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Sample records for distal intersection tenosynovitis

  1. Distal intersection tenosynovitis of the wrist: a lesser-known extensor tendinopathy with characteristic MR imaging features

    International Nuclear Information System (INIS)

    Parellada, Antoni J.; Gopez, Angela G.; Morrison, William B.; Sweet, Stephanie; Leinberry, Charles F.; Reiter, Sean B.; Kohn, Mark

    2007-01-01

    To present the MRI imaging findings of extensor tenosynovitis at the distal intersection or crossover between the second (extensor carpi radialis longus (ECRL) and brevis (ECRB)) and third (extensor pollicis longus (EPL)) extensor compartment tendons, and the anatomical details that may play a role in the pathogenesis of this condition. The imaging studies and clinical records of five patients (three females and two males, with ages ranging between 22 and 78 years; mean age, 49 years) presenting with pain on the dorsal and radial aspect of the wrist were reviewed by two musculoskeletal radiologists in consensus. Three cases were identified serendipitously during routine clinical reading sessions; a follow-up computerized database search for additional cases reported in the prior two years yielded two additional cases. The overall number of cases screened was 1,031. The diagnosis of tendinopathy affecting the second and third compartment extensor tendons was made on the basis of MRI findings and clinical follow-up, or synovectomy. All patients showed signs of tenosynovitis: in four patients both the tendons of the second and third extensor compartments were affected; the fifth patient showed signs of tenosynovitis of the EPL tendon, and tendinosis of the extensor carpi radialis tendons. Three patients showed tenosynovitis proximal and distal to the point of intersection; and in two of them, a discrete point of constriction was appreciated at the crossover site in relation to the extensor retinaculum. Two patients showed tenosynovitis limited to the segment distal to the point of decussation. Tendinosis tended to follow the presence of tenosynovitis. In one of the patients, subtendinous reactive marrow edema in Lister's tubercle was noted. Distal intersection tenosynovitis may be related to the biomechanical pulley effect exerted by Lister's tubercle on the EPL tendon as it leaves the third compartment and crosses over the extensor carpi radialis tendons, as well as

  2. Distal intersection tenosynovitis of the wrist: a lesser-known extensor tendinopathy with characteristic MR imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Parellada, Antoni J. [DII - Diagnostic Imaging, Inc., Philadelphia, PA (United States); Frankford Hospitals - Torresdale Campus, Department of Radiology, Philadelphia, PA (United States); Gopez, Angela G.; Morrison, William B. [Thomas Jefferson University, Department of Radiology, Philadelphia, PA (United States); Sweet, Stephanie [Thomas Jefferson University, Philadelphia Hand Center, Philadelphia, PA (United States); Leinberry, Charles F. [Thomas Jefferson University, Department of Orthopedic Surgery - Hand Surgery, Philadelphia, PA (United States); Reiter, Sean B.; Kohn, Mark [DII - Diagnostic Imaging, Inc., Philadelphia, PA (United States)

    2007-03-15

    To present the MRI imaging findings of extensor tenosynovitis at the distal intersection or crossover between the second (extensor carpi radialis longus (ECRL) and brevis (ECRB)) and third (extensor pollicis longus (EPL)) extensor compartment tendons, and the anatomical details that may play a role in the pathogenesis of this condition. The imaging studies and clinical records of five patients (three females and two males, with ages ranging between 22 and 78 years; mean age, 49 years) presenting with pain on the dorsal and radial aspect of the wrist were reviewed by two musculoskeletal radiologists in consensus. Three cases were identified serendipitously during routine clinical reading sessions; a follow-up computerized database search for additional cases reported in the prior two years yielded two additional cases. The overall number of cases screened was 1,031. The diagnosis of tendinopathy affecting the second and third compartment extensor tendons was made on the basis of MRI findings and clinical follow-up, or synovectomy. All patients showed signs of tenosynovitis: in four patients both the tendons of the second and third extensor compartments were affected; the fifth patient showed signs of tenosynovitis of the EPL tendon, and tendinosis of the extensor carpi radialis tendons. Three patients showed tenosynovitis proximal and distal to the point of intersection; and in two of them, a discrete point of constriction was appreciated at the crossover site in relation to the extensor retinaculum. Two patients showed tenosynovitis limited to the segment distal to the point of decussation. Tendinosis tended to follow the presence of tenosynovitis. In one of the patients, subtendinous reactive marrow edema in Lister's tubercle was noted. Distal intersection tenosynovitis may be related to the biomechanical pulley effect exerted by Lister's tubercle on the EPL tendon as it leaves the third compartment and crosses over the extensor carpi radialis tendons

  3. Acute Hemorrhagic Flexor Tenosynovitis due to Vincula Injury

    Science.gov (United States)

    Maher, Rory

    2015-01-01

    Summary: A 20-year-old previously well woman presented to the emergency department with classical signs of acute flexor tenosynovitis, 4 hours after a minor puncture wound over the volar aspect of her right middle finger distal interphalangeal joint. Exploration of the flexor sheath in theatre revealed frank blood within the sheath and extension of the puncture wound through the profundus tendon into the short vincula beneath. The blood was irrigated from the sheath, and the patient made a complete recovery by 2 weeks postoperatively. Although rare, irritation and distension of the flexor sheath caused by vincular hemorrhage can be an alternative mechanism for the development of acute flexor tenosynovitis, and as with pyogenic flexor tenosynovitis, prompt surgical treatment can minimize the risk of long-term functional impairment. PMID:26301147

  4. Stenosing tenosynovitis

    OpenAIRE

    Vuillemin, V.; Guerini, H.; Bard, H.; Morvan, G.

    2012-01-01

    Tenosynovitis refers to an inflammatory condition involving the synovial sheath of a tendon. Stenosing tenosynovitis is a peculiar entity caused by multiple factors, including local anatomy, mechanical factors, and hormonal factors. The main forms include de Quervain tendinopathy; trigger finger (stenosing tenosynovitis involving the flexor digitorum tendons); stenosing tenosynovitis of the extensor carpi ulnaris, extensor carpi radialis, or extensor comunis tendons; stenosing tenosynovitis o...

  5. The effects of implant composition on extensor tenosynovitis in a canine distal radius fracture model.

    Science.gov (United States)

    Sinicropi, Stefano M; Su, Brian W; Raia, Frank J; Parisien, May; Strauch, Robert J; Rosenwasser, Melvin P

    2005-03-01

    Dorsal plating of distal radius fractures with titanium plates has resulted in clinically observed tenosynovitis and tendon rupture. The goal of this study was to investigate whether titanium-based implants result in more extensor tendon inflammation than matched stainless-steel implants in a canine fracture model. An osteotomy was created in the distal radius of 18 beagles and fixed with 2.7-mm 4-hole plates composed of commercially pure titanium, titanium alloy (Ti-Al6-V4), or 316L stainless steel. Animals were killed at an average of 4 months. Tendon gliding was assessed by applying a force at the extensor musculotendinous junction and noting gliding. Histologic grading (mild, moderate, severe) was based on cellular hypertrophy, hyperplasia, and leukocytic infiltration. Tendons glided freely in 100% stainless-steel specimens, 75% of titanium alloy, and 43% of commercially pure titanium groups. A severe inflammatory reaction was identified in 60% of the titanium alloy (Ti-A16-V4) group, 57% of the pure titanium group, and 0% of the stainless-steel group. Dorsal plating of the canine radius with commercially pure titanium or titanium alloy implants produced a greater inflammatory peritendinous response than matched stainless-steel implants.

  6. Intersection syndrome: MR imaging with anatomic comparison of the distal forearm

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Jose E. de; Kim, Hyun-Jin; Albertotti, Flavio; Resnick, Donald [University of California, San Diego, VA San Diego Healthcare System, San Diego (United States)

    2004-11-01

    To correlate the anatomic and MR imaging characteristics of the area of intersection of the first and the second dorsal extensor tendon compartments (DETC) in the distal forearm in an attempt to improve the design of MR imaging protocols used for the evaluation of intersection syndrome. Ten forearms of nine cadavers underwent MR imaging in the axial and sagittal-oblique planes before and after tenography with direct injection of a gadolinium-containing contrast agent into the first DETC in four forearms, the second DETC in four forearms, and both compartments in the remaining two forearms. The area of intersection between the first and second DETC was identified in each case as well as its distance from Lister's tubercle. Subsequently all forearms were sectioned in the axial (8 forearms) or sagittal-oblique planes (2 remaining forearms) to parallel the imaging planes. Detailed examination of each of the anatomic slices was performed in a search for anatomic variations and for possible anatomic connections of the tendons sheaths. One forearm was dissected to identify the area of intersection. The area of intersection between the first and second DETC occurred between 3.5 cm and 4.8 cm (mean 4.18 cm) proximal to Lister's tubercle. After tenography, gadolinium solution was noted in the third DETC in two of four specimens in which the second DETC was injected and in one of two specimens in which both the first and second DETC were injected. Extension of the gadolinium solution between the first and second DETC was noted during isolated injections of either compartment, although this finding may have related to iatrogenic injection effects. The axial plane was the most valuable for assessment of the area of intersection of the first and second DETC. MR imaging is a noninvasive method that can be used for the evaluation of distal forearm and wrist pain. Standard wrist protocols do not include the area of intersection between the first and second DETC and, in

  7. Intersection syndrome: MR imaging with anatomic comparison of the distal forearm

    International Nuclear Information System (INIS)

    Lima, Jose E. de; Kim, Hyun-Jin; Albertotti, Flavio; Resnick, Donald

    2004-01-01

    To correlate the anatomic and MR imaging characteristics of the area of intersection of the first and the second dorsal extensor tendon compartments (DETC) in the distal forearm in an attempt to improve the design of MR imaging protocols used for the evaluation of intersection syndrome. Ten forearms of nine cadavers underwent MR imaging in the axial and sagittal-oblique planes before and after tenography with direct injection of a gadolinium-containing contrast agent into the first DETC in four forearms, the second DETC in four forearms, and both compartments in the remaining two forearms. The area of intersection between the first and second DETC was identified in each case as well as its distance from Lister's tubercle. Subsequently all forearms were sectioned in the axial (8 forearms) or sagittal-oblique planes (2 remaining forearms) to parallel the imaging planes. Detailed examination of each of the anatomic slices was performed in a search for anatomic variations and for possible anatomic connections of the tendons sheaths. One forearm was dissected to identify the area of intersection. The area of intersection between the first and second DETC occurred between 3.5 cm and 4.8 cm (mean 4.18 cm) proximal to Lister's tubercle. After tenography, gadolinium solution was noted in the third DETC in two of four specimens in which the second DETC was injected and in one of two specimens in which both the first and second DETC were injected. Extension of the gadolinium solution between the first and second DETC was noted during isolated injections of either compartment, although this finding may have related to iatrogenic injection effects. The axial plane was the most valuable for assessment of the area of intersection of the first and second DETC. MR imaging is a noninvasive method that can be used for the evaluation of distal forearm and wrist pain. Standard wrist protocols do not include the area of intersection between the first and second DETC and, in those cases

  8. Tuberculous Peroneal Tenosynovitis

    OpenAIRE

    Yu Chung Wong; Tun Hing Lui

    2016-01-01

    Musculoskeletal tuberculosis accounts for 1–5% of all cases of tuberculosis. Tuberculous tenosynovitis is an uncommon form of musculoskeletal tuberculosis occurring primarily in the hands and wrists and is rarely reported in the tendons of the feet. A case of tuberculous peroneal tenosynovitis is reported. Although tuberculosis is an uncommon cause of tenosynovitis, particularly in the foot, it should be included in the differential diagnosis of patients suffering from persistent swelling and...

  9. Sonographic characterization of tenosynovitis

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Gwy Suk; Lim, Hyo Keum; Lee, In Jae; Lee, Kil Woo; Bae, Sang Hoon; Lee, Kyung Hwan [College of Medicine, Hallym University, Seoul (Korea, Republic of)

    1992-03-15

    Tenosynovitis of the extremities is not uncommon but its diagnosis is not easy owing to its non-specific clinical manifestation. Thus it was beyond the field of imaging diagnosis so far. Recently the development of high resolution ultrasonogram has aided preoperative imaging diagnosis of tenosynovitis. The authors performed a retrospective reviewed of 27 patients who had ultrasonography due to tendon pathology(including 18 tenosynovitis) by observing sonographic findings and evaluation the diagnosis value of each finding. The overall diagnostic accuracy was 81.1% and common sonographic findings were focal swelling of the tendon, well-defined margin of the lesion, preserved fibrillar pattern, echo change of the lesion site and fluid collection. Above all, fluid collection. was the only statistically significant criterion for diagnosis of tenosynovitis(p<0.05). But its sensitivity was as low as 50%. In conclusion the ultrasonography is useful in diagnosis of tenosynovitis and fluid collection is of diagnostic value, but the differentiation between nodular tenosynovitis without fluid collection and other benign tumor is still beyond the scope of ultrasonographic diagnosis.

  10. Sonographic characterization of tenosynovitis

    International Nuclear Information System (INIS)

    Seo, Gwy Suk; Lim, Hyo Keum; Lee, In Jae; Lee, Kil Woo; Bae, Sang Hoon; Lee, Kyung Hwan

    1992-01-01

    Tenosynovitis of the extremities is not uncommon but its diagnosis is not easy owing to its non-specific clinical manifestation. Thus it was beyond the field of imaging diagnosis so far. Recently the development of high resolution ultrasonogram has aided preoperative imaging diagnosis of tenosynovitis. The authors performed a retrospective reviewed of 27 patients who had ultrasonography due to tendon pathology(including 18 tenosynovitis) by observing sonographic findings and evaluation the diagnosis value of each finding. The overall diagnostic accuracy was 81.1% and common sonographic findings were focal swelling of the tendon, well-defined margin of the lesion, preserved fibrillar pattern, echo change of the lesion site and fluid collection. Above all, fluid collection. was the only statistically significant criterion for diagnosis of tenosynovitis(p<0.05). But its sensitivity was as low as 50%. In conclusion the ultrasonography is useful in diagnosis of tenosynovitis and fluid collection is of diagnostic value, but the differentiation between nodular tenosynovitis without fluid collection and other benign tumor is still beyond the scope of ultrasonographic diagnosis

  11. Tuberculous Peroneal Tenosynovitis

    Directory of Open Access Journals (Sweden)

    Yu Chung Wong

    2016-06-01

    Full Text Available Musculoskeletal tuberculosis accounts for 1–5% of all cases of tuberculosis. Tuberculous tenosynovitis is an uncommon form of musculoskeletal tuberculosis occurring primarily in the hands and wrists and is rarely reported in the tendons of the feet. A case of tuberculous peroneal tenosynovitis is reported. Although tuberculosis is an uncommon cause of tenosynovitis, particularly in the foot, it should be included in the differential diagnosis of patients suffering from persistent swelling and pain in the hind foot, especially in countries where tuberculosis is prevalent.

  12. Isolated Tenosynovitis as a Sole Manifestation: The Great Mimicker Still Continues to Surprise Us

    Science.gov (United States)

    De, Abhishek; Surana, Trupti V; Biswas, Saugato; Reja, Abu Hena Hasanoor; Chatterjee, Gobinda

    2015-01-01

    A middle aged male presented with non-tender cystic swelling over left distal forearm since 1 year. No other cutaneous abnormality could be found except mild paresthesia of the overlying skin and equivocal thickening of the ipsilateral ulnar nerve. Routine investigation was within normal limits. Detailed workup of the patient including MRI of the lesion suggested the diagnosis as tenosynovitis with a soft tissue mass. Fine needle aspiration cytology from the cyst showed foamy macrophages and acid fast bacilli; while PCR of the aspirate confirmed the etiological agent as M. leprae. We, thus, report a unique case of isolated tenosynovitis as a sole manifestation of pure neural leprosy which is extremely rare in world literature. PMID:25814736

  13. Peroneus longus tenosynovitis.

    OpenAIRE

    Folan, J. C.

    1981-01-01

    Tenosynovitis of the tendon of peroneus longus has rarely been described in the literature (Aberle-Horstenegg, 1932; Burman and Lapidus, 1931). This is a report on the condition in two athletes and in one of whom the os peroneum was absent on the side of the tenosynovitis. It emphasises the importance of a detailed review of athletes' training patterns when assessing their injuries.

  14. Tuberculous flexor tenosynovitis of the hand

    OpenAIRE

    Mohamed Ali Sbai; Sofien Benzarti; Monia Boussen; Riadh Maalla

    2015-01-01

    Tuberculosis is a major public health problem in developing countries. Flexor tenosynovitis of the fingers constitutes an exceptional tuberculosis localization (Gabl et al., 1997; Senda et al., 2011) [1],[2]. Unusual presentations, such as tuberculous tenosynovitis, often go undetected and are associated with a diagnostic and therapeutic delay, especially when bacteriological research proves to be negative. Here, we report a case of tuberculous flexor tenosynovitis of the hand.

  15. Mycobacterium marinum infections of the distal upper extremities: clinical course and imaging findings in two cases with delayed diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Amrami, K.K.; Sundaram, M. [Dept. of Radiology, Mayo Clinic, SW, Rochester, MN (United States); Shin, A.Y.; Bishop, A.T. [Dept. of Orthopedics, Mayo Clinic, Rochester, MN (United States)

    2003-09-01

    Mycobacterium marinum infections cause tenosynovitis of the distal upper extremities and develop as a consequence of skin abrasions acquired in contaminated water. We report on two patients whose MR imaging studies showed tenosynovitis of the distal upper extremity secondary to M. marinum. In one patient sequential MR imaging showed development of bony erosions. Appropriate treatment was delayed in both patients because the diagnosis was not considered. We report on and discuss the clinical course and MR imaging findings in two patients with M. marinum infection. (orig.)

  16. Mycobacterium marinum infections of the distal upper extremities: clinical course and imaging findings in two cases with delayed diagnosis

    International Nuclear Information System (INIS)

    Amrami, K.K.; Sundaram, M.; Shin, A.Y.; Bishop, A.T.

    2003-01-01

    Mycobacterium marinum infections cause tenosynovitis of the distal upper extremities and develop as a consequence of skin abrasions acquired in contaminated water. We report on two patients whose MR imaging studies showed tenosynovitis of the distal upper extremity secondary to M. marinum. In one patient sequential MR imaging showed development of bony erosions. Appropriate treatment was delayed in both patients because the diagnosis was not considered. We report on and discuss the clinical course and MR imaging findings in two patients with M. marinum infection. (orig.)

  17. Ankle tenosynovitis in rheumatoid arthritis: clinical and ultrasonographic evaluation

    Directory of Open Access Journals (Sweden)

    Ana Luiza Naves Pereira

    2016-11-01

    Full Text Available Objective: To investigate ankle tenosynovitis in rheumatoid arthritis patients, regarding its presence, the kind of tendon involved and the concordance between clinical and ultrasound findings. Methods: Twenty patients with rheumatoid arthritis and pain or swollen ankle joint were evaluated. Tendon involvement was evaluated with ultrasound imaging. The Health Assessment Questionnaire (HAQ was performed for disability evaluation. Age, sex, disease duration, and vocational activity levels were also obtained. The statistical analysis included Fisher’s exact test. The significance level was 0.05. Results: Tenosynovitis was found in 13 of 20 (65.0% patients in 19 joints, in which 6 were bilaterally (46.1% and unilateral in 7 (53.8%. Tibialis posterior tenosynovitis was seen in nine (45.0% patients, Achilles tenosynovitis in seven (35.0%, tibialis anterior tenosynovitis in three (15.0%, and peroneal tenosynovitis in three (15.0% patients. We found concordance between symptomatic ankle and ultrasonographic findings in 92.3% of the patients with tenosynovitis. Association between severe HAQ with tendon involvement was not found (p>0.05. Disease duration was not associated with tenosynovitis. Patients were predominantly older, female, with mean age around 50.8 years. The long disease duration of patients presented a mean of 11.4 years and, most of them, with no vocational activity (65.0%. Conclusions: The results indicate that ankle tenosynovitis is very common in rheumatoid arthritis patients, both unilateral and bilateral. Tibialis posterior was the most common tendon involvement found. Finally, we found concordance between the clinical and ultrasound findings in almost all rheumatoid arthritis patients with ankle tenosynovitis.

  18. Subcutaneous sarcoidosis associated with sarcoid tenosynovitis.

    Science.gov (United States)

    Enzenauer, R J; Waterhouse, W J; West, S G

    1996-10-01

    Subcutaneous sarcoidosis and sarcoid tenosynovitis are unusual manifestations of systemic sarcoidosis. We report two Japanese women with disseminated sarcoidosis presenting with subcutaneous and tenosynovial involvement demonstrated by computed tomography and magnetic resonance imaging. Sarcoidosis must be considered in the differential diagnosis of unexplained subcutaneous nodulosis or tenosynovitis in patients with or without a previous diagnosis of sarcoidosis.

  19. Intersection Syndrome: The Subtle Squeak of an Overused Wrist.

    Science.gov (United States)

    Skinner, Thomas M

    2017-01-01

    Patient histories that include wrist pain can be pivotal in the distinction between intersection syndrome (IS) and the more common de Quervain's tenosynovitis (DQT). Presented here is a 26-year-old pregnant woman with a history of rowing who developed left radial/dorsal wrist pain and a rubbing/squeaking sensation. Nine months of conservative DQT therapy and a landmark-guided corticosteroid injection failed to relieve her symptoms. An in-clinic ultrasound showed tenosynovitis at the intersection of the first and second compartments, confirming a diagnosis of IS. She found immediate relief with ultrasound-guided saline hydrodissection, the injection of saline into the intercompartmental space to reduce adhesions. Both DQT and IS are overuse injuries caused by repetitive wrist extension, as occurs in rowing, and either condition can worsen after pregnancy. Distinguishing the subtleties between DQT and IS can be challenging. Close attention to the patient's description of the pain can guide treatment, potentially expediting recovery. In addition, saline hydrodissection can be both a diagnostic tool and a potentially therapeutic alternative to steroid injections for such tendinopathies. © Copyright 2017 by the American Board of Family Medicine.

  20. Pyogenic Flexor Tenosynovitis in an Infant

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    James I. Gragg

    2017-03-01

    Full Text Available Pyogenic flexor tenosynovitis is a rare, though well known infectious process of the flexor tendon sheath of the hand. This condition is generally diagnosed in adults by the observance of the four Kanavel signs. Application of the Kanavel signs to diagnosis in the pediatric population, however, is of unknown utility. We present the case of a 13-month-old male with pyogenic flexor tenosynovitis who presented with all four of the Kanavel signs.

  1. Tuberculous tenosynovitis of the wrist: MRI findings in three patients

    Energy Technology Data Exchange (ETDEWEB)

    Sueyoshi, E. [Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852 (Japan); Uetani, M. [Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852 (Japan); Hayashi, K. [Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852 (Japan); Kohzaki, S. [Nagasaki Municipal Hospital, Nagasaki (Japan)

    1996-08-01

    We report recent MRI findings in patients with tuberculous tenosynovitis of the wrist. Marked synovial thickening around the flexor tendons and fluid in the tendon sheath were clearly shown on MRI. Post-contrast study was useful in distinguishing the thick tenosynovium from the surrounding structures and fluid in the tendon sheath. The well-enhanced tenosynovium was also seen in the carpal tunnel in all cases. On the basis of these findings, we could easily distinguish tenosynovitis from other soft-tissue-mass lesions, such as tumors or infected ganglia. Tuberculous tenosynovitis is often not diagnosed early, and its differentiation from soft tissue tumors may be clinically difficult. MRI, particularly post-contrast study, is useful for early diagnosis of, and planning treatment for, tuberculous tenosynovitis. (orig.). With 3 figs.

  2. Tuberculous tenosynovitis of the wrist: MRI findings in three patients

    International Nuclear Information System (INIS)

    Sueyoshi, E.; Uetani, M.; Hayashi, K.; Kohzaki, S.

    1996-01-01

    We report recent MRI findings in patients with tuberculous tenosynovitis of the wrist. Marked synovial thickening around the flexor tendons and fluid in the tendon sheath were clearly shown on MRI. Post-contrast study was useful in distinguishing the thick tenosynovium from the surrounding structures and fluid in the tendon sheath. The well-enhanced tenosynovium was also seen in the carpal tunnel in all cases. On the basis of these findings, we could easily distinguish tenosynovitis from other soft-tissue-mass lesions, such as tumors or infected ganglia. Tuberculous tenosynovitis is often not diagnosed early, and its differentiation from soft tissue tumors may be clinically difficult. MRI, particularly post-contrast study, is useful for early diagnosis of, and planning treatment for, tuberculous tenosynovitis. (orig.). With 3 figs

  3. Tubercular tenosynovitis of extensor tendons of foot--a rare ...

    African Journals Online (AJOL)

    Tuberculosis of soft tissues as a result of spread from adjacent bone or joint is a well recognized entity. However isolated tuberculous pyomyositis, bursitis and tenosynovitis are rare, constituting about 1% of skeletal tuberculosis. Tubercular tenosynovitis commonly involves tendon sheaths of wrist and hand. Cases of ...

  4. Tuberculosis tenosynovitis of the extensor tendons of the wrist

    OpenAIRE

    Mrabet, Dalila; Ouenniche, Kmar; Mizouni, Habiba; Ounaies, Mouna; Khémiri, Chékib; Sahli, Héla; Sellami, Slaheddine

    2011-01-01

    Mycobacterial tuberculous tenosynovitis of the extensor tendon sheath is an extremely rare manifestation of extrapulmonary tuberculosis. The diagnosis may be easily delayed because of its non-specific clinical signs. We report a new case of tuberculous tenosynovitis of the extensor without concomitant pulmonary tuberculosis or documented immunodeficiency.

  5. An Unusual Cause of Flexor Tenosynovitis: Streptococcus mitis

    Science.gov (United States)

    Ulucay, Cağatay; Ozler, Turhan

    2014-01-01

    Summary: Streptococcus mitis is a commensal organism of the human oropharynx that rarely causes infection in healthy individuals. Herein, we describe a previously healthy 35-year-old woman who presented with acute pyogenic flexor tenosynovitis of the left index finger due to S. mitis infection. The patient’s infection was treated successfully via surgical and medical interventions, and during follow-up, it was determined that she was complement component C3 deficient. Tenosynovitis is an emergent clinical syndrome that can result in permanent disability or amputation. To the best of our knowledge, this case report is the first to describe tenosynovitis due to S. mitis; in addition, it highlights the importance of initiating therapy with antibiotics that are effective against this rare pathogen. PMID:25587497

  6. An Unusual Cause of Flexor Tenosynovitis: Streptococcus mitis

    Directory of Open Access Journals (Sweden)

    Ugur Anil Bingol, MD

    2014-12-01

    Full Text Available Summary: Streptococcus mitis is a commensal organism of the human oropharynx that rarely causes infection in healthy individuals. Herein, we describe a previously healthy 35-year-old woman who presented with acute pyogenic flexor tenosynovitis of the left index finger due to S. mitis infection. The patient’s infection was treated successfully via surgical and medical interventions, and during follow-up, it was determined that she was complement component C3 deficient. Tenosynovitis is an emergent clinical syndrome that can result in permanent disability or amputation. To the best of our knowledge, this case report is the first to describe tenosynovitis due to S. mitis; in addition, it highlights the importance of initiating therapy with antibiotics that are effective against this rare pathogen.

  7. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Rowbotham, Emma L.; Freeston, Jane E.; Emery, Paul; Grainger, Andrew J.

    2016-01-01

    The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. (orig.)

  8. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Rowbotham, Emma L. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Freeston, Jane E. [Department of Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Emery, Paul [University of Leeds, Arthritis Research UK, Leeds Musculoskeletal Biomedical Research Unit, LTHT Leeds Institute of Rheumatic Musculoskeletal Medicine, Leeds (United Kingdom); Grainger, Andrew J. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Chapel Allerton Hospital, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds (United Kingdom)

    2016-02-15

    The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. (orig.)

  9. The Use of the OMERACT Ultrasound Tenosynovitis Scoring System in Multicenter Clinical Trials.

    Science.gov (United States)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Naredo, Esperanza; Iagnocco, Annamaria; Möller, Ingrid; D'Agostino, Maria-Antonietta; Gandjbakhch, Frédérique; Terslev, Lene

    2018-02-01

    To test the sensitivity to change of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) ultrasound (US) scoring system for tenosynovitis when applied in a multicenter design. RA patients with US-verified tenosynovitis were recruited when scheduled for treatment intensification. Tenosynovitis was assessed at baseline, and 3 and 6 months followup, using the semiquantitative OMERACT scoring system. Expressed in median (25th; 75th percentiles), the overall greyscale and Doppler score decreased significantly from baseline at 4 (2; 7) and 3 (2; 6), to 6 months at 2 (0; 3) and 0 (0; 1, p The OMERACT US scoring system for tenosynovitis showed high responsiveness, supporting its use for diagnosing and monitoring tenosynovitis in multicenter trials.

  10. Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Naredo, Esperanza; D'Agostino, Maria Antonietta; Wakefield, Richard J

    2013-01-01

    OBJECTIVE: To produce consensus-based scoring systems for ultrasound (US) tenosynovitis and to assess the intraobserver and interobserver reliability of these scoring systems in rheumatoid arthritis (RA). METHODS: We undertook a Delphi process on US-defined tenosynovitis and US scoring system...... recruited. Ten rheumatologists expert in MSUS blindly, independently and consecutively scored for tenosynovitis in B-mode and PD mode three wrist extensor compartments, two finger flexor tendons and two ankle tendons of each patient in two rounds in a blinded fashion. Intraobserver reliability was assessed...... Doppler signal within the synovial sheath. The intraobserver reliability for tenosynovitis scoring on B-mode and PD mode was good (κ value 0.72 for B-mode; κ value 0.78 for PD mode). Interobserver reliability assessment showed good κ values for PD tenosynovitis scoring (first round, 0.64; second round, 0...

  11. Tenosynovitis of the ankles as onset of sarcoidosis in a patient with ulcerative colitis

    Directory of Open Access Journals (Sweden)

    F. Cozzi

    2011-09-01

    Full Text Available Arthritis and tenosynovitis are frequently reported as complications of inflammatory bowel diseases. About 10% of patients with ulcerative colitis presents articular inflammation, usually in the phases of activity of intestinal disease. Tenosynovitis is also a frequent complication of ulcerative colitis. We describe here a case of tenosynovitis of both ankles occurring in a patient affected by ulcerative colitis not in active phase. Chest X-ray and TC showed hilar lymphonode enlargement and transbronchial biopsy confirmed the diagnosis of sarcoidosis. In this disease tenosynovitis is very rare, unlike arthritis that is rather common. In conclusion we observed a case of ankle bilateral tenosynovitis as onset manifestation of sarcoidosis.

  12. Tibialis Posterior Tenosynovitis: A Unique Musculoskeletal Manifestation of Gout.

    Science.gov (United States)

    Shupper, Peter; Stitik, Todd P

    2018-02-01

    Extra-articular manifestations of gout can present in several ways, including tenosynovitis. We present a rare case of acute tibialis posterior gouty tenosynovitis. An 82-year-old man with a history of well-controlled gout presented with acute onset of left ankle pain, occurring without inciting event. The medial ankle was slightly erythematous with moderate dorsal-medial swelling and mild dorsal-lateral swelling, with severe tenderness to palpation over the medial retro-malleolar region. Range of motion and manual muscle testing were pain limited throughout. Ultrasound examination revealed a left posterior tibialis tendon sheath tenosynovitis with effusion and overlying soft tissue edema. Tendon sheath aspirate revealed sodium urate crystals and a white blood cell count of 6400/μL. Tendon sheath injection with a mixture of 1% lidocaine and dexamethasone 4 mg resulted in symptom resolution. Repeat ultrasound examination demonstrated no evidence of tibialis posterior tendon sheath effusion. This case is unique not only because acute gouty posterior tibialis tenosynovitis is very rare, particularly in a normouricemic individual, but also because the sonographic evidence of gouty infiltration into the posterior tibialis tendon and overlying subcutaneous tissue considerably aided in arriving at the correct diagnosis in a timely manner.

  13. Hyperparathyroidism-related extensor tenosynovitis at the wrist: a general review of the literature.

    Science.gov (United States)

    Ichihara, Satoshi; Hidalgo-Diaz, Juan Jose; Prunières, Guillaume; Facca, Sybille; Bodin, Frédéric; Boucher, Stéphanie; Liverneaux, Philippe

    2015-07-01

    Extensor tenosynovitis often occurs accompanying with rheumatoid arthritis, gout, trauma, mycobacterium and dialysis-related amyloidosis. However, there is no recognition of extensor tenosynovitis accompanying with hyperparathyroidism. The purpose of this general review was to describe the clinical condition and to report the results of surgical intervention in the extensor tenosynovitis at the wrist related to hyperparathyroidism. Hyperparathyroidism is thought to be a rare disease in adult. Although renal symptoms are the commonest symptom, musculoskeletal complaints also occur in hyperparathyroidism. From our general review, hyperparathyroidism deserves consideration in the differential diagnosis of extensor tenosynovitis at the wrist.

  14. Isolated Tuberculous Tenosynovitis of the Anterior Tibial and Extensor Digitorum Longus Tendons

    Directory of Open Access Journals (Sweden)

    Berhan Genç

    2013-01-01

    Full Text Available Musculoskeletal system is involved in 1-5% of extrapulmonary cases of tuberculosis. Tuberculous tenosynovitis is a rare form of musculoskeletal tuberculosis. Tuberculosis of the tendon sheath in the hand has been seen in a few cases. Involvement of the tendons of the leg is less common. Diagnosis is not easy as there are no specific clinical symptoms or signs. A 33-year-old male presented with painful swelling in the distal right lower limb that caused restriction of movement. Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons. Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue. A diagnosis of tuberculosis was made and medical treatment was initiated that proved successful. Patient remained infection-free at 26-month follow-up examination.

  15. Ultrasonography for diagnosis, monitoring and treatment of tenosynovitis in patients with rheumatoid arthritis.

    Science.gov (United States)

    Danielsen, Mads Ammitzbøll

    2018-03-01

    Rheumatod arthritis is a chronic systemic autoimmune disease, characterized by inflammation in joints and tendon sheaths, which frequently leads to permanent and serious disability due to joint destruction, but also tendon and ligament ruptures. Clinical management of rheumatoid arthritis has traditionally been supported by biochemical and radiographic findings. However, imaging modalities like ultrasound and magnetic resonance imaging (MRI) have improved the possibility for better management of rheumatoid arthritis patients, due to higher sensitivity and specificity for detecting ongoing inflammation, this thesis is focusing on tenosynovitis as recent studies have shown that inflammation in tendon sheaths, i.e. tenosynovitis, is a very common manifestation of rheumatoid arthritis and may often be mistaken for synovitis. Furthermore, presence of ultrasonographic tenosynovitis may predict clinical flare and erosive progression. 
The main aim of this PhD thesis was to further develop and validate ultrasound as a tool for diagnosis, monitoring and treatment of tenosynovitis. This was investigated in four studies: 
Study I: 3D Doppler Ultrasound findings in healthy wrist and finger tendon sheaths - Can feeding vessels lead to misinterpretation in Doppler-detected tenosynovitis? 
Study II: Image fusion of Ultrasound and MRI and B-flow evaluation of tenosynovitis - A pilot study on new imaging techniques in rheumatoid arthritis patients. 
Study III: Validity and sensitivity to change of the semi-quantitative Outcome Measures in Rheumatology Clinical Trials (OMERACT) ultrasound scoring system for tenosynovitis in patients with rheumatoid arthritis and for the quantitative scoring system, pixel index. 
Study IV: Intramuscular versus ultrasound guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis - A randomised, double-blind, controlled study with ultrasound and clinical follow up at 4 and 12 weeks. 
From the

  16. Interobserver reliability of the Amsterdam Severity Scale in Stenosing Tenosynovitis (ASSiST)

    NARCIS (Netherlands)

    Peter, W.F.; Steultjens, M.P.M.; Mesman, T.; Dekker, J.; Hoeksma, A.F.

    2009-01-01

    STUDY DESIGN: Interobserver reliability study. INTRODUCTION: A scale was developed to measure the severity of stenosing tenosynovitis: the Amsterdam Severity Scale in Stenosing Tenosynovitis (ASSiST). PURPOSE OF THE STUDY: To study the interobserver reliability of the ASSiST. METHODS: Patients

  17. INTRA SHEATH STEROID INJECTIONS IN MANAGEMENT OF DE QUERVAIN’S TENOSYNOVITIS

    Directory of Open Access Journals (Sweden)

    Muralidhara

    2015-12-01

    Full Text Available INTRODUCTION De Quervain’s tenosynovitis is a painful and often disabling condition that is mainly observed in workers who perform repetitive manual tasks, wrestlers and bowlers. MATERIALS AND METHODS A Retrospective study was done in orthopaedic department at tertiary care hospital for one year from June 2013 to May 2014. 60 patients were included in the present study. RESULTS Out of 60 patients diagnosed with De Quervain’s tenosynovitis 54(90% were treated conservatively and surgical management was done in 9(10% cases. CONCLUSION Conservative treatment of De Quervain’s tenosynovitis with steroid injections is a preferable method of treatment. Surgical release should be confined to patients resistant to conservative treatment

  18. MRI assessment of tenosynovitis in children with juvenile idiopathic arthritis: inter- and intra-observer variability

    International Nuclear Information System (INIS)

    Lambot, Karen; Brunelle, Francis; Boavida, Peter; Damasio, Maria Beatrice; Tanturri de Horatio, Laura; Barbuti, Domenico; Desgranges, Marie; Bader-Meunier, Brigitte; Quartier, Pierre; Malattia, Clara; Bracaglia, Claudia; Ording Mueller, Lil-Sofie; Elie, Caroline; Rosendahl, Karen

    2013-01-01

    There is sparse knowledge about grading tenosynovitis using MRI. The purpose of this study was to assess the reliability of a tenosynovitis MRI scoring system in juvenile idiopathic arthritis. Children with juvenile idiopathic arthritis and wrist involvement were enrolled in two paediatric centres, from October 2006 to January 2010. The extensor (compartments II, IV and VI) and flexor tendons were assessed for the presence of tenosynovitis on T1-weighted postcontrast fat-saturated MR images and were scored from 0 (normal) to 2 (moderate to severe) by two observers independently. Intra- and interobserver agreement was assessed. Ninety children (age range: 5-18.5 years) were included, of whom 34 had tenosynovitis involving extensors and 28 had tenosynovitis involving flexors. A total of 360 tendon areas were analysed, of which 114 had tenosynovitis (86/270 extensors and 28/90 flexors). Intra-reader 1 agreement was excellent for the extensors (k = 0.82-0.91) and for the flexors (k = 0.85); intra-reader 2 agreement was moderate to good for the extensors (k = 0.51-0.72) and good for the flexors (k = 0.64). Inter-reader agreement was good for the extensors (k = 0.69-0.73) and moderate for the flexors (k = 0.49). The proposed MRI scoring system for the assessment of wrist tenosynovitis in juvenile idiopathic arthritis appears feasible with an observer agreement sufficient for clinical use. (orig.)

  19. MRI assessment of tenosynovitis in children with juvenile idiopathic arthritis: inter- and intra-observer variability

    Energy Technology Data Exchange (ETDEWEB)

    Lambot, Karen; Brunelle, Francis [Hopital Necker-Enfants Malades, Department of Paediatric Radiology, Paris (France); Boavida, Peter [Great Ormond Street Hospital, Department of Radiology, London (United Kingdom); Damasio, Maria Beatrice [Ospedale Pediatrico Gaslini, Department of Radiology, Genoa (Italy); Tanturri de Horatio, Laura; Barbuti, Domenico [Ospedale Pediatrico Bambino Gesu, Department of Radiology, Rome (Italy); Desgranges, Marie; Bader-Meunier, Brigitte; Quartier, Pierre [Hopital Necker-Enfants Malades, Department of Paediatric Immunology, Hematology and Rheumatology, APHP French Reference Center ' ' Arthrites juveniles' ' , Paris (France); Malattia, Clara [University of Genoa, Department of Paediatrics, Genoa (Italy); Bracaglia, Claudia [Ospedale Pediatrico Bambino Gesu, Department of Paediatrics, Rome (Italy); Ording Mueller, Lil-Sofie [Great Ormond Street Hospital, Department of Radiology, London (United Kingdom); University Hospital of North Norway, Department of Radiology, Tromsoe (Norway); Elie, Caroline [Paris Descartes University, Department of Biostatistics, Hopital Necker-Enfants Malades, Paris (France); Rosendahl, Karen [Great Ormond Street Hospital, Department of Radiology, London (United Kingdom); Haukeland University Hospital, Department of Radiology, Bergen (Norway)

    2013-07-15

    There is sparse knowledge about grading tenosynovitis using MRI. The purpose of this study was to assess the reliability of a tenosynovitis MRI scoring system in juvenile idiopathic arthritis. Children with juvenile idiopathic arthritis and wrist involvement were enrolled in two paediatric centres, from October 2006 to January 2010. The extensor (compartments II, IV and VI) and flexor tendons were assessed for the presence of tenosynovitis on T1-weighted postcontrast fat-saturated MR images and were scored from 0 (normal) to 2 (moderate to severe) by two observers independently. Intra- and interobserver agreement was assessed. Ninety children (age range: 5-18.5 years) were included, of whom 34 had tenosynovitis involving extensors and 28 had tenosynovitis involving flexors. A total of 360 tendon areas were analysed, of which 114 had tenosynovitis (86/270 extensors and 28/90 flexors). Intra-reader 1 agreement was excellent for the extensors (k = 0.82-0.91) and for the flexors (k = 0.85); intra-reader 2 agreement was moderate to good for the extensors (k = 0.51-0.72) and good for the flexors (k = 0.64). Inter-reader agreement was good for the extensors (k = 0.69-0.73) and moderate for the flexors (k = 0.49). The proposed MRI scoring system for the assessment of wrist tenosynovitis in juvenile idiopathic arthritis appears feasible with an observer agreement sufficient for clinical use. (orig.)

  20. Wrist Tenosynovitis due to Mycobacterium bovis Infection: Case Series and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mehmet Derviş Güner, MD

    2014-12-01

    Full Text Available Summary: Tuberculosis infections are still one of the most important public health problems among developing countries. Musculoskeletal involvement represents 10–15% of all extrapulmonary cases. Tuberculosis tenosynovitis is usually misdiagnosed as nonspecific tenosynovitis. To avoid misdiagnosis and mistreatment, it is important to be alert for mycobacterial infections. This article presents 3 patients with wrist tenosynovitis, which was caused by Mycobacterium bovis infection. The article also includes review of the literature.

  1. Tenosynovitis of the ankles as onset of sarcoidosis in a patient with ulcerative colitis

    OpenAIRE

    F. Cozzi; M. Podswiadek; A. Furlan; S. Todesco

    2011-01-01

    Arthritis and tenosynovitis are frequently reported as complications of inflammatory bowel diseases. About 10% of patients with ulcerative colitis presents articular inflammation, usually in the phases of activity of intestinal disease. Tenosynovitis is also a frequent complication of ulcerative colitis. We describe here a case of tenosynovitis of both ankles occurring in a patient affected by ulcerative colitis not in active phase. Chest X-ray and TC showed hilar lymphonode enlargement and t...

  2. Wrist Tenosynovitis due to Mycobacterium bovis Infection: Case Series and Review of the Literature

    Science.gov (United States)

    Güner, Mehmet Derviş; Bektaş, Umut; Akmeşe, Ramazan; Armangil, Mehmet; Ay, Şadan

    2014-01-01

    Summary: Tuberculosis infections are still one of the most important public health problems among developing countries. Musculoskeletal involvement represents 10–15% of all extrapulmonary cases. Tuberculosis tenosynovitis is usually misdiagnosed as nonspecific tenosynovitis. To avoid misdiagnosis and mistreatment, it is important to be alert for mycobacterial infections. This article presents 3 patients with wrist tenosynovitis, which was caused by Mycobacterium bovis infection. The article also includes review of the literature. PMID:25587496

  3. Corticosteroid injection for de Quervain's tenosynovitis

    NARCIS (Netherlands)

    Peters-Veluthamaningal, Cyriac; van der Windt, Danielle A. W. M.; Winters, Jan C.; Jong, Betty Meyboom-de

    2009-01-01

    Back ground De Quervain's tenosynovitis is a disorder characterised by pain on the radial (thumb) side of the wrist and functional disability of the hand. It can be treated by corticosteroid injection, splinting and surgery. Objectives To summarise evidence on the efficacy and safety of

  4. Magnetic resonance imaging findings in patients with peroneal tendinopathy and peroneal tenosynovitis

    International Nuclear Information System (INIS)

    Kijowski, Richard; Smet, Arthur de; Mukharjee, Rajat

    2007-01-01

    To compare the magnetic resonance (MR) imaging findings of a group of patients with clinically diagnosed peroneal tendonopathy and peroneal tenosynovitis with the MR imaging findings of a control group of patients with no clinical evidence of peroneal tendon disorder. The MR examinations of 24 patients with symptomatic peroneal tendinopathy or peroneal tenosynovitis and 70 patients with no clinical evidence of peroneal tendon disorder were retrospectively reviewed to determine the presence or absence of four MR imaging findings: 1) predominantly or uniform intermediate signal intensity within the peroneal tendons on one or more axial proton density-weighted images, 2) predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images, 3) intermediate T2 signal intensity within the peroneal tendons, and 4) circumferential fluid within the common peroneal tendon sheath greater than 3 mm in maximal width. The sensitivity and specificity of these MR imaging findings for determining the presence or absence or symptomatic peroneal tendinopathy or peroneal tenosynovitis were calculated. The sensitivity of MR imaging findings 1, 2, 3, and 4 for determining the presence of peroneal tendinopathy or peroneal tenosynovitis were 92%, 92%, 50%, and 17% respectively. The specificity of MR imaging findings 1, 2, 3, and 4 for determining the absence of peroneal tendinopathy or peroneal tenosynovitis were 57%, 79%, 93%, and 100% respectively. The presence of predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images is a highly sensitive and moderately specific indicator of symptomatic peroneal tendinopathy. The presence of intermediate T2 signal within the peroneal tendons, and the presence of circumferential fluid within the peroneal tendon sheath greater than 3 mm in maximal width, are highly specific indicators of peroneal

  5. Magnetic resonance imaging findings in patients with peroneal tendinopathy and peroneal tenosynovitis

    Energy Technology Data Exchange (ETDEWEB)

    Kijowski, Richard; Smet, Arthur de [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States); Mukharjee, Rajat [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States); University of Wisconsin Hospital, Department of Statistics, Madison, WI (United States)

    2007-02-15

    To compare the magnetic resonance (MR) imaging findings of a group of patients with clinically diagnosed peroneal tendonopathy and peroneal tenosynovitis with the MR imaging findings of a control group of patients with no clinical evidence of peroneal tendon disorder. The MR examinations of 24 patients with symptomatic peroneal tendinopathy or peroneal tenosynovitis and 70 patients with no clinical evidence of peroneal tendon disorder were retrospectively reviewed to determine the presence or absence of four MR imaging findings: 1) predominantly or uniform intermediate signal intensity within the peroneal tendons on one or more axial proton density-weighted images, 2) predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images, 3) intermediate T2 signal intensity within the peroneal tendons, and 4) circumferential fluid within the common peroneal tendon sheath greater than 3 mm in maximal width. The sensitivity and specificity of these MR imaging findings for determining the presence or absence or symptomatic peroneal tendinopathy or peroneal tenosynovitis were calculated. The sensitivity of MR imaging findings 1, 2, 3, and 4 for determining the presence of peroneal tendinopathy or peroneal tenosynovitis were 92%, 92%, 50%, and 17% respectively. The specificity of MR imaging findings 1, 2, 3, and 4 for determining the absence of peroneal tendinopathy or peroneal tenosynovitis were 57%, 79%, 93%, and 100% respectively. The presence of predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images is a highly sensitive and moderately specific indicator of symptomatic peroneal tendinopathy. The presence of intermediate T2 signal within the peroneal tendons, and the presence of circumferential fluid within the peroneal tendon sheath greater than 3 mm in maximal width, are highly specific indicators of peroneal

  6. Association between distal ulnar morphology and extensor carpi ulnaris tendon pathology

    International Nuclear Information System (INIS)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Kattapuram, Susan V.; Torriani, Martin

    2014-01-01

    The purpose of this study was to evaluate the association between distal ulnar morphology and extensor carpi ulnaris (ECU) tendon pathology. We retrospectively reviewed 71 adult wrist MRI studies with ECU tendon pathology (tenosynovitis, tendinopathy, or tear), and/or ECU subluxation. Subjects did not have a history of trauma, surgery, infection, or inflammatory arthritis. MRI studies from 46 subjects without ECU tendon pathology or subluxation were used as controls. The following morphological parameters of the distal ulna were measured independently by two readers: ulnar variance relative to radius, ulnar styloid process length, ECU groove depth and length. Subjects and controls were compared using Student's t test. Inter-observer agreement (ICC) was calculated. There was a significant correlation between negative ulnar variance and ECU tendon pathology (reader 1 [R1], P = 0.01; reader 2 [R2], P 0.64 for all parameters. Distal ulnar morphology may be associated with ECU tendon abnormalities. (orig.)

  7. Enhanced MR imaging of tenosynovitis of hand and wrist in inflammatory arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, J.; Ashilyan, O.; Anavim, A.; Tramma, S. [Univ. of California, Orange (United States). Dept. of Radiological Sciences

    2006-11-15

    The purpose of this study is to describe the appearance of tenosynovitis in various tendon groups in the wrist and hand and to compare MR enhanced and non-enhanced imaging evaluation of tenosynovitis of hand and wrist in inflammatory arthritis. We reviewed 72 MRI studies of hands and wrists, including coronal, axial and sagittal images in 30 consecutive patients with inflammatory arthritis and tenosynovitis. We compared the degree of synovitis on T2-weighted vs contrast-enhanced T1-weighted images, using a predetermined scale. We also measured the extent of tenosynovitis in three dimensions. The tendons were assigned to volar, dorsal, ulnar and radial groups in the wrist and to extensor, flexor and thumb groups in the hand. Degree of tenosynovitis (graded 0-3), cross-sectional area and volume of the inflamed synovium in various tendon groups were then compared by statistical analysis. Review of the medical records revealed the following diagnoses in our patient population: rheumatoid arthritis (n=16), unspecified inflammatory polyarthritis (n=9), psoriatic arthritis (n=2), CREST syndrome (n=1), systemic lupus erythematosus (n=1), paraneoplastic syndrome with arthritis (n=1). The average T2 brightness scores and post-gadolinium enhancement scores were 1.0 and 1.7 respectively (P<0.001) in the wrist studies. The average T2 brightness scores and post-gadolinium enhancement scores were 0.7 and 1.4, respectively (P<0.001) in the hand studies. The average sensitivity of T2-weighted imaging for detection of tenosynovitis was 40% in the hand and 67% in the wrist tendons, when contrast-enhanced images were used as a reference. Carpal tunnel flexor tendons were the most frequently affected tendons of the wrist. The most frequently affected tendons of the hand were second and third flexor tendons. The hand flexors demonstrated higher degrees of enhancement and larger volumes of the inflamed tenosynovium than did the hand extensors and tendons of the thumb.

  8. Enhanced MR imaging of tenosynovitis of hand and wrist in inflammatory arthritis

    International Nuclear Information System (INIS)

    Tehranzadeh, J.; Ashilyan, O.; Anavim, A.; Tramma, S.

    2006-01-01

    The purpose of this study is to describe the appearance of tenosynovitis in various tendon groups in the wrist and hand and to compare MR enhanced and non-enhanced imaging evaluation of tenosynovitis of hand and wrist in inflammatory arthritis. We reviewed 72 MRI studies of hands and wrists, including coronal, axial and sagittal images in 30 consecutive patients with inflammatory arthritis and tenosynovitis. We compared the degree of synovitis on T2-weighted vs contrast-enhanced T1-weighted images, using a predetermined scale. We also measured the extent of tenosynovitis in three dimensions. The tendons were assigned to volar, dorsal, ulnar and radial groups in the wrist and to extensor, flexor and thumb groups in the hand. Degree of tenosynovitis (graded 0-3), cross-sectional area and volume of the inflamed synovium in various tendon groups were then compared by statistical analysis. Review of the medical records revealed the following diagnoses in our patient population: rheumatoid arthritis (n=16), unspecified inflammatory polyarthritis (n=9), psoriatic arthritis (n=2), CREST syndrome (n=1), systemic lupus erythematosus (n=1), paraneoplastic syndrome with arthritis (n=1). The average T2 brightness scores and post-gadolinium enhancement scores were 1.0 and 1.7 respectively (P<0.001) in the wrist studies. The average T2 brightness scores and post-gadolinium enhancement scores were 0.7 and 1.4, respectively (P<0.001) in the hand studies. The average sensitivity of T2-weighted imaging for detection of tenosynovitis was 40% in the hand and 67% in the wrist tendons, when contrast-enhanced images were used as a reference. Carpal tunnel flexor tendons were the most frequently affected tendons of the wrist. The most frequently affected tendons of the hand were second and third flexor tendons. The hand flexors demonstrated higher degrees of enhancement and larger volumes of the inflamed tenosynovium than did the hand extensors and tendons of the thumb

  9. Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice

    NARCIS (Netherlands)

    Peters-Veluthamaningal, Cyriac; Winters, Jan C.; Groenier, Klaas H.; Meyboom-deJong, Betty

    2009-01-01

    Background: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist and leads to wrist pain and to impaired function of the wrist and hand. It can be treated by splinting, local corticosteroid injection and operation. In this study effectiveness of local

  10. Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

    International Nuclear Information System (INIS)

    Yoon, Hyun Jung; Kwon, Jong Won; Yoon, Young Cheol; Choi, Sang Hee

    2011-01-01

    Nontuberculous mycobacterial infections can cause destructive tenosynovitis of the hand. We report on and discuss the clinical course and distinctive radiologic findings of two patients with hand tenosynovitis secondary to M. marinum and intracellulare infection, which are different from those of the nontuberculous mycobacterial infections reported in the previous literature.

  11. Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyun Jung; Kwon, Jong Won; Yoon, Young Cheol; Choi, Sang Hee [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-11-15

    Nontuberculous mycobacterial infections can cause destructive tenosynovitis of the hand. We report on and discuss the clinical course and distinctive radiologic findings of two patients with hand tenosynovitis secondary to M. marinum and intracellulare infection, which are different from those of the nontuberculous mycobacterial infections reported in the previous literature.

  12. MR arthrographic findings in tenosynovitis of the long bicipital tendon of the shoulder

    International Nuclear Information System (INIS)

    Gueckel, C.; Nidecker, A.

    1998-01-01

    Purpose. To assess the MR arthrographic findings of bicipital tenosynovitis in correlation with arthroscopy. Design and patients. The shoulder MR arthrographies of 500 consecutive patients were retrospectively analyzed for signs of bicipital tenosynovitis and associated pathologies. Forty patients (8%) had MR evidence of bicipital tenosynovitis, but only 17 (3%) with arthroscopic confirmation were included in the study. The MR findings in these patients were compared with those of 10 patients with rotator cuff lesions but arthroscopically normal long biceps tendons. MR arthrography was performed with 10-15 ml of a 250 mmol/l gadoterate meglumine (Gd-DOTA) solution injected under fluoroscopic guidance, and transaxial, oblique coronal and sagittal MR sequences were obtained. Results. All 17 patients showed one or more abnormal findings: signal increase in the tendon with or without fusiform distension was seen in 12, surface irregularities in six, adhesions in 11 and noncommunicating effusions of the tendon sheath in six. Associated abnormalities of the rotator cuff were present in 16 while the seventeenth patient had glenohumeral synovitis without rotator cuff pathology. MR arthrograms correlated with arthroscopic findings in the joint but comparison was not possible in the intertubercular groove portion of the biceps tendon. None of the 10 patients with an arthroscopically normal biceps tendon showed any of the MR findings of bicipital tenosynovitis. Conclusion. Bicipital tenosynovitis is detectable by MR arthrography. In most cases it is an associated finding of rotator cuff abnormalities and likely to have a similar etiology. When lesions of the anterior rotator cuff are recognized, the biceps tendon should be scrutinized for inflammatory changes. (orig.)

