Hypercalcaemia and acute renal failure after major burns: An under-diagnosed condition.

BACKGROUND: Hypercalcaemia has been shown to occur in about 20% of patients with major burns requiring prolonged intensive care unit (ICU) treatment, and it may be associated with renal failure. Having observed the early onset of hypercalcaemia, the study aimed to determine the frequency and timing of this condition in a European patient cohort. METHODS: A retrospective cohort study on a prospectively collected, computerised database of the 225 burn-injury ICU admissions between 2001 and 2007 was undertaken. The inclusion criteria included: burns >20% of the body surface area (BSA) or in-hospital stay >20 days. Hypercalcaemia was defined as an ionised plasma calcium (Ca(2+)) concentration >1.32 mmol l(-1) (or total corrected calcium=[Ca]c>2.55 mmol l(-1)). Four emblematic cases are reported in this article. RESULTS: A total of 73 patients met the inclusion criteria (age: 13-88 years, burns: 12-85% BSA): of these, 22 (30%) developed hypercalcaemia. The median time to the first hypercalcaemia value was 21 days. Only 11 patients had both high Ca(2+) and elevated [Ca]c (which remained normal in others). The risk factors of the disorder were burned surface (p=0.017) and immobilisation (fluidised bed use: p<0.05, duration: p=0.02) followed by burned BSA. Acute renal failure tended to be more frequent in hypercalcaemic patients (five (23%) vs. three (6%): p=0.11), while mortality was not increased. The disorder resolved with hydration and mobilisation in most cases: pamidronate was successful in three cases that were most severe. CONCLUSION: Hypercalcaemia and associated acute renal failure occur more frequently and earlier than previously reported. Determining the ionised Ca rather than the total Ca with albumin correction enables earlier detection of hypercalcaemia. Bisphosphonates are an effective treatment option in controlling severe hypercalcaemia and preventing bone loss.

Investigation of high-resolution functional magnetic resonance imaging by means of surface and array radiofrequency coils at 7 T.

In this investigation, high-resolution, 1x1x1-mm(3) functional magnetic resonance imaging (fMRI) at 7 T is performed using a multichannel array head coil and a surface coil approach. Scan geometry was optimized for each coil separately to exploit the strengths of both coils. Acquisitions with the surface coil focused on partial brain coverage, while whole-brain coverage fMRI experiments were performed with the array head coil. BOLD sensitivity in the occipital lobe was found to be higher with the surface coil than with the head array, suggesting that restriction of signal detection to the area of interest may be beneficial for localized activation studies. Performing independent component analysis (ICA) decomposition of the fMRI data, we consistently detected BOLD signal changes and resting state networks. In the surface coil data, a small negative BOLD response could be detected in these resting state network areas. Also in the data acquired with the surface coil, two distinct components of the positive BOLD signal were consistently observed. These two components were tentatively assigned to tissue and venous signal changes.

The fixation of the cemented femoral component. Effects of stem stiffness, cement thickness and roughness of the cement-bone surface.

After cemented total hip arthroplasty (THA) there may be failure at either the cement-stem or the cement-bone interface. This results from the occurrence of abnormally high shear and compressive stresses within the cement and excessive relative micromovement. We therefore evaluated micromovement and stress at the cement-bone and cement-stem interfaces for a titanium and a chromium-cobalt stem. The behaviour of both implants was similar and no substantial differences were found in the size and distribution of micromovement on either interface with respect to the stiffness of the stem. Micromovement was minimal with a cement mantle 3 to 4 mm thick but then increased with greater thickness of the cement. Abnormally high micromovement occurred when the cement was thinner than 2 mm and the stem was made of titanium. The relative decrease in surface roughness augmented slipping but decreased debonding at the cement-bone interface. Shear stress at this site did not vary significantly for the different coefficients of cement-bone friction while compressive and hoop stresses within the cement increased slightly.

Non-resorbable glass fibre-reinforced composite with porous surface as bone substitute material: Experimental studies in vitro and in vivo focused on bone-implant interface

