Primary Dislocation of the Patella : A Clinical Study

A total of 177 patients with primary dislocation of the patella (PDP) were admitted to two trauma centers in Helsinki, Finland during 1991 to 1992. The inclusion criteria were: 1. Acute (≤14 days old) first-time lateral dislocation of the patella. 2. No previous knee operations or major knee injuries. 3. No ligament injuries to be repaired. 4. No osteochondral fractures requiring fixation. 50 patients were excluded. 30 of these excluded patients would have met the inclusion criteria, 19 patients received treatment by consultants not involved in the study, 7 refused to participate and 4 had an erroneous randomization. 127 patients including, 82 females, were then randomized to have either tailor-made operative procedure (group O) or conservative treatment (group C). The aftercare was similar for both groups. The mean age of the patients was 20 (9-47) years. All patients were subjected to analysis of trauma history (starting position and knee movement during the dislocation), examination under anesthesia (EUA) and arthroscopy. 70 patients (52 females) were randomized by their odd year of birth to operative group O and 57 patients (30 females) by their even year of birth to conservative group C. The diagnosis of PDP was based on locked dislocation in 68 patients, on dislocatability in EUA in 47 patients, and on subluxation in EUA combined with typical intra-articular lesions in 12 patients. In group O, 63 patients had exploration of the injuries on the medial side of the knee and tailor made reconstruction added with lateral release in 54 cases. The medial injury was operated by suturing in 39 patients, by duplication in 18 patients and by additional augmentation of the medial patellofemoral ligament (MPFL) with adductor magnus tenodesis in 6 patients. 7 patients, without locking in trauma history and only subluxation in EUA had only lateral release for realignment. In adductor magnus tenodesis the proximal end of the distal tendinous part was rerouted to the upper medial border of the patella. In the conservative group C, the treatment was adjusted to the extent of patellar displacement in EUA. Patients with dislocation in EUA had 3 weeks’ immobilization with the knee in slight flexion. Mobilization was started with a soft patellar stabilizing orthosis (PSO) used for additional three weeks. The patients with subluxation in EUA wore an orthosis for six weeks. The aftercare was similar in group O. The outcome was similar in both groups. After an average of 25 (20-45) months´ follow-up, the subjective result was better in group C in respect of the mean Hughston VAS knee score (87 for group O and 90 for group C, p=0.04, visual analog scale), but similar in terms of the patient’s own overall opinion and the mean Lysholm II knee score. Recurrent instability episodes occurred in 18 patients in group O and in 20 patients in group C. After an average of 7 (6-9) years´ follow-up, the groups did not show statistical difference either in respect of the patient’s own overall opinion, or the mean Hughston VAS and Kujala knee scores. The proportions of stable patellae was 25/70 (36%) in group O and 17/57 (30%) in group O (p=0.5). In a multivariate risk analysis, there was a correlation between low Kujala score (<90) as dependent parameter and female gender (OR: 3.5; 95% CI: 1.4-9.0), and loose body on primary radiographs (OR: 4.1; 95% CI: 1.2-15). Recurrent instability correlated with young age at the time of PDP (OR: 0.9; 95% CI: 0.8-1.0/year). Girls with open tibial apophysis had the worst prognosis for instability (88%; 95% CI: 77-98). The most common mechanisms in trauma history of the patients were movement to flexion from a straight start (78%) and movement to extension from a well-bent start (8%). Spontaneous relocation of the patella had taken place in 13/39 of girls, in 11/21 of boys, in 26/42 of women and in 17/24 of men with skeletal maturity of the tibia. The dislocation in EUA was non-rotating in 96/126 patients followed by outward rotating dislocation in 14/126 patients. Operative treatment policy in PDP is not recommended. Locking tendency of the patella in PDP depended on the skeletal maturation. Recurrence rate after PDP was higher than expected.

Från regeringsformen till grundlagen

Aineisto on Keskustakampuksen kirjaston digitoimaa ja kirjasto vastaa aineiston käyttöluvista.