  13. MR arthrographic findings in tenosynovitis of the long bicipital tendon of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Gueckel, C. [Department of Radiology, University Hospital of Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Nidecker, A. [MRI Institut Rebgasse, Untere Rebgasse 18, CH-4058 Basel (Switzerland)

    1998-01-01

    Purpose. To assess the MR arthrographic findings of bicipital tenosynovitis in correlation with arthroscopy. Design and patients. The shoulder MR arthrographies of 500 consecutive patients were retrospectively analyzed for signs of bicipital tenosynovitis and associated pathologies. Forty patients (8%) had MR evidence of bicipital tenosynovitis, but only 17 (3%) with arthroscopic confirmation were included in the study. The MR findings in these patients were compared with those of 10 patients with rotator cuff lesions but arthroscopically normal long biceps tendons. MR arthrography was performed with 10-15 ml of a 250 mmol/l gadoterate meglumine (Gd-DOTA) solution injected under fluoroscopic guidance, and transaxial, oblique coronal and sagittal MR sequences were obtained. Results. All 17 patients showed one or more abnormal findings: signal increase in the tendon with or without fusiform distension was seen in 12, surface irregularities in six, adhesions in 11 and noncommunicating effusions of the tendon sheath in six. Associated abnormalities of the rotator cuff were present in 16 while the seventeenth patient had glenohumeral synovitis without rotator cuff pathology. MR arthrograms correlated with arthroscopic findings in the joint but comparison was not possible in the intertubercular groove portion of the biceps tendon. None of the 10 patients with an arthroscopically normal biceps tendon showed any of the MR findings of bicipital tenosynovitis. Conclusion. Bicipital tenosynovitis is detectable by MR arthrography. In most cases it is an associated finding of rotator cuff abnormalities and likely to have a similar etiology. When lesions of the anterior rotator cuff are recognized, the biceps tendon should be scrutinized for inflammatory changes. (orig.) With 4 figs., 4 tabs., 22 refs.

  14. MRI of fractures of the distal radius: comparison with conventional radiographs

    International Nuclear Information System (INIS)

    Spence, L.D.; Eustace, S.

    1998-01-01

    Objective. To compare the evaluation of fractures of the distal radius with MRI and conventional radiographs. To demonstrate the ability of MRI to detect unsuspected soft tissue derangement accompanying this common injury. Design and patients. Twenty-one consecutive inpatients admitted following fracture of the distal radius underwent preoperative evaluation with both conventional radiographs and MRI. In each case, analysis was made of both the osseous and soft tissue injury. MRI findings were compared with those identified on conventional radiographs and at subsequent surgical fixation. Results. Of 21 patients with fractures of the distal radius, 20 had extension to the radiocarpal articulation, 14 had distal radio-ulnar joint extension and 5 had avulsion of the ulnar styloid.Occult carpal bone fractures accompanying fracture of the distal radius were identified in two patients: one of the capitate and the other of the second metacarpal base. Ten patients (48%) had associated soft tissue injury: six patients had scapholunate ligament rupture, two patients had disruption of the triangular fibrocartilage, one patient had extensor carpi ulnaris tenosynovitis and one patient had a tear of a dorsal radiocarpal ligament. Of five patients with ulnar styloid avulsions, none had evidence of triangular fibrocartilage tears. Conclusion. MRI affords better evaluation of osseous injury accompanying distal radial fractures than conventional radiographs. Intra-articular soft tissue injury accompanies distal radial fractures in almost 50% of cases. Scapholunate ligament disruption commonly accompanies intra-articular fracture through the lunate facet of the distal radius. Fracture of the ulnar styloid is infrequently associated with tear of the triangular fibrocartilage. (orig.)

  15. MRI of fractures of the distal radius: comparison with conventional radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Spence, L.D.; Eustace, S. [Medical Center, Boston, MA (United States). Dept. of Radiol.; Savenor, A.; Nwachuku, I.; Tilsley, J. [Department of Orthopedics, Boston Medical Center, Boston, MA 02118 (United States)

    1998-05-01

    Objective. To compare the evaluation of fractures of the distal radius with MRI and conventional radiographs. To demonstrate the ability of MRI to detect unsuspected soft tissue derangement accompanying this common injury. Design and patients. Twenty-one consecutive inpatients admitted following fracture of the distal radius underwent preoperative evaluation with both conventional radiographs and MRI. In each case, analysis was made of both the osseous and soft tissue injury. MRI findings were compared with those identified on conventional radiographs and at subsequent surgical fixation. Results. Of 21 patients with fractures of the distal radius, 20 had extension to the radiocarpal articulation, 14 had distal radio-ulnar joint extension and 5 had avulsion of the ulnar styloid.Occult carpal bone fractures accompanying fracture of the distal radius were identified in two patients: one of the capitate and the other of the second metacarpal base. Ten patients (48%) had associated soft tissue injury: six patients had scapholunate ligament rupture, two patients had disruption of the triangular fibrocartilage, one patient had extensor carpi ulnaris tenosynovitis and one patient had a tear of a dorsal radiocarpal ligament. Of five patients with ulnar styloid avulsions, none had evidence of triangular fibrocartilage tears. Conclusion. MRI affords better evaluation of osseous injury accompanying distal radial fractures than conventional radiographs. Intra-articular soft tissue injury accompanies distal radial fractures in almost 50% of cases. Scapholunate ligament disruption commonly accompanies intra-articular fracture through the lunate facet of the distal radius. Fracture of the ulnar styloid is infrequently associated with tear of the triangular fibrocartilage. (orig.) With 5 figs., 16 refs.

  16. MRI features in de Quervain's tenosynovitis of the wrist

    International Nuclear Information System (INIS)

    Glajchen, N.; Schweitzer, M.

    1996-01-01

    De Quervain's stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain's synovitis was suggested (n=5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain's disease. De Quervain's tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings. (orig.)

  17. Pyogenic Tenosynovitis in Infants: A Case Series.

    Science.gov (United States)

    Lironi, Céline; Steiger, Christina; Juchler, Céline; Spyropoulou, Vasiliki; Samara, Eleftheria; Ceroni, Dimitri

    2017-11-01

    Pyogenic tenosynovitis is an uncommon condition in children, and there are few published case reports. We present a series of 11 cases who were treated in the Geneva Children Hospital in the last 10 years. Kingella kingae was the main pathogen, and the characteristics of infection (inflammatory indices, clinical findings and severity) are similar to other osteoarticular K. kingae infections in infants.

  18. Predictors of Stenosing Tenosynovitis in the Hand and Hand-Related Activity Limitations in Patients With Rheumatoid Arthritis

    NARCIS (Netherlands)

    Ursum, J.; Horsten, N.C.; Hoeksma, A.F.; Dijkmans, B.A.C.; Knol, D.L.; van Schaardenburg, D.; Dekker, J.; Roorda, L.D.

    2011-01-01

    Ursum J, Horsten NC, Hoeksma AF, Dijkmans BA, Knol DL, van Schaardenburg D, Dekker J, Roorda LD. Predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis. Objectives To identify early predictors of stenosing tenosynovitis in the

  19. Forgotten but Not Gone! Syphilis Induced Tenosynovitis

    Directory of Open Access Journals (Sweden)

    Felicia Ratnaraj

    2016-01-01

    Full Text Available Objective. Tenosynovitis, inflammation of a tendon and its synovial sheath, is a rare manifestation of secondary syphilis and if diagnosed early is reversible. Background. A 52-year-old male with past medical history of untreated syphilis presented with gradual onset of swelling and pain of the right fourth metacarpophalangeal joint (MCP. He reported a history of painless penile lesions after having sexual intercourse with a new partner approximately five months ago which was treated with sulfamethoxazole/trimethoprim. An RPR done at that time came back positive with a high titer; however, patient was lost to follow-up. On examination, patient had an edematous, nonerythematous right fourth proximal interphalangeal (PIP joint. Urgent irrigation, debridement, and exploration of the right hand into the tendon sheath were performed. With his history of syphillis, an RPR was done, which was reactive with a titer of 1 : 64. A confirmatory FTA-ABS test was completed, rendering a positive result. Based on his history of untreated syphilis, dormancy followed by clinical scenario of swelling of the right fourth finger, and a high RPR titer, he was diagnosed with secondary syphilis manifesting as tenosynovitis.

  20. Validity and sensitivity to change of the semi-quantitative OMERACT ultrasound scoring system for tenosynovitis in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Naredo, Esperanza

    2016-01-01

    OBJECTIVES: The aim was to evaluate the metric properties of the semi-quantitative OMERACT US scoring system vs a novel quantitative US scoring system for tenosynovitis, by testing its intra- and inter-reader reliability, sensitivity to change and comparison with clinical tenosynovitis scoring...... in a 6-month follow-up study. METHODS: US and clinical assessments of the tendon sheaths of the clinically most affected hand and foot were performed at baseline, 3 and 6 months in 51 patients with RA. Tenosynovitis was assessed using the semi-quantitative scoring system (0-3) proposed by the OMERACT US...... tenosynovitis score was performed, calculating a sum score per patient. RESULTS: The intra- and inter-observer agreements for US tenosynovitis assessments were very good at baseline and for change for GS and CD, but less good for PI. The smallest detectable change was 0.97 for GS, 0.93 for CD and 30.1 for PI...

  1. Tenosynovitis caused by Pyracantha coccinea injury of the hand

    NARCIS (Netherlands)

    Theuvenet, W.J.; Essed, C.E.; Eggelmeijer, F.; Alink, G.M.

    2000-01-01

    Tenosynovitis caused by Pyracantha coccinea (fire thorn) has not been reported before, most likely because it is uncommon and the diagnosis is difficult to confirm. The symptoms, differential diagnosis, and the surgical treatment are described. Three cases are reported. It is postulated that natural

  2. MRI features in de Quervain`s tenosynovitis of the wrist

    Energy Technology Data Exchange (ETDEWEB)

    Glajchen, N. [Mount Sinai Hospital, New York, NY (United States). Dept. of Radiology; Schweitzer, M. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology

    1996-01-01

    De Quervain`s stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain`s synovitis was suggested (n=5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain`s disease. De Quervain`s tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings. (orig.)

  3. A prolonged case of Mycobacterium marinum flexor tenosynovitis: radiographic and histological correlation, and review of the literature

    International Nuclear Information System (INIS)

    Wongworawat, M.D.; Holtom, P.; Learch, T.J.; Fedenko, A.; Stevanovic, M.V.

    2003-01-01

    We report on a 30-year-old man with prolonged Mycobacterium marinum flexor tenosynovitis. Due to low clinical suspicion, diagnosis was not made until 8 years after initial presentation. The history and magnetic resonance and tissue examination findings are consistent with mycobacterial tenosynovitis. These findings are presented, together with a review of the literature. (orig.)

  4. A prolonged case of Mycobacterium marinum flexor tenosynovitis: radiographic and histological correlation, and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Wongworawat, M.D. [Dept. of Orthopaedic Surgery, Loma Linda Univ. Medical Center, Loma Linda, CA (United States); USC Univ. Hospital, Los Angeles, CA (United States); Holtom, P.; Learch, T.J.; Fedenko, A.; Stevanovic, M.V. [USC Univ. Hospital, Los Angeles, CA (United States)

    2003-09-01

    We report on a 30-year-old man with prolonged Mycobacterium marinum flexor tenosynovitis. Due to low clinical suspicion, diagnosis was not made until 8 years after initial presentation. The history and magnetic resonance and tissue examination findings are consistent with mycobacterial tenosynovitis. These findings are presented, together with a review of the literature. (orig.)

  5. Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Fana, Viktoria

    2017-01-01

    and tenosynovitis were randomised into two double-blind groups: (A) 'intramuscular group', receiving intramuscular injection of betamethasone and US-guided intratenosynovial isotonic saline injection and (B) 'intratenosynovial group' receiving saline intramuscularly and US-guided intratenosynovial betamethasone......% (2/24) versus 44% (11/25), that is, difference of ?36pp (?58pp to ?13pp), p=0.003. Most US, clinical and patient-reported scores improved more in the 'intratenosynovial group' at all follow-up visits. Conclusions In this randomised double-blind clinical trial, patients with RA and tenosynovitis...

  6. Tuberculous tenosynovitis of the wrist: diagnosis with US and contribution of MRI

    International Nuclear Information System (INIS)

    Miquel, A.; Frouge, C.; Adrien, C.; Hibou, I.; Bittoun, J.; Bisson, M.; Blery, M.

    1995-01-01

    Chronic tenosynovitis of the hand due to Mycobacterium tuberculosis has become rare. In the two cases presented here, the final diagnosis was obtained by isolation of the organism in the intercarpal fluid (1 case), or by a synovial biopsy (1 case). Ultrasonography showed a hypoechoic thickening of one or several tendon sheaths. MR enabled better differentiation between the thickening of the synovium itself and a fluid effusion. The criteria permitting to differentiate tuberculous from non-infectious tenosynovitis are: young age, male sex, specific epidemiological factors, elevated erythrocyte sedimentation rate, marked local swelling, association with other foci of tuberculosis, unusual exudation and synovial thickening, and association with osteitis. (authors). 11 refs., 2 figs

  7. Extended MRI findings of intersection syndrome

    International Nuclear Information System (INIS)

    Lee, Roger P.; Hatem, Stephen F.; Recht, Michael P.

    2009-01-01

    The symptoms and physical findings of intersection syndrome have been well described in the clinical medical literature. However, the magnetic resonance imaging (MRI) findings in patients with intersection syndrome of the forearm have only recently been described in a small number of patients. We review our experience with imaging of intersection syndrome, describe previously unreported MRI findings, and emphasize modifications to MRI protocols for its evaluation. Institutional review board approval was obtained for this retrospective review of patients with MRI findings consistent with intersection syndrome of the forearm during the period from January 2004 to September 2006. Six patients were identified, three males and three females, with an average age of 39.3 years. The MRI examinations were reviewed to assess signal abnormalities within and adjacent to the first and second dorsal extensor tendon compartments (DETC): tendinosis, peritendinous edema or fluid, muscle edema, subcutaneous edema, and juxtacortical edema. The overall longitudinal extent of signal alterations was measured as well as the distance from Lister's tubercle to the crossover of the first and second DETC. Review of the MRIs showed increased intrasubstance tendon signal suggesting tendinosis in two of the six patients, peritendinous edema or fluid in all six patients, muscle edema in five of the six patients, and subcutaneous edema in three of the six patients. Juxtacortical edema was seen in one patient. Peritendinous edema or fluid extended distally beyond the radiocarpal joint in three of the six patients. The average distance from Lister's tubercle to the crossover of the first and second DETC was 3.95 cm, in keeping with recently published data. Intersection syndrome is an uncommon MRI diagnosis. In addition to the previously described MRI findings of edema adjacent to the first or second DETC, possibly with proximal extension and subcutaneous edema, we have identified additional

  8. Stenosing tenosynovitis of the flexors - or trigger finger

    Directory of Open Access Journals (Sweden)

    Rames Mattar Junior

    2008-03-01

    Full Text Available Stenosing tenosynovitis of the fl exors, known as trigger fi nger, is a verycommon problem seen by the Occupational Medicine practitioners,the orthopaedic surgeon and the hand surgeon. The purpose of thischapter is to summarize information on aspects of this conditionlikely to be of interest and relevant to the health professionals. Topicscovered include clinical observations related to ethiology, risk factors,diagnosis and case management.

  9. High-intensity laser therapy during chronic degenerative tenosynovitis experimentally induced in broiler chickens

    Science.gov (United States)

    Fortuna, Damiano; Rossi, Giacomo; Bilotta, Teresa W.; Zati, Allesandro; Gazzotti, Valeria; Venturini, Antonio; Pinna, Stefania; Serra, Christian; Masotti, Leonardo

    2002-10-01

    The aims of this study was the safety and the efficacy of High Intensity Laser Therapy (HILT) on chronic degenerative tenosynovitis. We have effectuated the histological evaluation and seroassay (C reactive protein) on 18 chickens affect by chronic degenerative tenosynovitis experimentally induced. We have been employed a Nd:YAG laser pulsed wave; all irradiated subjects received the same total energy (270 Joule) with a fluence of 7,7 J/cm2 and intensity of 10,7 W/cm2. The histological findings revealed a distinct reduction of the mineralization of the choral matrix, the anti-inflammatory effect of the laser, the hyperplasia of the synoviocytes and ectasia of the lymphatic vessels.

  10. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis.

    OpenAIRE

    Rowbotham, EL; Freeston, JE; Emery, P; Grainger, AJ

    2015-01-01

    AIM: The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. METHODS: Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon t...

  11. Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice

    Directory of Open Access Journals (Sweden)

    Groenier Klaas H

    2009-10-01

    Full Text Available Abstract Background De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist and leads to wrist pain and to impaired function of the wrist and hand. It can be treated by splinting, local corticosteroid injection and operation. In this study effectiveness of local corticosteroid injections for de Quervain's tenosynovitis provided by general practitioners was assessed. Methods Participants with de Quervain's tenosynovitis were recruited by general practitioners. Short-term outcomes (one week after injections were assessed in a randomised, placebo-controlled trial. Long-term effectiveness was evaluated in an open prospective cohort-study of steroid responders during a follow-up period of 12 months. Participants were randomised to one or two local injections of 1 ml of triamcinolonacetonide (TCA or 1 ml of NaCl 0.9% (placebo. Non-responders to NaCl were treated with additional TCA injections. Main outcomes were immediate treatment response, severity of pain, improvement as perceived by participant and functional disability using sub items hand and finger function of the Dutch Arthritis Impact Measurement Scale (Dutch AIMS-2-HFF. Results 11 general practitioners included 21 wrists in 21 patients. The TCA-group had better results for short-term outcomes treatment response (78% vs. 25%; p = 0.015, perceived improvement (78% vs. 33%; p = 0.047 and severity of pain (4.27 vs. 1.33; p = 0.031 but not for the Dutch-AIMS-HFF (2.71 vs. 1.92; p = 0.112. Absolute risk reduction for the main outcome short-term treatment response was 0.55 (95% CI: 0.34, 0.76 with a number needed to treat of 2 (95% CI: 1, 3. In the cohort of steroid responders (n = 12 the beneficial effects of steroid injections were sustained during the follow-up of 12 months regarding severity of pain (p = 0.67 and scores of Dutch AIMS-2-HFF (p = 0.36, but not for patient perceived improvement (p = 0.02. No adverse events were observed during the 12

  12. Bicipital tendinitis and tenosynovitis in the dog: a study of 15 cases.

    Science.gov (United States)

    Bruce, W J; Burbidge, H M; Bray, J P; Broome, C J

    2000-04-01

    To describe the clinical, radiographic, and sonographic features of 15 dogs with bicipital tendinitis and tenosynovitis, classify them according to cause, and evaluate the long-term efficacy of treatment. Dogs exhibiting forelimb lameness with pain localised to the biceps tendon were included in the study. Sonographic examination of the tendon and tendon sheath, and radiographic examination including positive contrast arthrograms of the shoulder joint were performed, and assessed for features consistent with biceps tendon disease. In some cases, synovial-fluid analysis and surgical investigation were also undertaken. The causes of the conditions were classified as either traumatic, mechanical, neoplastic or inflammatory. Dogs were treated conservatively with rest and anti-inflammatory drugs, or surgically by either transection of the transverse humeral ligament or tenodesis of the biceps tendon. Assessment of the effects of treatment was made by re-examination at six weeks and from information gained by telephone interview with the dog's owner at longer-term follow-up. Bicipital tendinitis and tenosynovitis were common causes of forelimb lameness in active, middle-aged or older, medium to large-breed dogs. The most sensitive physical tests for localising pain to the biceps apparatus were shoulder flexion with the elbow extended, focal digital pressure applied directly to the biceps origin, and the biceps retraction test. Sonographic assessment was found to be more sensitive than shoulder radiography or arthrography for characterising the lesion. Conservative treatment of 11 traumatic cases resulted in good or excellent function at long-term follow-up. One mechanical bicipital tendinitis secondary to mineral deposits within the supraspinatus tendon improved following transection of the transverse humeral ligament and removal of the deposits. One of two cases of inflammatory tendinitis/ tenosynovitis improved following tenodesis. One dog with neoplastic disease did

  13. Effects of metabolic syndrome on the functional outcomes of corticosteroid injection for De Quervain tenosynovitis.

    Science.gov (United States)

    Roh, Y H; Noh, J H; Gong, H S; Baek, G H

    2017-06-01

    Metabolic syndrome is a constellation of medical conditions that arise from insulin resistance and abnormal adipose deposition and function. In patients with metabolic syndrome and De Quervain tenosynovitis this might affect the outcome of treatment by local corticosteroid injection. A total of 64 consecutive patients with De Quervain tenosynovitis and metabolic syndrome treated with corticosteroid injection were age- and sex-matched with 64 control patients without metabolic syndrome. The response to treatment, including visual analogue scale score for pain, objective findings consistent with De Quervain tenosynovitis (tenderness at first dorsal compartment, Finkelstein test result), and Disability of the Arm, Shoulder, and Hand score were assessed at 6, 12, and 24 weeks follow-up. Treatment failure was defined as persistence of symptoms or surgical intervention. Prior to treatment, patients with metabolic syndrome had mean initial pain visual analogue scale and Disability of the Arm, Shoulder, and Hand scores similar to those in the control group. The proportion of treatment failure in the metabolic syndrome group (43%) was significantly higher than that in the control group (20%) at 6 months follow-up. The pain visual analogue scale scores in the metabolic syndrome group were higher than the scores in the control group at the 12- and 24-week follow-ups. The Disability of the Arm, Shoulder, and Hand scores of the metabolic syndrome group were higher (more severe symptoms) than those of the control group at the 12- and 24-week follow-ups. Although considerable improvements in symptom severity and hand function will likely occur in patients with metabolic syndrome, corticosteroid injection for De Quervain tenosynovitis is not as effective in these patients compared with age- and sex-matched controls in terms of functional outcomes and treatment failure. III.

  14. Development and Validation of the OMERACT Rheumatoid Arthritis Magnetic Resonance Tenosynovitis Scoring System in a Multireader Exercise.

    Science.gov (United States)

    Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frédérique; Haavardsholm, Espen A; Peterfy, Charles G; Vital, Edward M; Emery, Paul; Conaghan, Philip G; Østergaard, Mikkel

    2017-11-01

    To develop and validate a magnetic resonance imaging (MRI) tenosynovitis (TS) score for tendons at the wrist and metacarpophalangeal (MCP) joint levels in patients with rheumatoid arthritis (RA). Axial T1-weighted precontrast and postcontrast fat-saturated MR image sets of the hands of 43 patients with RA initiating rituximab therapy were obtained at baseline and after 14, 26, 38, or 52 weeks. The MR images were scored twice by 4 readers. Nine tendon compartments of the wrist and 4 flexor tendon compartments at the MCP joints were assessed. Tenosynovitis was scored as follows: 0: No; 1: The overall PEA/PCA intrareader and interreader agreements for change scores in all tendons were 73.8%/97.6% and 47.9%/85.0%, respectively. Average SRM was moderate for total scores and 60.5% of the patients had a tenosynovitis change score ≥ SDC. The TS score showed high intrareader and interreader agreement for wrist and finger tendons, with moderate responsiveness, and the majority of the patients showed a change above the SDC. This scoring system may be included as a component of the RAMRIS.

  15. Point-of-Care Ultrasound in the Evaluation of Pyogenic Flexor Tenosynovitis.

    Science.gov (United States)

    Cohen, Stephanie G; Beck, Sierra C

    2015-11-01

    A 4-year-old girl presented to the emergency department for evaluation of finger swelling after a dog bite. Point-of-care ultrasound was used to diagnose pyogenic flexor tenosynovitis of the digit after visualizing a fluid collection within the flexor tendon sheath. The patient underwent emergent incision and drainage of the digit with good outcome.

  16. Systematic review and meta-analysis on the work-related cause of de Quervain tenosynovitis: a critical appraisal of its recognition as an occupational disease.

    Science.gov (United States)

    Stahl, Stéphane; Vida, Daniel; Meisner, Christoph; Lotter, Oliver; Rothenberger, Jens; Schaller, Hans-Eberhard; Stahl, Adelana Santos

    2013-12-01

    The authors systematically reviewed all of the etiopathologic factors discussed in the literature to verify the classification of de Quervain tenosynovitis on the list of occupational diseases. The authors searched Ovid MEDLINE, EMBASE, and the Cochrane Library for articles discussing the cause of de Quervain tenosynovitis. The literature was classified by the level of evidence presented, the etiopathologic hypothesis discussed, the authors' conclusion about the role of the etiopathologic hypothesis, and the first author's professional background. The quality of reporting of the observational studies was evaluated by an extended Strengthening the Reporting of Observational Studies in Epidemiology statement checklist. A meta-analysis of all controlled cohort studies was performed. The Bradford Hill criteria were used to evaluate a causal relationship between de Quervain tenosynovitis and occupational risk factors. A total of 179 references were found, and 80 articles were included. On average, only 35 percent (median, 35 percent; range, 16 to 60 percent) of all items on the extended Strengthening the Reporting of Observational Studies in Epidemiology checklist were addressed per article. The meta-analysis to evaluate the strength of the association between de Quervain tenosynovitis and (1) repetitive, (2) forceful, or (3) ergonomically stressful manual work suggested an odds ratio of 2.89 (95 percent CI, 1.4 to 5.97; p = 0.004). No evidence was found to support the Bradford Hill criteria for a causal relationship between de Quervain tenosynovitis and occupational risk factors. No sufficient scientific evidence was provided to confirm a causal relationship between de Quervain tenosynovitis and occupational risk factors. Risk, III.

  17. Development and validation of the OMERACT rheumatoid arthritis magnetic resonance tenosynovitis scoring system in a multireader exercise

    DEFF Research Database (Denmark)

    Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frédérique

    2017-01-01

    Objective: To develop and validate a magnetic resonance imaging (MRI) tenosynovitis (TS) score for tendons at the wrist and metacarpophalangeal (MCP) joint levels in patients with rheumatoid arthritis (RA). Methods: Axial T1-weighted precontrast and postcontrast fat-saturated MR image sets...... of the hands of 43 patients with RA initiating rituximab therapy were obtained at baseline and after 14, 26, 38, or 52 weeks. The MR images were scored twice by 4 readers. Nine tendon compartments of the wrist and 4 flexor tendon compartments at the MCP joints were assessed. Tenosynovitis was scored as follows...

  18. The Efficacy of Local Injection of Methylprednisolone and Lidocaine with and Without Splint, in Treating Patients with De Quervain's Tenosynovitis

    Directory of Open Access Journals (Sweden)

    Saleh

    2012-02-01

    Full Text Available Introduction: Suffering from de Quervain's tenosynovitis due to repetitive and routine activities leads to considerable referrals to orthopedic clinics and increasing health care costs and wasting of patients' time. The present study aimed to compare the efficacy of local injection of methylprednisolone with and without splint for treatment of patients suffering from de Quervain's tenosynovitis. Methods: In a clinical trial study, 72 patients with de Quervain's tenosynovitis were selected in 2010 and were randomly divided into two groups. Therapeutic intervention in the first group was injection of 40 mg methylprednisone and 1 ml lidocaine with splint, and in the second group it was injection 40 mg methylprednisone and 1ml lidocaine without splint. Both groups followed this treatment for three periods(21 day. The related data were collected by visual analogue scale. Then data was analyzed by SPSS (ver. 16 using Fisher exact test and t test. Results: The findings of this study revealed that after the 3-week period of treatment the mean reduced pain intensity and improvement in the first group was significantly lower than the second group(p<0/05. Conclusion: Therefore, local injection of methylprednisone and lidocaine with splint is an effective method in the treatment of de Quervain's tenosynovitis.

  19. Tenosynovitis in rheumatoid arthritis patients on biologic treatment

    DEFF Research Database (Denmark)

    Hammer, Hilde Berner; Kvien, Tore K; Terslev, Lene

    2017-01-01

    , clinical and laboratory assessments were performed when starting biologic DMARD (bDMARD) and after 1, 2, 3, 6 and 12 months including bilateral grey-scale (GS) and power Doppler (PD) semi-quantitatively (0-3) scoring of ECU and TP tendons and 18 joints. Changes from baseline to follow-up were explored...... by Wilcoxon signed rank test, associations by Spearman's rank correlations and responses to treatment by Standardised Response Means (SRMs). RESULTS: 157 patients (mean age/disease duration 52.4/10.2 years) were included. ECU/TP tenosynovitis was frequent (baseline GS/PD pathology in 76/50% of patients...

  20. Biomechanical effects of steroid injections used to treat pyogenic flexor tenosynovitis

    Directory of Open Access Journals (Sweden)

    Turvey Blake R

    2012-10-01

    Full Text Available Abstract Background A recent study from our laboratory has demonstrated improved range of motion in the toes of broiler chickens afflicted with pyogenic flexor tenosynovitis when treated with local antibiotic and corticosteroid injections, without surgical drainage. However, the use of corticosteroids as an adjunct treatment raised peer concern, as steroids are thought to have deleterious effects on tendon strength. The purpose of this study was to compare the tensile strength of the aforementioned steroid treated tendons, to a group of tendons administered with the current standard treatment: systemic antibiotics, surgical drainage and no corticosteroids. Methods Twenty-three tendons’ structural and material properties were investigated (fifteen receiving the standard treatment, eight receiving the steroid treatment. The measurements from each group were interpreted via Student’s unpaired t-test and a post-hoc power analysis. Results The steroid treated tendons did demonstrate a trend toward decreased mechanical properties when compared with the standard treatment group, but the results were not statistically significant. Conclusions Treatment of septic tenosynovitis with local corticosteroid and local antibiotic injections resulted in better digital motion, without a significant loss of tendon strength, over a twenty-eight day recovery period.

  1. [Effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand].

    Science.gov (United States)

    Wang, H; Xia, F; Xing, D M; Ren, D; Feng, W; Chen, Y; Xiao, Z H; Zhao, Z M

    2017-05-01

    Objective: To investigate the effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand. Methods: A total of 9 cases acute and chronic suppurative tenosynovitis patients from January 2013 to April 2015 in Puai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were retrospectively reviewed. There were 6 males and 3 females, aging from 27 to 65 years, the average age was 55 years. There were 3 cases of index finger, 3 cases of middle finger, 2 cases of ring finger, 1 case include three fingers. The infection causes included stabbing with fishbone in 3 cases, stabbing with animal bone fragments in 3 cases, wound by sawdust in 3 cases, meat grinder injury in 1 case, multiple fingers crush injury postoperative infection of garbage truck in 1 case. Bacterial infection included 2 cases with Staphylococcus aureus, 2 cases with Staphylococcus epidermidis, 1 case with normal Escherichia coli, 1 case with mixed infection of Enterobacter aerogenes, Klebsiella oxytoca and Staphylococcus, 1 case with Bauman Acinetobacter bacillus, 1 case with Proteus mirabilis and 1 case of no growth of pathogenic bacteria culture. After thorough debridement, vacuum sealing drainage was used to observe the characteristics of irrigation fluid, the formation of cavity inflammation, the prognosis of infection and the recovery of finger function. Results: Seven patients with suppurative tenosynovitis were treated for 7 to 14 days, replaced the vacuum sealing drainage dressing once; 1 patient was an illustration of the finger tip defect flap infected patients after 21 days of treatment, replaced the vacuum sealing drainage dressing twice, 1 patient was an illustration of the central refers to trauma, postoperative infection patients 28 d, replaced three times in the VSD. The follow-up time was 3 to 12 months (mean 8.2 months), 7 patients without tendon necrosis, secondary suture with no infection, 2 cases of

  2. Recurrent Mycobacterium marinum tenosynovitis of the wrist mimicking extraarticular synovial chondromatosis on MR images

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Edward Y.; Rubin, David A. [Department of Radiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Brown, David M. [The Orthopedic Center of St. Louis, St. Louis, MO (United States)

    2004-07-01

    Tenosynovitis caused by atypical mycobacterial infections may produce rice bodies within affected tendon sheaths. We report a case of recurrent M. marinum infection involving the flexor tendons within the carpal tunnel in which the rice bodies were mistaken for synovial chondromatosis on MR images. (orig.)

  3. Recurrent Mycobacterium marinum tenosynovitis of the wrist mimicking extraarticular synovial chondromatosis on MR images

    International Nuclear Information System (INIS)

    Lee, Edward Y.; Rubin, David A.; Brown, David M.

    2004-01-01

    Tenosynovitis caused by atypical mycobacterial infections may produce rice bodies within affected tendon sheaths. We report a case of recurrent M. marinum infection involving the flexor tendons within the carpal tunnel in which the rice bodies were mistaken for synovial chondromatosis on MR images. (orig.)

  4. Infectious tenosynovitis with bloodstream infection caused by Erysipelothrix rhusiopathiae, a case report on an occupational pathogen.

    Science.gov (United States)

    Hofseth, Kristine; Dalen, Håvard; Kibsgaard, Leif; Nebb, Solrun; Kümmel, Angela; Mehl, Arne

    2017-01-05

    Erysipelothrix rhusiopathiae is an established animal pathogen, which may cause infections in humans. It is a gram-positive rod and found in the tonsils or the digestive tracts of animals. The bacterium is occupationally related, as usually only people with frequent animal contacts are infected. We report a case of a patient who was admitted with an infectious tenosynovitis with bloodstream infection due to E. rhusiopathiae, and to our knowledge, this is the first report of a tenosynovitis with systemic manifestation associated with this bacterium. A 52-year old Norwegian man, who worked with transportation of swine cadavers, was admitted to the local hospital with sepsis and unknown focus of infection. A few days earlier he had an injury to the skin of one of his fingers that later proved to be infected with E. rhusiopathiae. There were no other causes for his symptoms than the infectious tenosynovitis with systemic manifestation. The infection resolved on treatment with antibiotics and surgery. A transoesophageal echocardiogram was performed to exclude endocarditis, which may be associated with this pathogen. This case report highlights the importance of clinicians being aware of this bacterium, and we describe risk factors for infection, differences in the clinical manifestations of the disease, challenges with diagnosing the bacterium and adverse effects of immunosuppressive drugs. Recommended treatment is appropriate antibiotic therapy and adequate debridement and surgical drainage of the tendon sheath.

  5. Flexor pollicis longus tenosynovitis in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Manfield, Laura; Thomas, Mark; Lee, Se Won

    2014-06-01

    Carpal tunnel syndrome is typically diagnosed from history and physical examination then confirmed with electrodiagnosis. Electrodiagnosis provides only limited anatomic information and evaluation of space-occupying lesions. The authors present two cases in which demonstrated flexor pollicis longus tenosynovitis coexistent with carpal tunnel syndrome was diagnosed with ultrasonography. Ultrasonography is an effective modality that enhances the investigation of diseases in the soft tissues of the wrist and the hand. It can be useful in directing specific treatment by increasing diagnostic accuracy.

  6. Flexor Tenosynovitis Due to Tuberculosis in Hand and Wrist: Is Tenosynovectomy Imperative?

    Science.gov (United States)

    Kabakaş, Fatih; Uğurlar, Meriç; Turan, Derya Bayirli; Yeşiloğlu, Nebil; Mersa, Berkan; Özçelik, İsmail Bülent

    2016-08-01

    The treatment of flexor tenosynovitis in the hand and wrist due to tuberculosis is controversial. Although some authors recommend the antituberculous chemotherapy, the others recommend the surgical treatment. In this article, 12 patients with synovial tuberculosis of the flexor aspect of the hand and the wrist were evaluated with respect to diagnosis and treatment modalities. None of the patients had a history of tuberculosis, concomitant disease, immunosuppressive drug use, drug abuse, and human immunodefficiency virus positivity. A chest x-ray and family screening were performed in all of the cases, none had evidence of tuberculosis in the lung. The biopsy, histopathological examination, acid-fast bacillus staining, and BACTEC tuberculosis culture were performed. Antituberculous chemotherapy was initiated in patients diagnosed with tuberculosis by either histological or microbiological examinations. The patients did not undergo any further surgery after biopsy procedures. The lesions regressed totally in all patients after 3 months of treatment. Carpal tunnel syndrome symptoms and signs recruited at five months of treatment. In patients with flexor tuberculosis tenosynovitis, it is possible to achieve good results by applying only medical therapy after a biopsy, and without the need for further surgery.

  7. Tenosynovitis of a digit due to Erysipelothrix rhusiopathiae: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    K. Tolis

    2015-11-01

    Full Text Available Erysipelothrix rhusiopathiae is a Gram-positive bacterium that in humans causes skin infections, such as erysipeloid, as a result of direct contact with contaminated animals or their waste or products. We present the first reported case of tenosynovitis of a finger in a 30-year-old woman.

  8. Predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Ursum, J.; Horsten, N.C.; Hoeksma, A.F.; Dijkmans, B.A.; Knol, D.L.; Schaardenburg, D. van; Dekker, J.; Roorda, L.D.

    2011-01-01

    Objectives: To identify early predictors of stenosing tenosynovitis in the hand and hand-related activity limitations in patients with rheumatoid arthritis (RA). Design: A longitudinal study of an inception cohort. Setting: A large outpatient clinic. Participants: Consecutive patients who attended

  9. Association between distal ulnar morphology and extensor carpi ulnaris tendon pathology

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Kattapuram, Susan V.; Torriani, Martin [General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts, Boston, MA (United States)

    2014-06-15

    The purpose of this study was to evaluate the association between distal ulnar morphology and extensor carpi ulnaris (ECU) tendon pathology. We retrospectively reviewed 71 adult wrist MRI studies with ECU tendon pathology (tenosynovitis, tendinopathy, or tear), and/or ECU subluxation. Subjects did not have a history of trauma, surgery, infection, or inflammatory arthritis. MRI studies from 46 subjects without ECU tendon pathology or subluxation were used as controls. The following morphological parameters of the distal ulna were measured independently by two readers: ulnar variance relative to radius, ulnar styloid process length, ECU groove depth and length. Subjects and controls were compared using Student's t test. Inter-observer agreement (ICC) was calculated. There was a significant correlation between negative ulnar variance and ECU tendon pathology (reader 1 [R1], P = 0.01; reader 2 [R2], P < 0.0001; R1 and R2 averaged data, P < 0.0001) and ECU tendon subluxation (P = 0.001; P = 0.0001; P < 0.0001). In subjects with ECU tendon subluxation there was also a trend toward a shorter length (P = 0.3; P <0.0001; P = 0.001) and a shallower ECU groove (P = 0.01; P = 0.03; P = 0.01; R1 and R2 averaged data with Bonferroni correction, P = 0.08). ECU groove depth (P = 0.6; P = 0.8; P = 0.9) and groove length (P = 0.1; P = 0.4; P = 0.7) showed no significant correlation with ECU tendon pathology, and length of the ulnar styloid process showed no significant correlation with ECU tendon pathology (P = 0.2; P = 0.3; P = 0.2) or subluxation (P = 0.4; P = 0.5; P = 0.5). Inter-observer agreement (ICC) was >0.64 for all parameters. Distal ulnar morphology may be associated with ECU tendon abnormalities. (orig.)

  10. Conservative care of De Quervain's tenosynovitis/ tendinopathy in a warehouse worker and recreational cyclist: a case report.

    Science.gov (United States)

    Howell, Emily R

    2012-06-01

    This case study was conducted to evaluate the conservative management of a patient presenting with right sided wrist and thumb pain diagnosed as De Quervain's tenosynovitis/tendinopathy. A 49-year-old female warehouse worker and recreational cyclist with right-sided De Quervain's tenosynovitis/tendinopathy that began after a long-distance cycling trip. Treatment included ultrasound, soft tissue and myofascial release therapy, tool assisted fascial stripping or "guasha", acupuncture, mobilizations and kinesiology taping. Home advice included icing, rest, wrist bracing, elevation and eccentric rehabilitation exercises. The positive outcome was a complete resolution of the patient's complaint. This case demonstrates how De Quervain's disease is a challenging condition to treat with conservative methods and can be aggravated with new exacerbating factors as treatment continues. In this case, the addition of the active care (including eccentric exercises and self-care) helped to reinforce the passive care given in the office and accelerate the recovery.

  11. A comparison of ultrasound and clinical examination in the detection of flexor tenosynovitis in early arthritis

    Directory of Open Access Journals (Sweden)

    Abouqal Redouane

    2011-05-01

    Full Text Available Abstract Background Tenosynovitis is widely accepted to be common in rheumatoid arthritis (RA and postulated to be the first manifestation of RA, but its true prevalence in early disease and in particular the hand has not been firmly established. The aims of this study were first to investigate the frequency and distribution of finger flexor tenosynovitis using ultrasound in early arthritis, second to compare clinical examination with ultrasound (US using the latter as the gold standard. Methods 33 consecutive patients who had who were initially diagnosed with polyarthritis and suspected of polyarthritis and clinical suspicion of inflammatory arthritis of the hands and wrists were assessed during consecutive, routine presentations to the rheumatology outpatient clinic. We scanned a total of 165 finger tendons and subsequent comparisons were made using clinical examination. Results Flexor tenosynovitis was found in 17 patients (51.5% on ultrasound compared with 16 (48.4% of all patients on clinical examination. Most commonly damaged joint involved on US was the second finger followed by the third, fifth, and fourth. Both modalities demonstrated more pathology on the second and third metacarpophalangeal (MCP compared with the fourth and fifth MCP. A joint-by-joint comparison of US and clinical examination demonstrated that although the sensitivity, specificities and positive predictive values of clinical examination were relatively high, negative predictive value of clinical examination was low (0.23. Conclusions Our study suggest that clinical examination can be a valuable tool for detecting flexor disease in view of its high specificity and positive predictive values, but a negative clinical examination does not exclude inflammation and an US should be considered. Further work is recommended to standardize definitions and image acquisition for peritendinous inflammation for ultrasound.

  12. Tuberculous tenosynovitis of the wrist: diagnosis with US and contribution of MRI; Tenosynovite tuberculeuse du poignet: diagnostic echographique et apport de l`IRM

    Energy Technology Data Exchange (ETDEWEB)

    Miquel, A.; Frouge, C.; Adrien, C.; Hibou, I.; Bittoun, J.; Bisson, M.; Blery, M. [Hopital de Bicetre, 94 - le Kremlin-Bicetre (France)

    1995-05-01

    Chronic tenosynovitis of the hand due to Mycobacterium tuberculosis has become rare. In the two cases presented here, the final diagnosis was obtained by isolation of the organism in the intercarpal fluid (1 case), or by a synovial biopsy (1 case). Ultrasonography showed a hypoechoic thickening of one or several tendon sheaths. MR enabled better differentiation between the thickening of the synovium itself and a fluid effusion. The criteria permitting to differentiate tuberculous from non-infectious tenosynovitis are: young age, male sex, specific epidemiological factors, elevated erythrocyte sedimentation rate, marked local swelling, association with other foci of tuberculosis, unusual exudation and synovial thickening, and association with osteitis. (authors). 11 refs., 2 figs.

  13. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Garg Arun

    2012-06-01

    Full Text Available Abstract Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A

  14. Tenosynovitis Evaluation Using Image Fusion and B-Flow - A Pilot Study on New Imaging Techniques in Rheumatoid Arthritis Patients

    DEFF Research Database (Denmark)

    Ammitzbøll-Danielsen, Mads; Glinatsi, Daniel; Torp-Pedersen, Søren

    2017-01-01

    .40) for tendon sheaths. No statistically significant difference was found between US tendon area and MRI tendon area 2 (Wilcoxon's test; p = 0.47). Overall, the agreement between grayscale and color Doppler (CD) US and MRI tenosynovitis visualization and scoring was good, but not between CD and BFI. Conclusion...

  15. Mycobacterium arupense, Mycobacterium heraklionense, and a Newly Proposed Species, "Mycobacterium virginiense" sp. nov., but Not Mycobacterium nonchromogenicum, as Species of the Mycobacterium terrae Complex Causing Tenosynovitis and Osteomyelitis.

    Science.gov (United States)

    Vasireddy, Ravikiran; Vasireddy, Sruthi; Brown-Elliott, Barbara A; Wengenack, Nancy L; Eke, Uzoamaka A; Benwill, Jeana L; Turenne, Christine; Wallace, Richard J

    2016-05-01

    Mycobacterium terrae complex has been recognized as a cause of tenosynovitis, with M. terrae and Mycobacterium nonchromogenicum reported as the primary etiologic pathogens. The molecular taxonomy of the M. terrae complex causing tenosynovitis has not been established despite approximately 50 previously reported cases. We evaluated 26 isolates of the M. terrae complex associated with tenosynovitis or osteomyelitis recovered between 1984 and 2014 from 13 states, including 5 isolates reported in 1991 as M. nonchromogenicum by nonmolecular methods. The isolates belonged to three validated species, one new proposed species, and two novel related strains. The majority of isolates (20/26, or 77%) belonged to two recently described species: Mycobacterium arupense (10 isolates, or 38%) and Mycobacterium heraklionense (10 isolates, or 38%). Three isolates (12%) had 100% sequence identity to each other by 16S rRNA and 99.3 to 100% identity by rpoB gene region V sequencing and represent a previously undescribed species within the M. terrae complex. There were no isolates of M. terrae or M. nonchromogenicum, including among the five isolates reported in 1991. The 26 isolates were susceptible to clarithromycin (100%), rifabutin (100%), ethambutol (92%), and sulfamethoxazole or trimethoprim-sulfamethoxazole (70%). The current study suggests that M. arupense, M. heraklionense, and a newly proposed species ("M. virginiense" sp. nov.; proposed type strain MO-233 [DSM 100883, CIP 110918]) within the M. terrae complex are the major causes of tenosynovitis and osteomyelitis in the United States, with little change over 20 years. Species identification within this complex requires sequencing methods. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  16. Bicipital tenosynovitis in the dog: evaluation with positive contrast arthrography

    International Nuclear Information System (INIS)

    Barthez, P.Y.; Morgan, J.P.

    1993-01-01

    This paper describes seven dogs with traumatic bicipital tenosynovitis in which complete clinical, radiographic, and surgical evaluations were performed. All were adult dogs of medium to large breed and were presented with a chronic front limb lameness of several months' duration and shoulder muscle atrophy. Survey radiographs of the scapulohumeral joint showed new bone production almost exclusively in the region of the biceps tendon, i.e., the intertubercular groove and the supraglenoid tuberosity. Arthrograms in six of seven dogs revealed difficulty in filling or irregular filling of the bicipital tendon sheath, best seen on the mediolateral view of the shoulder. On surgical exploration, macroscopic lesions of the tendon and/or the sheath were observed in all dogs and included adhesions, fibrosis, scar tissue, edema, and thickening. Partial tear of the tendon was observed in three dogs

  17. Subclinical synovitis and tenosynovitis by ultrasonography (US) 7 score in patients with rheumatoid arthritis treated with synthetic drugs, in clinical remission by DAS28.

    Science.gov (United States)

    Ventura-Ríos, Lucio; Sánchez Bringas, Guadalupe; Hernández-Díaz, Cristina; Cruz-Arenas, Esteban; Burgos-Vargas, Rubén

    2017-11-29

    To identify synovitis and tenosynovitis active by using the Ultrasound 7 (US 7) scoring system in patients with rheumatoid arthritis (RA) in clinical remission induced by synthetic disease-modifying antirheumatic drugs (DMARDs). This is a multicentric, cross-sectional, observational study including 94 RA patients >18 years old who were in remission as defined by the 28-joints disease activity score (DAS28) <2.6 induced by synthetic DMARD during at least 6 months. Patients with a previous or current history of biologic DMARD treatment were not included in the study. Demographic and clinical data were collected by the local rheumatologist; the US evaluation was performed by a calibrated rheumatologist, who intended to detect grayscale synovitis and power Doppler (PD) using the 7-joint scale. Intra and inter-reader exercises of images between 2 ultrasonographers were realized. Patients' mean age was 49.1±13.7 years; 83% were women. The mean disease duration was 8±7 years and remission lasted for 27.5±31.8 months. The mean DAS28 score was 1.9±0.66. Grayscale synovitis was present in 94% of cases; it was mild in 87.5% and moderate in 12.5%. Only 12.8% of the patients had PD. The metatarsophalangeal, metacarpophalangeal, and carpal joints of the dominant hand were the joints more frequently affected by synovitis. Tenosynovitis by grayscale was observed in 9 patients (9.6%). The intra and inter-reading kappa value were 0.77, p<0.003 (CI 95%, 0.34-0.81) and 0.81, p<0.0001 (CI 95%, 0.27-0.83) respectively. Low percentage of synovitis and tenosynovitis active were founded according to PD US by 7 score in RA patients under synthetic DMARDs during long remission. This score has benefit because evaluate tenosynovitis, another element of subclinical disease activity. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  18. Mycobacterium arupense, Mycobacterium heraklionense, and a Newly Proposed Species, “Mycobacterium virginiense” sp. nov., but Not Mycobacterium nonchromogenicum, as Species of the Mycobacterium terrae Complex Causing Tenosynovitis and Osteomyelitis

    Science.gov (United States)

    Vasireddy, Sruthi; Brown-Elliott, Barbara A.; Wengenack, Nancy L.; Eke, Uzoamaka A.; Benwill, Jeana L.; Turenne, Christine; Wallace, Richard J.

    2016-01-01

    Mycobacterium terrae complex has been recognized as a cause of tenosynovitis, with M. terrae and Mycobacterium nonchromogenicum reported as the primary etiologic pathogens. The molecular taxonomy of the M. terrae complex causing tenosynovitis has not been established despite approximately 50 previously reported cases. We evaluated 26 isolates of the M. terrae complex associated with tenosynovitis or osteomyelitis recovered between 1984 and 2014 from 13 states, including 5 isolates reported in 1991 as M. nonchromogenicum by nonmolecular methods. The isolates belonged to three validated species, one new proposed species, and two novel related strains. The majority of isolates (20/26, or 77%) belonged to two recently described species: Mycobacterium arupense (10 isolates, or 38%) and Mycobacterium heraklionense (10 isolates, or 38%). Three isolates (12%) had 100% sequence identity to each other by 16S rRNA and 99.3 to 100% identity by rpoB gene region V sequencing and represent a previously undescribed species within the M. terrae complex. There were no isolates of M. terrae or M. nonchromogenicum, including among the five isolates reported in 1991. The 26 isolates were susceptible to clarithromycin (100%), rifabutin (100%), ethambutol (92%), and sulfamethoxazole or trimethoprim-sulfamethoxazole (70%). The current study suggests that M. arupense, M. heraklionense, and a newly proposed species (“M. virginiense” sp. nov.; proposed type strain MO-233 [DSM 100883, CIP 110918]) within the M. terrae complex are the major causes of tenosynovitis and osteomyelitis in the United States, with little change over 20 years. Species identification within this complex requires sequencing methods. PMID:26962085

  19. Types of intersections.

    NARCIS (Netherlands)

    2015-01-01

    There are many types of intersections in the Netherlands. In an inherently safe road traffic system, however, the number of intersection types needs to be limited, depending on the road types that intersect. The desired types of intersections do not always correspond with the recommendations in the

  20. Grounded Intersectionality

    DEFF Research Database (Denmark)

    Marfelt, Mikkel Mouritz

    2016-01-01

    associated with intersectional research. The findings assist in positioning the proposed methodological framework within recent intersectional debates. Findings – The review shows a rise in intersectional publications since the birth of the “intersectionality” term in 1989. Moreover, the paper points to four...... oriented but still emphasizes stable concepts. Moreover, it does not give primacy to oppression. Finally, it adopts a critical stance on the nature of the macro, meso, and micro levels as dominant analytical perspectives. As a result, this paper focusses on the importance of intersectionality...

  1. Detection of vascularity in wrist tenosynovitis: power doppler ultrasound compared with contrast-enhanced grey-scale ultrasound.

    Science.gov (United States)

    Klauser, Andrea S; Franz, Magdalena; Arora, Rohit; Feuchtner, Gudrun M; Gruber, Johann; Schirmer, Michael; Jaschke, Werner R; Gabl, Markus F

    2010-01-01

    We sought to assess vascularity in wrist tenosynovitis by using power Doppler ultrasound (PDUS) and to compare detection of intra- and peritendinous vascularity with that of contrast-enhanced grey-scale ultrasound (CEUS). Twenty-six tendons of 24 patients (nine men, 15 women; mean age ± SD, 54.4 ± 11.8 years) with a clinical diagnosis of tenosynovitis were examined with B-mode ultrasonography, PDUS, and CEUS by using a second-generation contrast agent, SonoVue (Bracco Diagnostics, Milan, Italy) and a low-mechanical-index ultrasound technique. Thickness of synovitis, extent of vascularized pannus, intensity of peritendinous vascularisation, and detection of intratendinous vessels was incorporated in a 3-score grading system (grade 0 to 2). Interobserver variability was calculated. With CEUS, a significantly greater extent of vascularity could be detected than by using PDUS (P < 0.001). In terms of peri- and intratendinous vessels, CEUS was significantly more sensitive in the detection of vascularization compared with PDUS (P < 0.001). No significant correlation between synovial thickening and extent of vascularity could be found (P = 0.089 to 0.097). Interobserver reliability was calculated to be excellent when evaluating the grading score (κ = 0.811 to 1.00). CEUS is a promising tool to detect tendon vascularity with higher sensitivity than PDUS by improved detection of intra- and peritendinous vascularity.

  2. DISTAL MYOPATHIES

    Science.gov (United States)

    Dimachkie, Mazen M.; Barohn, Richard J.

    2014-01-01

    Over a century ago, Gowers described two young patients in whom distal muscles weakness involved the hand, foot, sternocleidomastoid, and facial muscles in the other case the shoulder and distal leg musculature. Soon after, , similar distal myopathy cases were reported whereby the absence of sensory symptoms and of pathologic changes in the peripheral nerves and spinal cord at postmortem examination allowed differentiation from Charcot-Marie-Tooth disease. In 1951, Welander described autosomal dominant (AD) distal arm myopathy in a large Scandanavian cohort. Since then the number of well-characterized distal myopathies has continued to grow such that the distal myopathies have formed a clinically and genetically heterogeneous group of disorders. Affected kindred commonly manifest weakness that is limited to foot and toe muscles even in advanced stages of the disease, with variable mild proximal leg, distal arm, neck and laryngeal muscle involvement in selected individuals. An interesting consequence of the molecular characterization of the distal myopathies has been the recognition that mutation in a single gene can lead to more than one clinical disorder. For example, Myoshi myopathy (MM) and limb girdle muscular dystrophy (LGMD) type 2B are allelic disorders due to defects in the gene that encodes dysferlin. The six well described distal myopathy syndromes are shown in Table 1. Table 2 lists advances in our understanding of the myofibrillar myopathy group and Table 3 includes more recently delineated and less common distal myopathies. In the same manner, the first section of this review pertains to the more traditional six distal myopathies followed by discussion of the myofibrillar myopathies. In the third section, we review other clinically and genetically distinctive distal myopathy syndromes usually based upon single or smaller family cohorts. The fourth section considers other neuromuscular disorders that are important to recognize as they display prominent

  3. Hand and wrist involvement in systemic sclerosis: US features.

    Science.gov (United States)

    Freire, Véronique; Bazeli, Ramin; Elhai, Muriel; Campagna, Raphaël; Pessis, Éric; Avouac, Jérôme; Allanore, Yannick; Drapé, Jean-Luc; Guérini, Henri

    2013-12-01

    To characterize ultrasonographic (US) features in the hand of patients with systemic sclerosis (SSc) and to evaluate the sensitivity of US in the detection of calcinosis and acroosteolysis. The local ethics committee approved this study, and oral informed consent was obtained. A total of 44 consecutive patients with SSc (34 women; mean age, 56.1 years ± 12.1 [standard deviation]; 10 men; mean age, 45.0 years ± 14.0) and 30 healthy control subjects (20 women; mean age, 46.3 years ± 12.1; 10 men; mean age, 39.6 years ± 10.8) were included between October 2010 and December 2011. Bilateral US, including Doppler assessment of the wrists, hands, and fingers, was performed, and presence of synovitis, tenosynovitis with or without a layered appearance, calcifications, acroosteolysis, and distal vascularization was recorded. Radiography of both hands was performed to assess for acroosteolysis and calcinosis. Frequency of US features, sensitivity of US for calcinosis and acroosteolysis, and respective confidence intervals were calculated. Synovitis was found in 17 patients (39%). Tenosynovitis was found in 12 patients (27%), and it had a layered pattern in 15 (41%) of 37 cases. Calcinosis was found in 17 patients (39%) with US, with a sensitivity of 89%. Acroosteolysis was found in nine (20%) patients with US and in 10 (23%) patients with radiography, with 90% sensitivity for US. Distal vascularization was detected in 26 patients (59%) and 30 control subjects (100%) and was in contact with the acroosteolysis bed in seven (78%) of nine patients with SSc. US can be used to assess features of SSc, including synovitis, tenosynovitis, calcinosis, acroosteolysis, and distal vascularization and is sensitive for calcinosis and acroosteolysis detection. A layered pattern (similar to the appearance of an artichoke heart) of tenosynovitis was seen commonly. Online supplemental material is available for this article. © RSNA, 2013.

