Surgical exposures and options for instrumentation in acetabular fracture fixation: Pararectus approach versus the modified Stoppa.

BACKGROUND As an alternative to the modified Stoppa approach, the Pararectus approach is used clinically for treatment of acetabular fractures involving the anterior column. The current study assessed the surgical exposure and the options for instrumentation using both of these approaches. METHODS Surgical dissections were conducted on five human cadavers (all male, mean age 88 years (82-97)) using the modified Stoppa and the Pararectus approach, with the same skin incision length (10cm). Distal boundaries of the exposed bony surfaces were marked using a chisel. After removal of all soft-tissues, distances from the boundaries in the false and true pelvis were measured with reference to the pelvic brim. The exposed bone was coloured and calibrated digital images of each inner hemipelvis were taken. The amount of exposed surface using both approaches was assessed and represented as a percentage of the total bony surface of each hemipelvis. For instrumentation, a suprapectineal quadrilateral buttress plate was used. Screw lengths were documented, and three-dimensional CT reconstructions were performed to assess screw trajectories qualitatively. Wilcoxon's signed rank test for paired groups was used (level of significance: p<0.05). RESULTS After utilization of the Pararectus approach, the distances from the farthest boundaries of exposed bone towards the pelvic brim were significantly higher in the false but not the true pelvis, compared to the modified Stoppa approach. The percentage (mean±SD) of exposed bone accessible after utilizing the Pararectus approach was 42±8%, compared to 29±6% using the modified Stoppa (p=0.011). In cadavers exposed by the Pararectus approach, screws placed for posterior fixation and as a posterior column screw were longer by factor 1.8 and 2.1, respectively (p<0.05), and screws could be placed more posteromedial towards the posterior inferior iliac spine or in line with the posterior column directed towards the ischial tuberosity. CONCLUSION Compared to the modified Stoppa, the Pararectus approach facilitates a greater surgical access in the false pelvis, provides versatility for fracture fixation in the posterior pelvic ring and allows for the option to extend the approach without a new incision.

Baseline test of compact vehicle side structure, 35 mph, 90 degree impact, Torino-to-Volare, test no. 9. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Assessment of statistical change criteria used to define significant change in neuropsychological test performance following cardiac surgery

Objective: This paper compares four techniques used to assess change in neuropsychological test scores before and after coronary artery bypass graft surgery (CABG), and includes a rationale for the classification of a patient as overall impaired. Methods: A total of 55 patients were tested before and after surgery on the MicroCog neuropsychological test battery. A matched control group underwent the same testing regime to generate test–retest reliabilities and practice effects. Two techniques designed to assess statistical change were used: the Reliable Change Index (RCI), modified for practice, and the Standardised Regression-based (SRB) technique. These were compared against two fixed cutoff techniques (standard deviation and 20% change methods). Results: The incidence of decline across test scores varied markedly depending on which technique was used to describe change. The SRB method identified more patients as declined on most measures. In comparison, the two fixed cutoff techniques displayed relatively reduced sensitivity in the detection of change. Conclusions: Overall change in an individual can be described provided the investigators choose a rational cutoff based on likely spread of scores due to chance. A cutoff value of ≥20% of test scores used provided acceptable probability based on the number of tests commonly encountered. Investigators must also choose a test battery that minimises shared variance among test scores.

Validation and reliability of the Modified Elderly Mobility Scale

Objective: To establish concurrent validity, interrater and test-retest reliability of the Modified Elderly Mobility Scale (MEMS). Methods: Ninety elderly patients were scored on the MEMS. To establish concurrent validity, 75 patients MEMS scores were compared to Functional Independence Measure (FIM) scores using Spearman's correlation. Videotaped patient performances were used to establish interrater and test-retest reliability using percentage absolute agreement and intraclass correlation coefficients (ICCs). Results: The total MEMS score demonstrated a significant association with the motor (r = 0.725) and total FIM scores (r = 0.718). Absolute agreement for interrater reliability was greater than 93% for all test items, with 97 and 98% for the two new measures, respectively. Test-retest reliability demonstrated similar high levels of absolute agreement and had ICCs ranging from 0.870 to 1.0. Conclusions: The MEMS is a quick, valid and reliable test of motor function of elderly patients with a spread of functional levels.

