992 resultados para corrective orthodontics


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INTRODUCTION: This study evaluated changes in the smile characteristics of patients with maxillary constriction submitted to rapid maxillary expansion (RME). METHODS: The sample consisted of 81 extraoral photographs of maximum smile of 27 patients with mean age of 10 years, before expansion and 3 and 6 months after fixation of the expanding screw. The photographs were analyzed on the software Cef X 2001, with achievement of the following measurements: Transverse smile area, buccal corridors, exposure of maxillary incisors, gingival exposure of maxillary incisors, smile height, upper and lower lip thickness, smile symmetry and smile arch. Statistical analysis was performed by analysis of variance (ANOVA), at a significance level of 5%. RESULTS: RME promoted statistically significant increase in the transverse smile dimension and exposure of maxillary central and lateral incisors; maintenance of right and left side smile symmetry and of the lack of parallelism between the curvature of the maxillary incisal edges and lower lip border. CONCLUSIONS: RME was beneficial for the smile esthetics with the increase of the transverse smile dimension and exposure of maxillary central and lateral incisors.

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OBJECTIVE: To verify if there is difference in the buccal and posterior corridor width in cases treated with extraction of one and four premolars. METHODS: Through posed smile photographs of 23 Class II patients, subdivision, treated with extraction of one premolar and 25 Class I and Class II patients, subdivision, treated with extraction of four premolars, the percentage of buccal and posterior corridor width was calculated. The two protocols of extractions were compared regarding the buccal and posterior corridor width by independent t tests. RESULTS: There was no statistically significant difference on the buccal and posterior corridor widths between patients treated with symmetric and asymmetric extraction. CONCLUSION: The buccal and posterior corridor did not differ between the evaluated protocols of extractions.

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The mechanisms of tissue changes induced by occlusal trauma are in no way comparable to orthodontic movement. In both events the primary cause is of a physical nature, but the forces delivered to dental tissues exhibit completely different characteristics in terms of intensity, duration, direction, distribution, frequency and form of uptake by periodontal tissues. Consequently, the tissue effects induced by occlusal trauma are different from orthodontic movement. It can be argued that occlusal trauma generates a pathological tissue injury in an attempt to adapt to new excessive functional demands. Orthodontic movement, in turn,performs physiological periodontal bone remodeling to change the position of the teeth in a well-planned manner, eventually restoring normalcy.

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OBJECTIVE: The aim of this prospective study was to cephalometrically analyze the stability of dentoalveolar and skeletal changes produced by a removable appliance with palatal crib associated to high-pull chincup in individuals with anterior open bite treated for 12 months, and compare them to individuals with similar malocclusion and age, not submitted to orthodontic treatment, also followed for the same period. METHODS: Nineteen children with a mean age of 9.78 years old treated for 12 months with a removable appliance with palatal crib associated with chincup therapy were evaluated after 15 months (post-treatment period) and compared with a control group of 19 subjects with mean age of 9.10 years with the same malocclusion that was followed-up for the same period. Seventy-six lateral cephalograms were evaluated at T1 (after correction) and T2 (follow-up) and cephalometric variables were analyzed by statistical tests. RESULTS: The results did not show significant skeletal, soft tissue or maxillary dentoalveolar changes. Overall, treatment effects on the experimental group were maintained at T2 evaluation with an increase of 0.56 mm in overbite. Overjet and maxillary incisors/molars position (vertical and sagittal) remained essentially unchanged during the study period. Only mandibular incisors showed significant changes (labial inclination and protrusion) compared to control group. CONCLUSIONS: Thus, it can be concluded that the early open bite treatment with a removable appliance and palatal crib associated with high-pull chincup therapy provided stability of 95%.