  4. Extracorporeal shockwave therapy in a dog with chronic bicipital tenosynovitis.

    Science.gov (United States)

    Venzin, C; Ohlerth, S; Koch, D; Spreng, D

    2004-03-01

    A 15-month-old, spayed female, Bernese mountain dog was presented to the Institute of Small Animal Surgery at the University of Zurich because of chronic left forelimb lameness. The referring veterinarian diagnosed pain in the left shoulder region and had treated the dog with systemic non-steroidal anti-inflammatory drugs and restricted exercise for a two-week period. The follow-up examination revealed only minimal improvement and therefore, the dog was referred for further diagnostic evaluation. Chronic bicipital tenosynovitis and tendinitis of the infraspinatus muscle was diagnosed based on survey radiographs, arthrography, ultrasound, computed tomography (CT), and synovial fluid cytology. The dog underwent three sessions of extracorporeal shockwave therapy and substantial clinical improvement was observed. On follow-up examinations, only mild left forelimb lameness was evident following exercise, and changes in the intertubercular groove and at the supraglenoid tuberosity appeared less active on radiographs and CT. However, six months following treatment, mild degenerative joint disease was apparent.

  5. MR Imaging and US of the Wrist Tendons.

    Science.gov (United States)

    Plotkin, Benjamin; Sampath, Srihari C; Sampath, Srinath C; Motamedi, Kambiz

    2016-10-01

    The tendons of the wrist are commonly symptomatic. They can be injured, infected, or inflamed. Magnetic resonance imaging and ultrasonography are useful tools for evaluating the wrist. Pathologic conditions of the wrist tendons include de Quervain tenosynovitis, extensor carpi ulnaris tendinopathy, rheumatoid tenosynovitis, infectious synovitis, tendon tears, hydroxyapatite deposition disease, intersection syndrome, tenosynovial giant cell tumor, and fibroma of the tendon sheath. In this article, we review the normal appearance of the wrist tendons, discuss relevant anatomy, and give an overview of common pathologic conditions affecting the wrist tendons. Online supplemental material is available for this article. © RSNA, 2016.

  6. Tenosinovitis flexora piógena de la mano: hallazgos ecográficos Pyogenic flexor tenosynovitis of the hand: sonographic findings

    Directory of Open Access Journals (Sweden)

    A. Rodríguez

    2007-09-01

    Full Text Available Los autores describen los hallazgos ecográficos en tres pacientes con tenosinovitis flexora piógena (TFP de la mano. Los hallazgos patológicos encontrados en el Eco-Doppler Color fueron un halo hipoecogénico peritendinoso y una hipervascularización de la vaina sinovial. La Ecografía es un procedimiento no invasivo que permite diagnosticar de manera eficiente y precoz la TFP y permite además realizar un estadiaje preoperatorio siendo una guía útil para planificar la cirugía en función de la cantidad y localización de la colección purulenta y de la integridad tendinosa.The authours describe the sonographic findings in three cases of pyogenic flexor tenosynovitis of the hand. Hipoechogenic peritendinous area and hipervascularization of the synovial sheath revealed as the pathologic findings. In Color Doppler US Ultrasound is a non-invasive procedure that allows to make an accurate and early diagnosis of pyogenic flexor tenosynovitis, it is an useful guide for planning surgery taking account the amount and localization of the purulence and the integrity of the tendons.

  7. Poliartritis y tenosinovitis grave por Streptococcus agalactiae en un paciente con hipoesplenia funcional Severe polyarthritis and tenosynovitis caused by Streptococcus agalactiae in a patient with functional hyposplenia

    Directory of Open Access Journals (Sweden)

    Domingo C. Balderramo

    2002-08-01

    Full Text Available La artritis por Streptococcus agalactiae es infrecuente. No conocemos publicaciones de casos sobre la afección tendinosa por este microorganismo. Se presenta una mujer de 46 años que consultó por fiebre, poliartralgias, mialgias, diarrea y vómitos. Como antecedentes presentaba carcinoma papilar de tiroides e hipoesplenia funcional. Al examen se encontraba hemodinámicamente inestable, febril, con artritis de mano izquierda, muñecas, codos, hombro derecho y tobillo izquierdo. Presentaba tenosinovitis en ambos pies y en la mano izquierda. Los hemocultivos y el cultivo de la bursa olecraniana derecha fueron positivos para S. agalactiae. La ecografía mostró signos de tenosinovitis del tibial anterior izquierdo. Completó 20 días de tratamiento endovenoso con cefazolina y 12 días de cefuroxima oral. El cuadro articular revirtió completamente en 60 días. El Streptococcus agalactiae puede causar, en forma infrecuente, un síndrome de poliartritis, tenosinovitis y fiebre similar al producido por la infección gonocócica.Cases of arthritis caused by Streptococcus agalactiae are infrequent and in our knowledge there are no case reports of tenosynovitis caused by S. agalactiae. A 46-year-old woman presented with fever, polyarthralgia, myalgia, diarrhea and vomiting. She had a history of papillary thyroid carcinoma and functional hyposplenia. She was febrile, with arthritis in hands, wrists, elbows, right shoulder and left ankle joints, and presented tenosynovitis in both feet and left hand. Blood and right olecranon bursa sample cultures were positive for S. agalactiae. An ultrasound scan made at the musculus tibialis anterior of left foot revealed signs of tenosynovitis. She was treated with intravenous cefazolin for 20 days and oral cefuroxime for 12 days. The joint involvement completely subsided in 60 days. Streptococcus agalactiae can cause, infrequently, a polyarthritis and tenosynovitis syndrome similar to disseminated gonococcal

  8. Tuberculous Tenosynovitis Presenting as Ganglion of Wrist

    Directory of Open Access Journals (Sweden)

    Shahaji Chavan

    2012-01-01

    Full Text Available Tuberculosis (TB is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist Soft in consistency Non tender Non compressible Mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigations were normal. Ultrsonography showed giant cell tumor of Extensor Digitorum sheath. X-ray: soft tissue swelling and MRI was suggestive of extensor tendon sheath extraskeletal synovial Koch’s, or giant cell tumor of tendon sheath. Excision of swelling was planned and intraoperatively, rice bodies were seen inside it. Histopathological examination showed caseous necrosis with granuloma formation. Patient was put on DOT1 therapy. Tuberculous tenosynovitis was first described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were first described in 1895 by Reise. Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with extensive curettage lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia.

  9. A distal earthquake cluster concurrent with the 2006 explosive eruption of Augustine Volcano, Alaska

    Science.gov (United States)

    Fisher, M.A.; Ruppert, N.A.; White, R.A.; Wilson, Frederic H.; Comer, D.; Sliter, R.W.; Wong, F.L.

    2009-01-01

    Clustered earthquakes located 25??km northeast of Augustine Volcano began about 6??months before and ceased soon after the volcano's 2006 explosive eruption. This distal seismicity formed a dense cluster less than 5??km across, in map view, and located in depth between 11??km and 16??km. This seismicity was contemporaneous with sharply increased shallow earthquake activity directly below the volcano's vent. Focal mechanisms for five events within the distal cluster show strike-slip fault movement. Cluster seismicity best defines a plane when it is projected onto a northeast-southwest cross section, suggesting that the seismogenic fault strikes northwest. However, two major structural trends intersect near Augustine Volcano, making it difficult to put the seismogenic fault into a regional-geologic context. Specifically, interpretation of marine multichannel seismic-reflection (MCS) data shows reverse faults, directly above the seismicity cluster, that trend northeast, parallel to the regional geologic strike but perpendicular to the fault suggested by the clustered seismicity. The seismogenic fault could be a reactivated basement structure.

  10. Distal corporoplasty for distal cylinders extrusion after penile prosthesis implantation.

    Science.gov (United States)

    Carrino, Maurizio; Chiancone, Francesco; Battaglia, Gaetano; Pucci, Luigi; Fedelini, Paolo

    2017-02-03

    Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in "Distal corporoplasty" technique. We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an "AMS 700 inflatable penile prosthesis (LGX)" from January 2013 to November 2015 at our hospital. All procedures were performed by a single surgical team. Intraoperative and postoperative complications have been classified and reported according to Satava6 and Clavien-Dindo (CD) system.7 Mean values with standard deviations (±SD) were computed and reported for all items. Mean age of the patients was 53.61 (±11.90) years. Mean body max index (BMI) was 24.22 (±2.51). Mean operative time was 85.2 (±13.1) minutes. Blood losses were minimal. No intraoperative complications are reported according to Satava classification. Four out of 18 patients (22.22%) experienced postoperative complications according to CD system. All patients had sexual intercourse for the first time postsurgery after a mean of 59.11 ± 2.08 days. Mean follow-up was 22.11 (±9.95). Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Distal corporoplasty was first described by Mulcahy. He reported a series of 14 patients with a follow-up of about 2 years with optimal functional outcomes. Moreover, distal corporoplasty resulted in shorter operative time, better function, less pain, and fewer recurrences than Gortex windsock repair.10 In our experience, distal corporoplasty is a simple and safe procedure in the treatment of distal cylinders extrusion when the prosthetic material is not exposed to the exterior.

  11. L'intersectionnalité contre l'intersection

    NARCIS (Netherlands)

    Chauvin, S.; Jaunait, A.

    2015-01-01

    Intersectionality against intersection. Is the notion of intersectionality doomed to being part of the problem it designates? Intersectionality theory was not developed to merely point at intersections but to capture subject positions made invisible by dominant systems of normative representation.

  12. Distal digital replantation.

    Science.gov (United States)

    Jazayeri, Leila; Klausner, Jill Q; Chang, James

    2013-11-01

    Hand surgeons have been hesitant to perform distal digital replantation because of the technical challenges and the perception of a high cost-to-benefit ratio. Recent studies, however, have shown high survival rates and excellent functional and aesthetic results, providing renewed enthusiasm for distal replantation. The authors reviewed the literature and summarize key points regarding the surgical treatment, perioperative care, and outcomes of distal digital replantation. They describe specific techniques and considerations for surgical repair in each of four distal zones as described by Sebastin and Chung. Zone 1A replantation involves an artery-only anastomosis of a longitudinal pulp artery. Venous anastomosis first becomes possible in zone 1B. Zone 1C involves periarticular amputations where arthrodesis of the distal interphalangeal joint is usually indicated. Repair of the artery, vein, and nerve is technically optimal in zone 1D, where venous anastomosis should be performed. Overall, survival rates for distal digital replantation are similar to those reported for more proximal replantation. The literature reports good outcomes regarding nail salvage, fingertip sensibility, and range of motion, with restoration of length and aesthetic appearance. Distal replantation performed at institutions that specialize in microsurgery and specifically tailored to the level of injury is associated with good survival, function, and patient satisfaction and superior aesthetic outcome. More prospective data are needed to evaluate the cost of treatment, psychological outcomes, and functional outcomes of distal replantation compared with revision amputation.

  13. Spontaneous Extensor Tendon Rupture in the Rheumatoid Wrist: Risk Factors and Preventive Role of Extended Tenosynovectomy.

    Science.gov (United States)

    Hsueh, Jung-Hua; Liu, Wen-Chung; Yang, Kuo-Chung; Hsu, Kuei-Chang; Lin, Cheng-Ta; Chen, Lee-Wei

    2016-03-01

    Spontaneous extensor tendon rupture is often seen in rheumatoid arthritis (RA) patients, but the risk factors are not clearly defined. We therefore collected the data of RA patients with previous extensor tendon rupture and those with tenosynovitis and analyzed the relationship between extended tenosynovectomy and spontaneous extensor tendon rupture. We retrospectively reviewed 17 spontaneous extensor tendon rupture episodes in 15 RA patients and 14 tenosynovitis episodes that required tenosynovectomy in 12 RA patients from 1997 to 2013. Correlations between the incidence of tendon rupture, X-ray findings, and clinical findings in the affected wrists before tendon rupture were analyzed statistically using the test for proportion. The following parameters were significantly correlated with spontaneous extensor tendon rupture: disease duration longer than 8 years, persistent tenosynovitis longer than 1 year duration, and Larsen grade greater than 4 (P = 0.02, 0.03, and 0.01, respectively). Dislocation of the distal end of the ulna, carpal collapse, and the scallop sign on X-ray contributed to a higher spontaneous extensor tendon rupture rate among RA patients (P = 0.01, 0.05, and 0.03, respectively). Extended tenosynovectomy was performed on 14 wrists in 12 RA patients with persistent tenosynovitis longer than 6 months, and Larsen grade did not deteriorate in this group compared with those who did not undergo the surgery. No spontaneous extensor tendon rupture occurred following the surgery. Risk factors of spontaneous extensor tendon rupture included disease duration longer than 8 years, persistent tenosynovitis longer than 1 year, and wrist Larsen grade greater than 4. Dislocation of the distal end of the ulna, carpal collapse, and the scallop sign on X-ray indicated a higher probability of extensor tendon rupture. Rheumatologists should consult with hand surgeons promptly to preserve hand function before tendon rupture. Prophylactic extended tenosynovectomy

  14. Intersectionality research in counseling psychology.

    Science.gov (United States)

    Grzanka, Patrick R; Santos, Carlos E; Moradi, Bonnie

    2017-10-01

    This article introduces the special section on intersectionality research in counseling psychology. Across the 4 manuscripts that constitute this special section, a clear theme emerges: a need to return to the roots and politics of intersectionality. Importantly, the 2 empirical articles in this special section (Jerald, Cole, Ward, & Avery, 2017; Lewis, Williams, Peppers, & Gadson, 2017) are studies of Black women's experiences: a return, so to speak, to the subject positions and social locations from which intersectionality emanates. Shin et al. (2017) explore why this focus on Black feminist thought and social justice is so important by highlighting the persistent weaknesses in how much research published in leading counseling psychology journals has tended to use intersectionality as a way to talk about multiple identities, rather than as a framework for critiquing systemic, intersecting forms of oppression and privilege. Shin and colleagues also point to the possibilities intersectionality affords us when scholars realize the transformative potential of this critical framework. Answers to this call for transformative practices are foregrounded in Moradi and Grzanka's (2017) contribution, which surveys the interdisciplinary literature on intersectionality and presents a series of guidelines for using intersectionality responsibly. We close with a discussion of issues concerning the applications of intersectionality to counseling psychology research that spans beyond the contributions of each manuscript in this special section. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. INTERSECTIONAL DISCRIMINATION AGAINST CHILDREN

    DEFF Research Database (Denmark)

    Ravnbøl, Camilla Ida

    This paper adds a perspective to existing research on child protection by engaging in a debate on intersectional discrimination and its relationship to child protection. The paper has a twofold objective, (1) to further establish intersectionality as a concept to address discrimination against...... children, and (2) to illustrate the importance of addressing intersectionality within rights-based programmes of child protection....

  16. Maxillary molar distalization with the dual-force distalizer supported by mini-implants: a clinical study.

    Science.gov (United States)

    Oberti, Giovanni; Villegas, Carlos; Ealo, Martha; Palacio, John Camilo; Baccetti, Tiziano

    2009-03-01

    The objective of this prospective study was to describe the clinical effects of a bone-supported molar distalizing appliance, the dual-force distalizer. The study group included 16 patients (mean age, 14.3 years) with Class II molar relationships. Study models and lateral cephalograms were taken before and after the distalizing movement to record significant dental and skeletal changes (Wilcoxon test). The average distalization time was 5 months, with a movement rate of 1.2 mm per month; the distalization amounts were 5.9 +/- 1.72 mm at the crown level and 4.4 +/- 1.41 mm at the furcation level. The average molar inclination was 5.6 degrees +/- 3.7 degrees ; this was less than the amount of inclination generated by bone-supported appliances that use single distalizing forces. The correlation between inclination and distalization was not significant, indicating predominantly bodily movement. The teeth anterior to the first molar moved distally also; the second premolars distalized an average of 4.26 mm, and the incisors retruded by 0.53 mm. The dual-force distalizer is a valid alternative distalizing appliance that generates controlled molar distalization with a good rate of movement and no loss of anchorage.

  17. Comparing the effects of infrastructure on bicycling injury at intersections and non-intersections using a case–crossover design

    Science.gov (United States)

    Harris, M Anne; Reynolds, Conor C O; Winters, Meghan; Cripton, Peter A; Shen, Hui; Chipman, Mary L; Cusimano, Michael D; Babul, Shelina; Brubacher, Jeffrey R; Friedman, Steven M; Hunte, Garth; Monro, Melody; Vernich, Lee; Teschke, Kay

    2013-01-01

    Background This study examined the impact of transportation infrastructure at intersection and non-intersection locations on bicycling injury risk. Methods In Vancouver and Toronto, we studied adult cyclists who were injured and treated at a hospital emergency department. A case–crossover design compared the infrastructure of injury and control sites within each injured bicyclist's route. Intersection injury sites (N=210) were compared to randomly selected intersection control sites (N=272). Non-intersection injury sites (N=478) were compared to randomly selected non-intersection control sites (N=801). Results At intersections, the types of routes meeting and the intersection design influenced safety. Intersections of two local streets (no demarcated traffic lanes) had approximately one-fifth the risk (adjusted OR 0.19, 95% CI 0.05 to 0.66) of intersections of two major streets (more than two traffic lanes). Motor vehicle speeds less than 30 km/h also reduced risk (adjusted OR 0.52, 95% CI 0.29 to 0.92). Traffic circles (small roundabouts) on local streets increased the risk of these otherwise safe intersections (adjusted OR 7.98, 95% CI 1.79 to 35.6). At non-intersection locations, very low risks were found for cycle tracks (bike lanes physically separated from motor vehicle traffic; adjusted OR 0.05, 95% CI 0.01 to 0.59) and local streets with diverters that reduce motor vehicle traffic (adjusted OR 0.04, 95% CI 0.003 to 0.60). Downhill grades increased risks at both intersections and non-intersections. Conclusions These results provide guidance for transportation planners and engineers: at local street intersections, traditional stops are safer than traffic circles, and at non-intersections, cycle tracks alongside major streets and traffic diversion from local streets are safer than no bicycle infrastructure. PMID:23411678

  18. Stenosing Tenosynovitis of the Flexor Hallucis Longus Tendon Associated with the Plantar Capsular Accessory Ossicle at the Interphalangeal Joint of the Great Toe

    Directory of Open Access Journals (Sweden)

    Song Ho Chang

    2017-01-01

    Full Text Available This report presents a case of stenosing tenosynovitis of the flexor hallucis longus tendon associated with the plantar capsular accessory ossicle at the interphalangeal joint of the great toe, which was confirmed by intraoperative observation and was successfully treated with surgical resection of the ossicle. As the plantar capsular accessory ossicle was not visible radiographically due to the lack of ossification, ultrasonography was helpful for diagnosing this disorder.

  19. Intersectional perspective in elderly care.

    Science.gov (United States)

    Cuesta, Marta; Rämgård, Margareta

    2016-01-01

    Earlier research has shown that power relationships at workplaces are constructed by power structures. Processes related to power always influence the working conditions for (in this study in elderly care) the working groups involved. Power structures are central for intersectional analysis, in the sense that the intersectional perspective highlights aspects such as gender and ethnicity (subjective dimensions) and interrelates them to processes of power (objective dimension). This qualitative study aims to explore in what way an intersectional perspective could contribute to increased knowledge of power structures in a nursing home where the employees were mostly immigrants from different countries. By using reflexive dialogues related to an intersectional perspective, new knowledge which contributes to the employees' well-being could develop. Narrative analysis was the method used to conduct this study. Through a multi-stage focus group on six occasions over 6 months, the staff were engaged in intersectional and critical reflections about power relationship with the researchers, by identifying patterns in their professional activities that could be connected to their subjectivities (gender, ethnicity, etc.). The result of this study presents three themes that express the staff's experiences and connect these experiences to structural discrimination. 1) Intersectionality, knowledge, and experiences of professionalism; 2) Intersectionality, knowledge, and experiences of collaboration; and 3) Intersectionality, knowledge, and experiences of discrimination. The result demonstrates that an intersectional perspective reinforces the involved abilities, during the conversations, into being clear about, for example, their experiences of discrimination, and consequently developing a better understanding of their professionalism and collaboration. Such deeper reflections became possible through a process of consciousness raising, strengthening the employee's self

  20. Intersectional perspective in elderly care

    Directory of Open Access Journals (Sweden)

    Marta Cuesta

    2016-05-01

    Full Text Available Earlier research has shown that power relationships at workplaces are constructed by power structures. Processes related to power always influence the working conditions for (in this study in elderly care the working groups involved. Power structures are central for intersectional analysis, in the sense that the intersectional perspective highlights aspects such as gender and ethnicity (subjective dimensions and interrelates them to processes of power (objective dimension. This qualitative study aims to explore in what way an intersectional perspective could contribute to increased knowledge of power structures in a nursing home where the employees were mostly immigrants from different countries. By using reflexive dialogues related to an intersectional perspective, new knowledge which contributes to the employees’ well-being could develop. Narrative analysis was the method used to conduct this study. Through a multi-stage focus group on six occasions over 6 months, the staff were engaged in intersectional and critical reflections about power relationship with the researchers, by identifying patterns in their professional activities that could be connected to their subjectivities (gender, ethnicity, etc.. The result of this study presents three themes that express the staff's experiences and connect these experiences to structural discrimination. 1 Intersectionality, knowledge, and experiences of professionalism; 2 Intersectionality, knowledge, and experiences of collaboration; and 3 Intersectionality, knowledge, and experiences of discrimination. The result demonstrates that an intersectional perspective reinforces the involved abilities, during the conversations, into being clear about, for example, their experiences of discrimination, and consequently developing a better understanding of their professionalism and collaboration. Such deeper reflections became possible through a process of consciousness raising, strengthening the employee

  1. Intersectional perspective in elderly care

    Science.gov (United States)

    Cuesta, Marta; Rämgård, Margareta

    2016-01-01

    Earlier research has shown that power relationships at workplaces are constructed by power structures. Processes related to power always influence the working conditions for (in this study in elderly care) the working groups involved. Power structures are central for intersectional analysis, in the sense that the intersectional perspective highlights aspects such as gender and ethnicity (subjective dimensions) and interrelates them to processes of power (objective dimension). This qualitative study aims to explore in what way an intersectional perspective could contribute to increased knowledge of power structures in a nursing home where the employees were mostly immigrants from different countries. By using reflexive dialogues related to an intersectional perspective, new knowledge which contributes to the employees’ well-being could develop. Narrative analysis was the method used to conduct this study. Through a multi-stage focus group on six occasions over 6 months, the staff were engaged in intersectional and critical reflections about power relationship with the researchers, by identifying patterns in their professional activities that could be connected to their subjectivities (gender, ethnicity, etc.). The result of this study presents three themes that express the staff's experiences and connect these experiences to structural discrimination. 1) Intersectionality, knowledge, and experiences of professionalism; 2) Intersectionality, knowledge, and experiences of collaboration; and 3) Intersectionality, knowledge, and experiences of discrimination. The result demonstrates that an intersectional perspective reinforces the involved abilities, during the conversations, into being clear about, for example, their experiences of discrimination, and consequently developing a better understanding of their professionalism and collaboration. Such deeper reflections became possible through a process of consciousness raising, strengthening the employee's self

  2. Spatial database for intersections.

    Science.gov (United States)

    2015-08-01

    Deciding which intersections in the state of Kentucky warrant safety improvements requires a comprehensive inventory : with information on every intersection in the public roadway network. The Kentucky Transportation Cabinet (KYTC) : had previously c...

  3. EJWS retrospective on intersectionality

    NARCIS (Netherlands)

    Davis, K.E.; Zarkov, Dubravka

    2017-01-01

    The EJWS has been at the forefront of debates about intersectionality in Europe. In the past two decades, the journal has published countless articles on intersectionality as theory, methodology, and political framework for doing critical feminist research. We have selected some of these articles

  4. Reverse Distal Transverse Palmar Arch in Distal Digital Replantation.

    Science.gov (United States)

    Wei, Ching-Yueh; Orozco, Oscar; Vinagre, Gustavo; Shafarenko, Mark

    2017-11-01

    Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated. Applying the reverse distal transverse palmar arch technique, 11 cases of distal digital replantation were performed between January 2011 and July 2016. The described procedure was used for arterial anastomosis in 10 cases and arteriovenous shunting for venous drainage in 1 case. A retrospective case review was conducted. The technical description and clinical outcome evaluations are presented. Ten of the 11 replanted digits survived, corresponding to an overall success rate of 91%. One replant failed due to venous insufficiency. Blood transfusions were not required for any of the patients. Follow-up (range, 1.5-5 months) revealed near-normal range of motion and good aesthetic results. All of the replanted digits developed protective sensation. The average length of hospital admission was 5 days. All patients were satisfied with the results and were able to return to their previous work. The use of the reverse distal transverse palmar arch is a novel and reliable technique in distal digital replantation when an increase in vessel length is required, allowing for a tension-free arterial repair without the need for vein grafts.

  5. Intersectionality, Race-Gender Subordination, and Education

    Science.gov (United States)

    Harris, Angela; Leonardo, Zeus

    2018-01-01

    In this chapter, we unpack "intersectionality as an analytical framework." First, we cite Black Lives Matter as an impetus for discussing intersectionality's current traction. Second, we review the genealogy of "intersectionality" beginning with Kimberlé Crenshaw's formulation, which brought a Black Studies provocation into…

  6. Exploring Class-Based Intersectionality

    Science.gov (United States)

    Block, David; Corona, Victor

    2014-01-01

    This paper argues that language, culture and identity researchers need to take the intersectionality of identity inscriptions seriously and, further to this, that an intersectional approach which emanates from an interest in social class provides a productive way to examine the lives and experience of individuals living in multicultural societies.…

  7. 30 CFR 57.7055 - Intersecting holes.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Intersecting holes. 57.7055 Section 57.7055... Jet Piercing Drilling-Surface and Underground § 57.7055 Intersecting holes. Holes shall not be drilled where there is a danger of intersecting a misfired hole or a hole containing explosives, blasting agents...

  8. UpSet: Visualization of Intersecting Sets

    Science.gov (United States)

    Lex, Alexander; Gehlenborg, Nils; Strobelt, Hendrik; Vuillemot, Romain; Pfister, Hanspeter

    2016-01-01

    Understanding relationships between sets is an important analysis task that has received widespread attention in the visualization community. The major challenge in this context is the combinatorial explosion of the number of set intersections if the number of sets exceeds a trivial threshold. In this paper we introduce UpSet, a novel visualization technique for the quantitative analysis of sets, their intersections, and aggregates of intersections. UpSet is focused on creating task-driven aggregates, communicating the size and properties of aggregates and intersections, and a duality between the visualization of the elements in a dataset and their set membership. UpSet visualizes set intersections in a matrix layout and introduces aggregates based on groupings and queries. The matrix layout enables the effective representation of associated data, such as the number of elements in the aggregates and intersections, as well as additional summary statistics derived from subset or element attributes. Sorting according to various measures enables a task-driven analysis of relevant intersections and aggregates. The elements represented in the sets and their associated attributes are visualized in a separate view. Queries based on containment in specific intersections, aggregates or driven by attribute filters are propagated between both views. We also introduce several advanced visual encodings and interaction methods to overcome the problems of varying scales and to address scalability. UpSet is web-based and open source. We demonstrate its general utility in multiple use cases from various domains. PMID:26356912

  9. [Distal clavicle fracture].

    Science.gov (United States)

    Seppel, G; Lenich, A; Imhoff, A B

    2014-06-01

    Reposition and fixation of unstable distal clavicle fractures with a low profile locking plate (Acumed, Hempshire, UK) in conjunction with a button/suture augmentation cerclage (DogBone/FibreTape, Arthrex, Naples, FL, USA). Unstable fractures of the distal clavicle (Jäger and Breitner IIA) in adults. Unstable fractures of the distal clavicle (Jäger and Breitner IV) in children. Distal clavicle fractures (Jäger and Breitner I, IIB or III) with marked dislocation, injury of nerves and vessels, or high functional demand. Patients in poor general condition. Fractures of the distal clavicle (Jäger and Breitner I, IIB or III) without marked dislocation or vertical instability. Local soft-tissue infection. Combination procedure: Initially the lateral part of the clavicle is exposed by a 4 cm skin incision. After reduction of the fracture, stabilization is performed with a low profile locking distal clavicle plate. Using a special guiding device, a transclavicular-transcoracoidal hole is drilled under arthroscopic view. Additional vertical stabilization is arthroscopically achieved by shuttling the DogBone/FibreTape cerclage from the lateral portal cranially through the clavicular plate. The two ends of the FibreTape cerclage are brought cranially via adjacent holes of the locking plate while the DogBone button is placed under the coracoid process. Thus, plate bridging is achieved. Finally reduction is performed and the cerclage is secured by surgical knotting. Use of an arm sling for 6 weeks. Due to the fact that the described technique is a relatively new procedure, long-term results are lacking. In the short term, patients postoperatively report high subjective satisfaction without persistent pain.

  10. 30 CFR 56.7055 - Intersecting holes.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Intersecting holes. 56.7055 Section 56.7055... Piercing Drilling § 56.7055 Intersecting holes. Holes shall not be drilled where there is a danger of intersecting a misfired hole or a hole containing explosives blasting agents, or detonators. [56 FR 46508, Sept...

  11. Spleen-preserving distal pancreatectomy in trauma.

    Science.gov (United States)

    Schellenberg, Morgan; Inaba, Kenji; Cheng, Vincent; Bardes, James M; Lam, Lydia; Benjamin, Elizabeth; Matsushima, Kazuhide; Demetriades, Demetrios

    2018-01-01

    Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. All patients who underwent distal pancreatectomy (January 1, 2007, to December 31, 2014) were identified from the National Trauma Data Bank. Patients with concomitant splenic injury and those who underwent partial splenectomy were excluded. Demographics, clinical data, procedures, and outcomes were collected. Study groups were defined by surgical procedure: distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy. Baseline characteristics between groups were compared with univariate analysis. Multivariate analysis was performed with logistic and linear regression to examine differences in outcomes. Over the 8-year study period, 2,223 patients underwent distal pancreatectomy. After excluding 1,381 patients with concomitant splenic injury (62%) and 8 (pancreatectomy and splenectomy, those who underwent spleen-preserving distal pancreatectomy were younger (p pancreatectomy (p = 0.017). Complications, mortality, and intensive care unit LOS were not significantly different. In young patients after blunt trauma who are not severely injured, a spleen-preserving distal pancreatectomy should be considered to allow for conservation of splenic function and a shorter hospital LOS. In all other patients, the surgeon should not hesitate to remove the spleen with the distal pancreas. Therapy, level IV.

  12. Self-Localization at Street Intersections.

    Science.gov (United States)

    Fusco, Giovanni; Shen, Huiying; Coughlan, James M

    2014-05-01

    There is growing interest among smartphone users in the ability to determine their precise location in their environment for a variety of applications related to wayfinding, travel and shopping. While GPS provides valuable self-localization estimates, its accuracy is limited to approximately 10 meters in most urban locations. This paper focuses on the self-localization needs of blind or visually impaired travelers, who are faced with the challenge of negotiating street intersections. These travelers need more precise self-localization to help them align themselves properly to crosswalks, signal lights and other features such as walk light pushbuttons. We demonstrate a novel computer vision-based localization approach that is tailored to the street intersection domain. Unlike most work on computer vision-based localization techniques, which typically assume the presence of detailed, high-quality 3D models of urban environments, our technique harnesses the availability of simple, ubiquitous satellite imagery (e.g., Google Maps) to create simple maps of each intersection. Not only does this technique scale naturally to the great majority of street intersections in urban areas, but it has the added advantage of incorporating the specific metric information that blind or visually impaired travelers need, namely, the locations of intersection features such as crosswalks. Key to our approach is the integration of IMU (inertial measurement unit) information with geometric information obtained from image panorama stitchings. Finally, we evaluate the localization performance of our algorithm on a dataset of intersection panoramas, demonstrating the feasibility of our approach.

  13. Comparison of standard laparoscopic distal pancreatectomy with minimally invasive distal pancreatectomy using the da Vinci S system.

    Science.gov (United States)

    Ito, Masahiro; Asano, Yukio; Shimizu, Tomohiro; Uyama, Ichiro; Horiguchi, Akihiko

    2014-01-01

    Minimally invasive procedures for pancreatic pathologies are increasingly being used, including distal pancreatectomy. This study aimed to assess the indications for and outcomes of the da Vinci distal pancreatectomy procedure. We reviewed the medical records of patients who underwent pancreatic head resection from April 2009 to September 2013. Four patients (mean age, 52.7 years) underwent da Vinci distal pancreatectomy and 10 (mean age, 68.0 +/- 12.1 years) underwent laparoscopic distal pancreatectomy. The mean surgical duration was 292 +/- 153 min and 306 +/- 29 min, the mean blood loss was 153 +/- 71 mL and 61.7 +/- 72 mL, and the mean postoperative length of stay was 24 +/- 11 days and 14 +/- 3 days in the da Vinci distal pancreatectomy and laparoscopic distal pancreatectomy groups, respectively. One patient who underwent da Vinci distal pancreatectomy developed a pancreatic fistula, while 2 patients in the laparoscopic distal pancreatectomy group developed splenic ischemia and gastric torsion, respectively. Laparoscopic and robotic pancreatic resection were both safe and feasible in selected patients with distal pancreatic pathologies. Further studies are necessary to clarify the role of robotic surgery in the advanced laparoscopic era.

  14. An innovative technique to distalize maxillary molar using microimplant supported rapid molar distalizer

    Directory of Open Access Journals (Sweden)

    Meenu Goel

    2013-01-01

    Full Text Available Introduction: In recent years, enhancements in implants have made their use possible as a mode of absolute anchorage in orthodontic patients. In this paper, the authors have introduced an innovative technique to unilaterally distalize the upper left 1 st molar to obtain an ideal Class I molar relationship from a Class II existing molar relationship with an indigenous designed distalizer. Clinical Innovation: For effective unilateral diatalization of molar, a novel cantilever sliding jig assembly was utilized with coil spring supported by a buccally placed single micro implant. The results showed 3 mm of bodily distalization with 1 mm of intrusion and 2° of distal tipping of upper left 1 st molar in 1.5 months. Discussion: This appliance is relatively easy to insert, well-tolerated, and requires minimal patient cooperation compared to other present techniques of molar distalization. Moreover, it is particularly useful in cases that are Class II on one side and Class I on the other, with a minor midline discrepancy and nominal overjet. Patient acceptance level was reported to be within patients physiological and comfort limits.

  15. Distal renal tubular acidosis

    Science.gov (United States)

    ... this disorder. Alternative Names Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA Images Kidney anatomy Kidney - blood and urine flow References Bose A, Monk RD, Bushinsky DA. Kidney ...

  16. ISR Intersection 1

    CERN Multimedia

    CERN PhotoLab

    1974-01-01

    The experimental apparatus used at intersection 1 by the CERN-Bologna Collaboration (experiment R105). It consists of two almost identical magnetic spectrometers centered at 90 degrees on opposite sides of the intersection region. In each spectrometer one can see magnetostrictive wire spark chambers, a magnet, more chambers and various hodoscopes of scintillation counters. Gas Cerenkov counters (almost invisible in the picture) are located in the gap of each magnet. On the left hand side, a matrix of 119 lead glass Cerenkov counters is located behind some concrete and iron shielding.

  17. Molecular dynamics simulation of dislocation intersections in aluminum

    International Nuclear Information System (INIS)

    Li, M.; Chu, W.Y.; Qian, C.F.; Gao, K.W.; Qiao, L.J.

    2003-01-01

    The molecular dynamics method is used to simulate dislocation intersection in aluminum containing 1.6x10 6 atoms using embedded atom method (EAM) potential. The results show that after intersection between two right-hand screw dislocations of opposite sign there are an extended jog corresponding to a row of 1/3 vacancies in the intersected dislocation, and a trail of vacancies behind the moving dislocation. After intersection between screw dislocations of same sign, there are an extended jog corresponding to a row of 1/3 interstitials in the intersected dislocation, and a trail of interstitials behind the moving dislocation. After intersection between screw and edge dislocations with different Burgers vector, there are a constriction corresponding to one 1/3 vacancy in the edge dislocation, and no point-defects behind the screw dislocation. When a moving screw dislocation intersects an edge dislocation with the same Burgers vector, the point of intersection will split into two constrictions corresponding to one 1/3 vacancy and 1/3 interstitial, respectively. The moving screw dislocation can pass the edge dislocation only after the two constrictions, which can move along the line of intersection of the two slip planes, meet and annihilate

  18. Intersectional embodiment and power

    DEFF Research Database (Denmark)

    Elg, Camilla; Jensen, Sune Qvotrup

    Through almost two decades the term ‘intersectionality' has gained influence in post colonial studies, gender studies, feminist theory and other research fields occupied with how social differences are distributed and how individuals are socially constructed  in stratified societies. The ‘interse......Through almost two decades the term ‘intersectionality' has gained influence in post colonial studies, gender studies, feminist theory and other research fields occupied with how social differences are distributed and how individuals are socially constructed  in stratified societies...... not seem to gain much attention in social stratification research in general. In our paper we will present our work on an embodied approach to intersectionality, which is inspired by Pierre Bourdieu and other thinkers of embodiment. We will argue for the importance of a focus on the embodiment of social...

  19. Cache-Oblivious Red-Blue Line Segment Intersection

    DEFF Research Database (Denmark)

    Arge, Lars; Mølhave, Thomas; Zeh, Norbert

    2008-01-01

    We present an optimal cache-oblivious algorithm for finding all intersections between a set of non-intersecting red segments and a set of non-intersecting blue segments in the plane. Our algorithm uses $O(\\frac{N}{B}\\log_{M/B}\\frac{N}{B}+T/B)$ memory transfers, where N is the total number...... of segments, M and B are the memory and block transfer sizes of any two consecutive levels of any multilevel memory hierarchy, and T is the number of intersections....

  20. Distal protection in cardiovascular medicine: current status.

    Science.gov (United States)

    Ali, Onn Akbar; Bhindi, Ravinay; McMahon, Aisling C; Brieger, David; Kritharides, Leonard; Lowe, Harry C

    2006-08-01

    Iatrogenic and spontaneous downstream microembolization of atheromatous material is increasingly recognized as a source of cardiovascular morbidity and mortality. Devising ways of reducing this distal embolization using a variety of mechanical means--distal protection--is currently under intense and diverse investigation. This review therefore summarizes the present status of distal protection. It examines the problem of distal embolization, describes the available distal protection devices, reviews those areas of cardiovascular medicine where distal protection devices are being investigated, and discusses potential future developments.

  1. Intersectionality - an intercategorical approach

    DEFF Research Database (Denmark)

    Emerek, Ruth

    2017-01-01

    The aim of this article is to demonstrate how to empirically uncover intersectional complexity by simple methods. The article is based on three examples of intercategorical complexity. Firstly, by discussing gender mainstreaming, it is shown that a narrow focus on categories without their interse...... of a study in partial analyses may reveal intersectionality. The examples show how interaction and interwoven categories can be included in intercategorical analyses of structural relationships....

  2. De Qeurvian Tenosynovitis: Clinical Outcomes of Surgical Treatment with Longitudinal and Transverse Incision

    Directory of Open Access Journals (Sweden)

    Arefah Dehghani Tafti

    2011-03-01

    Full Text Available AbstractObjectives: De Quervain disease is a mechanical tenosynovitis due to inadequacy volume between abductor pollicis longus, extensor pollicis brevis and their tunnel. Treatment methods include immobilization, steroid injections, and operation. For the first time Fritz De Quervain described surgical treatment of this disease. Since then, various ways of treatment have been reported. The purpose of this study is to compare the clinical outcomes of a longitudinal incision with a transverse incision in De Quervain disease.Methods: This was a randomized controlled clinical trial conducted in three hospitals in Iran, Yazd from March 2003 to September 2008. One hundred-twenty patients with De Quervain disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed for three months to compare the surgical outcomes.Results: During a three month follow-up, a significant difference was shown between the two methods (p=0.03. Results of surgical treatment with longitudinal incision were excellent (only 5 hypertrophic scars, but there were 13 postoperative complaints with transverse incision.Conclusion: According to our findings, longitudinal incision in surgical treatment of De Quervain disease is better than transverse incision.

  3. DESIGNING AN EFFECTIVE INTERSECTION USING CAD ENVIRONMENT

    Directory of Open Access Journals (Sweden)

    CRISAN George-Horea

    2017-05-01

    Full Text Available Ensuring the safety and streamline in road traffic are very important aims, with regard to the nowadays people mobility level. Road infrastructure is an essential element that can meet these requirements. Thus, it is proposed to develop an effective model of intersection by using CAD software tools. This type of intersection can be successfully used on almost any category of roads, increasing road traffic safety, reducing passing times through the intersection and in the same time, reducing conflict points and increase the intersection capacity.

  4. Statistical modeling of total crash frequency at highway intersections

    Directory of Open Access Journals (Sweden)

    Arash M. Roshandeh

    2016-04-01

    Full Text Available Intersection-related crashes are associated with high proportion of accidents involving drivers, occupants, pedestrians, and cyclists. In general, the purpose of intersection safety analysis is to determine the impact of safety-related variables on pedestrians, cyclists and vehicles, so as to facilitate the design of effective and efficient countermeasure strategies to improve safety at intersections. This study investigates the effects of traffic, environmental, intersection geometric and pavement-related characteristics on total crash frequencies at intersections. A random-parameter Poisson model was used with crash data from 357 signalized intersections in Chicago from 2004 to 2010. The results indicate that out of the identified factors, evening peak period traffic volume, pavement condition, and unlighted intersections have the greatest effects on crash frequencies. Overall, the results seek to suggest that, in order to improve effective highway-related safety countermeasures at intersections, significant attention must be focused on ensuring that pavements are adequately maintained and intersections should be well lighted. It needs to be mentioned that, projects could be implemented at and around the study intersections during the study period (7 years, which could affect the crash frequency over the time. This is an important variable which could be a part of the future studies to investigate the impacts of safety-related works at intersections and their marginal effects on crash frequency at signalized intersections.

  5. Intersectionality and Critical Race Parenting

    Science.gov (United States)

    DePouw, Christin

    2018-01-01

    This conceptual article employs critical race theory (CRT) as a theoretical framework to explore the importance of intersectionality in critical race parenting. In particular, I focus on intersectionality to understand better how Whiteness and racial power play out in intimate relationships within the family, particularly between White parents and…

  6. Authenticity in Leadership: Intersectionality of Identities.

    Science.gov (United States)

    Jones, Susan R

    2016-12-01

    This chapter situates leadership and the process of becoming a leader within an understanding of identity, particularly intersecting social identities and intersectionality. © 2016 Wiley Periodicals, Inc., A Wiley Company.

  7. [New anterolateral approach of distal femur for treatment of distal femoral fractures].

    Science.gov (United States)

    Zhang, Bin; Dai, Min; Zou, Fan; Luo, Song; Li, Binhua; Qiu, Ping; Nie, Tao

    2013-11-01

    To assess the effectiveness of the new anterolateral approach of the distal femur for the treatment of distal femoral fractures. Between July 2007 and December 2009, 58 patients with distal femoral fractures were treated by new anterolateral approach of the distal femur in 28 patients (new approach group) and by conventional approach in 30 patients (conventional approach group). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, disease duration, complication, or preoperative intervention (P > 0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, hospitalization days, and Hospital for Special Surgery (HSS) score of knee were recorded. Operation was successfully completed in all patients of 2 groups, and healing of incision by first intention was obtained; no vascular and nerves injuries occurred. The operation time and intraoperative fluoroscopy frequency of new approach group were significantly less than those of conventional approach group (P 0.05). All patients were followed up 12-36 months (mean, 19.8 months). Bone union was shown on X-ray films; the fracture healing time was (12.62 +/- 2.34) weeks in the new approach group and was (13.78 +/- 1.94) weeks in the conventional approach group, showing no significant difference (t=2.78, P=0.10). The knee HSS score at last follow-up was 94.4 +/- 4.2 in the new approach group, and was 89.2 +/- 6.0 in the conventional approach group, showing significant difference between 2 groups (t=3.85, P=0.00). New anterolateral approach of the distal femur for distal femoral fractures has the advantages of exposure plenitude, minimal tissue trauma, and early function rehabilitation training so as to enhance the function recovery of knee joint.

  8. Scattering Amplitudes from Intersection Theory.

    Science.gov (United States)

    Mizera, Sebastian

    2018-04-06

    We use Picard-Lefschetz theory to prove a new formula for intersection numbers of twisted cocycles associated with a given arrangement of hyperplanes. In a special case when this arrangement produces the moduli space of punctured Riemann spheres, intersection numbers become tree-level scattering amplitudes of quantum field theories in the Cachazo-He-Yuan formulation.

  9. Tracer Flux Balance at an Urban Canyon Intersection

    Science.gov (United States)

    Carpentieri, Matteo; Robins, Alan G.

    2010-05-01

    Despite their importance for pollutant dispersion in urban areas, the special features of dispersion at street intersections are rarely taken into account by operational air quality models. Several previous studies have demonstrated the complex flow patterns that occur at street intersections, even with simple geometry. This study presents results from wind-tunnel experiments on a reduced scale model of a complex but realistic urban intersection, located in central London. Tracer concentration measurements were used to derive three-dimensional maps of the concentration field within the intersection. In combination with a previous study (Carpentieri et al., Boundary-Layer Meteorol 133:277-296, 2009) where the velocity field was measured in the same model, a methodology for the calculation of the mean tracer flux balance at the intersection was developed and applied. The calculation highlighted several limitations of current state-of-the-art canyon dispersion models, arising mainly from the complex geometry of the intersection. Despite its limitations, the proposed methodology could be further developed in order to derive, assess and implement street intersection dispersion models for complex urban areas.

  10. Using Intersectionality in Student Affairs Research

    Science.gov (United States)

    Strayhorn, Terrell L.

    2017-01-01

    This chapter presents intersectionality as a useful heuristic for conducting research in higher education and student affairs contexts. Much more than just another theory, intersectionality can powerfully shape student affairs research in both obvious and tacit ways.

  11. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report

    OpenAIRE

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-01-01

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous in...

  12. SOFTWARE MODULE FOR CONSTRUCTING THE INTERSECTION OF TRIANGULATED SURFACES

    Directory of Open Access Journals (Sweden)

    Vladimir V. Kurgansky

    2018-03-01

    Full Text Available The effective algorithm is proposed for implementing Boolean operations over triangulated surfaces, namely, disjunction, conjunction and Boolean difference, and its software implementation. The idea consists in as follow. The first step is to determine pairs of intersecting triangles: localizing the intersection of the two surfaces using the bounding volume of the parallelepipeds and the future of their intersection. The second step is constructing an intersection line for each pair of triangles: a pair of intersecting triangles is selected, and the segment along which they intersect is constructed. Further, thanks to the entered data structure, "adjacent" triangles are selected, among which are selected those that form the intersecting pair. The process described above continues as long as such triangles can be detected. After that the triangles involved in the intersection are retriangulated. For each triangle, all the edges are known on which it intersects with triangles from another surface. These edges are structural edges in the triangulation problem with constraints for a given triangle. The third step is to combine all surfaces into one surface. Further, subsurfaces are constructed along the loops of intersection limited by the found loops. Since the intersection line of the surfaces was constructed in sequence, it is possible to specify the direction of each edge. Any edge from the intersection line is selected. The triangle is added to the subsurface under construction, which includes this edge and its orientation is the same as the direction of the edge. The edge which was selected previously is deleted from intersection line, but two new edges are added is the remaining edges of added triangle. The third step is to combine all surfaces into one surface. Further, subsurfaces are constructed along the cycles of intersection limited by the found cycles. Since the intersection line of the surfaces was constructed in sequence, it is

  13. Watching Electrons at Conical Intersections and Funnels

    Science.gov (United States)

    Jonas, David M.; Smith, Eric R.; Peters, William K.; Kitney, Katherine A.

    2009-06-01

    The electronic motion at conical intersections and funnels is probed after polarized excitation of aligned electronic wavepackets. The pulses have bandwidth sufficient to observe vibrations mainly through their effect on the electrons. Vibrational symmetry can be identified by the polarization anisotropy of vibrational quantum beats. The polarized transients show signatures of electronic wavepacket motion (due to the energy gaps) and of electron transfer between orbitals (due to the couplings) driven by the conical intersection. For a conical intersection in a four-fold symmetric symmetry silicon naphthalocyanine molecule, electronic motions on a 100 fs timescale are driven by couplings of 1 meV. In the lower symmetry free-base naphthalocyanine, the conical intersection may be missed or missing (conical funnel), and the motions are nearly as rapid, but electronic equilibration is incomplete for red-edge excitation. These experiments probe non-adiabatic electronic dynamics with near-zero nuclear momentum - the electronic motions are determined by the principal slopes of the conical intersection and the width of the vibrational wavepacket.

  14. Framing Gender Intersections in the European Union

    DEFF Research Database (Denmark)

    Lombardo, Emanuela; Agustin, Lise Rolandsen

    2012-01-01

    are increasingly present but they are treated implicitly and from a separate perspective, and the inclusion of a wide range of inequalities often implies a degendering of the policy content. We assess the implications of the identified intersectionality trends for the quality of intersectionality in gender...... equality policies, and we suggest the practice of an “intersectionality impact assessment” as a way to improve the quality of EU policy-making....

  15. The intersectionality framework and identity intersections in the Journal of Counseling Psychology and The Counseling Psychologist: A content analysis.

    Science.gov (United States)

    Shin, Richard Q; Welch, Jamie C; Kaya, Aylin E; Yeung, Jeffrey G; Obana, Chynna; Sharma, Rajni; Vernay, Collin N; Yee, Stephanie

    2017-10-01

    The framework of intersectionality is a powerful analytical tool for making sense of how interlocking systems of privilege and oppression are experienced by individuals and groups. Despite the long history of the concept, intersectionality has only recently gained attention in psychology. We conducted a content analysis to assess counseling psychology's engagement with an intersectional perspective. All articles published in the Journal of Counseling Psychology (n = 4,800) and The Counseling Psychologist (n = 1,915) from their first issues until July 2016 were reviewed to identify conceptual and empirical work focused on intersectionality. A total of 40 articles were identified and examined for themes. Limitations and future directions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Development of an in-vehicle intersection collision countermeasure

    Science.gov (United States)

    Pierowicz, John A.

    1997-02-01

    Intersection collisions constitute approximately twenty-six percent of all accidents in the United States. Because of their complexity, and demands on the perceptual and decision making abilities of the driver, intersections present an increased risk of collisions between automobiles. This situation provides an opportunity to apply advanced sensor and processing capabilities to prevent these collisions. A program to determine the characteristics of intersection collisions and identify potential countermeasures will be described. This program, sponsored by the National Highway Traffic Safety Administration, utilized accident data to develop a taxonomy of intersection crashes. This taxonomy was used to develop a concept for an intersection collision avoidance countermeasure. The concept utilizes in-vehicle position, dynamic status, and millimeter wave radar system and an in-vehicle computer system to provide inputs to an intersection collision avoidance algorithm. Detection of potential violation of traffic control device, or proceeding into the intersection with inadequate gap will lead to the presentation of a warning to the driver. These warnings are presented to the driver primarily via a head-up display and haptic feedback. Roadside to vehicle communication provides information regarding phased traffic signal information. Active control of the vehicle's brake and steering systems are described. Progress in the development of the systems will be presented along with the schedule of future activities.

  17. Anatomical study of the radius and center of curvature of the distal femoral condyle

    KAUST Repository

    Kosel, Jü rgen; Giouroudi, Ioanna; Scheffer, Cornie; Dillon, Edwin Mark; Erasmus, Pieter J.

    2010-01-01

    In this anatomical study, the anteroposterior curvature of the surface of 16 cadaveric distal femurs was examined in terms of radii and center point. Those two parameters attract high interest due to their significance for total knee arthroplasty. Basically, two different conclusions have been drawn in foregoing studies: (1) The curvature shows a constant radius and (2) the curvature shows a variable radius. The investigations were based on a new method combining three-dimensional laser-scanning and planar geometrical analyses. This method is aimed at providing high accuracy and high local resolution. The high-precision laser scanning enables the exact reproduction of the distal femurs - including their cartilage tissue - as a three-dimensional computer model. The surface curvature was investigated on intersection planes that were oriented perpendicularly to the surgical epicondylar line. Three planes were placed at the central part of each condyle. The intersection of either plane with the femur model was approximated with the help of a b-spline, yielding three b-splines on each condyle. The radii and center points of the circles, approximating the local curvature of the b-splines, were then evaluated. The results from all three b-splines were averaged in order to increase the reliability of the method. The results show the variation in the surface curvatures of the investigated samples of condyles. These variations are expressed in the pattern of the center points and the radii of the curvatures. The standard deviations of the radii for a 90 deg arc on the posterior condyle range from 0.6 mm up to 5.1 mm, with an average of 2.4 mm laterally and 2.2 mm medially. No correlation was found between the curvature of the lateral and medial condyles. Within the range of the investigated 16 samples, the conclusion can be drawn that the condyle surface curvature is not constant and different for all specimens when viewed along the surgical epicondylar axis. For the portion

  18. Intersection spaces, spatial homology truncation, and string theory

    CERN Document Server

    Banagl, Markus

    2010-01-01

    Intersection cohomology assigns groups which satisfy a generalized form of Poincaré duality over the rationals to a stratified singular space. The present monograph introduces a method that assigns to certain classes of stratified spaces cell complexes, called intersection spaces, whose ordinary rational homology satisfies generalized Poincaré duality. The cornerstone of the method is a process of spatial homology truncation, whose functoriality properties are analyzed in detail. The material on truncation is autonomous and may be of independent interest to homotopy theorists. The cohomology of intersection spaces is not isomorphic to intersection cohomology and possesses algebraic features such as perversity-internal cup-products and cohomology operations that are not generally available for intersection cohomology. A mirror-symmetric interpretation, as well as applications to string theory concerning massless D-branes arising in type IIB theory during a Calabi-Yau conifold transition, are discussed.