Use of Document Management Systems - a Case Study of the Finnish Construction Industry

Triggered by the very quick proliferation of Internet connectivity, electronic document management (EDM) systems are now rapidly being adopted for managing the documentation that is produced and exchanged in construction projects. Nevertheless there are still substantial barriers to the efficient use of such systems, mainly of a psychological nature and related to insufficient training. This paper presents the results of empirical studies carried out during 2002 concerning the current usage of EDM systems in the Finnish construction industry. The studies employed three different methods in order to provide a multifaceted view of the problem area, both on the industry and individual project level. In order to provide an accurate measurement of overall usage volume in the industry as a whole telephone interviews with key personnel from 100 randomly chosen construction projects were conducted. The interviews showed that while around 1/3 of big projects already have adopted the use of EDM, very few small projects have adopted this technology. The barriers to introduction were investigated through interviews with representatives for half a dozen of providers of systems and ASP-services. These interviews shed a lot of light on the dynamics of the market for this type of services and illustrated the diversity of business strategies adopted by vendors. In the final study log files from a project which had used an EDM system were analysed in order to determine usage patterns. The results illustrated that use is yet incomplete in coverage and that only a part of the individuals involved in the project used the system efficiently, either as information producers or consumers. The study also provided feedback on the usefulness of the log files.

External Bias Dependent Direct To Indirect Band Gap Transition in Graphene Nanoribbon

In this work, using self-consistent tight-binding calculations. for the first time, we show that a direct to indirect band gap transition is possible in an armchair graphene nanoribbon by the application of an external bias along the width of the ribbon, opening up the possibility of new device applications. With the help of the Dirac equation, we qualitatively explain this band gap transition using the asymmetry in the spatial distribution of the perturbation potential produced inside the nanoribbon by the external bias. This is followed by the verification of the band gap trends with a numerical technique using Magnus expansion of matrix exponentials. Finally, we show that the carrier effective masses possess tunable sharp characters in the vicinity of the band gap transition points.

Pietismin kuva - ikkuna yksityiseen hengellisyyteen : Johann Arndtin opetukset pietistisen embleemin perustana

The image of Pietism a window to personal spirituality. The teachings of Johann Arndt as the basis of Pietist emblems The Pietist effect on spiritual images has to be scrutinised as a continuum initiating from the teachings of Johann Arndt who created a protestant iconography that defended the status of pictures and images as the foundation of divine revelation. Pietist artworks reveal Arndtian part of secret, eternal world, and God. Even though modern scholars do not regarded him as a founding father of Pietism anymore, his works have been essential for the development of iconography, and the themes of the Pietist images are linked with his works. For Arndt, the starting point is in the affecting love for Christ who suffered for the humankind. The reading experience is personal and the words point directly at the reader and thus appear as evidence of the guilt of the reader as well as of the love of God. Arndt uses bounteous and descriptive language which has partially affected promoting and picturing of many themes. Like Arndt, Philipp Jakob Spener also emphasised the heart that believes. The Pietist movement was born to oppose detached faith and the lack of the Holy Ghost. Christians touched by the teachings of Arndt and Spener began to create images out of metaphors presented by Arndt. As those people were part of the intelligentsia, it was natural that the fashionable emblematics of the 17th century was moulded for the personal needs. For Arndt, the human heart is manifested as a symbol of soul, personal faith or unbelief as well as an allegory of the burning love for Jesus. Due to this fact, heart emblems were gradually widely used and linked with the love of Christ. In the Nordic countries, the introduction of emblems emanated from the gentry s connections to the Central Europe where emblems were exploited in order to decorate books, artefacts, interiors, and buildings as well as visual/literal trademarks of the intelligentsia. Emblematic paintings in the churches of the castles of Venngarn (1665) and Läckö (1668), owned by Magnus Gabriel De la Gardie, are one of the most central interior paintings preserved in the Nordic countries, and they emphasise personal righteous life. Nonetheless, it was the books by Arndt and the Poet s Society in Nurnberg that bound the Swedish gentry and the scholars of the Pietist movement together. The Finnish gentry had no castles or castle churches so they supported county churches, both in building and in maintenance. As the churches were not private, their iconography could not be private either. Instead, people used Pietist symbols such as Agnus Dei, Cor ardens, an open book, beams, king David, frankincense, wood themes and Virtues. In the Pietist images made for public spaces, the attention is focused on pedagogical, metaphorical, and meaningful presentation as well as concealed statements.

