Surgical hip dislocation for treatment of femoroacetabular impingement: factors predicting 5-year survivorship.

BACKGROUND Patients with femoroacetabular impingement (FAI) often develop pain, impaired function, and progression of osteoarthritis (OA); this is commonly treated using surgical hip dislocation, femoral neck and acetabular rim osteoplasty, and labral reattachment. However, results with these approaches, in particular risk factors for OA progression and conversion to THA, have varied. QUESTIONS/PURPOSES We asked if patients undergoing surgical hip dislocation with labral reattachment to treat FAI experienced (1) improved hip pain and function; and (2) prevention of OA progression; we then determined (3) the survival of the hip at 5-year followup with the end points defined as the need for conversion to THA, progression of OA by at least one Tönnis grade, and/or a Merle d'Aubigné-Postel score less than 15; and calculated (4) factors predicting these end points. METHODS Between July 2001 and March 2003, we performed 146 of these procedures in 121 patients. After excluding 35 patients (37 hips) who had prior open surgery and 11 patients (12 hips) who had a diagnosis of Perthes disease, this study evaluated the 75 patients (97 hips, 66% of the procedures we performed during that time) who had a mean followup of 6 years (range, 5-7 years). We used the anterior impingement test to assess pain, the Merle d'Aubigné-Postel score to assess function, and the Tönnis grade to assess OA. Survival and predictive factors were calculated using the method of Kaplan and Meier and Cox regression, respectively. RESULTS The proportion of patients with anterior impingement decreased from 95% to 17% (p < 0.001); the Merle d'Aubigné-Postel score improved from a mean of 15 to 17 (p < 0.001). Seven hips (7%) showed progression of OA and another seven hips (7%) converted to THA Survival free from any end point (THA, progression of OA, or a Merle d'Aubigné-Postel < 15) of well-functioning joints at 5 years was 91%; and excessive acetabular rim trimming, preoperative OA, increased age at operation, and weight were predictive factors for the end points. CONCLUSIONS At 5-year followup, 91% of patients with FAI treated with surgical hip dislocation, osteoplasty, and labral reattachment showed no THA, progression of OA, or an insufficient clinical result, but excessive acetabular trimming, OA, increased age, and weight were associated with early failure. To prevent early deterioration of the joint, excessive rim trimming or trimming of borderline dysplastic hips has to be avoided.

A Schwarz lemma for Kahler affine metrics and the canonical potential of a proper convex cone

This is an account of some aspects of the geometry of Kahler affine metrics based on considering them as smooth metric measure spaces and applying the comparison geometry of Bakry-Emery Ricci tensors. Such techniques yield a version for Kahler affine metrics of Yau s Schwarz lemma for volume forms. By a theorem of Cheng and Yau, there is a canonical Kahler affine Einstein metric on a proper convex domain, and the Schwarz lemma gives a direct proof of its uniqueness up to homothety. The potential for this metric is a function canonically associated to the cone, characterized by the property that its level sets are hyperbolic affine spheres foliating the cone. It is shown that for an n -dimensional cone, a rescaling of the canonical potential is an n -normal barrier function in the sense of interior point methods for conic programming. It is explained also how to construct from the canonical potential Monge-Ampère metrics of both Riemannian and Lorentzian signatures, and a mean curvature zero conical Lagrangian submanifold of the flat para-Kahler space.

