The measurement of applied forces during anterior single rod surgical correction of adolescent idiopathic scoliosis

INTRODUCTION. Following anterior thoracoscopic instrumentation and fusion for the treatment of thoracic AIS, implant related complications have been reported as high as 20.8%. Currently the magnitudes of the forces applied to the spine during anterior scoliosis surgery are unknown. The aim of this study was to measure the segmental compressive forces applied during anterior single rod instrumentation in a series of adolescent idiopathic scoliosis patients. METHODS. A force transducer was designed, constructed and retrofitted to a surgical cable compression tool, routinely used to apply segmental compression during anterior scoliosis correction. Transducer output was continuously logged during the compression of each spinal joint, the output at completion converted to an applied compression force using calibration data. The angle between adjacent vertebral body screws was also measured on intra-operative frontal plane fluoroscope images taken both before and after each joint compression. The difference in angle between the two images was calculated as an estimate for the achieved correction at each spinal joint. RESULTS. Force measurements were obtained for 15 scoliosis patients (Aged 11-19 years) with single thoracic curves (Cobb angles 47˚- 67˚). In total, 95 spinal joints were instrumented. The average force applied for a single joint was 540 N (± 229 N)ranging between 88 N and 1018 N. Experimental error in the force measurement, determined from transducer calibration was ± 43 N. A trend for higher forces applied at joints close to the apex of the scoliosis was observed. The average joint correction angle measured by fluoroscope imaging was 4.8˚ (±2.6˚, range 0˚-12.6˚). CONCLUSION. This study has quantified in-vivo, the intra-operative correction forces applied by the surgeon during anterior single rod instrumentation. This data provides a useful contribution towards an improved understanding of the biomechanics of scoliosis correction. In particular, this data will be used as input for developing patient-specific finite element simulations of scoliosis correction surgery.

Contribution of different physical forces to the disjoining pressure of a thin water film being pressed by an oil droplet

With an objective to understand the nature of forces which contribute to the disjoining pressure of a thin water film on a steel substrate being pressed by an oil droplet, two independent sets of experiments were done. (i) A spherical silica probe approaches the three substrates; mica, PTFE and steel, in a 10 mM electrolyte solution at two different pHs (3 and 10). (ii) The silica probe with and without a smeared oil film approaches the same three substrates in water (pH = 6). The surface potential of the oil film/water was measured using a dynamic light scattering experiment. Assuming the capacity of a substrate for ion exchange the total interaction force for each experiment was estimated to include the Derjaguin-Landau-Verwey-Overbeek (DLVO) force, hydration repulsion, hydrophobic attraction and oil-capillary attraction. The best fit of these estimates to the force-displacement characteristics obtained from the two sets of experiment gives the appropriate surface potentials of the substrates. The procedure allows an assessment of the relevance of a specific physical interaction to an experimental configuration. Two of the principal observations of this work are: (i) The presence of a surface at constant charge, as in the presence of an oil film on the probe, significantly enhances the counterion density over what is achieved when both the surfaces allow ion exchange. This raises the corresponding repulsion barrier greatly. (ii) When the substrate surface is wettable by oil, oil-capillary attraction contributes substantially to the total interaction. If it is not wettable the oil film is deformed and squeezed out. (C) 2010 Elsevier Inc. All rights reserved.

The measurement of applied forces during anterior single rod correction of adolescent idiopathic scoliosis

Adolescent idiopathic scoliosis (AIS) is the most common form of spinal deformity in paediatrics, prevalent in approximately 2-4% of the general population. While it is a complex three-dimensional deformity, it is clinically characterised by an abnormal lateral curvature of the spine. The treatment for severe deformity is surgical correction with the use of structural implants. Anterior single rod correction employs a solid rod connected to the anterior spine via vertebral body screws. Correction is achieved by applying compression between adjacent vertebral body screws, before locking each screw onto the rod. Biomechanical complication rates have been reported as high as 20.8%, and include rod breakage, screw pull-out and loss of correction. Currently, the corrective forces applied to the spine are unknown. These forces are important variables to consider in understanding the biomechanics of scoliosis correction. The purpose of this study was to measure these forces intra-operatively during anterior single rod AIS correction.

