Precision of tibial tunnel placement under arthroscopic control alone in posterior cruciate ligament reconstruction: A radiological study

Introduction: Accurate and reproducible tibial tunnel placement minimizing the risk of neurovascular damage is a crucial condition for successful arthroscopic reconstruction of the posterior cruciate ligament (PCL). This step is commonly performed under fluoroscopic control. Hypothesis: Performing the tibial tunnel under exclusive arthroscopic control allows accurate and reliable tunnel placement according to recommendations in the literature. Materials and Methods: Between February 2007 and December 2009, 108 arthroscopic single bundle PCL reconstructions in tibial tunnel technique were performed. The routine postoperative radiographs were screened according to previously defined quality criterions. After critical analysis, the radiographs of 48 patients (48 knees) were enrolled in the study. 10 patients had simultaneous ACL reconstruction and 7 had PCL revision surgery. The tibial tunnel was placed under direct arthroscopic control through a posteromedial portal using a standard tibial aming device. Key anatomical landmarks were the exposed tibial insertion of the PCL and the posterior horn of the medial meniscus. First, the centre of the posterior tibial tunnel outlet on the a-p view was determined by digital analysis of the postoperative radiographes. Its distance to the medial tibial spine was measured parallel to the tibia plateau. The mediolateral position was expressed by the ratio between the distance of the tunnel outlet to the medial border and the total width of the tibial plateau. On the lateral view the vertical tunnel position was measured perpendicularly to a tangent of the medial tibial plateau. All measurement were repeated at least twice and carried out by two examiners. Results: The mean mediolateral tunnel position was 49.3 ± 4.6% (ratio), 6.7 ± 3.6 mm lateral to the medial tibial spine. On the lateral view the tunnel centre was 10.1 ± 4.5 mm distal to the bony surface of the medial tibial plateau. Neurovascular damage was observed in none of our patients. Conclusion: The results of this radiological study confirm that exclusive arthroscopic control for tibial tunnel placement in PCL reconstruction yields reproducible and accurate results according to the literature. Our technique avoids radiation, facilitates the operation room setting and enables the surgeon to visualize the anatomic key landmarks for tibial tunnel placement.

Disseny d'un sistema de control del consum d'aigua automàtic

Avui en dia s’ha convertit en una necessitat tenir cura del medi ambient i optimitzar els recursos naturals. En el camp per estalviar energia s’han fet grans progressos i disposem d’un gran ventall de dispositius que ens ajuden i ens faciliten l’optimització del consum d’energia. Però és una realitat que en l’estalvi del consum d’aigua el progrés ha estat molt menor i es limita molt a donar consells i repartir dosificadors d’aigua. Qui no ha vist carrers o jardins o cases inundades amb milers de litres d’aigua? Aquesta realitat m’ha portat a dissenyar i desenvolupar un prototip que em permeti tenir un millor control del consum d’aigua. El prototip, a trets principals, consta d’un sensor, una electrovàlvula i una placa Arduino Atmega. El sensor ens permet mesurar els litres consumits durant un cert període de temps. Passat aquest temps de mostreig es compara els litres consumits amb el consum habitual, en aquell període de temps. En cas de sobrepassar el volum programat es tancarà l’electrovàlvula de forma automàtica i rebrem un SMS al telèfon. L’activació de l’alarma es pot ajustar que sigui al igualar-se els dos valors, litres programats i litres consumits. També es pot programar el percentatge que cal sobrepassar de litres consumits per activar l’alarma, com el temps de mostreig. El fet de poder programar tots aquests valors ens permet fer un ajust ideal per a la instal·lació que es vol tenir controlada. A més, el prototip es pot utilitzar per enviar a la companyia d’aigua el valor del comptador de forma automàtica. D’aquesta forma la companyia d’aigua també optimitza recursos estalviant-se el desplaçament de personal a la instal·lació per fer la lectura corresponent. El prototip està basat amb un Arduino Atmega que ens permet el processament de les dades programades i capturades pel sensor. També s’ha incorporat una pantalla TFT Touch 2’8”, que permet visualitzar i programar els valors d’una forma molt més intuïtiva. Per enviar els SMS s’utilitza una placa d’Arduino Cel·lular Shield - SM5100B, a la qual només cal afegir una targeta SIM. A priori, el prototip té un elevat cost al fabricar una sola unitat i pot semblar poc útil. Però ens pot estalviar alguna sorpresa en les factures d’aigua si tenim una fuita i no ens n’adonem fins a veure el rebut de la companyia. Si es fabriqués a grans quantitats es podria abaratir el preu i fer-lo encara més engrescador.