Data Flow Analysis and the Linear Programming Model

* The research is supported partly by INTAS: 04-77-7173 project, http://www.intas.be

Points quantiques : caractérisation et applications en sciences pharmaceutiques

L’imagerie médicale a longtemps été limitée à cause des performances médiocres des fluorophores organiques. Récemment la recherche sur les nanocristaux semi-conducteurs a grandement contribué à l’élargissement de la gamme d’applications de la luminescence dans les domaines de l’imagerie et du diagnostic. Les points quantiques (QDs) sont des nanocristaux de taille similaire aux protéines (2-10 nm) dont la longueur d’onde d’émission dépend de leur taille et de leur composition. Le fait que leur surface peut être fonctionnalisée facilement avec des biomolécules rend leur application particulièrement attrayante dans le milieu biologique. Des QDs de structure « coeur-coquille » ont été synthétisés selon nos besoins en longueur d’onde d’émission. Dans un premier article nous avons modifié la surface des QDs avec des petites molécules bi-fonctionnelles portant des groupes amines, carboxyles ou zwitterions. L’effet de la charge a été analysé sur le mode d’entrée des QDs dans deux types cellulaires. À l’aide d’inhibiteurs pharmacologiques spécifiques à certains modes d’internalisation, nous avons déterminé le mode d’internalisation prédominant. L’endocytose par les radeaux lipidiques représente le mode d’entrée le plus employé pour ces QDs de tailles similaires. D’autres modes participent également, mais à des degrés moindres. Des disparités dans les modes d’entrée ont été observées selon le ligand de surface. Nous avons ensuite analysé l’effet de l’agglomération de différents QDs sur leur internalisation dans des cellules microgliales. La caractérisation des agglomérats dans le milieu de culture cellulaire a été faite par la technique de fractionnement par couplage flux-force (AF4) associé à un détecteur de diffusion de la lumière. En fonction du ligand de surface et de la présence ou non de protéines du sérum, chacun des types de QDs se sont agglomérés de façon différente. À l'aide d’inhibiteur des modes d’internalisation, nous avons corrélé les données de tailles d’agglomérats avec leur mode d’entrée cellulaire. Les cellules microgliales sont les cellules immunitaires du système nerveux central (CNS). Elles répondent aux blessures ou à la présence d’inflammagènes en relâchant des cytokines pro-inflammatoires. Une inflammation non contrôlée du CNS peut conduire à la neurodégénérescence neuronale et est souvent observée dans les cas de maladies chroniques. Nous nous sommes intéressés au développement d’un nanosenseur pour mesurer des biomarqueurs du début de l’inflammation. Les méthodes classiques pour étudier l’inflammation consistent à mesurer le niveau de protéines ou molécules relâchées par les cellules stressées (par exemple monoxyde d’azote, IL-1β). Bien que précises, ces méthodes ne mesurent qu’indirectement l’activité de la caspase-1, responsable de la libération du l’IL-1β. De plus ces méthode ne peuvent pas être utilisées avec des cellules vivantes. Nous avons construit un nanosenseur basé sur le FRET entre un QD et un fluorophore organique reliés entre eux par un peptide qui est spécifiquement clivé par la caspase-1. Pour induire l’inflammation, nous avons utilisé des molécules de lipopolysaccharides (LPS). La molécule de LPS est amphiphile. Dans l’eau le LPS forme des nanoparticules, avec des régions hydrophobes à l’intérieure. Nous avons incorporé des QDs dans ces régions ce qui nous a permis de suivre le cheminement du LPS dans les cellules microgliales. Les LPS-QDs sont internalisés spécifiquement par les récepteurs TLR-4 à la surface des microglies. Le nanosenseur s’est montré fonctionnel dans la détermination de l’activité de la caspase-1 dans cellules microgliales activées par le LPS. Éventuellement, le senseur permettrait d’observer en temps réel l’effet de thérapies ciblant l’inflammation, sur l’activité de la caspase-1.

Studies of stability of fluid flowa using variational methods

The study of stability problems is relevant to the study of structure of a physical system. It 1S particularly important when it is not possible to probe into its interior and obtain information on its structure by a direct method. The thesis states about stability theory that has become of dominant importance in the study of dynamical systems. and has many applications in basic fields like meteorology, oceanography, astrophysics and geophysics- to mention few of them. The definition of stability was found useful 1n many situations, but inadequate in many others so that a host of other important concepts have been introduced in past many years which are more or less related to the first definition and to the common sense meaning of stability. In recent years the theoretical developments in the studies of instabilities and turbulence have been as profound as the developments in experimental methods. The study here Points to a new direction for stability studies based on Lagrangian formulation instead of the Hamiltonian formulation used by other authors.

