Cranioplasty: why throw the bone flap out?

Patients who undergo decompressive craniectomy for intracranial hypertension often require interval cranioplasty. Many cranioplasty agents are currently in use. The authors suggest that storage of the patient's own bone flap in the subcutaneous tissue of the abdominal wall, is a safe, efficacious and cost-effective alternative to use of synthetic cranioplasty materials.

The effect of the spectral distribution of wave energy on the performance of a bottom hinged flap type wave energy converter

The power output from a wave energy converter is typically predicted using experimental and/or numerical modelling techniques. In order to yield meaningful results the relevant characteristics of the device, together with those of the wave climate must be modelled with sufficient accuracy.

The wave climate is commonly described using a scatter table of sea states defined according to parameters related to wave height and period. These sea states are traditionally modelled with the spectral distribution of energy defined according to some empirical formulation. Since the response of most wave energy converters vary at different frequencies of excitation, their performance in a particular sea state may be expected to depend on the choice of spectral shape employed rather than simply the spectral parameters. Estimates of energy production may therefore be affected if the spectral distribution of wave energy at the deployment site is not well modelled. Furthermore, validation of the model may be affected by differences between the observed full scale spectral energy distribution and the spectrum used to model it.

This paper investigates the sensitivity of the performance of a bottom hinged flap type wave energy converter to the spectral energy distribution of the incident waves. This is investigated experimentally using a 1:20 scale model of Aquamarine Power’s Oyster wave energy converter, a bottom hinged flap type device situated at the European Marine Energy Centre (EMEC) in approximately 13m water depth. The performance of the model is tested in sea states defined according to the same wave height and period parameters but adhering to different spectral energy distributions.

The results of these tests show that power capture is reduced with increasing spectral bandwidth. This result is explored with consideration of the spectral response of the device in irregular wave conditions. The implications of this result are discussed in the context of validation of the model against particular prototype data sets and estimation of annual energy production.

Numerical Study of Wave Slamming on an Oscillating Flap

Bottom hinged Oscillating Wave Surge Converters (OWSCs) are efficient devices for extracting power from ocean waves. There is limited knowledge about wave slamming on such devices. This paper deals with numerical studies of wave slamming on an oscillating flap to investigate the mechanism of slamming events. In our model, the Navier–Stokes equations are discretized using the Finite Volume method with the Volume of Fluid (VOF) approach for interface capturing. Waves are generated by a flaptype wave maker in the numerical wave tank, and the dynamic mesh method is applied to model the motion of the oscillating flap. Basic mesh and time step refinement studies are performed. The flow characteristics in a slamming event are analysed based on numerical results. Various simulations with different flap densities, water depths and wave amplitudes are performed for a better understanding of the slamming.

Skin-reducing mastectomy and one-stage implant reconstruction with a myodermal flap: A safe and effective technique in risk-reducing and therapeutic mastectomy

Introduction: Immediate reconstruction following mastectomy for breast cancer has been shown to be oncologically safe and associated with improved psychosocial outcomes for patients. Bostwick described a technique for one-stage implant based reconstruction, combining skin-sparing mastectomy with concurrent reduction of the skin envelope. This report reviews the experience of a single centre using skin-reducing mastectomy and one-stage implant reconstruction in both early stage breast cancer and risk-reducing mastectomy, with specific reference to frequency of complications, implant loss and oncological outcomes.

Methods and results: A retrospective review was undertaken to identify women who had undergone skin-reducing mastectomy and one-stage implant reconstruction using a de-epithelialised dermal flap, between October 2008 and October 2012. One hundred and four consecutive mastectomies, with reconstruction, were performed by two surgeons on 64 patients. No complications were seen in 43.8% of patients. At three months, four implants were lost (3.8% of breast reconstructions, 6.3% of patients), due to either peri-implant infection or mastectomy skin flap necrosis. One patient required unplanned return to theatre for evacuation of a haematoma. Minor mastectomy skin flap necrosis was seen in 10 breasts (9.6% of reconstructed breasts) and superficial wound infection in 8 breasts (7.7% of reconstructed breasts). All of these complications were managed conservatively and none required operative intervention. At a median follow up of 35 months (4-53 months) there had been one episode of ipsilateral axillary nodal recurrence.