Application of digital image analysis to the study of banded spherulite during growing and melting process

A digital image analysis(DIA) technique can be applied directly to the image obtained by polarizing microscope. The time-resolved DIA apparatus including image collecting, showing and data analysis has been home-made. As an example, it has been used to study the banded spherulite in the blends of poly(epsilon-caprolactone) (PCL) and poly(styrene-ran-acrylonitrile) (SAN).

ACL reconstruction with physiological graft tension by intraoperative adjustment of the anteroposterior translation to the uninjured contralateral knee.

PURPOSE Fixation of anterior cruciate ligament (ACL) substitutes with non-physiological anteroposterior translation (APT) worsens outcome. The aim was to present a technique for physiological APT adjustment of the transplant in ACL reconstruction and its outcome at midterm. METHODS In a consecutive series of 28 patients (age 32 ± 11 years, 24 male), chronic ACL deficiency was treated by bone-patella-tendon-bone reconstruction. Transplant APT was adjusted to that of the contralateral uninjured ACL, measured 3, 6, and 12 months postoperatively using the Rolimeter. At a median follow-up of 5.3 years (3-8 years), 82% of the patients were re-evaluated with APT measurement and using IKDC-, Tegner-, Lysholm-Scores, conventional radiographs and MRI. RESULTS No differences in APT (mean ± SD) between uninjured and reconstructed knees were observed after adjustment (6 ± 1 versus 6 ± 1 mm, n.s.). Three months postoperatively, a statistically significant increase in APT (7 ± 1 mm) and a further increase at midterm (9 ± 2 mm) were observed. Patients scored "normal" or "nearly normal", respectively, in 79% (IKDC) and 4 (3-9) points (Tegner; median, range) or 89 ± 9 points (Lysholm; mean ± SD). Radiological evaluation showed no, minimal or moderate joint degeneration in 5, 20 and 75% of patients, respectively. MRI confirmed intact ACL transplants in all patients. CONCLUSION ACL reconstruction using the presented technique was considered successful, as patients did not suffer from subjective instability, radiographic analysis did not provide evidence for graft rupture at midterm. However, APT increase and occurrence of degenerative changes in reconstructed knees at the midterm might not be prevented even by restoration of a physiological APT in ACL reconstruction. The Rolimeter can be used for quick and easy intraoperative indirect control of the applied tension to the ACL transplant by measuring the APT to obtain physiological tensioning resulting in a satisfying outcome at midterm. LEVEL OF EVIDENCE IV.

An evaluation of coping ability as a guide to the treatment of persons diagnosed with schizophrenia and substance abuse

This dissertation introduced substance abuse to the Dynamic Vulnerability Formulation (DVF) and the social competence model to determine if the relationship between schizophrenic symptomatology and coping ability in the DVF applied also to the dually diagnosed schizophrenic or if these variables needed to be modified. It compared the coping abilities of dually and singly diagnosed clients in day treatment and identified, examined, and assessed the relative influence of relevant mediating variables on two dimensions of coping ability of the dually diagnosed: coping skills and coping effort. These variables were: presence of negative and nonnegative symptoms, duration of mental illness, type of substance used, and age of first substance use.^ A priori effect sizes based on previous empirical research were used to interpret the results related to the comparison of demographic, socioeconomic, and treatment characteristics between the singly and dually diagnosed study samples. The data suggested that the singly diagnosed group had higher coping skills than the dually diagnosed group, particularly in the areas of housing stability, work affect, and total social adjustment. The dually diagnosed group had lower scores on one aspect of coping effort--agency or self-efficacy. The data supported the presence of an inverse relationship between symptom severity and coping skills, particularly for the dually diagnosed group. The data did not support the presence of an inverse relationship between symptom severity and coping effort, but did suggest a positive relationship between symptom severity and one measure of coping effort, agency, for the dually diagnosed group. Regression equations using each summary measure of coping skill--social adjustment and role functioning--yielded statistically significant F-ratios. Thirty-six percent of the variance in social adjustment and thirty-one percent of the variance in role functioning were explained by the relative influence of the relevant variables. Both negative and non-negative symptoms were the only significant predictors of social adjustment. The non-negative symptoms variable was the sole significant predictor of role functioning. The results of this study provided partial support for the use of the Dynamic Vulnerability Formulation (DVF) with the dually diagnosed. ^

