Prospective randomized controlled trial comparing dynamic hip screw and screw fixation for undisplaced subcapital hip fractures

Background
Neck of femur fractures (NOFFs) are a common cause of morbidity and mortality in our community. Minimally displaced intracapsular fractures are treated with internal fixation by a two-hole dynamic hip screw (DHS) or three partially threaded cancellous screws. Data to support the superiority of one are limited. This prospective randomized controlled trial compares outcomes with these two fixation methods.

Methods
We prospectively recruited patients over 50 years, with an acute fracture subcapital NOFF, who walked and lived independently, and were cognitively intact. They were randomized into DHS or cancellous screw groups and followed up for 2 years (overall 75.9%). Outcomes of mortality, revision, loss of fixation, avascular necrosis, surgical complications, WOMAC, Harris hip score and SF-12 were measured.

Results
We recruited 62 patients (31 DHS, 29 cancellous screws, 2 failed consent). Six deaths (19.3%) were seen in each group. A total of 3.2% of DHS (1 out of 31) and 10.3% (3 out of 29) of cancellous screw patients required re-operation (P = 0.272). There was no statistical significant difference in patient satisfaction, quality of life (QoL), radiological union or osteonecrosis. There are trends towards better functional scores and QoL in cancellous screws, particularly at 1 year (P = 0.0061), but with a higher re-operation rate. There was a combined mortality and transition to institutional care of 40.0% (24 out of 60) at 2 years.

Conclusions
This study found no difference in outcomes between DHS and cancellous screws in the treatment of subcapital NOFFs in a fit, independent population, but we found a high level of physical decline in previously fit, independently ambulating patients. A large, multicentre trial will be required to differentiate between these two fixation methods.

A comparison of the yaw constraining performance of SCARA-tau parallel manipulator variants via screw theory

The SCARA-Tau parallel manipulator was derived with the objective to overcome the limited workspace-to-footprint ratio of the DELTA parallel manipulator while maintaining its many benefits. The SCARA-Tau family has later been extended and a large number of variants have been proposed. In this paper, we analyse four of these variants, which together encompass the main differences between all the proposed SCARA-Tau manipulators. The analysed manipulator variants utilise an identical arrangement of five of the six linkages connecting the actuated arms and the manipulated platform and exhibit the same input-output Jacobian. The normalised reciprocal product between the wrench of the sixth linkage and the twist of the platform occurring without this linkage provides a measure on how effectively the sixth linkage constrains the manipulated platform. A comparison of the manipulator variants with respect to this measure demonstrates each variants suitability for specific applications.

Impact of ripening stages of banana flour on the quality of extruded products

The study investigated the physical, nutritional and sensory properties of different ripening stages of banana during extrusion processing in combination with rice flour to develop quality snack products. Dehydrated banana flours at ripening stages 4, 5 and 6 (peel colour) were mixed separately at 40% banana to 60% rice flour levels. The mixtures were extruded through a twin-screw extruder at 120 °C barrel temperature, 220 and 260 r.p.m, screw speed and 12% feed moisture. Increase in ripeness indicated negative effect on expansion and water absorption capacity while increasing the water solubility index and moisture retention (wet basis) of the products. Protein and mineral (except for zinc and copper) content of the products were significantly different (P < 0.05) from 4 to 6 of the ripening stages. Most of the essential amino acids in the extruded products increased significantly (P < 0.05) at the ripening stage of 6. All the products were within the acceptable range in the 9-point Hedonic scale showing the best texture and flavour scores for stage 4 and 6, respectively. The extruded products show potential as snack products because of their nutritional quality and sensory acceptability.

Bis(3-endo-camphoryl)phosphinic acid, a non-racemic helical supramolecular host with aquapores

Bis(3-endo-camphoryl)phosphinic acid (1) was prepared by the reaction of the lithium enolate of D-(+)-camphor and phosphorous trichloride followed by an oxidative work up. Compound 1 crystallizes from wet toluene as monohydrate 1·H2O, which was investigated by X-ray crystallography. Molecules of 1 are associated by strong hydrogen bonds giving rise to the formation of a supramolecular helix. The interior channel of the helix is filled by a one-dimensional (1D) string of water molecules that are also associated by hydrogen bonding. The 1D string adopts a twisted zigzag conformation. Although the hydrogen bond networks are not cross-linked both the screw of the helix and the twist of the 1D string of water molecules are left-handed (M) and controlled by the chiral camphoryl residues situated on the exterior of the helix. The overall supramolecular structure is strongly reminiscent of aquaporin-1, a significant membrane-channel protein responsible for the transport of water into the cells.