Modeling and control of electromechanical systems

The material presented in the these notes covers the sessions Modelling of electromechanical systems, Passive control theory I and Passive control theory II of the II EURON/GEOPLEX Summer School on Modelling and Control of Complex Dynamical Systems.We start with a general description of what an electromechanical system is from a network modelling point of view. Next, a general formulation in terms of PHDS is introduced, and some of the previous electromechanical systems are rewritten in this formalism. Power converters, which are variable structure systems (VSS), can also be given a PHDS form.We conclude the modelling part of these lectures with a rather complex example, showing the interconnection of subsystems from several domains, namely an arrangement to temporally store the surplus energy in a section of a metropolitan transportation system based on dc motor vehicles, using either arrays of supercapacitors or an electric poweredflywheel. The second part of the lectures addresses control of PHD systems. We first present the idea of control as power connection of a plant and a controller. Next we discuss how to circumvent this obstacle and present the basic ideas of Interconnection and Damping Assignment (IDA) passivity-based control of PHD systems.

Vendor Managed Inventory: the Critical Success Factors from the Manufacturer Point of View

Yritykset ovat pakotettuja erilaisiin yhteistyömuotoihin pärjätäkseen kiristyvässä kilpailussa. Yhteistyösuhteet kulkevat eri nimillä riippuen teollisuuden alasta ja siitä, missä kohtaa toimitusketjua ne toteutuvat, mutta periaatteessa kaikki pohjautuvat samaan ideaan kuin Vendor Managed Inventory (VMI); varastoon jakysyntään liittyvä tieto jaetaan toimitusketjun eri osapuolien kesken, jotta tuotanto, jakelu ja varastonhallinta olisi mahdollista optimoida. Vendor Managed Inventory on ideana yksinkertainen, mutta vaatii onnistuakseen paljon. Perusolettamus on, että toimittajan on kyettävä hallinnoimaan asiakkaan varastoa paremmin kuin asiakas itse. Tämä ei kuitenkaan ole mahdollista ilman riittävää yhteistyötä, oikeanlaista informaatiota tai sopivia tuoteominaisuuksia. Tämän työn tarkoitus on esitellä kriittiset menestystekijät valmistajan kannalta, kun näkyvyys todelliseen kysyntään on heikko ja kyseessäolevat tuotteet ovat ominaisuuksiltaan toimintamalliin huonosti soveltuvia. VMItoimintamallin soveltuvuus matkapuhelimia valmistavan yrityksen liiketoimintaan, sekä sen vaikutus asiakasyhteistyöhön, kannattavuuteen ja toiminnan tehostamiseen on myös tutkittu.

Clinically relevant quality measures for risk factor control in primary care: a retrospective cohort study.

