937 resultados para Internal fixation in fractures


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Dissertação mest., Gestão da água e da costa, Universidade do Algarve, 2007

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senior thesis written for Oceanography 445

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El trauma de codo y la fractura de cúpula radial resultan ser un motivo de consulta frecuente en nuestro medio. Es común en nuestro medio que a pesar de tener radiografías de codo en las que se evidencia fractura de cúpula radial se solicite un TAC de codo. Consideramos que el TAC es una herramienta útil en algunos casos de fracturas de la cúpula radial, es decir, no se debe tomar de forma rutinaria el TAC de codo en los pacientes con fracturas de cúpula radial como es usual en nuestro medio. Existen pocos estudios que comparan la concordancia inter observador de las clasificaciones utilizadas para las fracturas de cúpula radial, pero, no existe en la literatura mundial un estudio que evalué las diferencias entre la clasificación de la fractura en base a radiografías y tomografía entre un grupo ortopedistas traumatólogos y sub-especialistas de miembro superior. La realización de este estudio permite elaborar guías de manejo de pacientes con fractura de cúpula radial en la que se racionalizara el uso del TAC de codo.

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Las fracturas de la cúpula radial corresponden a un tercio de todas las fracturas del codo en adultos (1), por lo que se toman radiografías o tomografías, sin embargo no existe literatura que soporte la realización de la tomografía como estudio complementario, por lo que preguntamos ¿La tomografía de codo cambia la conducta tomada previamente con radiografía en fracturas de cúpula radial? Se propone un estudio de concordancia, donde se evalúan las radiografías y tomografías por parte de dos cirujanos de codo, de pacientes con diagnóstico de fractura de cúpula radial valorados en urgencias de dos hospitales de tercer nivel de Bogotá desde enero 2011 a enero 2013. Se revisaron 116 historias, 99 cumplieron los criterios, las radiografías fueron revisadas por dos ortopedistas de codo quienes realizaron clasificación de Mason obteniendo un κ 1 (p˂ 0,00), propuesta de tratamiento postradiografía κ 0,934 (p˂ 0,000 IC95% 0.85, 1). Tratamiento post-tomografía de codo κ 0.949 (p˂ 0,00 IC95% 0.867,1). Concordancia intra-ortopedista de la conducta pre y post-tomografía hay cambio en la conducta del ortopedista 1 en 32.6% (κ 0.674 p˂ 0,00 IC95% 0.52, 0.818) y del ortopedista 2 en 36% (κ 0.64 p˂ 0,00 IC95% 0.452, 0.792). Se dividieron los pacientes en Mason I, II, III con concordancia considerable en los pacientes Mason I y III, mientras que en Mason II fue una concordancia aceptable lo que significa que el uso de tomografía de codo cambia la conducta en general pero sobretodo en pacientes clasificados Masson II.

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This paper reviews a study to examine signal detection in the auditory system.

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The vibrational spectrum of dimethyl acetylene has been remeasured with better resolving power than hitherto, and the rotational fine structure of some perpendicular type bands has been partly analyzed. The energy levels of a molecule of this kind in which internal rotation of methyl groups may arise have been re-examined theoretically and the rotational structure of the absorption bands has been more clearly defined than previously. The experimental results are consistent with the assumption of unrestricted internal rotation of the methyl groups, and the Coriolis factors $\zeta _{i}$ for several vibrations have been determined.

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The biological reduction of atmospheric N-2 to ammonium (nitrogen fixation) provides about 65% of the biosphere's available nitrogen. Most of this ammonium is contributed by legume rhizobia symbioses(1), which are initiated by the infection of legume hosts by bacteria (rhizobia), resulting in formation of root nodules. Within the nodules, rhizobia are found as bacteroids, which perform the nitrogen fixation: to do this, they obtain sources of carbon and energy from the plant, in the form of dicarboxylic acids(2,3). It has been thought that, in return, bacteroids simply provide the plant with ammonium. But here we show that a more complex amino-acid cycle is essential for symbiotic nitrogen fixation by Rhizobium in pea nodules. The plant provides amino acids to the bacteroids, enabling them to shut down their ammonium assimilation. In return, bacteroids act like plant organelles to cycle amino acids back to the plant for asparagine synthesis. The mutual dependence of this exchange prevents the symbiosis being dominated by the plant, and provides a selective pressure for the evolution of mutualism.

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Accurately measured peptide masses can be used for large-scale protein identification from bacterial whole-cell digests as an alternative to tandem mass spectrometry (MS/MS) provided mass measurement errors of a few parts-per-million (ppm) are obtained. Fourier transform ion cyclotron resonance (FTICR) mass spectrometry (MS) routinely achieves such mass accuracy either with internal calibration or by regulating the charge in the analyzer cell. We have developed a novel and automated method for internal calibration of liquid chromatography (LC)/FTICR data from whole-cell digests using peptides in the sample identified by concurrent MS/MS together with ambient polydimethyl-cyclosiloxanes as internal calibrants in the mass spectra. The method reduced mass measurement error from 4.3 +/- 3.7 ppm to 0.3 +/- 2.3 ppm in an E. coli LC/FTICR dataset of 1000 MS and MS/MS spectra and is applicable to all analyses of complex protein digests by FTICRMS. Copyright (c) 2006 John Wiley & Sons, Ltd.

