Cortical thickness mapping to identify focal osteoporosis in patients with hip fracture.

BACKGROUND: Individuals with osteoporosis are predisposed to hip fracture during trips, stumbles or falls, but half of all hip fractures occur in those without generalised osteoporosis. By analysing ordinary clinical CT scans using a novel cortical thickness mapping technique, we discovered patches of markedly thinner bone at fracture-prone regions in the femurs of women with acute hip fracture compared with controls. METHODS: We analysed CT scans from 75 female volunteers with acute fracture and 75 age- and sex-matched controls. We classified the fracture location as femoral neck or trochanteric before creating bone thickness maps of the outer 'cortical' shell of the intact contra-lateral hip. After registration of each bone to an average femur shape and statistical parametric mapping, we were able to visualise and quantify statistically significant foci of thinner cortical bone associated with each fracture type, assuming good symmetry of bone structure between the intact and fractured hip. The technique allowed us to pinpoint systematic differences and display the results on a 3D average femur shape model. FINDINGS: The cortex was generally thinner in femoral neck fracture cases than controls. More striking were several discrete patches of statistically significant thinner bone of up to 30%, which coincided with common sites of fracture initiation (femoral neck or trochanteric). INTERPRETATION: Femoral neck fracture patients had a thumbnail-sized patch of focal osteoporosis at the upper head-neck junction. This region coincided with a weak part of the femur, prone to both spontaneous 'tensile' fractures of the femoral neck, and as a site of crack initiation when falling sideways. Current hip fracture prevention strategies are based on case finding: they involve clinical risk factor estimation to determine the need for single-plane bone density measurement within a standard region of interest (ROI) of the femoral neck. The precise sites of focal osteoporosis that we have identified are overlooked by current 2D bone densitometry methods.

Unsteady ejectors: The effect of driver jet mark-space ratio

mark Unsteady ejectors can be driven by a wide range of driver jets. These vary from pulse detonation engines, which typically have a long gap between each slug of fluid exiting the detonation tube (mark-space ratios in the range 0.1-0.2) to the exit of a pulsejet where the mean mass flow rate leads to a much shorter gap between slugs (mark-space ratios in the range 2-3). The aim of this paper is to investigate the effect of mark-space ratio on the thrust augmentation of an unsteady ejector. Experimental testing was undertaken using a driver jet with a sinusoidal exit velocity profile. The mean value, amplitude and frequency of the velocity profile could be changed allowing the length to diameter ratio of the fluid slugs L/D and the mark-space ratio (the ratio of slug length to the spacing between slugs) L/S to be varied. The setup allowed L/S of the jet to vary from 0.8 to 2.3, while the L/D ratio of the slugs could take any values between 3.5 and 7.5. This paper shows that as the mark-space ratio of the driver jet is increased the thrust augmentation drops. Across the range of mark-space ratios tested, there is shown to be a drop in thrust augmentation of 0.1. The physical cause of this reduction in thrust augmentation is shown to be a decrease in the percentage time over which the ejector entrains ambient fluid. This is the direct result ofthe space between consecutive slugs in the driver jet decreasing. The one dimensional model reported in Heffer et al. [1] is extended to include the effect of varying L/S and is shown to accurately capture the experimentally measured behavior ofthe ejector. Copyright © 2010 by the American Institute of Aeronautics and Astronautics, Inc.

Physicians in leadership: the association between medical director involvement and staff-to-patient ratios

In a hospital environment that demands a careful balance between commercial and clinical interests, the extent to which physicians are involved in hospital leadership varies greatly. This paper assesses the influence of the extent of this involvement on staff-to-patient ratios. Using data gathered from 604 hospitals across Germany, this study evidences the positive relationship between a full-time medical director (MD) or heavily involved part-time MD and a higher staff-to-patient ratio. The data allows us to control for a range of confounding variables, such as size, rural/urban location, ownership structure, and case-mix. The results contribute to the sparse body of empirical research on the effect of clinical leadership on organizational outcomes.