BACKGROUND: Assessment of the proportion of patients with well controlled cardiovascular risk factors underestimates the proportion of patients receiving high quality of care. Evaluating whether physicians respond appropriately to poor risk factor control gives a different picture of quality of care. We assessed physician response to control cardiovascular risk factors, as well as markers of potential overtreatment in Switzerland, a country with universal healthcare coverage but without systematic quality monitoring, annual report cards on quality of care or financial incentives to improve quality. METHODS: We performed a retrospective cohort study of 1002 randomly selected patients aged 50-80 years from four university primary care settings in Switzerland. For hypertension, dyslipidemia and diabetes mellitus, we first measured proportions in control, then assessed therapy modifications among those in poor control. "Appropriate clinical action" was defined as a therapy modification or return to control without therapy modification within 12 months among patients with baseline poor control. Potential overtreatment of these conditions was defined as intensive treatment among low-risk patients with optimal target values. RESULTS: 20% of patients with hypertension, 41% with dyslipidemia and 36% with diabetes mellitus were in control at baseline. When appropriate clinical action in response to poor control was integrated into measuring quality of care, 52 to 55% had appropriate quality of care. Over 12 months, therapy of 61% of patients with baseline poor control was modified for hypertension, 33% for dyslipidemia, and 85% for diabetes mellitus. Increases in number of drug classes (28-51%) and in drug doses (10-61%) were the most common therapy modifications. Patients with target organ damage and higher baseline values were more likely to have appropriate clinical action. We found low rates of potential overtreatment with 2% for hypertension, 3% for diabetes mellitus and 3-6% for dyslipidemia. CONCLUSIONS: In primary care, evaluating whether physicians respond appropriately to poor risk factor control, in addition to assessing proportions in control, provide a broader view of the quality of care than relying solely on measures of proportions in control. Such measures could be more clinically relevant and acceptable to physicians than simply reporting levels of control.

Improving globally distributed software development and support processes - A workflow view

We propose a new approach and related indicators for globally distributed software support and development based on a 3-year process improvement project in a globally distributed engineering company. The company develops, delivers and supports a complex software system with tailored hardware components and unique end-customer installations. By applying the domain knowledge from operations management on lead time reduction and its multiple benefits to process performance, the workflows of globally distributed software development and multitier support processes were measured and monitored throughout the company. The results show that the global end-to-end process visibility and centrally managed reporting at all levels of the organization catalyzed a change process toward significantly better performance. Due to the new performance indicators based on lead times and their variation with fixed control procedures, the case company was able to report faster bug-fixing cycle times, improved response times and generally better customer satisfaction in its global operations. In all, lead times to implement new features and to respond to customer issues and requests were reduced by 50%.

Cultural control of herbicide-resistant Lolium rigidum Gaud. populations in winter cereal in Northeastern Spain

Lolium rigidum Gaud. is one of the most common weed species in winter cereals in Northeastern Spain. Herbicide resistance has been growing since the mid 90's and exclusive herbicide use is not enough in many cases, so that it is necessary to combine as many control tools as possible. Six field trials have been conducted during the cropping seasons 2001-02, 2002-03 and 2003-04 on winter cereal infested with herbicide resistant L. rigidum in Northeastern Spain testing different cultural control strategies. Sowing delay was conducted at five fields, mouldboard ploughing at four fields, the combination of sowing delay and ploughing at two fields, increasing the cereal sowing density and combined with sowing delay at one field. Sowing delay was confirmed to have an irregular efficacy depending on the L. rigidum emergence during the delay period. In the trials, weed emergence was reduced up to 88% in the best case but there was no effect in two cases. Ploughing had a more constant efficacy and reduced weed emergence between 50 and 80% although stoniness impeded in one occasion a correct soil inversion causing a very low efficacy. Increasing the cereal sowing rate did not reduce the weed population. The combination of the different methods did not increase significantly the individual efficacy, and one method was clearly more effective than the other, depending on the trial. In fields with high L. rigidum density, these methods are not effective enough and need to be combined with other methods, which are discussed in the text.

Transferring control demands across incidental learning tasks - Stronger sequence usage in serial reaction task after shortcut option in letter string checking

After incidentally learning about a hidden regularity, participants can either continue to solve the task as instructed or, alternatively, apply a shortcut. Past research suggests that the amount of conflict implied by adopting a shortcut seems to bias the decision for vs. against continuing instruction-coherent task processing. We explored whether this decision might transfer from one incidental learning task to the next. Theories that conceptualize strategy change in incidental learning as a learning-plus-decision phenomenon suggest that high demands to adhere to instruction-coherent task processing in Task 1 will impede shortcut usage in Task 2, whereas low control demands will foster it. We sequentially applied two established incidental learning tasks differing in stimuli, responses and hidden regularity (the alphabet verification task followed by the serial reaction task, SRT). While some participants experienced a complete redundancy in the task material of the alphabet verification task (low demands to adhere to instructions), for others the redundancy was only partial. Thus, shortcut application would have led to errors (high demands to follow instructions). The low control demand condition showed the strongest usage of the fixed and repeating sequence of responses in the SRT. The transfer results are in line with the learning-plus-decision view of strategy change in incidental learning, rather than with resource theories of self-control.