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OBJECTIVE: The objective of this retrospective study was to compare, by means of lateral cephalograms, the facial growth pattern changes due to the treatment with and without extractions of four first premolars in dolichofacial individuals. METHODS: Groups 1 and 2 were constituted of 23 dolichofacial patients each, with Class II malocclusion, division 1 and initial age average of 12.36 and 12.29 years, respectively. Patients from Group 1 were treated without extractions and Group 2 was treated with extraction of the four first premolars, given that both used occipital headgear. Groups were compatibilized according to age, treatment period, gender and malocclusion severity. The t test was applied for intergroups comparison. RESULTS: Most variables (SN.PP, SN.Ocl and FMA) did not present statistically significant difference between groups. CONCLUSION: Although the treatment with extractions tend to reduce the mandibular plane angle (SN.GoGn) and the facial axis (NS.Gn), the analyzed treatment protocols did not affect in a clinically relevant way the facial growth pattern.

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Em conformidade com a dúvida de seu título, o difundido livro The New Brutalism: Ethic or Aesthetic? de Reyner Banham não é possível explicar o Brutalismo como manifestação artística coesa, dotada de consistência e reprodutibilidade formal. A citação de arquitetos famosos, porém divergentes, parece associar e comparar obras ásperas com a pretensão de reerguer uma arquitetura moderna considerada ascética, monótona e insuficiente e gera um teoricismo da aparência crua e do moralismo dos objetos. Discurso que oculta, ou desvia a atenção do retorno artístico à sublimidade e construção artesanal. O Brutalismo é aceito como evolução natural dos estágios modernos anteriores e sanciona artefatos toscos, pesados e inacabados como se fossem filiados ao processo moderno desinfestado. Esconde contradições e disfarça seu rompimento com o moderno para prolongar a expressão Movimento moderno. Mas o objeto claro, econômico e preciso é repudiado pelo consumidor e, por ser pouco representativo, o artista faz sua maquiagem com episódios contrastantes e monumentais na informalidade das cidades espontâneas. No entanto, parece possível suspender a noção positiva e corretiva do Brutalismo para entendê-lo como um recuo artístico vulgarizador que despreza aperfeiçoamento e afronta a atitude moderna com banalização conceptiva, exagero, figuralidade, musculação estrutural, grandeza tectônica, rudimento e rudeza. Assim, moralismo, retorno rústico e originalidade desqualificam a expressão International Style entendida como a culminação da arquitetura moderna do pós-guerra, ao depreciá-la como decadente, como produto imobiliário, comercial e corporativo a serviço do capital. Essa interpretação desvela uma crítica anti-industrial, portanto antimodernista e diversa da pós-modernidade, porém contestadora e realista para fornecer imagens à cultura e aos insensíveis à estrutura da forma moderna. Diverso da pós-modernidade pela dependência ao moderno e ausência de apelo popular. Tornada insignificante a configuração oportuna do artefato, o arquiteto tenta reter sua notabilidade artística, ou o prestígio que parece enfraquecer na aparência símile da especificação de catálogo, no rigor modular. Indispõe-se e repudia componentes, Standards e acabamentos impessoais da indústria da construção para insistir em autoria e inspiração, mas repete cacoetes estilísticos de época e o inexplicável uso intensivo de concreto bruto e aparente para sentir-se engajado e atualizado. Porém, é necessário distinguir obras de aparência severa concebidas pela atitude moderna mais autêntica das de concreto aparente em tipos ou configurações aberrantes. Para avançar na discussão do Brutalismo propõe-se entender este fenômeno com a substituição do juízo estético moderno de sentido visual postulado por Immanuel Kant (1724-1804) por um sentimento estético fácil e relacionado com a sensação da empatia, com a Einfühlung de Robert Vischer (1847-1933). Na época da cultura de massas, admite-se o rebaixamento das exigências no artefato e a adaptação brutalista com a transfiguração dos processos de arquitetura moderna. Assim, a forma é substituída pela figura ou pelo resumo material; a estrutura formal subjacente pelo ritmo e exposição da estrutura física; o reconhecimento visual pelo entusiasmo psicológico ou pelo impulso dionisíaco; a concepção substituída pelo partido, ou, ainda, pelo conceito; a sistematização e a ordem pela moldagem e a organização; a abstração e síntese pela originalidade e essencialidade, o sentido construtivo pela honestidade material; a identidade das partes pela fundição ou pela unicidade objetal e a residência pela cabana primitiva.