Prevalência de oclusopatias e comparação entre a Classificação de Angle e o Índice de Estética Dentária em escolares do interior do estado de São Paulo - Brasil

INTRODUÇÃO: as oclusopatias estão entre os principais problemas de saúde bucal em todo o mundo, juntamente com a cárie dentária e a doença periodontal, e vários índices têm sido utilizados para registrá-las. OBJETIVOS: verificar a prevalência de oclusopatias utilizando a Classificação de Angle e o Índice de Estética Dentária (DAI), sua severidade e a necessidade de tratamento ortodôntico registradas pelo DAI, e comparar os resultados de ambos os índices, visando correlacionar o padrão dos dados coletados e a viabilidade de utilizá-los de forma conjunta. MÉTODOS: a amostra consistiu de 734 escolares com idade de 12 anos, de ambos os sexos, da rede pública do município de Lins/SP. Foram realizados exames nos pátios das escolas com utilização de sondas IPC a olho nu. RESULTADOS: pela Classificação de Angle, encontrou-se 33,24% das crianças com oclusão normal e 66,76% com má oclusão. Pelo DAI, observou-se que 65,26% das crianças apresentavam-se sem anormalidades ou com más oclusões leves. A má oclusão definida esteve presente em 12,81%, a má oclusão severa foi observada em 10,90% e a muito severa ou incapacitante em 11,03%. A maioria das crianças (70,57%) apresentou relação molar normal, e o overjet maxilar anterior foi a alteração mais frequentemente observada. No cruzamento dos índices houve semelhanças e divergências. CONCLUSÃO: o DAI não foi sensível a alguns problemas de oclusão detectados pela Classificação de Angle, e a recíproca foi verdadeira, demonstrando que ambos os índices possuem pontos distintos na detecção das oclusopatias, podendo ser utilizados de forma reciprocamente complementar.

Estimation of a preference map of new consumers for spatial load forecasting simulation methods using a spatial analysis of points

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influence of contact points on the performance of caries detection methods in approximal surfaces of primary molars: an in vivo study

This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D 0 = health, D 1 –D 4 = disease; D2: D 0 , D 1 = health, D 2 –D 4 = disease; D3: D 0 –D 2 = health, D 3 , D 4 = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/ specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.

Estudio de las formas de aplicación de la fotografía sobre los materiales pétreos para la arquitectura = Study of photography application methods over architectural stony materials

