Temporary Internal Fixation for Ligamentous and Osseous Lisfranc Injuries: Outcome and Technical Tip

BACKGROUND Open rather than closed reduction and internal fixation as well as primary definitive arthrodesis are well accepted for ligamentous and osseous Lisfranc injuries. For ligamentous injuries, a better outcome after primary definitive partial arthrodesis has been published. METHODS Of 135 Lisfranc injuries that were treated from 1998 to 2012 with open reduction, temporary internal fixation by screws and plates, and restricted weight bearing in a lower leg cast for 3 months followed by an arch support for another 4 to 6 weeks, 29 ligamentous Lisfranc injuries were available for follow-up. They were compared with 29 osseous Lisfranc injuries matched in age and gender. RESULTS Between the groups, there were no significant differences in average age (39.9 vs 38 years) or in average follow-up time (8.3 vs 9.1 years). Also, no significant differences were seen in the AOFAS midfoot score (84 vs 85.3 points), the FFI pain scale (9.9 vs 14.9 points), SF 36 physical component (56.2 vs 53.9 points), SF 36 mental component (57 vs 56.4 points), or VAS for pain (1.6 vs 1.5 points). The FFI function scale was significantly lower in the ligamentous group (11.6 vs 19.5 points). Radiographically, loss of reduction was recorded 3 times in the ligamentous injuries and 4 times in the osseous injuries. Arthritis was mild/moderate/severe in 5/3/0 ligamentous injuries and in 7/2/1 osseous injuries, requiring 1 definitive secondary Lisfranc arthrodesis in each group. CONCLUSION With longer and conservative postoperative management, open reduction and temporary internal fixation in ligamentous and osseous Lisfranc injuries led to equal medium-term outcome. Inferior outcome in ligamentous injuries was not found. LEVEL OF EVIDENCE Level III, retrospective comparative cohort study.

Content and Context Aware Strategies for QoS Support in VANETs

The increasing interest in autonomous coordinated driving and in proactive safety services, exploiting the wealth of sensing and computing resources which are gradually permeating the urban and vehicular environments, is making provisioning of high levels of QoS in vehicular networks an urgent issue. At the same time, the spreading model of a smart car, with a wealth of infotainment applications, calls for architectures for vehicular communications capable of supporting traffic with a diverse set of performance requirements. So far efforts focused on enabling a single specific QoS level. But the issues of how to support traffic with tight QoS requirements (no packet loss, and delays inferior to 1ms), and of designing a system capable at the same time of efficiently sustaining such traffic together with traffic from infotainment applications, are still open. In this paper we present the approach taken by the CONTACT project to tackle these issues. The goal of the project is to investigate how a VANET architecture, which integrates content-centric networking, software-defined networking, and context aware floating content schemes, can properly support the very diverse set of applications and services currently envisioned for the vehicular environment.

Decision Support Models for Composing and Navigating through e-Learning Objects

Libraries of learning objects may serve as basis for deriving course offerings that are customized to the needs of different learning communities or even individuals. Several ways of organizing this course composition process are discussed. Course composition needs a clear understanding of the dependencies between the learning objects. Therefore we discuss the metadata for object relationships proposed in different standardization projects and especially those suggested in the Dublin Core Metadata Initiative. Based on these metadata we construct adjacency matrices and graphs. We show how Gozinto-type computations can be used to determine direct and indirect prerequisites for certain learning objects. The metadata may also be used to define integer programming models which can be applied to support the instructor in formulating his specifications for selecting objects or which allow a computer agent to automatically select learning objects. Such decision models could also be helpful for a learner navigating through a library of learning objects. We also sketch a graph-based procedure for manual or automatic sequencing of the learning objects.

A unified approach to architecture conformance checking

Architectural decisions can be interpreted as structural and behavioral constraints that must be enforced in order to guarantee overarching qualities in a system. Enforcing those constraints in a fully automated way is often challenging and not well supported by current tools. Current approaches for checking architecture conformance either lack in usability or offer poor options for adaptation. To overcome this problem we analyze the current state of practice and propose an approach based on an extensible, declarative and empirically-grounded specification language. This solution aims at reducing the overall cost of setting up and maintaining an architectural conformance monitoring environment by decoupling the conceptual representation of a user-defined rule from its technical specification prescribed by the underlying analysis tools. By using a declarative language, we are able to write tool-agnostic rules that are simple enough to be understood by untrained stakeholders and, at the same time, can be can be automatically processed by a conformance checking validator. Besides addressing the issue of cost, we also investigate opportunities for increasing the value of conformance checking results by assisting the user towards the full alignment of the implementation with respect to its architecture. In particular, we show the benefits of providing actionable results by introducing a technique which automatically selects the optimal repairing solutions by means of simulation and profit-based quantification. We perform various case studies to show how our approach can be successfully adopted to support truly diverse industrial projects. We also investigate the dynamics involved in choosing and adopting a new automated conformance checking solution within an industrial context. Our approach reduces the cost of conformance checking by avoiding the need for an explicit management of the involved validation tools. The user can define rules using a convenient high-level DSL which automatically adapts to emerging analysis requirements. Increased usability and modular customization ensure lower costs and a shorter feedback loop.

