Extracortical plate fixation with new plate inserts and cerclage wires for the treatment of periprosthetic hip fractures

PURPOSE Fixation of periprosthetic hip fractures with intracortical anchorage might not be feasible in cases with bulky implants and/or poor bone stock. METHODS Rotational stability of new plate inserts with extracortical anchorage for cerclage fixation was measured and compared to the stability found using a standard technique in a biomechanical setup using a torsion testing machine. In a synthetic PUR bone model, transverse fractures were fixed distally using screws and proximally by wire cerclages attached to the plates using "new" (extracortical anchorage) or "standard" (intracortical anchorage) plate inserts. Time to fracture consolidation and complications were assessed in a consecutive series of 18 patients (18 female; mean age 81 years, range 55-92) with periprosthetic hip fractures (ten type B1, eight type C-Vancouver) treated with the new device between July 2003 and July 2010. RESULTS The "new" device showed a higher rotational stability than the "standard" technique (p < 0.001). Fractures showed radiographic consolidation after 14 ± 5 weeks (mean ± SD) postoperatively in patients. Revision surgery was necessary in four patients, unrelated to the new technique. CONCLUSION In periprosthetic hip fractures in which fixation with intracortical anchorage using conventional means might be difficult due to bulky revision stems and/or poor bone stock, the new device may be an addition to the range of existing implants.

Evaluating the prevalence, content and readability of complementary and alternative medicine (CAM) web pages on the internet.

Complementary and alternative medicine (CAM) use is growing rapidly. As CAM is relatively unregulated, it is important to evaluate the type and availability of CAM information. The goal of this study is to deter-mine the prevalence, content and readability of online CAM information based on searches for arthritis, diabetes and fibromyalgia using four common search engines. Fifty-eight of 599 web pages retrieved by a "condition search" (9.6%) were CAM-oriented. Of 216 CAM pages found by the "condition" and "condition + herbs" searches, 78% were authored by commercial organizations, whose pur-pose involved commerce 69% of the time and 52.3% had no references. Although 98% of the CAM information was intended for consumers, the mean read-ability was at grade level 11. We conclude that consumers searching the web for health information are likely to encounter consumer-oriented CAM advertising, which is difficult to read and is not supported by the conventional literature.

Le temps des hommes doubles. Les arrangements face à l’occupation, de la Révolution française à la guerre de 1870

Le temps des hommes doubles : Louis Aragon a désigné ainsi la séparation voire l’opposition entre l’homme social et l’homme privé dans la société capitaliste. Pour les auteurs réunis ici, il s’agit plutôt de signifier qu’au temps de la souveraineté nationale en armes, dès lors que sont plus rigoureusement assignées aux soldats et aux citoyens à la fois une « identité » et une « cause » supposées dépasser leur état civil et leurs intérêts particuliers, l’occupation militaire multiplie, dans la recherche d’accommodements entre les deux camps, les tensions et les combinaisons possibles entre fonctions ou statuts publics, sociabilités et influences locales, opinions et besoins. Pour caractériser les évolutions qui ont eu lieu entre les guerres déclarées par la France à l’Autriche en 1792 et à la Prusse en 1870, le présent livre met l’accent sur trois thèmes. Il traite d’abord des enjeux politiques et administratifs de l’occupation, parmi lesquels la neutralité, son devenir en tant que concept dans les relations internationales, et le positionnement des États neutres dans des conflits où l’on s’efforce de mobiliser aussi les opinions publiques. L’attention se porte ensuite sur les armées occupantes. Quelle que soit la part d’idéologie que l’autorité politique introduit dans leurs missions, la première de ces missions est de garantir leur propre sécurité. La recherche des accommodements ou le constat de l’extrême difficulté d’en trouver sont enfin abordés du point de vue des sociétés en proie à l’occupation. Dans ces situations où le présent peut être vécu et interprété en fonction d’une mémoire individuelle et collective d’expériences antérieures, le rôle joué par les occupants ne se réduit pas à la brutalité de la soldatesque et à l’exploitation économique.