Added luminance ramp alters perceived edge blur and contrast:A critical test for derivative-based models of edge coding

In many models of edge analysis in biological vision, the initial stage is a linear 2nd derivative operation. Such models predict that adding a linear luminance ramp to an edge will have no effect on the edge's appearance, since the ramp has no effect on the 2nd derivative. Our experiments did not support this prediction: adding a negative-going ramp to a positive-going edge (or vice-versa) greatly reduced the perceived blur and contrast of the edge. The effects on a fairly sharp edge were accurately predicted by a nonlinear multi-scale model of edge processing [Georgeson, M. A., May, K. A., Freeman, T. C. A., & Hesse, G. S. (in press). From filters to features: Scale-space analysis of edge and blur coding in human vision. Journal of Vision], in which a half-wave rectifier comes after the 1st derivative filter. But we also found that the ramp affected perceived blur more profoundly when the edge blur was large, and this greater effect was not predicted by the existing model. The model's fit to these data was much improved when the simple half-wave rectifier was replaced by a threshold-like transducer [May, K. A. & Georgeson, M. A. (2007). Blurred edges look faint, and faint edges look sharp: The effect of a gradient threshold in a multi-scale edge coding model. Vision Research, 47, 1705-1720.]. This modified model correctly predicted that the interaction between ramp gradient and edge scale would be much larger for blur perception than for contrast perception. In our model, the ramp narrows an internal representation of the gradient profile, leading to a reduction in perceived blur. This in turn reduces perceived contrast because estimated blur plays a role in the model's estimation of contrast. Interestingly, the model predicts that analogous effects should occur when the width of the window containing the edge is made narrower. This has already been confirmed for blur perception; here, we further support the model by showing a similar effect for contrast perception. © 2007 Elsevier Ltd. All rights reserved.

Development and evaluation of a non-destructive adhesion test

The object of this work was to further develop the idea introduced by Muaddi et al (1981) which enables some of the disadvantages of earlier destructive adhesion test methods to be overcome. The test is non-destructive in nature but it does need to be calibrated against a destructive method. Adhesion is determined by measuring the effect of plating on internal friction. This is achieved by determining the damping of vibrations of a resonating specimen before and after plating. The level of adhesion was considered by the above authors to influence the degree of damping. In the major portion of the research work the electrodeposited metal was Watt's nickel, which is ductile in nature and is therefore suitable for peel adhesion testing. The base metals chosen were aluminium alloys S1C and HE9 as it is relatively easy to produce varying levels of adhesion between the substrate and electrodeposited coating by choosing the appropriate process sequence. S1C alloy is the commercially pure aluminium and was used to produce good adhesion. HE9 aluminium alloy is a more difficult to plate alloy and was chosen to produce poorer adhesion. The "Modal Testing" method used for studying vibrations was investigated as a possible means of evaluating adhesion but was not successful and so research was concentrated on the "Q" meter. The method based on the use of a "Q" meter involves the principle of exciting vibrations in a sample, interrupting the driving signal and counting the number of oscillations of the freely decaying vibrations between two known preselected amplitudes of oscillations. It was not possible to reconstruct a working instrument using Muaddi's thesis (1982) as it had either a serious error or the information was incomplete. Hence a modified "Q" meter had to be designed and constructed but it was then difficult to resonate non-magnetic materials, such as aluminium, therefore, a comparison before and after plating could not be made. A new "Q" meter was then developed based on an Impulse Technique. A regulated miniature hammer was used to excite the test piece at the fundamental mode instead of an electronic hammer and test pieces were supported at the two predetermined nodal points using nylon threads. This instrument developed was not very successful at detecting changes due to good and poor pretreatments given before plating, however, it was more sensitive to changes at the surface such as room temperature oxidation. Statistical analysis of test results from untreated aluminium alloys show that the instrument is not always consistent, the variation was even bigger when readings were taken on different days. Although aluminium is said to form protective oxides at room temperature there was evidence that the aluminium surface changes continuously due to film formation, growth and breakdown. Nickel plated and zinc alloy immersion coated samples also showed variation in Q with time. In order to prove that the variations in Q were mainly due to surface oxidation, aluminium samples were lacquered and anodised Such treatments enveloped the active surfaces reacting with the environment and the Q variation with time was almost eliminated especially after hard anodising. This instrument detected major differences between different untreated aluminium substrates.Also Q values decreased progressively as coating thicknesses were increased. This instrument was also able to detect changes in Q due to heat-treatment of aluminium alloys.