Desde que el Hombre era morador de las cavernas ha sido manifiesto su deseo innato por grabar y reproducir "instantáneas con las que perpetuarse o sobre las que mirarse ". La aparición y desarrollo de la fotografía como medio para poder captar y fijar "la imagen directa de la realidad circundante " pronto se convierte en un nuevo lenguaje estético y poético que permite al artista la interpretación y reflexión de lo observado. Se imprime a la imagen el carácter de la mirada del fotógrafo, estableciendo un diálogo conceptual con el juego de luces. La presente Tesis plantea la creación de una nueva piel de arquitectura mediante la impresión fotográfica sobre materiales pétreos. La búsqueda de la expresividad de los materiales como soporte de expresión artística implica un cambio de escala al trasladar la instantánea fotográfica a la arquitectura y la aplicación de un nuevo soporte al imprimir la fotografía sobre materiales arquitectónicos. Se justifica la elección del dispositivo láser CO2 como sistema de impresión fotográfica sobre los materiales pétreos arquitectónicos, como la técnica que permite la unión física de la imagen y el proyecto arquitectónico, generando un valor añadido a través del arte de la fotografía. Se justifica la elección de los materiales investigados, Silestone® Blanco Zeus y GRC® con TX Active® Aria, de forma que la investigación de esta nueva piel de arquitectura abarca tanto la envolvente del edificio como su volumen interior, permitiendo cerrar el círculo arquitectónico "in&out" y dota al proyecto arquitectónico de un valor añadido al introducir conceptos sostenibles de carácter estético y medioambiental. Se realiza una consulta a las empresas del sector arquitectónico relacionadas directamente con la producción y distribución de los materiales Silestone® y GRC®, así como a las empresas especializadas en sistemas de impresión fotográfica sobre materiales, acerca del estado del arte. Se recorre la Historia de la fotografía desde sus orígenes hasta el desarrollo de la era digital y se analiza su condición artística. Se recopilan los sistemas de impresión fotográfica que han evolucionado en paralelo con los dispositivos de captura de la instantánea fotográfica y se describe en profundidad el sistema de impresión fotográfica mediante dispositivo láser CO2. Se describen los procesos de fabricación, las características técnicas, cualidades y aplicaciones de los materiales pétreos arquitectónicos Silestone® Blanco Zeus y GRC® con TX Active® Aria. Se explica la técnica utilizada para la captación de la imagen fotográfica, su justificación artística y su proceso de impresión mediante dispositivo láser CO2 bajo diferentes parámetros sobre muestras de los materiales arquitectónicos investigados. Se comprueba la viabilidad de desarrollo de la nueva piel de arquitectura sobre Silestone® Blanco Zeus y GRC® con TX Active® Aria sometiendo a las piezas impresas bajo diferentes parámetros a tres ensayos de laboratorio. En cada uno de ellos se concreta el objetivo y procedimiento del ensayo, la enumeración de las muestras ensayadas y los parámetros bajo los que han sido impresas, el análisis de los resultados del ensayo y las conclusiones del ensayo. Ensayo de amplitud térmica. Se determina el grado de afectación de las imágenes impresas bajo la acción de contrastes térmicos. Series de muestras de Silestone® Blanco Zeus y GRC® con TX Active® Aria impresas con láser CO2 se someten a ciclos de contraste frío-calor de 12 horas de duración para una amplitud térmica total de 102°C. Se realiza una toma sistemática de fotografías microscópicas con lupa de aumento de cada pieza antes y después de los ciclos frío-calor y la observación de las transformaciones que experimentan los materiales bajo la acción del láser CO2. Ensayo de exposición a la acción de la radiación ultravioleta (UV). Se determina el grado de afectación de las imágenes impresas al activar la capacidad autolimpiante de partículas orgánicas. Una serie de muestras de GRC® con TX Active® Aria impresa con láser CO2 se someten a ciclos de exposición de radiación ultravioleta de 26 horas de duración. Se somete la serie a un procedimiento de activación del aditivo TX Active®. Se simula la contaminación orgánica mediante la aplicación controlada de Rodamina B, tinte orgánico, y se simula la radiación UV mediante el empleo de una bombilla de emisión de rayos ultravioleta. Se realiza una toma sistemática de fotografías macroscópicas de la serie de muestras ensayadas: antes de aplicación de la Rodamina B, momento 00:00h, momento 04:00h y momento 26:00h del ensayo. Se procede a la descarga y análisis del histograma de las fotografías como registro de la actividad fotocatalítica. Ensayo de la capacidad autodescontaminante del GRC® con TX Active® impreso con láser CO2. Se comprueba si la capacidad autodescontaminante del GRC® con TX Active® se ve alterada como consecuencia de la impresión de la imagen fotográfica impresa con láser CO2. Serie de muestras de GRC® con TX Active® Aria impresa con láser CO2 se someten a test de capacidad autodescontaminante: atmósfera controlada y contaminada con óxidos de nitrógeno en los que se coloca cada pieza ensayada bajo la acción de una lámpara de emisión de radiación ultravioleta (UV). Se registra la actividad fotocatalítica en base a la variación de concentración de óxido de nitrógeno. Se recopila el análisis e interpretación de los resultados de los ensayos de laboratorio y se elaboran las conclusiones generales de la