Proximal Femoral Osteotomies with the Paediatric Hip Plate (LCP): Valgus osteotomy.

OBJECTIVE Proximal femoral osteotomy with stable fixation and sufficient correction. Low complication rates due to exact preoperative planning. INDICATIONS Congenital or traumatic femoral neck pseudarthrosis. Coxa vara. CONTRAINDICATIONS None. In severe deformities, a single femoral osteotomy may not solve the problem; thus, additional correction, e.g., a pelvic osteotomy, is required. SURGICAL TECHNIQUE Correct planning of the correction angle. Lateral approach. Subperiosteal detachment of vastus lateralis muscle. Place guide wire on the femoral neck to judge anteversion. Insert positioning wire 5 mm distal to trochanteric physis. Insert 2.8 mm Kirschner wire in the femoral neck. Osteotomy of the femur after marking the rotation by Kirschner wires or oscillating saw. Slide LC plate over Kirschner wires. Replace Kirschner wires with screws. Reduction of the femoral shaft to the plate with bone forceps. Definitive fixation of the plate to the femoral shaft by cortex or locking screws. Readaptation of vastus lateralis muscle over the plate. POSTOPERATIVE MANAGEMENT Partial weightbearing for 4-6 weeks depending on the age of the patient without any external fixation (e. g. cast) is possible. RESULTS Recent studies support the authors' findings of sufficient correction and stable fixation after proximal femoral osteotomy with the LCP pediatric hip plate. Low complication rates and stable fixation.

Periacetabular osteotomy restores the typically excessive range of motion in dysplastic hips with a spherical head

BACKGROUND Residual acetabular dysplasia is seen in combination with femoral pathomorphologies including an aspherical femoral head and valgus neck-shaft angle with high antetorsion. It is unclear how these femoral pathomorphologies affect range of motion (ROM) and impingement zones after periacetabular osteotomy. QUESTIONS/PURPOSES (1) Does periacetabular osteotomy (PAO) restore the typically excessive ROM in dysplastic hips compared with normal hips; (2) how do impingement locations differ in dysplastic hips before and after PAO compared with normal hips; (3) does a concomitant cam-type morphology adversely affect internal rotation; and (4) does a concomitant varus-derotation intertrochanteric osteotomy (IO) affect external rotation? METHODS Between January 1999 and March 2002, we performed 200 PAOs for dysplasia; of those, 27 hips (14%) met prespecified study inclusion criteria, including availability of a pre- and postoperative CT scan that included the hip and the distal femur. In general, we obtained those scans to evaluate the pre- and postoperative acetabular and femoral morphology, the degree of acetabular reorientation, and healing of the osteotomies. Three-dimensional surface models based on CT scans of 27 hips before and after PAO and 19 normal hips were created. Normal hips were obtained from a population of CT-based computer-assisted THAs using the contralateral hip after exclusion of symptomatic hips or hips with abnormal radiographic anatomy. Using validated and computerized methods, we then determined ROM (flexion/extension, internal- [IR]/external rotation [ER], adduction/abduction) and two motion patterns including the anterior (IR in flexion) and posterior (ER in extension) impingement tests. The computed impingement locations were assigned to anatomical locations of the pelvis and the femur. ROM was calculated separately for hips with (n = 13) and without (n = 14) a cam-type morphology and PAOs with (n = 9) and without (n = 18) a concomitant IO. A post hoc power analysis based on the primary research question with an alpha of 0.05 and a beta error of 0.20 revealed a minimal detectable difference of 4.6° of flexion. RESULTS After PAO, flexion, IR, and adduction/abduction did not differ from the nondysplastic control hips with the numbers available (p ranging from 0.061 to 0.867). Extension was decreased (19° ± 15°; range, -18° to 30° versus 28° ± 3°; range, 19°-30°; p = 0.017) and ER in 0° flexion was increased (25° ± 18°; range, -10° to 41° versus 38° ± 7°; range, 17°-41°; p = 0.002). Dysplastic hips had a higher prevalence of extraarticular impingement at the anteroinferior iliac spine compared with normal hips (48% [13 of 27 hips] versus 5% [one of 19 hips], p = 0.002). A PAO increased the prevalence of impingement for the femoral head from 30% (eight of 27 hips) preoperatively to 59% (16 of 27 hips) postoperatively (p = 0.027). IR in flexion was decreased in hips with a cam-type deformity compared with those with a spherical femoral head (p values from 0.002 to 0.047 for 95°-120° of flexion). A concomitant IO led to a normalization of ER in extension (eg, 37° ± 7° [range, 21°-41°] of ER in 0° of flexion in hips with concomitant IO compared with 38° ± 7° [range, 17°-41°] in nondysplastic control hips; p = 0.777). CONCLUSIONS Using computer simulation of hip ROM, we could show that the PAO has the potential to restore the typically excessive ROM in dysplastic hips. However, a PAO can increase the prevalence of secondary intraarticular impingement of the aspherical femoral head and extraarticular impingement of the anteroinferior iliac spines in flexion and internal rotation. A cam-type morphology can result in anterior impingement with restriction of IR. Additionally, a valgus hip with high antetorsion can result in posterior impingement with decreased ER in extension, which can be normalized with a varus derotation IO of the femur. However, indication of an additional IO needs to be weighed against its inherent morbidity and possible complications. The results are based on a limited number of hips with a pre- and postoperative CT scan after PAO. Future prospective studies are needed to verify the current results based on computer simulation and to test their clinical importance.