The Dialectical Relationship of Preferential and Multilateral Trade Agreements

Preferentialism and multilateralism are not two independent and succinct avenues in the pur-suit of market access and regulatory policies. They historically build upon each other in a dialectical process, closely related and linked through regulatory bridges and references. They influence and direct each other in various ways. The paper mainly focuses on the evolution of international protection of intellectual property rights and of services. The multilateral regulation of the TRIPS and others derive from years of regulatory experience and high numbers of preferential agreements across the globe. The GATS and others, on the other hand, have entered the pluri- or multilateral stage early. Once regulation has reached the mul-tilateral stage, preferentialism focuses on WTO-plus and -extra commitments. Both areas, however, show close interaction. The principle of MFN ensures that multilateralism and preferentialism do not evolve independently from each other. It produces significant spill-over effects of preferential agreements. Such effects and the need to develop uniform and coherent regulatory standards have led in parallel to a number of preferential, plurilateral and multilateral regulatory initiatives. We submit that the process will eventually encourage the return to multilateralism and negotiations in international fora, in particular the WTO while traditional market access may stay with preferential relations among Nations. Such burden-sharing between different regulatory fora should be reflected in future WTO rules providing the overall backbone of the system.

Edad dentaria : adecuación regional de los métodos de Nolla y Demirjian

El presente trabajo aborda los métodos de estimación de las edades dentarias en una población representativa de la región de Cuyo en la República Argentina. Si bien los métodos desarrollados para medir el desarrollo dentario constituyen herramientas de gran utilidad, éstos han sido formulados en conjuntos poblacionales muy acotados. Por ello, el objetivo general de este trabajo ha sido aplicar los métodos tradicionales de medición, obtener datos referenciales de la edad dentaria y evaluar el error de estimación de estos métodos para medir la edad dentaría en la población en estudio. Se calcularon las edades dentarias por los métodos de Nolla y Demirjian sobre 374 estudios panorámicos de niños y adolescentes entre 5 y 17 años, previa estratificación nutricional de la población en estudio y se compararon con edades cronológicas decimales. Los datos obtenidos fueron sometidos a prueba estadística ANOVA y prueba de correlación de Pearson mediante paquete estadístico Graphpad Prism 5. Los resultados obtenidos presentaron correlación adecuada r = 0,92; p < 0,0001, sin embargo revelaron diferencias estadísticamente significativas entre la edad cronológica y las edades dentarias calculadas Test ANOVA p < 0,0001, lo que expresó la limitación diagnóstica de los métodos estudiados al aplicarlos en esta población. El método de Nolla produjo una subestimación, lo que reflejó que nuestra población estuvo atrasada entre 4 y 6 meses respecto a la muestra estudiada para el método. En cambio, el método de Demirjian arrojó una sobrestimación, lo que indicó que nuestra población estuvo adelantada respecto de la muestra estudiada para la realización del método. Estas correcciones calculadas permiten realizar la correcta estimación de la edad dentaria al ser aplicadas a la población de nuestra región.

