Congenital upper limb defects in Finland 1993-2005

Background: Interest in limb defects has grown after the thalidomide tragedy in the 1960s. As a result, congenital malformation registries, monitoring changes in birthprevalence and defect patterns, have been established in several countries. However, there are only a few true population based studies on birth prevalence of upper limb defects. The burden of hospital care among these children, specifically in terms of the number of admissions and total time spent in hospital, is also unknown. Aims and Methods: This study is based on information gathered from the Finnish Register of Congenital malformations (FRM) and the Finnish Hospital Discharge Register (FHDR). A total of 417 children born between 1993 and 2005 with an upper limb defect were gathered from the FRM. The upper limb defects were classified using the International Federation of Societies for Surgery of the Hand -classification that enables comparison with previous and future studies. Birth and live birth prevalence, sex and side distribution, frequency of associated anomalies as well as the proportion of perinatal and infant deaths according to the different subtypes were calculated. The number of hospital admissions, days spent in hospital, number and type of surgical operations were collected from the FHDR. Special features of two subgroups, radial ray defects (RRD) and constriction band syndrome (CBS), were explored. Results: Upper limb defects were observed in 417 of 753 342 consecutive births and in 392 of 750 461 live births. Birth prevalence was 5.5 per 10 000 births and 5.2 per 10 000 live births. Multiple anomalies or a known syndrome was found in 250 cases (60%). Perinatal mortality was 139 per 1000 births and infant mortality 135 per 1000 live births (overall Finnish perinatal mortality <5 per 1000 births and infant mortality 3.7 per 1000 live births). Altogether, 138 infants had RRD and 120 (87%) of these had either a known syndrome or multiple major anomalies. The proportion of perinatal deaths in RRD group was 29% (40/138) and infant deaths 35% (43/123). Fifty-one children had CBS in upper limbs. Fifteen of these (29%) had other major anomalies associated with constriction rings. The number of hospital admissions per year of children with congenital upper limb defects was 11-fold and the time spent in hospital 13-fold as compared with the general paediatric population. Conclusions: Birth prevalence of congenital upper limb defects was 5.5 per 10 000 births and 5.2 per 10 000 live births. RRD was especially associated with other major anomalies and high mortality. Nearly one third of the children with CBS also had other major anomalies suggesting different aetiologies inside the group. The annual burden of hospital care of children with congenital upper limb defects was at least 11-fold as compared with the general paediatric population.

Congenital ventricular septal defects and prenatal exposure to cyclooxygenase inhibitors

Ventricular septal defects (VSDs) are common congenital abnormalities which have been reported to be associated with maternal fever and various environmental factors. The aim of the present study was to evaluate the effect of prenatal exposure to cyclooxygenase (COX) inhibitors on heart defects. A retrospective statistical analysis was performed using data collected in our laboratory during various teratological studies carried out on albino CRL:(WI)WUBR Wistar strain rats from 1997 to 2004. The observations were compared with concurrent and historic control data, as well as findings from other developmental toxicological studies with selective and nonselective COX-2 inhibitors. Despite the lack of significant differences in the frequency of VSDs between drug-exposed and control groups, statistical analysis by the two-sided Mantel-Haenszel test and historical control data showed a higher incidence of heart defects in offspring exposed to nonselective COX inhibitors (30.06/10,000). Unlike other specific inhibitors, aspirin (46.26/10,000) and ibuprofen (106.95/10,000) significantly increased the incidence of the VSD when compared with various control groups (5.38-19.72/10,000). No significant differences in length or weight were detected between fetuses exposed to COX inhibitors and born with VSD and non-malformed offsprings. However, a statistically significant increase of fetal body length and decrease of body mass index were found in fetuses exposed to COX inhibitors when compared with untreated control. We conclude that prenatal exposure to COX inhibitors, especially aspirin and ibuprofen, increased the incidence of VSDs in rat offspring but was not related to fetal growth retardation.