The development of load-bearing osseous implant with desired mechanical and surface properties in order to promote incorporation with bone and to eliminate risk of bone resorption and implant failure is a very challenging task. Bone formation and resoption processes depend on the mechanical environment. Certain stress/strain conditions are required to promote new bone growth and to prevent bone mass loss. Conventional metallic implants with high stiffness carry most of the load and the surrounding bone becomes virtually unloaded and inactive. Fibre-reinforced composites offer an interesting alternative to metallic implants, because their mechanical properties can be tailored to be equal to those of bone, by the careful selection of matrix polymer, type of fibres, fibre volume fraction, orientation and length. Successful load transfer at bone-implant interface requires proper fixation between the bone and implant. One promising method to promote fixation is to prepare implants with porous surface. Bone ingrowth into porous surface structure stabilises the system and improves clinical success of the implant. The experimental part of this work was focused on polymethyl methacrylate (PMMA) -based composites with dense load-bearing core and porous surface. Three-dimensionally randomly orientated chopped glass fibres were used to reinforce the composite. A method to fabricate those composites was developed by a solvent treatment technique and some characterisations concerning the functionality of the surface structure were made in vitro and in vivo. Scanning electron microscope observations revealed that the pore size and interconnective porous architecture of the surface layer of the fibre-reinforced composite (FRC) could be optimal for bone ingrowth. Microhardness measurements showed that the solvent treatment did not have an effect on the mechanical properties of the load-bearing core. A push-out test, using dental stone as a bone model material, revealed that short glass fibre-reinforced porous surface layer is strong enough to carry load. Unreacted monomers can cause the chemical necrosis of the tissue, but the levels of leachable resisidual monomers were considerably lower than those found in chemically cured fibre-reinforced dentures and in modified acrylic bone cements. Animal experiments proved that surface porous FRC implant can enhance fixation between bone and FRC. New bone ingrowth into the pores was detected and strong interlocking between bone and the implant was achieved.

No evidence of association of MUC-1 genetic polymorphism with embryo implantation failure

Pregnancy loss can be caused by several factors involved in human reproduction. Although up to 50% of cases remain unexplained, it has been postulated that the major cause of failed pregnancy is an error of embryo implantation. Transmembrane mucin-1 (MUC-1) is a glycoprotein expressed on the endometrial cell surface which acts as a barrier to implantation. The gene that codes for this molecule is composed of a polymorphic tandem repeat of 60 nucleotides. Our objective was to determine if MUC-1 genetic polymorphism is associated with implantation failure in patients with a history of recurrent abortion. The study was conducted on 10 women aged 25 to 35 years with no history of successful pregnancy and with a diagnosis of infertility. The control group consisted of 32 patients aged 25 to 35 years who had delivered at least two full-term live children and who had no history of abortions or fetal losses. MUC-1 amplicons were obtained by PCR and observed on agarose and polyacrylamide gel after electrophoresis. Statistical analysis showed no significant difference in the number of MUC-1 variable number of tandem repeats between these groups (P > 0.05). Our results suggest that there is no effect of the polymorphic MUC-1 sequence on the implantation failure. However, the data do not exclude MUC-1 relevance during embryo implantation. The process is related to several associated factors such as the mechanisms of gene expression in the uterus, specific MUC-1 post-translational modifications and appropriate interactions with other molecules during embryo implantation.

Armourstone revetments : will standard design criteria prevent failure? /

Bank stabilization structures are used to prevent the loss of valuable land within the urban environment and the decision for the type of structure used depends on the properties of the stream. In the urban areas of Southern Ontario there is a preference for the use of armourstone blocks as bank stabilization. The armourstone revetment is a free standing stone structure with large blocks of stone layered vertically and offset from one another. During fieldwork at Forty Mile Creek in Grimsby, Ontario armourstone failure was identified by the removal of two stones within one column from the wall. Since the footer stones were still in place, toe scour was eliminated as a cause of failure. Through theoretical, field, and experimental work the process of suction has been identified as a mode of failure for the armourstone wall and the process of suction works similarly to quarrying large blocks of rock off bedrock streambeds. The theory of lateral suction has previously not been taken into consideration for the design of these walls. The physical and hydraulic evidence found in the field and studied during experimental work indicate that the armourstone wall is vulnerable to the process of suction. The forces exerted by the flow and the resistance of the block determine the stability of the armourstone block within the wall. The design of the armourstone wall, high surface velocities, and short pulses of faster flowing water within the profile could contribute to armourstone failure by providing the forces needed for suction to occur, therefore adjustments to the design of the wall should be made in order to limit the effect.