Den medeltida svenska hustrun och lagen : En studie i förmyndarskap, begränsningar och möjligheter 1350-1442

Denna studie behandlar kvinnans juridiska handlingsutrymme under Magnus Erikssons lagar 1350-1442. Det har länge antagits att den gifta kvinnan under medeltiden var omyndig, eftersom hon enligt lagen skulle ha en målsman (på fornsvenska malsman). Senare tids forskning har dock börjat påpeka att kvinnan inte var omyndig i dagens bemärkelse, men inte desto djupare utvecklat frågan om hennes rättigheter. Genom att jämföra lagtexterna med praxis har jag undersökt hur lagutrymmet som stadgade att en make skulle vara sin hustrus malsman påverkade kvinnans rättigheter. Under den undersökta tidsperioden tycks malsmanskapet inte i någon större utsträckning ha juridiskt begränsat kvinnan, men praxis visar att tradition och praktikaliteter bjöd att maken i allmänhet representerade sin hustru i juridiska göromål. Studien visar att representation inte nödvändigtvis indikerade myndighet, och att det faktum att hustrun representerades av sin make inte medförde omyndighet. Männens konstanta kontakt med den juridiska världen och kvinnornas synnerligen begränsade dito kom ändå på sikt att minska hennes juridiska medvetenhet, och därmed hennes möjlighet att påverka. Den viktigaste slutsatsen är likväl denna begränsning inte var lagstadgad. I studien tar jag också ställning till olika genusteoretiska förklaringsmodeller, nämligen enkönsmodellen och teorin om skilda sfärer. Enligt enkönsmodellen, som utvecklades av Laqueur i början av 1990-talet, sågs inte kvinnan och mannen som två olika kön, utan som olika grader av en man. Kvinnan skulle enligt det vara en mindre utvecklad variant av mannen. Resultaten i studien tyder dock snarare på att kvinnor och män sågs som två olika kön, men att de verkade inom olika sfärer. Den avgörande faktorn var förmågan att föda barn, där de som födde barn tillhörde en privat sfär, med hemmet i centrum, och de som inte födde barn tillhörde en offentlig sfär, där juridik, politik och ekonomi ingick. Därför argumenterar jag för att män förväntades sköta de juridiska göromålen även för sin hustru, eftersom det tillhörde hans sfär. Hustrun hade dock möjligheten, både enligt lagen och enligt praxis, att själv sköta exempelvis försäljningar och upprätta testamenten, och begränsades snarare av sitt kön än av genusstrukturer. Studien lyfter också fram problematiken med det diversifierade svenska medeltida samhället, och ifrågasätter traditionen med en indelning i endast två genus, en manlighet och en kvinnlighet. Resultaten tyder på att det var stora lokala skillnader beträffande en hustrus begränsningar och möjligheter, och att lagarna mer fungerade som riktlinjer än som faktiska regler. På grund av källmaterialets beskaffenhet går det inte att avgöra på vilket sätt social status spelade in, även om det är rimligt att anta att det fanns betydande skillnader mellan rikets övre och lägre skikt. Däremot finns det inget som indikerar att hustruns malsman skulle ha varit liktydig med det nutida målsman någonstans i riket, eller i någon samhällsgrupp.

Maximum group velocity in a one-dimensional model with a sinusoidally varying staggered potential

We use Floquet theory to study the maximum value of the stroboscopic group velocity in a one-dimensional tight-binding model subjected to an on-site staggered potential varying sinusoidally in time. The results obtained by numerically diagonalizing the Floquet operator are analyzed using a variety of analytical schemes. In the low-frequency limit we use adiabatic theory, while in the high-frequency limit the Magnus expansion of the Floquet Hamiltonian turns out to be appropriate. When the magnitude of the staggered potential is much greater or much less than the hopping, we use degenerate Floquet perturbation theory; we find that dynamical localization occurs in the former case when the maximum group velocity vanishes. Finally, starting from an ``engineered'' initial state where the particles (taken to be hard-core bosons) are localized in one part of the chain, we demonstrate that the existence of a maximum stroboscopic group velocity manifests in a light-cone-like spreading of the particles in real space.

Diagnóstico fitosanitario de la producción de frijol común (Phaseolus vulgaris L.) en la zona de Nueva Guinea, época de apante 1994-1995