Letter to the editor : likelihood of tetraplegia after CT clearance of the cervical spine in obtunded blunt trauma patients

...the probabilistic computer simulation study by Dunham and colleagues evaluating the impact of different cervical spine management (CSM) strategies on tetraplegia and brain injury outcomes.1 Based on literature findings, expert opinion and with use of advances programming techniques the authors conclude that early collar removal without cervical spine magnetic resonance imaging (MRI) is a preferable CSM strategy for comatose, blunt trauma patients with extremity movement and a negative cervical spine computed tomography(CT) scan. Although we do not have the required expertise to comment on the applied statistical approach, we would like to comment on one of the medical assumptions raised by the authors, namely the likelihood of tetraplegia in this specific population....

Hydrodynamic forces on heave plates for offshore systems oscillating close to the seabed or the free surface

La energía eólica marina es uno de los recursos energéticos con mayor proyección pudiendo contribuir a reducir el consumo de combustibles fósiles y a cubrir la demanda de energía en todo el mundo. El concepto de aerogenerador marino está basado en estructuras fijas como jackets o en plataformas flotantes, ya sea una semisumergible o una TLP. Se espera que la energía eólica offshore juegue un papel importante en el perfil de producción energética de los próximos años; por tanto, las turbinas eólicas deben hacerse más fables y rentables para ser competitivas frente a otras fuentes de energía. Las estructuras flotantes pueden experimentar movimientos resonantes en estados de la mar con largos períodos de oleaje. Estos movimientos disminuyen su operatividad y pueden causar daños en los componentes eléctricos de las turbinas y en las palas, también en los risers y moorings. La respuesta de la componente vertical del movimiento puede reducirse mediante diferentes actuaciones: (1) aumentando la amortiguación del sistema, (2) manteniendo el período del movimiento vertical fuera del rango de la energía de la ola, y (3) reduciendo las fuerzas de excitación verticales. Un ejemplo típico para llevar a cabo esta reducción son las "Heave Plates". Las heave plates son placas que se utilizan en la industria offshore debido a sus características hidrodinámicas, ya que aumentan la masa añadida y la amortiguación del sistema. En un análisis hidrodinámico convencional, se considera una estructura sometida a un oleaje con determinadas características y se evalúan las cargas lineales usando la teoría potencial. El amortiguamiento viscoso, que juega un papel crucial en la respuesta en resonancia del sistema, es un dato de entrada para el análisis. La tesis se centra principalmente en la predicción del amortiguamiento viscoso y de la masa añadida de las heave plates usadas en las turbinas eólicas flotantes. En los cálculos, las fuerzas hidrodinámicas se han obtenido con el f n de estudiar cómo los coeficientes hidrodinámicos de masa añadida5 y amortiguamiento varían con el número de KC, que caracteriza la amplitud del movimiento respecto al diámetro del disco. Por otra parte, se ha investigado la influencia de la distancia media de la ‘heave plate’ a la superficie libre o al fondo del mar, sobre los coeficientes hidrodinámicos. En este proceso, un nuevo modelo que describe el trabajo realizado por la amortiguación en función de la enstrofía, es descrito en el presente documento. Este nuevo enfoque es capaz de proporcionar una correlación directa entre el desprendimiento local de vorticidad y la fuerza de amortiguación global. El análisis también incluye el estudio de los efectos de la geometría de la heave plate, y examina la sensibilidad de los coeficientes hidrodinámicos al incluir porosidad en ésta. Un