal radius fractures on muscle strength, range of motion (ROM), and function. Randomized controlled trial (26-wk follow-up). Hospital, orthopedic fracture clinic. Women older than 50 years with a unilateral distal radius fracture. Fifty-one participants were randomized and 39 participants were included in the final data analysis. Participants were randomized to standard rehabilitation (Control) or standard rehabilitation plus strength training (Train). Standard rehabilitation included forearm casting for 40.4±6.2 days and hand exercises for the fractured extremity. Nonfractured hand strength training for the training group began immediately postfracture and was conducted at home 3 times/week for 26 weeks. The primary outcome measure was peak force (handgrip dynamometer). Secondary outcomes were ROM (flexion/extension; supination/pronation) via goniometer and the Patient Rated Wrist Evaluation questionnaire score for the fractured arm. For the fractured hand, the training group (17.3±7.4kg) was significantly stronger than the control group (11.8±5.8kg) at 12 weeks postfracture (P<.017). There were no significant strength differences between the training and control groups at 9 (12.5±8.2kg; 11.3±6.9kg) or 26 weeks (23.0±7.6kg; 19.6±5.5kg) postfracture, respectively. Fractured hand ROM showed that the training group had significantly improved wrist flexion/extension (100.5°±19.2°) than the control group (80.2°±18.7°) at 12 weeks postfracture (P<.017). There were no significant differences between the training and control groups for flexion/extension ROM at 9 (78.0°±20.7°; 81.7°±25.7°) or 26 weeks (104.4°±15.5°; 106.0°±26.5°) or supination/pronation ROM at 9 (153.9°±23.9°; 151.8°±33.0°), 12 (170.9°±9.3°; 156.7°±20.8°) or 26 weeks (169.4°±11.9°; 162.8°±18.1°), respectively. There were no significant differences in Patient Rated Wrist Evaluation questionnaire scores between the training and control groups at 9 (54.2±39.0; 65.2±28.9), 12 (36.4±37.2; 46.2±35.3), or 26 weeks (23.6±25.6; 19.4±16.5), respectively. Strength training for the nonfractured limb after a distal radius fracture was associated with improved strength and ROM in the fractured limb at 12 weeks postfracture. These results have important implications for rehabilitation strategies after unilateral injuries. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

[Multidisciplinary approach of hip fractures based on Hungarian data].

PubMed

Juhász, Krisztina; Turchányi, Béla; Mintál, Tibor; Somogyi, Péter

2016-09-01

Hip fractures are described by increased mortality, loss of quality of life, functional decline and burden of diseases. They show a growing number worldwide. The aim of the present study is to summarise the existing data on the incidence, mortality, complications and rehabilitation of hip fractures, which relevance is reported only by few studies. To reduce mortality and complications of hip fractures the authors emphasize the importance of primary treatment within 12 hours, appropriate selection of surgical methods corresponding to the fracture type after the assessment of femoral head viability, vitamin D supplementation, same conditions for primary treatment during everyday of the week, and an adequate acute treatment and rehabilitation for patient's general health status. In the future integrated processing of multidisciplinary results of hip fractures based on Hungarian data can support the development of efficient treatment and prevention strategies, which can be advantageous for the patient, families, health care system, and the society, too, by the reduction of costly complications of hip fracture healing and mortality. Orv. Hetil., 2016, 157(37), 1469-1475.

[Food supplements--potential and limits: part 3].

PubMed

Ströhle, Alexander; Wolters, Maike; Hahn, Andreas

2013-09-01

Ageing processes are associated with physiological changes, e.g. a reduction of metabolically active body mass and an impaired hunger-satiety regulation, which--combined with chronic diseases and psychosocial problems--significantly increase the risk for malnutrition. However, considering their nutrition and health status elderly people are a very heterogeneous group. The nutrition situation of "young" seniors does generally not differ from the situation of working-age adults while institutionalized elderly people and those in need of care often show signs of a global malnutrition. The critical nutrients in the nutrition of the elderly particularly include vitamin B12 and D. Six percent of all elderly have a manifest and 10 to 30% a functional vitamin B12 deficiency. The main cause is vitamin B12 malabsorption resulting from a type B atrophic gastritis. The functional vitamin B12 deficiency and the associated hyperhomocysteinemia are risk factors for neurodegenerative diseases and accelerate bone loss. With increasing age the vitamin D status is deteriorating. About 50% of the elderly living in private households is deficient in vitamin D; in geriatrics vitamin D deficiency is more the rule than an exception. This is caused by a reduced endogenous biosynthesis, low UVB exposure and a diet low in vitamin D. A vitamin D deficiency increases the risk for falls and fractures as well as the risk for neurodegenerative diseases. Also the overall mortality is increased.