Mechanochemical synthesis of niobium pentoxide nanoparticles

Acicular α-FeOOH particles are formed through aging of ferric oxyhydroxide colloidal solution formed by the neutralization of FeCl₃ aqueous solution by NaOH. The effect of foreign ion addition to the colloidal solution on the formation and morphology of α-FeOOH particles has been investigated. The magnetic properties of Fe₃O₄ particles made from the obtained particles have also been investigated. The rate constant of the formation of α-FeOOH remarkably decreased, but the crystallite size of α-FeOOH particles increased with increasing the quantity of phosphate ion added even with small amounts. These results have been explained as follows: the phosphate ions are selectively adsorbed on the (a) plane of α-FeOOH, cover the (a) plane, and block the crystal growth of the (a) plane of the α-FeOOH. The quantities of the phosphate ion adsorbed on the b and c planes are relatively small. The complex ion of Fe(OH)₄^- is preferentially deposited on both (b) and (c) planes, and the crystal growth of (b) and (c) planes is greatly accelerated. The relationship between the morphology of the formed α-FeOOH particles and the quantity of phosphate ion added has been investigated. The asterisk type particles: α-FeOOH particles heterogeneously junctioned to α-Fe₂O₃ particles, were formed when a small amount of phosphate was added to the mother liquid. The α-FeOOH crystal epitaxially grew on the junction interface with the α-Fe₂O₃ crystal. In the case of the aging at the temperature as high as 80°C, the cross type junctioned particles were stably formed at pH below 12.0. The Fe₃O₄ particles with screw-like unique three-dimensional morphology were produced from the heterogeneously junctioned particles.

An evaluation of the performance of advanced melded composite joints

Melding is an efficient three step composite joining process that involves the selective cure of composite adherends before the final adhesive joint is created using the adherends own resin system. Melding does not require many of the processes and compromises associated with conventional techniques like adhesive bonding and mechanical fastening.

The Taguchi design of experiments technique was used to optimise three melded joint factors for a unidirectional epoxy prepreg material. The performance of the joint was evaluated using tensile and flexural strength as well as flexural modulus. It was found that not having a step for every ply in the joint was the most influential factor affecting joint performance. This was due to the differing failure modes induced by this factors various levels, which varied the amount of fibre breakage at failure.

Boron nitride nanotube films grown from boron ink painting

The growth of nanotube films can have important applications in building nanoscale functional devices or solving interfacial and heat problems. We report that high-density boron nitride nanotube (BNNT) films with any desired pattern can be grown on complicated surfaces using a boron (B) ink process. The special B ink, a mixture of nanosized B particles, metal nitrate and ethanol, is first painted, sprayed or inkjet printed at the desired location with required pattern, and then the ink layer is annealed in a nitrogen-containing atmosphere to form BNNT film. This is the first method capable of growing BNNTs on complex non-flat surfaces, which greatly broadens the potential application of BNNTs. For example, it is demonstrated here that a BNNT coated steel mesh can separate water and oil on a microlitre scale; a needle given an internal BNNT coating could greatly enhance microfluidic transport; and a coated screw could be used to minimize wear at the interface.

X-ray diffraction line broadening from gold and platinum thin films

X-ray diffraction line profile analysis has been used to study the microstructure of (Ill) oriented gold and platinum thin films deposited by thermal evaporation and DC magnetron sputtering. In addition to crystallite size broadening, the profiles from these films displayed broadening arising from dislocations. A parallel investigation, using transmission electron microscopy (TEM) was undertaken to study the nature of dislocations formed, and to provide information on the dimensions of the crystallite columns in the films. X-ray data were collected at room temperature to determine the anisotropy of the broadening with (hkl), using a Siemens D5000 powder diffractometer (CuKa radiation) and two high-resolution synchrotron instruments (BM 16 at the ESRF [A=0.35A] and station 2.3 at the Daresbury laboratory. Two approaches to instrument deconvolution were investigated; Fourier deconvolution and fundamental parameters profile fitting, using Lab6 as a reference material to determine the instrument profile function. After removal of the crystallite size broadening contribution from the measured integral breadths, the residual microstrain broadening was modelled assuming dislocations based on a FCC a/2<110>{ Ill} slip system. The results of the X-ray analysis agreed with dark field TEM micrographs, which showed that many of the crystallites contained dislocations of mixed character (screw- edge).

Fixed-angle locking proximal humerus plate: an evaluation of functional results and implant-related outcomes

Background
Displaced and unstable proximal humeral fractures are challenging injuries to treat. Proximal humeral locking plates are a recent development for the treatment of these complex fractures.

Methods
Retrospective analysis of 23 patients with 23 proximal humeral fractures treated with the Synthes locking proximal humerus plate. These were Neer two-, three- and four-part fractures. Follow-up was at a mean of 22 months and included clinical assessment using the Constant score (CS) and the Short Form-12 health questionnaire. Radiographic assessment was performed to assess implant-related complication in relation to the initial fracture pattern and the presence of adequate medial support.

Results
The mean CS for all patients was 60.4 (range, 29–85). The mean adjusted CS was 82% (range, 30–117), active forward flexion 127 degrees and the active abduction 115 degrees. Initial fracture pattern, the presence or absence of adequate medial support and age did not significantly influence the clinical scores. Complications included one infection, two cases of avascular necrosis, two cases of varus collapse with screw penetration and one non-union. The overall reoperation rate was 26%. There was an increased rate of complications in those with inadequate medial support (P = 0.0183) and a trend to higher complication rates in four-part fractures.

Conclusion
Using the locking proximal humerus plate for the treatment of proximal humeral fractures is an acceptable procedure with comparable outcomes with historical controls, but with a complication rate of 30%. More important than implant selection, however, is the ability to achieve a stable reduction with calcar support.

Motion/Force transmission analysis of axis-symmetric parallel mechanisms with closed-loop sub-chains

 This thesis presents several results regarding the kinematic performance analysis of axis-symmetric parallel mechanisms with closed-loop sub-chains. Screw theory based methods have been utilised to generate new indices, along with a formal procedure, enabling the systematic and complete singularity and motion/force transmission analysis of parallel mechanisms with these closed-loop sub-chains.