Growth cone MKK7 mRNA targeting regulates MAP1b-dependent microtubule bundling to control neurite elongation

Local mRNA translation in neurons has been mostly studied during axon guidance and synapse formation but not during initial neurite outgrowth. We performed a genome-wide screen for neurite-enriched mRNAs and identified an mRNA that encodes mitogen-activated protein kinase kinase 7 (MKK7), a MAP kinase kinase (MAPKK) for Jun kinase (JNK). We show that MKK7 mRNA localizes to the growth cone where it has the potential to be translated. MKK7 is then specifically phosphorylated in the neurite shaft, where it is part of a MAP kinase signaling module consisting of dual leucine zipper kinase (DLK), MKK7, and JNK1. This triggers Map1b phosphorylation to regulate microtubule bundling leading to neurite elongation. We propose a model in which MKK7 mRNA localization and translation in the growth cone allows for a mechanism to position JNK signaling in the neurite shaft and to specifically link it to regulation of microtubule bundling. At the same time, this uncouples activated JNK from its functions relevant to nuclear translocation and transcriptional activation.

Evaluation of elevator shafts as a pathway for fungal spores and particles to enter a hospital housing immuno-compromised patients

Background. It is estimated that hospitals spend between 28 and 33 billion dollars per year as a result of hospital-acquired infections. (Scott, 2009) The costs continue to rise despite the guidance and controls provided by hospital infection control staff to reduce patient exposures to fungal spores and other infectious agents. With all processes and controls in place, the vented elevator shaft represents an unprotected opening from the top of the building to the lower floors. The hypothesis for this prospective study is that there is a positive correlation between the number of Penicillium/Aspergillus-like spores, Cladosporium, ascospores, basidiospores in spores/m3 as individual spore categories found in the hoistway vent of an elevator shaft and the levels of the same spores, sampled near-simultaneously in the outdoor intake of the elevator shaft. Specific aims of this study include determining if external Penicillium/Aspergillus-like spores are entering the healthcare facility via the elevator shaft and hoistway vents. Additional aims include determining levels of Penicillium/Aspergillus-like spores outdoors, in the elevator shafts, and indoors in areas possibly affected by elevator shaft air; and, finally, to evaluate whether any effect is observed due to the installation of a hoistway vent damper, installed serendipitously during this study. ^ Methods. Between April 2010 and September 2010, a total of 3,521 air samples were collected, including 363 spore trap samples analyzed microscopically for seven spore types, and polymerase chain reaction analyses on 254 air samples. 2178 particle count measurements, 363 temperature readings and 363 relative humidity readings were also obtained from 7 different locations potentially related to the path of air travel inside and near a centrally-located and representative elevator shaft. ^ Results. Mean Penicillium/Aspergillus-like spore values were higher outside the building (530 spores/m3 of air) than inside the hoistway (22.8 spores/m3) during the six month study. Mean values inside the hospital were lower than outside throughout the study, ranging from 15 to 73 spores/m3 of air. Mean Penicillium/Aspergillus-like spore counts inside the hoistway decreased from 40.1 spores/m3 of air to 9 spores/m3 of air following the installation of a back draft damper between the outside air and the elevator shaft. Comparison of samples collected outside the building and inside the hoistway vent prior to installing the damper indicated a strong positive correlation (Spearman's Rho=0.8008, p=0.0001). The similar comparison following the damper installation indicated a moderate non-significant inverse correlation (Spearman's rho = −0.2795, p=0.1347). ^ Conclusion. Elevator shafts are one pathway for mold spores to enter a healthcare facility. A significant correlation was detected between spores and particle counts inside the hoistway and outside prior to changes in the ventilation system. The insertion of the back draft damper appeared to lower the spore counts inside the hoistway and inside the building. The mold spore counts in air outside the study building were higher in the period following the damper installation while the levels inside the hoistway and hospital decreased. Cladosporium and Penicillium/Aspergillus -like spores provided a method for evaluating indoor air quality as a natural tracer from outside the building to inside the building. Ascospores and basidiospores were not a valuable tracer due to low levels of detection during this study. ^ Installation of a back draft damper provides additional protection for the indoor environment of a hospital or healthcare facility, including in particular patients who may be immunocompromised. Current design standards and references do not require the installation of a back draft damper, but evaluation of adding language to relevant building codes should be considered. The data indicate a reduction in levels of Penicillium/Aspergillus -like spores, particle counts and a reduction in relative humidity inside of the elevator shaft after damper installation.^