[Treatment of postoperative nonunion of fracture of lower limb with bone grafting by intervertebral disc endoscope].

PubMed

Zhang, Jianlin; Tan, Yu'e; Ye, Jun; Han, Fangmin

2012-02-01

To explore the effectiveness of bone grafting by intervertebral disc endoscope for postoperative nonunion of fracture of lower limb. Between August 2004 and August 2008, 40 patients (23 males and 17 females) with postoperative nonunion of femoral and tibial fracture, aged 20-63 years (mean, 41.5 years) were treated. Nonunion of fracture occurred at 10-16 months after internal fixation. During the first operation, the internal fixation included interlocking intramedullary nailing of femoral fracture in 12 cases and plate in 16 cases, and interlocking intramedullary nailing of tibial fractures in 9 cases and plate in 3 cases. The X-ray films showed hypertrophic nonunion in 24 cases, common nonunion in 3 cases, and atrophic nonunion in 13 cases. The average operation time was 61 minutes (range, 40-80 minutes), and the blood loss was 80-130 mL (mean, 100 mL). The hospitalization time were 6-11 days (mean, 8.1 days). Incisions healed by first intention in all patients with no complication of infection or neurovascular injury. Forty patients were followed up 10-16 months (mean, 12.3 months). The X-ray films showed that all patients achieved healing of fracture after 4-10 months (mean, 6.8 months). No pain, disfunction, or internal fixation failure occurred. Bone grafting by intervertebral disc endoscope is an effective method for treating postoperative nonunion of femoral and tibial fracture.

DETERMINATION ROXARSONE AND ITS ...

EPA Pesticide Factsheets

Roxarsone (3-nitro-4-hydroxyphenyl-arsonic acid) is one of the most widely used growthpromoting and disease-controlling feed additives in the United States. Most broiler chickens are fed roxarsone to promote weight gain and control parasites. Most of the roxarsone is believed to be excreted unchanged, and the resulting arsenic-containing waste is commonly recycled as fertilizer. Once in the environment, roxarsone can easily degrade into much more mobile and toxic arsenic (As) species. While HPLC coupled to ICP-MS has been used for the determination of As species including roxarsone degradation products, it is limited in its resolution. Capillary electrophoresis (CE) has the advantages of simple hardware and high efficiency. When coupled with ICP-MS for detection, CE-ICP-MS can provide a sensitive, highly selective method for the determination of roxarsone and its transformation products. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spec

ADDRESSING EMERGING ISSUES IN WATER QUALITY ...

EPA Pesticide Factsheets

Public concern over cleanliness and safety of source and recreational waters has prompted researchers to look for indicators of water quality. Giving public water authorities multiple tools to measure and monitor levels of chemical contaminants, as well as chemical markers of contamination, simply and rapidly would enhance public protection. The goals of water quality are outlined in the Water Quality Multi-year Plan [http://intranet.epa.gov/ospintra/Planning/wq.pdf] and the research in this task falls under GPRA Goal 2, 2.3.2, Long Term Goals 1, 2, and 4. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG

The effect of bone fracture unevenness on ultrasound axial transmission measurements: A pilot 2D simulation study

NASA Astrophysics Data System (ADS)

Machado, Christiano B.; Pereira, Wagner C. A.; Padilla, Frédéric; Laugier, Pascal

