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  1. The role of trochanteric flip osteotomy in fixation of certain acetabular fractures

    Directory of Open Access Journals (Sweden)

    Sandeep Gupta

    2017-06-01

    Conclusion: Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way.

  2. The role of trochanteric flip osteotomy in fixation of certain acetabular fractures.

    Science.gov (United States)

    Gupta, Sandeep; Singh, Jagdeep; Virk, Jagandeep Singh

    2017-06-01

    Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in posterior and lateral exposures of the acetabulum. It also decreases the need for excessive muscle retraction. The purpose of the study was to investigate the outcome associated with trochanteric flip osteotomy in the management of certain acetabulum fractures. From January 2011 to December 2013, 25 displaced acetabular fractures were treated by open reduction and internal fixation. The fractures were managed using a Kocher-Langenbeck approach along with trochanteric flip osteotomy. At 3rd, 6th and 24th month follow-up, all patients had radiographic examination and underwent a final clinical evaluation based on the modified Merle d'Aubigne and Postel score. The strength of the abductors was assessed according to the Medical Research Council (MRC) grading system. Congruent reduction was achieved in all patients and all osteotomies healed within an average period of 3.8 months. All our patients were allowed full weight bearing at the end of 3 months and with no abductor lurch at the end of 6 months follow-up. There were no cases of avascular necrosis of femoral head. None of the patients had any neurovascular complication or infection by the end of the follow-up period. Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  3. Does the Flipped Classroom Improve Learning in Graduate Medical Education?

    Science.gov (United States)

    Riddell, Jeff; Jhun, Paul; Fung, Cha-Chi; Comes, James; Sawtelle, Stacy; Tabatabai, Ramin; Joseph, Daniel; Shoenberger, Jan; Chen, Esther; Fee, Christopher; Swadron, Stuart P

    2017-08-01

    The flipped classroom model for didactic education has recently gained popularity in medical education; however, there is a paucity of performance data showing its effectiveness for knowledge gain in graduate medical education. We assessed whether a flipped classroom module improves knowledge gain compared with a standard lecture. We conducted a randomized crossover study in 3 emergency medicine residency programs. Participants were randomized to receive a 50-minute lecture from an expert educator on one subject and a flipped classroom module on the other. The flipped classroom included a 20-minute at-home video and 30 minutes of in-class case discussion. The 2 subjects addressed were headache and acute low back pain. A pretest, immediate posttest, and 90-day retention test were given for each subject. Of 82 eligible residents, 73 completed both modules. For the low back pain module, mean test scores were not significantly different between the lecture and flipped classroom formats. For the headache module, there were significant differences in performance for a given test date between the flipped classroom and the lecture format. However, differences between groups were less than 1 of 10 examination items, making it difficult to assign educational importance to the differences. In this crossover study comparing a single flipped classroom module with a standard lecture, we found mixed statistical results for performance measured by multiple-choice questions. As the differences were small, the flipped classroom and lecture were essentially equivalent.

  4. Step to improve neural cryptography against flipping attacks.

    Science.gov (United States)

    Zhou, Jiantao; Xu, Qinzhen; Pei, Wenjiang; He, Zhenya; Szu, Harold

    2004-12-01

    Synchronization of neural networks by mutual learning has been demonstrated to be possible for constructing key exchange protocol over public channel. However, the neural cryptography schemes presented so far are not the securest under regular flipping attack (RFA) and are completely insecure under majority flipping attack (MFA). We propose a scheme by splitting the mutual information and the training process to improve the security of neural cryptosystem against flipping attacks. Both analytical and simulation results show that the success probability of RFA on the proposed scheme can be decreased to the level of brute force attack (BFA) and the success probability of MFA still decays exponentially with the weights' level L. The synchronization time of the parties also remains polynomial with L. Moreover, we analyze the security under an advanced flipping attack.

