What is the frequency of nerve injuries associated with acetabular fractures?

BACKGROUND Acetabular fractures and surgical interventions used to treat them can result in nerve injuries. To date, only small case studies have tried to explore the frequency of nerve injuries and their association with patient and treatment characteristics. High-quality data on the risk of traumatic and iatrogenic nerve lesions and their epidemiology in relation to different fracture types and surgical approaches are lacking. QUESTIONS/PURPOSES The purpose of this study was to determine (1) the proportion of patients who develop nerve injuries after acetabular fracture; (2) which fracture type(s) are associated with increased nerve injury risk; and (3) which surgical approach was associated with the highest proportion of patients developing nerve injuries using data from the German Pelvic Trauma Registry. Two secondary aims were (4) to assess hospital volume-nerve-injury relationship; and (5) internal data validity. METHODS Between March 2001 and June 2012, 2236 patients with acetabular fractures were entered into a prospectively maintained registry from 29 hospitals; of those, 2073 (92.7%) had complete records on the endpoints of interest in this retrospective study and were analyzed. The neurological status in these patients was captured at their admission and at the discharge. A total of 1395 of 2073 (67%) patients underwent surgery, and the proportions of intervention-related and other hospital-acquired nerve injuries were obtained. Overall proportions of patients developing nerve injuries, risk based on fracture type, and risk of surgical approach type were analyzed. RESULTS The proportion of patients being diagnosed with nerve injuries at hospital admission was 4% (76 of 2073) and at discharge 7% (134 or 2073). Patients with fractures of the "posterior wall" (relative risk [RR], 2.0; 95% confidence interval [CI], 1.4-2.8; p=0.001), "posterior column and posterior wall" (RR, 2.9; CI, 1.6-5.0; p=0.002), and "transverse+posterior wall" fracture (RR, 2.1; CI, 1.3-3.5; p=0.010) were more likely to have nerve injuries at hospital discharge. The proportion of patients with intervention-related nerve injuries and that of patients with other hospital-acquired nerve injuries was 2% (24 of 1395 and 46 of 2073, respectively). They both were associated with the Kocher-Langenbeck approach (RR, 3.0; CI, 1.4-6.2; p=0.006; and RR, 2.4; CI, 1.4-4.3; p=0.004, respectively). CONCLUSIONS Acetabular fractures with the involvement of posterior wall were most commonly accompanied with nerve injuries. The data suggest also that Kocher-Langenbeck approach to the pelvic ring is associated with a higher risk of perioperative nerve injuries. Trauma surgeons should be aware of common nerve injuries, particularly in posterior wall fractures. The results of the study should help provide patients with more exact information on the risk of perioperative nerve injuries in acetabular fractures. LEVEL OF EVIDENCE Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

High-Spin Molecules: Synthesis, X-ray Characterization, and Magnetic Behavior of Two New Cyano-Bridged Ni II 9 Mo V 6 and Ni II 9 W V 6 Clusters with a S = 12 Ground State

The preparations, X-ray structures, and magnetic characterizations are presented for two new pentadecanuclear cluster compounds:  [NiII{NiII(MeOH)3}8(μ-CN)30{MV(CN)3}6]·xMeOH·yH2O (MV = MoV (1) with x = 17, y = 1; MV = WV (2) with x = 15, y = 0). Both compounds crystallize in the monoclinic space group C2/c, with cell dimensions of a = 28.4957(18) Å, b = 19.2583(10) Å, c = 32.4279(17) Å, β = 113.155(6)°, and Z = 4 for 1 and a = 28.5278(16) Å, b = 19.2008(18) Å, c = 32.4072(17) Å, β = 113.727(6)°, and Z = 4 for 2. The structures of 1 and 2 consist of neutral cluster complexes comprising 15 metal ions, 9 NiII and 6 MV, all linked by μ-cyano ligands. Magnetic susceptibilities and magnetization measurements of compounds 1 and 2 in the crystalline and dissolved state indicate that these clusters have a S = 12 ground state, originating from intracluster ferromagnetic exchange interactions between the μ-cyano-bridged metal ions of the type NiII−NC−MV. Indeed, these data show clearly that the cluster molecules stay intact in solution. Ac magnetic susceptibility measurements reveal that the cluster compounds exhibit magnetic susceptibility relaxation phenomena at low temperatures since, with nonzero dc fields, χ‘ ‘M has a nonzero value that is frequency dependent. However, there appears no out-of-phase (χ‘ ‘M) signal in zero dc field down to 1.8 K, which excludes the expected signature for a single molecule magnet. This finding is confirmed with the small uniaxial magnetic anisotropy value for D of 0.015 cm-1, deduced from the high-field, high-frequency EPR measurement, which distinctly reveals a positive sign in D. Obviously, the overall magnetic anisotropy of the compounds is too low, and this may be a consequence of a small single ion magnetic anisotropy combined with the highly symmetric arrangement of the metal ions in the cluster molecule.