2012-05-01

Ultrasound axial transmission (UAT) has been proposed to the diagnosis and follow-up of fracture healing. Some researchers have already pointed out the influence of fracture length, geometry and callus composition on the ultrasound time-of-flight and attenuation, with experimental and simulation studies. The aim of this work was to develop a pilot study on the effect of bone fracture unevenness on UAT measurements. Two-dimensional (2D) numerical simulations of ultrasound wave propagation were run using a custom-made finite-difference time domain code (SimSonic2D). Numerical models were composed of two 4-mm thick bone plates, with fracture lengths varying from 0 to 4 mm. For each case, an upward (UWun) and downward (DWun) unevenness of 0.5, 1.0 and 1.5 mm was implemented in the second plate. The 1-MHz emitter and receptor transducers were placed at 40 mm from each other, 20 mm apart from the center fracture. Two configurations were considered: 1.5 mm above the plates (for the 0-mm unevenness case) and transducers in contact with bone plate. For each situation, the time-of-flight of the first arriving signal (TOFFAS) and the FAS energy amplitude loss measured by the sound pressure level (SPLFAS) were computed. Results showed that there was a linear increase in TOFFAS with increasing fracture length, and a decrease of SPLFAS with the presence of a discontinuity. TOFFAS values were decreased with UWun (-0.87 μs for UWun = 1.5 mm), and increased with DWun (+0.99 μs for DWun = 1.5 mm). The SPLFAS increased with both UWun (+3.54 dB for UWun = 1.5 mm) and DWun (+8.15 dB for DWun = 1.5 mm). Both parameters showed the same variability. When transducers were put in contact with bone surface, fracture unevenness had no influence on TOF and SPL estimates. Previous works have already demonstrated that a fracture of 3 mm can increase TOFFAS in an order of 1 μs. Considering these preliminary results, it can be concluded that, although the variable fracture unevenness (until 1.5 mm) produced small parameters changes, and since it may not be changed significantly during the regeneration process, it may not sufficiently affect UAT measurements for an adequate diagnosis and fracture follow up.

Physical risk factors identification based on body sensor network combined to videotaping.

PubMed

Vignais, Nicolas; Bernard, Fabien; Touvenot, Gérard; Sagot, Jean-Claude

2017-11-01

The aim of this study was to perform an ergonomic analysis of a material handling task by combining a subtask video analysis and a RULA computation, implemented continuously through a motion capture system combining inertial sensors and electrogoniometers. Five workers participated to the experiment. Seven inertial measurement units, placed on the worker's upper body (pelvis, thorax, head, arms, forearms), were implemented through a biomechanical model of the upper body to continuously provide trunk, neck, shoulder and elbow joint angles. Wrist joint angles were derived from electrogoniometers synchronized with the inertial measurement system. Worker's activity was simultaneously recorded using video. During post-processing, joint angles were used as inputs to a computationally implemented ergonomic evaluation based on the RULA method. Consequently a RULA score was calculated at each time step to characterize the risk of exposure of the upper body (right and left sides). Local risk scores were also computed to identify the anatomical origin of the exposure. Moreover, the video-recorded work activity was time-studied in order to classify and quantify all subtasks involved into the task. Results showed that mean RULA scores were at high risk for all participants (6 and 6.2 for right and left sides respectively). A temporal analysis demonstrated that workers spent most part of the work time at a RULA score of 7 (right: 49.19 ± 35.27%; left: 55.5 ± 29.69%). Mean local scores revealed that most exposed joints during the task were elbows, lower arms, wrists and hands. Elbows and lower arms were indeed at a high level of risk during the total time of a work cycle (100% for right and left sides). Wrist and hands were also exposed to a risky level for much of the period of work (right: 82.13 ± 7.46%; left: 77.85 ± 12.46%). Concerning the subtask analysis, subtasks called 'snow thrower', 'opening the vacuum sealer', 'cleaning' and 'storing' have been identified as the most awkward for right and left sides given mean RULA scores and percentages of time spent at risky levels. Results analysis permitted to suggest ergonomic recommendations for the redesign of the workstation. Contributions of the proposed innovative system dedicated to physical ergonomic assessment are further discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

High cesium concentrations in groundwater in the upper 1.2 km of fractured crystalline rock - Influence of groundwater origin and secondary minerals

NASA Astrophysics Data System (ADS)

Mathurin, Frédéric A.; Drake, Henrik; Tullborg, Eva-Lena; Berger, Tobias; Peltola, Pasi; Kalinowski, Birgitta E.; Åström, Mats E.