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The assessment of the RAMS (Reliability, Availability, Maintainability and Safety) performances of system generally includes the evaluations of the “Importance” of its components and/or of the basic parameters of the model through the use of the Importance Measures. The analytical equations proposed in this study allow the estimation of the first order Differential Importance Measure on the basis of the Birnbaum measures of components, under the hypothesis of uniform percentage changes of parameters. The aging phenomena are introduced into the model by assuming exponential-linear or Weibull distributions for the failure probabilities. An algorithm based on a combination of MonteCarlo simulation and Cellular Automata is applied in order to evaluate the performance of a networked system, made up of source nodes, user nodes and directed edges subjected to failure and repair. Importance Sampling techniques are used for the estimation of the first and total order Differential Importance Measures through only one simulation of the system “operational life”. All the output variables are computed contemporaneously on the basis of the same sequence of the involved components, event types (failure or repair) and transition times. The failure/repair probabilities are forced to be the same for all components; the transition times are sampled from the unbiased probability distributions or it can be also forced, for instance, by assuring the occurrence of at least a failure within the system operational life. The algorithm allows considering different types of maintenance actions: corrective maintenance that can be performed either immediately upon the component failure or upon finding that the component has failed for hidden failures that are not detected until an inspection; and preventive maintenance, that can be performed upon a fixed interval. It is possible to use a restoration factor to determine the age of the component after a repair or any other maintenance action.

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The objective of this study was to evaluate right ventricular function in patients with right ventricular volume overload in patients with (tetralogy of Fallot, and pulmonary atresia + VSD ) underwent corrective surgery; with echocardiography measure that can be easily applied; and to study the relationship between ProBNP and the contractile function of the right ventricle, dilated right atrium, and the consequences of pulmonary insufficiency . Methods: The study included 50 patients (50% males, mean age 30.64 ± 13.30 years) with prior cardiac surgical intervention of TDF (90%) or pulmonary atresia + VSD (10%). (49 pz) have performed a cardiac MRI and clinical evaluation, (47 pz) echocardiogram, (48 pz) ECG, (34 pz) a cardiopulmonary exercise testing, (29 pz) a dosage of ProBNP. Results: The S-wave velocity (p <0.0001), the TAPSE (p <0.0001) correlated significantly with RVEF estimated by cardiac MRI. The VO2 max was 27.93 ± 12.91 ml / kg / min, 15% of patients had VE/VCO2 The peak> 35. ProBNP correlated positively and significantly with the area of the right atrium (p = 0.0001), and negative and significant with VO2 max (p = 0.04). Those who have increased pulmonary insufficiency (PVR fraction> 30%) have a significantly increased RVED volume (p = 0.01), reduced VO2 max (p = 0.04), and lower ejection fraction of LV (p = 0.02) than the group of patients with PVR ≤ 30. Conclusion: The TAPSE and S-wave velocity are fundamental and may become the technique of choice for routine assessment of RV systolic function in adult patients with TOF. The monitoring of the Pro BNP is probably a choice, given the simplicity and their information that correlate with the test cardiopulmonary. In view of the ventricular-ventricular interaction, so measures to maintain or restore the functioning of the pulmonary valve could preserve biventricular function.

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This report elaborates on the master degree thesis developed by the candidate within the company Superjet International. The performed activity focuses on the study and design of VAMP (Virtual Aircraft Multipurpose Platform). VAMP is a new interactive platform, not necessarily limited to the Aeronautical sector, aimed to analyse technical failures, identify risk and recommend the most appropriate corrective actions for maintenance cost reduction, taking into account reliability, availability, maintainability and safety.