  19. Arthroplasty of the distal ulna distal in managing patients with post-traumatic disorders of the distal radioulnar joint: measurement of quality of life

    Directory of Open Access Journals (Sweden)

    Marcio Aurélio Aita

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To measure the quality of life and clinical-functional results from patients diagnosed with osteoarthrosis of the distal radioulnar joint who underwent surgical treatment using the technique of total arthroplasty of the ulna, with a total or partial Ascension(r prosthesis of the distal ulna. METHODS: Ten patients were evaluated after 12 months of follow-up subsequent to total or partial arthroplasty of the distal ulna. All of them presented post-traumatic osteoarthrosis and/or chronic symptomatic instability of the distal radioulnar joint. The study was prospective. Seven patients had previously undergone wrist procedures (two cases with Darrach, three with Sauvé-Kapandji and two with ligament reconstruction of the fibrocartilage complex and three presented fractures of the distal ulna that evolved with pain, instability and osteoarthrosis of the distal radioulnar joint. The following were assessed: quality of life (DASH scale; percentage degree of palm grip strength (kgf and pronosupination range of motion in relation to the unaffected side; pain (VAS; return to work; subjective evaluation of radiography; and complications. RESULTS: The patients presented a mean range of motion of 174.5° (normal side: 180°. Quality of life was analyzed by applying the DASH questionnaire and the mean value found was 5.9. The mean pain score using the VAS was 2.3. The mean degree of palm grip strength (kgf was 50.7, which represented 90.7% of the strength on the unaffected side. The complication rate was 10%: this patient presented slight dorsal instability of the ulna and persistent pain, and did not return to work. This patient is still being followed up in the outpatient clinic and occupational therapy sector, with little improvement. He does not wish to undergo a new procedure. The mean length of follow-up was 16.8 months, with a minimum of 10 and maximum of 36 months. CONCLUSION: This concept is subject to the test of time

  20. Optimising Signalised Intersection Using Wireless Vehicle Detectors

    DEFF Research Database (Denmark)

    Adjin, Daniel Michael Okwabi; Torkudzor, Moses; Asare, Jack

    Traffic congestion on roads wastes travel times. In this paper, we developed a vehicular traffic model to optimise a signalised intersection in Accra, using wireless vehicle detectors. Traffic volume gathered was extrapolated to cover 2011 and 2016 and were analysed to obtain the peak hour traffic...... volume causing congestion. The intersection was modelled and simulated in Synchro7 as an actuated signalised model using results from the analysed data. The model for morning peak periods gave optimal cycle lengths of 100s and 150s with corresponding intersection delay of 48.9s and 90.6s in 2011 and 2016...... respectively while that for the evening was 55s giving delay of 14.2s and 16.3s respectively. It is shown that the model will improve traffic flow at the intersection....

  1. Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study for short-term outcomes.

    Science.gov (United States)

    Lai, Eric C H; Tang, Chung Ngai

    2015-09-01

    Robotic system has been increasingly used in pancreatectomy. However, the effectiveness of this method remains uncertain. This study compared the surgical outcomes between robot-assisted laparoscopic distal pancreatectomy and conventional laparoscopic distal pancreatectomy. During a 15-year period, 35 patients underwent minimally invasive approach of distal pancreatectomy in our center. Seventeen of these patients had robot-assisted laparoscopic approach, and the remaining 18 had conventional laparoscopic approach. Their operative parameters and perioperative outcomes were analyzed retrospectively in a prospective database. The mean operating time in the robotic group (221.4 min) was significantly longer than that in the laparoscopic group (173.6 min) (P = 0.026). Both robotic and conventional laparoscopic groups presented no significant difference in spleen-preservation rate (52.9% vs. 38.9%) (P = 0.505), operative blood loss (100.3 ml vs. 268.3 ml) (P = 0.29), overall morbidity rate (47.1% vs. 38.9%) (P = 0.73), and post-operative hospital stay (11.4 days vs. 14.2 days) (P = 0.46). Both groups also showed no perioperative mortality. Similar outcomes were observed in robotic distal pancreatectomy and conventional laparoscopic approach. However, robotic approach tended to have the advantages of less blood loss and shorter hospital stay. Further studies are necessary to determine the clinical position of robotic distal pancreatectomy.

  2. Research on traffic flow characteristics at signal intersection

    Science.gov (United States)

    Zeng, Jun-Wei; Yu, Sen-Bin; Qian, Yong-Sheng; Wei, Xu-Ting; Feng, Xiao; Wang, Hui

    2017-09-01

    Based on the cautious driving behavior and the principle of the vehicles at left-side having priority to pass in the intersection, a two-dimensional cellular automata model for planar signalized intersection (NS-STCA) is established. The different turning vehicles are regarded as the research objects and the effect of the left-turn probability, signal cycle, vehicle flow density on traffic flow at the intersection is investigated.

  3. QUING WHY paper: Framing gender intersections in the European Union: what implications for the quality of intersectionality in policies?

    DEFF Research Database (Denmark)

    Agustin, Lise Rolandsen; Lombardo, Emanuela

    are increasingly present but they are treated implicitly and from a separate perspective, and the inclusion of a wide range of inequalities often implies a degendering of the policy content. We assess the implications of the identified intersectionality trends for the quality of intersectionality in gender...... equality policies and we suggest the practice of an ‘intersectionality impact assessment’ as a way to improve the quality of EU policy-making. In this regard, we particularly focus on the interface between the civil society and the EU institutions....

  4. Charting Relations between Intersectionality Theory and the Neurodiversity Paradigm

    Directory of Open Access Journals (Sweden)

    Lauren Rose Strand

    2017-06-01

    Full Text Available This essay explores central elements and applications of intersectionality theory and the neurodiversity paradigm. First, the histories and tenets of intersectionality theory and neurodiversity paradigm are provided. Then, areas are explored where each of the two approaches might further engage with the principles of the other. Finally, the essay concludes by broadly considering the efforts made by the Black Lives Matter movement and the Autistic Self Advocacy Network to bring attention to and end police violence as both networks employ and attend to elements of intersectionality and neurodiversity. The way these two networks draw on both intersectionality and neurodiversity to further their mission could be a possible site for scholars to consider in the interest of advancing dialogues between intersectionality theory and the neurodiversity paradigm. Ultimately, the essay calls for a continued exploration of the potentials for intersectionality and neurodiversity to complement and complicate one another, both in terms of theoretical development and coalition building.

  5. Intersection carbon monoxide modeling

    International Nuclear Information System (INIS)

    Zamurs, J.

    1990-01-01

    In this note the author discusses the need for better air quality mobile source models near roadways and intersections. To develop the improved models, a better understanding of emissions and their relation to ambient concentrations is necessary. The database for the modal model indicates that vehicles do have different emission levels for different engine operating modes. If the modal approach is used information is needed on traffic signal phasing, queue lengths, delay times, acceleration rates, deceleration rates, capacity, etc. Dispersion estimates using current air quality models may be inaccurate because the models do not take into account intersecting traffic streams, multiple buildings of varying setbacks, height, and spacing

  6. Intersection assistance: a safe solution for older drivers?

    Science.gov (United States)

    Dotzauer, Mandy; Caljouw, Simone R; de Waard, Dick; Brouwer, Wiebo H

    2013-10-01

    Within the next few decades, the number of older drivers operating a vehicle will increase rapidly (Eurostat, 2011). As age increases so does physical vulnerability, age-related impairments, and the risk of being involved in a fatal crashes. Older drivers experience problems in driving situations that require divided attention and decision making under time pressure as reflected by their overrepresentation in at-fault crashes on intersections. Advanced Driver Assistance Systems (ADAS) especially designed to support older drivers crossing intersections might counteract these difficulties. In a longer-term driving simulator study, the effects of an intersection assistant on driving were evaluated. 18 older drivers (M=71.44 years) returned repeatedly completing a ride either with or without a support system in a driving simulator. In order to test the intersection assistance, eight intersections were depicted for further analyses. Results show that ADAS affects driving. Equipped with ADAS, drivers allocated more attention to the road center rather than the left and right, crossed intersections in shorter time, engaged in higher speeds, and crossed more often with a critical time-to-collision (TTC) value. The implications of results are discussed in terms of behavioral adaptation and safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Rank 2 fusion rings are complete intersections

    DEFF Research Database (Denmark)

    Andersen, Troels Bak

    We give a non-constructive proof that fusion rings attached to a simple complex Lie algebra of rank 2 are complete intersections.......We give a non-constructive proof that fusion rings attached to a simple complex Lie algebra of rank 2 are complete intersections....

  8. Low-cost safety enhancements for stop-controlled and signalized intersections

    Science.gov (United States)

    2009-05-01

    The purpose of this document is to present information on suggested effective, low-cost intersection countermeasures developed using intersection safety research results and input from an intersection safety expert panel. These low-cost countermeasur...

  9. Safety Evaluation of Destination Lighting at Stop-Controlled Cross Intersections

    Science.gov (United States)

    2018-02-02

    Unlit or inadequately lit intersections reduce the ability of drivers to recognize upcoming intersections during nighttime hours. Drivers also face difficulty in properly negotiating the intersection because lack of adequate lighting increases the li...

  10. Traffic monitoring and modeling for Intersection Safety

    NARCIS (Netherlands)

    Pyykönen, P.; Molinier, M.; Klunder, G.A.

    2010-01-01

    The INTERSAFE-2 project aims to develop and demonstrate a Cooperative Intersection Safety System that is able to significantly reduce injury and fatal accidents at intersections. The cooperative sensor data fusion is based on state-of-the-art and advanced on-board sensors for object recognition and

  11. Transnational Intersectionality in Family Therapy With Resettled Refugees.

    Science.gov (United States)

    Gangamma, Rashmi; Shipman, Daran

    2018-04-01

    In this article, we discuss incorporating the transnational intersectionality framework in family therapy with resettled refugees. Transnational intersectionality is an extension of the framework of intersectionality which helps to better understand complexities of power and oppression across national contexts and their influence on refugees' lives. Adopting this framework alerts family therapists to: (a) develop critical awareness of refugee's transnational contexts; (b) understand differences in experiences of social identities across contexts; (c) acknowledge postmigration factors of oppression affecting resettlement; and (d) critically reflect upon therapist-interpreter-client intersectionalities. This shifts our conceptualization of therapy with refugees to actively consider transnational contexts which refugees uniquely occupy. We describe the framework and provide two case illustrations to highlight its usefulness. © 2017 American Association for Marriage and Family Therapy.

  12. Potassium secretion in mammalian distal colon

    DEFF Research Database (Denmark)

    Sørensen, Mads Vaarby

    2009-01-01

    Epithelial organs adjust the „inner milieu“ of the body and are crucial for all homeostatic processes. Epithelial transport of different solutes and water is regulated phenomena. The regulation processes include both long term hormonal regulation and short term local agonist mediated regulation....... This research project is the summary of 3 original papers addressing the functional role of different regulating factors on ion transport in mouse distal colon. The first paper addresses the effect of luminal nucleotides on electrogenic Na+ absorption. The distal colon, like the distal nephron is an aldosterone......-sensitive tissue and participates in the regulation of Na+ excretion. In the distal nephron it was found that luminal nucleotides inhibit ENaC-mediated Na+ absorption. Here it was addressed whether luminal nucleotides regulate Na+ absorption and if so, which of the known luminal P2 receptors are involved. Using...

  13. Urban Intersection Recognition and Construction Based on Big Trace Data

    Directory of Open Access Journals (Sweden)

    TANG Luliang

    2017-06-01

    Full Text Available Intersection is an important part of the generation and renewal of urban traffic network. In this paper, a new method was proposed to detect urban intersections automatically from the spatiotemporal big trace data. Firstly, the turning point pairs were based on tracking the trace data collected by vehicles. Secondly, different types of turning point pairs were clustered by using spatial growing clustering method based on angle and distance differences, and the clustering methods of local connectivity was used to recognize the intersection. Finally, the intersection structure of multi-level road network was constructed with the range of the intersection and turning point pairs. Taking the taxi trajectory data in Wuhan city as an example, the experimental results showed that the method proposed in this paper can automatically detect and recognize the road intersection and its structure.

  14. Power, privilege and disadvantage: Intersectionality theory and political representation

    Directory of Open Access Journals (Sweden)

    Eline Severs

    2017-06-01

    Full Text Available This article critically reviews the extant literature on social group representation and clarifies the advantages of intersectionality theory for studying political representation. It argues that the merit of intersectionality theory can be found in its ontology of power. Intersectionality theory is founded on a relational conception of political power that locates the constitution of power relations within social interactions, such as political representation. As such, intersectionality theory pushes scholarship beyond studying representation inequalities —that are linked to presumably stable societal positions— to also consider the ways in which political representation (recreates positions of privilege and disadvantage.

  15. Beyond the Cake Model: Critical Intersectionality and the Relative Advantage of Disadvantage

    Directory of Open Access Journals (Sweden)

    Robert Lee Oprisko

    2015-01-01

    Full Text Available Intersectionality came about as a critique of traditional, uniaxial studies of oppression. The initial wave argued that the intersection(s of multiple axes of social construction create uniquely experienced forms of domination and oppression that can only be studied within the context of said intersections. Methodologically, intersectional research has been used primarily as a tool of studying dichotomous intersections of race, gender, and class. However, theoretically focused literature articulates the importance of operating in a more complex understanding of intersectional axes by adding both breadth and depth. Current intersectional studies, therefore, are locked intradeoff between precision and generalizability in any quantitative research and intersect thus far, the power of intersectionality remains unrealized. This paper argues for a large-scale expansion of the number of variables studied in order to gain the most precise understandings of social construction. This creates a tradeoff between precision and generalizability. The power of intersectionality however is not in its generalizability, but rather in its precision for the study of small-n groups. We suggest moving beyond the cake model and into acritical intersectionalitymodel that embraces the agential realism of quantum politics.

  16. Intersectionality and Educational Leadership: A Critical Review

    Science.gov (United States)

    Agosto, Vonzell; Roland, Ericka

    2018-01-01

    In this review of research, we explore intersectionality in the literature on K-12 educational leadership. We seek to understand how researchers have used intersectionality and what their findings or arguments reveal about the work of leading to reduce inequities in education. We ask, What traditions and trends associated with intersectionality…

  17. Driving Simulator study for intelligent cooperative intersection safety system (IRIS)

    NARCIS (Netherlands)

    Vreeswijk, J.; Schendzielorz, T.; Mathias, P.; Feenstra, P.

    2008-01-01

    About forty percent of all accidents occur at intersections. The Intelligent Cooperative Intersection Safety system (IRIS), as part of the European research project SAFESPOT, is a roadside application and aims at minimizing the number of accidents at controlled and uncontrolled intersections. IRIS

  18. Appropriate Pupilness: Social Categories Intersecting in School

    Science.gov (United States)

    Kofoed, Jette

    2008-01-01

    The analytical focus in this article is on how social categories intersect in daily school life and how intersections intertwine with other empirically relevant categories such as normality, pupilness and (in)appropriatedness. The point of empirical departure is a daily ritual where teams for football are selected. The article opens up for a…

  19. Complicating Counterspaces: Intersectionality and the Michigan Womyn's Music Festival.

    Science.gov (United States)

    McConnell, Elizabeth A; Todd, Nathan R; Odahl-Ruan, Charlynn; Shattell, Mona

    2016-06-01

    The counterspaces framework articulated by Case and Hunter (2012), follows from community psychology's long-standing interest in the potential for settings to promote well-being and liberatory responses to oppression. This framework proposes that certain settings (i.e., "counterspaces") facilitate a specific set of processes that promote the well-being of marginalized groups. We argue that an intersectional analysis is crucial to understand whether and how counterspaces achieve these goals. We draw from literature on safe spaces and present a case study of the Michigan Womyn's Music Festival (Michfest) to illustrate the value of an intersectional analysis and explore how these processes operate. Based on 20 in-person interviews, 23 responses to an online survey, and ethnographic field notes, we show how Michfest was characterized by a particular intersection of identities at the setting level, and intersectional diversity complicated experiences at the individual level. Moreover, intersectional identities provided opportunities for dialogue and change at the setting level, including the creation of counterspaces within counterspaces. Overall, we demonstrate the need to attend to intersectionality in counterspaces, and more broadly in how we conceptualize settings in community psychology. © Society for Community Research and Action 2016.

  20. Assessment at Al-Ameer signalized intersection in Samawa city

    Directory of Open Access Journals (Sweden)

    Joni Hasan

    2018-01-01

    Full Text Available The aim of this paper is to evaluate traffic performance of Al-Ameer signalized intersection in Samawa city, which fits with the prevailing conditions and geometric properties of the intersection. The technique of video recording has used for collection the traffic volume data for all approaches. These data are abstracted from video films. SYNCHRO 8 software was used to evaluate and analyze the intersection and choose the best suggestion. The evaluation process result showed that the intersection is operated with level of service (LOS F. By suggestion of several strategies which vary from signal optimization to geometric improvements. The best solution has been found by suggestion an overpass at the east-west direction, and the level of service has improved from (LOS F to (LOS C, this result is considered an acceptable and economical solution for the existing problems at intersection.

  1. Combined open proximal and stent-graft distal repair for distal arch aneurysms: an alternative to total debranching.

    Science.gov (United States)

    Zierer, Andreas; Sanchez, Luis A; Moon, Marc R

    2009-07-01

    We present herein a novel, combined, simultaneous open proximal and stent-graft distal repair for complex distal aortic arch aneurysms involving the descending aorta. In the first surgical step, the transverse arch is opened during selective antegrade cerebral perfusion, and a Dacron graft (DuPont, Wilmington, DE) is positioned down the descending aorta in an elephant trunk-like fashion with its proximal free margin sutured circumferentially to the aorta just distal to the left subclavian or left common carotid artery. With the graft serving as the new proximal landing zone, subsequent endovascular repair is performed antegrade during rewarming through the ascending aorta.

  2. The trend of road traffic crashes at urban signalised intersection

    Science.gov (United States)

    Farhana Nasarrudin, Nurul; Razelan, Intan Suhana Mohd

    2018-04-01

    Road traffic crash is one of the main contributing factors for deaths in the world. Intersection is listed as the second road type which road crashes occurred frequently. Hence, the traffic light was installed to minimise the road crashes at intersection. However, the crashes are still occurring and arising. The objective of this study was to exhibit the trend of road crashes at the signalised intersections. The data of road crashes for the past 6 years were analysed using descriptive analysis. The results showed that the road traffic crashes at three- and four-legged signalised intersection recorded the increasing trend. In conclusion, this finding shows that the road traffic crashes for these types of signalised intersection in Malaysia is rising. It is also one the contributors to the increasing number of crashes in Malaysia. This finding will encourage the local authority to conduct awareness programs on the safety at the signalised intersection.

  3. An efficient quantum scheme for Private Set Intersection

    Science.gov (United States)

    Shi, Run-hua; Mu, Yi; Zhong, Hong; Cui, Jie; Zhang, Shun

    2016-01-01

    Private Set Intersection allows a client to privately compute set intersection with the collaboration of the server, which is one of the most fundamental and key problems within the multiparty collaborative computation of protecting the privacy of the parties. In this paper, we first present a cheat-sensitive quantum scheme for Private Set Intersection. Compared with classical schemes, our scheme has lower communication complexity, which is independent of the size of the server's set. Therefore, it is very suitable for big data services in Cloud or large-scale client-server networks.

  4. Distal clavicular osteolysis: MR evidence for subchondral fracture

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, Ara; Palmer, William E. [Massachusetts General Hospital, Department of Radiology, Division of Musculoskeletal Radiology, Yawkey Center, Boston, MA (United States); Llopis, Eva [Hospital de la Ribera, Department of Radiology, Valencia (Spain)

    2007-01-15

    To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MRI. This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in 36 patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MRI. These cases were then compared with 36 age-matched controls. At MRI, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. Of the 36 patients, 32 (89%) had fluid in the acromioclavicular joint, while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. There were 13 patients (36%) with associated labral tears, while eight patients (22%) had partial-thickness rotator cuff tears. In the control group one of 36 (3%) had a subchondral line (P<0.05), while ten of 36 (28%) had rotator cuff tears and 13 of 36 (36%) had labral tears. These latter two were not statistically significant between the groups. A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint. (orig.)

  5. Distal clavicular osteolysis: MR evidence for subchondral fracture

    International Nuclear Information System (INIS)

    Kassarjian, Ara; Palmer, William E.; Llopis, Eva

    2007-01-01

    To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MRI. This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in 36 patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MRI. These cases were then compared with 36 age-matched controls. At MRI, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. Of the 36 patients, 32 (89%) had fluid in the acromioclavicular joint, while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. There were 13 patients (36%) with associated labral tears, while eight patients (22%) had partial-thickness rotator cuff tears. In the control group one of 36 (3%) had a subchondral line (P<0.05), while ten of 36 (28%) had rotator cuff tears and 13 of 36 (36%) had labral tears. These latter two were not statistically significant between the groups. A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint. (orig.)

  6. Safety analysis of urban signalized intersections under mixed traffic.

    Science.gov (United States)

    S, Anjana; M V L R, Anjaneyulu

    2015-02-01

    This study examined the crash causative factors of signalized intersections under mixed traffic using advanced statistical models. Hierarchical Poisson regression and logistic regression models were developed to predict the crash frequency and severity of signalized intersection approaches. The prediction models helped to develop general safety countermeasures for signalized intersections. The study shows that exclusive left turn lanes and countdown timers are beneficial for improving the safety of signalized intersections. Safety is also influenced by the presence of a surveillance camera, green time, median width, traffic volume, and proportion of two wheelers in the traffic stream. The factors that influence the severity of crashes were also identified in this study. As a practical application, the safe values of deviation of green time provided from design green time, with varying traffic volume, is presented in this study. This is a useful tool for setting the appropriate green time for a signalized intersection approach with variations in the traffic volume. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Linear Determination of a Camera's Intrinsic Parameters Using Two Intersecting Circles

    Directory of Open Access Journals (Sweden)

    Xu Chen

    2014-03-01

    Full Text Available An approach using two intersecting circles is proposed as a linear approach for determining a camera's intrinsic parameters. The two intersecting coplanar circles have four intersection points in the projective plane: two real points and two circular points. In the image plane, the diagonal triangle - on which the image of the four intersection points composes a complete quadrangle - is a self-polar triangle for the projection curves of the circles. The vertex of the self-polar triangle is the null space of the degenerate conic formed by the image of the four intersection points. By solving the three vertices of the self-polar triangle using the image coordinates of the two real intersection points, the degenerate conic can be obtained. The image of the two circular points is then computed from the intersection points of the degenerate conic. Using the image of the circular points from the three images of the same planar pattern with different directions, the intrinsic parameters can be linearly determined.

  8. P-union and P-intersection of neutrosophic cubic sets

    OpenAIRE

    Florentin Smarandache; Chang Su Kim

    2015-01-01

    Conditions for the P-intersection and P-intersection of falsity-external (resp. indeterminacy-external and truth-external) neutrosophic cubic sets to be an falsity-external (resp. indeterminacy-external and truth- external) neutrosophic cubic set are provided. Conditions for the P-union and the P-intersection of two truth-external (resp. indeterminacy-external and falsity-external) neutrosophic cubic sets to be a truth-internal (resp. indeterminacy-internal and falsity-internal) neutrosoph...

  9. Predicting crash-relevant violations at stop sign-controlled intersections for the development of an intersection driver assistance system.

    Science.gov (United States)

    Scanlon, John M; Sherony, Rini; Gabler, Hampton C

    2016-09-01

    Intersection crashes resulted in over 5,000 fatalities in the United States in 2014. Intersection Advanced Driver Assistance Systems (I-ADAS) are active safety systems that seek to help drivers safely traverse intersections. I-ADAS uses onboard sensors to detect oncoming vehicles and, in the event of an imminent crash, can either alert the driver or take autonomous evasive action. The objective of this study was to develop and evaluate a predictive model for detecting whether a stop sign violation was imminent. Passenger vehicle intersection approaches were extracted from a data set of typical driver behavior (100-Car Naturalistic Driving Study) and violations (event data recorders downloaded from real-world crashes) and were assigned weighting factors based on real-world frequency. A k-fold cross-validation procedure was then used to develop and evaluate 3 hypothetical stop sign warning algorithms (i.e., early, intermediate, and delayed) for detecting an impending violation during the intersection approach. Violation detection models were developed using logistic regression models that evaluate likelihood of a violation at various locations along the intersection approach. Two potential indicators of driver intent to stop-that is, required deceleration parameter (RDP) and brake application-were used to develop the predictive models. The earliest violation detection opportunity was then evaluated for each detection algorithm in order to (1) evaluate the violation detection accuracy and (2) compare braking demand versus maximum braking capabilities. A total of 38 violating and 658 nonviolating approaches were used in the analysis. All 3 algorithms were able to detect a violation at some point during the intersection approach. The early detection algorithm, as designed, was able to detect violations earlier than all other algorithms during the intersection approach but gave false alarms for 22.3% of approaches. In contrast, the delayed detection algorithm sacrificed

  10. SPATIAL UNCERTAINTY IN LINE-SURFACE INTERSECTIONS WITH APPLICATIONS TO PHOTOGRAMMETRY

    Directory of Open Access Journals (Sweden)

    J. Marshall

    2012-07-01

    Full Text Available The fields of photogrammetry and computer vision routinely use line-surface intersections to determine the point where a line intersects with a surface. The object coordinates of the intersection point can be found using standard geometric and numeric algorithms, however expressing the spatial uncertainty at the intersection point may be challenging, especially when the surface morphology is complex. This paper describes an empirical method to characterize the unknown spatial uncertainty at the intersection point by propagating random errors in the stochastic model using repeated random sampling methods. These methods accommodate complex surface morphology and nonlinearities in the functional model, however the penalty is the resulting probability density function associated with the intersection point may be non-Gaussian in nature. A formal hypothesis test is presented to show that straightforward statistical inference tools are available whether the data is Gaussian or not. The hypothesis test determines whether the computed intersection point is consistent with an externally-derived known truth point. A numerical example demonstrates the approach in a photogrammetric setting with a single frame image and a gridded terrain elevation model. The results show that uncertainties produced by the proposed empirical method are intuitive and can be assessed with conventional methods found in textbook hypothesis testing.

  11. Political Intersectionality and Democratic Politics in the European Public Sphere

    DEFF Research Database (Denmark)

    Siim, Birte

    2015-01-01

    Public Sphere (EPS). It is inspired by results and reflections from the European Gender Project (EGP) , where intersectionality was used as an approach for analysing negotiations between gender and ethno-national diversity in selected European countries and in relation to the European Public Sphere....... The aim of the essay is to further deepen the theoretical and empirical understanding of intersectionality by reflecting on the relations between political intersectionality and democratic politics from a particular European perspective. It thus confronts theory and research findings concerning...... intersections of gender and ethnic diversity in political life at the national and transnational levels across Europe. In this context, political intersectionality refers to the framing of gender and ethnic diversity by major political actors as well as by activities of women’s and anti-racist organisations...

  12. BLM Colorado PLSS Intersected

    Data.gov (United States)

    Department of the Interior — Shapefile Format –The fully intersected data is the atomic level of the PLSS that is similar to the coverage or the smallest pieces used to build the PLSS. Polygons...

  13. Integrating intersectionality and biomedicine in health disparities research.

    Science.gov (United States)

    Kelly, Ursula A

    2009-01-01

    Persisting health disparities have lead to calls for an increase in health research to address them. Biomedical scientists call for research that stratifies individual indicators associated with health disparities, for example, ethnicity. Feminist social scientists recommend feminist intersectionality research. Intersectionality is the multiplicative effect of inequalities experienced by nondominant marginalized groups, for example, ethnic minorities, women, and the poor. The elimination of health disparities necessitates integration of both paradigms in health research. This study provides a practical application of the integration of biomedical and feminist intersectionality paradigms in nursing research, using a psychiatric intervention study with battered Latino women as an example.

  14. Finite temperature corrections to tachyon mass in intersecting D-branes

    International Nuclear Information System (INIS)

    Sethi, Varun; Chowdhury, Sudipto Paul; Sarkar, Swarnendu

    2017-01-01

    We continue with the analysis of finite temperature corrections to the Tachyon mass in intersecting branes which was initiated in https://www.doi.org/10.1007/JHEP09(2014)063. In this paper we extend the computation to the case of intersecting D3 branes by considering a setup of two intersecting branes in flat-space background. A holographic model dual to BCS superconductor consisting of intersecting D8 branes in D4 brane background was proposed in https://www.doi.org/10.1016/j.nuclphysb.2011.07.011. The background considered here is a simplified configuration of this dual model. We compute the one-loop Tachyon amplitude in the Yang-Mills approximation and show that the result is finite. Analyzing the amplitudes further we numerically compute the transition temperature at which the Tachyon becomes massless. The analytic expressions for the one-loop amplitudes obtained here reduce to those for intersecting D1 branes obtained in https://www.doi.org/10.1007/JHEP09(2014)063 as well as those for intersecting D2 branes.

  15. Finite temperature corrections to tachyon mass in intersecting D-branes

    Energy Technology Data Exchange (ETDEWEB)

    Sethi, Varun [Department of Physics and Astrophysics, University of Delhi,Delhi 110007 (India); Chowdhury, Sudipto Paul [Institute of Physics, Sachivalaya Marg,Bhubaneswar 751005 (India); Sarkar, Swarnendu [Department of Physics and Astrophysics, University of Delhi,Delhi 110007 (India)

    2017-04-19

    We continue with the analysis of finite temperature corrections to the Tachyon mass in intersecting branes which was initiated in https://www.doi.org/10.1007/JHEP09(2014)063. In this paper we extend the computation to the case of intersecting D3 branes by considering a setup of two intersecting branes in flat-space background. A holographic model dual to BCS superconductor consisting of intersecting D8 branes in D4 brane background was proposed in https://www.doi.org/10.1016/j.nuclphysb.2011.07.011. The background considered here is a simplified configuration of this dual model. We compute the one-loop Tachyon amplitude in the Yang-Mills approximation and show that the result is finite. Analyzing the amplitudes further we numerically compute the transition temperature at which the Tachyon becomes massless. The analytic expressions for the one-loop amplitudes obtained here reduce to those for intersecting D1 branes obtained in https://www.doi.org/10.1007/JHEP09(2014)063 as well as those for intersecting D2 branes.

  16. Particle-nuclear intersections

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    With the traditional distinctions between particle and nuclear physics becoming increasing blurred, the Fifth Conference on the Intersections of Particle and Nuclear Physics, held from May 31 to June 6 in St. Petersburg, Florida, brought together particle and nuclear physicists to discuss common research efforts and to define and plan a united approach

  17. Complex Road Intersection Modelling Based on Low-Frequency GPS Track Data

    Science.gov (United States)

    Huang, J.; Deng, M.; Zhang, Y.; Liu, H.

    2017-09-01

    It is widely accepted that digital map becomes an indispensable guide for human daily traveling. Traditional road network maps are produced in the time-consuming and labour-intensive ways, such as digitizing printed maps and extraction from remote sensing images. At present, a large number of GPS trajectory data collected by floating vehicles makes it a reality to extract high-detailed and up-to-date road network information. Road intersections are often accident-prone areas and very critical to route planning and the connectivity of road networks is mainly determined by the topological geometry of road intersections. A few studies paid attention on detecting complex road intersections and mining the attached traffic information (e.g., connectivity, topology and turning restriction) from massive GPS traces. To the authors' knowledge, recent studies mainly used high frequency (1 s sampling rate) trajectory data to detect the crossroads regions or extract rough intersection models. It is still difficult to make use of low frequency (20-100 s) and easily available trajectory data to modelling complex road intersections geometrically and semantically. The paper thus attempts to construct precise models for complex road intersection by using low frequency GPS traces. We propose to firstly extract the complex road intersections by a LCSS-based (Longest Common Subsequence) trajectory clustering method, then delineate the geometry shapes of complex road intersections by a K-segment principle curve algorithm, and finally infer the traffic constraint rules inside the complex intersections.

  18. Unilateral maxillary molar distalization with zygoma-gear appliance.

    Science.gov (United States)

    Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

    2012-08-01

    The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3°. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1°), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 × 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  19. The Priority of Intersectionality in Academic Medicine.

    Science.gov (United States)

    Eckstrand, Kristen L; Eliason, Jennifer; St Cloud, Tiffani; Potter, Jennifer

    2016-07-01

    Recent societal events highlight inequities experienced by underrepresented and marginalized communities. These inequities are the impetus for ongoing efforts in academic medicine to create inclusive educational and patient care environments for diverse stakeholders. Frequently, approaches focus on singular populations or broad macroscopic concepts and do not always elucidate the complexities that arise at the intersection between multiple identities and life experiences. Intersectionality acknowledges multidimensional aspects of identity inclusive of historical, structural, and cultural factors. Understanding how multiple identity experiences impact different individuals, from patients to trainees to providers, is critical for improving health care education and delivery. Building on existing work within academic medicine, this Commentary outlines six key recommendations to advance intersectionality in academic medicine: embrace personal and collective loci of responsibility; examine and rectify unbalanced power dynamics; celebrate visibility and intersectional innovation; engage all stakeholders in the process of change; select and analyze meaningful metrics; and sustain the commitment to achieving health equity over time. Members of the academic medical community committed to advancing health equity can use these recommendations to promote and maintain meaningful changes that recognize and respond to the multidimensional voices and expressed needs of all individuals engaged in providing and receiving health care.

  20. Women's health, men's health, and gender and health: implications of intersectionality.

    Science.gov (United States)

    Hankivsky, Olena

    2012-06-01

    Although intersectionality is now recognized in the context of women's health, men's health, and gender and health, its full implications for research, policy, and practice have not yet been interrogated. This paper investigates, from an intersectionality perspective, the common struggles within each field to confront the complex interplay of factors that shape health inequities. Drawing on developments within intersectionality scholarship and various sources of research and policy evidence (including examples from the field of HIV/AIDS), the paper demonstrates the methodological feasibility of intersectionality and in particular, the wide-ranging benefits of de-centering gender through intersectional analyses. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Intra-Articular Osteotomy for Distal Humerus Malunion

    Directory of Open Access Journals (Sweden)

    René K. Marti

    2009-01-01

    Full Text Available Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.

  2. Intersectionality and the Canadian Museum for Human Rights

    Science.gov (United States)

    Dhamoon, Rita Kaur; Hankivsky, Olena

    2015-01-01

    In this commentary, the authors propose than an intersectionality perspective can transform understandings of the contentious content of the Canadian Museum for Human Rights (CMHR). The use of an intersectionality perspective starts from the position that such discourses as racialization, gendering, capitalism, and ableism are mutually…

  3. Intersection of Three Planes Revisited--An Algebraic Approach

    Science.gov (United States)

    Trenkler, Götz; Trenkler, Dietrich

    2017-01-01

    Given three planes in space, a complete characterization of their intersection is provided. Special attention is paid to the case when the intersection set does not exist of one point only. Besides the vector cross product, the tool of generalized inverse of a matrix is used extensively.

  4. Volar plating for distal radius fractures--do not trust the image intensifier when judging distal subchondral screw length.

    Science.gov (United States)

    Park, Derek H; Goldie, Boyd S

    2012-09-01

    The use of the volar plate to treat distal radius fractures is increasing but despite the theoretical advantages of a volar approach there have been reports of extensor tendon ruptures due to prominent screw tips protruding past the dorsal cortex. The valley in the intermediate column between Lister tubercle and the sigmoid notch of the distal radius makes it difficult to rely on fluoroscopy to judge screw length. Our aim was to quantify the dimensions of this valley and to demonstrate the danger of relying on intraoperative image intensification fluoroscopy to determine lengths of distal screws. We measured the depth of this valley in the intermediate column of the distal radius in 33 patients with computed tomographic (9 patients) or magnetic resonance image (24 patients) scans of the wrist. There was a consistent valley in all images examined [average 1.8 mm (95% confidence interval, 1.6-2.0 mm)]. Thirty-nine percent of wrists had a valley depth of at least 2 mm. Standard lateral views or rotation of the forearm to obtain oblique views does not identify prominent screw tips; and whatever the rotation of the forearm, screw tips protruding beyond dorsal cortex may look as if it is within the bone when in fact it is out. When drilling we suggest noting the depth at which the drill bit just penetrates dorsal cortex and routinely downsize the distal screw length by 2 mm. We caution against relying on flourosocopy when judging the length of the distal subchondral screws.

  5. MULTIAGENT PLANNING OF INTERSECTION PASSAGE BY AUTONOMOUS VEHICLES

    Directory of Open Access Journals (Sweden)

    I. A. Zikratov

    2016-09-01

    Full Text Available We propose a traffic management system for autonomous vehicles that are agents at the intersection. In contrast to the known solutions based on the usage of semiautonomous control systems in assembly with the control unit, this algorithm is based on the principles of decentralized multiagent control. The best travel plan for intersection passage is produced by means of optimization methods jointly by all agents belonging to a dynamic collaboration of autonomous vehicles. The order of road intersection optimal for a given criterion is determined by the agents in the process of information exchange about themselves and environment. Our experiments show that this protocol can reduce significantly the traffic density as compared to the traditional systems of traffic management. Moreover, the effectiveness of the proposed algorithm increases with increasing density of road traffic. In addition, the absence of the critical object, that is the control unit, in the control system, reduces significantly the effectiveness of possible failures and hacker attacks on the intersection control system.

  6. Refined open intersection numbers and the Kontsevich-Penner matrix model

    Energy Technology Data Exchange (ETDEWEB)

    Alexandrov, Alexander [Center for Geometry and Physics, Institute for Basic Science (IBS),Pohang 37673 (Korea, Republic of); Centre de Recherches Mathématiques (CRM), Université de Montréal,Montréal (Canada); Department of Mathematics and Statistics, Concordia University,Montréal (Canada); Institute for Theoretical and Experimental Physics (ITEP),Moscow (Russian Federation); Buryak, Alexandr [Department of Mathematics, ETH Zurich, Zurich (Switzerland); Tessler, Ran J. [Institute for Theoretical Studies, ETH Zurich,Zurich (Switzerland)

    2017-03-23

    A study of the intersection theory on the moduli space of Riemann surfaces with boundary was recently initiated in a work of R. Pandharipande, J.P. Solomon and the third author, where they introduced open intersection numbers in genus 0. Their construction was later generalized to all genera by J.P. Solomon and the third author. In this paper we consider a refinement of the open intersection numbers by distinguishing contributions from surfaces with different numbers of boundary components, and we calculate all these numbers. We then construct a matrix model for the generating series of the refined open intersection numbers and conjecture that it is equivalent to the Kontsevich-Penner matrix model. An evidence for the conjecture is presented. Another refinement of the open intersection numbers, which describes the distribution of the boundary marked points on the boundary components, is also discussed.

  7. Refined open intersection numbers and the Kontsevich-Penner matrix model

    International Nuclear Information System (INIS)

    Alexandrov, Alexander; Buryak, Alexandr; Tessler, Ran J.

    2017-01-01

    A study of the intersection theory on the moduli space of Riemann surfaces with boundary was recently initiated in a work of R. Pandharipande, J.P. Solomon and the third author, where they introduced open intersection numbers in genus 0. Their construction was later generalized to all genera by J.P. Solomon and the third author. In this paper we consider a refinement of the open intersection numbers by distinguishing contributions from surfaces with different numbers of boundary components, and we calculate all these numbers. We then construct a matrix model for the generating series of the refined open intersection numbers and conjecture that it is equivalent to the Kontsevich-Penner matrix model. An evidence for the conjecture is presented. Another refinement of the open intersection numbers, which describes the distribution of the boundary marked points on the boundary components, is also discussed.

  8. Estimating rear-end accident probabilities at signalized intersections: a comparison study of intersections with and without green signal countdown devices.

    Science.gov (United States)

    Ni, Ying; Li, Keping

    2014-01-01

    Rear-end accidents are the most common accident type at signalized intersections, because the diversity of actions taken increases due to signal change. Green signal countdown devices (GSCDs), which have been widely installed in Asia, are thought to have the potential of improving capacity and reducing accidents, but some negative effects on intersection safety have been observed in practice; for example, an increase in rear-end accidents. A microscopic modeling approach was applied to estimate rear-end accident probability during the phase transition interval in the study. The rear-end accident probability is determined by the following probabilities: (1) a leading vehicle makes a "stop" decision, which was formulated by using a binary logistic model, and (2) the following vehicle fails to stop in the available stopping distance, which is closely related to the critical deceleration used by the leading vehicle. Based on the field observation carried out at 2 GSCD intersections and 2 NGSCD intersections (i.e., intersections without GSCD devices) along an arterial in Suzhou, the rear-end probabilities at GSCD and NGSCD intersections were calculated using Monte Carlo simulation. The results suggested that, on the one hand, GSCDs caused significantly negative safety effects during the flashing green interval, especially for vehicles in a zone ranging from 15 to 70 m; on the other hand, GSCD devices were helpful in reducing rear-end accidents during the yellow interval, especially in a zone from 0 to 50 m. GSCDs helped shorten indecision zones and reduce rear-end collisions near the stop line during the yellow interval, but they easily resulted in risky car following behavior and much higher rear-end collision probabilities at indecision zones during both flashing green and yellow intervals. GSCDs are recommended to be cautiously installed and education on safe driving behavior should be available.

  9. Conceptualizing distal drivers in land use competition

    DEFF Research Database (Denmark)

    Niewhöner, Jörg; Nielsen, Jonas Ø; Gasparri, Gasparri

    2016-01-01

    This introductory chapter explores the notion of ‘distal drivers’ in land use competition. Research has moved beyond proximate causes of land cover and land use change to focus on the underlying drivers of these dynamics. We discuss the framework of telecoupling within human–environment systems...... as a first step to come to terms with the increasingly distal nature of driving forces behind land use practices. We then expand the notion of distal as mainly a measure of Euclidian space to include temporal, social, and institutional dimensions. This understanding of distal widens our analytical scope...... for the analysis of land use competition as a distributed process to consider the role of knowledge and power, technology, and different temporalities within a relational or systemic analysis of practices of land use competition. We conclude by pointing toward the historical and social contingency of land use...

  10. Fractures of the distal phalanx in the horse

    International Nuclear Information System (INIS)

    Yovich, J.V.

    1989-01-01

    Fractures of the distal phalanx are an important cause of lameness referable to the foot. Depending on the fracture configuration and articular involvement, conservative or surgical treatment may be required. Fractures of the distal phalanx have been divided into six categories based on fracture configuration. Discussion of clinical features, management, and prognosis for horses with distal phalangeal fractures is presented for each fracture type

  11. Inequalities for dual quermassintegrals of mixed intersection bodies

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Abstract. In this paper, we first introduce a new concept of dual quermassintegral sum function of two star bodies and establish Minkowski's type inequality for dual quermassintegral sum of mixed intersection bodies, which is a general form of the. Minkowski inequality for mixed intersection bodies. Then, we give the ...

  12. Plastic limit loads for cylindrical shell intersections under combined loading

    International Nuclear Information System (INIS)

    Skopinsky, V.N.; Berkov, N.A.; Vogov, R.A.

    2015-01-01

    In this research, applied methods of nonlinear analysis and results of determining the plastic limit loads for shell intersection configurations under combined internal pressure, in-plane moment and out-plane moment loadings are presented. The numerical analysis of shell intersections is performed using the finite element method, geometrically nonlinear shell theory in quadratic approximation and plasticity theory. For determining the load parameter of proportional combined loading, the developed maximum criterion of rate of change of relative plastic work is employed. The graphical results for model of cylindrical shell intersection under different two-parameter combined loadings (as generalized plastic limit load curves) and three-parameter combined loading (as generalized plastic limit load surface) are presented on the assumption that the internal pressure, in-plane moment and out-plane moment loads were applied in a proportional manner. - Highlights: • This paper presents nonlinear two-dimensional FE analysis for shell intersections. • Determining the plastic limit loads under combined loading is considered. • Developed maximum criterion of rate of change of relative plastic work is employed. • Plastic deformation mechanism in shell intersections is discussed. • Results for generalized plastic limit load curves of branch intersection are presented

  13. Outlook from the intersections

    International Nuclear Information System (INIS)

    Haxton, W.C.

    1995-01-01

    I review a number of the physics themes of the Fifth Conference on the Intersections of Particle and Nuclear Physics, discussing the significance and promise of current work at the interface of these fields. copyright 1995 American Institute of Physics

  14. Posttraumatic osteolysis of the distal clavicula end

    International Nuclear Information System (INIS)

    Hermanns, P.H.; Beeger, R.; Koetter, D.; Hamburg Univ.

    1981-01-01

    Posttraumatic osteolysis of bone is rare. Its etiology is unknown. A case of posttraumatic osteolysis of the distal clavicle end is reported. Differentialdiagnostical and ethiological relations are discussed. The literature of posttraumatic osteolysis especially of distal clavicle osteolysis is reported. (orig.) [de

  15. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report.

    Science.gov (United States)

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-12-23

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous injury and subsequently these were confirmed on surgery.Although it is a rare syndrome, early diagnosis and treatment prevents permanent neurological deficits and improve patient's quality of life.

  16. The Intersection of Gender and Age: An Exploration

    Science.gov (United States)

    Gander, Michelle

    2014-01-01

    The understanding of gender inequality for women entering work has not been subject to significant research or theorizing. This small study indicated that young women entering the workplace are subject to direct discrimination and by using an intersectionality approach this paper proposes that the intersection of gender and young age results in…

  17. Buckling behaviour of imperfect ring-stiffened cone-cylinder intersections under internal pressure

    International Nuclear Information System (INIS)

    Zhao, Y.

    2005-01-01

    Cone-cylinder intersections are used commonly in pressure vessels and piping. In the case of a cone large end-to-cylinder intersection under internal pressure, the intersection is subject to a large circumferential compressive force. While both the cone and the cylinder may be locally thickened to strengthen the intersection, it is often desirable and convenient to provide an annular plate ring at the cone-to-cylinder joint to supplement local thickening or as an alternative strengthening measure, leading to a ring-stiffened cone-cylinder intersection. Only limited work has been carried out specifically on ring-stiffened cone-cylinder intersections under internal pressure. This paper presents the first experimental study on such intersections. In addition to the presentation of test results including geometric imperfections, failure behaviour and the determination of buckling mode and load based on displacement measurements, results from nonlinear bifurcation analysis using the perfect shape and nonlinear analysis using the measured imperfect shape are presented and compared with the experimental results

  18. Intersectionality as a Framework for Inclusive Environments

    Science.gov (United States)

    Nunez, A. M.

    2016-12-01

    To create more inclusive environments for the advancement of scientific inquiry, it is critical to consider the role of intersectionality. Originating in activism and legal scholarship grounded in the realities of women of color, the concept of intersectionality emphasizes how societal power dynamics shape the differential construction of life opportunities of diverse demographic groups across a variety of social identities, contexts, and historical conditions. Importantly, intersectionality also recognizes that individuals can simultaneously hold privileged and marginalized identities. For example, while white women scientists are less represented in leadership and decision-making positions than their male counterparts, but they typically do not experience the marginalization of being mistaken for cleaning staff at their institutions, as many African American and Latina scientists report. Thus, white women are relatively privileged in this context. This case and national survey data demonstrate the critical importance of recognizing that the intersection of racial and gender identities creates complex and multi-faceted challenges for diverse women scientists in navigating the organizational culture of science. Educational research indicates that interventions seeking to create more inclusivity in science should take into account the relationships between various social identities, contexts, and broader historical conditions that affect the advancement of historically underrepresented minority groups. Therefore, this presentation will provide a conceptual framework of intersectionality to guide interventions to encourage all scientists to recognize the distinctive intellectual and social contributions of those from diverse gender, race, class, disability, sexual orientation, and other identity backgrounds. It will also address how this framework can be applied to develop programs, policies, and practices that transform organizational cultures to be more inclusive

  19. A STUDY OF SURGICAL MANAGEMENT OF DISTAL FEMORAL FRACTURES BY DISTAL FEMORAL LOCKING COMPRESSION PLATE OSTEOSYNTHESIS

    Directory of Open Access Journals (Sweden)

    Dema Rajaiah

    2016-08-01

    Full Text Available AIMS AND OBJECTIVES To study the fractures of distal end of femur and the mechanism of injury in distal end femur fractures, the advantages and disadvantages of open reduction and internal fixation of distal end femur fractures by distal femoral locking compression plate osteosynthesis and to analyse the outcome in terms of range of Knee motion, time to union, and limb shortening. RESULTS The mean age of patient is 44 years, 85% are males, road traffic accidents account for majority (80%, right side involved in 70%, Muller’s type C fracture is common, good range of movements is seen 90% of cases and union occurred in 95% in 5 months. The results were assessed using Neer’s score, seven (35% patients had excellent results, eight (40% patients had good results, four (20% patients had fair results and one (5% patient had poor result. CONCLUSION From our study, we conclude that DF-LCP is a safe and reliable implant and has shown excellent to satisfactory results in majority of intra-articular fractures (AO type C. Fixation with locking compression plate showed more effectiveness in severely osteoporotic bones, shorter operative stay, faster recovery, faster union rates and excellent functional outcome.

  20. Revisiting Street Intersections Using Slot-Based Systems.

    Directory of Open Access Journals (Sweden)

    Remi Tachet

    Full Text Available Since their appearance at the end of the 19th century, traffic lights have been the primary mode of granting access to road intersections. Today, this centuries-old technology is challenged by advances in intelligent transportation, which are opening the way to new solutions built upon slot-based systems similar to those commonly used in aerial traffic: what we call Slot-based Intersections (SIs. Despite simulation-based evidence of the potential benefits of SIs, a comprehensive, analytical framework to compare their relative performance with traffic lights is still lacking. Here, we develop such a framework. We approach the problem in a novel way, by generalizing classical queuing theory. Having defined safety conditions, we characterize capacity and delay of SIs. In the 2-road crossing configuration, we provide a capacity-optimal SI management system. For arbitrary intersection configurations, near-optimal solutions are developed. Results theoretically show that transitioning from a traffic light system to SI has the potential of doubling capacity and significantly reducing delays. This suggests a reduction of non-linear dynamics induced by intersection bottlenecks, with positive impact on the road network. Such findings can provide transportation engineers and planners with crucial insights as they prepare to manage the transition towards a more intelligent transportation infrastructure in cities.

  1. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

  2. Consensus-based identification of factors related to false-positives in ultrasound scanning of synovitis and tenosynovitis.

    Science.gov (United States)

    Ikeda, Kei; Narita, Akihiro; Ogasawara, Michihiro; Ohno, Shigeru; Kawahito, Yutaka; Kawakami, Atsushi; Ito, Hiromu; Matsushita, Isao; Suzuki, Takeshi; Misaki, Kenta; Ogura, Takehisa; Kamishima, Tamotsu; Seto, Yohei; Nakahara, Ryuichi; Kaneko, Atsushi; Nakamura, Takayuki; Henmi, Mihoko; Fukae, Jun; Nishida, Keiichiro; Sumida, Takayuki; Koike, Takao

    2016-01-01

    We aimed to identify causes of false-positives in ultrasound scanning of synovial/tenosynovial/bursal inflammation and provide corresponding imaging examples. We first performed systematic literature review to identify previously reported causes of false-positives. We next determined causes of false-positives and corresponding example images for educational material through Delphi exercises and discussion by 15 experts who were an instructor and/or a lecturer in the 2013 advanced course for musculoskeletal ultrasound organized by Japan College of Rheumatology Committee for the Standardization of Musculoskeletal Ultrasonography. Systematic literature review identified 11 articles relevant to sonographic false-positives of synovial/tenosynovial inflammation. Based on these studies, 21 candidate causes of false-positives were identified in the consensus meeting. Of these items, 11 achieved a predefined consensus (≥ 80%) in Delphi exercise and were classified as follows: (I) Gray-scale assessment [(A) non-specific synovial findings and (B) normal anatomical structures which can mimic synovial lesions due to either their low echogenicity or anisotropy]; (II) Doppler assessment [(A) Intra-articular normal vessels and (B) reverberation)]. Twenty-four corresponding examples with 49 still and 23 video images also achieved consensus. Our study provides a set of representative images that can help sonographers to understand false-positives in ultrasound scanning of synovitis and tenosynovitis.

  3. Multiphase flow in geometrically simple fracture intersections

    Science.gov (United States)

    Basagaoglu, H.; Meakin, P.; Green, C.T.; Mathew, M.; ,

    2006-01-01

    A two-dimensional lattice Boltzmann (LB) model with fluid-fluid and solid-fluid interaction potentials was used to study gravity-driven flow in geometrically simple fracture intersections. Simulated scenarios included fluid dripping from a fracture aperture, two-phase flow through intersecting fractures and thin-film flow on smooth and undulating solid surfaces. Qualitative comparisons with recently published experimental findings indicate that for these scenarios the LB model captured the underlying physics reasonably well.

  4. MOTORCYCLE CRASH PREDICTION MODEL FOR NON-SIGNALIZED INTERSECTIONS

    Directory of Open Access Journals (Sweden)

    S. HARNEN

    2003-01-01

    Full Text Available This paper attempts to develop a prediction model for motorcycle crashes at non-signalized intersections on urban roads in Malaysia. The Generalized Linear Modeling approach was used to develop the model. The final model revealed that an increase in motorcycle and non-motorcycle flows entering an intersection is associated with an increase in motorcycle crashes. Non-motorcycle flow on major road had the greatest effect on the probability of motorcycle crashes. Approach speed, lane width, number of lanes, shoulder width and land use were also found to be significant in explaining motorcycle crashes. The model should assist traffic engineers to decide the need for appropriate intersection treatment that specifically designed for non-exclusive motorcycle lane facilities.

  5. Contemporary Management of Primary Distal Urethral Cancer

    NARCIS (Netherlands)

    Traboulsi, S.L.; Witjes, J.A.; Kassouf, W.

    2016-01-01

    Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation

  6. Evaluation of j-turn intersection design performance in Missouri.

    Science.gov (United States)

    2013-12-01

    Research shows that a high percentage of crashes that take place on high-speed rural expressways occur at intersections with : minor roads. One low-cost alternative design for improving the safety of at-grade intersections on such expressways is the ...

  7. Distal technologies and type 1 diabetes management.

    Science.gov (United States)

    Duke, Danny C; Barry, Samantha; Wagner, David V; Speight, Jane; Choudhary, Pratik; Harris, Michael A

    2018-02-01

    Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals. In this Review, we summarise the empirical literature to provide current information about the effectiveness of available distal technologies to improve type 1 diabetes management. We also discuss privacy, ethics, and regulatory considerations, issues of global adoption, knowledge gaps in distal technology, and recommendations for future directions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. We Are Still Here: Re-Centring the Quintessential Subject of Intersectionality

    OpenAIRE

    Chantler, Khatidja; Thiara, R

    2017-01-01

    This paper argues that “Black woman” should remain the quintessential subject of intersectionality as we are concerned that racialization has been submerged within intersectionality debates. Drawing on research and policy related to violence against women in minoritized communities in the UK, we (re)interrogate the explanatory power and effects of intersectionality.

  9. At the cross-roads: an on-road examination of driving errors at intersections.

    Science.gov (United States)

    Young, Kristie L; Salmon, Paul M; Lenné, Michael G

    2013-09-01

    A significant proportion of road trauma occurs at intersections. Understanding the nature of driving errors at intersections therefore has the potential to lead to significant injury reductions. To further understand how the complexity of modern intersections shapes behaviour of these errors are compared to errors made mid-block, and the role of wider systems failures in intersection error causation is investigated in an on-road study. Twenty-five participants drove a pre-determined urban route incorporating 25 intersections. Two in-vehicle observers recorded the errors made while a range of other data was collected, including driver verbal protocols, video, driver eye glance behaviour and vehicle data (e.g., speed, braking and lane position). Participants also completed a post-trial cognitive task analysis interview. Participants were found to make 39 specific error types, with speeding violations the most common. Participants made significantly more errors at intersections compared to mid-block, with misjudgement, action and perceptual/observation errors more commonly observed at intersections. Traffic signal configuration was found to play a key role in intersection error causation, with drivers making more errors at partially signalised compared to fully signalised intersections. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Intra-articular osteotomy for distal humerus malunion

    NARCIS (Netherlands)

    Marti, René K.; Doornberg, Job

    2009-01-01

    Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular

  11. Distal Communication by Chimpanzees (Pan troglodytes): Evidence for Common Ground?

    Science.gov (United States)

    Leavens, David A; Reamer, Lisa A; Mareno, Mary Catherine; Russell, Jamie L; Wilson, Daniel; Schapiro, Steven J; Hopkins, William D

    2015-01-01

    van der Goot et al. (2014) proposed that distal, deictic communication indexed the appreciation of the psychological state of a common ground between a signaler and a receiver. In their study, great apes did not signal distally, which they construed as evidence for the human uniqueness of a sense of common ground. This study exposed 166 chimpanzees to food and an experimenter, at an angular displacement, to ask, "Do chimpanzees display distal communication?" Apes were categorized as (a) proximal or (b) distal signalers on each of four trials. The number of chimpanzees who communicated proximally did not statistically differ from the number who signaled distally. Therefore, contrary to the claim by van der Goot et al., apes do communicate distally. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

  12. Switching Exciton Pulses Through Conical Intersections

    Science.gov (United States)

    Leonhardt, K.; Wüster, S.; Rost, J. M.