Alimento con alto contenido de fructanos

El topinambur (Helianthus tuberosus L.) es una especie perteneciente a la familia de las Asteráceas originaria de América del Norte. Esta especie produce tallos subterráneos (tubérculos) que almacenan polisacáridos en forma de fructanos y, dentro de éstos, la inulina es el principal carbohidrato de reserva. Este compuesto posee características beneficiosas en la salud al actuar como fibra dietaria, sin disminuir la absorción de minerales. La presencia de inulina y sus derivados, hace de los tubérculos una buena fuente de fibra dietaria y particularmente de fibra funcional, cuya definición comprende a aquellos carbohidratos no digeribles aislados que tienen efectos fisiológicos beneficiosos en los seres humanos. Los objetivos de este estudio fueron: o Elaborar puré de alto contenido de fructanos, con variantes, a partir de tubérculos de topinambur de variedades Roja y Blanca; o Caracterizar de forma físico-química los tubérculos sin procesar y los purés elaborados; o Cuantificar el contenido de fructanos presente en los tubérculos sin procesar y en los productos obtenidos luego de cada elaboración; o Evaluar la aceptación por parte de los consumidores del puré preparado, mediante una prueba de evaluación sensorial. Siguiendo los objetivos, se elaboraron los purés, realizaron las caracterizaciones físico-químicas y cuantificaciones de fructanos en los tubérculos y productos obtenidos, y se sometió el preparado a una prueba sensorial afectiva con escala hedónica. Los resultados obtenidos indican que el procesamiento de tubérculos de topinambur para obtener puré, no modifica sustancialmente el contenido de fructanos, y las pérdidas asociadas al mismo varían entre el 0% y el 16% dependiendo del ensayo. Los consumidores aceptarían comprar el producto evaluado, si se ofreciera en el mercado a igual costo que un puré de papas tradicional, y no exhiben preferencia de una variedad de topinambur sobre la otra en los productos preparados. Por ello resulta viable elaborar puré de topinambur de variedad Roja o Blanca, el cual se considera beneficioso para la salud por su alto contenido en fructanos, cuyo valor mínimo cuantificado fue de 7,4% en el producto preparado, considerando que el mismo sería aceptado por la población.

Radiocarbon age and sedimentation rates of bottom sediments in the Obskaya Gube (Ob River estuary

Complex geological-geochemical studies of water column and bottom sediments were carried out during Cruise 49 of R/V "Dmitry Mendeleev" in the Kara Sea shelf zone along the Obskaya Guba (Ob River estuary) from the Pur River and Taz River mouths to 76°N. Carbon-14 concentrations in organic matter from bottom sediments were determined at 5 stations. Constant initial 14C concentration model was used to determine sedimentation rates that were taken as a basis for calculating ages of sediment cores and their separate parts and for inferring location of a depocenter, i.e. a region of maximal discharge of fine-dispersed fraction of suspended matter of river run-off. Sedimentation rate in the depocenter is 170 cm/ka. Southward moves of the depocenter were recorded for periods of sea-level rises 2 and 5 thousand years ago. Bottom sediments in the depocenter contain 45% of organic matter primary produced in the Obskaya Guba. This organic matter is an energetic basis for bottom fauna life. About 55% of organic matter comes with river run-off.

Discarge compilation from The Global River Discharge (RivDIS) Project

The Global River Discharge (RivDIS) data set contains monthly discharge measurements for 1018 stations located throughout the world. The period of record varies widely from station to station, with a mean of 21.5 years. These data were digitized from published UNESCO archives by Charles Voromarty, Balaze Fekete, and B.A. Tucker of the Complex Systems Research Center (CSRC) at the University of New Hampshire. River discharge is typically measured through the use of a rating curve that relates local water level height to discharge. This rating curve is used to estimate discharge from the observed water level. The rating curves are periodically rechecked and recalibrated through on-site measurement of discharge and river stage.

Arquitectura óptima: Cuatro medios prácticos para optimizar proyectos de arquitectura