2014-05-01

Dissolved and solid phase cesium (Cs) was studied in the upper 1.2 km of a coastal granitoid fracture network on the Baltic Shield (Äspö Hard Rock Laboratory and Laxemar area, SE Sweden). There unusually high Cs concentrations (up to 5-6 μg L-1) occur in the low-temperature (<20 °C) groundwater. The material includes water collected in earlier hydrochemical monitoring programs and secondary precipitates (fracture coatings) collected on the fracture walls, as follows: (a) hydraulically pristine fracture groundwater sampled through 23 surface boreholes equipped for the retrieval of representative groundwater at controlled depths (Laxemar area), (b) fracture groundwater affected by artificial drainage collected through 80 boreholes drilled mostly along the Äspö Hard Rock Laboratory (underground research facility), (c) surface water collected in local streams, a lake and sea bay, and shallow groundwater collected in 8 regolith boreholes, and (d) 84 new specimens of fracture coatings sampled in cores from the Äspö HRL and Laxemar areas. The groundwater in each area is different, which affects Cs concentrations. The highest Cs concentrations occurred in deep-seated saline groundwater (median Äspö HRL: 4.1 μg L-1; median Laxemar: 3.7 μg L-1) and groundwater with marine origin (Äspö HRL: 4.2 μg L-1). Overall lower, but variable, Cs concentrations were found in other types of groundwater. The similar concentrations of Cs in the saline groundwater, which had a residence time in the order of millions of years, and in the marine groundwater, which had residence times in the order of years, shows that duration of water-rock interactions is not the single and primary control of dissolved Cs in these systems. The high Cs concentrations in the saline groundwater is ascribed to long-term weathering of minerals, primarily Cs-enriched fracture coatings dominated by illite and mixed-layer clays and possibly wall rock micaceous minerals. The high Cs concentrations in the groundwater of marine origin are, in contrast, explained by relatively fast cation exchange reactions. As indicated by the field data and predicted by 1D solute transport modeling, alkali cations with low-energy hydration carried by intruding marine water are capable of (NH4+ in particular and K+ to some extent) replacing Cs+ on frayed edge (FES) sites on illite in the fracture coatings. The result is a rapid and persistent (at least in the order of decades) buildup of dissolved Cs concentrations in fractures where marine water flows downward. The identification of high Cs concentrations in young groundwater of marine origin and the predicted capacity of NH4+ to displace Cs from fracture solids are of particular relevance in the disposal of radioactive nuclear waste deep underground in crystalline rock.

Effects of Teriparatide in Patients with Osteoporosis in Clinical Practice: 42-Month Results During and After Discontinuation of Treatment from the European Extended Forsteo® Observational Study (ExFOS).

PubMed

Napoli, Nicola; Langdahl, Bente L; Ljunggren, Östen; Lespessailles, Eric; Kapetanos, George; Kocjan, Tomaz; Nikolic, Tatjana; Eiken, Pia; Petto, Helmut; Moll, Thomas; Lindh, Erik; Marin, Fernando

2018-06-16

This study aimed to describe clinical outcomes in patients prescribed teriparatide and followed up for 18 months after stopping the drug in real-life conditions. The Extended Forsteo® Observational Study analysed incident clinical fractures in 6-month intervals using logistic regression with repeated measures. Changes in back pain (visual analogue scale) and health-related quality of life (HRQoL; EQ-5D questionnaire) were analysed using mixed models for repeated measures. Patients were analysed if they had a post-baseline visit, regardless of whether and for how long they took teriparatide. Of 1531 patients analysed (90.7% female, mean age: 70.3 years), 76 (5.0%) never took teriparatide. Median treatment duration was 23.6 months. The adjusted odds of clinical fracture decreased by 47% in the > 12- to 18-month treatment period (p = 0.013) compared with the first 6-month period, with no statistically significant reduction in the > 18- to 24-month interval. The clinical fracture rate remained stable during the 18 months' post-teriparatide, when approximately 98% of patients took osteoporosis medication (51% bisphosphonates). Clinical vertebral fractures were reduced at every time period compared with the first 6 months. Adjusted mean back pain scores decreased and EQ-5D scores increased significantly at each post-baseline observation. In a real-life clinical setting, the risk of clinical fractures declined during 24 months of teriparatide treatment. This reduction was maintained 18 months after stopping teriparatide. In parallel, patients reported significant improvements in back pain and HRQoL. The results should be interpreted in the context of the non-controlled design of this observational study.