El presente trabajo es el resultado de un diagnóstico realizado en el municipio de Nueva Guinea, Zelaya Central, en la época de apante (1994-1995). El estudio fue dirigido a los factores biológicos que afectan la producción de frijol común (Phaseolus vulgaris L.) principalmente plagas, enfermedades y malezas. El estudio abarcó nueve colonias y 14 productores del municipio de Nueva Guinea. Los resultados muestran que el principal problema de plagas es la babosa Vaginulus plebeius Fisher. Las medias de control contra las plagas están enfocadas al manejo de la especie en mención. Referente a las malezas se observó predominancia de malezas de hoja fina tales como retumbo Rottboellia cochinchinenesís (Lour) Clayton, zacate guinea Panicum maximun Jacq., retana Ischaemun ciliari Salisb y el zacate gallina Cynodon dactylon (L.) Pers. Las malezas de hoja ancha se presentaron en menor proporción, sobresaliendo la especie batatilla o campanila lpomoea tilliaceae (Wild) Choisy. La diversidad de las malezas es mayor en labranza convencional. la menor cantidad de especies de malezas se encontró en la labranza mínima. Las enfermedades de mayor relevancia son la antracnosis Colletotríchum lindemutianum ( Sacc & Magnus ) BCMV (virus del mosaíco común del frijol) y bacteriosis común del frijol Xanthomonas campestris pv phaseoli ( Smith ) Dye. La escasa precipitación durante el período del estudio probablemente influyó en que las enfermedades fungosas no se manifestaran en los lotes muestreados. El análisis económico muestra que la producción de frijol común en Nueva Guinea no fue rentable en el ciclo estudiado.

Diagnóstico fitosanitario de la producción de frijol común (Phaseolus vulgaris L.) en el Pacífico Sur de Nicaragua, época de postrera 1995-1996

Este trabajo consistió en un diagnóstico fitosanitario que se llevó a cabo durante la época de postrera (1995 1996), en la Región Pacífico sur de Nicaragua que comprende los departamentos de Rivas, Granada, Masaya y Carazo. El objetivo del trabajo fue conocer la problemática fitosanitaria del frijol en la zona. Para ello se seleccionaron productores de la zona, los cuales constituyeron la muestra de estudio. Los resultados indican que las principales plagas son Femitia tabaci (Gennadius) (Homóptera: Aleyrodidae) y Vaginutus plebema Fisher, (Gastropoda). Las medidas de control para el caso de la Femitia tabaci (Gennadius) fue básicamente cultural Mustia hilachosa Thanatephorus cucumeris (Frank) Donk pudo haber sido la principal causa de bajos rendimientos en la zona presentándose en los lotes de frijol común de forma virulenta. También se presentó la mancha angular (Isariopsis griseola (Sacc) Ferr), la antracnosis (Colletotribum Indemuthimun Sacc Magnus) y la virosis. Para el caso de las malezas, las de mayor presencia en la zona fueron: Claunmelins dittiusa, Burn, f. (siempre viva), Cyperus spp. (coyolillo), Baltumara recta L. (me caso no me caso), Cynadan dactylon (L.) Pers (zacate gallina), Sida acuta Burn F. (escoba lisa), Ixofhonus unisetus K. B. Presl. (zacate dulce) y Paspalum conjugatum (pasto horqueta). En análisis económico del estudio en la zona indica que la producción en el ciclo estudiado no fue rentable globalmente hablando, ya que el 62 por ciento de los productores no recuperaron lo invertido en el ciclo productivo. Se pudo conocer por medio del estudio el poco apoyo técnico y económico por parte de los organismos gubernamentales y la banca estatal que tienen los productores de la zona, pudiendo esto haber sido un factor que incidiera en aspectos tales como la reducción de las áreas establecidas y altos costos de producción.

Efficacy and Residue Comparisons between Two Slow-release Formulations of Fluridone

Residue profiles and efficacy of Avast and Sonar, two slow release pellet formulations of fluridone {1-methyl-3-phenyl-5- [3-(trifluoromethyl)phenly]-4(1H)-pyridinone}, were compared in outdoor tanks. Hydrilla (Hydrilla verticillata (L.f.) Royle) and southern naiad (Najas guadalupensis (Sprengel) Magnus) were treated with a split application of 6, 12, 18 and 24 μg/l a.i. fluridone and the concentrations of both formulations compared over a 134-day period. Both pellet formulations exhibited very similar residues over time for each respective treatment, resulted in peak concentrations of fluridone 40 to 50 days after application, and effectively and similarly controlled southern naiad and hydrilla at all rates tested by 92 days after initial application. (PDF contains 3 pages.)