diseño novedoso de una heave plate, basado en la teoría fractal, también fue analizado experimentalmente y comparado con datos experimentales obtenidos por otros autores. Para la resolución de las ecuaciones de Navier Stokes se ha usado un solver basado en el método de volúmenes finitos. El solver usa las librerías de OpenFOAM (Open source Field Operation And Manipulation), para resolver un problema multifásico e incompresible, usando la técnica VOF (volume of fluid) que permite capturar el movimiento de la superficie libre. Los resultados numéricos han sido comparados con resultados experimentales llevados a cabo en el Canal del Ensayos Hidrodinámicos (CEHINAV) de la Universidad Politécnica de Madrid y en el Canal de Experiencias Hidrodinámicas (CEHIPAR) en Madrid, al igual que con otros experimentos realizados en la Escuela de Ingeniería Mecánica de la Universidad de Western Australia. Los principales resultados se presentan a continuación: 1. Para pequeños valores de KC, los coeficientes hidrodinámicos de masa añadida y amortiguamiento incrementan su valor a medida que el disco se aproxima al fondo marino. Para los casos cuando el disco oscila cerca de la superficie libre, la dependencia de los coeficientes hidrodinámicos es más fuerte por la influencia del movimiento de la superficie libre. 2. Los casos analizados muestran la existencia de un valor crítico de KC, donde la tendencia de los coeficientes hidrodinámicos se ve alterada. Dicho valor crítico depende de la distancia al fondo marino o a la superficie libre. 3. El comportamiento físico del flujo, para valores de KC cercanos a su valor crítico ha sido estudiado mediante el análisis del campo de vorticidad. 4. Introducir porosidad al disco, reduce la masa añadida para los valores de KC estudiados, pero se ha encontrado que la porosidad incrementa el valor del coeficiente de amortiguamiento cuando se incrementa la amplitud del movimiento, logrando un máximo de damping para un disco con 10% de porosidad. 5. Los resultados numéricos y experimentales para los discos con faldón, muestran que usar este tipo de geometrías incrementa la masa añadida cuando se compara con el disco sólido, pero reduce considerablemente el coeficiente de amortiguamiento. 6. Un diseño novedoso de heave plate basado en la teoría fractal ha sido experimentalmente estudiado a diferentes calados y comparado con datos experimentales obtenidos por otro autores. Los resultados muestran un comportamiento incierto de los coeficientes y por tanto este diseño debería ser estudiado más a fondo. ABSTRACT Offshore wind energy is one of the promising resources which can reduce the fossil fuel energy consumption and cover worldwide energy demands. Offshore wind turbine concepts are based on either a fixed structure as a jacket or a floating offshore platform like a semisubmersible, spar or tension leg platform. Floating offshore wind turbines have the potential to be an important part of the energy production profile in the coming years. In order to accomplish this wind integration, these wind turbines need to be made more reliable and cost efficient to be competitive with other sources of energy. Floating offshore artifacts, such oil rings and wind turbines, may experience resonant heave motions in sea states with long peak periods. These heave resonances may increase the system downtime and cause damage on the system components and as well as on risers and mooring systems. The heave resonant response may be reduced by different means: (1) increasing the damping of the system, (2) keeping the natural heave period outside the range of the wave energy, and (3) reducing the heave excitation forces. A typical example to accomplish this reduction are “Heave Plates”. Heave plates are used in the offshore industry due to their hydrodynamic characteristics, i.e., increased