Market Study of Electric Drive Motion Control Business

Tämän diplomityön tavoitteena oli tutkia älykkäiden paikoituskäyttöjen markkinoita ja liiketoimintamalleja. Työn pääongelmina oli määritellä alalla käytössä olevaa terminologiaa, määrittää markkinoiden koko paikoitusominaisuudet omaaville kolmivaihetaajuusmuuttajille, tutkia viiden alalla toimivan paikoituskäyttötoimittajan liiketoimintarakenteita ja tuotteita teknisestä näkökulmasta sekä esitellä kaksi teollisuuden käyttökohdetta paikoituskäytölle. Työn sisältö voidaan jakaa neljään eri osioon. Terminologian määrittely- ja markkinatutkimusosiot perustuvat pääasiassa kirjallisuustutkimukseen. Paikoituskäyttöjen toimittajia sekä niiden tuotteita käsittelevä osuus perustuu kirjallisuustutkimukseen sekä teknisiin esitteisiin ja manuaaleihin. Paikoituskäyttöjen sovellusesimerkit on selvitetty haastatteluin. Työ painottuu paikoituskäyttötoimittajien tuotteiden, tuoteominaisuuksien ja tuotetarjonnan tarkasteluun. Työn tuloksena on määritelty paikoituskäyttöjen liiketoiminnan tärkeimmät termit, paikoituskäyttöjen markkinoiden koko sekä markkinoiden koko paikoitusominaisuudet omaavalle kolmivaihetaajuusmuuttajalle. Alalla toimivien paikoituskäyttötoimittajien liiketoimintarakenne on selvitetty, jonka mukaan toimittajat on profiloitu komponentti-, komponenttipaketti-, toimialakeskeisiksi tai automaatiotoimittajiksi. Toimittajien paikoituskäyttötuotteet on luokiteltu viiteen eri luokkaan niiden teknisten ominaisuuksien perusteella. Lisäksi paikoituskäyttöjen suorituskyvyt on selvitetty säätimien momentti-, nopeus-, ja paikoituslaskenta-aikatasojen sekä kenttäväyläliityntöjen suhteen. Työssä kuvatut vanerinsorvausprosessi sekä FMS -materiaalinkäsittelyprosessi esittävät paikoituskäyttöjen potentiaalisia sovelluskohteita.

Modernization of protection and control system of HV/MV substation in Russia

This work describes different possibilities of protection and control system improvement of primary distribution substation. The status of condition and main problems of power networks from reliability point of view in Russia are described. This work studies technologies used today in Russia for protection of distribution networks with their disadvantages. Majority of medium voltage networks (6-35 kV) has isolated network point. There is still no any protection available on the market which allows to estimate distance to fault in case of earth fault. The thesis analyses methods of earth fault distance calculation. On the basis of computer simulation the influence of various factors on calculation accuracy is studied. The practical implementation of the method presupposes usage of digital relay. Application of digital relay is accompanied by numerous opportunities which are described in this work. Also advantages of system implemented on the basis of IEC 61850 standard are examined. Finally, suitability of modern digital relays from GOST standard point of view is analyzed.