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Research in the late 1980s showed that in many corporate real estates users were not fully aware of the full extent of their property holdings. In many cases, not only was the value of the holdings unknown, but there was uncertainty over the actual extent of ownership within the portfolio. This resulted in a large number of corporate occupiers reviewing their property holdings during the 1990s, initially to create a definitive asset register, but also to benefit from an more efficient use of space. Good management of corporately owned property assets is of equal importance as the management of other principal resources within the company. A comprehensive asset register can be seen as the first step towards a rational property audit. For the effective, efficient and economic delivery of services, it is vital that all property holdings are utilised to the best advantage. This requires that the property provider and the property user are both fully conversant with the value of the property holding and that an asset/internal rent/charge is made accordingly. The advantages of internal rent charging are twofold. Firstly, it requires the occupying department to “contribute” an amount to the business equivalent to the open market rental value of the space that it occupies. This prevents the treating of space as a free good and, as individual profit centres, each department will then rationalise its holdings to minimise its costs. The second advantage is from a strategic viewpoint. By charging an asset rent, the holding department can identify the performance of its real estate holdings. This can then be compared to an internal or external benchmark to help determine whether the company has adopted the most efficient tenure pattern for its properties. This paper investigates the use of internal rents by UK-based corporate businesses and explains internal rents as a form of transfer pricing in the context of management and responsibility accounting. The research finds that the majority of charging organisations introduced internal rents primarily to help calculate true profits at the business unit level. However, less than 10% of the charging organisations introduced internal rents primarily to capture the return on assets within the business. There was also a sizeable element of the market who had no plans to introduce internal rents. Here, it appears that, despite academic and professional views that internal rents are beneficial in improving the efficient use of property, opinion at the business and operational level has not universally accepted this proposition.

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Individuals with schizophrenia, particularly those with passivity symptoms, may not feel in control of their actions, believing them to be controlled by external agents. Cognitive operations that contribute to these symptoms may include abnormal processing in agency as well as body representations that deal with body schema and body image. However, these operations in schizophrenia are not fully understood, and the questions of general versus specific deficits in individuals with different symptom profiles remain unanswered. Using the projected-hand illusion (a digital video version of the rubber-hand illusion) with synchronous and asynchronous stroking (500 ms delay), and a hand laterality judgment task, we assessed sense of agency, body image, and body schema in 53 people with clinically stable schizophrenia (with a current, past, and no history of passivity symptoms) and 48 healthy controls. The results revealed a stable trait in schizophrenia with no difference between clinical subgroups (sense of agency) and some quantitative (specific) differences depending on the passivity symptom profile (body image and body schema). Specifically, a reduced sense of self-agency was a common feature of all clinical subgroups. However, subgroup comparisons showed that individuals with passivity symptoms (both current and past) had significantly greater deficits on tasks assessing body image and body schema, relative to the other groups. In addition, patients with current passivity symptoms failed to demonstrate the normal reduction in body illusion typically seen with a 500 ms delay in visual feedback (asynchronous condition), suggesting internal timing problems. Altogether, the results underscore self-abnormalities in schizophrenia, provide evidence for both trait abnormalities and state changes specific to passivity symptoms, and point to a role for internal timing deficits as a mechanistic explanation for external cues becoming a possible source of self-body input.

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This research report is based on a study undertaken in Australia, and aims to evaluate the role of internal audit in corporate governance and management. It identifies the accountability structures and objectives of internal audit, considers the nature of internal audit functions and the extent of application of The Institute of Internal Auditors Standards of Professional Practice, reviews the relationships of the chief audit executives (CAEs) and assesses the nature of financial report risks and other issues covered by internal auditors. The research findings include a diversity of accountability structures for CAEs and a range of internal audit activities, with the application of the IIA Standards being in need of improvement. In conclusion, the researchers make recommendations for improvements in practice to be considered by The Institute of Internal Auditors and other regulating and governing bodies.

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The selection of an inappropriate regime by policy makers can thwart the effective implementation of public policy and lead to implementation failure. Competing values in the implementation process have a significant impact on the results of implementation, and the regime selected for implementation implies the choice of one value over another. Stoker has argued that on the one hand central leadership is valued for consistency, benefits of scale, co-ordination and cost sharing (instrumental model); and on the other, diffuse authority is valued as knowledge is particular and situational, and the task of analysis is to understand the problems, perspectives and interactions of implementation participants at the contact point between public programs and their clients (accommodation model). This study examines the implementation regime chosen by the Victorian Government for the introduction of a modern internal auditing function into the Victorian Public Service, using the Bureau of Internal Audit within its Department of Management and Budget. The selection of the Department of Management and Budget for the introduction of Internal Audit as a managerial accountability mechanism indicates that the instrumental model was held by the Victorian Government to be the most important in implementation. It is argued that use of a top-down central agency leadership approach resulted in implementation failure. Three propositions suggesting the mechanisms by which this result is brought about are examined: that lack of co-ordinated planning at the outset will result in inadequate definition of client needs as part of policy formulation; that intraorganisational conflict during the implementation success, as individual participants are likely to exercise their veto; and the increasing the number of participants contributes to complexity, so that they should only be involved in implementation when their presence is absolutely required. It is argued that the essential task of implementation is to create an environment where participants are likely to co-operate to achieve predetermined public policy goals; and that the introduction of a modern internal auditing approach into the Victorian Public Service required a more participatory implementation regime in order to facilitate policy outcomes and prevent implementation failure. It is also argued that the dominance of economic reform over accountability in Victoria restricted the ability of the Bureau of Internal Audit to implement change to internal audit practices within Victorian Government departments. The selection of an instrumental model of implementation by the Department of Management and Budget is examined in the context of the environment that existed in Victoria between 1982-1987; and while some of the values which Stoker associates with the top-down approach to policy making were observed, an alternative view to the development of internal auditing in the Victorian Public Service can be sustained.