40 CFR 146.12 - Construction requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... potential, porosity, and gamma ray logs before the casing is installed; (B) Fracture finder logs; and (C) A... wells: (1) Fluid pressure; (2) Temperature; (3) Fracture pressure; (4) Other physical and chemical...

40 CFR 146.12 - Construction requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... potential, porosity, and gamma ray logs before the casing is installed; (B) Fracture finder logs; and (C) A... wells: (1) Fluid pressure; (2) Temperature; (3) Fracture pressure; (4) Other physical and chemical...

40 CFR 146.12 - Construction requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... potential, porosity, and gamma ray logs before the casing is installed; (B) Fracture finder logs; and (C) A... wells: (1) Fluid pressure; (2) Temperature; (3) Fracture pressure; (4) Other physical and chemical...

Clinical evaluation of ceramic inlays and onlays fabricated with two systems: 12-year follow-up.

PubMed

Santos, Maria Jacinta Moraes Coelho; Freitas, Maria Cristina; Azevedo, Larissa Marinho; Santos, Gildo Coelho; Navarro, Maria Fidela; Francischone, Carlos Eduardo; Mondelli, Rafael Francisco

2016-09-01

The aim of this study was to evaluate the 12-year clinical performance of sintered (Duceram, Dentsply-Degussa, Dentsply International Inc., PA, USA)-D and pressable (IPS Empress, Ivoclar-Vivadent, Schaan, Leichtenstein)-IPS ceramic inlay and onlay restorations. Eighty-six restorations were placed in 35 patients with a median age of 33 years by a single operator. The restorations were luted with dual-cured resin luting material (Variolink II, Ivoclar-Vivadent, Schaan, Leichtenstein) and Syntac Classic adhesive under rubber dam. The evaluations were conducted by two independent investigators at the baseline, 1, 2, 3, 5, and 12 years using the modified USPHS criteria. At the 12-year recall, 22 patients were evaluated (62.86 %), totalling 48 (55.81 %) restorations. Seven restorations were fractured (one from Duceram and six from IPS), eight restorations presented secondary caries (three from Duceram and five from IPS), nine restorations showed unacceptable defects at the restoration margin and needed repair or replacement (two from Duceram and seven from IPS), and four IPS restorations presented pulp sensitivity. Chi-square and Mann-Whitney tests revealed that IPS Empress system showed the best results for color match and surface texture (p < 0.05) but a significant worse result for fracture (p = 0.05). Wilcoxon test showed significant differences in relation to color match, surface texture, marginal discoloration, and marginal integrity between the baseline and 12-year recall for both ceramic systems. This long-term clinical study observed that the main reasons for failure of ceramic restorations were related to fracture, recurrent caries, and decreased marginal integrity over time. Carefully monitoring of the ceramic-tooth interface may extend their clinical longevity.

Universal Linear Scaling of Permeability and Time for Heterogeneous Fracture Dissolution

NASA Astrophysics Data System (ADS)

Wang, L.; Cardenas, M. B.

2017-12-01

Fractures are dynamically changing over geological time scale due to mechanical deformation and chemical reactions. However, the latter mechanism remains poorly understood with respect to the expanding fracture, which leads to a positively coupled flow and reactive transport processes, i.e., as a fracture expands, so does its permeability (k) and thus flow and reactive transport processes. To unravel this coupling, we consider a self-enhancing process that leads to fracture expansion caused by acidic fluid, i.e., CO2-saturated brine dissolving calcite fracture. We rigorously derive a theory, for the first time, showing that fracture permeability increases linearly with time [Wang and Cardenas, 2017]. To validate this theory, we resort to the direct simulation that solves the Navier-Stokes and Advection-Diffusion equations with a moving mesh according to the dynamic dissolution process in two-dimensional (2D) fractures. We find that k slowly increases first until the dissolution front breakthrough the outbound when we observe a rapid k increase, i.e., the linear time-dependence of k occurs. The theory agrees well with numerical observations across a broad range of Peclet and Damkohler numbers through homogeneous and heterogeneous 2D fractures. Moreover, the theory of linear scaling relationship between k and time matches well with experimental observations of three-dimensional (3D) fractures' dissolution. To further attest to our theory's universality for 3D heterogeneous fractures across a broad range of roughness and correlation length of aperture field, we develop a depth-averaged model that simulates the process-based reactive transport. The simulation results show that, regardless of a wide variety of dissolution patterns such as the presence of dissolution fingers and preferential dissolution paths, the linear scaling relationship between k and time holds. Our theory sheds light on predicting permeability evolution in many geological settings when the self-enhancing process is relevant. References: Wang, L., and M. B. Cardenas (2017), Linear permeability evolution of expanding conduits due to feedback between flow and fast phase change, Geophys. Res. Lett., 44(9), 4116-4123, doi: 10.1002/2017gl073161.

