41 resultados para KNEE PROSTHESIS


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Galactic cosmic-ray (CR) acceleration to the knee in the spectrum at a few PeV is only possible if the magnetic field ahead of a supernova remnant (SNR) shock is strongly amplified by CRs escaping the SNR. A model formulated in terms of the electric charge carried by escaping CRs predicts the maximum CR energy and the energy spectrum of CRs released into the surrounding medium. We find that historical SNRs such as Cas A, Tycho and Kepler may be expanding too slowly to accelerate CRs to the knee at the present time.

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In supernova remnants, the nonlinear amplification of magnetic fields upstream of collisionless shocks is essential for the acceleration of cosmic rays to the energy of the "knee" at 10(15.5) eV. A nonresonant instability driven by the cosmic ray current is thought to be responsible for this effect. We perform two-dimensional, particle-in-cell simulations of this instability. We observe an initial growth of circularly polarized nonpropagating magnetic waves as predicted in linear theory. It is demonstrated that in some cases the magnetic energy density in the growing waves can grow to at least 10 times its initial value. We find no evidence of competing modes, nor of significant modification by thermal effects. At late times, we observe saturation of the instability in the simulation, but the mechanism responsible is an artifact of the periodic boundary conditions and has no counterpart in the supernova-shock scenario.

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Restoration of joint centre during total hip arthroplasty is critical. While computer-aided navigation can improve accuracy during total hip arthroplasty, its expense makes it inaccessible to the majority of surgeons. This article evaluates the use, in the laboratory, of a calliper with a simple computer application to measure changes in femoral head centres during total hip arthroplasty. The computer application was designed using Microsoft Excel and used calliper measurements taken pre- and post-femoral head resection to predict the change in head centre in terms of offset and vertical height between the femoral head and newly inserted prosthesis. Its accuracy was assessed using a coordinate measuring machine to compare changes in preoperative and post-operative head centre when simulating stem insertion on 10 sawbone femurs. A femoral stem with a modular neck was used, which meant nine possible head centre configurations were available for each femur, giving 90 results. The results show that using this technique during a simulated total hip arthroplasty, it was possible to restore femoral head centre to within 6?mm for offset (mean 1.67?±?1.16?mm) and vertical height (mean 2.14?±?1.51?mm). It is intended that this low-cost technique be extended to inform the surgeon of a best-fit solution in terms of neck length and neck type for a specific prosthesis.

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In this paper we investigate the received signal characteristics of on-body communications channels at 2.45 GHz. The hypothetical body area network configuration considered a transmitter node situated on the person’s left waist and receiving nodes positioned on the head, knee and wrist of the person’s right side. The on-body channel measurements were performed in both anechoic and reverberant environments while the person was moving. It was found that the recently proposed shadowed κ‒μ fading model provided an excellent fit to the measured data.

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In this paper, we have developed a low-complexity algorithm for epileptic seizure detection with a high degree of accuracy. The algorithm has been designed to be feasibly implementable as battery-powered low-power implantable epileptic seizure detection system or epilepsy prosthesis. This is achieved by utilizing design optimization techniques at different levels of abstraction. Particularly, user-specific critical parameters are identified at the algorithmic level and are explicitly used along with multiplier-less implementations at the architecture level. The system has been tested on neural data obtained from in-vivo animal recordings and has been implemented in 90nm bulk-Si technology. The results show up to 90 % savings in power as compared to prevalent wavelet based seizure detection technique while achieving 97% average detection rate. Copyright 2010 ACM.

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For older patients, clinicians should consider maintaining teeth and using functionally-orientated treatment strategies as an alternative to removable prostheses. When the remaining dentition has a poor prognosis, key teeth should be preserved as overdenture abutments and a gradual transition to edentulousness planned. Where complete dentures are provided, these can be retained using dental implants to overcome many of the problems associated with conventional replacement dentures.

CLINICAL RELEVANCE: The elderly population of today is better informed and more demanding of oral healthcare providers than previous generations. Clinicians should be aware of all the prosthodontic treatment options available for older patients.