Scanning Electron Microscopy Studies on Tear and Wear Failure of Short Kevlar Fiber-Thermoplastic- Polyurethane Composite

Tear and wear properties of short kevlar fiber, thermoplastic polcurethane (TPU) composite with respect to fiber loading-and fiber onentation has been studied and the fracture surfaces were examined under scanning electron microscope (SEM). Tear strength first decreased up to 20 phr fiber loading and then gradually increased with increasing fiber loading. Anisotropy in tear strength was evident beyond a fiber loading of 20 phr. Tear fracture surface of unfilled TPU showed sinusoidal folding characteristics of high strength matrix. At low fiber loading the tear failure was mainly due to fibermatrix failure whereas at higher fiber loading the failure occurred by fiber breakage. Abrasion loss shows a continuous rise with increasing fiber loading, the loss in the transverse orientation of fibers being higher than that in the longitudinal orientation. The abraded surface showed lone cracks and ridges parallel to the direction of abrasion indicating an abrasive wear mechanism. In the presence of fber the abrasion loss was mainly due to fiber low.

Spatio-temporal surface soil heat flux estimates from satellite data: results for the AMMA experiment at the Fakara (Niger) supersite

This paper describes a method that employs Earth Observation (EO) data to calculate spatiotemporal estimates of soil heat flux, G, using a physically-based method (the Analytical Method). The method involves a harmonic analysis of land surface temperature (LST) data. It also requires an estimate of near-surface soil thermal inertia; this property depends on soil textural composition and varies as a function of soil moisture content. The EO data needed to drive the model equations, and the ground-based data required to provide verification of the method, were obtained over the Fakara domain within the African Monsoon Multidisciplinary Analysis (AMMA) program. LST estimates (3 km × 3 km, one image 15 min−1) were derived from MSG-SEVIRI data. Soil moisture estimates were obtained from ENVISAT-ASAR data, while estimates of leaf area index, LAI, (to calculate the effect of the canopy on G, largely due to radiation extinction) were obtained from SPOT-HRV images. The variation of these variables over the Fakara domain, and implications for values of G derived from them, were discussed. Results showed that this method provides reliable large-scale spatiotemporal estimates of G. Variations in G could largely be explained by the variability in the model input variables. Furthermore, it was shown that this method is relatively insensitive to model parameters related to the vegetation or soil texture. However, the strong sensitivity of thermal inertia to soil moisture content at low values of relative saturation (<0.2) means that in arid or semi-arid climates accurate estimates of surface soil moisture content are of utmost importance, if reliable estimates of G are to be obtained. This method has the potential to improve large-scale evaporation estimates, to aid land surface model prediction and to advance research that aims to explain failure in energy balance closure of meteorological field studies.

Probabilistic physically-based cloud screening of satellite infra-red imagery for operational sea surface temperature retrieval

We propose and demonstrate a fully probabilistic (Bayesian) approach to the detection of cloudy pixels in thermal infrared (TIR) imagery observed from satellite over oceans. Using this approach, we show how to exploit the prior information and the fast forward modelling capability that are typically available in the operational context to obtain improved cloud detection. The probability of clear sky for each pixel is estimated by applying Bayes' theorem, and we describe how to apply Bayes' theorem to this problem in general terms. Joint probability density functions (PDFs) of the observations in the TIR channels are needed; the PDFs for clear conditions are calculable from forward modelling and those for cloudy conditions have been obtained empirically. Using analysis fields from numerical weather prediction as prior information, we apply the approach to imagery representative of imagers on polar-orbiting platforms. In comparison with the established cloud-screening scheme, the new technique decreases both the rate of failure to detect cloud contamination and the false-alarm rate by one quarter. The rate of occurrence of cloud-screening-related errors of >1 K in area-averaged SSTs is reduced by 83%. Copyright © 2005 Royal Meteorological Society.

Calibration of structure in a distributed forecasting model for a semiarid flash flood: dynamic surface storage and channel roughness

Flash floods pose a significant danger for life and property. Unfortunately, in arid and semiarid environment the runoff generation shows a complex non-linear behavior with a strong spatial and temporal non-uniformity. As a result, the predictions made by physically-based simulations in semiarid areas are subject to great uncertainty, and a failure in the predictive behavior of existing models is common. Thus better descriptions of physical processes at the watershed scale need to be incorporated into the hydrological model structures. For example, terrain relief has been systematically considered static in flood modelling at the watershed scale. Here, we show that the integrated effect of small distributed relief variations originated through concurrent hydrological processes within a storm event was significant on the watershed scale hydrograph. We model these observations by introducing dynamic formulations of two relief-related parameters at diverse scales: maximum depression storage, and roughness coefficient in channels. In the final (a posteriori) model structure these parameters are allowed to be both time-constant or time-varying. The case under study is a convective storm in a semiarid Mediterranean watershed with ephemeral channels and high agricultural pressures (the Rambla del Albujón watershed; 556 km 2 ), which showed a complex multi-peak response. First, to obtain quasi-sensible simulations in the (a priori) model with time-constant relief-related parameters, a spatially distributed parameterization was strictly required. Second, a generalized likelihood uncertainty estimation (GLUE) inference applied to the improved model structure, and conditioned to observed nested hydrographs, showed that accounting for dynamic relief-related parameters led to improved simulations. The discussion is finally broadened by considering the use of the calibrated model both to analyze the sensitivity of the watershed to storm motion and to attempt the flood forecasting of a stratiform event with highly different behavior.