investigación. Se sintetizan las futuras líneas de investigación que, a partir de las investigaciones realizadas y de sus conclusiones generales, podrían desarrollarse en el ámbito de la impresión fotográfica sobre materiales arquitectónicos. Se describe el rendimiento tecnológico y artístico generado por las investigaciones previas que han dado origen y desarrollo a la Tesis Doctoral. ABSTRACT Since ancient time, humanity has been driven by an innate wish to reproduce and engrave "snapshots that could help to perpetúate or to look at one self". Photography's birth and its development as a mean to capture and fix "the direct image of the surrounding reality" quickly becomes a new aesthetical and poetical language allowing the artist to interpret and think over what has been observed. The photographer's eye is imprinted onto the image, and so the conceptual dialogue between the artist and the light beams begins. The current thesis suggests the creation of a new architectural skin through photography imprinting over stony materials. The search for material's expressiveness as a medium of artistic expression involves a change of scale as it transfers photographic snapshot into architecture and the use of a new photographic printing support over architectural materials. CO2 laser is the chosen printing system for this technique as it allows the physical union of the image and the architectonic project, generating an added value through the art of photography. The researched materials selected were Silestone®, Blanco Zeus and GRC® with TX Active® Aria. This new architectural skin contains the building surrounding as well as its interior volume, closing the architectonic "in & out" circle and adding a value to the project by introducing aesthetical and environmental sustainable concepts. Architecture companies related to the production and distribution of materials like Silestone® and GRC®, as well as companies specialized in photography printing over materials were consulted to obtain a State of the Art. A thorough analysis of photography's History from its origins to the digital era development was made and its artistic condition was studied in this thesis. In this study the author also makes a compilation of several photographic printing systems that evolved together with photographic snapshot devices. The CO2 laser-based photographic printing system is also described in depth. Regarding stony materials of architecture like Silestone®, Blanco Zeus and GRC® with TX Active® Aria, the present study also describes their manufacture processes as well as technical features, quality and application. There is also an explanation about the technique to capture the photographic image, its artistic justification and its CO2 laser-based printing system over the researched materials under different parameters. We also tested the feasibility of this new architectural skin over Silestone® Blanco Zeus and GRC® with TX Active® Aria. The pieces were tested under different parameters in three laboratory trials. Each trial comprises of an explanation of its objective and its process, the samples were numbered and the printing parameters were specified. Finally, with the analysis of the results some conclusions were drawn. In the thermal amplitude trial we tried to determine how printed images were affected as a result of the action of thermal contrasts. Series of samples of Silestone® Blanco Zeus and GRC® with TX Active® Aria printed with CO2 laser were subjected to several 12h warm-cold cycles for thermal total amplitude of 102oc. Each sample was captured systematically with microscopic enhanced lenses before and after cold-warm cycles. The changes experienced by these materials under the effect of CO2 laser were observed and recorded. Trial regarding the Ultraviolet Radiation (UR) effect on images. We determined to which extent printed images were affected once the self-cleaning organic particles were activated. This time GRC® with TX Active® Aria samples printed with CO2 laser were exposed to a 26h UR cycle. The samples were subjected to the activation of TX Active® additive. Through the controlled application of Rodamine B and organic dye we were able to simulate the organic contamination process. UR was simulated using an ultraviolet beam emission bulb. A systematic capture of macroscopic pictures of the tested sample series was performed at different time points: before Rodamine B application, at moment 00:00h, moment 04:00h and moment 26:00h of the trial. Picture's histogram was downloaded and analyzed as a log of photocatalytic activity. Trial regarding the self-decontaminating ability of GRC® with TX Active® printed with CO2 laser. We tested if this self-decontaminating ability is altered as a result of CO2 laser printed image. GRC® with TX Active® Aria samples printed with CO2 laser, were subject to self-decontaminating ability tests with controlled and nitrogen oxide contaminated atmosphere. Each piece was put under the action of an UR emission lamp. Photocatalytic activity was recorded according to the variation in nitrogen oxide concentration. The results of the trial and their interpretation as well as the general conclusions of the research are also compiled in the present study. Study conclusions enable to draw future research lines of potential applications of photographic printing over architecture materials. Previous research generated an artistic and technological outcome that led to the development of this doctoral thesis.