Conclusion: One-stage implant reconstruction using a myo-dermal flap technique following skin-reducing mastectomy is safe and should be considered in selected patients. Most complications are minor and will resolve with conservative management. Major complications such as implant failure or immediate reoperation, were relatively uncommon (6.3% patients, 3.8% of reconstructed breasts). Early follow-up suggests that oncological outcomes are satisfactory, but longer follow-up is required to substantiate this. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Wave loads on the foundation of a bottom-hinged modular flap structure

Large loads result in expensive foundations which are a substantial proportion of the capital cost of flap-type Wave Energy Converters (WECs). Devices such as Oyster 800, currently deployed at the European Marine Energy Centre (EMEC), comprise a single flap for the full width of the machine. Splitting a flap-type device into smaller vertical flap modules, to make a ‘modular-flap’, might reduce the total foundation loads, whilst still providing acceptable performance in terms of energy conversion.
This paper investigates the foundation loads of an undamped modular-flap device, comparing them to those for a rigid flap of an equivalent width. Physical modelling in a wave tank is used, with loads recorded using a six degree of freedom (DoF) load cell. Both fatigue and extreme loading analysis was conducted. The rotations of the flaps were also recorded, using a motion-tracking system.

Improving signal reliability in outdoor body-to-body communications using front and back positioned antenna diversity

It has previously been shown that human body shadowing can have a considerable impact on body-to-body communications channels in low multipath environments. Signal degradation directly attributable to shadowing when one user's body obstructs the main line of sight can be as great as 40 dB. When both people's bodies obstruct the direct line of sight path, the communications link can be lost altogether even at very short distances of a few metres. In this paper, using front and back positioned antennas, we investigate the utility of a simple selection combination diversity combining scheme with the aim of mitigating human body shadowing in outdoor body-to-body communications channels at 2.45 GHz. Early results from this work are extremely promising, indicating substantial diversity gains, as great as 29 dB, may be achieved in a number of everyday scenarios likely to be encountered in body-to-body networking. © 2012 IEEE.

Continuity - based and discontinuity - based segmentation in transparent and spatially segregated global motion

The mechanisms underlying the parsing of a spatial distribution of velocity vectors into two adjacent (spatially segregated) or overlapping (transparent) motion surfaces were examined using random dot kinematograms. Parsing might occur using either of two principles. Surfaces might be defined on the basis of similarity of motion vectors and then sharp perceptual boundaries drawn between different surfaces (continuity-based segmentation). Alternatively, detection of a high gradient of direction or speed separating the motion surfaces might drive the process (discontinuity-based segmentation). To establish which method is used, we examined the effect of blurring the motion direction gradient. In the case of a sharp direction gradient, each dot had one of two directions differing by 135°. With a shallow gradient, most dots had one of two directions but the directions of the remainder spanned the range between one motion-defined surface and the other. In the spatial segregation case the gradient defined a central boundary separating two regions. In the transparent version the dots were randomly positioned. In both cases all dots moved with the same speed and existed for only two frames before being randomly replaced. The ability of observers to parse the motion distribution was measured in terms of their ability to discriminate the direction of one of the two surfaces. Performance was hardly affected by spreading the gradient over at least 25% of the dots (corresponding to a 1° strip in the segregation case). We conclude that detection of sharp velocity gradients is not necessary for distinguishing different motion surfaces.

Investment and Capitalization of Firms in the USA

In the USA today, the precipitous rise of new financial mechanisms for capitalisation of firms as well as the merger and acquisition of others, especially risk equity capital through venture capitalist and investment banking, has sparked growth and helped to bring the economy out of the 1990s recession into a robust continuous growth pattern well positioned for the next century. The scenario is not new. For the venture capitalists of ''Silicon Valley'' in California, the experience is not new. They have seen the new industries arise before, like a phoenix from ashes of ruin, despair and even failure. Venture capital poured into high tech start-up companies has been an enormous source of financial support for the entrepreneurs who head new and growing companies. The mid-1990s marked the most dramatic increase yet recorded. Indicators, such as the NASDAQ document, outlined the solid and continuous growth in high tech industries. The paper discusses investment in US corporations within the context of governance and management of the company. Discussion about the various forms of finance are related to the organisation and management of the US corporation. Critical to any firm today are its ability to find innovative, new products or services. A growing literature on resource-base framework for analysis will be discussed as part of the firm's development of research for commercialisation. The results of a recent survey further shed light on the relationship between corporate financial management and allocated resources for research and development as the ''engine'' for new product development and therefore corporate market share and growth. The conclusion is that more financial mechanisms will be created and changed within US corporate systems to adjust, grow, and expand companies in the global economic arena, as the inevitable economic pattern leads to mergers, consolidations, and increasing cooperation and alliances among firms.