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Die vorliegende Arbeit beschäftigt sich mit rechtlichen Fragestellungen rund um Bewertungs-portale im Internet. Zentrale Themen der Arbeit sind dabei die Zulässigkeit der Veröffentlichung der von den Nutzern abgegebenen Bewertungen vor dem Hintergrund möglicherweise entgegenstehender datenschutzrechtlicher Bestimmungen und der Persönlichkeitsrechte der Betroffenen. Des weiteren wird der Rechtsschutz der Betroffenen erörtert und in diesem Zusammenhang die haftungsrechtlichen Risiken der Forenbetreiber untersucht. Gegenstand der Arbeit sind dabei sowohl Online-Marktplätze wie eBay, auf denen sowohl der Bewertende als auch der Bewertete registriert und mit dem Bewertungsverfahren grundsätz-lich einverstanden sind (geschlossene Portale), als auch Portale, auf denen – oftmals unter einem Pseudonym und ohne vorherige Anmeldung – eine freie Bewertungsabgabe, zu Pro-dukteigenschaften, Dienstleistungen bis hinzu Persönlichkeitsmerkmalen des Bewerteten möglich ist (offene Portale). Einleitung und Erster Teil Nach einer Einleitung und Einführung in die Problematik werden im ersten Teil die verschie-denen Arten der Bewertungsportale kurz vorgestellt. Die Arbeit unterscheidet dabei zwischen so genannten geschlossenen Portalen (transaktionsbegleitende Portale wie eBay oder Ama-zon) auf der einen Seite und offenen Portalen (Produktbewertungsportale, Hotelbewertungs-portale und Dienstleistungsbewertungsportale) auf der anderen Seite. Zweiter Teil Im zweiten Teil geht die Arbeit der Frage nach, ob die Veröffentlichung der durch die Nutzer abgegebenen Bewertungen auf den offenen Portalen überhaupt erlaubt ist oder ob hier mögli-cherweise das Persönlichkeitsrecht der Betroffenen und hier insbesondere das Recht auf in-formationelle Selbstbestimmung in Form der datenschutzrechtlichen Bestimmungen die freie Bewertungsabgabe unzulässig werden lässt. Untersucht werden in diesem Zusammenhang im einzelnen Löschungs- bzw. Beseitigungsan-sprüche der Betroffenen aus § 35 Abs. 2 Satz 2 Nr. 1 BDSG bzw. §§ 1004 i. V. m. 823 Abs. 1 BGB (allgemeines Persönlichkeitsrecht). Die Arbeit kommt in datenschutzrechtlicher Hinsicht zu dem Schluss, dass die Bewertungen personenbezogene Daten darstellen, die den datenschutzrechtlichen Bestimmungen unterlie-gen und eine Veröffentlichung der Bewertungen nach dem im deutschen Recht geltenden da-tenschutzrechtlichen Erlaubnisvorbehalt grundsätzlich nicht in Betracht kommt. Vor dem Hintergrund dieser den tatsächlichen Gegebenheiten und Interessenlagen im Internet nicht mehr gerecht werdenden Gesetzeslage diskutiert der Autor sodann die Frage, ob die datenschutzrechtlichen Bestimmungen in diesen Fällen eine Einschränkung durch die grund-gesetzlich garantierten Informationsfreiheiten erfahren müssen. Nach einer ausführlichen Diskussion der Rechtslage, in der auf die Besonderheiten der ein-zelnen Portale eingegangen wird, kommt die Arbeit zu dem Schluss, dass die Frage der Zuläs-sigkeit der Veröffentlichung der Bewertungen von einer Interessenabwägung im Einzelfall abhängt. Als Grundsatz kann jedoch gelten: Ist die bewertete Tätigkeit oder Person in Bezug auf die bewertete Eigenschaft ohnehin einer breiten Öffentlichkeit zugänglich, erscheint eine Veröffentlichung der Daten nicht bedenklich. Dagegen wird man einen Löschungs- bzw. Be-seitigungsanspruch bejahen müssen für die Bewertungen, die Tätigkeiten oder Eigenschaften des Bewerteten, die in keinem Zusammenhang mit ihm als öffentlicher Person stehen, betref-fen. Anschließend geht die Arbeit auf die Persönlichkeitsrechte der Betroffenen und der sich hier-aus ergebenden Beseitigungs- und Unterlassungsansprüchen gemäß der §§ 1004 Abs. 1, 823 Abs. 1 BGB ein, verneint jedoch wegen dem Vorrang der spezialgesetzlichen Bestimmungen aus dem Bundesdatenschutzgesetz letztlich eine Anwendbarkeit der Anspruchsgrundlagen. Schließlich wird in diesem Teil noch kurz auf die Zulässigkeit der Bewertung juristischer Per-sonen eingegangen, die im Grundsatz bejaht wird. Dritter Teil Sofern der zweite Teil der Arbeit zu dem Schluss kommt, dass die Veröffentlichung der Be-wertungen zulässig ist, stellt sich im dritten Teil die Frage, welche Möglichkeiten das Recht dem Bewerteten bietet, gegen negative Bewertungen vorzugehen. Untersucht werden, dabei datenschutzrechtliche, deliktsrechtliche, vertragliche und wettbe-werbsrechtliche Ansprüche. Ein Schwerpunkt dieses Teils liegt in der Darstellung der aktuellen Rechtsprechung zu der Frage wann eine Bewertung eine Tatsachenbehauptung bzw. ein Werturteil darstellt und den sich hieraus ergebenden unterschiedlichen Konsequenzen für den Unterlassungsanspruch des Betroffenen. Diejenigen Bewertungen, die eine Meinungsäußerung darstellen, unterstehen dem starken Schutz der Meinungsäußerungsfreiheit. Grenze der Zulässigkeit sind hier im wesentlichen nur die Schmähkritik und Beleidigung. An Tatsachenbehautpungen dagegen sind schärfere Maßstäbe anzulegen. In diesem Zusammenhang wird der Frage nachgegangen, ob vertragliche Beziehungen zwischen den Beteiligten (Bewertenden, Bewertete und Portalbetreiber) die Meinungsäußerungsfreiheit einschränkt, was jedenfalls für die geschlossenen Portale bejaht wird. Vierter Teil Der vierte Teil der Arbeit beschäftigt sich mit den „Zu-gut-Bewertungen“. Es geht dabei um wettbewerbsrechtliche Ansprüche im Falle verdeckter Eigenbewertungen. Solche Eigenbewertungen, die unter dem Deckmantel der Pseudonymität als Werbemittel zur Imageverbesserung in entsprechenden Bewertungsportale verbreitet werden ohne den wahren Autor erkennen zu lassen, sind in wettbewerbsrechtlicher Hinsicht grundsätzlich unzulässig. Fünfter Teil Im letzten Teil der Arbeit wird schließlich der Frage nach der Verantwortlichkeit der Portal-betreiber für rechtswidrige Bewertungen nachgegangen. Zunächst wird die Feststellung getroffen, dass es sich bei den von den Nutzern abgegebenen Bewertungen um fremde Inhalte handelt und somit die Haftungsprivilegierungen der § 11 Abs. 1 TDG, § 9 Abs. 1 MDStV eingreifen, wonach die Forenbetreiber für die rechtswidrigen Bewertungen jedenfalls so lange nicht verantwortlich sind, solange sie hiervon keine Kenntnis haben. Da von dieser Haftungsprivilegierung nach der Rechtsprechung des Bundesgerichtshofs die Störerhaftung nicht umfasst ist, wird die Reichweite die Forenbetreiber aus der Störerhaftung treffenden Überwachungspflichten diskutiert. Die Arbeit kommt hier zu dem Ergebnis, dass in den Fällen, in denen dem Adressaten der Bewertung die Identität des Verfassers bekannt ist, sich die Verpflichtungen der Forenbetrei-ber auf die Beseitigung bzw. Sperrung der rechtswidrigen Bewertung beschränken. Sofern die Identität des Bewertenden unbekannt ist, haften die Forenbetreiber als Mitstörer und dem Be-troffenen stehen Unterlassungsansprüche auch gegen die Forenbetreiber zu.