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Ageing of the population, together with prolonged retention of teeth, has brought new challenges to dentistry. Whereas in the past oral care for the elderly was restricted to provision of dentures, older patients are now presenting with dental caries and failed restorations. These problems may have an impact on their general health and quality of life. Poor oral hygiene, xerostomia and diet are among the risk factors for caries in older patients and need to be addressed in order to achieve control of the disease. Carious lesions can be treated conservatively in many cases or may need surgical management.

CLINICAL RELEVANCE: Caries is an oral health issue among older patients and can result in tooth loss. Oral health has a great impact on general health and quality of life of elderly people.

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Toothwear is commonly observed in dentate older patients and may be physiological or pathological in nature. Toothwear can be caused by abrasion, attrition, erosion or a combination of aetiologies. Where treatment is required, a number of options exist, including the use of adhesive materials and fixed and removable prosthodontics.

CLINICAL RELEVANCE: With patients retaining natural teeth into old age, physiological and pathological toothwear amongst dentate older patients is an increasingly common presentation.

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The design optimization of a cold-formed steel portal frame building is considered in this paper. The proposed genetic algorithm (GA) optimizer considers both topology (i.e., frame spacing and pitch) and cross-sectional sizes of the main structural members as the decision variables. Previous GAs in the literature were characterized by poor convergence, including slow progress, that usually results in excessive computation times and/or frequent failure to achieve an optimal or near-optimal solution. This is the main issue addressed in this paper. In an effort to improve the performance of the conventional GA, a niching strategy is presented that is shown to be an effective means of enhancing the dissimilarity of the solutions in each generation of the GA. Thus, population diversity is maintained and premature convergence is reduced significantly. Through benchmark examples, it is shown that the efficient GA proposed generates optimal solutions more consistently. A parametric study was carried out, and the results included. They show significant variation in the optimal topology in terms of pitch and frame spacing for a range of typical column heights. They also show that the optimized design achieved large savings based on the cost of the main structural elements; the inclusion of knee braces at the eaves yield further savings in cost, that are significant.

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PURPOSE: This systematic review aimed to report and explore the survival of dental veneers constructed from non-feldspathic porcelain over 5 and 10 years.

MATERIALS AND METHODS: A total of 4,294 articles were identified through a systematic search involving all databases in the Cochrane Library, MEDLINE (OVID), EMBASE, Web of Knowledge, specific journals (hand-search), conference proceedings, clinical trials registers, and collegiate contacts. Articles, abstracts, and gray literature were sought by two independent researchers. There were no language limitations. One hundred sixteen studies were identified for full-text assessment, with 10 included in the analysis (5 qualitative, 5 quantitative). Study characteristics and survival (Kaplan-Meier estimated cumulative survival and 95% confidence interval [CI]) were extracted or recalculated. A failed veneer was one which required an intervention that disrupted the original marginal integrity, had been partially or completely lost, or had lost retention more than twice. A meta-analysis and sensitivity analysis of Empress veneers was completed, with an assessment of statistical heterogeneity and publication bias. Clinical heterogeneity was explored for results of all veneering materials from included studies.

RESULTS: Within the 10 studies, veneers were fabricated with IPS Empress, IPS Empress 2, Cerinate, and Cerec computer-aided design/computer-assisted manufacture (CAD/CAM) materials VITA Mark I, VITA Mark II, Ivoclar ProCad. The meta-analysis showed the pooled estimate for Empress veneers to be 92.4% (95% CI: 89.8% to 95.0%) for 5-year survival and 66% to 94% (95% CI: 55% to 99%) for 10 years. Data regarding other non-feldspathic porcelain materials were lacking, with only a single study each reporting outcomes for Empress 2, Cerinate, and various Cerec porcelains over 5 years. The sensitivity analysis showed data from one study had an influencing and stabilizing effect on the 5-year pooled estimate.

CONCLUSION: The long-term outcome (> 5 years) of non-feldspathic porcelain veneers is sparsely reported in the literature. This systematic review indicates that the 5-year cumulative estimated survival for etchable non-feldspathic porcelain veneers is over 90%. Outcomes may prove clinically acceptable with time, but evidence remains lacking and the use of these materials for veneers remains experimental.