Strain-gauge, brushless torque meter

A torque meter comprising hollow-keyed, input and output female shafts adapted to receive the male shafts of the power source and machine respectively. Each shaft has a circular flange whose face is perpendicular to the center line of the shafts. Each flange has a plurality of equally spaced cylindrical recesses machined into the inside face thereto adapted to receive conical inserts therein. Balls are contained by the conical inserts and transmit the rotational movement from the input to the output shaft. A stationary housing extends around the input and output shaft and has a transducer shell secured thereto. When force is applied to the input shaft to cause movement, the balls encounter torsional resistance which causes the balls to roll up the ramps of the conical seat inserts to separate the two torque flanges. The force transmitted through the balls causes rotation to the output shaft and produces tension to the stationary transducer shell. The stationary transducer shell is instrumented with semi-conductor strain gauges.

Aportes para una sociología del cuerpo : un análisis de los usos del cuerpo en la práctica de la danza clásica, moderna y contemporánea a partir de los discursos y saberes producidos por coreógrafos y bailarines durante el siglo XX

Este plan se propone indagar cómo se construyen las concepciones del cuerpo en la práctica de la danza escénica occidental, a partir del análisis de fuentes bibliográficas escritas por maestros coreógrafos y bailarines del siglo XX. En este sentido, la danza opera como instancia de recorte específico sobre un tema más general; el de construir un aporte a los desarrollos de una teoría social del cuerpo, de reciente formación en nuestro país, en base al análisis de unos referentes empíricos concretos. Se espera poder construir líneas de análisis fructíferas que, en base a la deconstrucción del saber generado en el campo de las prácticas específicas a observar y su re-construcción con eje en los elementos de la teoría social contemporánea, articulen el problema y análisis del cuerpo, con tópicos básicos del análisis sociológico: la cuestión de la subjetividad, las nuevas formas de auto-dominio y auto-control y la cuestión de las prácticas o experiencias autónomas y disruptivas.

La representación literaria del caos y la re-unificación de las Dos Tierras : Breve esbozo de dos textos literarios del Reino Medio

Parte del conocimiento y la comprensión que poseemos de las sociedades del mundo antiguo procede del análisis de los textos literarios. El eje estructurador es el derrumbe de los valores y las instituciones que organizaron la vida quienes habitaron el Antiguo Egipto en el paso del Reino Antiguo al Reino Medio. Analizaremos la Profecía de Neferty ylas Admoniciones de Ipuwer. Habrían sido elaborados durante el Reino Medio y poseerían connotaciones propagandísticas de legitimación y justificación de la toma del poder por parte de Amenemhat I y sus sucesores. Elaborados dentro de los círculos palatinos, poseen una marcada intencionalidad política