Monitoring Surface Displacement of the Colby Green Retaining Pond Dams

The Colby Green is a campus expansion project which began in October of 2003. The construction would result in three new buildings, additional parking, and an elliptical 75,000-squarefoot green southeast of Mayflower Hill Drive. There were also plans for the construction of three run-off management and sediment ponds below the green, to manage flooding of the green. Three drains in the green transport water to the three retaining ponds which slowly disperse water into the surrounding environment. The ponds were created by constructing earthen dams around the drain outlets. The dams are composed of soil, cobbles, and boulders procured from the surrounding excavation site. Unfortunately, earthen dams are susceptible to many types of erosion which result in their failure. In this case the potential for clay and silt from the underlying Presumpscot Formation to mix with the soil in the earthen dams raised concerns with regards to frost action. In order to monitor the surface displacement of the dams I drove 92 poles into the ground in 8 straight lines across the faces of the dams in the fall of 2005. I returned to the sites during and after the spring thaw of 2006, to check for any signs of movement resulting from frost-heave, surface creep, or any other form of mass wasting. Fortunately, there was no recordable sign of movement in the stakes across any of the retaining ponds. The dams appear to be functioning as designed.

3-D reconstruction by extended depth-of-field in failure analysis - Case study II: Fractal analysis of interlaminar fracture in carbon/epoxy composites

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

THE EFFECT of DIFFERENT SURFACE TREATMENTS on THE SHEAR BOND STRENGTH of LUTING CEMENTS TO TITANIUM

Statement of problem. Although titanium presents attractive physical and mechanical properties, there is a need for improving the bond at the titanium/luting cement interface for the longevity of metal ceramic restorations.Purpose. The purpose of this study was to evaluate the effect of surface treatments on the shear bond strength (SBS) of resin-modified glass ionomer and resin cements to commercially pure titanium (CP Ti).Material and methods. Two hundred and forty CP Ti cast disks (9.0 x 3.0 mm) were divided into 8 surface treatment groups (n=30): 1) 50 mu m Al2O3 particles; 2) 120 mu m Al2O3 particles; 3) 250 mu m Al2O3 particles; 4) 50 mu m Al2O3 particles + silane (RelyX Ceramic Primer); 5) 120 mu m Al2O3 particles + silane; 6) 250 mu m Al2O3 particles + silane; 7) 30 mu m silica-modified Al2O3 particles (Cojet Sand) + silane; and 8) 120 mu m Al2O3 particles, followed by 110 mu m silica-modified Al2O3 particles (Rocatec). The luting cements 1) RelyX Luting 2; 2) RelyX ARC; or 3) RelyX U100 were applied to the treated CP Ti surfaces (n=10). Shear bond strength (SBS) was tested after thermal cycling (5000 cycles, 5 degrees C to 55 degrees C). Data were analyzed by 2-way analysis of variance (ANOVA) and the Tukey HSD post hoc test (alpha=.05). Failure mode was determined with a stereomicroscope (x20).Results. The surface treatments, cements, and their interaction significantly affected the SBS (P<.001). RelyX Luting 2 and RelyX U100 exhibited similar behavior for all surface treatments. For both cements, only the group abraded with 50 mu m Al2O3 particles had lower SBS than the other groups (P<.05). For RelyX ARC, regardless of silane application, abrasion with 50 mu m Al2O3 particles resulted in significantly lower SBS than abrasion with 120 mu m and 250 mu m particles, which exhibited statistically similar SBS values to each other. Rocatec + silane promoted the highest SBS for RelyX ARC. RelyX U100 presented the highest SBS mean values (P<.001). All groups showed a predominance of adhesive failure mode.Conclusions. The adhesive capability of RelyX Luting 2 and RelyX U100 on the SBS was decisive, while for RelyX ARC, mechanical and chemical factors were more influential. (J Prosthet Dent 2012;108:370-376)

Efficacy of Air-abrasion Technique and Additional Surface Treatment at Titanium/Resin Cement Interface

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Adhesive Bonding of Resin Composite to Various Ni-Cr Alloy Surfaces Using Different Metal Conditioners and a Surface Modification System

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)