High-resolution multi-proxy record of the last interglacial period from Lake Van, eastern Anatolian high plateau, Turkey

A high-resolution multi-proxy record from Lake Van, eastern Anatolia, derived from a lacustrine sequence cored at the 357 m deep Ahlat Ridge (AR), allows a comprehensive view of paleoclimate and environmental history in the continental Near East during the last interglacial (LI). We combined paleovegetation (pollen), stable oxygen isotope (d18Obulk) and XRF data from the same sedimentary sequence, showing distinct variations during the period from 135 to 110 ka ago leading into and out of full interglacial conditions. The last interglacial plateau, as defined by the presence of thermophilous steppe-forest communities, lasted ca. 13.5 ka, from ~129.1-115.6 ka BP. The detailed palynological sequence at Lake Van documents a vegetation succession with several climatic phases: (I) the Pistacia zone (ca. 131.2-129.1 ka BP) indicates summer dryness and mild winter conditions during the initial warming, (II) the Quercus-Ulmus zone (ca. 129.1-127.2 ka BP) occurred during warm and humid climate conditions with enhanced evaporation, (III) the Carpinus zone (ca. 127.2-124.1 ka BP) suggest increasingly cooler and wetter conditions, and (IV) the expansion of Pinus at ~124.1 ka BP marks the onset of a colder/drier environment that extended into the interval of global ice growth. Pollen data suggest migration of thermophilous trees from refugial areas at the beginning of the last interglacial. Analogous to the current interglacial, the migration documents a time lag between the onset of climatic amelioration and the establishment of an oak steppe-forest, spanning 2.1 ka. Hence, the major difference between the last interglacial compared to the current interglacial (Holocene) is the abundance of Pinus as well as the decrease of deciduous broad-leaved trees, indicating higher continentality during the last interglacial. Finally, our results demonstrate intra-interglacial variability in the low mid-latitudes and suggest a close connection with the high-frequency climate variability recorded in Greenland ice cores.

Agaete revisited: new data on the Gran Canaria tsunamiites.

The tsunami deposits of the valley of Agaete (Pérez-Torrado et al., 2006), north-western Gran Canaria, attributed to the Guimar flank collapse in Tenerife, have been revisited and new data are presented here. Besides the occurrences reported by Pérez-Torrado et al. (2006) a new outcrop was found and named “La Ruina” (at 28º 05’ 47,41” N; 15º 41’ 52,04” W; 71 m asl). The above-mentioned authors suggested the possibility that more than one marine conglomerate deposit could be present in the outcrops of “Llanos de Turmán” and “Berrazales”. At “La Gasolinera” and “La Aldea 1” the conglomerates are formed by a single layer representing one depositional event; at “La Aldea 2”, the conglomerates are composed of two layers directly contacting with each other, but evidence of a time hiatus between them was not found. Although the hypothesis of stacking of two depositional units within the same episode versus deposition of two distinct layers in different time-moments is debatable at the present state of knowledge, the first possibility is favoured. The field evidence at “Llanos de Turman” and “Berrazales” unquestionably shows that terrestrial sediments (colluvia; paleosols) are present and separate two marine conglomerate deposits, indicating that at least two distinct tsunami inundations are needed to explain the stratigraphy. However, at the new “La Ruina” outcrop, besides the two deposits mentioned above, a third and older marine conglomerate was found, clearly separated in time from the ones cited above. The existence of marine conglomerates emplaced in different moments is evidenced by the occurrence of intercalated paleosols, colluvia and other subaerial materials, implying significant time intervals between the emplacement of marine conglomeratic layers. A number of gastropod operculae from the tsunamiites were sent for U-Th dating to try to further constrain the age span of these deposits. The field evidence presented above shows that the emplacement of the deposits is related to, at least, three tsunami events. The lateral correlation between different outcrops is difficult due to variable number of deposits in each outcrop, lateral discontinuity and variability, and to compositional and textural similarity between distinct tsunami sediments. The occurrence of three Pleistocene tsunami deposits in the same area points to a relatively high frequency of tsunamis (generated by landslides, surface rupturing earthquakes, fast entry of voluminous volcanic deposits into the sea or large submarine eruptions). It is possible that this recurrence of tsunami inundations may reflect multiple-phased landslides responsible for the mega-landslide scars prominent in the geomorphology of the neighbouring island of Tenerife. This is a contribution from project “Estabilidad de los edificios volcánicos en Canarias: análisis de los factores geológicos, geomecánicos y paleoclimáticos. Aplicación a los flancos N y S de la isla de Tenerife” financed by MCT, Spain.