La representación literaria del caos y la re-unificación de las Dos Tierras : Breve esbozo de dos textos literarios del Reino Medio

Parte del conocimiento y la comprensión que poseemos de las sociedades del mundo antiguo procede del análisis de los textos literarios. El eje estructurador es el derrumbe de los valores y las instituciones que organizaron la vida quienes habitaron el Antiguo Egipto en el paso del Reino Antiguo al Reino Medio. Analizaremos la Profecía de Neferty ylas Admoniciones de Ipuwer. Habrían sido elaborados durante el Reino Medio y poseerían connotaciones propagandísticas de legitimación y justificación de la toma del poder por parte de Amenemhat I y sus sucesores. Elaborados dentro de los círculos palatinos, poseen una marcada intencionalidad política

Aportes para una sociología del cuerpo : un análisis de los usos del cuerpo en la práctica de la danza clásica, moderna y contemporánea a partir de los discursos y saberes producidos por coreógrafos y bailarines durante el siglo XX

Este plan se propone indagar cómo se construyen las concepciones del cuerpo en la práctica de la danza escénica occidental, a partir del análisis de fuentes bibliográficas escritas por maestros coreógrafos y bailarines del siglo XX. En este sentido, la danza opera como instancia de recorte específico sobre un tema más general; el de construir un aporte a los desarrollos de una teoría social del cuerpo, de reciente formación en nuestro país, en base al análisis de unos referentes empíricos concretos. Se espera poder construir líneas de análisis fructíferas que, en base a la deconstrucción del saber generado en el campo de las prácticas específicas a observar y su re-construcción con eje en los elementos de la teoría social contemporánea, articulen el problema y análisis del cuerpo, con tópicos básicos del análisis sociológico: la cuestión de la subjetividad, las nuevas formas de auto-dominio y auto-control y la cuestión de las prácticas o experiencias autónomas y disruptivas.

Aportes para una sociología del cuerpo : un análisis de los usos del cuerpo en la práctica de la danza clásica, moderna y contemporánea a partir de los discursos y saberes producidos por coreógrafos y bailarines durante el siglo XX

Este plan se propone indagar cómo se construyen las concepciones del cuerpo en la práctica de la danza escénica occidental, a partir del análisis de fuentes bibliográficas escritas por maestros coreógrafos y bailarines del siglo XX. En este sentido, la danza opera como instancia de recorte específico sobre un tema más general; el de construir un aporte a los desarrollos de una teoría social del cuerpo, de reciente formación en nuestro país, en base al análisis de unos referentes empíricos concretos. Se espera poder construir líneas de análisis fructíferas que, en base a la deconstrucción del saber generado en el campo de las prácticas específicas a observar y su re-construcción con eje en los elementos de la teoría social contemporánea, articulen el problema y análisis del cuerpo, con tópicos básicos del análisis sociológico: la cuestión de la subjetividad, las nuevas formas de auto-dominio y auto-control y la cuestión de las prácticas o experiencias autónomas y disruptivas.

La representación literaria del caos y la re-unificación de las Dos Tierras : Breve esbozo de dos textos literarios del Reino Medio

Parte del conocimiento y la comprensión que poseemos de las sociedades del mundo antiguo procede del análisis de los textos literarios. El eje estructurador es el derrumbe de los valores y las instituciones que organizaron la vida quienes habitaron el Antiguo Egipto en el paso del Reino Antiguo al Reino Medio. Analizaremos la Profecía de Neferty ylas Admoniciones de Ipuwer. Habrían sido elaborados durante el Reino Medio y poseerían connotaciones propagandísticas de legitimación y justificación de la toma del poder por parte de Amenemhat I y sus sucesores. Elaborados dentro de los círculos palatinos, poseen una marcada intencionalidad política

EVA: Laparoscopic instrument tracking based on endoscopic video analysis for psychomotor skills assessment