Efeito magnetocalórico em sistemas ferrimagnéticos

Nesta tese, o efeito magnetocalórico é estudado teoricamente partindo de um hamiltoniano modelo que leva em conta uma rede magnética formada por diversas sub-redes magnéticas acopladas. No hamiltoniano são consideradas as interações de troca, Zeeman e magnetoelástica. Primeiramente, o hamiltoniano é apresentado em sua forma generalizada para R sub-redes magnéticas e a influência dos parâmetros do modelo na temperatura de Nèel e na temperatura de compensação é analisada no sistema com duas sub-redes magnéticas. Encontramos que, dependendo dos parâmetros de troca, arranjos ferrimagnético, antiferromagnético e ferromagnéticos podem ser obtidos. O efeito magnetocalórico foi sistematicamente estudado para diversos arranjos possíveis, posteriormente foi estudado em compostos reais do tipo R3Fe5O12 (RIG), sistema formado por três sub-redes magnéticas. Retornando ao sistema com duas sub-redes magnéticas foi analisada a influência da interação magnetoelástica no efeito magnetocalórico nos arranjos ferrimagnéticos obtidos previamente. Aplicando este modelo para uma estrutura cúbica do tipo perovskita, estudamos o efeito magnetocalórico nos compostos EuZrO3 e EuTiO3. Uma metodologia para a obtenção da magnetização de uma amostra policristalina foi apresentada e ainda estudamos o efeito magnetocalórico anisotrópico de natureza antiferromagnética.

Estudo do efeito magnetocalórico nos compostos da série Gd1-xDyxAl2

Nesta dissertação, foram investigadas as propriedades magnéticas e magnetocalóricas nos compostos intermetálicos de terras-raras Gd1-xDyxAl2 (x = 0, 0.25, 0.50, 0.75 e 1.00) usando abordagens teórica e experimental. Do ponto de vista teórico, a série Gd1-xDyxAl2 foi descrita através de um modelo para o hamiltoniano magnético, incluindo o efeito Zeeman, interação de troca e a anisotropia de campo elétrico cristalino. As entropias da rede e eletrônica foram consideradas nas aproximações de Debye e de gás de elétrons livres, respectivamente. A parte experimental inclui a preparação do material, sua caracterização e medidas das quantidades magnéticas e magnetocalóricas. Os resultados experimentais e os cálculos teóricos da variação adiabática da temperatura (ΔTad) e da variação isotérmica da entropia (ΔS T), sob variações de campo magnético ao longo da direção de fácil magnetização, estão de bom acordo. O efeito da aplicação do campo magnético ao longo de uma direção de difícil magnetização foi estudado e as componentes da magnetização em função da temperatura foram investigadas. Também foi observado que a temperatura de reorientação de spin, TR, diminui quando a intensidade do campo magnético aumenta. Além disso, as concentrações molares ótimas de um material híbrido formado pelos compostos Gd1-xDyxAl2 (x = 0, 0.25, 0.50, 0.75 e 1.00) foram simuladas usando um método numérico de matriz proposto por Smaili e Chahine. O compósito apresenta um bom intervalo de temperatura para um refrigerador magnético de 60 até 170 K.

Investigação do efeito magnetocalórico convencional e anisotrópico no sistema Er(1-y)Ho(y)N

O efeito magnetocalórico, base da refrigeração magnética, é caracterizado por duas quantidades: a variação isotérmica da entropia (ΔST) e a variação adiabática da temperatura (ΔTad) as quais podem ser obtidas sob variações na intensidade de um campo magnético aplicado. Em sistemas que apresentam anisotropia magnética, pode‐se definir o efeito magnetocalórico anisotrópico, o qual, por definição, é calculado através da variação na direção de aplicação de um campo magnético cuja intensidade se mantém fixa. Nos materiais de nosso interesse, o efeito magnetocalórico é estudado teoricamente partindo de um hamiltoniano modelo que leva em conta a rede magnética (que pode ser composta por diversas sub-redes magnéticas acopladas), rede cristalina e a dinâmica dos elétrons de condução. No hamiltoniano magnético são consideradas as interações de troca, Zeeman e campo cristalino (esta ultima responsável pela anisotropia magnética). Recentemente, estudamos o efeito magnetocalórico convencional e o efeito magnetocalórico anisotrópico nos compostos mononitretos com terras-raras, a saber: Ho(y)Er(1-y)N para as concentrações y= 0,1,0.5 e 0.75. Comparações entre nossos resultados teóricos e os dados experimentais para o EMC foram bastante satisfatórias [3,9]. Além disso, diversas predições teóricas como a existência de uma fase ferrimagnética no sistema Ho(y)Er(1-y)N (para a concentração y=0.5) e reorientações de spin nas sub-redes do Ho e Er foram feitas [25].