added mass and damping. Conventional offshore hydrodynamic analysis considers a structure in waves, and evaluates the linear and nonlinear loads using potential theory. Viscous damping, which is expected to play a crucial role in the resonant response, is an empirical input to the analysis, and is not explicitly calculated. The present research has been mainly focused on the prediction of viscous damping and added mass of floating offshore wind turbine heave plates. In the calculations, the hydrodynamic forces have been measured in order to compute how the hydrodynamic coefficients of added mass1 and damping vary with the KC number, which characterises the amplitude of heave motion relative to the diameter of the disc. In addition, the influence on the hydrodynamic coefficients when the heave plate is oscillating close to the free surface or the seabed has been investigated. In this process, a new model describing the work done by damping in terms of the flow enstrophy, is described herein. This new approach is able to provide a direct correlation between the local vortex shedding processes and the global damping force. The analysis also includes the study of different edges geometry, and examines the sensitivity of the damping and added mass coefficients to the porosity of the plate. A novel porous heave plate based on fractal theory has also been proposed, tested experimentally and compared with experimental data obtained by other authors for plates with similar porosity. A numerical solver of Navier Stokes equations, based on the finite volume technique has been applied. It uses the open-source libraries of OpenFOAM (Open source Field Operation And Manipulation), to solve 2 incompressible, isothermal immiscible fluids using a VOF (volume of fluid) phase-fraction based interface capturing approach, with optional mesh motion and mesh topology changes including adaptive re-meshing. Numerical results have been compared with experiments conducted at Technical University of Madrid (CEHINAV) and CEHIPAR model basins in Madrid and with others performed at School of Mechanical Engineering in The University of Western Australia. A brief summary of main results are presented below: 1. At low KC numbers, a systematic increase in added mass and damping, corresponding to an increase in the seabed proximity, is observed. Specifically, for the cases when the heave plate is oscillating closer to the free surface, the dependence of the hydrodynamic coefficients is strongly influenced by the free surface. 2. As seen in experiments, a critical KC, where the linear trend of the hydrodynamic coefficients with KC is disrupted and that depends on the seabed or free surface distance, has been found. 3. The physical behavior of the flow around the critical KC has been explained through an analysis of the flow vorticity field. 4. The porosity of the heave plates reduces the added mass for the studied porosity at all KC numbers, but the porous heave plates are found to increase the damping coefficient with increasing amplitude of oscillation, achieving a maximum damping coefficient for the heave plate with 10% porosity in the entire KC range. 5. Another concept taken into account in this work has been the heave plates with flaps. Numerical and experimental results show that using discs with flaps will increase added mass when compared to the plain plate but may also significantly reduce damping. 6. A novel heave plate design based on fractal theory has tested experimentally for different submergences and compared with experimental data obtained by other authors for porous plates. Results show an unclear behavior in the coefficients and should be studied further. Future work is necessary in order to address a series of open questions focusing on 3D effects, optimization of the heave plates shapes, etc.