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Over the last 60 years, computers and software have favoured incredible advancements in every field. Nowadays, however, these systems are so complicated that it is difficult – if not challenging – to understand whether they meet some requirement or are able to show some desired behaviour or property. This dissertation introduces a Just-In-Time (JIT) a posteriori approach to perform the conformance check to identify any deviation from the desired behaviour as soon as possible, and possibly apply some corrections. The declarative framework that implements our approach – entirely developed on the promising open source forward-chaining Production Rule System (PRS) named Drools – consists of three components: 1. a monitoring module based on a novel, efficient implementation of Event Calculus (EC), 2. a general purpose hybrid reasoning module (the first of its genre) merging temporal, semantic, fuzzy and rule-based reasoning, 3. a logic formalism based on the concept of expectations introducing Event-Condition-Expectation rules (ECE-rules) to assess the global conformance of a system. The framework is also accompanied by an optional module that provides Probabilistic Inductive Logic Programming (PILP). By shifting the conformance check from after execution to just in time, this approach combines the advantages of many a posteriori and a priori methods proposed in literature. Quite remarkably, if the corrective actions are explicitly given, the reactive nature of this methodology allows to reconcile any deviations from the desired behaviour as soon as it is detected. In conclusion, the proposed methodology brings some advancements to solve the problem of the conformance checking, helping to fill the gap between humans and the increasingly complex technology.