La investigación trata de mostrar cuatro acciones habitualmente empleadas al proyectar arquitectura. La tesis narra el discurso que construyen cuatro acciones como mecanismos optimizadores, fundamentales, activos y necesarios cuando creamos nuevos proyectos. En este trabajo se estudian en profundidad cuatro acciones optimizadoras a través de numerosos casos de estudio. Se estudia también la presencia de estas acciones en otros campos creativos, como la biología, el arte, la literatura, la filosofía, la matemática o la psicología de la creatividad. Se busca qué tienen en común estas cuatro acciones y se indaga sobre la posible narración que construyen entre ellas. La mayor parte de los textos que constituyen este trabajo se escriben en un formato próximo al del ensayo, empleando tiempos verbales presentes evitando los tiempos verbales pretéritos o imperfectos para potenciar la acción a través el estilo narrativo. La investigación se ha realizado a partir de fuentes bibliográficas existentes en numerosas bibliotecas. Se han llevado a cabo estudios de campo realizados a través de entrevistas personales a interlocutores expertos, no sólo de teoría arquitectónica sino también de prácticas constructivas, así como visitas a lugares íntimamente relacionados con el tema de investigación. Se ha completado el estudio de casos con ejercicios prácticos realizados por el autor de esta tesis, para profundizar con la propia investigación por empatía con los autores estudiados. La investigación bibliográfica principal se ha desarrollado en las bibliotecas de la Universidad Politécnica de Madrid, de la Universidad de Alicante, de la Universidad Autónoma de Madrid, de la Universidad Europea de Madrid, de la Universidad Camilo José Cela, de la Universidad Complutense de Madrid, de la Columbia University, de la Harvard University, de la Delft University, de Heidelberg University, de la Biblioteca Central de Madrid y de la Regional de Murcia, así como de la del COAMU. También se ha utilizado recursos bibliográficos propios. La metodología utilizada muestra desde diferentes perspectivas el problema de las acciones optimizadoras, desde obras artísticas, pasando por ejemplos de arquitectura construida hasta ejercicios puramente intelectuales. La acumulación ha sido el método de obtención de conocimiento de esta tesis. Se han acumulado conocimientos y posteriormente se ha profundizado, reflexionando sobre los datos que se han ido obteniendo. Al profundizar se enlazan unas pruebas con otras, hilando y ensamblándolas en un discurso que hace continuo y coherente la aparición de cada caso estudiado. Estas entidades probatorias son acciones que han sido aplicadas frecuentemente por distintas generaciones de autores que proyectan utilizando alguna de estas cuatro acciones. Partimos de una extensa bibliografía general y de otra específica. A través de citas e imágenes se muestra el repertorio de objetos y textos estudiados. Los casos de estudio seleccionados exponen los efectos que produce cada acción en el ejercicio del proyectar. Se ha estudiado la necesidad de cada acción en todas y cada una de las partes del ciclo creativo del proyecto, tanto en prácticas imaginadas como en construidas, de los autores que proyectan. Se citan y se interpretan las descripciones de biólogos, sociólogos, antropólogos, psicólogos, escritores, artistas, arquitectos, matemáticos, ingenieros, físicos, médicos y filósofos en los cuales estas acciones se encuentran conscientemente incorporadas en su procedimiento de proyectar y de pensar. Por último, hemos obtenido unos resultados adecuados a la metodología empleada y a los objetivos planteados gracias a la acumulación y clasificación de pruebas. Los resultados se exponen a modo de discursos conclusivos con un intencionado carácter abierto que despliega nuevas posibles nuevas vías de investigación entorno a los temas estudiados. ABSTRACT. The research seeks to show four commonly used actions in designing architecture. Thesis recounts the speech that built four actions like optimizer, fundamental, active and necessary mechanisms when we create new projects. In this work it studies in depth four optimizer actions through numerous case studies. Also, it considers the presence of these actions in other creative fields, such as biology, art, literature, philosophy, mathematics or psychology of creativity. It is intended what these four actions have in common and it explores the possible narrative constructed among them. Most of the texts that constitute this work are written in a format close to the essay, using present tenses avoiding past or imperfect tenses of enhancing the action through the narrative style. Research has been done from literature sources available in numerous libraries. Field studies have been carried out through personal interviews with expert speakers, not just of architectonic theory but also from constructive practices, as well as visits to sites closely related to the research topic. case studies with practical exercises conducted by the author of this thesis has been completed, to deepen with the own research by empathy with the studied authors. Main bibliographical investigation has been developed in the libraries of UPM, UA, UAM, UEM, the CJC, the UCM, Columbia University, Harvard University Delft University, Heidelberg University, Madrid Central Library, Regional Murcia Library and COAMU Library. Also it has been used own bibliographical resources. Methodology shows from different perspectives the problem of optimizers actions, from art, passing through examples of architecture built up to puré intellectual exercise. Accumulation has been the method of obtaining knowledge of this thesis. it has been accumulated knowledge and later it has been deepened, reflecting on the data that have been obtained. By deepening tests are linked with other, spinning and locking into a discourse that makes continuous and consistent the development of each case study. These evidentiary entities are actions that have been frequently applied by different generations of authors who project using some of these four stocks. We leave from an extensive general bibliography and another specific one. Through quotes and pictures it shows the repertoire of objects and texts studied. The selected study cases set out the effects that each action produces in the exercise of projecting. It has studied the need of each action in every parts of creative cycle of the project, both imagined as constructed practices, by the authors who project. It is quoted and interpreted the descriptions of biologists, sociologists, anthropologists, psychologists, writers, artists, architects, mathematicians, engineers, physicists, physicians and philosophers in which these actions are consciously incorporated into his projecting and thinking procedure. Finally, we have obtained adequate results to the used methodology and to the stated objectives through the accumulation and classification of evidence. The results are presented as conclusive speeches with an intentional open character that unfolds new possible research routes around the studied topics.