Neutrophil function and metabolism in individuals with diabetes mellitus

Neutrophils act as first-line-of-defense cells and the reduction of their functional activity contributes to the high susceptibilityto and severity of infections in diabetes mellitus. Clinical investigations in diabetic patients and experimental studies in diabetic rats and mice clearly demonstrated consistent defects of neutrophil chemotactic, phagocytic and microbicidal activities. Other alterations that have been reported to occur during inflammation in diabetes mellitus include: decreased microvascular responses to inflammatory mediators such as histamine and bradykinin, reduced protein leakage and edema formation, reduced mast cell degranulation, impairment of neutrophil adhesionto the endothelium and migration to the site of inflammation, production of reactive oxygen species and reduced release of cytokines and prostaglandin by neutrophils, increased leukocyte apoptosis, and reduction in lymph node retention capacity. Since neutrophil function requires energy, metabolic changes (i.e., glycolytic and glutaminolytic pathways) may be involved in the reduction of neutrophil function observed in diabetic states. Metabolic routes by which hyperglycemia is linked to neutrophil dysfunction include the advanced protein glycosylation reaction, the polyol pathway, oxygen-free radical formation, the nitric oxide-cyclic guanosine-3'-5'monophosphate pathway, and the glycolytic and glutaminolytic pathways. Lowering of blood glucose levels by insulin treatment of diabetic patients or experimental animals has been reported to have significant correlation with improvement of neutrophil functional activity. Therefore, changes might be primarily linked to a continuing insulin deficiency or to secondary hyperglycemia occurring in the diabetic individual. Accordingly, effective control with insulin treatment is likely to be relevant during infection in diabetic patients.

Lipolysis of emulsion models of triglyceride-rich lipoproteins is altered in male patients with abdominal aorta aneurysm

Disorders of the lipid metabolism may play a role in the genesis of abdominal aorta aneurysm. The present study examined the intravascular catabolism of chylomicrons, the lipoproteins that carry the dietary lipids absorbed by the intestine in the circulation in patients with abdominal aorta aneurysm. Thirteen male patients (72 ± 5 years) with abdominal aorta aneurysm with normal plasma lipid profile and 13 healthy male control subjects (73 ± 5 years) participated in the study. The method of chylomicron-like emulsions was used to evaluate this metabolism. The emulsion labeled with 14C-cholesteryl oleate and ³H-triolein was injected intravenously in both groups. Blood samples were taken at regular intervals over 60 min to determine the decay curves. The fractional clearance rate (FCR) of the radioactive labels was calculated by compartmental analysis. The FCR of the emulsion with ³H-triolein was smaller in the aortic aneurysm patients than in controls (0.025 ± 0.017 vs 0.039 ± 0.019 min-1; P < 0.05), but the FCR of14C-cholesteryl oleate of both groups did not differ. In conclusion, as indicated by the triglyceride FCR, chylomicron lipolysis is diminished in male patients with aortic aneurysm, whereas the remnant removal which is traced by the cholesteryl oleate FCR is not altered. The results suggest that defects in the chylomicron metabolism may represent a risk factor for development of abdominal aortic aneurysm.

FANCD2 Western blot as a diagnostic tool for Brazilian patients with Fanconi anemia

Fanconi anemia is a rare hereditary disease showing genetic heterogeneity due to a variety of mutations in genes involved in DNA repair pathways, which may lead to different clinical manifestations. Phenotypic variability makes diagnosis difficult based only on clinical manifestations, therefore laboratory tests are necessary. New advances in molecular pathogenesis of this disease led researchers to develop a diagnostic test based on Western blot for FANCD2. The objective of the present study was to determine the efficacy of this method for the diagnosis of 84 Brazilian patients with Fanconi anemia, all of whom tested positive for the diepoxybutane test, and 98 healthy controls. The FANCD2 monoubiquitinated isoform (FANCDS+/FANCD2L-) was not detected in 77 patients (91.7%). In 2 patients (2.4%), there was an absence of both the monoubiquitinated and the non-ubiquitinated proteins (FANCD2S-/FANCD2L-) and 5 patients (5.9%) had both isoforms (FANCD2S+/FANCD2L+). This last phenotype suggests downstream subtypes or mosaicism. All controls were diepoxybutane negative and were also negative on the FANCD2 Western blot. The Western blot for FANCD2 presented a sensitivity of 94% (79/84) and specificity of 100% (98/98). This method was confirmed as an efficient approach to screen Brazilian patients with deleterious mutations on FANCD2 (FANCD2S-/FANCD2L-) or other upstream genes of the FA/BRCA pathway (FANCDS+/FANCD2L-), to confirm the chromosome breakage test and to classify patients according to the level of FA/BRCA pathway defects. However, patients showing both FANCD2 isoforms (FANCD2S+/FANCD2L+) require additional studies to confirm mutations on downstream Fanconi anemia genes or the presence of mosaicism.