Modified hydrogel matrices in fibre optic sensors

Common problems encountered in clinical sensing are those of non-biocompatibility, and slow response time of the device. The latter, also applying to chemical sensors, is possibly due to a lack of understanding of polymer support or membrane properties and hence failure to optimise membranes chosen for specific sensor applications. Hydrogels can be described as polymers which swell in water. In addition to this, the presence of water in the polymer matrix offers some control of biocompatibility. They thus provide a medium through which rapid transport of a sensed species to an incorporated reagent could occur. This work considers the feasibility of such a system, leading to the design and construction of an optical sensor test bed. The development of suitable membrane systems and of suitable coating techniques in order to apply them to the fibre optics is described. Initial results obtained from hydrogel coatings implied that the refractive index change in the polymer matrix, due to a change in water content with pH is the major factor contributing to the sensor response. However the presence of the colourimetric reagent was also altering the output signal obtained. An analysis of factors contributing to the overall response, such as colour change and membrane composition were made on both the test bed, via optical response, and on whole membranes via measurement of water content change. The investigation of coatings with low equilibrium water contents, of less than 10% was carried out and in fact a clearer signal response from the test bed was noted. Again these membranes were suprisingly responding via refractive index change, with the reagent playing a primary role in obtaining a sensible or non-random response, although not in a colourimetric fashion. A photographic study of these coatings revealed some clues as to the physical nature of these coatings and hence partially explained this phenomenon. A study of the transport properties of the most successful membrane, on a coated wire electrode and also on the fibre optic test bed, in a series of test environments, indicated that the reagent was possibly acting as an ion exchanger and hence having a major influence on transport and therefore sensor characteristics.

Properties and performance of polymer modified cements and mortars

Polymer modified cements and mortars have become popular for use as patch repair materials. General evidence suggests that these materials offer considerable improvements compared to traditional mortars although the mechanisms for this are not fully understood. This work elucidates the factors which govern some properties and performance of different polymer systems. In view of the wide range of commercial systems available, investigations concentrated on the use of three of the most commonly available groups of polymers. These were: (1) Styrene Butadiene Rubber (SBR), (2) Acrylics and, (3) Ethylene Vinyl Acetates (EVA). The later two were in the form of both emulsions and redispersible powders. Experiments concentrated on: (1) Rheological behaviour of polymer modified cement pastes; (2) Workability of polymer modified mortars; (3) Influence of curing conditions on the pore size distribution and diffusion of chloride ions; (4) Bond strength of polymer modified cement and mortar patches; and (5) Microscopic examination and semi-quantitative analyses of the bulk and interfacial microstructures. The following main conclusions were reached: (1) The addition of polymer emulsions have a considerable influence on the workability of fresh cement pastes, the extent of this depending on the type of system used. (2) The rheological parameters of fresh polymer modified mortars can be established using a two-point workability test which may be used when comparing the properties of different systems at constant workability. (3) Curing conditions affect the properties of polymer modified systems and a wet/dry curing regime was essential for good adhesion of these materials to mortar substrates. (4) In contrast, the wet/dry curing regime resulted in a curing affected zone at the surface of patch materials. This can result in a much coarser pore structure and enhanced diffusion of e.g. chloride ions. (5) The microstructure of polymer modified systems was very different compared with the unmodified cement/mortar and varied depending on curing conditions.

Apparatus and test methods for measuring the impact of golf balls on turf and their application in the field

An apparatus was developed to project spinning golf balls directly onto golf greens. This employed a modified baseball/practice machine with two counter-rotating pneumatic wheels. The speed of the wheels could be varied independently allowing backspin to be given to the ball. The ball was projected into a darkened enclosure where the motion of the ball before and after impacting with the turf was recorded using a still camera and a stroboscope. The resulting photographs contained successive images of the ball on a single frame of film. The apparatus was tested on eighteen golf courses resulting in 721 photographs of impacts. Statistical analysis was carried out on the results of the photographs and from this, two types of green emerged. On the first, the ball tended to rebound with topspin, while on the second, the ball retained backspin after impact if the initial backspin was greater than about 350 rads-1. Eleven tests were devised to determine the characteristics of greens and statistical techniques were used to analyse the relationships between these tests. These showed the effects of the green characteristics on ball/turf impacts. It was found that the ball retained backspin on greens that were freely drained and had less than 60% of Poa annua (annual meadow grass) in their swards. Visco-elastic models were used to simulate the impact of the ball with the turf. Impacts were simulated by considering the ball to be rigid and the turf to be a two layered system consisting of springs and dampers. The model showed good agreement with experiment and was used to simulate impacts from two different shots onto two contrasting types of green.