Removing superfluous versions in polyvariant specialization of prolog programs.

Polyvariant specialization allows generating múltiple versions of a procedure, which can then be separately optimized for different uses. Since allowing a high degree of polyvariance often results in more optimized code, polyvariant specializers, such as most partial evaluators, can genérate a large number of versions. This can produce unnecessarily large residual programs. Also, large programs can be slower due to cache miss effects. A possible solution to this problem is to introduce a minimization step which identifies sets of equivalent versions, and replace all occurrences of such versions by a single one. In this work we present a unifying view of the problem of superfluous polyvariance. It includes both partial deduction and abstract múltiple specialization. As regards partial deduction, we extend existing approaches in several ways. First, previous work has dealt with puré logic programs and a very limited class of builtins. Herein we propose an extensión to traditional characteristic trees which can be used in the presence of calis to external predicates. This includes all builtins, librarles, other user modules, etc. Second, we propose the possibility of collapsing versions which are not strictly equivalent. This allows trading time for space and can be useful in the context of embedded and pervasive systems. This is done by residualizing certain computations for external predicates which would otherwise be performed at specialization time. Third, we provide an experimental evaluation of the potential gains achievable using minimization which leads to interesting conclusions.

Non-strict independent and-parallelism

This paper presents and develops a generalized concept of Non-Strict Independent And Parallelism (NSIAP). NSIAP extends the applicability of Independent And- Parallelism (IAP) by enlarging the class of goals which are eligible for parallel execution. At the same time it maintains IAP's ability to run non-deterministic goals in parallel and to preserve the computational complexity expected in the execution of the program by the programmer. First, a parallel execution framework is defined and some fundamental correctness results, in the sense of equivalence of solutions with the sequential model, are discussed for this framework. The issue of efficiency is then considered. Two new definitions of NSI are given for the cases of puré and impure goals respectively and efficiency results are provided for programs parallelized under these definitions which include treatment of the case of goal failure: not only is reduction of execution time guaranteed (modulo run-time overheads) in the absence of failure but it is also shown that in the worst case of failure no speed-down will occur. In addition to applying to NSI, these results carry over and complete previous results shown in the context of IAP which did not deal with the case of goal failure. Finally, some practical examples of the application of the NSIAP concept to the parallelization of a set of programs are presented and performance results, showing the advantage of using NSI, are given.

An overview of the ciao system

Ciao is a logic-based, multi-paradigm programming system. One of its most distinguishing features is that it supports a large number of semantic and syntactic language features which can be selectively activated or deactivated for each program module. As a result, a module can be written in, for example, ISO-Prolog plus constraints and higher order, while another can be a puré logic module with a different control rule such as iterative deepening and/or tabling, and perhaps using constructive negation. A powerful and modular extensión mechanism allows user-level design and implementation of such features and sub-languages. Another distinguishing feature of Ciao is its powerful assertion language, which allows expressing many kinds of program properties (ranging from, e.g., moded types to resource consumption), as well as tests and documentation. The compiler is capable of statically ñnding violations of these properties or verifying that programs comply with them, and issuing certiñcates of this compliance. The compiler also performs many types of optimizations, including automatic parallelization. It offers very competitive performance, while retaining the flexibility and interactive development of a dynamic language. We will present a hands-on overview of the system, through small examples which emphasize the novel aspects and the motivations which lie behind Ciao's design and implementation.