Sensitivity to differences between posed and genuine facial expressions : are children easily fooled? /

Adults and children can discriminate various emotional expressions, although there is limited research on sensitivity to the differences between posed and genuine expressions. Adults have shown implicit sensitivity to the difference between posed and genuine happy smiles in that they evaluate T-shirts paired with genuine smiles more favorably than T-shirts paired with posed smiles or neutral expressions (Peace, Miles, & Johnston, 2006). Adults also have shown some explicit sensitivity to posed versus genuine expressions; they are more likely to say that a model i?,feeling happy if the expression is genuine than posed. Nonetheless they are duped by posed expressions about 50% of the time (Miles, & Johnston, in press). There has been no published study to date in which researchers report whether children's evaluation of items varies with expression and there is little research investigating children's sensitivity to the veracity of facial expressions. In the present study the same face stimuli were used as in two previous studies (Miles & Johnston, in press; Peace et al., 2006). The first question to be addressed was whether adults and 7-year-olds have a cognitive understanding of the differences between posed and genuine happiness {scenario task). They evaluated the feelings of children who expressed gratitude for a present that they did or did not want. Results indicated that all participants had a fundamental understanding of the difference between real and posed happiness. The second question involved adults' and children's implicit sensitivity to the veracity of posed and genuine smiles. Participants rated and ranked beach balls paired with faces showing posed smiles, genuine smiles, and neutral expressions. Adults ranked.but did not rate beach balls paired with genuine smiles more favorably than beach balls paired with posed smiles. Children did not demonstrate implicit sensitivity as their ratings and rankings of beach balls did not vary with expressions; they did not even rank beach balls paired with genuine expressions higher than beach balls paired with neutral expressions. In the explicit (show/feel) task, faces were presented without the beach balls and participants were first asked whether each face was showing happy and then whether each face wasfeeling happy. There were also two matching trials that presented two faces at once; participants had to indicate which person was actuallyfeeling happy. In the show condition both adults and 7-year-olds were very accurate on genuine and neutral expressions but made some errors on posed smiles. Adults were fooled about 50% of the time by posed smiles in thefeel condition (i.e., they were likely to say that a model posing happy was really feeling happy) and children were even less accurate, although they showed weak sensitivity to posed versus genuine expressions. Future research should test an older age group of children to determine when explicit sensitivity to posed versus genuine facial expressions becomes adult-like and modify the ranking task to explore the influence of facial expressions on object evaluations.

Electrophysiological and behavioural correlates of facial identity and expression perception deficits following a closed head injury /

A large variety of social signals, such as facial expression and body language, are conveyed in everyday interactions and an accurate perception and interpretation of these social cues is necessary in order for reciprocal social interactions to take place successfully and efficiently. The present study was conducted to determine whether impairments in social functioning that are commonly observed following a closed head injury, could at least be partially attributable to disruption in the ability to appreciate social cues. More specifically, an attempt was made to determine whether face processing deficits following a closed head injury (CHI) coincide with changes in electrophysiological responsivity to the presentation of facial stimuli. A number of event-related potentials (ERPs) that have been linked specifically to various aspects of visual processing were examined. These included the N170, an index of structural encoding ability, the N400, an index of the ability to detect differences in serially presented stimuli, and the Late Positivity (LP), an index of the sensitivity to affective content in visually-presented stimuli. Electrophysiological responses were recorded while participants with and without a closed head injury were presented with pairs of faces delivered in a rapid sequence and asked to compare them on the basis of whether they matched with respect to identity or emotion. Other behavioural measures of identity and emotion recognition were also employed, along with a small battery of standard neuropsychological tests used to determine general levels of cognitive impairment. Participants in the CHI group were impaired in a number of cognitive domains that are commonly affected following a brain injury. These impairments included reduced efficiency in various aspects of encoding verbal information into memory, general slower rate of information processing, decreased sensitivity to smell, and greater difficulty in the regulation of emotion and a limited awareness of this impairment. Impairments in face and emotion processing were clearly evident in the CHI group. However, despite these impairments in face processing, there were no significant differences between groups in the electrophysiological components examined. The only exception was a trend indicating delayed N170 peak latencies in the CHI group (p = .09), which may reflect inefficient structural encoding processes. In addition, group differences were noted in the region of the N100, thought to reflect very early selective attention. It is possible, then, that facial expression and identity processing deficits following CHI are secondary to (or exacerbated by) an underlying disruption of very early attentional processes. Alternately the difficulty may arise in the later cognitive stages involved in the interpretation of the relevant visual information. However, the present data do not allow these alternatives to be distinguished. Nonetheless, it was clearly evident that individuals with CHI are more likely than controls to make face processing errors, particularly for the more difficult to discriminate negative emotions. Those working with individuals who have sustained a head injury should be alerted to this potential source of social monitoring difficulties which is often observed as part of the sequelae following a CHI.