The effect of water depth on the performance of a small surging wave energy converter

The effect of water depth on the performance of a small surging wave energy converter (WEC) is investigated analytically, numerically and experimentally. It is shown that although the average annual incident wave power is significantly reduced by water depth, a large proportion of this reduction is due to the dissipation of highly energetic, but largely unexploitable seas. It is also shown that the power capture is related more closely to incident wave force than incident wave power. Experimental results demonstrate that both the surge wave force and power capture of a flap-type WEC increase in shallow water.

Evaluation of the antiangiogenic potential of AQ4N.

Purpose: A number of cytotoxic chemotherapy agents tested at low concentrations show antiangiogenic properties with limited cytotoxicity, e.g., cyclophosphamide, tirapazamine, and mitoxantrone. AQ4N is a bioreductive alkylaminoanthraquinone that is cytotoxic when reduced to AQ4; hence, it can be used to target hypoxic tumor cells. AQ4N is structurally similar to mitoxantrone and was evaluated for antiangiogenic properties without the need for bioreduction.

Experimental Design:The effect of AQ4N and fumagillin on human microvascular endothelial cells (HMEC-1) was measured using a variety ofin vitro assays, i.e., 3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide, wound scrape, tubule formation, rat aortic ring, and invasion assays. Low-dose AQ4N (20 mg/kg) was also given in vivo to mice bearing a tumor in a dorsal skin flap.

Results:AQ4N (10-11to10-5mol/L) hadno effect on HMEC-1viability. AQ4N (10-9to10-5mol/L) caused a sigmoidal dose-dependent inhibition of endothelial cell migration in the wound scrape model. Fumagillin showed a similar response over a lower dose range (10-13 to 10-9 mol/L); however, the maximal inhibition was less (25% versus 43% for AQ4N). AQ4N inhibited HMEC-1 cell contacts on Matrigel (10-8 to 10-5 mol/L), HMEC-1 cell invasion, and sprouting in rat aorta explants. Immunofluorescence staining with tubulin, vimentim, dynein, and phalloidin revealed that AQ4N caused disruption to the cell cytoskeleton. When AQ4N (20 mg/kg) was given in vivo for 5 days, microvessels disappeared in LNCaP tumors grown in a dorsal skin flap.

Conclusions:This combination of assays has shown that AQ4N possesses antiangiogenic effects in normoxic conditions, which could potentially contribute to antitumor activity

Developmental changes in the response to obstacles during prehension

Adults are proficient at reaching to grasp objects of interest in a cluttered workspace. The issue of concern, obstacle avoidance, was studied in 3 groups of young children aged 11-12, 9-10, and 7-8 years (n = 6 in each) and in 6 adults aged 18-24 years. Adults slowed their movements and decreased their maximum grip aperture when an obstacle was positioned close to a target object (the effect declined as the distance between target and obstacle increased). The children showed the same pattern, but the magnitude of the effect was quite different. In contrast to the adults, the obstacle continued to have a large effect when it was some distance from the target (and provided no physical obstruction to movement).

The preparation of reach to grasp movements in adults with Down syndrome

The aim of this study was to determine the extent to which adults with Down syndrome (DS) are able to utilise advance information to prepare reach to grasp movements. The study comprised ten adults with DS; ten children matched to an individual in the group with DS on the basis of their intellectual ability, and twelve adult controls. The participants used their right hand to reach out and grasp illuminated perspex blocks. Four target blocks were positioned on a table surface, two to each side of the midsagittal plane. In the complete precue condition, participants were provided with information specifying the location of the target. In the partial precue condition, participants were given advance information indicating the location of the object relative to the midsagittal plane (left or right). In the null condition, advance information concerning the position of the target object was entirely ambiguous. It was found that both reaction times and movement times were greater for the participants with DS than for the adults without DS. The reaction times exhibited by individuals with DS in the complete precue condition were lower than those observed in the null condition, indicating that they had utilised advance information to prepare their movements. In the group with DS, when advance information specified only the location of the target object relative to the midline, reaction times were equivalent to those obtained when ambiguous information was given. In contrast, the adults without DS exhibited reaction times that were lower in both the complete and partial precue conditions when compared to the null condition. The pattern of results exhibited by the children was similar to that of the adults without DS. The movement times exhibited by all groups were not influenced by the precue condition. In summary, our findings indicate that individuals with DS are able to use advance information if it specifies precisely the location of the target object in order to prepare a reach to grasp movement. The group with DS were unable, however, to obtain the normal advantage of advance information specifying only one dimension of the movement goal (i.e., the position of an object relative to the body midline). (C) 2001 Elsevier Science B.V. All rights reserved.