    2014-11-01

    Exciton pulses transport excitation and entanglement adiabatically through Rydberg aggregates, assemblies of highly excited light atoms, which are set into directed motion by resonant dipole-dipole interaction. Here, we demonstrate the coherent splitting of such pulses as well as the spatial segregation of electronic excitation and atomic motion. Both mechanisms exploit local nonadiabatic effects at a conical intersection, turning them from a decoherence source into an asset. The intersection provides a sensitive knob controlling the propagation direction and coherence properties of exciton pulses. The fundamental ideas discussed here have general implications for excitons on a dynamic network.

  13. Distal displacement of the maxilla and the upper first molar.

    Science.gov (United States)

    Baumrind, S; Molthen, R; West, E E; Miller, D M

    1979-06-01

    Data from a sample of 198 Class II cases treated with various appliances which deliver distally directed forces to the maxilla were examined to determine the frequency of absolute distal displacement of the upper first molar and of the maxilla. Analysis revealed that such distal displacement is possible and that it is, in fact, a frequent finding following treatment. Long-range stability of distal displacement was not assessed.

  14. Distal splenorenal shunt with partial spleen resection

    Directory of Open Access Journals (Sweden)

    Gajin Predrag

    2007-01-01

    Full Text Available Introduction: Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective. The aim of our study was to present the advantages of distal splenorenal shunt (Warren with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method. From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%, while in the second group there were 13 patients with splenomegaly (68%. Before surgery, the mean platelet count in the first group was 51.6±18.3x109/l, to 118.6±25.4x109/l postoperatively. The mean platelet count in the second group was 67.6±22.8x109/l, to 87.8±32.1x109/l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05. Comparing the

  15. Identification of black spots for traffic injury in road intersections dependence of injury definition

    DEFF Research Database (Denmark)

    Lund Hansen, Dennis; Lauritsen, Jens M

    2010-01-01

    injury information has been available for about 20 years and in the current project the aim was to investigate whether different definitions of black spots (hot spots) would point at different intersections for further scrutiny. During the years 2002 to 2007 all 29 719 patient contacts due to traffic...... defined as The upper decile of injury generating intersections. Intersections with at least one death or hospitalised patient. The intersections covering the upper decile of injuries. Results The three definitions in combination identified 295 injury burdened intersections. Only three intersections were...... identified by all three definitions. All intersections fulfilling definition three were also included in definition one. Definition two covered 103 intersections, only 22 of these were identified by definition one. Conclusion The definition of Black spot has huge implications for identification...

  16. Intersectionality and Liberal Education

    Science.gov (United States)

    Butler, Johnella E.

    2017-01-01

    Intersectionality--an integrated approach to analyzing the complex, matrix-like interconnections among patterns of discrimination based on race, gender, and other social identities, with the goal of highlighting how resulting inequalities are experienced--has many implications for exploring the relationship between knowledge and experience and for…

  17. Considering Intersectionality in Multiculturalism

    Science.gov (United States)

    Clark, Madeline

    2015-01-01

    The intersection of feminist theory and multiculturalism is discussed. Although Frisby makes several strong points, there are several aspects of his definition of multiculturalism that are simplistic. Expansion of ideas borrowed from feminism has potential to increase the nuance and accuracy of the conceptualization of multiculturalism.

  18. Exploring the promises of intersectionality for advancing women's health research

    Directory of Open Access Journals (Sweden)

    Clark Natalie

    2010-02-01

    Full Text Available Abstract Women's health research strives to make change. It seeks to produce knowledge that promotes action on the variety of factors that affect women's lives and their health. As part of this general movement, important strides have been made to raise awareness of the health effects of sex and gender. The resultant base of knowledge has been used to inform health research, policy, and practice. Increasingly, however, the need to pay better attention to the inequities among women that are caused by racism, colonialism, ethnocentrism, heterosexism, and able-bodism, is confronting feminist health researchers and activists. Researchers are seeking new conceptual frameworks that can transform the design of research to produce knowledge that captures how systems of discrimination or subordination overlap and "articulate" with one another. An emerging paradigm for women's health research is intersectionality. Intersectionality places an explicit focus on differences among groups and seeks to illuminate various interacting social factors that affect human lives, including social locations, health status, and quality of life. This paper will draw on recently emerging intersectionality research in the Canadian women's health context in order to explore the promises and practical challenges of the processes involved in applying an intersectionality paradigm. We begin with a brief overview of why the need for an intersectionality approach has emerged within the context of women's health research and introduce current thinking about how intersectionality can inform and transform health research more broadly. We then highlight novel Canadian research that is grappling with the challenges in addressing issues of difference and diversity. In the analysis of these examples, we focus on a largely uninvestigated aspect of intersectionality research - the challenges involved in the process of initiating and developing such projects and, in particular, the meaning

  19. Exploring the promises of intersectionality for advancing women's health research.

    Science.gov (United States)

    Hankivsky, Olena; Reid, Colleen; Cormier, Renee; Varcoe, Colleen; Clark, Natalie; Benoit, Cecilia; Brotman, Shari

    2010-02-11

    Women's health research strives to make change. It seeks to produce knowledge that promotes action on the variety of factors that affect women's lives and their health. As part of this general movement, important strides have been made to raise awareness of the health effects of sex and gender. The resultant base of knowledge has been used to inform health research, policy, and practice. Increasingly, however, the need to pay better attention to the inequities among women that are caused by racism, colonialism, ethnocentrism, heterosexism, and able-bodism, is confronting feminist health researchers and activists. Researchers are seeking new conceptual frameworks that can transform the design of research to produce knowledge that captures how systems of discrimination or subordination overlap and "articulate" with one another. An emerging paradigm for women's health research is intersectionality. Intersectionality places an explicit focus on differences among groups and seeks to illuminate various interacting social factors that affect human lives, including social locations, health status, and quality of life. This paper will draw on recently emerging intersectionality research in the Canadian women's health context in order to explore the promises and practical challenges of the processes involved in applying an intersectionality paradigm. We begin with a brief overview of why the need for an intersectionality approach has emerged within the context of women's health research and introduce current thinking about how intersectionality can inform and transform health research more broadly. We then highlight novel Canadian research that is grappling with the challenges in addressing issues of difference and diversity. In the analysis of these examples, we focus on a largely uninvestigated aspect of intersectionality research - the challenges involved in the process of initiating and developing such projects and, in particular, the meaning and significance of social

  20. A finite-element for the analysis of shell intersections

    International Nuclear Information System (INIS)

    Koves, W.J.; Nair, S.

    1994-01-01

    The analysis of discontinuity stresses at shell intersections is a problem of great importance in several major industries. Some of the major areas of interest are pressure-containing equipment, such as reactors and piping, in the nuclear and fossil power industry; pressure vessels and heat exchangers in the petrochemical industry; bracing in offshore oil platforms; and aerospace structures. A specialized shell-intersection finite element, which is compatible with adjoining shell elements, has been developed that has the capability of physically representing the complex three-dimensional geometry and stress state at shell intersections. The element geometry is a contoured shape that matches a wide variety of practical nozzle configurations used in ASME Code pressure vessel construction, and allows computational rigor. A closed-form theory of elasticity solution was used to compute the stress state and strain energy in the element. The concept of an energy-equivalent nodal displacement and force vector set was then developed to allow complete compatibility with adjoining shell elements and retain the analytical rigor within the element. This methodology provides a powerful and robust computation scheme that maintains the computational efficiency of shell element solutions. The shell-intersection element was then applied to the cylinder-sphere and cylinder-cylinder intersection problems

  1. Mitigating gas emissions at signalised intersections using wireless vehicle detectors

    Directory of Open Access Journals (Sweden)

    Moses Kwasi Torkudzor

    2015-09-01

    Full Text Available Traffic congestion on roads wastes travel times and increases fuel consumption as well as gas emissions which are dangerous to human health. This has led to growing concern about environmental protection and energy conservation and a number of studies to increase fuel economy and reduce gas emissions. To increase travel times so as to reduce fuel consumption and gas emissions, traffic signals at intersections must be well implemented. It is therefore necessary to employ the current technology of wireless sensor networks to enhance the optimisation of the signalised intersections so as to address such a concern. In this study, a vehicular traffic control model was developed to optimise a signalised intersection, using wireless vehicle detectors. Real-time traffic volume gathered were analysed to obtain the peak hour traffic volume causing congestion. The intersection was modelled and simulated in Synchro7 as an actuated signalised model using results from the analysed data. The model for morning peak and evening peak periods gave optimal cycle lengths which result in the reduction of gas emissions, fuel consumption and delay at the intersection.

  2. A comparison between robotic-assisted laparoscopic distal pancreatectomy versus laparoscopic distal pancreatectomy.

    Science.gov (United States)

    Goh, Brian K P; Chan, Chung Yip; Soh, Hui-Ling; Lee, Ser Yee; Cheow, Peng-Chung; Chow, Pierce K H; Ooi, London L P J; Chung, Alexander Y F

    2017-03-01

    This study aims to compare the early perioperative outcomes of robotic-assisted laparoscopic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). The clinicopathologic features of 45 consecutive patients who underwent minimally-invasive distal pancreatectomy from 2006 to 2015 were retrospectively reviewed. Thirty-nine patients who met our study criteria were included. Eight patients underwent RDP and 31 had LDP. There were 10 (25.6%) open conversions. Six (15.4%) patients had major (> grade 2) morbidities and there was no in-hospital mortality. There were 14 (35.9%) grade A and 9 (23.1%) grade B pancreatic fistulas. Comparison between RDP and LDP demonstrated no significant difference between the patients' baseline characteristics except there was increased frequency of spleen-preserving pancreatectomies (3 (37.5%) vs 25 (80.6%), P=0.016) and splenic-vessel preservation (5 (62.5%) vs 4 (12.9%), P=0.003) in RDP. Comparison between outcomes demonstrated that RDP was associated with a longer median operation time (452.5 (range, 300-685) vs 245 min (range, 85-430), P=0.001) and increased frequency of the procedure completed purely laparoscopically (8 (100%) vs 18 (58.1%), P=0.025). RDP can be safely adopted and is equivalent to LDP in most perioperative outcomes. It is also associated with a decreased frequency of the need for hand-assistance laparoscopic surgery or open conversion but needed a longer operation time. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. EnviroAtlas - Portland, ME - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  4. EnviroAtlas - Woodbine, IA - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  5. EnviroAtlas - Durham, NC - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  6. EnviroAtlas - Fresno, CA - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  7. EnviroAtlas - Cleveland, OH - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  8. EnviroAtlas - Memphis, TN - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  9. EnviroAtlas - Milwaukee, WI - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  10. EnviroAtlas - Portland, OR - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  11. EnviroAtlas - Tampa, FL - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  12. EnviroAtlas - Austin, TX - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  13. EnviroAtlas - Paterson, NJ - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  14. EnviroAtlas - Phoenix, AZ - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  15. EnviroAtlas - Pittsburgh, PA - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  16. Teaching Intersectional and Transnational Feminisms through Fiction and Film

    Science.gov (United States)

    Mahrouse, Gada

    2016-01-01

    Author Gada Mahrouse begins this article by saying that the terms "intersectional" and "transnational" are widely misunderstood and misused by academics. She writes that the first, "intersectionality," has become a buzzword, not only in feminist courses but also in mainstream disciplines and areas of research. She…

  17. Gender Equality, Intersectionality and Diversity in Europe

    DEFF Research Database (Denmark)

    Agustin, Lise Rolandsen

    . Drawing on discursive policy analysis, it addresses the interaction between policies, institutions and civil society actors in relation to gender equality, diversity and intersectionality at the European level. Rolandsen Agustín successfully integrates the concepts of diversity and gender equality...... into a contextualized approach to analyzing transnational intersectionality. This unique approach focuses on processes of institutionalization and mobilization, which are addressed in relation to the institutional setup of the EU, its policies and policymaking structures, as well as transnational civil society...

  18. Traffic design and signal timing of staggered intersections based on a sorting strategy

    Directory of Open Access Journals (Sweden)

    Zhengyi Cai

    2016-04-01

    Full Text Available A staggered intersection is a special type of intersection in a road network. Its geographical characteristics consist of two T-legged intersections that cause the lost time per cycle to become longer than at cross intersections under conventional signal control, thus leading to low intersection efficiency. This article shows that the problem can be eliminated at the left–right type of staggered intersection by channelization and signal phasing, based on a sorting strategy and pre-signal, which reduce the amount of lost time during the signal cycle using the split distance as the sorting area. VISSIM was used to model and analyze the proposed method as well as the conventional method for comparison purposes. The simulation revealed that the proposed method reduced the average delays and maximum queue lengths in each movement and for the entire intersection, both in the peak hours and in the off-peak hour.

  19. Democratising intersectionality? participatory structures and equality policies in Portugal

    Directory of Open Access Journals (Sweden)

    Alba Alonso Alvarez

    2017-06-01

    Full Text Available Scholarly work on intersectionality has shown some concern on whether this policy strategy is implemented in a participatory manner. The case of Portugal has been of particular interest since the country features a long tradition of involving civil society in the making of equality policies. This article revisits the Portuguese case in order to analyse recent developments. First, the participatory and coordinated approach adopted so far to deal with inequalities is described. Second, the analysis focuses on gender-based violence policies to help capturing new advancements. These policies have been recently enlarged to tackle the situation of women at the intersections and civil society actors have been actively involved in the policy-making process. In particular, the case of policies to combat female genital mutilation illustrates how participatory structures contribute to bring an intersectional perspective. The analysis of the Portuguese case allows thus reflecting on the potential benefits of democratising intersectionality as well as its limits.

  20. A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization.

    Science.gov (United States)

    Ozkalayci, Nurhat; Yetmez, Mehmet

    2016-01-01

    The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth.

  1. Reliability of drivers in urban intersections.

    Science.gov (United States)

    Gstalter, Herbert; Fastenmeier, Wolfgang

    2010-01-01

    The concept of human reliability has been widely used in industrial settings by human factors experts to optimise the person-task fit. Reliability is estimated by the probability that a task will successfully be completed by personnel in a given stage of system operation. Human Reliability Analysis (HRA) is a technique used to calculate human error probabilities as the ratio of errors committed to the number of opportunities for that error. To transfer this notion to the measurement of car driver reliability the following components are necessary: a taxonomy of driving tasks, a definition of correct behaviour in each of these tasks, a list of errors as deviations from the correct actions and an adequate observation method to register errors and opportunities for these errors. Use of the SAFE-task analysis procedure recently made it possible to derive driver errors directly from the normative analysis of behavioural requirements. Driver reliability estimates could be used to compare groups of tasks (e.g. different types of intersections with their respective regulations) as well as groups of drivers' or individual drivers' aptitudes. This approach was tested in a field study with 62 drivers of different age groups. The subjects drove an instrumented car and had to complete an urban test route, the main features of which were 18 intersections representing six different driving tasks. The subjects were accompanied by two trained observers who recorded driver errors using standardized observation sheets. Results indicate that error indices often vary between both the age group of drivers and the type of driving task. The highest error indices occurred in the non-signalised intersection tasks and the roundabout, which exactly equals the corresponding ratings of task complexity from the SAFE analysis. A comparison of age groups clearly shows the disadvantage of older drivers, whose error indices in nearly all tasks are significantly higher than those of the other groups

  2. Ultrafast X-Ray Spectroscopy of Conical Intersections

    Science.gov (United States)

    Neville, Simon P.; Chergui, Majed; Stolow, Albert; Schuurman, Michael S.

    2018-06-01

    Ongoing developments in ultrafast x-ray sources offer powerful new means of probing the complex nonadiabatically coupled structural and electronic dynamics of photoexcited molecules. These non-Born-Oppenheimer effects are governed by general electronic degeneracies termed conical intersections, which play a key role, analogous to that of a transition state, in the electronic-nuclear dynamics of excited molecules. Using high-level ab initio quantum dynamics simulations, we studied time-resolved x-ray absorption (TRXAS) and photoelectron spectroscopy (TRXPS) of the prototypical unsaturated organic chromophore, ethylene, following excitation to its S2(π π*) state. The TRXAS, in particular, is highly sensitive to all aspects of the ensuing dynamics. These x-ray spectroscopies provide a clear signature of the wave packet dynamics near conical intersections, related to charge localization effects driven by the nuclear dynamics. Given the ubiquity of charge localization in excited state dynamics, we believe that ultrafast x-ray spectroscopies offer a unique and powerful route to the direct observation of dynamics around conical intersections.

  3. Laparoscopic versus open distal pancreatectomy for pancreatic cancer.

    Science.gov (United States)

    Riviere, Deniece; Gurusamy, Kurinchi Selvan; Kooby, David A; Vollmer, Charles M; Besselink, Marc G H; Davidson, Brian R; van Laarhoven, Cornelis J H M

    2016-04-04

    Surgical resection is currently the only treatment with the potential for long-term survival and cure of pancreatic cancer. Surgical resection is provided as distal pancreatectomy for cancers of the body and tail of the pancreas. It can be performed by laparoscopic or open surgery. In operations on other organs, laparoscopic surgery has been shown to reduce complications and length of hospital stay as compared with open surgery. However, concerns remain about the safety of laparoscopic distal pancreatectomy compared with open distal pancreatectomy in terms of postoperative complications and oncological clearance. To assess the benefits and harms of laparoscopic distal pancreatectomy versus open distal pancreatectomy for people undergoing distal pancreatectomy for pancreatic ductal adenocarcinoma of the body or tail of the pancreas, or both. We used search strategies to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded and trials registers until June 2015 to identify randomised controlled trials (RCTs) and non-randomised studies. We also searched the reference lists of included trials to identify additional studies. We considered for inclusion in the review RCTs and non-randomised studies comparing laparoscopic versus open distal pancreatectomy in patients with resectable pancreatic cancer, irrespective of language, blinding or publication status.. Two review authors independently identified trials and independently extracted data. We calculated odds ratios (ORs), mean differences (MDs) or hazard ratios (HRs) along with 95% confidence intervals (CIs) using both fixed-effect and random-effects models with RevMan 5 on the basis of intention-to-treat analysis when possible. We found no RCTs on this topic. We included in this review 12 non-randomised studies that compared laparoscopic versus open distal pancreatectomy (1576 participants: 394 underwent laparoscopic distal pancreatectomy and 1182

  4. Conformational analysis by intersection: CONAN.

    Science.gov (United States)

    Smellie, Andrew; Stanton, Robert; Henne, Randy; Teig, Steve

    2003-01-15

    As high throughput techniques in chemical synthesis and screening improve, more demands are placed on computer assisted design and virtual screening. Many of these computational methods require one or more three-dimensional conformations for molecules, creating a demand for a conformational analysis tool that can rapidly and robustly cover the low-energy conformational spaces of small molecules. A new algorithm of intersection is presented here, which quickly generates (on average heuristics are applied after intersection to generate a small representative collection of conformations that span the conformational space. In a study of approximately 97,000 randomly selected molecules from the MDDR, results are presented that explore these conformations and their ability to cover low-energy conformational space. Copyright 2002 Wiley Periodicals, Inc. J Comput Chem 24: 10-20, 2003

  5. The OAFM magnet for ISR intersection I-8

    CERN Multimedia

    CERN PhotoLab

    1979-01-01

    The Open Axial Field Magnet (OAFM), weighing in at 300 tons, was installed in ISR intersection I-8 and brought into operation early in 1979. Fitted with a highly transparent "flat-fish" vacuum chamber, it served experiment R807 (large transverse momentum). Flat-fish vacuum chambers were originally developed for use inside the Split-Field Magnet (SFM) at intersection I-4: see 8310325 and references there.

  6. Intersection signal control multi-objective optimization based on genetic algorithm

    Directory of Open Access Journals (Sweden)

    Zhanhong Zhou

    2014-04-01

    Full Text Available A signal control intersection increases not only vehicle delay, but also vehicle emissions and fuel consumption in that area. Because more and more fuel and air pollution problems arise recently, an intersection signal control optimization method which aims at reducing vehicle emissions, fuel consumption and vehicle delay is required heavily. This paper proposed a signal control multi-object optimization method to reduce vehicle emissions, fuel consumption and vehicle delay simultaneously at an intersection. The optimization method combined the Paramics microscopic traffic simulation software, Comprehensive Modal Emissions Model (CMEM, and genetic algorithm. An intersection in Haizhu District, Guangzhou, was taken for a case study. The result of the case study shows the optimal timing scheme obtained from this method is better than the Webster timing scheme.

  7. Representing the intersection in France and America: theories of intersectionality meet social science

    NARCIS (Netherlands)

    Jaunait, A.; Chauvin, S.

    2012-01-01

    Forged in the United States in the 1980s, the notion of intersectionality sought to provide an umbrella term for the strategic and identity dilemmas faced by categories of persons suffering from combined forms of domination. This article retraces the comparative genealogy of the notion in the United

  8. A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization

    Directory of Open Access Journals (Sweden)

    Nurhat Ozkalayci

    2016-01-01

    Full Text Available The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth.

  9. Turning movements, vehicle offsets and ageing drivers driving behaviour at channelized and unchannelized intersections.

    Science.gov (United States)

    Choi, Jaisung; Tay, Richard; Kim, Sangyoup; Jeong, Seungwon

    2017-11-01

    Ageing drivers experience a higher risk of intersection crashes because of their decrease in driving efficiency, including the decline in cognitive ability, head and neck flexibility, and visual acuity. Although several studies have been conducted to examine the factors associated with ageing driver crashes at intersections, little research has been conducted to examine the differences in the factors related to ageing drivers' turning paths and intersection geometric features. This study aims to improve the safety of ageing drivers at intersections by identifying the maneuvers that are risky for them and tracking their turning movements at selected intersections. We find that ageing drivers experience more crashes at intersections than younger drivers, especially crashes involving turning movements. Furthermore, ageing drivers experience more crashes at unchannelized intersections compared to channelized intersections. In addition, this study finds that ageing drivers exhibit greater and more inconsistent offsets during turning movements compared to those of younger drivers at both channelized and unchannelized intersections. Ageing drivers also tend to make relatively sharper or tighter turns than younger drivers. Hence, transportation engineers and road safety professionals should consider appropriate countermeasures to reduce the risks of crashes involving ageing drivers at intersections. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. A FUNCTIONAL EVALUATION STUDY OF DISTAL FEMORAL FRACTURES FIXED WITH DISTAL FEMORAL LOCKING PLATE

    Directory of Open Access Journals (Sweden)

    Manikumar C. J

    2017-04-01

    Full Text Available BACKGROUND Fractures of the distal femur present considerable challenges in management. Older patients especially women sustain fractures due to osteoporosis. Supracondylar fractures of femur have a bimodal distribution. They account for 6% of all femur fractures and 31% if hip fractures were excluded. Nearly, 50% of distal femur intra-articular fractures are open fractures. Before 1970, most supracondylar fractures were treated nonoperatively; however, difficulties were often encountered including persistent angulatory deformity, knee joint incongruity, loss of knee motion and delayed mobilisation. The trend of open reduction and internal fixation has become evident in recent years with good results being obtained with AO blade plate, dynamic condylar screw, intramedullary supracondylar nail and locking compression plate. Elderly patients and osteoporosis pose difficulty in treating intra-articular fractures of the lower end of femur. Loss of stable fixation is of great concern in these cases. Hence, locking compression plate use has an advantage in these patients. MATERIALS AND METHODS In this study, 20 patients with closed fracture of distal femur were studied. All the cases were treated at the Department of Orthopaedics, Rangaraya Medical College/Government General Hospital, Kakinada, Andhra Pradesh, between November 2013 and November 2015. The method used for fracture fixation was open reduction and internal fixation with distal femoral locking plate. The duration of follow up ranged from 3 months to 24 months. All the fractures in this series were posttraumatic. The patients were functionally evaluated with Neer’s scoring system. 1 RESULTS Twenty distal femoral fractures were treated with distal femoral locking plates. 15 patients were males and 5 patients were females. The median age was 47 years ranging from 28-70 years. 16 of the fractures were caused by road traffic accidents and 2 were due to fall, 2 were due to assault. 12 patients

  11. Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Riviere, Deniece; van Laarhoven, C J H; Besselink, Marc; Abu-Hilal, Mohammed; Davidson, Brian R; Morris, Steve

    2017-01-01

    A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic distal pancreatectomy versus open distal pancreatectomy for pancreatic cancer. Model based cost-utility analysis estimating mean costs and quality-adjusted life years (QALYs) per patient from the perspective of the UK National Health Service. A decision tree model was constructed using probabilities, outcomes and cost data from published sources. A time horizon of 5 years was used. One-way and probabilistic sensitivity analyses were undertaken. The probabilistic sensitivity analysis showed that the incremental net monetary benefit was positive (£3,708.58 (95% confidence intervals (CI) -£9,473.62 to £16,115.69) but the 95% CI includes zero, indicating that there is significant uncertainty about the cost-effectiveness of laparoscopic distal pancreatectomy versus open distal pancreatectomy. The probability laparoscopic distal pancreatectomy was cost-effective compared to open distal pancreatectomy for pancreatic cancer was between 70% and 80% at the willingness-to-pay thresholds generally used in England (£20,000 to £30,000 per QALY gained). Results were sensitive to the survival proportions and the operating time. There is considerable uncertainty about whether laparoscopic distal pancreatectomy is cost-effective compared to open distal pancreatectomy for pancreatic cancer in the NHS setting.

  12. Evaluation of Red Light Camera Enforcement at Signalized Intersections

    Directory of Open Access Journals (Sweden)

    Abdulrahman AlJanahi

    2007-12-01

    Full Text Available The study attempts to find the effectiveness of adopting red light cameras in reducing red light violators. An experimental approach was adopted to investigate the use of red light cameras at signalized intersections in the Kingdom of Bahrain. The study locations were divided into three groups. The first group was related to the approaches monitored with red light cameras. The second group was related to approaches without red light cameras, but located within an intersection that had one of its approaches monitored with red light cameras. The third group was related to intersection approaches located at intersection without red light cameras (controlled sites. A methodology was developed for data collection. The data were then tested statistically by Z-test using proportion methods to compare the proportion of red light violations occurring at different sites. The study found that the proportion of red light violators at approaches monitored with red light cameras was significantly less than those at the controlled sites for most of the time. Approaches without red light cameras located within intersections having red light cameras showed, in general, fewer violations than controlled sites, but the results were not significant for all times of the day. The study reveals that red light cameras have a positive effect on reducing red light violations. However, these conclusions need further evaluations to justify their safe and economic use.

  13. Novel Intersection Type Recognition for Autonomous Vehicles Using a Multi-Layer Laser Scanner.

    Science.gov (United States)

    An, Jhonghyun; Choi, Baehoon; Sim, Kwee-Bo; Kim, Euntai

    2016-07-20

    There are several types of intersections such as merge-roads, diverge-roads, plus-shape intersections and two types of T-shape junctions in urban roads. When an autonomous vehicle encounters new intersections, it is crucial to recognize the types of intersections for safe navigation. In this paper, a novel intersection type recognition method is proposed for an autonomous vehicle using a multi-layer laser scanner. The proposed method consists of two steps: (1) static local coordinate occupancy grid map (SLOGM) building and (2) intersection classification. In the first step, the SLOGM is built relative to the local coordinate using the dynamic binary Bayes filter. In the second step, the SLOGM is used as an attribute for the classification. The proposed method is applied to a real-world environment and its validity is demonstrated through experimentation.

  14. Estimation of air quality improvement at road and street intersections

    Energy Technology Data Exchange (ETDEWEB)

    Hoeglund, P.G. [Royal Inst. of Technology, Stockholm (Sweden). Traffic and Transport Planning

    1995-12-31

    There has always been a very great problem to quantify the detrimental exhaust air pollution related to the traffic flow, especially at road and street intersections. Until now model calculations have been developed mainly for the links between the intersections. In an attempt to remedy this situation the author has developed a method of estimating emissions on the micro level from motor vehicles at intersections as a help for infrastructural design related to improved environmental conditions. Very parsimonious knowledge exists regarding the deceleration and acceleration patterns at road- and street intersections. Not many surveys are done neither in Sweden nor within other countries. Evidently, the need for knowledge regarding deceleration and acceleration behaviour on the micro level has until now not been given priority. In traffic safety related research studies have been done describing the drivers` deceleration and acceleration behaviour and the vehicles` braking performance. Those results give deceleration data for extreme situations and are not useful for describing normal decelerations and accelerations at road- and street intersections. Environment related problems within the traffic flow analysis are now accentuating the need for the studying of special deceleration and acceleration behaviours in combination with an alternative design of the road and street infrastructure. There is a big difference in different vehicles` amount of emitted exhaust pollutions during the passing of intersections depending on the vehicles` speed levels related to their deceleration and acceleration levels. (author)

  15. Estimation of air quality improvement at road and street intersections

    Energy Technology Data Exchange (ETDEWEB)

    Hoeglund, P G [Royal Inst. of Technology, Stockholm (Sweden). Traffic and Transport Planning

    1996-12-31

    There has always been a very great problem to quantify the detrimental exhaust air pollution related to the traffic flow, especially at road and street intersections. Until now model calculations have been developed mainly for the links between the intersections. In an attempt to remedy this situation the author has developed a method of estimating emissions on the micro level from motor vehicles at intersections as a help for infrastructural design related to improved environmental conditions. Very parsimonious knowledge exists regarding the deceleration and acceleration patterns at road- and street intersections. Not many surveys are done neither in Sweden nor within other countries. Evidently, the need for knowledge regarding deceleration and acceleration behaviour on the micro level has until now not been given priority. In traffic safety related research studies have been done describing the drivers` deceleration and acceleration behaviour and the vehicles` braking performance. Those results give deceleration data for extreme situations and are not useful for describing normal decelerations and accelerations at road- and street intersections. Environment related problems within the traffic flow analysis are now accentuating the need for the studying of special deceleration and acceleration behaviours in combination with an alternative design of the road and street infrastructure. There is a big difference in different vehicles` amount of emitted exhaust pollutions during the passing of intersections depending on the vehicles` speed levels related to their deceleration and acceleration levels. (author)

  16. Intersectionality and Transnational Feminism between Constructivism, Post-Structuralism and Epistemological Performances

    Directory of Open Access Journals (Sweden)

    Cristina Demaria

    2016-07-01

    Full Text Available What does it mean today to talk about intersectionality or, better, about intersectional approaches within the vast and fragmented field of Feminist Studies? And how can intersectionality help understanding the development of transnational feminism, and viceversa? By offering a brief critical genealogy of the notion of intersectionality, from the systemic to the anti-categorial positions that have characterized the debate on this notion, the essay tries to present a reading of the main questions that stemmed from thinking the working of the many power differentials and identity markers (gender, race, class, ages, disabilities, etc. that constitute regional, national and transnational subjectivities. In adopting an anti-categorial stance, this work attempts at showing how feminism has changed thanks to different, yet complementary, perspectives on intersectional subject formations and positioning, along with the relational and transnational struggles that have been imagined in order to refine a feminist gaze at every level of social, cultural and political life, be it theoretical, methodological or epistemological.

  17. Traumatic Distal Ulnar Artery Thrombosis

    Directory of Open Access Journals (Sweden)

    Ahmet A. Karaarslan

    2014-01-01

    Full Text Available This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.

  18. Distinct subclassification of DRG neurons innervating the distal colon and glans penis/distal urethra based on the electrophysiological current signature.

    Science.gov (United States)

    Rau, Kristofer K; Petruska, Jeffrey C; Cooper, Brian Y; Johnson, Richard D

    2014-09-15

    Spinal sensory neurons innervating visceral and mucocutaneous tissues have unique microanatomic distribution, peripheral modality, and physiological, pharmacological, and biophysical characteristics compared with those neurons that innervate muscle and cutaneous tissues. In previous patch-clamp electrophysiological studies, we have demonstrated that small- and medium-diameter dorsal root ganglion (DRG) neurons can be subclassified on the basis of their patterns of voltage-activated currents (VAC). These VAC-based subclasses were highly consistent in their action potential characteristics, responses to algesic compounds, immunocytochemical expression patterns, and responses to thermal stimuli. For this study, we examined the VAC of neurons retrogradely traced from the distal colon and the glans penis/distal urethra in the adult male rat. The afferent population from the distal colon contained at least two previously characterized cell types observed in somatic tissues (types 5 and 8), as well as four novel cell types (types 15, 16, 17, and 18). In the glans penis/distal urethra, two previously described cell types (types 6 and 8) and three novel cell types (types 7, 14, and 15) were identified. Other characteristics, including action potential profiles, responses to algesic compounds (acetylcholine, capsaicin, ATP, and pH 5.0 solution), and neurochemistry (expression of substance P, CGRP, neurofilament, TRPV1, TRPV2, and isolectin B4 binding) were consistent for each VAC-defined subgroup. With identification of distinct DRG cell types that innervate the distal colon and glans penis/distal urethra, future in vitro studies related to the gastrointestinal and urogenital sensory function in normal as well as abnormal/pathological conditions may be benefitted. Copyright © 2014 the American Physiological Society.

  19. Considering Gender and Student Leadership Through the Lens of Intersectionality.

    Science.gov (United States)

    Tillapaugh, Daniel; Mitchell, Donald; Soria, Krista M

    2017-06-01

    This chapter explores the concept of intersectionality and its applicability to student leadership development as well as recommendations on how intersectionality can provide transformative learning for students of all gender identities. © 2017 Wiley Periodicals, Inc., A Wiley Company.

  20. Nonunions of the distal tibia treated by reamed intramedullary nailing

    NARCIS (Netherlands)

    Richmond, Jeffrey; Colleran, Kevin; Borens, Olivier; Kloen, Peter; Helfet, David L.

    2004-01-01

    The purpose of this study is to determine the efficacy of reamed intramedullary nailing in the treatment of nonunions of the distal one-fourth of the tibia. Nonunions of the distal tibia are particularly difficult to treat given the short distal segment, the proximity to the ankle joint, and the

  1. Novel Intersection Type Recognition for Autonomous Vehicles Using a Multi-Layer Laser Scanner

    Directory of Open Access Journals (Sweden)

    Jhonghyun An

    2016-07-01

    Full Text Available There are several types of intersections such as merge-roads, diverge-roads, plus-shape intersections and two types of T-shape junctions in urban roads. When an autonomous vehicle encounters new intersections, it is crucial to recognize the types of intersections for safe navigation. In this paper, a novel intersection type recognition method is proposed for an autonomous vehicle using a multi-layer laser scanner. The proposed method consists of two steps: (1 static local coordinate occupancy grid map (SLOGM building and (2 intersection classification. In the first step, the SLOGM is built relative to the local coordinate using the dynamic binary Bayes filter. In the second step, the SLOGM is used as an attribute for the classification. The proposed method is applied to a real-world environment and its validity is demonstrated through experimentation.

  2. Intersections and Unions of Session Types

    Directory of Open Access Journals (Sweden)

    Coşku Acay

    2017-02-01

    Full Text Available Prior work has extended the deep, logical connection between the linear sequent calculus and session-typed message-passing concurrent computation with equi-recursive types and a natural notion of subtyping. In this paper, we extend this further by intersection and union types in order to express multiple behavioral properties of processes in a single type. We prove session fidelity and absence of deadlock and illustrate the expressive power of our system with some simple examples. We observe that we can represent internal and external choice by intersection and union, respectively, which was previously suggested by Padovani for a different language of session types motivated by operational rather than logical concerns.

  3. Real-life data for the optimization of the geometric layout of an intersection

    NARCIS (Netherlands)

    Fleuren, S.T.G.; Lefeber, A.A.J.

    2016-01-01

    This document contains the data of ten real-life intersections. This data can be used for the optimization of the geometric layout of the intersection, e.g., optimizing the arrival lanes, departure lanes and lane markings at the intersection.

  4. Using intersectionality responsibly: Toward critical epistemology, structural analysis, and social justice activism.

    Science.gov (United States)

    Moradi, Bonnie; Grzanka, Patrick R

    2017-10-01

    The increasing popularity of the concept of intersectionality in the social sciences, including in psychology, represents an opportunity to reflect on the state of stewardship of this concept, its roots, and its promise. In this context, the authors aim to promote responsible stewardship of intersectionality and to tip the momentum of intersectionality's flourishing toward fuller use and engagement of its roots and promise for understanding and challenging dynamics of power, privilege, and oppression. To this end, this article provides a set of guidelines for reflection and action. The authors organize these guidelines along 3 major formulations of intersectionality: intersectionality as a field of study, as analytic strategy or disposition, and as critical praxis for social justice. Ultimately, the authors call for expanding the use of intersectionality toward fuller engagement with its roots in Black feminist thought, its current interdisciplinary richness and potential, and its central aims to challenge and transform structures and systems of power, privilege, and oppression. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Some Results on the Intersection Graphs of Ideals of Rings

    International Nuclear Information System (INIS)

    Akbari, S.; Nikandish, R.; Nikmehr, M.J.

    2010-08-01

    Let R be a ring with unity and I(R)* be the set of all non-trivial left ideals of R. The intersection graph of ideals of R, denoted by G(R), is a graph with the vertex set I(R)* and two distinct vertices I and J are adjacent if and only if I intersection J ≠ 0. In this paper, we study some connections between the graph-theoretic properties of this graph and some algebraic properties of rings. We characterize all rings whose intersection graphs of ideals are not connected. Also we determine all rings whose clique number of the intersection graphs of ideals are finite. Among other results, it is shown that for every ring, if the clique number of G(R) is finite, then the chromatic number is finite too and if R is a reduced ring both are equal. (author)

  6. An Intersectional Perspective on Access to HIV-Related Healthcare for Transgender Women

    Science.gov (United States)

    Lacombe-Duncan, Ashley

    2016-01-01

    Abstract Transgender women experience decreased access to HIV-related healthcare relative to cisgender people, in part due to pervasive transphobia in healthcare. This perspective describes intersectionality as a salient theoretical approach to understanding this disparity, moving beyond transphobia to explore how intersecting systems of oppression, including cisnormativity, sexism/transmisogyny, classism, racism, and HIV-related, gender nonconformity, substance use, and sex work stigma influence HIV-related healthcare access for transgender women living with HIV. This perspective concludes with a discussion of how intersectionality-informed studies can be enhanced through studying underexplored intersections and bringing attention to women's resiliency and empowerment. PMID:29159304

  7. Teleparallel loop quantum cosmology in a system of intersecting branes

    Directory of Open Access Journals (Sweden)

    Alireza Sepehri

    2016-09-01

    Full Text Available Recently, some authors have removed the big bang singularity in teleparallel Loop Quantum Cosmology (LQC and have shown that the universe may undergo a number of oscillations. We investigate the origin of this type of teleparallel theory in a system of intersecting branes in M-theory in which the angle between them changes with time. This system is constructed by two intersecting anti-D8-branes, one compacted D4-brane and a D3-brane. These branes are built by joining M0-branes which develop in decaying fundamental strings. The compacted D4-brane is located between two intersecting anti-D8 branes and glues to one of them. Our universe is located on the D3 brane which wraps around the D4 brane from one end and sticks to one of the anti-D8 branes from the other one. In this system, there are three types of fields, corresponding to compacted D4 branes, intersecting branes and D3-branes. These fields interact with each other and make the angle between branes oscillate. By decreasing this angle, the intersecting anti-D8 branes approach each other, the D4 brane rolls, the D3 brane wraps around the D4 brane, and the universe contracts. By separating the intersecting branes and increasing the angle, the D4 brane rolls in the opposite direction, the D3 brane separates from it and the expansion branch begins. Also, the interaction between branes in this system gives us the exact form of the relevant Lagrangian for teleparallel LQC.

  8. Teleparallel loop quantum cosmology in a system of intersecting branes

    Energy Technology Data Exchange (ETDEWEB)

    Sepehri, Alireza, E-mail: alireza.sepehri@uk.ac.ir [Faculty of Physics, Shahid Bahonar University, P.O. Box 76175, Kerman (Iran, Islamic Republic of); Research Institute for Astronomy and Astrophysics of Maragha (RIAAM), P.O. Box 55134-441, Maragha (Iran, Islamic Republic of); Pradhan, Anirudh, E-mail: pradhan.anirudh@gmail.com [Department of Mathematics, Institute of Applied Sciences and Humanities, GLA University, Mathura-281 406, Uttar Pradesh (India); Beesham, Aroonkumar, E-mail: beeshama@unizulu.ac.za [Department of Mathematical Sciences, University of Zululand, Kwa-Dlangezwa 3886 (South Africa); Haro, Jaume de, E-mail: jaime.haro@upc.edu [Departament de Matemàtiques, Universitat Politècnica de Catalunya, Diagonal 647, 08028 Barcelona (Spain)

    2016-09-10

    Recently, some authors have removed the big bang singularity in teleparallel Loop Quantum Cosmology (LQC) and have shown that the universe may undergo a number of oscillations. We investigate the origin of this type of teleparallel theory in a system of intersecting branes in M-theory in which the angle between them changes with time. This system is constructed by two intersecting anti-D8-branes, one compacted D4-brane and a D3-brane. These branes are built by joining M0-branes which develop in decaying fundamental strings. The compacted D4-brane is located between two intersecting anti-D8 branes and glues to one of them. Our universe is located on the D3 brane which wraps around the D4 brane from one end and sticks to one of the anti-D8 branes from the other one. In this system, there are three types of fields, corresponding to compacted D4 branes, intersecting branes and D3-branes. These fields interact with each other and make the angle between branes oscillate. By decreasing this angle, the intersecting anti-D8 branes approach each other, the D4 brane rolls, the D3 brane wraps around the D4 brane, and the universe contracts. By separating the intersecting branes and increasing the angle, the D4 brane rolls in the opposite direction, the D3 brane separates from it and the expansion branch begins. Also, the interaction between branes in this system gives us the exact form of the relevant Lagrangian for teleparallel LQC.

  9. Ranking the types of intersections for assessing the safety of pedestrians using TOPSIS method

    Directory of Open Access Journals (Sweden)

    Călin ŞERBU

    2014-11-01

    Full Text Available Every year, more than 1500 accidents with pedestrian occur in the intersections in Romania. The number of accidents involving pedestrians in roundabouts intersections type increased approximately three times in 2013 compared to 2009 in Romania. This alarming increase led to the need of assessing the safety of pedestrians in intersections with or without safety systems. The safety systems for pedestrians and drivers include: the road marking, the pedestrian crossings marking, signal intersections with road signs, traffic lights or pedestrian safety barriers. We propose to assess the types of intersections with TOPSIS method.

  10. Traffic Feasibility Study for a Grade Separator at a Busy Intersection in Vellore

    Science.gov (United States)

    Vasantha Kumar, S.; Gulati, Himanshu; Arora, Shivam

    2017-11-01

    One of the byproduct of urbanization is traffic congestion and before suggesting any solutions to reduce congestion, understanding the present context becomes very important. Study of traffic volumes at busy intersections to find the percentage composition of different vehicle types, directional distribution and peak hour traffic volume is a first step towards understanding the present context of traffic. Hence in the present study, one of the busy intersections in Vellore, namely, Gandhi nagar intersection in Vellore-Katpadi road was selected and traffic flow data was collected using video surveys. It was found that at the selected intersection, the two wheelers and three wheelers alone share 80% of the total traffic when compared to other vehicle types. Nearly 700 trucks and multi axle trailers were observed to pass through the intersection during the analysis period of five hours. That is, on an average 2 trucks/multi axle trailers were passing through the intersection in each minute. As like in other major cities, entry of trucks and other heavy vehicles such as multi axle trailers into the city needs to be banned during peak hours for smooth flow of traffic within city limits. A highest hourly volume of 6939 PCU’s was observed between 4 and 5 pm at the selected intersection. By assuming a 10% uniform traffic growth every year, it was found that after about 4 years, i.e., in 2019, the traffic volume at the intersection may reach 10,000 PCU’s and may warrant for a grade separator or interchange at the intersection.

  11. Common intersection points in dense fluids via equations of state

    International Nuclear Information System (INIS)

    Parsafar, G. A.; Noorian, R.

    2001-01-01

    Some new of state which are derived for dense fluids in recent years, namely the linear isotherm regularity, the dense system equation of state, Ihm-Song-Mason equation of state, and a newly derived semi-empirical equation of state have used to investigate the common intersection point of isobaric expansivity (α p ) in dense fluids. We have shown that the accuracy of these equations of state in predicting such a common intersection point is reduced from the new semi-imperial equation of state, dense system equation of state, linear isotherm regularity, to Ihm-Song-Mason equation of state. respectively. Form physical point of view, the van der Waals equation of state is used to investigate such an intersection point. It is shown that the van der Waals repulsion forces and temperature dependency of the effective molecular diameter are important for existence of this common point. Finally, we have shown that the common intersection points of the isotherms of thermal pressure coefficient, the isotherms of heat capacity at constant volume, and the iso chores of internal pressure for a fluid are related to each other. Also, the common intersection points of the reduced bulk modulus and 1/(Tα p ) for isotherms of a fluid both appear at the same density

  12. EnviroAtlas - New Bedford, MA - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  13. EnviroAtlas - Green Bay, WI - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  14. EnviroAtlas - Des Moines, IA - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  15. EnviroAtlas - New York, NY - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  16. The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna.

    Science.gov (United States)

    Squires, Judy H; England, Eric; Mehta, Kaushal; Wissman, Robert D

    2014-07-01

    The purpose of this article is to review the anatomy, biomechanics, and multimodality imaging findings of common and uncommon distal radioulnar joint (DRUJ), triangular fibrocartilage complex, and distal ulna abnormalities. The DRUJ is a common site for acute and chronic injuries and is frequently imaged to evaluate chronic wrist pain, forearm dysfunction, and traumatic forearm injury. Given the complex anatomy of the wrist, the radiologist plays a vital role in the diagnosis of wrist pain and dysfunction.

  17. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-10-01

    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

  18. Prison violence and the intersectionality of race/ethnicity and gender

    Directory of Open Access Journals (Sweden)

    Kerryn E. Bell

    2018-03-01

    Full Text Available Objective to analyze the history occurrence and development of the problem of prison violence from the viewpoint of the intersectionality of raceethnicity and gender factors. Methods dialectical approach to cognition of social phenomena allowing to analyze them in historical development and functioning in the context of the totality of objective and subjective factors predetermined the following research methods formallogical comparativelegal and sociological. Results Minority men and women are significantly impacted by mass incarceration. Mass incarceration has also resulted in a growth in prison violence and previous studies in this area have focused on individuals and not their interconnected statuses. This study specifically considers the role of intersectional criminology and the commitment of prison violence in a large western state on female inmates. Intersectional criminology is a theoretical approach that enables a critical look at the impact of individuals39 interconnected statuses in relation to crime. The authors do not hypothesize about the reasons for the dependences between raceethnicity and gender factors and the level of prison violence but state that minority females commit more violent infractions in prison than White women. Intersectionality allows coming closer to solving the problem of identifying the incarcerated females as members of criminal groups and study the potential impact of this factor on the violence level. Scientific novelty for the first time the research proves that intersectionality allows receiving more reliable statistical results when estimating the level of prison violence. It has been proved that minority females commit more violent infractions in prison than White women. Thus this study builds upon previous arguments that intersectionality should be more widely used in future research and discusses implications for the findings. Practical significance the main provisions and conclusions of the article

  19. Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer

    NARCIS (Netherlands)

    Gurusamy, Kurinchi Selvan; Riviere, Deniece; van Laarhoven, C. J. H.; Besselink, Marc; Abu-Hilal, Mohammed; Davidson, Brian R.; Morris, Steve

    2017-01-01

    A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic distal

  20. An Adaptive Model for Calculating the Correlation Degree of Multiple Adjacent Signalized Intersections

    Directory of Open Access Journals (Sweden)

    Linhong Wang

    2013-01-01

    Full Text Available As an important component of the urban adaptive traffic control system, subarea partition algorithm divides the road network into some small subareas and then determines the optimal signal control mode for each signalized intersection. Correlation model is the core of subarea partition algorithm because it can quantify the correlation degree of adjacent signalized intersections and decides whether these intersections can be grouped into one subarea. In most cases, there are more than two intersections in one subarea. However, current researches only focus on the correlation model for two adjacent intersections. The objective of this study is to develop a model which can calculate the correlation degree of multiple intersections adaptively. The cycle lengths, link lengths, number of intersections, and path flow between upstream and downstream coordinated phases were selected as the contributing factors of the correlation model. Their jointly impacts on the performance of the coordinated control mode relative to the isolated control mode were further studied using numerical experiments. The paper then proposed a correlation index (CI as an alternative to relative performance. The relationship between CI and the four contributing factors was established in order to predict the correlation, which determined whether adjacent intersections could be partitioned into one subarea. A value of 0 was set as the threshold of CI. If CI was larger than 0, multiple intersections could be partitioned into one subarea; otherwise, they should be separated. Finally, case studies were conducted in a real-life signalized network to evaluate the performance of the model. The results show that the CI simulates the relative performance well and could be a reliable index for subarea partition.

  1. The Intersection Probability of Brownian Motion and SLEκ

    Directory of Open Access Journals (Sweden)

    Shizhong Zhou

    2015-01-01

    Full Text Available By using excursion measure Poisson kernel method, we obtain a second-order differential equation of the intersection probability of Brownian motion and SLEκ. Moreover, we find a transformation such that the second-order differential equation transforms into a hypergeometric differential equation. Then, by solving the hypergeometric differential equation, we obtain the explicit formula of the intersection probability for the trace of the chordal SLEκ and planar Brownian motion started from distinct points in an upper half-plane H-.

  2. [Comparison of laparoscopic distal pancreatectomy and open distal pancreatectomy in pancreatic ductal adenocarcinoma].

    Science.gov (United States)

    Xu, K; Su, J J; Su, M; Yan, L; Feng, J; Xin, X L; Chen, Y L

    2017-10-23

    Objective: To compare and evaluate the curative effect of laparoscopic distal pancreatectomy(LDP) and traditional open distal pancreatectomy(ODP) in pancreatic ductal adenocarcinoma. Methods: The clinical data of 15 patients treated by LDP and 87 contemporaneous cases treated by ODP from January 2010 to November 2015 was collected, and the curative effect and prognosis of these patients were retrospectively analyzed. Results: The operation time of LDP group was (286.5±48.1) min, significantly longer than that of OPD group(226.6±56.8) min ( P 0.05). In both LDP group and ODP group, none occurred percutaneous drainage, re-admissions, second operation or perioperative death. Conclusions: Compared to ODP, LDP is much safer and more steady in perioperative periodand operation. Patients of pancreatic ductal adenocarcinoma received LDP can acquire more benefit and recovery sooner, and LDP is a safe and effective operative method.

  3. Multiple intersecting cohesive discontinuities in 3D reservoir geomechanics

    OpenAIRE

    Das, K. C.; Sandha, S.S.; Carol, Ignacio; Vargas, P.E.; Gonzalez, Nubia Aurora; Rodrigues, E.; Segura Segarra, José María; Lakshmikantha, Ramasesha Mookanahallipatna; Mello,, U.

    2013-01-01

    Reservoir Geomechanics is playing an increasingly important role in developing and producing hydrocarbon reserves. One of the main challenges in reservoir modeling is accurate and efficient simulation of arbitrary intersecting faults. In this paper, we propose a new formulation to model multiple intersecting cohesive discontinuities (faults) in reservoirs using the XFEM framework. This formulation involves construction of enrichment functions and computation of stiffness sub-matrices for bulk...

  4. Feminist Intersectionality Research in Communications: Origins, Contributions and Tensions

    OpenAIRE

    Carolyn M. Byerly

    2017-01-01

    The text considers some of the important work in intersectionality that has been done by critical feminist and postcolonial scholars in media and other communication fields since the 1990s, focusing particularly on the kinds of problems they have examined and their contributions to feminist theory building. The discussion also explores some of the challenges and tensions that accompany scholarship conducted from a standpoint of intersectionality.

  5. Laparoscopic distal pancreatectomy for adenocarcinoma: safe and reasonable?

    Science.gov (United States)

    Postlewait, Lauren M.

    2015-01-01

    As a result of technological advances during the past two decades, surgeons now use minimally invasive surgery (MIS) approaches to pancreatic resection more frequently, yet the role of these approaches for pancreatic ductal adenocarcinoma resections remains uncertain, given the aggressive nature of this malignancy. Although there are no controlled trials comparing MIS technique to open surgical technique, laparoscopic distal pancreatectomy for pancreatic adenocarcinoma is performed with increasing frequency. Data from retrospective studies suggest that perioperative complication profiles between open and laparoscopic distal pancreatectomy are similar, with perhaps lower blood loss and fewer wound infections in the MIS group. Concerning oncologic outcomes, there appear to be no differences in the rate of achieving negative margins or in the number of lymph nodes (LNs) resected when compared to open surgery. There are limited recurrence and survival data on laparoscopic compared to open distal pancreatectomy for pancreatic adenocarcinoma, but in the few studies that assess long term outcomes, recurrence rates and survival outcomes appear similar. Recent studies show that though laparoscopic distal pancreatectomy entails a greater operative cost, the associated shorter length of hospital stay leads to decreased overall cost compared to open procedures. Multiple new technologies are emerging to improve resection of pancreatic cancer. Robotic pancreatectomy is feasible, but there are limited data on robotic resection of pancreatic adenocarcinoma, and outcomes appear similar to laparoscopic approaches. Additionally fluorescence-guided surgery represents a new technology on the horizon that could improve oncologic outcomes after resection of pancreatic adenocarcinoma, though published data thus far are limited to animal models. Overall, MIS distal pancreatectomy appears to be a safe and reasonable approach to treating selected patients with pancreatic ductal

  6. Failure at Frame-Stringer Intersections in PRSEUS Panels

    Science.gov (United States)

    Jegley, Dawn C.

    2012-01-01

    NASA, the Air Force Research Laboratory and The Boeing Company have worked to develop new low-cost, light-weight composite structures for aircraft. A Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS) concept has been developed which offers advantages over traditional metallic structures. In this concept a stitched carbon-epoxy material system has been developed with the potential for reducing the weight and cost of transport aircraft structure by eliminating fasteners, thereby reducing part count and labor. By adding unidirectional carbon rods to the top of stiffeners, the panel becomes more structurally efficient. This combination produces a more damage tolerant design. This study focuses on the intersection between the rod-stiffener and the foam-filled frame in a PRSEUS specimen. Compression loading is considered, which induces stress concentrations at the intersection point that can lead to failures. An experiment with accompanying analysis for a single-frame specimen is described, followed by a parametric study of simple reinforcements to reduce strains in the intersection region.

  7. Stresses at the intersection of two cylindrical shells

    International Nuclear Information System (INIS)

    Xue, M.D.; Chen, W.; Hwang, K.C.

    1995-01-01

    The stress analysis based on the theory of a thin shell is carried out for two normally intersecting cylindrical shells with a large diameter ratio. Instead of the Donnell shallow shell equation, the modified Morley equation, which is applicable to ρ 0 (R/T) 1/2 XXXX1, is used for the analysis of the shell with cut-out. The solution in terms of displacement function for the nozzle with a non-planar end is based on the Love equation. The boundary forces and displacements at the intersection are all transformed from Gaussian coordinates (α,β) on the shell, or Gaussian coordinates (ζ,θ) on the nozzle into three-dimensional cylindrical coordinates (ρ,θ,z). Their expressions on the intersecting curve are periodic functions of θ and expanded in Fourier series. Every harmonics of Fourier coefficients of boundary forces and displacements are obtained by numerical quadrature.The results obtained are in agreement with those from the finite element method and experiments for d/D≤0.8. ((orig.))