The influence of emotional body posture on adults' and 8-year-olds' perception facial expressions

The present set of experiments was designed to investigate the development of children's sensitivity of facial expressions observed within emotional contexts. Past research investigating both adults' and children's perception of facial expressions has been limited primarily to the presentation of isolated faces. During daily social interactions, however, facial expressions are encountered within contexts conveying emotions (e.g., background scenes, body postures, gestures). Recently, research has shown that adults' perception of facial expressions is influenced by these contexts. When emotional faces are shown in incongruent contexts (e.g., when an angry face is presented in a context depicting fear) adults' accuracy decreases and their reaction times increase (e.g., Meeren et a1. 2005). To examine the influence of emotional body postures on children's perception of facial expressions, in each of the experiments in the current study adults and 8-year-old children made two-alternative forced choice decisions about facial expressions presented in congruent (e.g., a face displayed sadness on a body displaying sadness) and incongruent (e.g., a face displaying fear on a body displaying sadness) contexts. Consistent with previous studies, a congruency effect (better performance on congruent than incongruent trials) was found for both adults and 8-year-olds when the emotions displayed by the face and body were similar to each other (e.g., fear and sad, Experiment l a ) ; the influence of context was greater for 8-year-olds than adults for these similar expressions. To further investigate why the congruency effect was larger for children than adults in Experiment 1 a, Experiment 1 b was conducted to examine if increased task difficulty would increase the magnitude of adults' congruency effects. Adults were presented with subtle facial and despite successfully increasing task difficulty the magnitude of the. congruency effect did not increase suggesting that the difference between children's and adults' congruency effects in Experiment l a cannot be explained by 8-year-olds finding the task difficult. In contrast, congruency effects were not found when the expressions displayed by the face and body were dissimilar (e.g., sad and happy, see Experiment 2). The results of the current set of studies are examined with respect to the Dimensional theory and the Emotional Seed model and the developmental timeline of children's sensitivity to facial expressions. A secondary aim of the series of studies was to examine one possible mechanism underlying congruency effe cts-holistic processing. To examine the influence of holistic processing, participants completed both aligned trials and misaligned trials in which the faces were detached from the body (designed to disrupt holistic processing). Based on the principles of holistic face processing we predicted that participants would benefit from misalignment of the face and body stimuli on incongruent trials but not on congruent trials. Collectively, our results provide some evidence that both adults and children may process emotional faces and bodies holistically. Consistent with the pattern of results for congruency effects, the magnitude of the effect of misalignment varied with the similarity between emotions. Future research is required to further investigate whether or not facial expressions and emotions conveyed by the body are perceived holistically.

Sir Isaac Brock Facial Reconstruction Project, n.d.

Christian Cardell Corbet, a descendant of Guernsey, Channel Islands, was born in 1966 at Pickering Beach on Lake Ontario. He developed his talents as a landscape artist and at the young age of 14 he began his informal education in commercial signage from his paternal grandfather. He studied at the University of Guelph and McMaster University Anatomy Laboratory. Corbet traveled to England where he began to experiment more in abstraction and non-objective work. In 1995, he presented a portrait of HM Queen Elizabeth the Queen Mother at Clarence House. This brought his career to an international level. He also creates two-dimensional works and has received acclaim for his bronze art medallions. He has gained international recognition as a Forensic Artist working as Artist in Residence for the University of Western Ontario. He does facial reconstructions for special assignments. These original drawings relate to a sculpted medallion of Brock which was authorized by Sir Geoffrey Rowland, Bailiff, Guernsey, Channel Islands and Minister of Education of the States of Guernsey. This is the first time in known recorded history that a forensic analysis and sculpture has been created to accurately depict the facial likeness of Sir Isaac Brock. This project has been established to mark the 2012 anniversary of the death of Brock.