Patient reported health related quality of life early outcomes at 12 months after surgically managed tibial plafond fracture.

PubMed

Bonato, Luke J; Edwards, Elton R; Gosling, Cameron McR; Hau, Raphael; Hofstee, Dirk Jan; Shuen, Alex; Gabbe, Belinda J

2017-04-01

Tibial plafond fractures represent a small but complex subset of fractures of the lower limb. The aim of this study was to describe the health related quality of life, pain and return to work outcomes 12 months following surgically managed tibial plafond fracture. The Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) database was used to identify patients with tibial plafond fractures. All patients captured by VOTOR with a tibial plafond fracture between September 2003 and July 2009, were identified consecutively and comprised the initial cohort. The radiographs of all identified patients were classified using the AO/OTA fracture classification. A review of the included patient's medical records was performed. Data were collected on the injury event, management and complications. Outcomes at 12 months were prospectively collected by telephone interview and included return to work, a numerical rating scale for assessment of pain and the Short Form 12 (SF-12). There were 98 unilateral tibial plafond fractures; 91 fractures were managed operatively, 4 non-operatively and 3 underwent amputation. The 91 operatively managed patients were the focus of this study. A two-stage management approach, involving temporary external fixation, followed by definitive open reduction and internal fixation, was the most common operative treatment. The follow-up rate at 12 months was 70%. 57% had returned to work by 12 months post-injury, the median (IQR) pain score was 2 (0-5) and 27% reported moderate to severe persistent pain. Mean PCS-12 scores were significantly lower than Australian norms (p=0.99), 38.2 for males and 37.5 for females. The presence of persistent pain, loss of physical health and a low return to work rate highlights the profound impact of tibial plafond fractures on patients' lives. Although this study looked at the early 12 month results, it is expected these outcomes will continue to improve over time. Further studies, with larger patient numbers, must focus on how to improve not only the operative management of these fractures, but also patient's mental and overall physical health in the long term. Improved management techniques and early identification of injury patterns known to perform poorly may help long-term outcomes. Copyright © 2016. Published by Elsevier Ltd.

Discrete Fracture Network Characterization of Fractured Shale Reservoirs with Implications to Hydraulic Fracturing Optimization

NASA Astrophysics Data System (ADS)

Jin, G.

2016-12-01

Shales are important petroleum source rocks and reservoir seals. Recent developments in hydraulic fracturing technology have facilitated high gas production rates from shale and have had a strong impact on the U.S. gas supply and markets. Modeling of effective permeability for fractured shale reservoirs has been challenging because the presence of a fracture network significantly alters the reservoir hydrologic properties. Due to the frequent occurrence of fracture networks, it is of vital importance to characterize fracture networks and to investigate how these networks can be used to optimize the hydraulic fracturing. We have conducted basic research on 3-D fracture permeability characterization and compartmentization analyses for fractured shale formations, which takes the advantages of the discrete fracture networks (DFN). The DFN modeling is a stochastic modeling approach using the probabilistic density functions of fractures. Three common scenarios of DFN models have been studied for fracture permeability mapping using our previously proposed techniques. In DFN models with moderately to highly concentrated fractures, there exists a representative element volume (REV) for fracture permeability characterization, which indicates that the fractured reservoirs can be treated as anisotropic homogeneous media. Hydraulic fracturing will be most effective if the orientation of the hydraulic fracture is perpendicular to the mean direction of the fractures. A DFN model with randomized fracture orientations, on the other hand, lacks an REV for fracture characterization. Therefore, a fracture permeability tensor has to be computed from each element. Modeling of fracture interconnectivity indicates that there exists no preferred direction for hydraulic fracturing to be most effective oweing to the interconnected pathways of the fracture network. 3-D fracture permeability mapping has been applied to the Devonian Chattanooga Shale in Alabama and the results suggest that an REV exist for fluid flow and transport modeling at element sizes larger than 200 m. Fracture pathway analysis indicates that hydraulic fracturing can be equally effective for hydrocarbon fluid/gas exploration as long as its orientation is not aligned with that of the regional system fractures.