Capacity approaching codes for non-coherent orthogonal modulation

This paper describes a curve-fitting approach for the design of capacity approaching coded modulation for orthogonal signal sets with non-coherent detection. In particular, bit-interleaved coded modulation with iterative decoding is considered. Decoder metrics are developed that do not require knowledge of the signal-to-noise ratio, yet still offer very good performance. © 2007 IEEE.

Practical matching of principal stress field geometries in composite components

A simple composite design methodology has been developed from the basic principles of composite component failure. This design approach applies the principles of stress field matching to develop suitable reinforcement patterns around three-dimensional details such as lugs in mechanical components. The resulting patterns are essentially curvilinear orthogonal meshes, adjusted to meet the restrictions imposed by geometric restraints and the intended manufacturing process. Whilst the principles behind the design methodology can be applied to components produced by differing manufacturing processes, the results found from looking at simple generic example problems suggest a realistic and practical generic manufacturing approach. The underlying principles of the design methodology are described and simple analyses are used to help illustrate both the methodology and how such components behave. These analyses suggest it is possible to replace high-strength steel lugs with composite components whose strength-to-weight ratio is some 4-5 times better. © 1998 Elsevier Science Ltd. All rights reserved.

A resonant micromachined electrostatic charge sensor

A micromachined electrometer, based on the concept of a variable capacitor, has been designed, modeled, fabricated, and tested. The device presented in this paper functions as a modulated variable capacitor, wherein a dc charge to be measured is up-modulated and converted to an ac voltage output, thus improving the signal-to-noise ratio. The device was fabricated in a commercial standard SOI micromachining process without the need for any additional processing steps. The electrometer was tested in both air and vacuum at room temperature. In air, it has a charge-to-voltage conversion gain of 2.06 nV/e, and a measured charge noise floor of 52.4 e/rtHz. To reduce the effects of input leakage current, an electrically isolated capacitor has been introduced between the variable capacitor and input to sensor electronics. Methods to improve the sensitivity and resolution are suggested while the long-term stability of these sensors is modeled and discussed. © 2006 IEEE.

Surface-stress-induced Mott transition and nature of associated spatial phase transition in single crystalline VO2 nanowires.

We demonstrate that the Mott metal-insulator transition (MIT) in single crystalline VO(2) nanowires is strongly mediated by surface stress as a consequence of the high surface area to volume ratio of individual nanowires. Further, we show that the stress-induced antiferromagnetic Mott insulating phase is critical in controlling the spatial extent and distribution of the insulating monoclinic and metallic rutile phases as well as the electrical characteristics of the Mott transition. This affords an understanding of the relationship between the structural phase transition and the Mott MIT.

A new, fast response CO2 sensor

The inability of emissions reduction methods to meet upcoming legislation without an unacceptable increase in vehicle cost is a major problem of automobile manufacturer. This work aims to develop a cost-effective reduction of automobile emissions. A prototype CO2 sensor with 5 msec response time was built and bench tested, then used on an engine. The sensor design was based on standard emissions measurement technology using non-dispersive IR absorption. An improved sensor has now been completed with significant improvements in terms of signal to noise ratio and long-term stability. The improved sensor will be used to measure CO2 concentrations on three different engines. The results will then be used to validate engine and catalyst models and to propose control strategies aimed at reducing overall emissions. A brief description of the sensor itself was presented. Original is an abstract.

Asymmetric quantizers are better at low SNR

We study the behavior of channel capacity when a one-bit quantizer is employed at the output of the discrete-time average-power-limited Gaussian channel. We focus on the low signal-to-noise ratio regime, where communication at very low spectral efficiencies takes place, as in Spread-Spectrum and Ultra-Wideband communications. It is well known that, in this regime, a symmetric one-bit quantizer reduces capacity by 2/π, which translates to a power loss of approximately two decibels. Here we show that if an asymmetric one-bit quantizer is employed, and if asymmetric signal constellations are used, then these two decibels can be recovered in full. © 2011 IEEE.