The antioxidant potential of modified quercetins and quercetin-metal complexes

Quercetin is a naturally occurring polyphenol compound present in grapes, red wine, tea, apples and some vegetables. Like other flavonoids, it has been found to have antioxidant activity in studies in vitro, although there is still much debate about the bioavailability of flavonoids in the diet and their in vivo antioxidant activity. In general, it is thought that the antioxidant efficiency of polyphenols increases with increasing hydroxylation of the rings, but there have been few studies of other substitutions. We have prepared several derivatives of quercetin, to test the effect of modification on their antioxidant potential. Sodium salts of quercetin-5-sulfonate and quercetin-5,8-sulfonate, and transition metal complexes of quercetin-5-sulfonate were analysed for their total antioxidant potential using the FRAP assay, and compared to unmodified quercetin. It was found that quercetin-5-sulfonate complexes with Zn, Cu(II), Fe(II) and Mg were all significantly better antioxidants than quercetin, quercetin-5-sulfonate was comparable to quercetin, whereas the sodium salt of quercetin-5,8-sulfonate had a decreased total antioxidant potential. Kinetic studies of the FRAP reaction showed no significant differences between quercitin and any of the derivatives. The reaction of all the quercetins in the FRAP assay was found to be slower to reach completion than ascorbate, and appeared to have biphasic characteristics. These results suggest that transition metal ions may facilitate the transfer of electrons from the polyphenol ring system to the oxidant, while substitution with S03 is electron-withdrawing and destabilizes the ring system. This is important both for understanding the antioxidant ability of flavonoids, and for the design of novel antioxidant compounds. Further work is being carried out to assess the ability of the quercetin complexes to protect cultured cells from oxidative stress.

Improved methodology to evaluate fracture properties of warm-mix asphalt using overlay test

This study developed a reliable and repeatable methodology to evaluate the fracture properties of asphalt mixtures with an overlay test (OT). In the proposed methodology, first, a two-step OT protocol was used to characterize the undamaged and damaged behaviors of asphalt mixtures. Second, a new methodology combining the mechanical analysis of viscoelastic force equilibrium in the OT specimen and finite element simulations was used to determine the undamaged properties and crack growth function of asphalt mixtures. Third, a modified Paris's law replacing the stress intensity factor by the pseudo J-integral was employed to characterize the fracture behavior of asphalt mixtures. Theoretical equations were derived to calculate the parameters A and n (defined as the fracture properties) in the modified Paris's law. The study used a detailed example to calculate A and n from the OT data. The proposed methodology was successfully applied to evaluate the impact of warm-mix asphalt (WMA) technologies on fracture properties. The results of the tested specimens showed that Evotherm WMA technology slightly improved the cracking resistance of asphalt mixtures, while foaming WMA technology provided comparable fracture properties. In addition, the study found that A decreased with the increase in n in general. A linear relationship between 2log(A) and n was established.

Effects of a modified English listening comprehension curriculum on students' achievement in English listening comprehension at Tamsui Oxford University College in Taiwan

Due to increased international trade, English as a foreign language is important to Taiwan. However, ESL teaching and learning in Taiwan emphasizes reading and writing skills only. ESL teaching in Taiwan causes students to lack competence in complete communication. Improving students' listening and speaking is a vital issue in Taiwan. ^ The purposes of this study are to determine the effects of a modified curriculum for the English listening comprehension course, to investigate whether the modified curriculum results in a significant improvement in student's listening comprehension, and to determine whether students were motivated to increase listening comprehension ability as a result of the new listening activities. An experimental and a control group, randomly assigned, received either the modified or the traditional curriculum at Tamsui Oxford University College (TOUC) in Taiwan over a fourteen week period of time. ^ A Michigan Listening Comprehension posttest was used to determine the difference in achievement between the two groups. A final examination was conducted to compare the two groups' achievement and to determine whether the goal of increasing listening comprehension achievement by using a modified curriculum was met. Subjects completed two questionnaires, one common form prior to class and another unique form for each group at the end of instruction. ^ Frequency distribution, chi-square, t-test for independent samples and analysis of covariance were used to analyze the data. The findings indicated that there were no significant differences in students' attitude and interest in English listening comprehension between those who were taught with an English listening modified curriculum compared with those students who were taught with a traditional curriculum. The findings also indicated that there was a difference in the final examination with the control group taught using the traditional curriculum scoring higher than the experimental group taught using the modified curriculum for performance in English listening comprehension, but there was no difference in scores on the Michigan Listening Comprehension Test (posttest). In addition, it was found that learning attitude and motivation influence students' learning. ^

Modified continuous ant colony algorithm for function optimization

Many classical as well as modern optimization techniques exist. One such modern method belonging to the field of swarm intelligence is termed ant colony optimization. This relatively new concept in optimization involves the use of artificial ants and is based on real ant behavior inspired by the way ants search for food. In this thesis, a novel ant colony optimization technique for continuous domains was developed. The goal was to provide improvements in computing time and robustness when compared to other optimization algorithms. Optimization function spaces can have extreme topologies and are therefore difficult to optimize. The proposed method effectively searched the domain and solved difficult single-objective optimization problems. The developed algorithm was run for numerous classic test cases for both single and multi-objective problems. The results demonstrate that the method is robust, stable, and that the number of objective function evaluations is comparable to other optimization algorithms.