Modelling and Control of Stepper Motors for High Accuracy Positioning Systems Used in Radioactive Environments

Hybrid Stepper Motors are widely used in open-loop position applications. They are the choice of actuation for the collimators in the Large Hadron Collider, the largest particle accelerator at CERN. In this case the positioning requirements and the highly radioactive operating environment are unique. The latter forces both the use of long cables to connect the motors to the drives which act as transmission lines and also prevents the use of standard position sensors. However, reliable and precise operation of the collimators is critical for the machine, requiring the prevention of step loss in the motors and maintenance to be foreseen in case of mechanical degradation. In order to make the above possible, an approach is proposed for the application of an Extended Kalman Filter to a sensorless stepper motor drive, when the motor is separated from its drive by long cables. When the long cables and high frequency pulse width modulated control voltage signals are used together, the electrical signals difer greatly between the motor and drive-side of the cable. Since in the considered case only drive-side data is available, it is therefore necessary to estimate the motor-side signals. Modelling the entire cable and motor system in an Extended Kalman Filter is too computationally intensive for standard embedded real-time platforms. It is, in consequence, proposed to divide the problem into an Extended Kalman Filter, based only on the motor model, and separated motor-side signal estimators, the combination of which is less demanding computationally. The efectiveness of this approach is shown in simulation. Then its validity is experimentally demonstrated via implementation in a DSP based drive. A testbench to test its performance when driving an axis of a Large Hadron Collider collimator is presented along with the results achieved. It is shown that the proposed method is capable of achieving position and load torque estimates which allow step loss to be detected and mechanical degradation to be evaluated without the need for physical sensors. These estimation algorithms often require a precise model of the motor, but the standard electrical model used for hybrid stepper motors is limited when currents, which are high enough to produce saturation of the magnetic circuit, are present. New model extensions are proposed in order to have a more precise model of the motor independently of the current level, whilst maintaining a low computational cost. It is shown that a significant improvement in the model It is achieved with these extensions, and their computational performance is compared to study the cost of model improvement versus computation cost. The applicability of the proposed model extensions is demonstrated via their use in an Extended Kalman Filter running in real-time for closed-loop current control and mechanical state estimation. An additional problem arises from the use of stepper motors. The mechanics of the collimators can wear due to the abrupt motion and torque profiles that are applied by them when used in the standard way, i.e. stepping in open-loop. Closed-loop position control, more specifically Field Oriented Control, would allow smoother profiles, more respectful to the mechanics, to be applied but requires position feedback. As mentioned already, the use of sensors in radioactive environments is very limited for reliability reasons. Sensorless control is a known option but when the speed is very low or zero, as is the case most of the time for the motors used in the LHC collimator, the loss of observability prevents its use. In order to allow the use of position sensors without reducing the long term reliability of the whole system, the possibility to switch from closed to open loop is proposed and validated, allowing the use of closed-loop control when the position sensors function correctly and open-loop when there is a sensor failure. A different approach to deal with the switched drive working with long cables is also presented. Switched mode stepper motor drives tend to have poor performance or even fail completely when the motor is fed through a long cable due to the high oscillations in the drive-side current. The design of a stepper motor output fillter which solves this problem is thus proposed. A two stage filter, one devoted to dealing with the diferential mode and the other with the common mode, is designed and validated experimentally. With this ?lter the drive performance is greatly improved, achieving a positioning repeatability even better than with the drive working without a long cable, the radiated emissions are reduced and the overvoltages at the motor terminals are eliminated.

Social transmission of reproductive behavior increases frequency of inherited disorders in a young-expanding population

The observation of high frequencies of certain inherited disorders in the population of Saguenay–Lac Saint Jean can be explained in terms of the variance and the correlation of effective family size (EFS) from one generation to the next. We have shown this effect by using the branching process approach with real demographic data. When variance of EFS is included in the model, despite its profound effect on mutant allele frequency, any mutant introduced in the population never reaches the known carrier frequencies (between 0.035 and 0.05). It is only when the EFS correlation between generations is introduced into the model that we can explain the rise of the mutant alleles. This correlation is described by a c parameter that reflects the dependency of children’s EFS on their parents’ EFS. The c parameter can be considered to reflect social transmission of demographic behavior. We show that such social transmission dramatically reduces the effective population size. This could explain particular distributions in allele frequencies and unusually high frequency of certain inherited disorders in some human populations.