  8. Distal finger replantation.

    Science.gov (United States)

    Scheker, Luis R; Becker, Giles W

    2011-03-01

    Reconstruction of the fingertip distal to the flexor tendon insertion by replantation remains controversial and technically challenging, but the anatomy of the fingertip has been well described and provides help in surgical planning. The open-book surgical technique is described with potential complications and is illustrated with clinical cases. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  9. A toy model for gauge-mediation in intersecting brane models

    International Nuclear Information System (INIS)

    Kumar, Jason

    2009-01-01

    We discuss the phenomenology of a toy intersecting brane model where supersymmetry is dynamically broken in an open-string hidden sector and gauge-mediated to the visible sector. Scalar masses ∼TeV are easily realizable, and R-symmetry is broken. These ideas are easily generalizable to other intersecting brane models.

  10. Avoided intersections of nodal lines

    International Nuclear Information System (INIS)

    Monastra, Alejandro G; Smilansky, Uzy; Gnutzmann, Sven

    2003-01-01

    We consider real eigenfunctions of the Schroedinger operator in 2D. The nodal lines of separable systems form a regular grid, and the number of nodal crossings equals the number of nodal domains. In contrast, for wavefunctions of non-integrable systems nodal intersections are rare, and for random waves, the expected number of intersections in any finite area vanishes. However, nodal lines display characteristic avoided crossings which we study in this work. We define a measure for the avoidance range and compute its distribution for the random wave ensemble. We show that the avoidance range distribution of wavefunctions of chaotic systems follows the expected random wave distributions, whereas for wavefunctions of classically integrable but quantum non-separable systems, the distribution is quite different. Thus, the study of the avoidance distribution provides more support to the conjecture that nodal structures of chaotic systems are reproduced by the predictions of the random wave ensemble

  11. Inter-categorical intersectionality and leisure-based physical activity in Canada.

    Science.gov (United States)

    Abichahine, Hayfa; Veenstra, Gerry

    2017-08-01

    Leisure-based physical activity is socially stratified in Canada. To date, inequalities in physical activity by race or ethnicity, gender, class or sexual orientation, in Canada and elsewhere, have largely been investigated as distinct, additive phenomena. Informed by intersectionality theory, this paper examines whether racial identity, gender, class and sexuality 'intersect' with one another to predict physical activity in data from Cycles 2.1 and 3.1 of the Canadian Community Health Survey (n= 149 574). In particular, we apply the intersectional principle of multiplicativity which suggests that people's experiences of their gender identities are raced, classed and sexualized; their racial experiences are gendered, classed and sexualized, and so forth. We find that the positive effect of income on being physically active is strong among visible minority men, of moderate strength among White men and women and weak to non-existent among visible minority women. We also find that a lesbian, gay or bisexual orientation corresponds with a higher likelihood of being physically active among women (especially among less educated women) but not among men. These multiplicative findings undermine additive approaches to investigating social inequalities in leisure-based physical activity and pave the way for future intersectional analyses of axes of inequality and their diverse, intersecting effects. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Distal renal tubular acidosis and hepatic lipidosis in a cat.

    Science.gov (United States)

    Brown, S A; Spyridakis, L K; Crowell, W A

    1986-11-15

    Clinical and laboratory evidence of hepatic failure was found in a chronically anorectic cat. Simultaneous blood and urine pH determinations established a diagnosis of distal renal tubular acidosis. The cat did not respond to treatment. Necropsy revealed distal tubular nephrosis and hepatic lipidosis. The finding of distal renal tubular acidosis in a cat with hepatic lipidosis emphasizes the importance of complete evaluation of acid-base disorders in patients.

  13. Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score-matching.

    Science.gov (United States)

    Nakamura, Masafumi; Wakabayashi, Go; Miyasaka, Yoshihiro; Tanaka, Masao; Morikawa, Takanori; Unno, Michiaki; Tajima, Hiroshi; Kumamoto, Yusuke; Satoi, Sohei; Kwon, Masanori; Toyama, Hirochika; Ku, Yonson; Yoshitomi, Hideyuki; Nara, Satoshi; Shimada, Kazuaki; Yokoyama, Takahide; Miyagawa, Shinichi; Toyama, Yoichi; Yanaga, Katsuhiko; Fujii, Tsutomu; Kodera, Yasuhiro; Tomiyama, Yasuyuki; Miyata, Hiroaki; Takahara, Takeshi; Beppu, Toru; Yamaue, Hiroki; Miyazaki, Masaru; Takada, Tadahiro

    2015-10-01

    Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score-matching. We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006-2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. After propensity score-matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  14. Domestic Violence among the Black Poor: Intersectionality and Social Justice

    Science.gov (United States)

    Conwill, William Louis

    2010-01-01

    There are striking gender, race, and class variations in rates of domestic violence. Some leading family theorists called for an intersectional analysis of how gender, race and class systems interact to improve domestic violence theory. This article improves domestic violence theory by: 1) using the discourse, or language, of intersectionality; 2)…

  15. Lighting levels for isolated intersections : leading to safety improvements : final report.

    Science.gov (United States)

    2015-01-01

    A number of studies have linked the benefits of roadway lighting to a reduction in crash rates at night for a variety : of roadway types including rural intersections. Assessing the effectiveness of intersection lighting has primarily : relied upon c...

  16. Intersectionality in European Union policymaking

    DEFF Research Database (Denmark)

    Lombardo, Emanuela; Agustin, Lise Rolandsen

    2016-01-01

    is particularly apt to deal with equality and diversity in policymaking. By analysing a selection of European Union policy documents on gender-based violence in the period 2000–2014, we attend to the question of what intersectionality can bring to policymaking in terms of strengthening inclusiveness and address...

  17. On the Krull intersection theorem in function algebras | Mortini ...

    African Journals Online (AJOL)

    A version of the Krull intersection theorem states that for Noetherian integral domains the Krull intersection ki(I) of every proper ideal I is trivial; that is. ∞. ki(I) := ∩ In = {0}. n=1. We investigate the validity of this result for various function algebras R, present ideals I of R for which ki(I) ≠ {0}, and give conditions on I so that ki(I) ...

  18. Feminist Intersectionality Research in Communications: Origins, Contributions and Tensions

    Directory of Open Access Journals (Sweden)

    Carolyn M. Byerly

    2017-06-01

    Full Text Available The text considers some of the important work in intersectionality that has been done by critical feminist and postcolonial scholars in media and other communication fields since the 1990s, focusing particularly on the kinds of problems they have examined and their contributions to feminist theory building. The discussion also explores some of the challenges and tensions that accompany scholarship conducted from a standpoint of intersectionality.

  19. Fractures of the bilateral distal radius and scaphoid: a case report

    Directory of Open Access Journals (Sweden)

    Ozkan Korhan

    2008-03-01

    Full Text Available Abstract Introduction Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. Case presentation A patient with bilateral comminuted, displaced distal fractures of the radius and bilateral fractures of the scaphoid was treated via internal fixation of the scaphoid fractures with Herbert screws and internal fixation of the distal radius fractures with locked volar plating. Conclusion Rigid internal fixation of distal radius and scaphoid fractures is mandatory to start early active rehabilitation of the wrist without the need for wrist immobilization with a plaster or external skeletal fixation.

  20. Evaluation of j-turn intersection design performance in Missouri, final report.

    Science.gov (United States)

    2013-12-01

    Research shows that a high percentage of crashes that take place on high-speed rural expressways occur at intersections : with minor roads. One low-cost alternative design for improving the safety of at-grade intersections on such expressways is : th...

  1. Helping Students Understand Intersectionality: Reflections from a Dialogue Project in Residential Life

    Science.gov (United States)

    Claros, Sharon Chia; Garcia, Gina A.; Johnston-Guerrero, Marc P.; Mata, Christine

    2017-01-01

    In this chapter, the authors share insights from a dialogue project focused on intersectionality within a residential life setting and discuss additional strategies for helping students understand intersectionality.

  2. Analysis of Driver Evasive Maneuvering Prior to Intersection Crashes Using Event Data Recorders.

    Science.gov (United States)

    Scanlon, John M; Kusano, Kristofer D; Gabler, Hampton C

    2015-01-01

    Intersection crashes account for over 4,500 fatalities in the United States each year. Intersection Advanced Driver Assistance Systems (I-ADAS) are emerging vehicle-based active safety systems that have the potential to help drivers safely navigate across intersections and prevent intersection crashes and injuries. The performance of an I-ADAS is expected to be highly dependent upon driver evasive maneuvering prior to an intersection crash. Little has been published, however, on the detailed evasive kinematics followed by drivers prior to real-world intersection crashes. The objective of this study was to characterize the frequency, timing, and kinematics of driver evasive maneuvers prior to intersection crashes. Event data recorders (EDRs) downloaded from vehicles involved in intersection crashes were investigated as part of NASS-CDS years 2001 to 2013. A total of 135 EDRs with precrash vehicle speed and braking application were downloaded to investigate evasive braking. A smaller subset of 59 EDRs that collected vehicle yaw rate was additionally analyzed to investigate evasive steering. Each vehicle was assigned to one of 3 precrash movement classifiers (traveling through the intersection, completely stopped, or rolling stop) based on the vehicle's calculated acceleration and observed velocity profile. To ensure that any significant steering input observed was an attempted evasive maneuver, the analysis excluded vehicles at intersections that were turning, driving on a curved road, or performing a lane change. Braking application at the last EDR-recorded time point was assumed to indicate evasive braking. A vehicle yaw rate greater than 4° per second was assumed to indicate an evasive steering maneuver. Drivers executed crash avoidance maneuvers in four-fifths of intersection crashes. A more detailed analysis of evasive braking frequency by precrash maneuver revealed that drivers performing complete or rolling stops (61.3%) braked less often than drivers

  3. CEDAW and women's intersecting identities: a pioneering new approach to intersectional discrimination

    OpenAIRE

    Campbell, M

    2015-01-01

    CEDAW is committed to eliminating all forms of discrimination and achieving gender equality so that all women can exercise and enjoy their human rights. This article argues that this implicitly includes a commitment to understanding and addressing intersectional discrimination. Women experience disadvantage and discrimination based on their sex and gender and that is inextricably linked to other identities, factors and experiences such as a race and poverty. Under CEDAW, if sex and gender is ...

  4. Wind tunnel measurements of pollutant turbulent fluxes in urban intersections

    Science.gov (United States)

    Carpentieri, Matteo; Hayden, Paul; Robins, Alan G.

    2012-01-01

    Wind tunnel experiments have been carried out at the EnFlo laboratory to measure mean and turbulent tracer fluxes in geometries of real street canyon intersections. The work was part of the major DAPPLE project, focussing on the area surrounding the intersection between Marylebone Road and Gloucester Place in Central London, UK. Understanding flow and dispersion in urban streets is a very important issue for air quality management and planning, and turbulent mass exchange processes are important phenomena that are very often neglected in urban modelling studies. The adopted methodology involved the combined use of laser Doppler anemometry and tracer concentration measurements. This methodology was applied to quantify the mean and turbulent flow and dispersion fields within several street canyon intersections. Vertical profiles of turbulent tracer flux were also measured. The technique, despite a number of limitations, proved reliable and allowed tracer balance calculations to be undertaken in the selected street canyon intersections. The experience gained in this work will enable much more precise studies in the future as issues affecting the accuracy of the experimental technique have been identified and resolved.

  5. A speed guidance strategy for multiple signalized intersections based on car-following model

    Science.gov (United States)

    Tang, Tie-Qiao; Yi, Zhi-Yan; Zhang, Jian; Wang, Tao; Leng, Jun-Qiang

    2018-04-01

    Signalized intersection has great roles in urban traffic system. The signal infrastructure and the driving behavior near the intersection are paramount factors that have significant impacts on traffic flow and energy consumption. In this paper, a speed guidance strategy is introduced into a car-following model to study the driving behavior and the fuel consumption in a single-lane road with multiple signalized intersections. The numerical results indicate that the proposed model can reduce the fuel consumption and the average stop times. The findings provide insightful guidance for the eco-driving strategies near the signalized intersections.

  6. Distally based superficial sural artery flap for soft tissue coverage in the distal 2/3 of leg and foot

    Directory of Open Access Journals (Sweden)

    Kamath B

    2005-01-01

    Full Text Available Background: Skin coverage for defects in the lower 2/3 of leg, ankle region and posterior heel has always been a difficult challenge for reconstructive surgeon. Methods: We describe our experience with the distally based superficial sural artery flap coverage in 48 patients with moderate sized defects in these difficult areas. Results: One out of 48 flaps (in 48 patients was lost totally and 3 suffered marginal necrosis which did not require any secondary procedure. These complications could have been avoided by proper selection of cases and refining technical skills. Conclusion: This simple procedure could be an important and versatile tool for any reconstructive surgeon in providing skin coverage in the distal leg and proximal foot. Preservation of major arteries of the lower limb, minimal donor defect, relatively uninjured donor area in compound fracture or poly trauma involving distal leg are some of the advantages of the flap.

  7. Congestion analysis of unsignalized intersections

    NARCIS (Netherlands)

    Abhishek,; Mandjes, M.R.H.; Boon, M.A.A.; Nunez Queija, R.

    2016-01-01

    This paper considers an unsignalized intersection used by two traffic streams. A stream of cars is using a primary road, and has priority over the other, low-priority, stream. Cars belonging to the latter stream cross the primary road if the gaps between two subsequent cars on the primary road is

  8. The impact of splenectomy on outcomes after distal and total pancreatectomy

    Directory of Open Access Journals (Sweden)

    Bramhall Simon

    2007-06-01

    Full Text Available Abstract Background Several authors advocate spleen preserving distal pancreatectomy, because of the increased complication rate after splenectomy. Methods Postoperative complications and survival after distal and total pancreatectomy, were recorded and retrospectively analyzed according to spleen preservation. Patients, who underwent distal and total pancreatectomy without histologically proven adenocarcinoma, or extrapancreatic disease, were included in the cohort which was divided into splenectomy and no splenectomy groups. Statistical analysis was performed using Fisher's test. Results The study group consisted of 62 patients who underwent distal and total pancreatectomy between 26/11/1987 to 6/1/2006. Splenectomy was performed in 35 out of 62 patients (56.5%, distal pancreatectomy was performed in 49 out of 62 patients (79%. Morbidity rate was 28.6% in splenectomy group and 14.8% in the no splenectomy group (p = 0.235, while 30 days mortality rate was 2.9%; one patient died in the splenectomy group (p = 1. Conclusion Spleen-preservation did not influence the outcomes after distal and total pancreatectomy in our series.

  9. Two-wave propagation in in vitro swine distal ulna

    Science.gov (United States)

    Mano, Isao; Horii, Kaoru; Matsukawa, Mami; Otani, Takahiko

    2015-07-01

    Ultrasonic transmitted waves were obtained in an in vitro swine distal ulna specimen, which mimics a human distal radius, that consists of interconnected cortical bone and cancellous bone. The transmitted waveforms appeared similar to the fast waves, slow waves, and overlapping fast and slow waves measured in the specimen after removing the surface cortical bone (only cancellous bone). In addition, the circumferential waves in the cortical bone and water did not affect the fast and slow waves. This suggests that the fast-and-slow-wave phenomenon can be observed in an in vivo human distal radius.

  10. Young Children's Sibling Relationship Quality: Distal and Proximal Correlates

    Science.gov (United States)

    Kretschmer, Tina; Pike, Alison

    2009-01-01

    Background: Relationships within families are interdependent and related to distal environmental factors. Low socioeconomic status (SES) and high household chaos (distal factors) have been linked to less positive marital and parent-child relationships, but have not yet been examined with regard to young children's sibling relationships. The…

  11. Clinical relevance of distal biceps insertional and footprint anatomy

    NARCIS (Netherlands)

    van den Bekerom, Michel P J; Kodde, Izaäk F.; Aster, Asir; Bleys, Ronald L A W; Eygendaal, Denise

    2016-01-01

    Purpose: The aim of this review was to present an overview, based on a literature search, of surgical anatomy for distal biceps tendon repairs, based on the current literature. Methods: A narrative review was performed using Pubmed/Medline using key words: Search terms were distal biceps,

  12. Outlook from the intersections

    International Nuclear Information System (INIS)

    Haxton, W.C.

    1994-01-01

    I review a number of the physics themes of the Fifth Conference on the Intersections of Particle and Nuclear Physics, discussing the significance and promise of current work at the interface of these fields. Some of thee themes are: pattern of quark and boson masses; solar neutrino problem; lepton flavor violation tests; atomic dipole moments studies; Δs=0 weak interaction between nucleons; and strongly-interacting many-body problems

  13. Electronic theodolite intersection systems

    OpenAIRE

    Bingley, R. M.

    1990-01-01

    The development of electronic surveying instruments, such as electronic theodolites, and concurrent advances in computer technology, has revolutionised engineering surveying; one of the more recent examples being the introduction of Electronic Theodolite Intersection Systems (ETISs). An ETIS consists of two or more electronic theodolites and a computer, with peripheral hardware and suitable software. The theoretical principles on which they are based have been known for a long time, but ...

  14. An Intersectional Analysis of Latin@ College Women's Counter-Stories in Mathematics

    Science.gov (United States)

    Leyva, Luis A.

    2016-01-01

    In this article, the author discusses the intersectionality of mathematics experiences for two Latin@ college women pursuing mathematics-intensive STEM (science, technology, engineering, and mathematics) majors at a large, predominantly White university. The author employs intersectionality and poststructural theories to explore and make meaning…

  15. EnviroAtlas - Minneapolis/St. Paul, MN - Estimated Intersection Density of Walkable Roads

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  16. Concave distal end of ulna metaphysis alone is not a sign of rickets

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, 5031, Cincinnati, OH (United States)

    2015-07-15

    Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

  17. Concave distal end of ulna metaphysis alone is not a sign of rickets

    International Nuclear Information System (INIS)

    Oestreich, Alan E.

    2015-01-01

    Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

  18. A novel model of distal colon cancer in athymic mice Novo modelo de câncer de cólon distal em camundongos atímicos

    Directory of Open Access Journals (Sweden)

    Denise Gonçalves Priolli

    2012-06-01

    Full Text Available PURPOSE: The present a novel adenocarcinoma model in athymic mice. METHODS: Seven athymic mice were used. Colon diversion and distal fistula were made. Adenocarcinoma cells were inoculated in the submucosa of fistula. Tumor growth was monitored daily. Scintigraphy with 99mTc-MIBI was performed to identify the tumor. RESULTS: The model of distal colon cancer is feasible. Tumor detection was possible by both, macroscopically and molecular imaging. All resections demonstrated poorly differentiated tumors. Colon obstruction occurred in one case, similarly to evolution in human tumors of distal colon. CONCLUSION: The proposed model of distal colon cancer is feasible, allows for easy monitoring of tumoral growth by both, macroscopically and molecular imaging, and is suitable for studying the evolution of tumor with implementation of cytotoxic therapy in vivo.OBJETIVO: Apresentar novo modelo de adenocarcinoma distal em camundongos atímicos. MÉTODOS: Foram utilizados sete camundongos atímicos. Desvio do cólon distal e fístula foram feitas. Células de adenocarcinoma foram inoculadas na submucosa da fístula. O crescimento do tumor foi monitorado diariamente. Cintilografia com 99mTc-MIBI foi realizada para identificar o tumor. RESULTADOS: O modelo de câncer de cólon distal é viável. Detecção do tumor foi possível macroscopicamente e por imagem molecular. Todas as ressecções demonstraram tumores pouco diferenciados. Obstrução do cólon ocorreu em um caso, de forma semelhante à evolução em tumores humanos do cólon distal. CONCLUSÃO: O modelo de câncer do cólon distal proposto é viável, permite a monitorização fácil do crescimento tumoral macroscopicamente e por imagem molecular, sendo adequado para o estudo da evolução de tumor com aplicação de terapia citotóxica in vivo.

  19. Intersectionality and the LGBT Cancer Patient.

    Science.gov (United States)

    Damaskos, Penny; Amaya, Beau; Gordon, RuthAnn; Walters, Chasity Burrows

    2018-02-01

    To present the ways in which race, ethnicity, class, gender, and sexual orientation interact in the context of cancer risk, access to care, and treatment by health care providers. Cancer risk factors, access to care, and treatment for lesbian, gay, bisexual, and transgender (LGBT) patients are discussed within the context of intersectionality and cultural humility. Peer reviewed articles, cancer organizations, and clinical practice. LGBT patients have multiple identities that intersect to create unique experiences. These experiences shape their interactions with the health care system with the potential for positive or negative consequences. More data is needed to describe the outcomes of those experiences and inform clinical practice. Oncology nurses have an obligation to acknowledge patients' multiple identities and use the practice of cultural humility to provide individualized, patient-centered care. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Fishtail deformity - a delayed complication of distal humeral fractures in children

    Energy Technology Data Exchange (ETDEWEB)

    Narayanan, Srikala [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Imaging, Boston, MA (United States); University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Shailam, Randheer; Nimkin, Katherine [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Imaging, Boston, MA (United States); Grottkau, Brian E. [Massachusetts General Hospital, Department of Orthopaedics, Pediatric Orthopaedics, Boston, MA (United States)

    2015-06-15

    Concavity in the central portion of the distal humerus is referred to as fishtail deformity. This entity is a rare complication of distal humeral fractures in children. The purpose of this study is to describe imaging features of post-traumatic fishtail deformity and discuss the pathophysiology. We conducted a retrospective analysis of seven cases of fishtail deformity after distal humeral fractures. Seven children ages 7-14 years (five boys, two girls) presented with elbow pain and history of distal humeral fracture. Four of the seven children had limited range of motion. Five children had prior grade 3 supracondylar fracture treated with closed reduction and percutaneous pinning. One child had a medial condylar fracture and another had a lateral condylar fracture; both had been treated with conservative casting. All children had radiographs, five had CT and three had MRI. All children had a concave central defect in the distal humerus. Other imaging features included joint space narrowing with osteophytes and subchondral cystic changes in four children, synovitis in one, hypertrophy or subluxation of the radial head in three and proximal migration of the ulna in two. Fishtail deformity of the distal humerus is a rare complication of distal humeral fractures in children. This entity is infrequently reported in the radiology literature. Awareness of the classic imaging features can result in earlier diagnosis and appropriate treatment. (orig.)

  1. Fishtail deformity - a delayed complication of distal humeral fractures in children

    International Nuclear Information System (INIS)

    Narayanan, Srikala; Shailam, Randheer; Nimkin, Katherine; Grottkau, Brian E.

    2015-01-01

    Concavity in the central portion of the distal humerus is referred to as fishtail deformity. This entity is a rare complication of distal humeral fractures in children. The purpose of this study is to describe imaging features of post-traumatic fishtail deformity and discuss the pathophysiology. We conducted a retrospective analysis of seven cases of fishtail deformity after distal humeral fractures. Seven children ages 7-14 years (five boys, two girls) presented with elbow pain and history of distal humeral fracture. Four of the seven children had limited range of motion. Five children had prior grade 3 supracondylar fracture treated with closed reduction and percutaneous pinning. One child had a medial condylar fracture and another had a lateral condylar fracture; both had been treated with conservative casting. All children had radiographs, five had CT and three had MRI. All children had a concave central defect in the distal humerus. Other imaging features included joint space narrowing with osteophytes and subchondral cystic changes in four children, synovitis in one, hypertrophy or subluxation of the radial head in three and proximal migration of the ulna in two. Fishtail deformity of the distal humerus is a rare complication of distal humeral fractures in children. This entity is infrequently reported in the radiology literature. Awareness of the classic imaging features can result in earlier diagnosis and appropriate treatment. (orig.)

  2. Spontaneous distal rupture of the plantar fascia.

    Science.gov (United States)

    Gitto, Salvatore; Draghi, Ferdinando

    2018-07-01

    Spontaneous ruptures of the plantar fascia are uncommon injuries. They typically occur at its calcaneal insertion and usually represent a complication of plantar fasciitis and local treatment with steroid injections. In contrast, distal ruptures commonly result from traumatic injuries. We describe the case of a spontaneous distal rupture of the plantar fascia in a 48-year-old woman with a low level of physical activity and no history of direct injury to the foot, plantar fasciitis, or steroid injections. © 2017 Wiley Periodicals, Inc.

  3. Determination of safety specifications as for criticality in pipelines systems with intersection

    International Nuclear Information System (INIS)

    Santos, R. dos; Vellozo, S.O.

    1982-01-01

    By the Monte Carlo method, criticality calculations were done for pipelines with several types of reflexion and configurations, filled with solution of plutonium nitrate, with 100 per cent of weight of Pu-239 isotope, in water. From the more simple pipeline intersection condition, type T, an intersection type cross and Double cross are studied. A second central column is aded. The intersections are studied in the minimal, nominal and maximal reflexion condition. Critical safety values are presented for some systems. (E.G.) [pt

  4. Minimally Invasive Distal Pancreatectomy: Review of the English Literature.

    Science.gov (United States)

    Wang, Kai; Fan, Ying

    2017-02-01

    Recently, the superiority of the minimally invasive approach, which results in a better cosmetic result, faster recovery, and shorter length of hospital stay, is a technique that has been progressively recognized as it has developed. And the minimally invasive approach has been applied to distal pancreatectomy (DP), which is a standard method for the treatment of benign, borderline, and part of malignant lesions of the pancreatic body and tail. This article aims to analyze the types, postoperative recovery, and outcomes of laparoscopic distal pancreatectomy (LDP). A systematic search of the scientific literature was performed using PubMed, EMBASE, online journals, and the Internet for all publications on LDP. Articles were selected if the abstract contained patients who underwent LDP for pancreatic diseases. All selected articles were reviewed and analyzed. If there were no contraindications for LDP, this operation is suitable for benign, borderline, or malignant tumors of the pancreatic body and tail, which should try to be performed with preservation of the spleen. LDP is safe and feasible under some conditions to experienced surgeon. Single-incision laparoscopic distal pancreatectomy (S-LDP) and robotic laparoscopic distal pancreatectomy (R-LDP) perioperative outcomes are similar with conventional multi-incision laparoscopic distal pancreatectomy (C-LDP). And the advantages of S-LDP and R-LDP require further exploration. With the application of enhanced recovery program (ERP), length of hospital stay and costs are reduced. LDP is safe and feasible under some conditions. Compared with open distal pancreatectomy, LDP has a lot of advantages; a trend was observed for LDP to replace traditional open surgery. LDP combined with ERP is expected to become standard in the treatment of pancreatic body and tail lesions.

  5. Simulation of queue length and vehicle delays on signal-controlled intersection

    Directory of Open Access Journals (Sweden)

    Leverents Evgeny

    2018-01-01

    Full Text Available The extensive use of information technology in the field of traffic control will increase the traffic capacity of intersection points and transports. To assess the efficacy of changing options for the road traffic organization or the reorganization of intersection points, you need to know the average delay in vehicles and the length of the queue. The adaptive traffic light control is one of such tools. Simulation modeling of traffic flows use for the definition of its work. The aim of this work is to create a simulation model of controlled intersection, which can evaluate the efficiency of the application the adaptive regulation in various traffic situations, including the availability or deficiency of pedestrian traffic through the intersection. The numerical experiment in in the model pass with using of the Monte Carlo method, which can to draw a conclusion about the calculated parameter on the basis of the result of the reproduction of the calculation model.

  6. Impact of a Nationwide Training Program in Minimally Invasive Distal Pancreatectomy (LAELAPS)

    NARCIS (Netherlands)

    de Rooij, Thijs; van Hilst, Jony; Boerma, Djamila; Bonsing, Bert A.; Daams, Freek; van Dam, Ronald M.; Dijkgraaf, Marcel G.; van Eijck, Casper H.; Festen, Sebastiaan; Gerhards, Michael F.; Koerkamp, Bas Groot; van der Harst, Erwin; de Hingh, Ignace H.; Kazemier, Geert; Klaase, Joost; de Kleine, Ruben H.; van Laarhoven, Cornelis J.; Lips, Daan J.; Luyer, Misha D.; Molenaar, I. Quintus; Patijn, Gijs A.; Roos, Daphne; Scheepers, Joris J.; van der Schelling, George P.; Steenvoorde, Pascal; Vriens, Menno R.; Wijsman, Jan H.; Gouma, Dirk J.; Busch, Olivier R.; Hilal, Mohammed Abu; Besselink, Marc G.; de Boer, Marieke T.

    2016-01-01

    Objective:To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP).Summary of Background Data:Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal

  7. Exploring Driver Injury Severity at Intersection: An Ordered Probit Analysis

    Directory of Open Access Journals (Sweden)

    Yaping Zhang

    2015-02-01

    Full Text Available It is well known that intersections are the most hazardous locations; however, only little is known about driver injury severity in intersection crashes. Hence, the main goal of this study was to further examine the different factors contributing to driver injury severity involved in fatal crashes at intersections. Data used for the present analysis was from the US DOT-Fatality Analysis Reporting System (FARS crash database from the year 2011. An ordered probit model was employed to fit the fatal crash data and analyze the factors impacting each injury severity level. The analysis results displayed that driver injury severity is significantly affected by many factors. They include driver age and gender, driver ethnicity, vehicle type and age (years of use, crash type, driving drunk, speeding, violating stop sign, cognitively distracted driving, and seat belt usage. These findings from the current study are beneficial to form a solid basis for adopting corresponding measures to effectively drop injury severity suffering from intersection crash. More insights into the effects of risk factors on driver injury severity could be acquired using more advanced statistical models.

  8. 10 Best resources on… intersectionality with an emphasis on low- and middle-income countries.

    Science.gov (United States)

    Larson, Elizabeth; George, Asha; Morgan, Rosemary; Poteat, Tonia

    2016-10-01

    Intersectionality has emerged as an important framework for understanding and responding to health inequities by making visible the fluid and interconnected structures of power that create them. It promotes an understanding of the dynamic nature of the privileges and disadvantages that permeate health systems and affect health. It considers the interaction of different social stratifiers (e.g. 'race'/ethnicity, indigeneity, gender, class, sexuality, geography, age, disability/ability, migration status, religion) and the power structures that underpin them at multiple levels. In doing so, it is a departure from previous health inequalities research that looked at these forms of social stratification in isolation from one another or in an additive manner. Despite its potential use and long history in other disciplines, intersectionality is uncommonly used in health systems research in low- and middle-income countries (LMICs). To orient readers to intersectionality theory and research, we first define intersectionality and describe its role in public health, and then we review resources on intersectionality. We found that applications in public health mostly increased after 2009, with only 14 out of 86 articles focused on LMICs. To arrive at 10 best resources, we selected articles based on the proportion of the article that was devoted to intersectionality, the strength of the intersectionality analysis, and its relevance to LMICs. The first four resources explain intersectionality as a methodology. The subsequent six articles apply intersectionality to research in LMIC with quantitative and qualitative analysis. We provide examples from India, Swaziland, Uganda and Mexico. Topics for the studies range from HIV, violence and sexual abuse to immunization and the use of health entitlements. Through these 10 resources, we hope to spark interest and open a needed conversation on the importance and use of intersectional analysis in LMICs as part of understanding people

  9. Torsion of wandering spleen and distal pancreas

    International Nuclear Information System (INIS)

    Sheflin, J.R.; Lee, C.M.; Kretchmar, K.A.

    1984-01-01

    Wandering spleen is the term applied to the condition in which a long pedicle allows the spleen to lie in an abnormal location. Torsion of a wandering spleen is an unusual cause of an acute abdomen and is rarely diagnosed preoperatively. Associated torsion of the distal pancreas is even more uncommon. The authors describe a patient with torsion of a wandering spleen and distal pancreas, who was correctly diagnosed, and define the merits of the imaging methods used. The initial examination should be 99 /sup m/Tc-sulfur colloid liner-spleen scanning

  10. Osteoblastoma-like osteosarcoma of the distal tibia

    Energy Technology Data Exchange (ETDEWEB)

    Abramovici, Luigia; Steiner, German C. [Department of Pathology and Laboratory Medicine, Hospital for Joint Diseases, New York, NY (United States); Kenan, Samuel [Department of Orthopaedic Oncology Surgery, Hospital for Joint Diseases, New York, NY (United States); Hytiroglou, Prodromos [Aristotle University, Thessaloniki (Greece); Rafii, Mahvash [Department of Radiology, Hospital for Joint Diseases, New York, NY (United States)

    2002-03-01

    We report a case of a 14-year-old boy with an intracompartmental lytic lesion with poorly defined margins in the right distal tibia that was originally treated with curettage and bone grafting. Histologic examination showed an osteoblastic tumor with unusual features, which was found on consultation to be an osteoblastoma-like osteosarcoma, a rare, low-grade variant of osteosarcoma. Subsequently, the patient underwent en bloc resection of the distal tibia, which was replaced with vascularized bone graft and followed by chemotherapy. Two years later, he is alive with lung metastases. (orig.)

  11. Osteoblastoma-like osteosarcoma of the distal tibia

    International Nuclear Information System (INIS)

    Abramovici, Luigia; Steiner, German C.; Kenan, Samuel; Hytiroglou, Prodromos; Rafii, Mahvash

    2002-01-01

    We report a case of a 14-year-old boy with an intracompartmental lytic lesion with poorly defined margins in the right distal tibia that was originally treated with curettage and bone grafting. Histologic examination showed an osteoblastic tumor with unusual features, which was found on consultation to be an osteoblastoma-like osteosarcoma, a rare, low-grade variant of osteosarcoma. Subsequently, the patient underwent en bloc resection of the distal tibia, which was replaced with vascularized bone graft and followed by chemotherapy. Two years later, he is alive with lung metastases. (orig.)

  12. The Contribution to the Procedure of Capacity Determination at Unsignalized Priority-controlled Intersections

    Directory of Open Access Journals (Sweden)

    Tomaž Tolazzi

    2004-01-01

    Full Text Available The problem of minor vehicles crossing or merging into themajor stream at unsignalized priority-controlled intersections iswell-known. Numerous solutions involve various assumptionsconcerning the major headway distributions, number of majorlanes, critical gap distributions, etc. Such cases can be dividedinto two main groups: intersections with two streams (one majorand one minor stream and intersections with more thantwo streams (more than one major stream and one minorstream. At roundabouts, also at single-lane roundabouts,there are similar problems like the ones at other unsignalizedpriority-controlled intersections. A vehicle at the roundaboutapproach can only cross the pedestrian crossing when a sufficienttime-gap between two pedestrians (or cyclists is provided.A vehicle at the roundabout entries can only merge into the majorstream when a sufficient gap between the two vehicles in themajor stream is provided. Because of that, single-lane roundaboutscan also be treated as unsignalized intersections withtwo major lanes: the first one in its circulatory roadway and thesecond one on the pedestrian crossing.

  13. Modeling traffic accidents at signalized intersections in the city of Norfolk, VA.

    Science.gov (United States)

    2010-12-31

    This study was an attempt to apply a proactive approach using traffic pattern and signalized intersection characteristics to predict accident rates at signalized intersections in a citys arterial network. An earlier analysis of accident data at se...

  14. Some insights into the intersection of physical planning and governance in Zimbabwe

    CSIR Research Space (South Africa)

    Chakwizira, J

    2008-04-01

    Full Text Available This paper presents some insights into the intersection of physical planning and governance in Zimbabwe. It argues that the major theoretical, policy and practice discourses - explaining the intersection of physical planning and governance - relate...

  15. Use of palatally inserted mini-screw for upper molar distalization: A case series

    Directory of Open Access Journals (Sweden)

    Valliollah Arash

    2015-09-01

    Full Text Available  Abstract Reports have shown that molars can be distalized successfully with virtually no orthodontic anchorage loss with an intraosseous anchorage, even with fully erupted second molars. The purpose of this study was evaluating the effects of mini-screws as skeletal anchorage for upper molar distalization. In this case series, three patients needing maxillary first molar distalization, were selected. mini-screw was inserted in the anterior part of the palate. The screws were anchored to the first premolars by transpalatal arch and immediately loaded (150-160 g by 0.018-inch arch-wire and steel open-coil spring to distalize maxillary molars. The skeletal and dental changes were measured on cephalograms obtained before and after distalization. The amount of first molar distalization in the patients was 4 mm with 2°of tipping, 4 mm with 5°of tipping, and 3.5 mm with 2°of tipping respectively. Upper incisors and first premolars were stable during distalization.       

  16. MATHEMATICAL METHODS TO DETERMINE THE INTERSECTION CURVES OF THE CYLINDERS

    Directory of Open Access Journals (Sweden)

    POPA Carmen

    2010-07-01

    Full Text Available The aim of this paper is to establish the intersection curves between cylinders, by using the Mathematica program. This thing can be obtained by introducing the curves equations, which are inferred, in Mathematica program. This paper take into discussion three right cylinders and another inclined to 45 degrees. The intersection curves can also be obtained by using the classical methods of the descriptive geometry.

  17. (M,N-Soft Intersection BL-Algebras and Their Congruences

    Directory of Open Access Journals (Sweden)

    Xueling Ma

    2014-01-01

    Full Text Available The purpose of this paper is to give a foundation for providing a new soft algebraic tool in considering many problems containing uncertainties. In order to provide these new soft algebraic structures, we discuss a new soft set-(M, N-soft intersection set, which is a generalization of soft intersection sets. We introduce the concepts of (M, N-SI filters of BL-algebras and establish some characterizations. Especially, (M, N-soft congruences in BL-algebras are concerned.

  18. Semi-autonomous Intersection Collision Avoidance through Job-shop Scheduling

    OpenAIRE

    Ahn, Heejin; Del Vecchio, Domitilla

    2016-01-01

    In this paper, we design a supervisor to prevent vehicle collisions at intersections. An intersection is modeled as an area containing multiple conflict points where vehicle paths cross in the future. At every time step, the supervisor determines whether there will be more than one vehicle in the vicinity of a conflict point at the same time. If there is, then an impending collision is detected, and the supervisor overrides the drivers to avoid collision. A major challenge in the design of a ...

  19. Laparoscopic radical nephroureterectomy: dilemma of the distal ureter.

    Science.gov (United States)

    Steinberg, Jordan R; Matin, Surena F

    2004-03-01

    Laparoscopic nephroureterectomy has recently emerged as a safe, minimally invasive approach to upper tract urothelial cancers. The most controversial and challenging feature of laparoscopic nephroureterectomy is the management of the distal ureter. We review the most common methods of managing the distal ureter, with emphasis on contemporary oncologic outcomes, indications, advantages, and disadvantages. There are currently in excess of five different approaches to the lower ureter. These techniques often combine features of endoscopic, laparoscopic, or open management. They include open excision, a transvesical laparoscopic detachment and ligation technique, laparoscopic stapling of the distal ureter and bladder cuff, the "pluck" technique, and ureteral intussusception. Each technique has distinct advantages and disadvantages, differing not only in technical approach, but oncological principles as well. While the existing published data do not overwhelmingly support one approach over the others, the open approach remains one of the most reliable and oncologically sound procedures. The principles of surgical oncology dictate that a complete, en-bloc resection, with avoidance of tumor seeding, remains the preferred treatment of all urothelial cancers. The classical open technique of securing the distal ureter and bladder cuff achieves this principle and has withstood the test of time. Transvesical laparoscopic detachment and ligation is an oncologically valid approach in patients without bladder tumors, but is limited by technical considerations. The laparoscopic stapling technique maintains a closed system but risks leaving behind ureteral and bladder cuff segments. Both transurethral resection of the ureteral orifice (pluck) and intussusception techniques should be approached with caution, as the potential for tumor seeding exists. Additional long-term comparative outcomes are needed to solve the dilemma of the distal ureter.

  20. Simultaneous bilateral distal biceps tendon repair: case report

    Directory of Open Access Journals (Sweden)

    Thiago Medeiros Storti

    Full Text Available ABSTRACT Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

  1. Simultaneous bilateral distal biceps tendon repair: case report.

    Science.gov (United States)

    Storti, Thiago Medeiros; Paniago, Alexandre Firmino; Faria, Rafael Salomon Silva

    2017-01-01

    Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

  2. Limited distal organelles and synaptic function in extensive monoaminergic innervation.

    Science.gov (United States)

    Tao, Juan; Bulgari, Dinara; Deitcher, David L; Levitan, Edwin S

    2017-08-01

    Organelles such as neuropeptide-containing dense-core vesicles (DCVs) and mitochondria travel down axons to supply synaptic boutons. DCV distribution among en passant boutons in small axonal arbors is mediated by circulation with bidirectional capture. However, it is not known how organelles are distributed in extensive arbors associated with mammalian dopamine neuron vulnerability, and with volume transmission and neuromodulation by monoamines and neuropeptides. Therefore, we studied presynaptic organelle distribution in Drosophila octopamine neurons that innervate ∼20 muscles with ∼1500 boutons. Unlike in smaller arbors, distal boutons in these arbors contain fewer DCVs and mitochondria, although active zones are present. Absence of vesicle circulation is evident by proximal nascent DCV delivery, limited impact of retrograde transport and older distal DCVs. Traffic studies show that DCV axonal transport and synaptic capture are not scaled for extensive innervation, thus limiting distal delivery. Activity-induced synaptic endocytosis and synaptic neuropeptide release are also reduced distally. We propose that limits in organelle transport and synaptic capture compromise distal synapse maintenance and function in extensive axonal arbors, thereby affecting development, plasticity and vulnerability to neurodegenerative disease. © 2017. Published by The Company of Biologists Ltd.

  3. Fractures of the distal radius in children: A retrospective evaluation

    Directory of Open Access Journals (Sweden)

    Selma Yazıcı

    2012-06-01

    Full Text Available Objectives: This study designed to evaluate the resultsof treatment, closed reduction and percutaneous wires, ofthe distal radius fractures in children.Materials and methods: A retrospective analysis wascarried out in children aged between 5-15 years who presentedwith a displaced fracture of the distal radius to ourhospital. They were initially treated with closed reductionand cast immobilization. If the fractures redisplaced treatedby percutaneous Kirschner (K- wire with scope undera general anaesthesia.Results: Totally 104 patients, who have distal radius fractureswere treated by closed reduction and immobilizationin a plaster cast. 13 patient who have distal radiusfractures were treated by closed reduction under generalanaesthesia and fixed by percutaneous Kirschner (K-wire. Patients with impaired the alignment of the fracturein late period were usually completely displaced fractures.(n=5, 4,3%, in early period, completely displaced fractures(n=5, 4,3% are superior to partial displaced fractures(n=2, 1,7%.Conclusion: In our study, when children with distal radiusfracture first come, they were treated by closed reductionand immobilization in a plaster cast. We thought that inredisplaced fractures patients were suitable for the closedreduction with percutaneous wire treatment.

  4. Planning of Autonomous Multi-agent Intersection

    Directory of Open Access Journals (Sweden)

    Viksnin Ilya I.

    2016-01-01

    Full Text Available In this paper, we propose a traffic management system with agents acting on behalf autonomous vehicle at the crossroads. Alternatively to existing solutions based on usage of semiautonomous control systems with the control unit, proposed in this paper algorithm apply the principles of decentralized multi-agent control. Agents during their collaboration generate intersection plan and determinate the optimal order of road intersection for a given criterion based on the exchange of information about them and their environment. The paper contains optimization criteria for possible routes selection and experiments that perform in order to estimate the proposed model. Experiment results show that this model can significantly reduce traffic density compared to the traditional traffic management systems. Moreover, the proposed algorithm efficiency increases with road traffic density. Furthermore, the availability of control unit in the system significantly reduces the negative impact of possible failures and hacker attacks.

  5. Influence of the cognitive workload on bicycle safety at four-legged intersections

    DEFF Research Database (Denmark)

    Kveladze, Irma; Agerholm, Niels

    2018-01-01

    is the influence of workload capacity on bicyclists spatial behaviour in a natural environment of four-legged intersections. Method: Due to the traffic safety of test participants, the study is divided in two phases. In the first phase, the actual physical environment of the four-legged intersection and bicyclists......-legged intersection. The eye tracking glasses will be used to make video and audio recording of visible field of where or how long bicyclists are allocating their visual attention while riding a bicycle and facing obstacles when crossing the four-legged intersection. On the second phase, a bicycle riding simulator...... riding task. This will allow to understand the allocation of bicyclists attention between primary and secondary tasks, to reveal the limit of the information processing capacity during biking. Results expected: Two experimental results will be incorporated to gain in-depth knowledge on bicycle accidents...

  6. (Engendering racial disparities in health trajectories: A life course and intersectional analysis

    Directory of Open Access Journals (Sweden)

    Liana J. Richardson

    2016-12-01

    Full Text Available Historically, intersectionality has been an underutilized framework in sociological research on racial/ethnic and gender inequalities in health. To demonstrate its utility and importance, we conduct an intersectional analysis of the social stratification of health using the exemplar of hypertension—a health condition in which racial/ethnic and gender differences have been well-documented. Previous research has tended to examine these differences separately and ignore how the interaction of social status dimensions may influence health over time. Using seven waves of data from the Health and Retirement Study and multilevel logistic regression models, we found a multiplicative effect of race/ethnicity and gender on hypertension risk trajectories, consistent with both an intersectionality perspective and persistent inequality hypothesis. Group differences in past and contemporaneous socioeconomic and behavioral factors did not explain this effect. Keywords: Race, Gender, Health inequalities, Intersectionality, Life course

  7. CEDAW and Women’s Intersecting Identities: A Pioneering New Approach to Intersectional Discrimination

    OpenAIRE

    Campbell,Meghan

    2015-01-01

    ABSTRACT CEDAW is committed to eliminating all forms of discrimination and achieving gender equality so that all women can exercise and enjoy their human rights. This article argues that this implicitly includes a commitment to understanding and addressing intersectional discrimination. Women experience disadvantage and discrimination based on their sex and gender and that is inextricably linked to other identities, factors and experiences such as a race and poverty. Under CEDAW, if sex and g...

  8. Research on Driver Behavior in Yellow Interval at Signalized Intersections

    Directory of Open Access Journals (Sweden)

    Zhaosheng Yang

    2014-01-01

    Full Text Available Vehicles are often caught in dilemma zone when they approach signalized intersections in yellow interval. The existence of dilemma zone which is significantly influenced by driver behavior seriously affects the efficiency and safety of intersections. This paper proposes the driver behavior models in yellow interval by logistic regression and fuzzy decision tree modeling, respectively, based on camera image data. Vehicle’s speed and distance to stop line are considered in logistic regression model, which also brings in a dummy variable to describe installation of countdown timer display. Fuzzy decision tree model is generated by FID3 algorithm whose heuristic information is fuzzy information entropy based on membership functions. This paper concludes that fuzzy decision tree is more accurate to describe driver behavior at signalized intersection than logistic regression model.

  9. Intersphincteric Resection and Coloanal Anastomosis in Treatment of Distal Rectal Cancer

    OpenAIRE

    Cipe, Gokhan; Muslumanoglu, Mahmut; Yardimci, Erkan; Memmi, Naim; Aysan, Erhan

    2012-01-01

    In the treatment of distal rectal cancer, abdominoperineal resection is traditionally performed. However, the recognition of shorter safe distal resection line, intersphincteric resection technique has given a chance of sphincter-saving surgery for patients with distal rectal cancer during last two decades and still is being performed as an alternative choice of abdominoperineal resection. The first aim of this study is to assess the morbidity, mortality, oncological, and functional outcomes ...

  10. The problem with the phrase women and minorities: intersectionality-an important theoretical framework for public health.

    Science.gov (United States)

    Bowleg, Lisa

    2012-07-01

    Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health's commitment to social justice makes it a natural fit with intersectionality's focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy.

  11. Distal antebrachial fractures in toy-breed dogs

    International Nuclear Information System (INIS)

    Muir, P.

    1997-01-01

    Antebrachial fractures account for approximately 17% of all canine fractures, with motor vehicle trauma cited as one of the primary causes. However, antebrachial fractures in toy-breed dogs are often sustained after apparently minimal trauma, such as jumping or falling, and are usually distal. The cause of antebrachial fractures in toy breeds is not well understood. Complications after treatment of distal antebrachial fractures in toy-breed dogs, including delayed union, nonunion, and malunion, are common and are potentially serious because they may necessitate limb amputation. This article reports on distal antebrachial fractures in 26 toy-breed dogs that wee presented to the University of California, Davis, Veterinary Medical Teaching Hospital from April 1987 to March 1996. The author found that (1) these fractures typically occur in growing or adolescent dogs; (2) the presence of complications of union is typically associated with prior treatment using intramedullary pinning or external coaptation; and (3) successful healing of this type of fracture is obtained via rigid stabilization with bone plating in combination with cancellous bone autograft

  12. Teaching Domestic Violence in the New Millennium: Intersectionality as a Framework for Social Change.

    Science.gov (United States)

    McQueeney, Krista

    2016-10-01

    This article describes an intersectional approach to teaching about domestic violence (DV), which aims to empower students as critical thinkers and agents of change by merging theory, service learning, self-reflection, and activism. Three intersectional strategies and techniques for teaching about DV are discussed: promoting difference-consciousness, complicating gender-only power frameworks, and organizing for change. The author argues that to empower future generations to end violence, educators should put intersectionality into action through their use of scholarship, teaching methods, and pedagogical authority. Finally, the benefits and challenges of intersectional pedagogy for social justice education are considered. © The Author(s) 2016.

  13. Evaluating the Impacts of Red Light Camera Deployment on Intersection Traffic Safety

    Science.gov (United States)

    2018-06-01

    Red-light cameras (RLC) are a popular countermeasure to reduce red-light running and improve intersection safety. Studies show that the reduction in side impact crashes at RLC intersections are often accompanied by no-change or an increase in the num...

  14. Ultrasound demonstration of distal biceps tendon bifurcation: normal and abnormal findings

    International Nuclear Information System (INIS)

    Tagliafico, Alberto; Capaccio, Enrico; Derchi, Lorenzo E.; Martinoli, Carlo; Michaud, Johan

    2010-01-01

    We demonstrate the US appearance of the distal biceps tendon bifurcation in normal cadavers and volunteers and in those affected by various disease processes. Three cadaveric specimens, 30 normal volunteers, and 75 patients were evaluated by means of US. Correlative MR imaging was obtained in normal volunteers and patients. In all cases US demonstrated the distal biceps tendon shaped by two separate tendons belonging to the short and long head of the biceps brachii muscle. Four patients had a complete rupture of the distal insertion of the biceps with retraction of the muscle belly. Four patients had partial tear of the distal biceps tendon with different US appearance. In two patients the partial tear involved the short head of the biceps brachii tendon, while in the other two patients, the long head was involved. Correlative MR imaging is also presented both in normal volunteers and patients. US changed the therapeutic management in the patients with partial tears involving the LH of the biceps. This is the first report in which ultrasound considers the distal biceps tendon bifurcation in detail. Isolated tears of one of these components can be identified by US. Knowledge of the distal biceps tendon bifurcation ultrasonographic anatomy and pathology has important diagnostic and therapeutic implications. (orig.)

  15. Intersection signal control multi-objective optimization based on genetic algorithm

    OpenAIRE

    Zhanhong Zhou; Ming Cai

    2014-01-01

    A signal control intersection increases not only vehicle delay, but also vehicle emissions and fuel consumption in that area. Because more and more fuel and air pollution problems arise recently, an intersection signal control optimization method which aims at reducing vehicle emissions, fuel consumption and vehicle delay is required heavily. This paper proposed a signal control multi-object optimization method to reduce vehicle emissions, fuel consumption and vehicle delay simultaneously at ...

  16. The Research of Vehicle Acceleration at Signalized Intersections

    Directory of Open Access Journals (Sweden)

    Vuk Bogdanović

    2013-02-01

    Full Text Available Vehicle acceleration is an important parameter used in planning various road elements, traffic signalization, geometric elements of an intersection, signal plans of traffic lights, etc. The knowledge of vehicle acceleration values is also necessary in using simulation softwares for more accurate analysis of the total situation at an intersection, on a road section or in a traffic network. In a lot of earlier studies, acceleration values were analysed and defined, mostly in optimal conditions for traffic functioning. However, values of almost all traffic flow parameters have been changed over time, due to changes in driving-dynamic vehicle characteristics, pneumatic tyres, material used for building road surface, etc. Besides, local environment influence and changes in drivers’ behaviour also significantly affect values of this parameter. According to HCM, it is advisable to perform local research for all values of the parameters recommended within the framework of this handbook, and to adapt their values to local conditions as well. The results of measuring the values of vehicles acceleration at signalized intersections in Novi Sad, Serbia, have been shown in this paper, using the procedure based on video recording processing.

  17. The intersection of culture, disability and assistive technology.

    Science.gov (United States)

    Ripat, Jacquie; Woodgate, Roberta

    2011-01-01

    Although the use of assistive technology (AT) is by an individual, it occurs within a much larger socio-cultural environment. The purpose of this article is to describe and analyse current knowledge about the intersection of culture and disability in the context of the AT user. Literature review of theoretical and empirical study papers that discuss cultural aspects related to AT use or provision. Understanding how an individual's culturally defined identity is shaped as an AT user, and the meaning the AT holds to that person and family, is essential to providing culturally appropriate AT services. AT providers also belong to a culture framed by their professional experiences; needed are ways of addressing ethnocentricity within culturally diverse practice settings. Some AT users may identify with a disability culture, a culture formed by a shared set of beliefs, values and behaviours around the construct of disability. This review reveals there is a paucity of knowledge about the intersection of AT and culture, and that this intersection requires further research. Embarking on this investigation is mandatory if we seek to meet the needs of the culturally diverse individuals who use AT.

  18. FIJI: A Framework for the Immersion-Journalism Intersection

    Directory of Open Access Journals (Sweden)

    Gary M. Hardee

    2017-07-01

    Full Text Available As journalists experiment with developing immersive journalism—first-person, interactive experiences of news events—guidelines are needed to help bridge a disconnect between the requirements of journalism and the capabilities of emerging technologies. Many journalists need to better understand the fundamental concepts of immersion and the capabilities and limitations of common immersive technologies. Similarly, developers of immersive journalism works need to know the fundamentals that define journalistic professionalism and excellence and the key requirements of various types of journalistic stories. To address these gaps, we have developed a Framework for the Immersion-Journalism Intersection (FIJI. In FIJI, we have identified four domains of knowledge that intersect to define the key requirements of immersive journalism: the fundamentals of immersion, common immersive technologies, the fundamentals of journalism, and the major types of journalistic stories. Based on these key requirements, we have formally defined four types of immersive journalism that are appropriate for public dissemination. In this article, we discuss the history of immersive journalism, present the four domains and key intersection of FIJI, and provide a number of guidelines for journalists new to creating immersive experiences.

  19. Locking plates in distal humerus fractures: study of 43 patients

    Directory of Open Access Journals (Sweden)

    Gupta Rakesh Kumar

    2013-08-01

    Full Text Available 【Abstract】Objective: The treatment of multi-fragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal hu-merus fractures. Methods: Forty-three consecutive patients with ar-ticular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. Forty patients were available for the final outcome analysis. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 14 cases of type C1, 7 cases of type C2 and 11 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score. Results: Forty patients were available for the final outcome analysis. There were 29 males and 11 females with an average age of 38.4 years (18-73 years. Clinical and ra-diological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks. The average follow-up was 12 months (10-18 months. Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 33 patients (82.5%. One pa-tient had superficial infection, and 4 had myositis ossificans. There were no cases of primary malposition or secondary displacement, implant failure or ulnar neuropathy. Conclusion: Anatomically preshaped distal humerus locking

  20. Clinical and non-clinical aspects of distal radioulnar joint instability

    NARCIS (Netherlands)

    Wijffels, M.; Brink, P.R.G.; Schipper, I.