Planar Topological Defects in Unconventional Superconductors

In this work, we consider the properties of planar topological defects in unconventional superconductors. Specifically, we calculate microscopically the interaction energy of domain walls separating degenerate ground states in a chiral p-wave fermionic superfluid. The interaction is mediated by the quasiparticles experiencing Andreev scattering at the domain walls. As a by-product, we derive a useful general expression for the free energy of an arbitrary nonuniform texture of the order parameter in terms of the quasiparticle scattering matrix. The thesis is structured as follows. We begin with a historical review of the theories of superconductivity (Sec. 1.1), which led the way to the celebrated Bardeen-Cooper- Schrieffer (BCS) theory (Sec. 1.3). Then we proceed to the treatment of superconductors with so-called "unconventional pairing" in Sec. 1.4, and in Sec. 1.5 we introduce the specific case of chiral p-wave superconductivity. After introducing in Sec. 2 the domain wall (DW) model that will be considered throughout the work, we derive the Bogoliubov-de Gennes (BdG) equations in Sec. 3.1, which determine the quasiparticle excitation spectrum for a nonuniform superconductor. In this work, we use the semiclassical (Andreev) approximation, and solve the Andreev equations (which are a particular case of the BdG equations) in Sec. 4 to determine the quasiparticle spectrum for both the single- and two-DW textures. The Andreev equations are derived in Sec. 3.2, and the formal properties of the Andreev scattering coefficients are discussed in the following subsection. In Sec. 5, we use the transfer matrix method to relate the interaction energy of the DWs to the scattering matrix of the Bogoliubov quasiparticles. This facilitates the derivation of an analytical expression for the interaction energy between the two DWs in Sec. 5.3. Finally, to illustrate the general applicability our method, we apply it in Sec. 6 to the interaction between phase solitons in a two-band s-wave superconductor.

Asymmetries of Influence: Differential Effects of Body Postures on Perceptions of Emotional Facial Expressions

The accuracy and speed with which emotional facial expressions are identified is influenced by body postures. Two influential models predict that these congruency effects will be largest when the emotion displayed in the face is similar to that displayed in the body: the emotional seed model and the dimensional model. These models differ in whether similarity is based on physical characteristics or underlying dimensions of valence and arousal. Using a 3- alternative forced-choice task in which stimuli were presented briefly (Exp 1a) or for an unlimited time (Exp 1b) we provide evidence that congruency effects are more complex than either model predicts; the effects are asymmetrical and cannot be accounted for by similarity alone. Fearful postures are especially influential when paired with facial expressions, but not when presented in a flanker task (Exp 2). We suggest refinements to each model that may account for our results and suggest that additional studies be conducted prior to drawing strong theoretical conclusions.

Effet d’une orthèse d’avancement mandibulaire neutre combinée à un masque facial et nasal dans le traitement de l’apnée obstructive du sommeil par CPAP

Le traitement de première ligne de l’apnée obstructive du sommeil est l’appareil à pression positive, soit le CPAP, qui est le plus souvent utilisé avec un masque nasal. Certains patients, incapables de tolérer le masque nasal, doivent se tourner vers le masque facial, qui peut parfois requérir une pression supérieure à celle utilisée avec le masque nasal pour éliminer tous les événements respiratoires. Nous supposons que l’ajustement serré du masque facial, dans le but de réduire les fuites, entraîne une pression de recul sur la mandibule; ceci diminuerait le calibre des voies aériennes supérieures, nécessitant donc une pression effective thérapeutique supérieure pour rétablir un passage de l’air. Nos objectifs étaient : 1) de démontrer s’il y avait une différence de pression effective entre le masque nasal et le masque facial, 2) de quantifier la fuite entre les deux masques, 3) d’évaluer l’effet d’une orthèse de rétention mandibulaire neutre (OMN), qui empêche le recul mandibulaire, sur la pression effective des deux masques et 4) d’évaluer s’il existait un lien entre la céphalométrie et les réponses variables des individus. Méthodologie : Lors de cette étude expérimentale croisée, huit sujets (2 femmes, 6 hommes) avec une moyenne d’âge de 56,3ans [33ans-65ans] ont reçu un examen orthodontique complet incluant une radiographie céphalométrique latérale. Ils ont ensuite passé deux nuits de polysomnographie au laboratoire du sommeil en protocole « split-night » où les deux masques ont été portés, seuls, la première nuit, et avec l’OMN, la deuxième nuit. Résultats : Nous avons trouvé que la pression effective thérapeutique était supérieure avec le masque facial comparativement au masque nasal de manière statistiquement significative. Nous avons observé une fuite supérieure avec le masque nasal, ce qui permet de dire que la fuite n’explique probablement pas cette différence de pression entre les deux masques. L’OMN n’a pas donné d’effet statistiquement significatif lorsque combinée au masque nasal, mais il aurait probablement été possible de trouver un effet positif avec le masque facial si le Bi-PAP avait été inclus dans le protocole de recherche. Conclusion : Nos résultats ne permettent pas de confirmer le rôle du recul mandibulaire, causé par la force exercée avec le masque facial, dans l’obtention de pressions supérieures avec ce masque, mais nous ne pouvons toutefois pas éliminer l’hypothèse. Les résultats suggèrent également que ce phénomène est peut-être plus fréquent qu’on ne le croit et qu’il pourrait y avoir un lien avec certains facteurs anatomiques individuels.