(Table 2) Aragonite, high and low magnesium calcite, major elements, bioclast and planktic foraminifera from ODP Hole 133-817A

Investigation of the Middle Miocene-Pleistocene succession in cores at ODP Site 817A (Leg 133), drilled on the slope south of the Queensland Plateau, identified the various material fluxes contributing to sedimentation and has determined thereby the paleogeographic events which occurred close to the studied area and influenced these fluxes. To determine proportions of platform origin and of plankton origin of carbonate mud, two reference sediments were collected: (1) back-reef carbonate mud from the Young Reef area (Great Barrier Reef); and (2) Late Miocene chalk from the Loyalty Basin, off New Caledonia. Through their biofacies and mineralogical and geochemical characters, these reference sediments were used to distinguish the proportions of platform and basin components in carbonate muds of 25 core samples from Hole 817A. Two "origin indexes" (i1 and i2) relate the proportion in platform and basin materials. The relative sedimentation rate is inferred from the high-frequency cycles determined by redox intervals in the cores. Bulk carbonate deposited in each core has been calculated in two ways with close results: (1) from calcimetric data available in the Leg 133 preliminary reports (Davies et al., 1991); and (2) from average magnetic susceptibility of cores, a value negatively correlated to the average carbonate content. Vertical changes in sedimentation rates, in carbonate content, in origin indexes and in "linear fluxes" document the evolution of sediment origins from platform carbonates, planktonic carbonates and insoluble material through time. These data are augmented with the variations in organic-matter content through the 817A succession. The observed changes and their interpretation are not modified by compaction, and are compatible with major paleogeographic events including drowning of the Queensland Plateau (Middle Miocene-Early Pliocene) and the renewal of shallow carbonate production, (1) during the Late Pliocene, and (2) from the Early Pleistocene. The birth and growth of the Great Barrier Reef is also recorded from 0.5 Ma by a strengthening of detrital carbonate deposition and possibly by a lack of clay minerals in the 4 upper cores, a response to trapping of terrigenous material behind this barrier. In addition, a maximum of biological silica production is displayed in the Middle Miocene. These changes constrain the time of events and the sequence-stratigraphy framework some components of which are transgression surface, maximum flooding surface and low-stand turbidites. Sedimentation rates and material fluxes show cycles lasting 1.75 Myr. Whatever their origin (climatic and/or eustatic) these cycles affected the planktonic production primarily. The changes also show that major carbonate variations in the deposits are due to a dilution effect by insoluble material (clay, biogenic silica and volcanic glasses) and that plankton productivity, controlling the major fraction of carbonate sedimentation, depends principally on terrigenous supplies, but also on deep-water upwelling. Accuracy of the method is reduced by redeposition, reworking, and probable occurrence of hiatuses.

Milankovitch frequency peaks of ODP Site 113-693 (Table 3)

The first well logs collected below the Antarctic circle were obtained during Leg 113 at Site 693 on the Dronning Maud Land Margin (Antarctica) in the Weddell Sea. Gamma-ray, resistivity, and sonic logs were collected between 108.0 and 439.0 mbsf. The downhole logs show good agreement with the data collected from cores and provide a continuous measurement of the sedimentary record. These continuous log records show that the rather uniform Tertiary lithology seen in cores is characterized by high-frequency variability in the log data. Several thin hard streaks are identified, the largest of which coincides with a major Miocene hiatus. Associated with this hiatus is a change to lower illite content (and correspondingly lower gamma-ray counts) and to a significant increase in diatom content. Spectral analysis of the logs was performed on the lower Pliocene through upper Oligocene interval (108.0-343.0 mbsf). Between 108.0 and 245.0 mbsf, average sedimentation rates (50 and 26 m/m.y.) are high enough to show that variance is present in the orbital eccentricity (~95 k.y.) and obliquity (~41 k.y.) bands. Between 253.0 and 343.0 mbsf, the sedimentation rate (8 m/m.y.) is too low to resolve high frequency variations. The Milankovitch frequencies are best developed in the resistivity logs. Resistivity is responding to changes in porosity, which in these sediments is controlled by the abundance of biosiliceous sediments, particularly diatoms. The orbital forcing suggested by the Milankovitch frequencies may be influencing diatom productivity by inducing oscillations in upwelling, ice coverage, pack ice, and/or polynya. Although variations in diatom abundance were observed in the cores, they were not attributed to a Milankovitch signal, and therefore in this environment, downhole logs are an important contribution to the detection and understanding of orbitally influenced changes in sedimentation.