    2012-01-01

    Untreated distal radioulnar joint (DRUJ) injuries can give rise to long lasting complaints. Although common, diagnosis and treatment of DRUJ injuries remains a challenge. The articulating anatomy of the distal radius and ulna, among others, enables an extensive range of forearm pronosupination

  1. Automation of a T-intersection using virtual platoons of cooperative autonomous vehicles

    NARCIS (Netherlands)

    Morales Medina, Alejandro; van de Wouw, N.; Nijmeijer, H.

    2015-01-01

    Both traffic throughput and the vehicle passenger safety can be increased by automating road intersections. We propose the virtual platooning concept to ensure a smooth, efficient and safe traffic flow through an automated intersection. The virtual platoon is formed by defining a virtual

  2. Where to locate transit stops: Cross-intersection profiles of ultrafine particles and implications for pedestrian exposure.

    Science.gov (United States)

    Choi, Wonsik; Ranasinghe, Dilhara; DeShazo, J R; Kim, Jae-Jin; Paulson, Suzanne E

    2018-02-01

    Epidemiological studies have shown that exposure to traffic-related pollutants increases incidence of adverse health outcomes. Transit users in cities across the globe commonly spend 15-45 min or more waiting at transit stops each day, often at locations with high levels of pollution from traffic. Here, we investigate the characteristics of concentration profiles of ultrafine particles (UFP) with 5 m spatial resolution across intersections, to determine the best place to site transit stops to minimize exposures. Cross-intersection UFP profiles were derived from 1744 profiles covering 90 m before and after each intersection center with a mobile monitoring platform. Measurements were made at 10 signalized intersections located at six urban sites, each with a distinct built environment, during both mornings and afternoons. Measurements were made within 1.5 m of the sidewalk and approximately at breathing height (1.5 m above ground level) to approximate sidewalk exposures. UFP profiles were strongly influenced by high emissions from vehicle stops and accelerations, and peaked within 30 m of intersection centers; from there concentrations decreased sharply with distance. Peak concentrations averaged about 90% higher than the minima along the block. They were accompanied by more frequent and larger transient concentration spikes, increasing the chance of people near the intersection being exposed to both short-term extremely high concentration spikes and higher average concentrations. The decays are somewhat larger before the intersection than after the intersection, however as siting transit stops after intersections is preferred for smooth traffic flow, we focus on after the intersection. Simple time-duration exposure calculations combined with breathing rates suggest moving a bus stop from 20 to 40-50 m after the intersection can reduce transit-users' exposure levels to total UFP substantially, in proportion to the reciprocal of the magnitude of elevation at

  3. Surgical treatment of distal biceps tendon rupture: a case report

    Directory of Open Access Journals (Sweden)

    Cristina N. Cozma

    2017-11-01

    Full Text Available Objectives. Distal biceps tendon rupture affects the functional upperextremity movement, impairing supination and flexion strength. According to age, profession and additional risks treatment might be nonoperative or surgical. Methods. We describe the case of a 43 years old male patient who sustained an injury to his right distal biceps and was diagnosed with acute right distal biceps rupture. Surgical treatment was decided and biceps tendon was reinserted to the radius tuberosity using a combination of a cortical button fixation associated with an interference screw. Results. Postoperative functional result was favorable with no complications and with no movement limitation after one month. Conclusions. When possible, distal biceps tendon repair should be realized surgically because this permits restoring of the muscle strength to near normal levels with no loss of motion. Nerve complications are common; therefore the surgery should be realized by experienced upper extremity surgeons.

  4. From r-spin intersection numbers to Hodge integrals

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Xiang-Mao; Li, Yuping [Institute of Applied Mathematics, Academy of Mathematics and Systems Science,Chinese Academy of Sciences,Beijing 100190, People’s Republic of (China); Meng, Lingxian [Institute of Applied Mathematics, Academy of Mathematics and Systems Science,Chinese Academy of Sciences,Beijing 100190, People’s Republic of (China); College of Mathematics and Information Science, Zhengzhou University of Light Industry,Zhengzhou 450002, People’s Republic of (China)

    2016-01-04

    Generalized Kontsevich Matrix Model (GKMM) with a certain given potential is the partition function of r-spin intersection numbers. We represent this GKMM in terms of fermions and expand it in terms of the Schur polynomials by boson-fermion correspondence, and link it with a Hurwitz partition function and a Hodge partition by operators in a (GL)-hat (∞) group. Then, from a W{sub 1+∞} constraint of the partition function of r-spin intersection numbers, we get a W{sub 1+∞} constraint for the Hodge partition function. The W{sub 1+∞} constraint completely determines the Schur polynomials expansion of the Hodge partition function.

  5. Compositions of professionalism in counselling work: An embodied and embedded intersectionality framework.

    Science.gov (United States)

    Adamson, Maria; Johansson, Marjana

    2016-12-01

    This article explores the embodied compositions of professionalism in the context of the counselling psychology profession in Russia. Specifically, we develop an embodied intersectionality framework for theorizing compositions of professionalism, which allows us to explain how multiple embodied categories of difference intersect and are relationally co-constitutive in producing credible professionals, and, importantly, how these intersections are contingent on intercorporeal encounters that take place in localized professional settings. Our exploration of how professionalism and professional credibility are established in Russian counselling shows that, rather than assuming that a hegemonic 'ideal body' is given preference in a professional context, different embodied compositions may be deemed credible in various work settings within the same profession. An embodied intersectionality framework allows us to challenge the notion of a single professional ideal and offer a dynamic and contextually situated analysis of the lived experiences of professional privilege and disadvantage.

  6. Distal protection filter device efficacy with carotid artery stenting: comparison between a distal protection filter and a distal protection balloon.

    Science.gov (United States)

    Iko, Minoru; Tsutsumi, Masanori; Aikawa, Hiroshi; Matsumoto, Yoshihisa; Go, Yoshinori; Nii, Kouhei; Abe, Gorou; Ye, Iwae; Nomoto, Yasuyuki; Kazekawa, Kiyoshi

    2013-01-01

    This retrospective study aimed to compare the effectiveness of the embolization prevention mechanism of two types of embolic protection device (EPD)-a distal protection balloon (DPB) and a distal protection filter (DPF). Subjects were 164 patients scheduled to undergo carotid artery stenting: a DPB was used in 82 cases (DPB group) from April 2007 until June 2010, and a DPF was used in 82 cases (DPF group) from July 2010 to July 2011. Rates of positive findings on postoperative diffusion-weighted imaging (DWI) and stroke incidence were compared. Positive postoperative DWI results were found in 34 cases in the DPB group (41.4 %), but in only 22 cases in the DPF group (26.8 %), and there was only a small significant difference within the DPF group. In the DPB group, there was one case of transient ischemic attack (TIA) (1.2 %) and four cases of brain infarction (2 minor strokes, 2 major strokes; 4.9 %), compared to the DFP group with one case of TIA (1.2 %) and no cases of minor or major strokes. In this study, significantly lower rates of occurrence of DWI ischemic lesions and intraoperative embolization were associated with use of the DPF compared to the DPB.

  7. Delay-based Passenger Car Equivalent at Signalized Intersections in Iran

    Directory of Open Access Journals (Sweden)

    Habibollah Nassiri

    2017-04-01

    Full Text Available Due to their different sizes and operational characteristics, vehicles other than passenger cars have a different influence on traffic operations especially at intersections. The passenger car equivalent (PCE is the parameter that shows how many passenger cars must be substituted for a specific heavy vehicle to represent its influence on traffic operation. PCE is commonly estimated using headway-based methods that consider the excess headway utilized by heavy vehicles. In this research, the PCE was estimated based on the delay parameter at three signalized intersections in Tehran, Iran. The data collected were traffic volume, travel time for each movement, signalization, and geometric design information. These data were analysed and three different models, one for each intersection, were constructed and calibrated using TRAF-NETSIM simulation software for unsaturated traffic conditions. PCE was estimated under different scenarios and the number of approach movements at each intersection. The results showed that for approaches with only one movement, PCE varies from 1.1 to 1.65. Similarly, for approaches with two and three movements, the PCE varies from 1.07 to 1.99 and from 0.76 to 3.6, respectively. In addition, a general model was developed for predicting PCE for intersections with all of the movements considered. The results obtained from this model showed that the average PCE of 1.5 is similar to the value recommended by the HCM (Highway Capacity Manual 1985. However, the predicted PCE value of 1.9 for saturated threshold is closer to the PCE value of 2 which was recommended by the HCM 2000 and HCM 2010.

  8. Geometrical Design Errors in Duhok Intersections by Driver Behavior

    Directory of Open Access Journals (Sweden)

    Dilshad Ali Mohammed

    2018-03-01

    Full Text Available In many situations, drivers if certain of the absence traffic monitoring system tend to shorten their driving paths and travel time across intersections. This behavior will be encouraged if the geometrical design suffers from mistakes, or the geometrical design and road conditions make it harder for drivers to follow the correct routes. Sometimes the intersection arrangement is confusing for the driver to distinguish the right from the wrong track. In this study, two sites with large number of driving mistakes were noticed. One site is a roundabout within the university of Duhok campus. The other is the intersection just outside the University of Duhok eastern main gate. At both sites, the geometry is very confusing and encourage driving mistakes. The university roundabout which was the first site investigated, was not properly designed encouraging wrong side driving. Many traffic accidents took place at this roundabout.  Wrong side driving reaches 32 % at peak hour in one approach.  This was reduced to 6% when temporary divisional island was installed. The other approach has a 15% wrong side driving and no remedy could be done to it. At the intersection near the university gate, wrong side driving reaches 56% of the traffic emerging from the main gate at peak hour. This was reduced to 14% when drivers are guided through direction sign. This percentage was reduced further to 9% with standing policeman.

  9. Intersectionality in Transnational Education Policy Research

    Science.gov (United States)

    Robert, Sarah A.; Yu, Min

    2018-01-01

    This review assesses intersectionality as a theoretical and methodological approach to transnational education policy research. In particular, we are concerned with how the concept is translated and interpreted to interrogate globally circulating education policies and how that transformation might inform the concept within Western and Northern…

  10. Vehicular crash data used to rank intersections by injury crash frequency and severity

    Directory of Open Access Journals (Sweden)

    Yi Liu

    2016-09-01

    Full Text Available This article contains data on research conducted in “A double standard model for allocating limited emergency medical service vehicle resources ensuring service reliability” (Liu et al., 2016 [1]. The crash counts were sorted out from comprehensive crash records of over one thousand major signalized intersections in the city of Chicago from 2004 to 2010. For each intersection, vehicular crashes were counted by crash severity levels, including fatal, injury Types A, B, and C for major, moderate, and minor injury levels, property damage only (PDO, and unknown. The crash data was further used to rank intersections by equivalent injury crash frequency. The top 200 intersections with the highest number of crash occurrences identified based on crash frequency- and severity-based scenarios are shared in this brief. The provided data would be a valuable source for research in urban traffic safety analysis and could also be utilized to examine the effectiveness of traffic safety improvement planning and programming, intersection design enhancement, incident and emergency management, and law enforcement strategies.

  11. Understanding the micro and macro politics of health: Inequalities, intersectionality & institutions - A research agenda.

    Science.gov (United States)

    Gkiouleka, Anna; Huijts, Tim; Beckfield, Jason; Bambra, Clare

    2018-03-01

    This essay brings together intersectionality and institutional approaches to health inequalities, suggesting an integrative analytical framework that accounts for the complexity of the intertwined influence of both individual social positioning and institutional stratification on health. This essay therefore advances the emerging scholarship on the relevance of intersectionality to health inequalities research. We argue that intersectionality provides a strong analytical tool for an integrated understanding of health inequalities beyond the purely socioeconomic by addressing the multiple layers of privilege and disadvantage, including race, migration and ethnicity, gender and sexuality. We further demonstrate how integrating intersectionality with institutional approaches allows for the study of institutions as heterogeneous entities that impact on the production of social privilege and disadvantage beyond just socioeconomic (re)distribution. This leads to an understanding of the interaction of the macro and the micro facets of the politics of health. Finally, we set out a research agenda considering the interplay/intersections between individuals and institutions and involving a series of methodological implications for research - arguing that quantitative designs can incorporate an intersectional institutional approach. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. On classical de Sitter and Minkowski solutions with intersecting branes

    Science.gov (United States)

    Andriot, David

    2018-03-01

    Motivated by the connection of string theory to cosmology or particle physics, we study solutions of type II supergravities having a four-dimensional de Sitter or Minkowski space-time, with intersecting D p -branes and orientifold O p -planes. Only few such solutions are known, and we aim at a better characterisation. Modulo a few restrictions, we prove that there exists no classical de Sitter solution for any combination of D 3/ O 3 and D 7/ O 7, while we derive interesting constraints for intersecting D 5/ O 5 or D 6/ O 6, or combinations of D 4/ O 4 and D 8/ O 8. Concerning classical Minkowski solutions, we understand some typical features, and propose a solution ansatz. Overall, a central information appears to be the way intersecting D p / O p overlap each other, a point we focus on.

  13. Effective spectral densities for system-environment dynamics at conical intersections: S{sub 2}-S{sub 1} conical intersection in pyrazine

    Energy Technology Data Exchange (ETDEWEB)

    Martinazzo, Rocco [Department of Physical Chemistry and Electrochemistry, University of Milan, Via Golgi 19, 20122 Milan (Italy); Hughes, Keith H. [School of Chemistry, Bangor University, Bangor, Gwynedd LL57 2UW (United Kingdom); Martelli, Fausto [Department of Physical Chemistry and Electrochemistry, University of Milan, Via Golgi 19, 20122 Milan (Italy); Departement de Chimie, Ecole Normale Superieure, 24 rue Lhomond, F-75231 Paris cedex 05 (France); Burghardt, Irene, E-mail: irene.burghardt@ens.fr [Departement de Chimie, Ecole Normale Superieure, 24 rue Lhomond, F-75231 Paris cedex 05 (France)

    2010-11-25

    Graphical abstract: The effect of high-dimensional environments on conical intersections can be described by hierarchies of approximate spectral densities, which translate to truncated effective-mode chains in the time domain. Abstract: A recently developed effective-mode representation is employed to characterize the influence of a multi-dimensional environment on the S{sub 2}-S{sub 1} conical intersection in pyrazine, taken as a paradigm case of high-dimensional dynamics at a conical intersection. We consider a simplified model by which four modes are strongly coupled to the electronic subsystem while a number of weakly coupled tuning modes, inducing energy gap fluctuations, are sampled from a spectral density. The latter is approximated by a series of simplified spectral densities which can be cast into a continued-fraction form, as previously demonstrated in Hughes et al. (K.H. Hughes, C.D. Christ, I. Burghardt, J. Chem. Phys. 131 (2009) 124108). In the time domain, the hierarchy of spectral densities translates to truncated effective-mode chains with a Markovian or quasi-Markovian (Rubin type) closure. A sequential deconvolution procedure is employed to generate this chain representation. The implications for the ultrafast dynamics and its representation in terms of reduced-dimensional models are discussed.

  14. Shifting Identities: Negotiating Intersections of Race and Gender in Canadian Administrative Contexts

    Science.gov (United States)

    Armstrong, Denise; Mitchell, Coral

    2017-01-01

    This qualitative study used a critical intersectional lens to examine how two black female Canadian principals negotiated their professional identities in administrative contexts. Both principals encountered gender and race-related pressures to fit normative expectations of administrators as white males. Navigating their intersecting identities…

  15. Study on Performance of Intersection Around The Underpass Using Micro Simulation Program

    Science.gov (United States)

    Arliansyah, J.; Bawono, R. T.

    2018-03-01

    In order to overcome the problems of congestion at the major intersections in Palembang City, there have been grade separation constructions in the form of flyover or underpass. One of them is the intersection of Patal Pusri Underpass. The smooth traffic due to the underpass construction needs to be balanced by the arrangement management at the intersections located close to the underpass to get the best network performance since both affect each other performance. The Taman Kenten and Seduduk Putih junctions which are just 569 and 226 meters from the underpass of Patal Pusri has to be analyzed for its needs of management and traffic arrangements to reduce its impact on the performance of the intersection of Patal Pusri or vice versa. Some alternatives of management and traffic arrangements were developed to get the best solutions and the Vissim 8.00 microsimulation program was used to evaluate the performance of intersections in the network where the compared parameters are the value of the queue length and average delay. The results of the analysis and the conducted modeling show that the best solution to optimize the performance of the two junctions are to make geometric changes and diversion of traffic flow at Seduduk Putih Junction and making geometric changes at Taman Kenten Junction.

  16. In-Street Wind Direction Variability in the Vicinity of a Busy Intersection in Central London

    Science.gov (United States)

    Balogun, Ahmed A.; Tomlin, Alison S.; Wood, Curtis R.; Barlow, Janet F.; Belcher, Stephen E.; Smalley, Robert J.; Lingard, Justin J. N.; Arnold, Sam J.; Dobre, Adrian; Robins, Alan G.; Martin, Damien; Shallcross, Dudley E.

    2010-09-01

    We present results from fast-response wind measurements within and above a busy intersection between two street canyons (Marylebone Road and Gloucester Place) in Westminster, London taken as part of the DAPPLE (Dispersion of Air Pollution and Penetration into the Local Environment; www.dapple.org.uk ) 2007 field campaign. The data reported here were collected using ultrasonic anemometers on the roof-top of a building adjacent to the intersection and at two heights on a pair of lamp-posts on opposite sides of the intersection. Site characteristics, data analysis and the variation of intersection flow with the above-roof wind direction ( θ ref ) are discussed. Evidence of both flow channelling and recirculation was identified within the canyon, only a few metres from the intersection for along-street and across-street roof-top winds respectively. Results also indicate that for oblique roof-top flows, the intersection flow is a complex combination of bifurcated channelled flows, recirculation and corner vortices. Asymmetries in local building geometry around the intersection and small changes in the background wind direction (changes in 15- min mean θ ref of 5°-10°) were also observed to have profound influences on the behaviour of intersection flow patterns. Consequently, short time-scale variability in the background flow direction can lead to highly scattered in-street mean flow angles masking the true multi-modal features of the flow and thus further complicating modelling challenges.

  17. An intersection graph of straight lines

    DEFF Research Database (Denmark)

    Thomassen, Carsten

    2002-01-01

    G. Ehrlich, S. Even, and R.E. Tarjan conjectured that the graph obtained from a complete 3 partite graph K4,4,4 by deleting the edges of four disjoint triangles is not the intersection graph of straight line segments in the plane. We show that it is....

  18. Intersectionality and Diversity in Higher Education,

    NARCIS (Netherlands)

    R.A. Icaza Garza (Rosalba); R. Vázquez (Rolando)

    2017-01-01

    textabstractWhat is ‘intersectionality’ and why does it matter to teachers and researchers of diversity in higher education? In this text, we approach intersectionality not just as concept that allows a critical enquiry into how class, gender and race shape society but also as praxis for social

  19. Intersectionality in Finnish adult education research: insights from the journal Aikuiskasvatus 2010-2016

    Directory of Open Access Journals (Sweden)

    Seija Keskitalo-Foley

    2017-11-01

    Full Text Available The article studies intersectionality in Finnish research on adult education. Specifically, we investigate the kinds of discussions on differences and their relations that are going on in such research. To this end we seek to identify intersectional approaches in the articles published in the journal Aikuiskasvatus between 2010 and 2016, a period marked by an increase in multiculturalism and social division as well as in gendered and sexual diversity in Finnish society. We understand intersectional differences as performative processes, not stable essences. Our study indicates that only few articles analysed intersectional differences explicitly. Implicitly recognised differences were mostly seen as givens. Categories such as ethnicity and race were found to be lacking in the data, but age, gender, social class, education, occupation and learning difficulties were discussed.

  20. Intersectionality and risk for ischemic heart disease in Sweden: Categorical and anti-categorical approaches.

    Science.gov (United States)

    Wemrell, Maria; Mulinari, Shai; Merlo, Juan

    2017-03-01

    Intersectionality theory can contribute to epidemiology and public health by furthering understanding of power dynamics driving production of health disparities, and increasing knowledge about heterogeneities within, and overlap between, social categories. Drawing on McCall, we relate the first of these potential contributions to categorical intersectionality and the second to anti-categorical intersectionality. Both approaches are used in study of risk of ischemic heart disease (IHD), based on register data on 3.6 million adults residing in Sweden by 2010, followed for three years. Categorical intersectionality is here coupled with between-group differences in average risk calculation, as we use intersectional categorizations while estimating odds ratios through logistic regressions. The anti-categorical approach is operationalized through measurement of discriminatory accuracy (DA), i.e., capacity to accurately categorize individuals with or without a certain outcome, through computation of the area under the curve (AUC). Our results show substantial differences in average risk between intersectional groupings. The DA of social categorizations is found to be low, however, due to outcome variability within and overlap between categories. We argue that measures of DA should be used for proper interpretation of differences in average risk between social (or any other) categories. Tension between average between-group risk and the DA of categorizations, which can be related to categorical and anti-categorical intersectional analyses, should be made explicit and discussed to a larger degree in epidemiology and public health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. “Bus Lane Within The Area Of Intersection” Method For Buses Priority On The Intersections

    Directory of Open Access Journals (Sweden)

    Vikovych Ihor

    2015-12-01

    Full Text Available The primary objective of this article is to formalize the “special bus lanes within the area of intersection” method that allows providing buses with space-time priority at signalized intersections (mostly of the isolated type, including those with no more than two traffic lanes in each direction at the approaches to the intersection. The article establishes the limits for efficient application of this method, and describes the results of a simulation experiment conducted in the VISSIM environment to investigate the functioning of the method on an actual intersection. The most critical phase of implementation of this method is to determine the optimum length of the special bus lane at the approach to the intersection. The optimum length of special bus lanes at the approaches to isolated or coordinated intersections is determined based on the maximum length of queued vehicles which is computed using the simulation models developed in the Objective-C language. The article covers the basic characteristics of those models, their structure and building principles, and also provides the model validation results. Simulation models can be used both for determination of the optimum length of special bus lanes at the approaches to signalized intersections and for analysis of intersection performance based on the maximum length of queued vehicles.

  2. The odd couple: using biomedical and intersectional approaches to address health inequities.

    Science.gov (United States)

    Hankivsky, Olena; Doyal, Lesley; Einstein, Gillian; Kelly, Ursula; Shim, Janet; Weber, Lynn; Repta, Robin

    Better understanding and addressing health inequities is a growing global priority. In this paper, we contribute to the literature examining complex relationships between biological and social dimensions in the field of health inequalities. Specifically, we explore the potential of intersectionality to advance current approaches to socio-biological entwinements. We provide a brief overview of current approaches to combining both biological and social factors in a single study, and then investigate the contributions of an intersectional framework to such work. We offer a number of concrete examples of how intersectionality has been used empirically to bring both biological and social factors together in the areas of HIV, post-traumatic stress disorder, female genital circumcision/mutilation/cutting, and cardiovascular disease. We argue that an intersectional approach can further research that integrates biological and social aspects of human lives and human health and ultimately generate better and more precise evidence for effective policies and practices aimed at tackling health inequities.

  3. The Benefit Impact of Air Pollution Reduction Through ATCS Implementation at Intersections

    Science.gov (United States)

    Budihardjo, Mochamad Arief; Huboyo, Haryono Setiyo; Samadikun, Budi Prasetyo

    2018-02-01

    The field study in five intersections that had ATCS, such as Krapyak, Tugu Muda, Polda, Bangkong and Fatmawati were done to investigate the effectivity of air pollution reduction. The study was done by estimating the differences between the vehicle speed due to the cycle duration of green light by field observation and video recording in each intersection. In five intersections that had been observed, the percentage of fuel consumption savings for two-wheeled vehicles were between 15 - 18%, meanwhile for four-wheel vehicles were between 30 - 46%. Based on the calculation that adopt the emission factor from CORINAIR and USEPA emission, the emission reduction based on pollutant types were TSP (12-17%), NOx (22-36%), CO (15-25%), HC (16-28%) and SO2 (22-35%). The result to the vehicles' speed that passed the intersections through ATCS has also indicated that the ATCS could increase vehicle speed and consequently reduce the emission.

  4. The Benefit Impact of Air Pollution Reduction Through ATCS Implementation at Intersections

    Directory of Open Access Journals (Sweden)

    Arief Budihardjo Mochamad

    2018-01-01

    Full Text Available The field study in five intersections that had ATCS, such as Krapyak, Tugu Muda, Polda, Bangkong and Fatmawati were done to investigate the effectivity of air pollution reduction. The study was done by estimating the differences between the vehicle speed due to the cycle duration of green light by field observation and video recording in each intersection. In five intersections that had been observed, the percentage of fuel consumption savings for two-wheeled vehicles were between 15 – 18%, meanwhile for four-wheel vehicles were between 30 – 46%. Based on the calculation that adopt the emission factor from CORINAIR and USEPA emission, the emission reduction based on pollutant types were TSP (12-17%, NOx (22-36%, CO (15-25%, HC (16-28% and SO2 (22-35%. The result to the vehicles' speed that passed the intersections through ATCS has also indicated that the ATCS could increase vehicle speed and consequently reduce the emission.

  5. Radiographic study of distal radial physeal closure in thoroughbred horses

    International Nuclear Information System (INIS)

    Vulcano, L.C.; Mamprim, M.J.; Muniz, L.M.R.; Moreira, A.F.; Luna, S.P.L.

    1997-01-01

    Monthly radiography was performed to study distal radial physeal closure in ten male and ten female Throughbred horses. The height, thoracic circumference and metacarpus circumference were also measured, Distal radial physeal closure time was sooner in females than males, and took 701 +/- 37 and 748 +/- 55 days respectively

  6. Empirical Analysis and Modeling of Stop-Line Crossing Time and Speed at Signalized Intersections

    Directory of Open Access Journals (Sweden)

    Keshuang Tang

    2016-12-01

    Full Text Available In China, a flashing green (FG indication of 3 s followed by a yellow (Y indication of 3 s is commonly applied to end the green phase at signalized intersections. Stop-line crossing behavior of drivers during such a phase transition period significantly influences safety performance of signalized intersections. The objective of this study is thus to empirically analyze and model drivers’ stop-line crossing time and speed in response to the specific phase transition period of FG and Y. High-resolution trajectories for 1465 vehicles were collected at three rural high-speed intersections with a speed limit of 80 km/h and two urban intersections with a speed limit of 50 km/h in Shanghai. With the vehicle trajectory data, statistical analyses were performed to look into the general characteristics of stop-line crossing time and speed at the two types of intersections. A multinomial logit model and a multiple linear regression model were then developed to predict the stop-line crossing patterns and speeds respectively. It was found that the percentage of stop-line crossings during the Y interval is remarkably higher and the stop-line crossing time is approximately 0.7 s longer at the urban intersections, as compared with the rural intersections. In addition, approaching speed and distance to the stop-line at the onset of FG as well as area type significantly affect the percentages of stop-line crossings during the FG and Y intervals. Vehicle type and stop-line crossing pattern were found to significantly influence the stop-line crossing speed, in addition to the above factors. The red-light-running seems to occur more frequently at the large intersections with a long cycle length.

  7. Distal Embolic Protection for Renal Arterial Interventions

    International Nuclear Information System (INIS)

    Dubel, Gregory J.; Murphy, Timothy P.

    2008-01-01

    Distal or embolic protection has intuitive appeal for its potential to prevent embolization of materials generated during interventional procedures. Distal protection devices (DPDs) have been most widely used in the coronary and carotid vascular beds, where they have demonstrated the ability to trap embolic materials and, in some cases, to reduce complications. Given the frequency of chronic kidney disease in patients with renal artery stenosis undergoing stent placement, it is reasonable to propose that these devices may play an important role in limiting distal embolization in the renal vasculature. Careful review of the literature reveals that atheroembolization does occur during renal arterial interventions, although it often goes undetected. Early experience with DPDs in the renal arteries in patients with suitable anatomy suggests retrieval of embolic materials in approximately 71% of cases and renal functional improvement/stabilization in 98% of cases. The combination of platelet inhibition and a DPD may provide even greater benefit. Given the critical importance of renal functional preservation, it follows that everything that can be done to prevent atheroembolism should be undertaken including the use of DPDs when anatomically feasible. The data available at this time support a beneficial role for these devices

  8. Asymptotic properties of axisymmetric Stokes flow of a viscous liquid with intersecting boundaries

    International Nuclear Information System (INIS)

    Voinov, O.V.

    2004-01-01

    The general axisymmetric problem on the liquid flow by the low Reynolds number when the boundary surfaces (both of the solid body and free one) are intersecting at the certain angle on the moving line, is considered. The work is aimed at establishing the asymptotic regularities of the behavior of the current function and voltages in the small vicinity of the intersection (contact) line of the boundary surfaces. The asymptotic analysis makes it possible to consider the arbitrary axisymmetric Stokes flow with the intersecting boundaries [ru

  9. Intersection layout, traffic volumes and accidents.

    NARCIS (Netherlands)

    Poppe, F.

    1988-01-01

    This paper reports on the accident research carried out as a part of a large project started in 1983. For this accident research an inventory was made of a large number of intersections.Recorded were layout features, accident data and estimates of traffic volumes. Attention will be given to the

  10. Optimal Locations of Bus Stops Connecting Subways near Urban Intersections

    Directory of Open Access Journals (Sweden)

    Yuan Cui

    2015-01-01

    Full Text Available Unsuitable locations of bus stops which provide feeder transportation connecting subways near urban intersections usually lead to the low efficiency of public transport and level of passenger service. A multiobjective optimization model to distribute such stop locations is proposed to attain the shortest total walk distance of passengers and minimum delay time of cars through intersections and travel time of buses. The Pareto frontier and optimal solutions for the proposed model are given by the distance-based and enumerative methods. The Xizhimen bus stop is selected to implement case studies for verifying the validity of the proposed model. The analysis of sensitivity on possible solutions is also carried out in the case studies. The results show that the proposed model is capable of optimizing the locations of bus stops connecting subways near intersections and helpful to improve the level of passengers service and operational efficiency of public transportation.

  11. Intersections of Hirzebruch–Zagier divisors and CM cycles

    CERN Document Server

    Howard, Benjamin

    2012-01-01

    This monograph treats one case of a series of conjectures by S. Kudla, whose goal is to show that Fourier of Eisenstein series encode information about the Arakelov intersection theory of special cycles on Shimura varieties of orthogonal and unitary type. Here, the Eisenstein series is a Hilbert modular form of weight one over a real quadratic field, the Shimura variety is a classical Hilbert modular surface, and the special cycles are complex multiplication points and the Hirzebruch–Zagier divisors. By developing new techniques in deformation theory, the authors successfully compute the Arakelov intersection multiplicities of these divisors, and show that they agree with the Fourier coefficients of derivatives of Eisenstein series.

  12. Using Cellular Automata to Investigate Pedestrian Conflicts with Vehicles in Crosswalk at Signalized Intersection

    Directory of Open Access Journals (Sweden)

    Xiaomeng Li

    2012-01-01

    Full Text Available The operational efficiency and safety of pedestrian flows at intersections is an important aspect of urban traffic. Particularly, conflicts between pedestrians and vehicles in crosswalk are one of the most influential factors for intersection safety. This paper presents a cellular automata model that simulates pedestrian and vehicle crossing behaviors at signalized intersections. Through the simulation, we investigate the effects of different pedestrian signal timing and crosswalk widths on the crosswalk capacity, the number of traffic conflicts between pedestrians and vehicles, and pedestrian delay due to the conflicts. The simulation results indicate that the cellular automata is an effective simulation platform for investigating complex pedestrian-related traffic phenomenon at signalized intersections.

  13. Contemporary Management of Primary Distal Urethral Cancer.

    Science.gov (United States)

    Traboulsi, Samer L; Witjes, Johannes Alfred; Kassouf, Wassim

    2016-11-01

    Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation therapy in women. There are no clear-cut indications for the choice of the most appropriate treatment modality. Organ-preserving modalities have shown effective and should be used whenever they do not compromise the oncological safety to decrease the physical and psychological trauma of dismemberment or loss of sexual/urinary function. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Orthogonal views improves localisation in bone scans of wrist

    International Nuclear Information System (INIS)

    Roth, A.L.

    1997-01-01

    Full text: Of all nuclear medicine studies, bone scans are the most fundamental. However, straightforward these may seem, there are always mechanisms that can be implemented which assist in a more precise diagnosis, particularly in areas with an intricate bone structure. An 18-year-old right-handed student presented to her doctor with a one month history of pain over the right distal radio-ulna joint area. Clinically, she had prominence of the right ulna, which suggested that there may have been a previous injury to the wrist. Also, pronation/supination were painful where there was swelling of the extensor carpi ulnaris tendon, as well as some discomfort with clicking in ulna deviation/rotation. The X-rays demonstrated some premature radial epiphysial closure. A bone scan was requested to attempt to localise the main inflammatory focus. The dynamic study was performed in the planar projection with an immediate blood pool for 300k being taken. These demonstrated a vascular blush medially. A medial blood pool image was acquired and it localised the abnormal vascularity as being dorsal. A separate focal area of less intense blood pooling was also noted in the line of the distal ulna. Delayed images showed increased uptake localised to the ulna styloid. Anatomically, the superficial vascular blush correlated with tenosynovitis. Hence, the orthogonal initial and delayed images were definitive in the diagnoses of tenosynovitis of the extensor carpi ulnaris tendon. This clearly complements the information provided by the palmar view. However, it is important to remember that an increased radiation dose to the technologist is incurred as a result of the extra orthogonal view, hence attention to technique is imperative

  15. Orthogonal views improves localisation in bone scans of wrist

    Energy Technology Data Exchange (ETDEWEB)

    Roth, A.L.

    1997-09-01

    Full text: Of all nuclear medicine studies, bone scans are the most fundamental. However, straightforward these may seem, there are always mechanisms that can be implemented which assist in a more precise diagnosis, particularly in areas with an intricate bone structure. An 18-year-old right-handed student presented to her doctor with a one month history of pain over the right distal radio-ulna joint area. Clinically, she had prominence of the right ulna, which suggested that there may have been a previous injury to the wrist. Also, pronation/supination were painful where there was swelling of the extensor carpi ulnaris tendon, as well as some discomfort with clicking in ulna deviation/rotation. The X-rays demonstrated some premature radial epiphysial closure. A bone scan was requested to attempt to localise the main inflammatory focus. The dynamic study was performed in the planar projection with an immediate blood pool for 300k being taken. These demonstrated a vascular blush medially. A medial blood pool image was acquired and it localised the abnormal vascularity as being dorsal. A separate focal area of less intense blood pooling was also noted in the line of the distal ulna. Delayed images showed increased uptake localised to the ulna styloid. Anatomically, the superficial vascular blush correlated with tenosynovitis. Hence, the orthogonal initial and delayed images were definitive in the diagnoses of tenosynovitis of the extensor carpi ulnaris tendon. This clearly complements the information provided by the palmar view. However, it is important to remember that an increased radiation dose to the technologist is incurred as a result of the extra orthogonal view, hence attention to technique is imperative.

  16. Rural expressway intersection safety toolbox : desktop reference.

    Science.gov (United States)

    2011-06-01

    This document is intended to be a guide for planning-level decisions concerning safety : issues and subsequent potential improvements at rural expressway intersections. It is : NOT a design guide. It simply presents the gamut of safety treatment opti...

  17. Teaching Note--Teaching Intersectionality: Transforming Cultural Competence Content in Social Work Education

    Science.gov (United States)

    Robinson, Michael Allen; Cross-Denny, Bronwyn; Lee, Karen Kyeunghae; Werkmeister Rozas, Lisa Marie; Yamada, Ann-Marie

    2016-01-01

    Intersectionality has been gaining momentum among social workers as a framework to allow a fuller understanding of the complexity of diverse social identities and the impact of social structures on power, privilege, and oppression. However, the application of intersectionality to teaching in social work education has been relatively absent in the…

  18. Drivers' smart advisory system improves driving performance at STOP sign intersections

    Directory of Open Access Journals (Sweden)

    Qing Li

    2017-06-01

    Full Text Available STOP signs are often physically blocked by obstacles at the corner, forming a safety threat. To enhance the safety at an un-signalized intersection like a STOP sign intersection, a radio frequency identification (RFID based drivers smart advisory system (DSAS was developed, which provides drivers with an earlier warning message when they are approaching an un-signalized intersection. In this research, a pilot field test was conducted with the DSAS alarm on an approach towards a STOP sign intersection in a residential area in Houston, Texas. The designed test route covers all turning movements, including left turn, through movement, and right turn. GPS units recorded test drivers' driving behaviors. A self-developed MATLAB program and statistically significant difference t-test were applied to analyze the impacts of the DSAS messages on drivers' driving performance, in terms of approaching speed profile, acceleration/deceleration rates, braking distance, and possible extra vehicle emissions induced by the introduction of the DSAS message. Drivers' preference on the DSAS was investigated by a designed survey questionnaire among test drivers. Results showed that the DSAS alarm was able to induce drivers to drive significantly slower to approach a STOP sign intersection, perform smaller fluctuation in acceleration/deceleration rates, and be more aware of a coming STOP sign indicated by decelerating earlier. All test drivers preferred to follow the DSAS alarm on roads for a safety concern. Further, the DSAS alarm caused the reduction in emission rates through movement. For a general observation, more road tests with more participants and different test routes were recommended.

  19. (Configuring gender in Bible translation: Cultural, translational and gender critical intersections

    Directory of Open Access Journals (Sweden)

    Jeremy Punt

    2014-06-01

    Full Text Available The gendered intersection of cultural studies and Bible translation is under acknowledged. Accounting for gender criticism in translation work requires, besides responsible theory and practice of translation, also attention to interwoven gender critical aspects. After a brief investigation of the intersections between biblical, translation and gender studies, translation in a few Pauline texts with bearing on gender and sexuality are investigated.

  20. Intersectionality and its journeys: from counterhegemonic feminist theories to law of european multilevel democracy

    Directory of Open Access Journals (Sweden)

    María Caterina La Barbera

    2017-06-01

    Full Text Available Democratization processes imply questioning the discriminatory effects of law and politics, and challenging exclusionary legal categories and political institutions. Intersectionality was born as a tool for critical legal analysis and allowed identifying the multiplicity of interactions generated by social exclusion on the grounds of gender, sexual orientation, race, religion, national origin, (disability and socioeconomic status, shedding light on the complexity of the mechanisms of power and privilege in social relations. In the last twenty-five years, intersectionality gained increasing popularity in the Anglophone academia, but it had uneven diffusion in the different socio-political contexts. The goal of this article is to identify the challenges of using intersectionality in the multilevel context of the European Union. To this end, the first part of this article addresses the conceptual origins of intersectionality, providing a genealogy that connects it with counterhegemonic feminist theories. In the second part, intersectionality is put in the American socio-legal context of the 70s where it originated in connection with the movement of Critical Legal Studies. Finally, considering the challenges involved in transposing into the legal framework of European Union a concept that traveled from another legal system, the third part of the article offers an overview of the recent development of European Union law as an example of the advancements and challenges that the introduction of intersectionality can suppose for democratic societies. The final goal of this study is to contribute to the broader debate on the implementation of intersectionality in the multilevel European democracy.

  1. One-stage lingual augmented urethroplasty in repair of distal penile ...

    African Journals Online (AJOL)

    E. Elsayed

    Abstract. Objectives: To evaluate the outcome of augmentation of shallow urethral plate by lingual graft in repair of distal penile hypospadias. Patients and methods: Between June 2008 and May 2011, the procedure was performed on 23 patients with mean age 2.3 years (range 1–3). All patients had distal penile ...

  2. Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients

    OpenAIRE

    Gupta, Rakesh K.; Rohilla, Rajesh Kumar; Sangwan, Kapil; Singh, Vijendra; Walia, Saurav

    2009-01-01

    Open reduction and internal fixation in distal tibial fractures jeopardises fracture fragment vascularity and often results in soft tissue complications. Minimally invasive osteosynthesis, if possible, offers the best possible option as it permits adequate fixation in a biological manner. Seventy-nine consecutive adult patients with distal tibial fractures, including one patient with a bilateral fracture of the distal tibia, treated with locking plates, were retrospectively reviewed. The 4.5-...

  3. Technology in Intersecting Figured Worlds.

    Science.gov (United States)

    Esbensen, Gertrud Lynge; Hasse, Cathrine

    2015-01-01

    In this chapter we analyze aspects of how Danish student nurses acquire technological literacy during their clinical internship at a Danish hospital. The argument is supported by several cases from Esbensen's empirical work. We focus on a Techno-Anthropological study of how student nurses learn to engage in technological mediated relations, and discuss how we think the ideas of intersecting worlds help to analyze some of the difficulties, student's experience.

  4. Stress intensity factors of corner cracks in two nozzle-cylinder intersections

    International Nuclear Information System (INIS)

    Kobayashi, A.S.; Polvanich, N.; Emery, A.F.; Love, W.J.

    1977-01-01

    In a recent paper, the authors presented the stress-intensity-magnification factors of a quarter-elliptical surface crack in a quarter-infinite solid and a circular crack approaching a reentry corner in a three-quarter infinite solid. These stress-intensity-magnification factors were used together with a curvature-correction factor to estimate the stress-intensity factor of a corner crack at a nozzle-cylinder intersection. Through appropriate superposition of the above stress-intensity-magnification factors, stress-intensity factors for hypothetical corner cracks at a nozzle-cylinder intersection subjected to internal pressure and transient thermal-stress loadings can be obtained. A description of a computer code based on this procedure as well as its applications in analyzing two corner-crack problems at a nozzle-cylinder intersection are discussed in this paper

  5. Distal vertebral artery reconstruction when managing vertebrobasilar insufficiency

    Directory of Open Access Journals (Sweden)

    D. M. Galaktionov

    2017-11-01

    Full Text Available This article presents a literature review devoted to the reconstruction of the distal vertebral artery and a clinical case of successful surgical treatment of a patient suffering from vertebrobasilar insufficiency caused by occlusion of the vertebral artery in a proximal segment. The external carotid artery-distal vertebral artery bypass was performed by using the radial artery.Received 27 February 2017. Revised 25 July 2017. Accepted 3 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest. 

  6. Neglected Distal Humeral Epiphyseal Injury - Two Case Reports

    Directory of Open Access Journals (Sweden)

    Dr. Pankaj Kumar

    2008-07-01

    Full Text Available Distal humeral epiphyseal separation is an uncommon injury in children, which can be missed or misdiagnosed at initial presentation. Awareness of this injury and appropriate radiological assessment helps in proper management. Neglected cases because of inappropriate diagnosis can result in cubitus varus deformity. Full range of movements of elbow can be achieved if properly diagnosed and managed. We present two cases of neglected distal humeral epiphyseal injury in children that resulted in cubitus varus deformity in one case. Full range of movements was achieved in both cases after proper management.

  7. Productive osseous changes about the wrist in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Cantor, R.M.; Braunstein, E.M.

    1987-01-01

    Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis. (orig.)

  8. Productive osseous changes about the wrist in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Cantor, R.M.; Braunstein, E.M.

    1987-07-01

    Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis.

  9. Distal pancreatectomy and splenectomy: a robotic or LESS approach.

    Science.gov (United States)

    Ryan, Carrie E; Ross, Sharona B; Sukharamwala, Prashant B; Sadowitz, Benjamin D; Wood, Thomas W; Rosemurgy, Alexander S

    2015-01-01

    The role and application of robotic surgery are debated, particularly given the expansion of laparoscopy, especially laparoendoscopic single-site (LESS) surgery. This cohort study was undertaken to delineate differences in outcomes between LESS and robotic distal pancreatectomy and splenectomy. With Institutional Review Board approval, patients undergoing LESS or robotic distal pancreatectomy and splenectomy from September 1, 2012, through December 31, 2014, were prospectively observed, and data were collected. The results are expressed as the median, with the mean ± SD. Thirty-four patients underwent a minimally invasive distal pancreatectomy and splenectomy: 18 with robotic and 16 with LESS surgery. The patients were similar in sex, age, and body mass index. Conversions to open surgery and estimated blood loss were similar. There were two intraoperative complications in the group that underwent the robotic approach. Time spent in the operating room was significantly longer with the robot (297 vs 254 minutes, P = .03), although operative duration (i.e., incision to closure) was not longer (225 vs 190 minutes; P = .15). Of the operations studied, 79% were undertaken for neoplastic processes. Tumor size was 3.5 cm for both approaches; R0 resections were achieved in all patients. Length of stay was similar in the two study groups (5 vs 4 days). There was one 30-day readmission after robotic surgery. Patient outcomes are similar with LESS or robotic distal pancreatectomy and splenectomy. Robotic operations require more time in the operating room. Both are safe and efficacious minimally invasive operations that follow similar oncologic principles for similar tumors, and both should be in the surgeon's armamentarium for distal pancreatectomy and splenectomy.

  10. Distal tibiofibular synostosis in a Nigerian: A case report | Owoeye ...

    African Journals Online (AJOL)

    X-ray of the bones showed an oblique fracture in the distal end of the shaft of fibula which is suggestive of post traumatic tibiofibular synostosis (TFS). Knowledge of distal TFS is important in resolving the puzzle of chronic shin pain of unknown origin and in accurate diagnosis of causes of ankle deformity and malformations.

  11. Beyond dichotomies: Gender and intersecting inequalities in climate change studies.

    Science.gov (United States)

    Djoudi, Houria; Locatelli, Bruno; Vaast, Chloe; Asher, Kiran; Brockhaus, Maria; Basnett Sijapati, Bimbika

    2016-12-01

    Climate change and related adaptation strategies have gender-differentiated impacts. This paper reviews how gender is framed in 41 papers on climate change adaptation through an intersectionality lens. The main findings show that while intersectional analysis has demonstrated many advantages for a comprehensive study of gender, it has not yet entered the field of climate change and gender. In climate change studies, gender is mostly handled in a men-versus-women dichotomy and little or no attention has been paid to power and social and political relations. These gaps which are echoed in other domains of development and gender research depict a 'feminization of vulnerability' and reinforce a 'victimization' discourse within climate change studies. We argue that a critical intersectional assessment would contribute to unveil agency and emancipatory pathways in the adaptation process by providing a better understanding of how the differential impacts of climate change shape, and are shaped by, the complex power dynamics of existing social and political relations.

  12. Dental and skeletal changes after intraoral molar distalization with sectional jig assembly.

    Science.gov (United States)

    Gulati, S; Kharbanda, O P; Parkash, H

    1998-09-01

    The present study was conducted on 10 subjects to evaluate dental and skeletal changes after intraoral molar distalization. The maxillary molars were distalized with a sectional jig assembly. Sentalloy open coil springs were used to exert 150 gm of force for a period of 12 weeks. A modified Nance appliance was the main source of anchorage. The pre- and postdistalization records included dental study casts, clinical photographs, and cephalograms. A total of 665 readings recorded from lateral cephalograms and dental casts were subjected to statistical analysis. The mean distal movement of the first molar was 2.78 mm, which was highly significant (o < 0.001). It moved distally at the rate of 0.86 mm/month. There was clinically some distal tipping (3.50 degrees) and distopalatal rotation (2.40 degrees). These changes were statistically significant (p < 0.001). The second molars accompanied the first molars and moved distally by nearly the same amount. There was 1.00 mm increase in the overjet and 2.60 degrees mesial tip of second premolar. The changes in the facial skeleton and dentition bases were minimal and statistically not significant. However, there was clockwise rotation of the mandible of 1.30 degrees that was statistically significant. This was the result of molar extrusion (1.60 mm).

  13. Social Support Contributes to Outcomes following Distal Radius Fractures

    Directory of Open Access Journals (Sweden)

    Caitlin J. Symonette

    2013-01-01

    Full Text Available Background. Distal radius fractures are the most common fracture of the upper extremity and cause variable disability. This study examined the role of social support in patient-reported pain and disability at one year following distal radius fracture. Methods. The Medical Outcomes Study Social Support Survey was administered to a prospective cohort of 291 subjects with distal radius fractures at their baseline visit. Pearson correlations and stepwise linear regression models (F-to-remove 0.10 were used to identify whether social support contributes to wrist fracture outcomes. The primary outcome of pain and disability at one year was measured using the Patient Rated Wrist Evaluation. Results. Most injuries were low energy (67.5% and were treated nonoperatively (71.9%. Pearson correlation analysis revealed that higher reported social support correlated with improved Patient Rated Wrist Evaluation scores at 1 year, r(n=181=-0.22, P<0.05. Of the subscales within the Social Support Survey, emotional/informational support explained a significant proportion of the variance in 1-year Patient Rated Wrist Evaluation scores, R2=4.7%, F (1, 181 = 9.98, P<0.05. Conclusion. Lower emotional/informational social support at the time of distal radius fracture contributes a small but significant percentage to patient-reported pain and disability outcomes.

  14. EMPLOYMENT OF ATMS TRAFFIC CONTROL DEVICE DATA TO ASSIST IN IDENTIFICATION OF CRASH-PRONE INTERSECTIONS

    Directory of Open Access Journals (Sweden)

    Kevin P. HWANG

    2008-01-01

    Full Text Available This paper employs information from the advanced traffic management system (ATMS of Kaohsiung, Taiwan to help differentiate those crash-prone intersections by discriminant analysis. From the 25,604 records of 2005, 1977 crashes that occurred at 119 intersections with traffic exposure data were compiled to calibrate and validate the model. The road attributes of crash records, traffic control devices and movement exposure are the three types of data used as predicting variables. The correct ratios for model calibration and validation range from 78.33% to 67.80%. if traffic movements are removed, the correct ratios become slightly lowered to 76.67% to 66.10%. Research findings reveal that with or without inclusion of exposure data in identifying high crash-prone intersections for an urban environment does not make a significant difference. in addition, layout and traffic control devices could possibly explain about 66.10 ∼ 78.33% of the possibility that an intersection will become a high crash intersection. it suggests that the developed approach could be a countermeasure for budget constraints and difficulties in continuation of exposure data collection, and the information of ATMS could help identify crash-prone urban intersections.

  15. Clinical and ultrasound features in patients with intersection syndrome or de Quervain's disease.

    Science.gov (United States)

    Sato, J; Ishii, Y; Noguchi, H

    2016-02-01

    We investigated the demographic characteristics of patients who were diagnosed with intersection syndrome and also investigated the dominance of the affected hand, duration of symptoms and any precipitating factor for pain of the wrist. These features were compared with patients who had de Quervain's disease. Ultrasonography was used to confirm the clinical diagnosis. Intersection syndrome occurred more frequently in men and in the dominant hand than de Quervain's disease when all the patients were compared and when peripartum women were excluded. It occurred at a younger age than de Quervain's disease only when the comparison excluded peripartum women. Patients with intersection syndrome presented with a much shorter duration of symptoms. These results were consistent with previous reports about occupational factors in intersection syndrome, and might be helpful in the understanding of epidemiological difference between the two conditions. Level 3. © The Author(s) 2015.

  16. From "Buzzword" to Best Practice: Applying Intersectionality to Children Exposed to Intimate Partner Violence.

    Science.gov (United States)

    Etherington, Nicole; Baker, Linda

    2016-03-07

    Empirical studies on the impact of intimate partner violence (IPV) on children have burgeoned over the last three decades. Notably absent from existing approaches to studying children exposed to IPV, however, is attention to how various positionalities intersect to impact the experiences of children and their families. In fact, while the importance of an intersectional framework for understanding IPV has been discussed for over two decades, little or no attention has been given to issues of children's exposure to IPV. In this article, we examine the current state of the literature on children exposed to IPV through an exploratory meta-analysis, finding limited application of intersectionality and a focus on discrete categories of difference. We then demonstrate why and how an intersectional framework should be applied to children exposed to IPV, with specific strategies for research and policy. We suggest a child-centered approach that recognizes diversity among children exposed to IPV, extending the challenge to traditional "one-size-fits-all" models to include an intersectionality-informed stance. © The Author(s) 2016.

  17. Proximal and distal alignment of normal canine femurs: A morphometric analysis.

    Science.gov (United States)

    Kara, Mehmet Erkut; Sevil-Kilimci, Figen; Dilek, Ömer Gürkan; Onar, Vedat

    2018-05-01

    Many researchers are interested in femoral conformation because most orthopaedic problems of the long bones occur in the femur and its joints. The neck-shaft (NSA) and the anteversion (AVA) angles are good predictors for understanding the orientation of the proximal end of the femur. The varus (aLDFA) and procurvatum (CDFA) angles have also been used to understand the orientation of the distal end of the femur. The purposes of this study were to investigate the relationship between the proximal and distal angles of the femur and to compare the distal femoral angles in male and female dogs in order to investigate the sexual dimorphism. The measurements of normal CDFAs, which have not been previously reported, may also provide a database of canine distal femoral morphology. A total of 75 cleaned healthy femora from different breeds or mixed breed of dogs were used. The three-dimensional images were reconstructed from computed tomographic images. The AVA, NSA, aLDFA and CDFA were measured on the 3D images. The correlation coefficients were calculated among the measured angles. The distal femoral angles were also compared between male and female femora. The 95% confidence intervals of the AVA and the NSA were calculated to be 24.22°-29.50° and 144.97°-147.50°, respectively. The 95% confidence intervals of the aLDFA and the CDFA for all studied dogs were 92.62°-94.08° and 89.09°-91.94°, respectively. The NSA showed no correlation with either the aLDFA or CDFA. There was a weak inverse correlation between the AVA and CDFA and a weak positive correlation between the AVA and aLDFA. The differences in the aLDFA and CDFA measurements between male and female dog were not significant. In conclusion, femoral version, regardless of the plane, might have little influence on distal femoral morphology in normal dogs. Besides this, there is no evidence of a sexual dimorphism in the varus and procurvatum angles of the dog distal femur. The data from this study may be used in

  18. An Eco-Driving Advisory System for Continuous Signalized Intersections by Vehicular Ad Hoc Network

    Directory of Open Access Journals (Sweden)

    Wei-Hsun Lee

    2018-01-01

    Full Text Available With the vehicular ad hoc network (VANET technology which support vehicle-to-vehicle (V2V and vehicle to road side unit (V2R/R2V communications, vehicles can preview the intersection signal plan such as signal countdown message. In this paper, an ecodriving advisory system (EDAS is proposed to reduce CO2 emissions and energy consumption by letting the vehicle continuously pass through multiple intersections with the minimum possibilities of stops. We extend the isolated intersection model to multiple continuous intersections scenario. A hybrid method combining three strategies including maximized throughput model (MTM, smooth speed model (SSM, and minimized acceleration and deceleration (MinADM is designed, and it is compared with related works maximized throughput model (MaxTM, open traffic light control model (OTLCM, and predictive cruise control (PCC models. Some issues for the practical application including safe car following, queue clearing, and gliding mode are discussed and conquered. Simulation results show that the proposed model outperforms OTLCM 25.1%~81.2% in the isolated intersection scenario for the CO2 emissions and 20.5%~84.3% in averaged travel time. It also performs better than the compared PCC model in CO2 emissions (19.9%~31.2% as well as travel time (24.5%~35.9% in the multiple intersections scenario.

  19. Belonging and Unbelonging from an Intersectional Perspective

    DEFF Research Database (Denmark)

    Christensen, Ann-Dorte

    2009-01-01

    lives and local communities. The three levels are explained and illustrated with empirical examples from a Nordic context, all based on the perspective of intersectionality between gender, class, race, and ethnicity. Finally, the article discusses some challenges for further research on belonging...

  20. Study on Determination of Preceding Vehicle Motion State at the Traffic Lights Intersection

    Directory of Open Access Journals (Sweden)

    Cailin Wu

    2014-10-01

    Full Text Available In order to enhance the security of automotive safety systems and reduce traffic accidents in traffic lights intersection, In view of this, it is proposed to apply the distance measurement technology of binocular vision ranging in determination of preceding vehicle motion state at the traffic lights intersection, We study the determination of preceding vehicle motion state at the traffic lights intersection based on binocular vision. The system, which is divided into four steps, adopts the theory combining the binocular stereo vision principle and the triangulation principle. First of all, from different angles, image information with preceding vehicles and traffic lights, collected by two CCD cameras, is processed and positioned. Next, two pairs of corresponding feature matching points is obtained by using the stereo matching method. Furthermore, the distance between the cameras and the preceding vehicle, and the distance between the cameras and the traffic lights are determined, according to the camera calibration technique, the parallax disparity principle and the triangulation principle. Finally, the determination about the motion state of traffic lights intersection is determined according to the distance difference principle. Experimental results show that the design, with high measurement accuracy and application value, realize the determination of preceding vehicle’s motion state at traffic lights intersection.