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La regolazione dei sistemi di propulsione a razzo a propellente solido (Solid Rocket Motors) ha da sempre rappresentato una delle principali problematiche legate a questa tipologia di motori. L’assenza di un qualsiasi genere di controllo diretto del processo di combustione del grano solido, fa si che la previsione della balistica interna rappresenti da sempre il principale strumento utilizzato sia per definire in fase di progetto la configurazione ottimale del motore, sia per analizzare le eventuali anomalie riscontrate in ambito sperimentale. Variazioni locali nella struttura del propellente, difettosità interne o eterogeneità nelle condizioni di camera posso dare origine ad alterazioni del rateo locale di combustione del propellente e conseguentemente a profili di pressione e di spinta sperimentali differenti da quelli previsti per via teorica. Molti dei codici attualmente in uso offrono un approccio piuttosto semplificato al problema, facendo per lo più ricorso a fattori correttivi (fattori HUMP) semi-empirici, senza tuttavia andare a ricostruire in maniera più realistica le eterogeneità di prestazione del propellente. Questo lavoro di tesi vuole dunque proporre un nuovo approccio alla previsione numerica delle prestazioni dei sistemi a propellente solido, attraverso la realizzazione di un nuovo codice di simulazione, denominato ROBOOST (ROcket BOOst Simulation Tool). Richiamando concetti e techiche proprie della Computer Grafica, questo nuovo codice è in grado di ricostruire in processo di regressione superficiale del grano in maniera puntuale, attraverso l’utilizzo di una mesh triangolare mobile. Variazioni locali del rateo di combustione posso quindi essere facilmente riprodotte ed il calcolo della balistica interna avviene mediante l’accoppiamento di un modello 0D non-stazionario e di uno 1D quasi-stazionario. L’attività è stata svolta in collaborazione con l’azienda Avio Space Division e il nuovo codice è stato implementato con successo sul motore Zefiro 9.