INTRODUCTION: The EVA (Endoscopic Video Analysis) tracking system a new tracking system for extracting motions of laparoscopic instruments based on non-obtrusive video tracking was developed. The feasibility of using EVA in laparoscopic settings has been tested in a box trainer setup. METHODS: EVA makes use of an algorithm that employs information of the laparoscopic instrument's shaft edges in the image, the instrument's insertion point, and the camera's optical centre to track the 3D position of the instrument tip. A validation study of EVA comprised a comparison of the measurements achieved with EVA and the TrEndo tracking system. To this end, 42 participants (16 novices, 22 residents, and 4 experts) were asked to perform a peg transfer task in a box trainer. Ten motion-based metrics were used to assess their performance. RESULTS: Construct validation of the EVA has been obtained for seven motion-based metrics. Concurrent validation revealed that there is a strong correlation between the results obtained by EVA and the TrEndo for metrics such as path length (p=0,97), average speed (p=0,94) or economy of volume (p=0,85), proving the viability of EVA. CONCLUSIONS: EVA has been successfully used in the training setup showing potential of endoscopic video analysis to assess laparoscopic psychomotor skills. The results encourage further implementation of video tracking in training setups and in image guided surgery.

Numerical simulation of tangling in jet engine turbines

The numerical analysis of certain safety related problems presents serious difficulties, since the large number of components present leads to huge finite elementmodels that can only be solved by using large and expensive computers or by making rough approaches to the problem. Tangling, or clashing, in the turbine of a jet engine airplane is an example of such problems. This is caused by the crash and friction between rotor and stator blades in the turbine after an eventual shaft failure. When facing the study of an event through numerical modelling, the accurate simulation of this problem would require the engineer to model all the rotor and stator blades existing in the turbine stage, using a small element size in all pieces. Given that the number of stator and rotor blades is usually around 200, such simulations would require millions of elements. This work presents a new numerical methodology, specifically developed for the accurate modelling of the tangling problem that, depending on the turbine configuration, is able to reduce the number of nodes up to an order of magnitude without losing accuracy. The methodology, which benefits from the cyclic configuration of turbines, is successfully applied to the numerical analysis of a hypothetical tangling event in a turbine, providing valuable data such as the rotating velocity decrease of the turbine, the braking torque and the damage suffered by the blades. The methodology is somewhat general and can be applied to any problem in which damage caused by the interaction between a rotating and static piece is to be analysed.

Estudio de la vibración en baja frecuencia de motor eléctrico

Se realizará un análisis en baja frecuencia del comportamiento de sistemas vibratorios excitados principalmente por un motor eléctrico. El sistema está formado por un motor eléctrico acoplado a un volante de inercia que produce una carga sobre citado motor diferente según las configuraciones adoptadas, todo ello montado sobre una base metálica de acero, soportada esta, mediante resortes de diferente características. El estudio contemplará la identificación de frecuencias de excitación, resonancias, pérdidas de inserción de los sistemas, transmisibilidad, problemas de alineamiento, desajustes, modos propios... para cada una de las diferentes situaciones en las que opera el sistema. ABSTRACT. In this Project will proceed to an behavior analysis of vibrating systems in low frequency mainly excited by an electric motor. The system is comprised of an electric motor coupled to inertial flywheel (o flywheel) which produces a different load upon said engine according to the configurations adopted. This system is mounted on a steel metal base which is supported by springs of different characteristics. This study will consider the excitation frequency identification, system resonances, insertion loss, transmissibility, shaft dealignment, eccentricities, mismatches, modal frequencies of the plate… for each of the situations in which the system operates.

Gear dynamics monitoring using discrete wavelet transformation and multi-layer perceptron neural networks

This paper presents a multi-stage algorithm for the dynamic condition monitoring of a gear. The algorithm provides information referred to the gear status (fault or normal condition) and estimates the mesh stiffness per shaft revolution in case that any abnormality is detected. In the first stage, the analysis of coefficients generated through discrete wavelet transformation (DWT) is proposed as a fault detection and localization tool. The second stage consists in establishing the mesh stiffness reduction associated with local failures by applying a supervised learning mode and coupled with analytical models. To do this, a multi-layer perceptron neural network has been configured using as input features statistical parameters sensitive to torsional stiffness decrease and derived from wavelet transforms of the response signal. The proposed method is applied to the gear condition monitoring and results show that it can update the mesh dynamic properties of the gear on line.