  1. Degrees of Intersectionality: Male Rap Artists in Sweden Negotiating Class, Race and Gender

    Directory of Open Access Journals (Sweden)

    Kalle Berggren

    2013-06-01

    Full Text Available “Intersectionality” has become a highly influential concept in gender research over the last 25 years. Debates have focused on differences and power asymmetries between women, in terms of race but also addressing class, age, sexuality, ability and nation. However, intersectional paradigms have been used to a much lesser extent in gender studies on men. This article seeks to contribute to an emerging discussion about intersectionality and masculinity by analyzing rap lyrics in Swe-dish songs. The data consists of a broad sample of rap lyrics by male artists 1991-2011, which is analyzed through poststructuralist discourse analysis and queer phenomenology. The analysis shows how classed discourses can be described in terms of orientation and flow, how racialization is articulated in terms of place, and the role of normative notions of gender and sexuality in anti-racist discourses. It is argued that this interconnectedness – class being related to race, which in turn is profoundly gendered – is neither well captured by the prevailing notion of “masculinities” in gender studies on men, nor by the “constitution” vs. “addition” dichotomy in intersectionality debates. Instead, it is suggested that degrees of in-tersectionality might be a more fruitful way of theorizing intersectionality in rela-tion to men.

  2. Clinical study for pancreatic fistula after distal pancreatectomy with mesh reinforcement

    Directory of Open Access Journals (Sweden)

    Akira Hayashibe

    2018-05-01

    Full Text Available Summary: Background: The purpose of this cohort study was to determine whether distal pancreatectomy with mesh reinforcement can reduce postoperative pancreatic fistula (POPF rates compared with bare stapler. Methods: In total, 51 patients underwent stapled distal pancreatectomy. Out of these, 22 patients (no mesh group underwent distal pancreatectomy with bare stapler and 29 patients (mesh group underwent distal pancreatectomy with mesh reinforced stapler. The risk factor for clinically relevant POPF (grades B and C after distal pancreatectomy was also evaluated. Results: Clinical characteristics were almost similar in both the groups. The days of the mean hospital stay and drainage tube insertion in the mesh group were significantly fewer than those in the no mesh group. The mean level of amylase in the discharge fluid in the mesh group was also significantly lower than that the in no mesh group. The rate of clinically relevant POPF (grades B and C in the mesh group was significantly lower than that in the no mesh group (p=0.016. Univariate analyses of risk factors for POPF (grades B and C revealed that only mesh reinforcement was associated with POPF (grades B and C. Moreover, on multivariate analyses of POPF risk factors with p value<0.2 in univariate analyses by logistic regression, mesh reinforcement was regarded as a significant factor for POPF(grades B and C. Conclusions: The distal pancreatectomy with mesh reinforced stapler was thought to be favorable for the prevention of clinically relevant POPF (grades B and C. Keywords: mesh reinforcement, pancreatic fistula, pancreatic surgery

  3. Chronic Obstructive Pulmonary Disease in Sweden: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy

    Directory of Open Access Journals (Sweden)

    Sten Axelsson Fisk

    2018-04-01

    Full Text Available Socioeconomic, ethnic and gender disparities in Chronic Obstructive Pulmonary Disease (COPD risk are well established but no studies have applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA within an intersectional framework to study this outcome. We study individuals at the first level of analysis and combinations of multiple social and demographic categorizations (i.e., intersectional strata at the second level of analysis. Here we used MAIHDA to assess to what extent individual differences in the propensity of developing COPD are at the intersectional strata level. We also used MAIHDA to determine the degree of similarity in COPD incidence of individuals in the same intersectional stratum. This leads to an improved understanding of risk heterogeneity and of the social dynamics driving socioeconomic and demographic disparities in COPD incidence. Using data from 2,445,501 residents in Sweden aged 45–65, we constructed 96 intersectional strata combining categories of age, gender, income, education, civil- and migration status. The incidences of COPD ranged from 0.02% for young, native males with high income and high education who cohabited to 0.98% for older native females with low income and low education who lived alone. We calculated the intra-class correlation coefficient (ICC that informs on the discriminatory accuracy of the categorizations. In a model that conflated additive and interaction effects, the ICC was good (20.0%. In contrast, in a model that measured only interaction effects, the ICC was poor (1.1% suggesting that most of the observed differences in COPD incidence across strata are due to the main effects of the categories used to construct the intersectional matrix while only a minor share of the differences are attributable to intersectional interactions. We found conclusive interaction effects. The intersectional MAIHDA approach offers improved information to guide public health

  4. Examining our privileges and oppressions: incorporating an intersectionality paradigm into nursing.

    Science.gov (United States)

    Van Herk, Kimberley A; Smith, Dawn; Andrew, Caroline

    2011-03-01

    An intersectionality paradigm is a means by which nurses can attend to issues of oppression and privilege within their practice and profession. Intersectionality is introduced as an essential theory to help debunk the hegemony of the 'white, middle class' perspective that often directs nursing research, practice, and education. The values and benefits of using an intersectionality paradigm in nursing are shown through recent research done with Aboriginal women. These findings contribute to an increased understanding of the importance and necessity of attending to the power relations that dominate nursing care encounters and influence the way nurses provide care. By acknowledging and responding to the presence of privilege and oppression and the associated power dynamics within the therapeutic encounter, nursing can strive further in helping to alleviate social injustices and health disparities that arise from unequal power relations. © 2011 Blackwell Publishing Ltd.

  5. Vehicular traffic flow at an intersection with the possibility of turning

    International Nuclear Information System (INIS)

    Foulaadvand, M Ebrahim; Belbasi, Somayyeh

    2011-01-01

    We have developed a Nagel-Schreckenberg cellular automata model for describing a vehicular traffic flow at a single intersection. A set of traffic lights operating in a fixed-time scheme controls the traffic flow. An open boundary condition is applied to the streets each of which conducts a unidirectional flow. Streets are single lane and cars can turn upon reaching to the intersection with prescribed probabilities. Extensive Monte Carlo simulations are carried out to find the model flow characteristics. In particular, we investigate the flow dependence on signalization parameters, turning probabilities and input rates. It is shown that for each set of parameters, there exists a plateau region inside which the total outflow from the intersection remains almost constant. We also compute total waiting time of vehicles per cycle behind red lights for various control parameters.

  6. Application of FEM analysis methods to a cylinder-cylinder intersection structure

    International Nuclear Information System (INIS)

    Xue Liping; Widera, G.E.O.; Sang Zhifu

    2005-01-01

    The objective of this paper is to study a particular cylindrical shell intersection (d/D=0.526) by use of both linear elastic and elastic-plastic stress analyses via the finite element method using the FEA software ANSYS. The former mainly focuses on the calculation of the stress concentration and flexibility factors in the intersection area before the structure experiences plastic behavior. When an elastic-plastic analysis method is employed, the limit load and burst pressure need to be determined. In this study, two different methods, the 'double elastic-slope method' and the 'tangent intersection method' are both employed to determine the limit pressure. To predict the burst pressure and failure location, the 'arc-length method' in ANSYS is used to solve the nonlinear problem. Finally, the FEA results are compared to experimental data and the agreement is shown to be good. (authors)

  7. Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer

    NARCIS (Netherlands)

    Gurusamy, K.S.; Riviere, D.M.; Laarhoven, C.J.H.M. van; Besselink, M.; Abu-Hilal, M.; Davidson, B.R.; Morris, S.

    2017-01-01

    BACKGROUND: A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic

  8. Intersphincteric Resection and Coloanal Anastomosis in Treatment of Distal Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Gokhan Cipe

    2012-01-01

    Full Text Available In the treatment of distal rectal cancer, abdominoperineal resection is traditionally performed. However, the recognition of shorter safe distal resection line, intersphincteric resection technique has given a chance of sphincter-saving surgery for patients with distal rectal cancer during last two decades and still is being performed as an alternative choice of abdominoperineal resection. The first aim of this study is to assess the morbidity, mortality, oncological, and functional outcomes of intersphincteric resection. The second aim is to compare outcomes of patients who underwent intersphincteric resection with the outcomes of patients who underwent abdominoperineal resection.

  9. Valgusdeformitet i anklen som følge af distal fibula-epifysefraktur

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid

    2011-01-01

    Ankle fracture with involvement of the growth plate is the second most common paediatric fracture after the distal radius. The most common fracture type according to Salter Harris (SH) is type II of the distal tibia combined with green stick of the fibula. Isolated fracture of the distal fibular...... growth plate is not common and as a rule it does not give any growth arrest. We describe a case of isolated fibular fracture SH type II in a ten year-old girl which ended with symptomatic valgus deformity of the ankle. The patient was operated with good results....

  10. Intelligent Agent Based Traffic Signal Control on Isolated Intersections

    Directory of Open Access Journals (Sweden)

    Daniela Koltovska

    2014-08-01

    Full Text Available The purpose of this paper is to develop an adaptive signal control strategy on isolated urban intersections. An innovative approach to defining the set of states dependent on the actual and primarily observed parameters has been introduced. ?he Q–learning algorithm has been applied. The developed self-learning adaptive signal strategy has been tested on a re?l intersection. The intelligent agent results have been compared to those in cases of fixed-time and actuated control. Regarding the average total delay, the total number of stops and the total throughput, the best results have been obtained for unknown traffic demand and over-capacity.

  11. Modal intersection types, two-level languages, and staged synthesis

    DEFF Research Database (Denmark)

    Henglein, Fritz; Rehof, Jakob

    2016-01-01

    -linguistic framework for staged program synthesis, where metaprograms are automatically synthesized which, when executed, generate code in a target language. We survey the basic theory of staged synthesis and illustrate by example how a two-level language theory specialized from λ∩ ⎕ can be used to understand......A typed λ-calculus, λ∩ ⎕, is introduced, combining intersection types and modal types. We develop the metatheory of λ∩ ⎕, with particular emphasis on the theory of subtyping and distributivity of the modal and intersection type operators. We describe how a stratification of λ∩ ⎕ leads to a multi...... the process of staged synthesis....

  12. Holomorphic Yukawa couplings for complete intersection Calabi-Yau manifolds

    Energy Technology Data Exchange (ETDEWEB)

    Blesneag, Stefan [Rudolf Peierls Centre for Theoretical Physics, Oxford University,1 Keble Road, Oxford, OX1 3NP (United Kingdom); Buchbinder, Evgeny I. [The University of Western Australia,35 Stirling Highway, Crawley WA 6009 (Australia); Lukas, Andre [Rudolf Peierls Centre for Theoretical Physics, Oxford University,1 Keble Road, Oxford, OX1 3NP (United Kingdom)

    2017-01-27

    We develop methods to compute holomorphic Yukawa couplings for heterotic compactifications on complete intersection Calabi-Yau manifolds, generalising results of an earlier paper for Calabi-Yau hypersurfaces. Our methods are based on constructing the required bundle-valued forms explicitly and evaluating the relevant integrals over the projective ambient space. We also show how our approach relates to an earlier, algebraic one to calculate the holomorphic Yukawa couplings. A vanishing theorem, which we prove, implies that certain Yukawa couplings allowed by low-energy symmetries are zero due to topological reasons. To illustrate our methods, we calculate Yukawa couplings for SU(5)-based standard models on a co-dimension two complete intersection manifold.

  13. Epidemiology of distal forearm fractures in Oslo, Norway.

    Science.gov (United States)

    Lofthus, C M; Frihagen, F; Meyer, H E; Nordsletten, L; Melhuus, K; Falch, J A

    2008-06-01

    The population of Oslo has the highest incidence of hip fracture reported. The present study shows that the overall incidence of distal forearm fractures in Oslo is higher than in other countries and has not changed significantly when comparing the incidence of 1998/99 with 1979. The population of Oslo has the highest incidence of hip fracture reported. The present study reports the incidence of distal forearm fracture in Oslo and the fracture rates of immigrants. Patients aged > or = 20 years resident in Oslo sustaining a distal forearm fracture in a one-year period in 1998/99 were identified using electronic diagnosis registers, patient protocols, and/or X-ray registers of the clinics in Oslo. Medical records were obtained and the diagnosis verified. The age- and sex-specific incidence rates were calculated and compared with those for 1979. Data on immigrant category and country of origin of the patients were obtained. The age-adjusted fracture rates per 10,000 for the age group > or = 50 years were 109.8 and 25.4 in 1998/99 compared with 108.3 and 23.5 in 1979 for women and men, respectively (n.s.). The relative risk of fracture in Asians was 0.72 (95% CI 0.53-1.00) compared with ethnic Norwegians. The overall incidence of distal forearm fractures in Oslo is higher than in other countries and has not changed significantly when comparing the incidence of 1998/99 with 1979. Furthermore, the present data suggest that Asian immigrants in Oslo have a slightly lower fracture risk than ethnic Norwegians.

  14. Autosomal dominant distal myopathy: Linkage to chromosome 14

    Energy Technology Data Exchange (ETDEWEB)

    Laing, N.G.; Laing, B.A.; Wilton, S.D.; Dorosz, S.; Mastaglia, F.L.; Kakulas, B.A. [Australian Neuromuscular Research Institute, Perth (Australia); Robbins, P.; Meredith, C.; Honeyman, K.; Kozman, H.

    1995-02-01

    We have studied a family segregating a form of autosomal dominant distal myopathy (MIM 160500) and containing nine living affected individuals. The myopathy in this family is closest in clinical phenotype to that first described by Gowers in 1902. A search for linkage was conducted using microsatellite, VNTR, and RFLP markers. In total, 92 markers on all 22 autosomes were run. Positive linkage was obtained with 14 of 15 markers tested on chromosome 14, with little indication of linkage elsewhere in the genome. Maximum two-point LOD scores of 2.60 at recombination fraction .00 were obtained for the markers MYH7 and D14S64 - the family structure precludes a two-point LOD score {ge} 3. Recombinations with D14S72 and D14S49 indicate that this distal myopathy locus, MPD1, should lie between these markers. A multipoint analysis assuming 100% penetrance and using the markers D14S72, D14S50, MYH7, D14S64, D14S54, and D14S49 gave a LOD score of exactly 3 at MYH7. Analysis at a penetrance of 80% gave a LOD score of 2.8 at this marker. This probable localization of a gene for distal myopathy, MPD1, on chromosome 14 should allow other investigators studying distal myopathy families to test this region for linkage in other types of the disease, to confirm linkage or to demonstrate the likely genetic heterogeneity. 24 refs., 3 figs., 1 tab.

  15. The Effect of Gender and Race Intersectionality on Student Learning Outcomes in Engineering

    Science.gov (United States)

    Ro, Hyun Kyoung; Loya, Karla I.

    2015-01-01

    Women and underrepresented minorities in traditionally White and male-dominated disciplines tend to report lower learning outcomes than their White peers. Adopting a feminist intersectionality framework, this study looks at the intersections of gender and race to investigate differences in self-assessed learning outcomes in engineering…

  16. Compelling Diversities, Educational Intersections: Policy, Practice, Parity

    Science.gov (United States)

    Taylor, Yvette

    2013-01-01

    The ninth international Gender and Education Association Conference "Compelling Diversities, Educational Intersections" hosted by the Weeks Centre for Social and Policy Research, London South Bank University engages with key debates surrounding the interplay between dynamics of education, work, employment and society in the context of…

  17. Performance Beyond The Binary: Towards An Intersectional And Intersexual Theatrical Discourse

    OpenAIRE

    Orlando, Josh

    2017-01-01

    AbstractPerformance Beyond The Binary:Towards An Intersectional And Intersexual Theatrical DiscourseMy research is rooted in post-structural feminist, intersectional, and queer theories. This thesis seeks to ignite a discursive dialogue about the sociopolitical reinforcement of the western gender binary in the theater. By drawing on political theories that highlight gender as an anti-essentialist product of culture (a social construct), I seek to discuss my methodologies of adapting these the...

  18. Distal Oblique Bundle Reinforcement for Treatment of DRUJ Instability.

    Science.gov (United States)

    Brink, Peter R G; Hannemann, Pascal F W

    2015-08-01

    Background Chronic, dynamic bidirectional instability in the distal radioulnar joint (DRUJ) is diagnosed clinically, based on the patient's complaints and the finding of abnormal laxity in the vicinity of the distal ulna. In cases where malunion is ruled out or treated and there are no signs of osteoarthritis, stabilization of the DRUJ may offer relief. To this end, several different techniques have been investigated over the past 90 years. Materials and Methods In this article we outline the procedure for a new technique using a tendon graft to reinforce the distal edge of the interosseous membrane. Description of Technique A percutaneous technique is used to harvest the palmaris longus tendon and to create a tunnel, just proximal to the sigmoid notch, through the ulna and radius in an oblique direction. By overdrilling the radial cortex, the knotted tendon can be pulled through the radius and ulna and the knot blocked at the second radial cortex, creating a strong connection between the radius and ulna at the site of the distal oblique bundle (DOB). The tendon is fixed in the ulna with a small interference screw in full supination, preventing subluxation of the ulna out of the sigmoid notch during rotation. Results Fourteen patients were treated with this novel technique between 2011 and October 2013. The QuickDASH score at 25 months postoperatively (range 16-38 months) showed an improvement of 32 points. Similarly, an improvement of 33 points (67-34 months) was found on the PRWHE. Only one recurrence of chronic, dynamic bidirectional instability in the DRUJ was observed. Conclusion This simple percutaneous tenodesis technique between radius and ulna at the position of the distal edge of the interosseous membrane shows promise in terms of both restoring stability and relieving complaints related to chronic subluxation in the DRUJ.

  19. Intersection democracy for winding branes and stabilization of extra dimensions

    International Nuclear Information System (INIS)

    Rador, Tonguc

    2005-01-01

    We show that, in the context of pure Einstein gravity, a democratic principle for intersection possibilities of branes winding around extra dimensions in a given partitioning yield stabilization, while what the observed space follows is matter-like dust evolution. Here democracy is used in the sense that, in a given decimation of extra dimensions, all possible wrappings and hence all possible intersections are allowed. Generally, the necessary and sufficient condition for this is that the dimensionality m of the observed space dimensions obey 3= =3, where N is the decimation order of the extra dimensions

  20. Traumatisk distal humerus-epifysiolyse hos nyfødt

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid; Nielsen, Keld Daubjerg

    2010-01-01

    Traumatic distal humerus epiphysiolysis (TDHE) is a rare injury in infants with an incidence of about 1:35,000 births. It is primarily a birth injury, but it is also seen in cases of battered child syndrome. Because of its rare occurrence and the diagnostic difficulties, the lesion may be overloo......Traumatic distal humerus epiphysiolysis (TDHE) is a rare injury in infants with an incidence of about 1:35,000 births. It is primarily a birth injury, but it is also seen in cases of battered child syndrome. Because of its rare occurrence and the diagnostic difficulties, the lesion may...

  1. Miyoshi-type distal muscular dystrophy. Clinical spectrum in 24 Dutch patients

    NARCIS (Netherlands)

    Linssen, W. H.; Notermans, N. C.; van der Graaf, Y.; Wokke, J. H.; van Doorn, P. A.; Höweler, C. J.; Busch, H. F.; de Jager, A. E.; de Visser, M.

    1997-01-01

    Miyoshi-type distal muscular dystrophy has now been found to be more frequent outside Japan than was previously thought. We studied 24 Dutch patients with Miyoshi-type distal muscular dystrophy and focused on its clinical expression and natural history, muscle CT-scans and muscle biopsy findings.

  2. Miyoshi-type distal muscular dystrophy. Clinical spectrum in 24 Dutch patients

    NARCIS (Netherlands)

    W.H.J.P. Linssen (Wim); N.C. Notermans (Nicolette); Y. van der Graaf (Yolanda); J.H.J. Wokke (John); P.A. van Doorn (Pieter); C.J. Höweler (Chris); H.F.M. Busch (Herman); A.E.J. de Jager (Aeiko); M. de Visser (Marianne)

    1997-01-01

    textabstractMiyoshi-type distal muscular dystrophy has now been found to be more frequent outside Japan than was previously thought. We studied 24 Dutch patients with Miyoshi-type distal muscular dystrophy and focused on its clinical expression and natural history muscle CT-scans and muscle biopsy

  3. Miyoshi-type distal muscular dystrophy - Clinical spectrum in 24 Dutch patients

    NARCIS (Netherlands)

    Linssen, WHJP; Notermans, NC; VanderGraaf, Y; Wokke, JHJ; VanDoorn, PA; Howeler, CJ; Busch, HFM; DeJager, AEJ; DeVisser, M

    1997-01-01

    Miyoshi-type distal muscular dystrophy has now been found to be more frequent outside Japan than was previously thought. We studied 24 Dutch patients with Miyoshi-type distal muscular dystrophy and focused on its clinical expression and natural history, muscle CT-scans and muscle biopsy findings.

  4. HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex.

    Science.gov (United States)

    Keltner, John R; Connolly, Colm G; Vaida, Florin; Jenkinson, Mark; Fennema-Notestine, Christine; Archibald, Sarah; Akkari, Cherine; Schlein, Alexandra; Lee, Jisu; Wang, Dongzhe; Kim, Sung; Li, Han; Rennels, Austin; Miller, David J; Kesidis, George; Franklin, Donald R; Sanders, Chelsea; Corkran, Stephanie; Grant, Igor; Brown, Gregory G; Atkinson, J Hampton; Ellis, Ronald J

    2017-03-01

    . Despite modern antiretroviral therapy, HIV-associated neuropathy is one of the most prevalent, disabling and treatment-resistant complications of HIV disease. The presence and intensity of distal neuropathic pain is not fully explained by the degree of peripheral nerve damage. A better understanding of brain structure in HIV distal neuropathic pain may help explain why some patients with HIV neuropathy report pain while the majority does not. Previously, we reported that more intense distal neuropathic pain was associated with smaller total cerebral cortical gray matter volumes. The objective of this study was to determine which parts of the cortex are smaller. . HIV positive individuals with and without distal neuropathic pain enrolled in the multisite (N = 233) CNS HIV Antiretroviral Treatment Effects (CHARTER) study underwent structural brain magnetic resonance imaging. Voxel-based morphometry was used to investigate regional brain volumes in these structural brain images. . Left ventral posterior cingulate cortex was smaller for HIV positive individuals with versus without distal neuropathic pain (peak P  = 0.017; peak t = 5.15; MNI coordinates x = -6, y = -54, z = 20). Regional brain volumes within cortical gray matter structures typically associated with pain processing were also smaller for HIV positive individuals having higher intensity ratings of distal neuropathic pain. . The posterior cingulate is thought to be involved in inhibiting the perception of painful stimuli. Mechanistically a smaller posterior cingulate cortex structure may be related to reduced anti-nociception contributing to increased distal neuropathic pain. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. Classification of Distal Fingertip Amputation Based on the Arterial System for Replantation

    OpenAIRE

    Park, Hyun Chul; Bahar-Moni, Ahmed Suparno; Cho, Sang Hyun; Kim, Sang Soo; Park, Hyun Sik; Ahn, Sang Cheon

    2012-01-01

    During replantation of distal fingertip amputation, identification of the artery is the most important but time consuming procedure. Depending on the damaged arterial structure, we classified distal fingertip amputations into 4 zones, on the basis of three dimensional concept. Zone 1 injury was defined as damage to the proximal central pulp artery; zone 2 injury, damage to the branch of the central pulp artery; zone 3 injury, damage to the distal central pulp artery; and zone 4 injury, no inj...

  6. Analysis and methods of improvement of safety at high-speed rural intersections : appendix B.

    Science.gov (United States)

    2012-04-01

    Since 2006, INDOT has been preparing an annual fivepercent report that identifies intersections and segments on Indiana state roads that require attention due to the excessive number and severity of crashes. Many of the identified intersections ar...

  7. Stepfamilies: The Intersection of Culture, Context, and Biology.

    Science.gov (United States)

    Bray, James

    1999-01-01

    Discusses five areas concerning Heatherington et al.'s study: nature and nurture issues; deviance versus normative behavior in stepfamilies; context and meaning in different types of families; intersecting developmental trajectories; and gender differences. (JPB)

  8. Distal radioulnar joint: functional anatomy, including pathomechanics.

    Science.gov (United States)

    Haugstvedt, J R; Langer, M F; Berger, R A

    2017-05-01

    The distal radioulnar joint allows the human to rotate the forearm to place the hand in a desired position to perform different tasks, without interfering with the grasping function of the hand. The ulna is the stable part of the forearm around which the radius rotates; the stability of the distal radioulnar joint is provided by the interaction between ligaments, muscles and bones. The stabilizing structures are the triangular fibrocartilage complex, the ulnocarpal ligament complex, the extensor carpi ulnaris tendon and tendon sheath, the pronator quadratus, the interosseous membrane and ligament, the bone itself and the joint capsule. The purpose of this review article is to present and illustrate the current understanding of the functional anatomy and pathomechanics of this joint.

  9. A Fully-Distributed Heuristic Algorithm for Control of Autonomous Vehicle Movements at Isolated Intersections

    Directory of Open Access Journals (Sweden)

    Abdallah A. Hassan

    2014-12-01

    Full Text Available Optimizing autonomous vehicle movements through roadway intersections is a challenging problem. It has been demonstrated in the literature that traditional traffic control, such as traffic signal and stop sign control are not optimal especially for heavy traffic demand levels. Alternatively, centralized autonomous vehicle control strategies are costly and not scalable given that the ability of a central controller to track and schedule the movement of hundreds of vehicles in real-time is questionable. Consequently, in this paper a fully distributed algorithm is proposed where vehicles in the vicinity of an intersection continuously cooperate with each other to develop a schedule that allows them to safely proceed through the intersection while incurring minimum delay. Unlike other distributed approaches described in the literature, the wireless communication constraints are considered in the design of the control algorithm. Specifically, the proposed algorithm requires vehicles heading to an intersection to communicate only with neighboring vehicles, while the lead vehicles on each approach lane share information to develop a complete intersection utilization schedule. The scheduling rotates between vehicles to identify higher traffic volumes and favor vehicles coming from heavier lanes to minimize the overall intersection delay. The simulated experiments show significant reductions in the average delay using the proposed approach compared to other methods reported in the literature and reduction in the maximum delay experienced by a vehicle especially in cases of heavy traffic demand levels.

  10. Exploring Intersections between Teenage Pregnancy and Gender

    African Journals Online (AJOL)

    Explorer les intersections entre la grossesse des adolescentes et les violences sexistes ... course may result to sexually transmitted dis- ... ployment options in later life. ... social and cultural context in which particular .... communication processes between males and fe- .... It was drawn up in order to stress that violence.

  11. Complete mucosal healing of distal lesions induced by twice-daily budesonide 2-mg foam promoted clinical remission of mild-to-moderate ulcerative colitis with distal active inflammation: double-blind, randomized study.

    Science.gov (United States)

    Naganuma, Makoto; Aoyama, Nobuo; Tada, Tomohiro; Kobayashi, Kiyonori; Hirai, Fumihito; Watanabe, Kenji; Watanabe, Mamoru; Hibi, Toshifumi

    2018-04-01

    Budesonide foam is used for the topical treatment of distal ulcerative colitis. This phase III study was performed to confirm mucosal healing and other therapeutic effects of twice-daily budesonide 2-mg foam in patients with mild-to-moderate ulcerative colitis including left-sided colitis and pancolitis. This was a multicenter, randomized, placebo-controlled, double-blind trial. A total of 126 patients with mild-to-moderate ulcerative colitis with active inflammation in the distal colon were randomized to two groups receiving twice-daily budesonide 2 mg/25 ml foam or placebo foam. The primary endpoint was the percentage of complete mucosal healing of distal lesions (endoscopic subscore of 0) at week 6. Some patients continued the treatment through week 12. Drug efficacy and safety were evaluated. The percentages of both complete mucosal healing of distal lesions and clinical remission were significantly improved in the budesonide as compared with the placebo group (p = 0.0003 and p = 0.0035). Subgroup analysis showed similar efficacy of budesonide foam for complete mucosal healing of distal lesions and clinical remission regardless of disease type. The clinical remission percentage tended to be higher in patients achieving complete mucosal healing of distal lesions than in other patients. There were no safety concerns with budesonide foam. This study confirmed for the first time complete mucosal healing with twice-daily budesonide 2-mg foam in mild-to-moderate ulcerative colitis with distal active inflammation. The results also indicated that complete mucosal healing of distal lesions by budesonide foam promotes clinical remission of ulcerative colitis. Clinical trial registration no.: Japic CTI-142704.

  12. Efficiency and safety of percuSurge distal protection device in acute ...

    African Journals Online (AJOL)

    user

    2011-04-25

    Apr 25, 2011 ... myocardial infarction. The long-term effects of the distal protection device are still in controversy. The enhanced myocardial efficacy and recovery by aspiration of liberated debris (EMERALD) trial failed to show the effectiveness of the distal protection device in patients with AMI (Yamada and Topol, 2000).

  13. Increasing Capacity of Intersections with Transit Priority

    Directory of Open Access Journals (Sweden)

    Yanxi Hao

    2016-12-01

    Full Text Available Dedicated bus lane (DBL and transit signal priority (TSP are two effective and low-cost ways of improving the reliability of transits. However, these strategies reduce the capacity of general traffic. This paper presents an integrated optimization (IO model to improve the performance of intersections with dedicated bus lanes. The IO model integrated geometry layout, main-signal timing, pre-signal timing and transit priority. The optimization problem is formulated as a Mix-Integer-Non-Linear-Program (MINLP that can be transformed into a Mix-Integer-Linear-Program (MILP and then solved by the standard branch-and-bound technique. The applicability of the IO model is tested through numerical experiment under different intersection layouts and traffic demands. A VISSIM micro simulation model was developed and used to evaluate the performance of the proposed IO model. The test results indicate that the proposed model can increase the capacity and reduce the delay of general traffic when providing priority to buses.

  14. Intersections between particle and nuclear physics

    International Nuclear Information System (INIS)

    Bunce, G.M.

    1988-01-01

    This report contains papers from an AIP conference on the intersections between particle and nuclear physics. Some of the general topics covered are: Accelerator physics; Antiproton physics; Electron and muon physics; Hadron scattering; Hadron spectroscopy; Meson and lepton decays; Neutrino physics; Nonaccelerator and astrophysics; Relativistic heavy-ion physics; and Spin physics. There are 166 papers that will be processed separately

  15. Tratamiento quirúrgico de la falange distal bífida por traumatismo de mano en la infancia Tratamento cirurgico de falange distal bifida pós traumatismo de mão na infância Surgical treatment of distal bifid phalanx post of hand trauma in childhood

    Directory of Open Access Journals (Sweden)

    F. Passos da Rocha

    2011-03-01

    Full Text Available La extremidad distal de los dedos es la parte de la mano que más frecuentemente se lesiona. Las principales complicaciones que pueden derivar de ese tipo de lesiones traumáticas incluyen: infecciones, retracciones de la piel, deformidades óseas y amputaciones. El presente artículo tiene como objetivo presentar el tratamiento quirúrgico seguido en un pacientes de 16 años que sufrió traumatismo sobre la falange distal del segundo dedo de la mano derecha a los 2 años de edad, a consecuencia del cual se produjo deformidad ósea y falange bífida asociada a retracción de la piel en el punto de la lesión.A extremidade distal dos dedos é a parte da mão mais freqüentemente lesionada. As principais complicações que podem ocorrer como conseqüências dessas lesões traumáticas incluem: as infecções, as retrações da pele, as deformidades ósseas e as amputações. O presente trabalho tem como objetivo relatar o tratamento cirúrgico de um paciente de 16 anos que sofreu um trauma na falange distal do segundo dedo da mão direita aos dois anos de idade, resultando em deformidade óssea e falange distal bífida associada a retração de pele no local onde ocorreu a lesão.The distal extremity of the fingers of the hand is the most frequently injured. The main complications that can occur as a result of these traumatic injuries include: infections, retraction of the skin, bone deformities and amputations. This article aims to report the surgical treatment of a 16 years old patient who suffered a trauma in the distal phalanx of the second finger of right hand when he was 2 years old, resulting in bone deformity and distal phalanx bifid associated with retraction of the skin at the site where the injury occurred.

  16. The statistics of the points where nodal lines intersect a reference curve

    International Nuclear Information System (INIS)

    Aronovitch, Amit; Smilansky, Uzy

    2007-01-01

    We study the intersection points of a fixed planar curve Γ with the nodal set of a translationally invariant and isotropic Gaussian random field Ψ(r) and the zeros of its normal derivative across the curve. The intersection points form a discrete random process which is the object of this study. The field probability distribution function is completely specified by the correlation G(|r - r'|) = (Ψ(r)Ψ(r')). Given an arbitrary G(|r - r'|), we compute the two-point correlation function of the point process on the line, and derive other statistical measures (repulsion, rigidity) which characterize the short- and long-range correlations of the intersection points. We use these statistical measures to quantitatively characterize the complex patterns displayed by various kinds of nodal networks. We apply these statistics in particular to nodal patterns of random waves and of eigenfunctions of chaotic billiards. Of special interest is the observation that for monochromatic random waves, the number variance of the intersections with long straight segments grows like Lln L, as opposed to the linear growth predicted by the percolation model, which was successfully used to predict other long-range nodal properties of that field

  17. Traffic Safety of Older Drivers in Various Types of Road Intersections

    Directory of Open Access Journals (Sweden)

    Tomaž Tollazzi

    2010-05-01

    Full Text Available In industrialized countries people over 50 years of age represent a rapidly growing part of population. Their lifestyle is also becoming more active, which means that the percentage of older drivers in the population of all drivers is also increasing. Many different studies have shown that elderly drivers are more frequently involved in specific types of accidents, especially at intersections. In the past 15 years there was a trend of increasing popularity of roundabouts in Slovenia. Their introduction was generally supported by the arguments of increased traffic-flow capacity and traffic safety as well. The studies on which these arguments are based were performed with an “ideal” type of driver in mind; the one that fully understands new rules and reacts correctly in all situations that may occur at such intersections, where there are no light signals to guide them. An elderly person does not necessarily conform to that ideal and if the percentage of elderly drivers became significant, the premises of the above mentioned studies may not be correct anymore which in turn implies that their results could also be questioned. The present study concentrated on the evaluation of traffic safety of elderly drivers, at various types of intersection, from their own perspective. Various statistical analyses of obtained data were performed. The most important finding was that we may claim, with high degree of probability, that the average person of the age of over 60 feels more unsafe at double-lane roundabouts than they would feel had the same intersection been equipped with traffic lights. Elderly traffic participants will always cause more accidents or participate in them due to hazardous factors. Challenge, arising from many different studies and researches, is in studying what measures and solutions can reduce the risk for elderly participants. KEYWORDS: traffic safety, road intersections, roundabouts, elderly people, older drivers

  18. Intersection negotiation problems of older drivers. Volume 1

    Science.gov (United States)

    1998-09-01

    This project included a background literature synthesis and observational field study. The research goals were to document driving problems and errors at intersections, for older drivers using their own cars to travel familiar and unfamiliar routes, ...

  19. Exploring Intersections between Teenage Pregnancy and Gender ...

    African Journals Online (AJOL)

    A qualitative study of teenage pregnancy was conducted over a period of three months in 1996 in Bulawayo, Zimbabwe. Interviews with teenage mothers and fathers gave reason to explore the various intersections between teenage pregnancy and gender violence. Gender violence is defined as acts of force or coercion ...

  20. Teaching Science from Cultural Points of Intersection

    Science.gov (United States)

    Grimberg, Bruna Irene; Gummer, Edith

    2013-01-01

    This study focuses on a professional development program for science teachers near or on American Indian reservations in Montana. This program was framed by culturally relevant pedagogy premises and was characterized by instructional strategies and content foci resulting from the intersection between three cultures: tribal, science teaching, and…

  1. Intersection of neighbourhood structure, parenting and externalizing ...

    African Journals Online (AJOL)

    Little is known about parenting practices and how it intersects with neighbourhood structure and externalizing behaviour, in South Africa. This chapter presents the findings of parental reflections on neighbourhood structure and problem behaviours, which is one component of a study, that is situated within a child safety, ...

  2. Distal vein patch as a form of autologus modification for infragenicular prosthetic bypass.

    Science.gov (United States)

    Totic, Dragan; Rustempasic, Nedzad; Djedovic, Muhamed; Solakovic, Sid; Vukas, Haris; Aslani, Ilijas; Krvavac, Alma; Rudalija, Dzejra; Ahmetasevic, Alen

    2013-01-01

    Preferred graft for infragenicular bypass is autologus vein. The problem is when there is not available autologus vein. Literature suggest that in these situations, prosthetic graft with some form of modification of distal anastomosis with autogenic tissue is valuable adjunctive. Frequently used modifications are Miller's cuff, Taylor's patch and St. Mary's boot. Recently, there are reports on "Distal vein patch" as a form of autologus modification which, due to its simplicity and patency rate, attracted attention. The aim of this study was to evaluate benefits of this novel modification by comparing its patencies with other autologus modification of distal anastomosis. Study was performed on 60 patients, diabetics, with critical limb ischemia (CLI). Patients were divided in two groups: Group with distal vein patch modification; and group with some other form modification - control group. Patients were followed at least 22 months. We examined patency of grafts by physical examination or using Color Doppler. For statistical purposes we used KIaplan Meier analysis and curve. Significance was determined by Mann-Whitney, Fisher's exact, Pearsons chi square or Student T test as appropriate. P value less than 0,05 was considered significant. Groups were fairly matched relative to demographics, risk factors, operative intervention and distal anastomosis site. There was not statistical difference in two year primary patency between distal vein patch and control group--50% vs 53% respectivly (X2 = 0,08; p = 0,773). Also, there was not statistically significant difference in extremity survival (77% vs 77%) and patient survival between groups (89% vs 93%; X2 = 2,458; p = 0,117). This study proved equivalent patencies of infragenicular prosthetic bypasses performed using distal vein patch technique as with any other modification of distal anastomosis.

  3. Management and treatment of distal ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Andrea Calafiore

    2013-12-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

  4. Left ventricular contractile function after distal protection in primary percutaneous coronary intervention Results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial

    DEFF Research Database (Denmark)

    Kofoed, K F; Kelbæk, H; Thuesen, L

    2011-01-01

    Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.......Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function....

  5. Fractures of the distal tibia treated with polyaxial locking plating.

    Science.gov (United States)

    Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

    2009-03-01

    We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial infections and evidence of delayed wound healing. Using the American Orthopaedic Foot and Ankle Society ankle score, the average functional score was 87.3 points (of 100 total possible points). Our results show the polyaxial locking plates, which offer more fixation versatility, may be a reasonable treatment option for distal tibia fractures with very short metaphyseal segments.

  6. Vertebral artery origin stent placement with distal protection: technical and clinical results.

    Science.gov (United States)

    Qureshi, A I; Kirmani, J F; Harris-Lane, P; Divani, A A; Ahmed, S; Ebrihimi, A; Al Kawi, A; Janjua, N

    2006-05-01

    To report the feasibility, safety, and 1-month results of performing stent placement for vertebral origin stenosis with the use of a distal protection device. Distal protection devices have been shown to reduce the number of cerebral emboli and subsequent ischemic events when used as adjuncts to percutaneous carotid intervention; however, one case of the use of a distal protection device for vertebral artery has been reported in the literature. We retrospectively determined rates of technical success and 1-month stroke or death associated with stent placement by using distal protection (Filter EX; Boston Scientific, Natick, Mass) in patients with symptomatic vertebral artery origin stenosis. Technical success was defined as successful deployment of distal protection device and stent at target lesion followed by successful retrieval of the device and a final residual stenosis of less than 30%. Other outcomes ascertained included any stroke, death, and semiquantitative assessment of particulate material retained by the filter device. The mean age of the 12 treated patients was 68 years (range, 52-88 years) and the group included 9 men and 3 women. The mean percentage of vertebral artery origin stenosis was 71 +/- 6%. Femoral and radial approaches were used in 9 and 3 cases, respectively. Technical success was achieved in 11 of the 12 patients in whom distal protection device placement was attempted. Postprocedure residual stenosis was 5 +/- 4%. Eight devices held macroscopically visible embolic debris (large and small amounts in 3 and 5 devices, respectively). No stroke or death was observed in the 1-month follow-up. The present study demonstrates the feasibility of performing stent placement for vertebral artery origin stenosis by using a distal protection device. Further studies are required to determine the effectiveness of this approach for vertebral artery origin atherosclerosis.

  7. CONTROLLING TRAFFIC FLOW IN MULTILANE-ISOLATED INTERSECTION USING ANFIS APPROACH TECHNIQUES

    Directory of Open Access Journals (Sweden)

    G. R. LAI

    2015-08-01

    Full Text Available Many controllers have applied the Adaptive Neural-Fuzzy Inference System (ANFIS concept for optimizing the controller performance. However, there are less traffic signal controllers developed using the ANFIS concept. ANFIS traffic signal controller with its fuzzy rule base and its ability to learn from a set of sample data could improve the performance of Existing traffic signal controlling system to reduce traffic congestions at most of the busy traffic intersections in city such as Kuala Lumpur, Malaysia. The aim of this research is to develop an ANFIS traffic signals controller for multilane-isolated four approaches intersections in order to ease traffic congestions at traffic intersections. The new concept to generate sample data for ANFIS training is introduced in this research. The sample data is generated based on fuzzy rules and can be analysed using tree diagram. This controller is simulated on multilane-isolated traffic intersection model developed using M/M/1 queuing theory and its performance in terms of average waiting time, queue length and delay time are compared with traditional controllers and fuzzy controller. Simulation result shows that the average waiting time, queue length, and delay time of ANFIS traffic signal controller are the lowest as compared to the other three controllers. In conclusion, the efficiency and performance of ANFIS controller are much better than that of fuzzy and traditional controllers in different traffic volumes.

  8. Thermodynamics of intersecting black branes from interacting elementary branes

    Energy Technology Data Exchange (ETDEWEB)

    Morita, Takeshi [Department of Physics, Shizuoka University,836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Shiba, Shotaro [Maskawa Institute for Science and Culture, Kyoto Sangyo University,Kamigamo-Motoyama, Kita-ku, Kyoto 603-8555 (Japan)

    2015-09-14

    If an Einstein-Maxwell-Dilaton system admits the extreme brane solution in which no force works between the parallel branes, the collective motion of nearly parallel branes exhibits the thermodynamical properties which are coincident with those of the corresponding black branes at low energy regime (up to unfixed numerical factors). Hence it may provide the microscopic description of the black branes (p-soup proposal). This fact motivates us to test this proposal in the intersecting black branes which have multiple brane charges and/or momentum along the brane direction. We consider the case that the multiple branes satisfy the intersection rule and feel no force when they are static, and find the agreement to the black hole thermodynamics.

  9. Classification of distal fingertip amputation based on the arterial system for replantation.

    Science.gov (United States)

    Park, Hyun Chul; Bahar-Moni, Ahmed Suparno; Cho, Sang Hyun; Kim, Sang Soo; Park, Hyun Sik; Ahn, Sang Cheon

    2013-06-01

    During replantation of distal fingertip amputation, identification of the artery is the most important but time consuming procedure. Depending on the damaged arterial structure, we classified distal fingertip amputations into 4 zones, on the basis of three dimensional concept. Zone 1 injury was defined as damage to the proximal central pulp artery; zone 2 injury, damage to the branch of the central pulp artery; zone 3 injury, damage to the distal central pulp artery; and zone 4 injury, no injury to the central pulp artery, injury only to the lateral pulp artery. From April 2010 to June 2011, 27 patients were evaluated. Successful replantation was observed in 21 patients. Skin necrosis occurred in six patients. For distal fingertip amputation classification based on the damaged arterial system is an easy method to find out the appropriate artery which should be anastomosed during replantation.

  10. Mirror symmetry, mirror map and applications to complete intersection Calabi-Yau spaces

    CERN Document Server

    Hosono, S.; Theisen, S.; Yau, Shing-Tung

    1995-01-01

    We extend the discussion of mirror symmetry, Picard-Fuchs equations, instanton corrected Yukawa couplings and the topological one loop partition function to the case of complete intersections with higher dimensional moduli spaces. We will develop a new method of obtaining the instanton corrected Yukawa couplings through a study of the solutions of the Picard-Fuchs equations. This leads to closed formulas for the prepotential for the K\\"ahler moduli fields induced from the ambient space for all complete intersections in nonsingular weighted projective spaces. As examples we treat part of the moduli space of the phenomenologically interesting three generation models which are found in this class. We also apply our method to solve the simplest model in which topology change was observed and discuss examples of complete intersections in singular ambient spaces.

  11. Robotic spleen-preserving distal pancreatectomy. A case report.

    Science.gov (United States)

    Vasilescu, C; Sgarbura, O; Tudor, S; Herlea, V; Popescu, I

    2009-01-01

    Distal pancreatectomy (DP) is the removal of the pancreatic tissue at the left side of the superior mesenteric vein and it is traditionally approached by an open or laparoscopic exposure. Preservation of the spleen is optional but appears to have a better immunological outcome. We present the case of a 53-year old patient with a 2.4/2.2 tumor located in the tail of the pancreas, with high tumour marker values for whom we decided to perform a robotic spleen-preserving distal pancreatectomy (RSPDP). The postoperative outcome was satisfactory. In conclusion, we recommend this type of approach for small pancreatic tail lesions.

  12. Modified distal shoe appliance--fabrication and clinical performance.

    Science.gov (United States)

    Gujjar, Kumar Raghav; Indushekar, K R; Amith, H V; Sharma, Shefali Li

    2012-01-01

    When the primary second molar is prematurely lost, mesial movement and migration of the permanent first molar often occurs. This is one of the most difficult problems of the developing dentition confronted by pediatric dentists. Use of a space maintainer that will guide the permanent first molar into its normal position is indicated. In cases with bilateral premature loss of primary molars, the conventional design of distal shoe poses a variety of problems and, therefore, necessitates a customized design for the eruption guidance of permanent first molars. The purpose of this case report is to discuss an innovative design of a distal shoe appliance, which was used with good clinical results.

  13. A Pitfall in Fixation of Distal Humeral Fractures with Pre-Contoured Locking Compression Plate

    Directory of Open Access Journals (Sweden)

    Prakash Jayakumar

    2015-04-01

    Full Text Available Anatomically precontoured locking plates are intended to facilitate the fixation of articular fractures and particularly those associated with osteoporosis. Fractures of the distal humerus are relatively uncommon injuries where operative intervention can be exceptionally challenging. The distal humeral trochlea provides a very narrow anatomical window through which to pass a fixed-angle locking screw, which must also avoid the olecranon, coronoid, and radial fossae. We describe 3 patients (ages 27, 49, and 73 years with a bicolumnar fracture of the distal humerus where very short distal locking screws were used. Intra-articular screw placement was avoided but loss of fixation occurred in two patients and a third was treated with a prolonged period of immobilization. We postulate that fixed-angle screw trajectories may make it difficult for the surgeon to place screws of adequate length in this anatomically confined region, and may lead to insufficient distal fixation. Surgical tactics should include placement of as many screws as possible into the distal fragment, as long as possible, and that each screw pass through a plate without necessarily locking in.

  14. Privileges and penalties in the legal profession: an intersectional analysis of career progression.

    Science.gov (United States)

    Tomlinson, Jennifer; Valizade, Danat; Muzio, Daniel; Charlwood, Andy; Aulakh, Sundeep

    2018-04-26

    Intersectionality theory is concerned with integrating social characteristics to better understanding complex human relations and inequalities in organizations and societies (McCall ). Recently, intersectionality research has taken a categorical and quantitative turn as scholars critically adopt but retain existing social categories to explain differences in labour market outcomes. A key contention is that social categories carry penalties or privileges and their intersection promotes or hinders the life chances of particular groups and individuals. An emergent debate is whether the intersection of disadvantaged characteristics (such as female gender or minority ethnic status) produce penalties that are additive, multiplicative or ameliorative. Research is inconclusive and as yet pays little attention to moderating factors such as employer type, size, geographic location or work profile. Drawing on administrative records for individuals qualified as solicitors in England and Wales, collected by the Solicitors Regulation Authority (SRA), combined with aggregated workforce data and firm characteristics of their law firms, we undertake a statistical analysis of the intersection of gender and ethnicity in the profession with a degree of precision and nuance not previously possible. In response to calls to broaden studies of inequalities and intersectionality beyond their effect on pay or income (Castilla ) we focus on career progression to partnership as our key measure of success. The original contribution of our study is twofold. First, we establish statistically different profiles of law firms, showing how the solicitors' profession is stratified by gender, ethnicity and socio-economic background, as well as the type of legal work undertaken by developing a model of socio-economic stratification in the profession. Second, we demonstrate that while penalties tend to be additive (i.e. the sum of the individual ethnic and gender penalties) this varies significantly by

  15. Genetics Home Reference: distal arthrogryposis type 1

    Science.gov (United States)

    ... 1 is a disorder characterized by joint deformities (contractures) that restrict movement in the hands and feet. ... distal arthrogryposis type 1 . However, researchers speculate that contractures may be related to problems with muscle contraction ...

  16. Palladium catalyzed selective distal C-H olefination of biaryl systems.

    Science.gov (United States)

    Maity, Soham; Hoque, Ehtasimul; Dhawa, Uttam; Maiti, Debabrata

    2016-11-29

    Palladium catalyzed selective distal C-H activation with nitrile based templates has been of significant research interest in recent times. In this report, we disclose the distal C-H olefination of biphenyl systems with high regio- and stereo-selectivity and useful synthetic yields. The utility of this method has been demonstrated through its wide olefin scope, its operation at the gram scale and the easy removal/recovery of the directing group.

  17. Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity.

    Science.gov (United States)

    Bauer, Greta R

    2014-06-01

    Intersectionality theory, developed to address the non-additivity of effects of sex/gender and race/ethnicity but extendable to other domains, allows for the potential to study health and disease at different intersections of identity, social position, processes of oppression or privilege, and policies or institutional practices. Intersectionality has the potential to enrich population health research through improved validity and greater attention to both heterogeneity of effects and causal processes producing health inequalities. Moreover, intersectional population health research may serve to both test and generate new theories. Nevertheless, its implementation within health research to date has been primarily through qualitative research. In this paper, challenges to incorporation of intersectionality into population health research are identified or expanded upon. These include: 1) confusion of quantitative terms used metaphorically in theoretical work with similar-sounding statistical methods; 2) the question of whether all intersectional positions are of equal value, or even of sufficient value for study; 3) distinguishing between intersecting identities, social positions, processes, and policies or other structural factors; 4) reflecting embodiment in how processes of oppression and privilege are measured and analysed; 5) understanding and utilizing appropriate scale for interactions in regression models; 6) structuring interaction or risk modification to best convey effects, and; 7) avoiding assumptions of equidistance or single level in the design of analyses. Addressing these challenges throughout the processes of conceptualizing and planning research and in conducting analyses has the potential to improve researchers' ability to more specifically document inequalities at varying intersectional positions, and to study the potential individual- and group-level causes that may drive these observed inequalities. A greater and more thoughtful incorporation

  18. Increased T2 signal intensity in the distal clavicle: incidence and clinical implications

    International Nuclear Information System (INIS)

    Fiorella, D.; Helms, C.A.; Speer, K.P.

    2000-01-01

    Objective. The objectives of the current study were (1) to quantify the incidence of increased T2 signal in the distal clavicle and (2) to assess the clinical significance of this finding in patients with chronic acromioclavicular (AC) joint pain.Design and patients. Eight patients (five male and three female, 15-41 years of age) with disabling shoulder pain localized to the AC joint and marked increased T2 signal in the distal clavicle are presented. These eight patients underwent MR examination over a 25 month period (August 1996 to September 1998). The dictated reports of all shoulder MR examinations conducted over this same time period were reviewed retrospectively for the presence of signal abnormality in the distal cla-vicle. Clinical data and, in five patients, findings at shoulder arthroscopy or open surgery, were correlated with the results of MR imaging. One patient underwent arthroscopy on both shoulders.Results. The selected eight patients each presented clinically with disabling shoulder pain localized to the AC joint. One patient is presented twice, as both shoulders were symptomatic (n=9). Plain film examination (9/9) failed to indicate a structural cause of shoulder pain in any of the patients. MR examination demonstrated abnormally increased T2 signal in the distal clavicle in all nine cases and no other cause for AC joint pain. Three patients responded to a course of conservative therapy. Six experienced refractory pain despite conservative therapy. Resection of the distal clavicle was performed in five of the six cases. All patients who underwent resection of the distal clavicle experienced complete resolution of AC joint pain. A retrospective review of the dictated reports for all shoulder MR imaging examinations performed at out institution over a 25 month period (August 1996 to September 1998; n=761) demonstrated a 12.5% incidence of abnormally increased T2 signal in the distal clav-icle.Conclusions. Increased T2 signal in the distal clavicle

  19. Increased T2 signal intensity in the distal clavicle: incidence and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Fiorella, D.; Helms, C.A. [Dept. of Radiology, Duke Univ., Durham, NC (United States); Speer, K.P. [Dept. of Orthopedic Surgery, Duke Univ., Durham, NC (United States)

    2000-12-01

    Objective. The objectives of the current study were (1) to quantify the incidence of increased T2 signal in the distal clavicle and (2) to assess the clinical significance of this finding in patients with chronic acromioclavicular (AC) joint pain.Design and patients. Eight patients (five male and three female, 15-41 years of age) with disabling shoulder pain localized to the AC joint and marked increased T2 signal in the distal clavicle are presented. These eight patients underwent MR examination over a 25 month period (August 1996 to September 1998). The dictated reports of all shoulder MR examinations conducted over this same time period were reviewed retrospectively for the presence of signal abnormality in the distal cla-vicle. Clinical data and, in five patients, findings at shoulder arthroscopy or open surgery, were correlated with the results of MR imaging. One patient underwent arthroscopy on both shoulders.Results. The selected eight patients each presented clinically with disabling shoulder pain localized to the AC joint. One patient is presented twice, as both shoulders were symptomatic (n=9). Plain film examination (9/9) failed to indicate a structural cause of shoulder pain in any of the patients. MR examination demonstrated abnormally increased T2 signal in the distal clavicle in all nine cases and no other cause for AC joint pain. Three patients responded to a course of conservative therapy. Six experienced refractory pain despite conservative therapy. Resection of the distal clavicle was performed in five of the six cases. All patients who underwent resection of the distal clavicle experienced complete resolution of AC joint pain. A retrospective review of the dictated reports for all shoulder MR imaging examinations performed at out institution over a 25 month period (August 1996 to September 1998; n=761) demonstrated a 12.5% incidence of abnormally increased T2 signal in the distal clav-icle.Conclusions. Increased T2 signal in the distal clavicle

  20. Vehicle speed guidance strategy at signalized intersection based on cooperative vehicle infrastructure system

    Directory of Open Access Journals (Sweden)

    Fengyuan JIA

    2017-10-01

    Full Text Available In order to reduce stopping time of vehicle at a signalized intersection, aiming at the difficulty, even the impossibility to obtain real-time queue length of intersection in third and fourth-tier cities in China sometimes, a speed guidance strategy based on cooperative vehicle infrastructure system is put forward and studied. For validating the strategy, the traffic signal timing data of the intersection at Hengshan Road and North Fengming Lake Road in Wuhu is collected by a vehicular traffic signal reminder system which is designed. The simulation experiments using the acquired data are done by software VISSIM. The simulation results demonstrate that the strategy under high and low traffic flow can effectively decrease the link travel-time, reducing average ratio is 9.2 % and 13.0 %, respectively, and the effect under low traffic flow is better than that under high traffic flow. The strategy improves efficiency of traffic at a signalized intersection and provides an idea for the application of vehicle speed guidance based on cooperative vehicle infrastructure system.