The shallow water approximation applied to the aluminium electrolysis process

The industrial production of aluminium is an electrolysis process where two superposed horizontal liquid layers are subjected to a mainly vertical electric current supplied by carbon electrodes. The lower layer consists of molten aluminium and lies on the cathode. The upper layer is the electrolyte and is covered by the anode. The interface between the two layers is often perturbed, leading to oscillations, or waves, similar to the waves on the surface of seas or lakes. The presence of electric currents and the resulting magnetic field are responsible for electromagnetic (Lorentz) forces within the fluid, which can amplify these oscillations and have an adverse influence on the process. The electrolytic bath vertical to horizontal aspect ratio is such, that it is advantageous to use the shallow water equations to model the interface motion. These are the depth-averaging the Navier-Stokes equations so that nonlinear and dispersion terms may be taken into account. Although these terms are essential to the prediction of wave dynamics, they are neglected in most of the literature on interface instabilities in aluminium reduction cells where only the linear theory is usually considered. The unknown variables are the two horizontal components of the fluid velocity, the height of the interface and the electric potential. In this application, a finite volume resolution of the double-layer shallow water equations including the electromagnetic sources has been developed, for incorporation into a generic three-dimensional computational fluid dynamics code that also deals with heat transfer within the cell.

The BEE Undergraduate Model for Knowledge Development applied to the QUT Spatial Science Course : Diversity in Surveying Curriculum

This paper provides an overview of the current QUT Spatial Science undergraduate program based in Brisbane, Queensland, Australia. It discusses the development and implementation of a broad-based educational model for the faculty of built environment and engineering courses and specifically to the course structure of the new Bachelor of Urban Development (Spatial Science) study major. A brief historical background of surveying courses is discussed prior to the detailing of the three distinct and complementary learning themes of the new course structure with a graphical course matrix. Curriculum mapping of the spatial science major has been undertaken as the course approaches formal review in late 2010. Work-integrated learning opportunities have been embedded into the curriculum and a brief outline is presented. Some issues relevant to the tertiary surveying/ spatial sector are highlighted in the context of changing higher education environments in Australia.

Mathematical modelling of muscle recruitment and function in the lumbar spine

Low back pain is an increasing problem in industrialised countries and although it is a major socio-economic problem in terms of medical costs and lost productivity, relatively little is known about the processes underlying the development of the condition. This is in part due to the complex interactions between bone, muscle, nerves and other soft tissues of the spine, and the fact that direct observation and/or measurement of the human spine is not possible using non-invasive techniques. Biomechanical models have been used extensively to estimate the forces and moments experienced by the spine. These models provide a means of estimating the internal parameters which can not be measured directly. However, application of most of the models currently available is restricted to tasks resembling those for which the model was designed due to the simplified representation of the anatomy. The aim of this research was to develop a biomechanical model to investigate the changes in forces and moments which are induced by muscle injury. In order to accurately simulate muscle injuries a detailed quasi-static three dimensional model representing the anatomy of the lumbar spine was developed. This model includes the nine major force generating muscles of the region (erector spinae, comprising the longissimus thoracis and iliocostalis lumborum; multifidus; quadratus lumborum; latissimus dorsi; transverse abdominis; internal oblique and external oblique), as well as the thoracolumbar fascia through which the transverse abdominis and parts of the internal oblique and latissimus dorsi muscles attach to the spine. The muscles included in the model have been represented using 170 muscle fascicles each having their own force generating characteristics and lines of action. Particular attention has been paid to ensuring the muscle lines of action are anatomically realistic, particularly for muscles which have broad attachments (e.g. internal and external obliques), muscles which attach to the spine via the thoracolumbar fascia (e.g. transverse abdominis), and muscles whose paths are altered by bony constraints such as the rib cage (e.g. iliocostalis lumborum pars thoracis and parts of the longissimus thoracis pars thoracis). In this endeavour, a separate sub-model which accounts for the shape of the torso by modelling it as a series of ellipses has been developed to model the lines of action of the oblique muscles. Likewise, a separate sub-model of the thoracolumbar fascia has also been developed which accounts for the middle and posterior layers of the fascia, and ensures that the line of action of the posterior layer is related to the size and shape of the erector spinae muscle. Published muscle activation data are used to enable the model to predict the maximum forces and moments that may be generated by the muscles. These predictions are validated against published experimental studies reporting maximum isometric moments for a variety of exertions. The model performs well for fiexion, extension and lateral bend exertions, but underpredicts the axial twist moments that may be developed. This discrepancy is most likely the result of differences between the experimental methodology and the modelled task. The application of the model is illustrated using examples of muscle injuries created by surgical procedures. The three examples used represent a posterior surgical approach to the spine, an anterior approach to the spine and uni-lateral total hip replacement surgery. Although the three examples simulate different muscle injuries, all demonstrate the production of significant asymmetrical moments and/or reduced joint compression following surgical intervention. This result has implications for patient rehabilitation and the potential for further injury to the spine. The development and application of the model has highlighted a number of areas where current knowledge is deficient. These include muscle activation levels for tasks in postures other than upright standing, changes in spinal kinematics following surgical procedures such as spinal fusion or fixation, and a general lack of understanding of how the body adjusts to muscle injuries with respect to muscle activation patterns and levels, rate of recovery from temporary injuries and compensatory actions by other muscles. Thus the comprehensive and innovative anatomical model which has been developed not only provides a tool to predict the forces and moments experienced by the intervertebral joints of the spine, but also highlights areas where further clinical research is required.