Fractures of the greater trochanter following total hip replacement.

PubMed

Brun, Ole-Christian L; Maansson, Lukas

2013-01-01

We studied the incidence of greater trochanteric fractures at our department following THR. In all we examined 911 patients retrospectively and found the occurance of a greater trochanteric fracture to be 3%. Patients with fractures had significantly poorer outcome on Oxford Hip score, Pain VAS, Satisfaction VAS and EQ-5D compared to THR without fractures. Greater trochanteric fracture following THR is one of the most common complications following THR. It has previously been thought to have little impact on the overall outcome following THR, but our study suggests otherwise.

Patient-specific puzzle implant preformed with 3D-printed rapid prototype model for combined orbital floor and medial wall fracture.

PubMed

Kim, Young Chul; Min, Kyung Hyun; Choi, Jong Woo; Koh, Kyung S; Oh, Tae Suk; Jeong, Woo Shik

2018-04-01

The management of combined orbital floor and medial wall fractures involving the inferomedial strut is challenging due to absence of stable cornerstone. In this article, we proposed surgical strategies using customized 3D puzzle implant preformed with Rapid Prototype (RP) skull model. Retrospective review was done in 28 patients diagnosed with combined orbital floor and medial wall fracture. Using preoperative CT scans, original and mirror-imaged RP skull models for each patient were prepared and sterilized. In all patients, porous polyethylene-coated titanium mesh was premolded onto RP skull model in two ways; Customized 3D jigsaw puzzle technique was used in 15 patients with comminuted inferomedial strut, whereas individual 3D implant technique was used in each fracture for 13 patients with intact inferomedial strut. Outcomes including enophthalmos, visual acuity, and presence of diplopia were assessed and orbital volume was measured using OsiriX software preoperatively and postoperatively. Satisfactory results were achieved in both groups in terms of clinical improvements. Of 10 patients with preoperative diplopia, 9 improved in 6 months, except one with persistent symptom who underwent extraocular muscle rupture. 18 patients who had moderate to severe enophthalmos preoperatively improved, and one remained with mild degree. Orbital volume ratio, defined as volumetric ratio between affected and control orbit, decreased from 127.6% to 99.79% (p < 0.05) in comminuted group, and that in intact group decreased from 117.03% to 101.3% (p < 0.05). Our surgical strategies using the jigsaw puzzle and individual reconstruction technique provide accurate restoration of combined orbital floor and medial wall fractures. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Shear Wave Splitting analysis of borehole microseismic reveals weak azimuthal anisotropy hidden behind strong VTI fabric of Lower Paleozoic shales in northern Poland

NASA Astrophysics Data System (ADS)

Gajek, Wojciech; Verdon, James; Malinowski, Michał; Trojanowski, Jacek

2017-04-01

Azimuthal anisotropy plays a key-role in hydraulic fracturing experiments, since it provides information on stress orientation and pre-existing fracture system presence. The Lower Paleozoic shale plays in northern Poland are characterized by a strong (15-18%) Vertical Transverse Isotropy (VTI) fabric which dominates weak azimuthal anisotropy being of order of 1-2%. A shear wave travelling in the subsurface after entering an anisotropic medium splits into two orthogonally polarized waves travelling with different velocities. Splitting parameters which can be assessed using a microseismic array are polarization of the fast shear wave and time delay between two modes. Polarization of the fast wave characterizes the anisotropic system on the wave path while the time delay is proportional to the magnitude of anisotropy. We employ Shear Wave Splitting (SWS) technique using a borehole microseismic dataset collected during a hydraulic stimulation treatment located in northern Poland, to image fracture strike masked by a strong VTI signature. During the inversion part, the VTI background parameters were kept constant using information from 3D seismic (VTI model used for pre-stack depth migration). Obtained fracture azimuths averaged over fracturing stages are consistent with the available XRMI imager logs from the nearby vertical well, however they are different from the large-scale maximum stress direction (by 40-45 degrees). Inverted Hudson's crack density (ca. 2%) are compatible with the low shear-wave anisotropy observed in the cross-dipole sonic logs (1-2%). This work has been funded by the Polish National Centre for Research and Development within the Blue Gas project (No BG2/SHALEMECH/14). Data were provided by the PGNiG SA. Collaboration with University of Bristol was supported within TIDES COST Action ES1401.