Diamond points; or, Things we should know : A compendium of facts, forms, methods and laws, for the safe conduct of business /

Mode of access: Internet.

The General Differential Operators Generated by a Quasi-Differential Expressions with their Interior Singular Points

The general ordinary quasi-differential expression M of n-th order with complex coefficients and its formal adjoint M + are considered over a regoin (a, b) on the real line, −∞ ≤ a < b ≤ ∞, on which the operator may have a finite number of singular points. By considering M over various subintervals on which singularities occur only at the ends, restrictions of the maximal operator generated by M in L2|w (a, b) which are regularly solvable with respect to the minimal operators T0 (M ) and T0 (M + ). In addition to direct sums of regularly solvable operators defined on the separate subintervals, there are other regularly solvable restrications of the maximal operator which involve linking the various intervals together in interface like style.

On The Critical Points of some Iteration Methods for Solving Algebraic Equations. Global Convergence Properties

In this work we give su±cient conditions for k-th approximations of the polynomial roots of f(x) when the Maehly{Aberth{Ehrlich, Werner-Borsch-Supan, Tanabe, Improved Borsch-Supan iteration methods fail on the next step. For these methods all non-attractive sets are found. This is a subsequent improvement of previously developed techniques and known facts. The users of these methods can use the results presented here for software implementation in Distributed Applications and Simulation Environ- ments. Numerical examples with graphics are shown.

(Table 1) Age control points and dating methods for sediment cores of the Sea of Okhotsk

Marine- and terrestrial-derived biomarkers (alkenones, brassicasterol, dinosterol, and long-chain n-alkanes), as well as carbonate, biogenic opal, and ice-rafted debris (IRD), were measured in two sediment cores in the Sea of Okhotsk, which is located in the northwestern Pacific rim and characterized by high primary productivity. Down-core profiles of phytoplankton markers suggest that primary productivity abruptly increased during the global Meltwater Pulse events 1A (about 14 ka) and 1B (about 11 ka) and stayed high in the Holocene. Spatial and temporal distributions of the phytoplankton productivity were found to be consistent with changes in the reconstructed sea ice distribution on the basis of the IRD. This demonstrates that the progress and retreat of sea ice regulated primary productivity in the Sea of Okhotsk with minimum productivity during the glacial period. The mass accumulation rates of alkenones, CaCO3, and biogenic opal indicate that the dominant phytoplankton species during deglaciation was the coccolithophorid, Emiliania huxleyi, which was replaced by diatoms in the late Holocene. Such a phytoplankton succession was probably caused by an increase in silicate supply to the euphotic layer, possibly associated with a change in surface hydrography and/or linked to enhanced upwelling of North Pacific Deep Water.

Symmetric Interior Penalty DG Methods for the Compressible Navier-Stokes Equations I: Method Formulation

In this article we consider the development of discontinuous Galerkin finite element methods for the numerical approximation of the compressible Navier-Stokes equations. For the discretization of the leading order terms, we propose employing the generalization of the symmetric version of the interior penalty method, originally developed for the numerical approximation of linear self-adjoint second-order elliptic partial differential equations. In order to solve the resulting system of nonlinear equations, we exploit a (damped) Newton-GMRES algorithm. Numerical experiments demonstrating the practical performance of the proposed discontinuous Galerkin method with higher-order polynomials are presented.