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La presente tesi intende compiere un’indagine, dal punto di vista storico-educativo, sulla storia delle case di correzione. Nello specifico si è tentato di analizzare il “caso” del Discolato bolognese, operando un confronto con altre analoghe istituzioni, sorte in due città campione, come Roma e Milano, per quanto riguarda il contesto italiano, e con la situazione inglese, per quanto riguarda il contesto internazionale. Il focus della ricerca si è incentrato sul rapporto tra devianza e internamento, considerato secondo una declinazione pedagogica. A tal proposito si è cercato di far emergere le modalità educative, nonché i principi e le finalità che sottostavano agli interventi istituzionali, non solo soffermandosi su quanto i regolamenti e gli statuti prescrivevano all’interno delle strutture correzionali, ma analizzando la reclusione nella sua effettiva organizzazione quotidiana. Per quanto riguarda la situazione bolognese è stata analizzata un’ampissima documentazione, conservata presso l’Archivio storico Provinciale di Bologna, che ha permesso di svolgere un’analisi di tipo quantitativo su un totale di 1105 individui al fine di delineare le principali caratteristiche demografiche e sociali delle persone internate nel Discolato bolognese. L’interpretazione delle fonti ha permesso anche un’indagine qualitativa, nel tentativo di ricostruire le storie di vita dei singoli reclusi. Da questa ricerca emerge un’immagine complessa delle case di correzione. Nel corso dei secoli, in modo particolare nelle diverse realtà prese in esame, esse hanno assunto caratteristiche e peculiarità differenti. La loro inefficacia fu la motivazione principale che condusse alla definitiva chiusura, quando si fece via via sempre più evidente la difficoltà a tradurre in pratica ciò che regolamenti e statuti - a livello teorico - prescrivevano.

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Tractor rollover represent a primary cause of death or serious injury in agriculture and despite the mandatory Roll-Over Protective Structures (ROPS), that reduced the number of injuries, tractor accidents are still of great concern. Because of their versatility and wide use many studies on safety are concerned with the stability of tractors, but they often prefer controlled tests or laboratory tests. The evaluation of tractors working in field, instead, is a very complex issue because the rollover could be influenced by the interaction among operator, tractor and environment. Recent studies are oriented towards the evaluation of the actual working conditions developing prototypes for driver assistance and data acquisition. Currently these devices are produced and sold by manufacturers. A warning device was assessed in this study with the aim to evaluate its performance and to collect data on different variables influencing the dynamics of tractors in field by monitoring continuously the working conditions of tractors operating at the experimental farm of the Bologna University. The device consists of accelerometers, gyroscope, GSM/GPRS, GPS for geo-referencing and a transceiver for the automatic recognition of tractor-connected equipment. A microprocessor processes data and provides information, through a dedicated algorithm requiring data on the geometry of the tested tractor, on the level of risk for the operator in terms of probable loss of stability and suggests corrective measures to reduce the potential instability of the tractor.

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Immediate breast reconstruction (IBR) has become an established procedure for women necessitating mastectomy. Traditionally, the nipple-areola complex (NAC) is resected during this procedure. The NAC, in turn, is a principal factor determining aesthetic outcome after breast reconstruction, and due to its particular texture and shape, a natural-looking NAC can barely be reconstructed with other tissues. The aim of this study was to assess the oncological safety as well as morbidity and aesthetic outcome after replantation of the NAC some days after IBR. Retrospective analysis of 85 patients receiving 88 mastectomies and IBR between 1998 and 2007 was conducted. NAC (n=29) or the nipple alone (n=23) were replanted 7 days (median, range 2-10 days) after IBR in 49 patients, provided the subareolar tissue was histologically negative for tumour infiltration. Local recurrence rate was assessed after 49 months (median, range 6-120 months). Aesthetic outcome was evaluated by clinical assessment during routine follow-up at least 12 months after the last intervention. Malignant involvement of the subareolar tissue was found in eight cases (9.1%). Patients qualifying for NAC replantation were in stage 0 in 29%, stage I in 15%, stage IIa in 31%, stage IIb in 17% and stage III in 8%. Total or partial necrosis occurred in 69% and 26% if the entire NAC or only the nipple were replanted, respectively (P<0.01). Depigmentation was seen in 52% and corrective surgery was done in 11 out of 52 NAC or nipple replantations. Local recurrence and isolated regional lymph node metastasis were observed in one single case each. Another 5.8% of the patients showed distant metastases. We conclude that the replantation of the NAC in IBR is oncologically safe, provided the subareolar tissue is free of tumour. However, the long-term aesthetic outcome of NAC replantation is not satisfying, which advocates replanting the nipple alone.