Accounting research: a critical view of the present situation and prospects

In this study we critically review the internal procedures of the accounting community for generating and disseminating knowledge. We contend that academic journals on accounting research are scarce, publish few articles and apply high rejection rates, and the review process is lengthy and expensive. Additionally, an academic elite has unparalleled predominance in comparison to other business disciplines, reflected in an unusual share of published articles with authors affiliated to a small number of academic institutions, and the predominance of certain topics and methodologies. The discipline does not allow the collaborative, iterative and flexible features of innovative knowledge communities. The discipline¿s internal procedures favour restriction, control, slowness, and expiration, rather than participation, speed and renewal. They are ill suited for advancing knowledge and bode badly for successful research. As a result, accounting academics present low research performance and the discipline is facing steady decline. More importantly, the discipline is handicapped in producing innovative knowledge able to contribute to critical research and long term social well-being. We also focus on the Spanish institutional situation, arguing that Spanish requirements for reaching tenured positions are difficult for accountants to meet. We highlight the need to raise awareness of the problem and change the procedures.

Plant-microbe interactions and the new biotechnological methods of plant disease control

Plants constitute an excellent ecosystem for microorganisms. The environmental conditions offered differ considerably between the highly variable aerial plant part and the more stable root system. Microbes interact with plant tissues and cells with different degrees of dependence. The most interesting from the microbial ecology point of view, however, are specific interactions developed by plant-beneficial (either non-symbiotic or symbiotic) and pathogenic microorganisms. Plants, like humans and other animals, also become sick, but they have evolved a sophisticated defense response against microbes, based on a combination of constitutive and inducible responses which can be localized or spread throughout plant organs and tissues. The response is mediated by several messenger molecules that activate pathogen-responsive genes coding for enzymes or antimicrobial compounds, and produces less sophisticated and specific compounds than immunoglobulins in animals. However, the response specifically detects intracellularly a type of protein of the pathogen based on a gene-for-gene interaction recognition system, triggering a biochemical attack and programmed cell death. Several implications for the management of plant diseases are derived from knowledge of the basis of the specificity of plant-bacteria interactions. New biotechnological products are currently being developed based on stimulation of the plant defense response, and on the use of plant-beneficial bacteria for biological control of plant diseases (biopesticides) and for plant growth promotion (biofertilizers)

Heating control of an electrical motor

Electrical motors on a ship attackable to different factors which decrease these lifetimes. One of the main external factors on a ship which usually is a reason of the motor failure is a moisture condensation which decreases the motor winding insulation and increase a probability of the short circuit. Therefore, the protection against moisture is necessary for ship electrical motors. The motor should be protected against moisture all time when it does not operate. The necessity of such protection requires a lot of energy consumption. This master’s thesis is focused on the creation of the electrical motor thermal model and on the different methods of the motor protection against moisture analysis with energy consumption point of view.

Configuring Health Care Services - Service Control Improvement

The costs of health care are increasing, and at the same time, population is aging. This leads health care organizations to focus more on home based care services. This thesis focuses on the home care organization of the South Karelian District of Social and Health Services (Eksote), which was established in 2010; how its operation is organized and managed, and which problem types are faced in the daily operation of home care. This thesis examines home care services through an extensive interview study, process mapping and statistical data analysis. To be able to understand the nature of services and special environment theory models, such as service management and performance measurement, service processes and service design are introduced. This study is conducted from an external researcher‟s point of view and should be used as a discussion opener. The outcome of this thesis is an upper level development path for Eksote home care. The organization should evaluate and build a service offering, then productize home care services and modularize the products and identify similarities. Service processes should be mapped to generate efficiency for repeating tasks. Units should be reasonably sized and geographically located to facilitate management and operation. All this can be done by recognizing the different types of service products: runners repeaters and strangers. Furthermore, the organization should not hide behind medical issues and should understand the legislative, medical and operational frameworks in health care.

Variable structure position control of an industrial robotic manipulator

The use of a robust position controller for a robotic manipulator moving in free space is presented. The aim is to implement in practice a controller that is robust to uncertainties in the model of the system, as well as being inexpensive from a computational point of view. Variable structure theory provides the technique for the design of such controller. The design steps are presented, first from a theoretical perspective and then applied to the control of a two degree-of-freedom manipulator. Simulation results that backed the implementation are presented, followed by the experiments conducted and the results that were obtained. The conclusion is that variable structure control is readily applicable to industrial robots for the robust control of positions.