The influence of ideological interest groups on congressional financial support of international family planning

The World Health Organization estimates there are about 585,000 maternal deaths each year, with 98% of the maternal deaths in developing countries. Access to family planning methods is one method to decrease maternal mortality and morbidity. ^ The U.S. was the leader in providing financial and technical assistance to developing countries to enable women to have this access. The election of Ronald Regan changed the course of U.S. support; abortion became a central factor in the political decision-making with regards to the financial support of international family planning. ^ One factor that may sway policy-makers' decisions is the influence of ideological interest groups, Political Action Committees funding of candidates in relation to votes on bills that impacted on financial support of international family planning and the amount spent by these groups on lobbyist was reviewed. Pro-choice funding of candidates was greater for the four of the fives votes supporting family planning. Pro-Choice lobbyist spending was $185,000 vs. $8,184,000 spent by Pro-Life ideological groups. ^

The Children’s Bureau’s Role in Promoting Parent Engagement and Family Support: A Brief History and Current Efforts

Over the years, federal child welfare policy has supported parent engagement and family support strategies through various Children’s Bureau funded state formula grant programs, research and demonstration discretionary grants, and technical assistance. This article highlights programs funded by two federal laws, Promoting Safe and Stable Families and the Child Abuse Prevention and Treatment Act, and Children’s Bureau’s efforts to test innovations and disseminate knowledge about promising and evidence-based practices regarding parent engagement and family support. The article begins with a brief legislative history and then describes several grant programs that are supported by the legislation. The article concludes with lessons learned and a discussion of the new opportunities for system changes through the Title IV-E Waiver Demonstration projects.

IGS Technical Report 2011

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2011 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2011.

IGS Technical Report 2012

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2012 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2012.

IGS Technical Report 2013

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2013 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2013.

IGS Technical Report 2014

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2014 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2014.

IGS Technical Report 2015

Applications of the Global Navigation Satellite Systems (GNSS) to Earth Sciences are numerous. The International GNSS Service (IGS), a federation of government agencies, universities and research institutions, plays an increasingly critical role in support of GNSS–related research and engineering activities. This Technical Report 2015 includes contributions from the IGS Governing Board, the Central Bureau, Analysis Centers, Data Centers, station and network operators, and others highlighting status and important activities, changes and results that took place and were achieved during 2015.

Myanmar's Economic Relations with China: Can China Support the Myanmar Economy?

Against the background of closer diplomatic, political and security ties between Myanmar and China since 1988, their economic relations have also grown stronger throughout the 1990s and up to 2005. China is now a major supplier of consumer and capital goods to Myanmar, in particular through border trade. China also provides a large amount of economic cooperation in the areas of infrastructure, energy and state-owned economic enterprises. Nevertheless, Myanmar’s trade with China has failed to have a substantial impact on its broad-based economic and industrial development. China’s economic cooperation apparently supports the present regime, but its effects on the whole economy will be limited with an unfavorable macroeconomic environment and distorted incentives structure. As a conclusion, strengthened economic ties with China will be instrumental in regime survival, but will not be a powerful force affecting the process of economic development in Myanmar.

Public Support for Enlargement: Economic, Cultural, or Normative?

The current research questioned whether public opinion on enlargement can be adequately explained only by economic calculation and cultural/community identity. When the analytical viewpoint was expanded from the conventional individual level to state level, it was revealed that constructivist considerations-such as the democratization and reunification of Europe-play a critical role in pushing forward enlargement. Drawing on the perspective of international relations, this study introduced a synthetic model to analyze public opinion on enlargement in the EU's 15 old member states. The analysis using a Eurobarometer dataset showed that on public support for enlargement, constructivist attitudes held as much sway as cultural/community attitudes. In fact, expectations of democratization were the most important determinant of support for enlargement in the case of Turkey.

The impact of a computer based adult literacy program on literacy and numeracy : evidence from India

With over 700 million illiterate adults in the world, many governments have implemented adult literacy programs across the world, although typically with low rates of success partly because the quality of teaching is low. One solution may lie in the standardization of teaching provided by computer-aided instruction. We present the first rigorous evidence of the effectiveness of a computer-based adult literacy program. A randomized control trial study of TARA Akshar Plus, an Indian adult literacy program, was implemented in the state of Uttar Pradesh in India. We find large, significant impacts of this computer-aided program on literacy and numeracy outcomes. We compare the improvement in learning to that of other traditional adult literacy programs and conclude that TARA Akshar Plus is effective in increasing literacy and numeracy for illiterate adult women.