Examining the impact of trait anxiety on the recognition of facial emotional expressions

Question : Cette thèse comporte deux articles portant sur l’étude d’expressions faciales émotionnelles. Le processus de développement d’une nouvelle banque de stimuli émotionnels fait l’objet du premier article, alors que le deuxième article utilise cette banque pour étudier l’effet de l’anxiété de trait sur la reconnaissance des expressions statiques. Méthodes : Un total de 1088 clips émotionnels (34 acteurs X 8 émotions X 4 exemplaire) ont été alignés spatialement et temporellement de sorte que les yeux et le nez de chaque acteur occupent le même endroit dans toutes les vidéos. Les vidéos sont toutes d’une durée de 500ms et contiennent l’Apex de l’expression. La banque d’expressions statiques fut créée à partir de la dernière image des clips. Les stimuli ont été soumis à un processus de validation rigoureux. Dans la deuxième étude, les expressions statiques sont utilisées conjointement avec la méthode Bubbles dans le but d’étudier la reconnaissance des émotions chez des participants anxieux. Résultats : Dans la première étude, les meilleurs stimuli ont été sélectionnés [2 (statique & dynamique) X 8 (expressions) X 10 (acteurs)] et forment la banque d’expressions STOIC. Dans la deuxième étude, il est démontré que les individus présentant de l'anxiété de trait utilisent préférentiellement les basses fréquences spatiales de la région buccale du visage et ont une meilleure reconnaissance des expressions de peur. Discussion : La banque d’expressions faciales STOIC comporte des caractéristiques uniques qui font qu’elle se démarque des autres. Elle peut être téléchargée gratuitement, elle contient des vidéos naturelles et tous les stimuli ont été alignés, ce qui fait d’elle un outil de choix pour la communauté scientifique et les cliniciens. Les stimuli statiques de STOIC furent utilisés pour franchir une première étape dans la recherche sur la perception des émotions chez des individus présentant de l’anxiété de trait. Nous croyons que l’utilisation des basses fréquences est à la base des meilleures performances de ces individus, et que l’utilisation de ce type d’information visuelle désambigüise les expressions de peur et de surprise. Nous pensons également que c’est la névrose (chevauchement entre l'anxiété et la dépression), et non l’anxiété même qui est associée à de meilleures performances en reconnaissance d’expressions faciales de la peur. L’utilisation d’instruments mesurant ce concept devrait être envisagée dans de futures études.

Effets du port continu de coquilles correctrices Invisalign® sur l’articulation temporo-mandibulaire et les muscles du complexe facial.