A Hybrid Method for Opinion Finding Task (KUNLP at TREC 2008 Blog Track)

DTIC Science & Technology

2008-11-01

retrieve relevant documents. For the Opinion Retrieval subtask, we propose a hybrid model of lexicon-based approach and machine learning approach for...estimating and ranking the opinionated documents. For the Polarized Opinion Retrieval subtask, we employ machine learning for predicting the polarity...and linear combination technique for ranking polar documents. The hybrid model which utilize both lexicon-based approach and machine learning approach

ABSTRACT PRESENTATION--PHARMACEUTICALS AS ...

EPA Pesticide Factsheets

Pharmaceuticals comprise a large and diverse array of contaminants that can occur in the environmentfrom the combined activities and actions of multitudes of individuals as well as from veterinary andagricultural use. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for med

ION COMPOSITION ELUCIDATION (ICE) FOR ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

PHARMACEUTICALS AND PERSONAL CARE PRODUCTS ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

PHARMACEUTICAL AND PERSONAL CARE PRODUCTS IN ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

OVERVIEW OF PHARMACEUTICALS AND PERSONAL ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

ORIGINS AND RAMIFICATIONS OF PHARMACEUTICALS & ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

PHARMACEUTICAL AND PERSONAL CARE PRODUCTS ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

ORIGINS AND RAMIFICATIONS OF PHARMACEUTICALS ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

PHARMACEUTICALS AS ENVIRONMENTAL ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

MERCURY MEASUREMENTS USING DIRECT-ANALYZER ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact Field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

SLIDE PRESENTATION--PHARMACEUTICALS AS ...

EPA Pesticide Factsheets

While pharmaceuticals are ubiquitous trace contaminants in the environment, thetypes, concentrations, and relative abundances of individual residues will vary depending on thegeographic locale and time of year, primarily a reflection of differing and varying prescribing andconsumption practices. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical

SYNTHETIC FRAGRANCES IN THE ENVIRONMENT ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

ENVIRONMENTAL STEWARDSHIP OF PHARMACEUTICALS ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

INVESTIGATING ENVIRONMENTAL SINKS OF MACROLIDE ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under the Contact Field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquirie

LEVELS OF SYNTHETIC MUSKS COMPOUNDS IN ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

ADVANCED TOOLS FOR ASSESSING SELECTED ...

EPA Pesticide Factsheets

The purpose of this poster is to present the application and assessment of advanced technologies in a real-world environment - wastewater effluent and source waters - for detecting six drugs (azithromycin, fluoxetine, omeprazole, levothyroxine, methamphetamine, and methylenedioxymethamphetamine). The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technica

POTENTIAL CONCERNS/EFFECTS ON HUMAN AND ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

MEETING TODAY'S EMERGING CONTAMINANTS WITH ...

EPA Pesticide Factsheets

This presentation will explore the many facets of research and development for emerging contaminants within the USEPA's National Exposure Research Laboratories (Athens, Cincinnati, Las Vegas, and Research Triangle Park). The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for

NON-REGULATED CONTAMINANTS: EMERGING ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

DETECTION OF ILLCIT DRUGS IN MUNICIPAL ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

ADVANCED TOOLS FOR ASSESSING SELECTED ...

EPA Pesticide Factsheets

The purpose of this poster is to present the application and assessment of advanced state-of-the-art technologies in a real-world environment - wastewater effluent and source waters - for detecting six drugs [azithromycin, fluoxetine, omeprazole, levothyroxine, methamphetamine, methylenedioxymethamphetamine (MDMA)]. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansi

PRESCRIBING FOR THE ENVIRONMENT | Science Inventory ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact Field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

INVESTIGATING ENVIRONMENTAL SINKS OF MACROLIDE ...

EPA Pesticide Factsheets

Possible environmental sinks (wastewater effluents, biosolids, sediments) of macrolide antibiotics (i.e., azithromycin, roxithromycin and clarithromycin)are investigated using state-of-the-art analytical chemistry techniques. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews