Composite skin grafts for basal cell carcinoma defects of the nose

Basal cell carcinoma is the most frequent cutaneous cancer of the nose and is characterized by its local spreading and exceptionally rare tendency to metastasize. Since a significant advantage has been seen in surgery compared to other treatments, surgical excision ensuring the highest chance of cure is frequently employed. Excision defects of the nose may be covered with either local flap or a full-thickness skin graft. In resurfacing such defects following excision of basal cell carcinomas, we favor the technique of composite-skin grafting which involves the harvesting of composite-skin graft including the epidermis, dermis and superficial layers of subcutaneous tissue to obtain the required thickness in the recipient site. This technique was used for defects remaining after the excision of basal cell carcinomas in a series of 15 patients. The areas involved were lateral nasal region (5 cases), nasal tip (4 cases), dorsum (3 cases), alar lobule (2 cases), and soft triangle (1 case). The mean follow-up was 14.2 months. The color, texture and thickness of the composite-skin graft harvested from the preauricular site and the neck compare favorably with the skin of the nose region. Satisfactory results, both clinically and in patient appreciation, have been obtained in both the reconstruction site and the appearance of the donor site in all patients.

Role of the extraosseus blood supply in osteoarthritic femoral heads

Blood perfusion to the femoral head might be endangered during the surgical approach or the preparation of the femoral head or both in hip resurfacing arthroplasty. The contribution of the intramedullary blood supply to the femoral head in osteoarthritis is questionable. Therefore, the contribution of the extraosseous blood supply to osteoarthritic femoral heads was measured intraoperatively to question if there is measurable blood flow between the epiphysis and metaphysis in osteoarthritic hips in case of extraosseus vessel damage. At defined points during surgery we acquired the epiphyseal and metaphyseal femoral head perfusion by high-energy laser Doppler flowmetry. Complete femoral neck osteotomy sparing the retinacular vessels to simulate intraosseous blood disruption showed unchanged epiphyseal blood flow compared to initial measurement after capsulotomy. The pulsatile signal disappeared after transection of the retinacular vessels. Based on these acute measurements, we conclude intramedullary blood vessels to the femoral head do not provide measurable blood supply to the epiphysis once the medial femoral circumflex artery or the retinacular vessels have been damaged. We recommend the use of a safe surgical approach for hip resurfacing and careful implantation of the femoral component to respect blood supply to the femoral head and neck region in hip resurfacing arthroplasty.

Surgical capping of superior semicircular canal dehiscence

Surgical plugging and resurfacing are well established treatments of superior semicircular canal dehiscence, while capping with hydroxyapatite cement has been little discussed in literature. The aim of this study was to prove the efficacy of the capping technique. Charts of patients diagnosed with superior semicircular canal dehiscence were reviewed retrospectively. All patients answered the dizziness handicap inventory, a survey analyzing the impact of their symptoms on their quality of life. Capping of the dehiscent canal was performed via the middle fossa approach in all cases. Ten out of 22 patients diagnosed with superior semicircular canal dehiscence were treated with surgical capping, nine of which were included in this study. No major perioperative complications occurred. In 8 out of 9 (89 %) patients, capping led to a satisfying reduction of the main symptoms. One patient underwent revision surgery 1 year after the initial intervention. Scores in the dizziness handicap inventory were lower in the surgically treated group than in the non-surgically treated group, but results were not statistically significant (P = 0.45). Overall, capping is a safe and efficient alternative to plugging and resurfacing of superior semicircular canal dehiscence.

The geomorphology and morphometry of the banded terrain in Hellas basin, Mars

Hellas basin is a large impact basin situated in the southern highlands of Mars. The north-western part of the basin has the lowest elevation (-7.5 km) on the planet and contains a possibly unique terrain type, which we informally call “banded terrain”. The banded terrain is made up of smooth-looking banded deposits that display signs of viscous behavior and a paucity of superimposed impact craters. In this study, we use newly acquired high spatial resolution images from the High Resolution Imaging Science Experiment (HiRISE) in addition to existing datasets to characterize the geomorphology, the morphometry and the architecture of the banded terrain. The banded terrain is generally confined to the NW edge of the Alpheus Colles plateau. The individual bands are ~3–15 km-long, ~0.3 km-wide and are separated by narrow inter-band depressions, which are ~65 m-wide and ~10 m-deep. The bands display several morphologies that vary from linear to concentric forms. Morphometric analysis reveals that the slopes along a given linear or lobate band ranges from 0.5° to 15° (average~6°), whereas the concentric bands are located on flatter terrain (average slope~2–3°). Crater-size frequency analysis yields an Amazonian-Hesperian boundary crater retention age for the terrain (~3 Gyr), which together, with the presence of very few degraded craters, either implies a recent emplacement, resurfacing, or intense erosion. The apparent sensitivity to local topography and preference for concentrating in localized depressions is compatible with deformation as a viscous fluid. In addition, the bands display clear signs of degradation and slumping at their margins along with a suite of other features that include fractured mounds, polygonal cracks at variable size-scales, and knobby/hummocky textures. Together, these features suggest an ice-rich composition for at least the upper layers of the terrain, which is currently being heavily modified through loss of ice and intense weathering, possibly by wind.

Radar investigations of Apollinaris Mons on Mars: Exploring the origin of the fan deposits

Apollinaris Mons is an isolated volcano on Mars straddling the boundary between the southern highlands and the northern plains. One of its most distinctive features is its massive fan-shaped deposit that extends from a breach on its summit to distances of more than 150 km and drapes its entire southern flank. The composition and formation mechanism of these deposits remains controversial. We investigate the radar properties of the fan deposits (FD) of Apollinaris Mons using low-frequency sounding radar data in combination with high-resolution images and crater-size frequency analysis to constrain their inner shape and bulk composition. Our analysis indicates that the FD attains an irregular thickness and is gradually thinner towards their lateral margins. The crater-size frequency analysis shows that they may have undergone repeated resurfacing, which is suggestive of long-term evolution. Our analysis of Shallow Radar (SHARAD) radargrams traversing different sections of the FD reveals multiple and different subsurface interfaces among the radargrams crossing the thinnest part, which suggests a layered and complex inner shape. Our estimates for the bulk real part of the dielectric constant of the FD ranges from 3 to 5, which is consistent with an icy-silicate mixture or pyroclastic composition. Therefore, we conclude that lahars or pyroclastic flows are the most likely mechanism that created the FD, yet we cannot rule out additional contributions from lava flows. A combination of multiple processes is also possible since the deposits appear to have been modified by fluvial processes at a later stage of their formation.

Is a Revision a Revision? An Analysis of National Arthroplasty Registries' Definitions of Revision.

BACKGROUND The reported survival of implants depends on the definition used for the endpoint, usually revision. When screening through registry reports from different countries, it appears that revision is defined quite differently. QUESTIONS/PURPOSES The purposes of this study were to compare the definitions of revision among registry reports and to apply common clinical scenarios to these definitions. METHODS We downloaded or requested reports of all available national joint registries. Of the 23 registries we identified, 13 had published reports that were available in English and were beyond the pilot phase. We searched these registries' reports for the definitions of the endpoint, mostly revision. We then applied the following scenarios to the definition of revision and analyzed if those scenarios were regarded as a revision: (A) wound revision without any addition or removal of implant components (such as hematoma evacuation); (B) exchange of head and/or liner (like for infection); (C) isolated secondary patella resurfacing; and (D) secondary patella resurfacing with a routine liner exchange. RESULTS All registries looked separately at the characteristic of primary implantation without a revision and 11 of 13 registers reported on the characteristics of revisions. Regarding the definition of revision, there were considerable differences across the reports. In 11 of 13 reports, the primary outcome was revision of the implant. In one registry the primary endpoint was "reintervention/revision" while another registry reported separately on "failure" and "reoperations". In three registries, the definition of the outcome was not provided, however in one report a results list gave an indication for the definition of the outcome. Wound revision without any addition or removal of implant components (scenario A) was considered a revision in three of nine reports that provided a clear definition on this question, whereas two others did not provide enough information to allow this determination. Exchange of the head and/or liner (like for infection; scenario B) was considered a revision in 11 of 11; isolated secondary patella resurfacing (scenario C) in six of eight; and secondary patella resurfacing with routine liner exchange (scenario D) was considered a revision in nine of nine reports. CONCLUSIONS Revision, which is the most common main endpoint used by arthroplasty registries, is not universally defined. This implies that some reoperations that are considered a revision in one registry are not considered a revision in another registry. Therefore, comparisons of implant performance using data from different registries have to be performed with caution. We suggest that registries work to harmonize their definitions of revision to help facilitate comparisons of results across the world's arthroplasty registries.

An integrated multi-agent framework for optimizing time, cost and environmental impact of construction processes

Environmentally conscious construction has received a significant amount of research attention during the last decades. Even though construction literature is rich in studies that emphasize the importance of environmental impact during the construction phase, most of the previous studies failed to combine environmental analysis with other project performance criteria in construction. This is mainly because most of the studies have overlooked the multi-objective nature of construction projects. In order to achieve environmentally conscious construction, multi-objectives and their relationships need to be successfully analyzed in the complex construction environment. The complex construction system is composed of changing project conditions that have an impact on the relationship between time, cost and environmental impact (TCEI) of construction operations. Yet, this impact is still unknown by construction professionals. Studying this impact is vital to fulfill multiple project objectives and achieve environmentally conscious construction. This research proposes an analytical framework to analyze the impact of changing project conditions on the relationship of TCEI. This study includes green house gas (GHG) emissions as an environmental impact category. The methodology utilizes multi-agent systems, multi-objective optimization, analytical network process, and system dynamics tools to study the relationships of TCEI and support decision-making under the influence of project conditions. Life cycle assessment (LCA) is applied to the evaluation of environmental impact in terms of GHG. The mixed method approach allowed for the collection and analysis of qualitative and quantitative data. Structured interviews of professionals in the highway construction field were conducted to gain their perspectives in decision-making under the influence of certain project conditions, while the quantitative data were collected from the Florida Department of Transportation (FDOT) for highway resurfacing projects. The data collected were used to test the framework. The framework yielded statistically significant results in simulating project conditions and optimizing TCEI. The results showed that the change in project conditions had a significant impact on the TCEI optimal solutions. The correlation between TCEI suggested that they affected each other positively, but in different strengths. The findings of the study will assist contractors to visualize the impact of their decision on the relationship of TCEI.

La metáfora en los museos de historia social

Antes de la puesta en práctica de los archivos en papel en el siglo XIX había muchas formas líricas de conocer el pasado, por ejemplo, a través del canto y de la pintura. En la evolución de los museos del siglo XIX, los artefactos ocuparon el lugar del conocimiento correspondiente de la “verdad” que se creía existente en el papel archivado. El trabajo del Museo procedió con la certeza del sentido común de una correspondencia individualizada racional entre un artefacto y su significado. La confianza en la capacidad denotativa del artefacto era así la estrategia para transmitir significado a los visitantes. Los museos están alejándose ahora de la denotación como estrategia de comunicación primaria, y uno de los modos que surge es la metáfora. Así como se entendía antiguamente que el significado fijo de los objetos residía en su pura materialidad, ahora vemos el resurgir de la materialidad en los museos, pero esta vez a través de la metáfora, teóricamente entendida como apoyada en la experiencia material del mundo por parte de nuestros cuerpos humanos.

Asphalt cement concrete pavement recycling, Cass and Montgomery Counties : final report for Iowa DOT project HR-1018, Federal Highway Administration demonstration project no. 39, contract no. DOT-FH-15-336, 1986

This demonstration project consisted of three adjacent highway resurfacing projects using asphalt cement concrete removed from an Interstate highway which had become severely rutted.

WHITE-NAPED CRANE Migratory Bird

Thesis (Master's)--University of Washington, 2016-08

Hallux rigidus: Arthroplasty or arthrodesis. What technique produces better results?

Hallux rígidus (HR) affects the first metatarsophalangeal joint (MTPJ) between 35% and 60% of the population over 65 years and there are multiple ways of treatment. Depending on the radiological stage where you find the deformity determines the procedure to be performed; in the early stages cheilectomy techniques and corrective osteotomy is performed while the more advanced ratings, the surgeon chooses destructive techniques considered as arthrodesis and arthroplasty. This final of degree project aims to focus on 1 MTPJ destructive techniques to clarify which of the procedures generates better results by a number of parameters; outcomes of the American Orthopaedic Foot scale and Ankle Society Hallux metatarsophalangeal Interphalangeal-scale (AOFAS), range of motion (ROM) of the 1ºAMTF, radiological classification. As for the implant arthroplasty technique, this article offers information on material and design that generates better relating to patient characteristics such as age, inflammatory joint diseases, viability and durability of the implant results. The conclusion from this review is that the values obtained in the arthrodesis according AOFAS decrease due to loss of mobility, but both techniques have similar values of effectiveness and concludes with the decision that the technique used is determined taking into account various factors and patient characteristics. Keywords: Hallux rígidus; (Hallux Rígidus) and surgery treatment; Hallux Rígidus arthrodesis; Hallux Rígidus arthroplasty; Hallux Rígidus (arthroplasty and arthrodesis).

Little Dairy on the Prairie: From Butter-makin' Women to High-tech Agriculture, July 10, 2008

In 2001, extensive archaeological excavations were conducted at the Oneida Cheese Factory in Jones County. The county is a microcosm of larger dairying trends found throughout northeast Iowa, the state's premier dairy-producing region, Jones County moved from homemade cheese and butter production by farm women, to the industrialization of the dairy farm and opening of cheese factories and butter creameries.A number of innovations affected the industry around the turn-of-the-twentieth century, including reliable butterfat testing, the introduction of ensilage (silos) that created year round milk production, and consolidation of the many local creameries into larger creamery organizations, such as the Diamond Creamery run by Henry D. Sherman of Jones County. Iowa's dairy industry of today looks very different from its heritage: consolidation and competition have drastically reduced the number of cows, dairy farms, and processing plants. In recent years, northeast Iowa has become the center of a movement to revitalize Iowa's dairy industry, particularly through the use of value-added strategies, such as niche markets and large regional co-operatives: the lessons from Iowa's dairying legacy are resurfacing as a solution to modern agricultural challenges.

A review of the S.C. Department of Transportation

Members of the General Assembly asked the Legislative Audit Council to conduct an audit of the S.C. Department of Transportation. The objectives were to:Identify funding levels since FY 05-06 ; Review expenditures since FY 05-06 ; Determine if the department has followed the provisions of Act 114 regarding prioritization ; Review contracting activities for fairness, percentage of out-of-state entity awards, and identify the amount awarded to contractors employing former SCDOT employees ; Report the status of problems identified in the annual audits performed as a result of S.C. Code of Laws §57-1-490 ; Perform a follow-up review of the contracted 2010 MGT, Inc. audit recommendations ; Review pavement resurfacing issues ; Conduct a limited review of certain management-related topics.