INTRODUCTION : L’articulation temporo-mandibulaire (ATM) est un système articulaire excessivement complexe. L'étiologie des désordres temporo-mandibulaires (DTM) est encore incertaine et le lien de cause à effet des traitements orthodontiques en tant que facteur de risque est une question qui a longuement été discutée. Cette étude clinique prospective vise à évaluer les effets à long terme du port continu de coquilles correctrices Invisalign® sur l’ATM et les muscles du complexe facial. MATÉRIELS ET MÉTHODES : L'étude incluait 43 adolescents et adultes âgés entre 13 et 51 ans (25 femmes et 18 hommes). Deux d'entre eux ont été exclus en raison de mauvaise coopération causant l’arrêt du traitement orthodontique. Les effets dans le temps des coquilles sur l'ATM et les muscles du complexe facial ont été évalués en utilisant l’examen du Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Le nombre de contractions musculaires durant le sommeil a été mesuré objectivement par enregistrements électromyographiques (EMG) et la fréquence de grincement et de serrement des dents à l’éveil a été rapportée subjectivement par les patients à l’aide de questionnaires. Des mesures répétées ont été effectuées aux temps suivants: avant le début du traitement pour les données contrôles (T1), deux semaines (T2), et six mois (T3) après le début du traitement. Les données numériques ont été analysées par l’analyse de variance (ANOVA) en mesures répétées et la méthode de Brunner-Langer, alors que les données nominales ont été évaluées par le test de Cochran-Mantel-Haenszel. Les résultats ont été considérés significatifs si p < 0.05. RÉSULTATS ET DISCUSSION : Le nombre de contractions musculaires par heure (index) durant le sommeil et leur durée moyenne n’ont pas été statistiquement différents entre les trois nuits d’enregistrement EMG (Brunner Langer, p > 0.005). Cependant, 67 % des participants ont rapporté avoir eu du grincement ou du serrement des dents la nuit au T2 et 64 % au T3 comparativement à 39 % au T1, ce qui était une augmentation significative (Cochran-Mantel-Haenszel, p = 0.0112). Quarante-quatre pour cent des patients ont signalé du grincement ou du serrement des dents pendant le jour au T1, tandis qu'un pourcentage nettement plus élevé de 66 % en a rapporté au T2 et 61 % au T3 (Cochran-Mantel-Haenszel, p = 0.0294). Au T1, 12 % des sujets ont indiqué qu'ils se sont réveillés avec une douleur musculaire, comparativement à 29 % au T2, ce qui était une augmentation significative (Cochran-Mantel-Haenszel, p = 0.0347). Au T2, il y avait une réduction significative des mouvements maximaux de la mandibule dans toutes les directions (ANOVA en mesures répétées, p < 0,05). De plus, il y a eu une augmentation significative du nombre de sites douloureux et de l'intensité de la douleur à la palpation de l'ATM et des muscles faciaux avec l'évaluation du RDC/TMD au T2 en comparaison aux T1 et T3 (Brunner Langer, p < 0,05). CONCLUSION : La présente étude n’a révélé aucun effet des coquilles sur l’activité oro-faciale durant le sommeil au fil du temps mesurée objectivement à l’aide des enregistrements EMG, mais une augmentation significative de la fréquence du grincement et du serrement des dents rapportée subjectivement par les patients au moyen des questionnaires aux T2 et T3. Au T2, il y avait une augmentation significative des symptômes de l'ATM et des muscles du complexe oro-facial, mais ces symptômes sont retournés au niveau initial avec le temps.

Performance Assessment of Sandwich Structures with Debonds and Dents

A sandwich construction is a special form of the laminated composite consisting of light weight core, sandwiched between two stiff thin face sheets. Due to high stiffness to weight ratio, sandwich construction is widely adopted in aerospace industries. As a process dependent bonded structure, the most severe defects associated with sandwich construction are debond (skin core bond failure) and dent (locally deformed skin associated with core crushing). Reasons for debond may be attributed to initial manufacturing flaws or in service loads and dent can be caused by tool drops or impacts by foreign objects. This paper presents an evaluation on the performance of honeycomb sandwich cantilever beam with the presence of debond or dent, using layered finite element models. Dent is idealized by accounting core crushing in the core thickness along with the eccentricity of the skin. Debond is idealized using multilaminate modeling at debond location with contact element between the laminates. Vibration and buckling behavior of metallic honeycomb sandwich beam with and without damage are carried out. Buckling load factor, natural frequency, mode shape and modal strain energy are evaluated using finite element package ANSYS 13.0. Study shows that debond affect the performance of the structure more severely than dent. Reduction in the fundamental frequencies due to the presence of dent or debond is not significant for the case considered. But the debond reduces the buckling load factor significantly. Dent of size 8-20% of core thickness shows 13% reduction in buckling load capacity of the sandwich column. But debond of the same size reduced the buckling load capacity by about 90%. This underscores the importance of detecting these damages in the initiation level itself to avoid catastrophic failures. Influence of the damages on fundamental frequencies, mode shape and modal strain energy are examined. Effectiveness of these parameters as a damage detection tool for sandwich structure is also assessed