  5. Flipping the classroom to improve student performance and satisfaction.

    Science.gov (United States)

    Missildine, Kathy; Fountain, Rebecca; Summers, Lynn; Gosselin, Kevin

    2013-10-01

    This study aimed to determine the effects of a flipped classroom (i.e., reversal of time allotment for lecture and homework) and innovative learning activities on academic success and the satisfaction of nursing students. A quasi-experimental design was used to compare three approaches to learning: traditional lecture only (LO), lecture and lecture capture back-up (LLC), and the flipped classroom approach of lecture capture with innovative classroom activities (LCI). Examination scores were higher for the flipped classroom LCI group (M = 81.89, SD = 5.02) than for both the LLC group (M = 80.70, SD = 4.25), p = 0.003, and the LO group (M = 79.79, SD = 4.51), p method than with either of the other methods (p teaching technologies with interactive classroom activities can result in improved learning but not necessarily improved student satisfaction. Copyright 2013, SLACK Incorporated.

  6. Posterior column reconstruction improves fusion rates at the level of osteotomy in three-column posterior-based osteotomies.

    Science.gov (United States)

    Lewis, Stephen J; Mohanty, Chandan; Gazendam, Aaron M; Kato, So; Keshen, Sam G; Lewis, Noah D; Magana, Sofia P; Perlmutter, David; Cape, Jennifer

    2018-03-01

    To determine the incidence of pseudarthrosis at the osteotomy site after three-column spinal osteotomies (3-COs) with posterior column reconstruction. 82 consecutive adult 3-COs (66 patients) with a minimum of 2-year follow-up were retrospectively reviewed. All cases underwent posterior 3-COs with two-rod constructs. The inferior facets of the proximal level were reduced to the superior facets of the distal level. If that was not possible, a structural piece of bone graft either from the local resection or a local rib was slotted in the posterior column defect to re-establish continual structural posterior bone across the lateral margins of the resection. No interbody cages were used at the level of the osteotomy. There were 34 thoracic osteotomies, 47 lumbar osteotomies and one sacral osteotomy with a mean follow-up of 52 (24-126) months. All cases underwent posterior column reconstructions described above and the addition of interbody support or additional posterior rods was not performed for fusion at the osteotomy level. Among them, 29 patients underwent one or more revision surgeries. There were three definite cases of pseudarthrosis at the osteotomy site (4%). Six revisions were also performed for pseudarthrosis at other levels. Restoration of the structural integrity of the posterior column in three-column posterior-based osteotomies was associated with > 95% fusion rate at the level of the osteotomy. Pseudarthrosis at other levels was the second most common reason for revision following adjacent segment disease in the long-term follow-up.

  7. The "flipped classroom" approach: Stimulating positive learning attitudes and improving mastery of histology among medical students.

    Science.gov (United States)

    Cheng, Xin; Ka Ho Lee, Kenneth; Chang, Eric Y; Yang, Xuesong

    2017-07-01

    Traditional medical education methodologies have been dramatically impacted by the introduction of new teaching approaches over the past few decades. In particular, the "flipped classroom" format has drawn a great deal of attention. However, evidence regarding the effectiveness of the flipped model remains limited due to a lack of outcome-based studies. In the present study, a pilot histology curriculum of the organ systems was implemented among 24 Traditional Chinese Medicine (TCM) students in a flipped classroom format at Jinan University. As a control, another 87 TCM students followed a conventional histology curriculum. The academic performance of the two groups was compared. In addition, a questionnaire was administered to the flipped classroom group. The test scores for the flipped classroom participants were found to be significantly higher compared to non-participants in the control group. These results suggest that students may benefit from using the flipped classroom format. Follow-up questionnaires also revealed that most of the flipped classroom participants undertook relatively more earnest preparations before class and were actively involved in classroom learning activities. The teachers were also found to have more class time for leading discussions and delivering quizzes rather than repeating rote didactics. Consequently, the increased teaching and learning activities contributed to a better performance among the flipped classroom group. This pilot study suggests that a flipped classroom approach can be used to improve histology education among medical students. However, future studies employing randomization, larger numbers of students, and more precise tracking methods are needed before definitive conclusions can be drawn. Anat Sci Educ 10: 317-327. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  8. Flipping Content to Improve Student Examination Performance in a Pharmacogenomics Course.

    Science.gov (United States)

    Munson, Amanda; Pierce, Richard

    2015-09-25

    Objective. To develop, implement, and evaluate active learning in a flipped class to improve student examination performance in the genetic foundations of pharmacogenomics. Design. The flipped classroom model was adopted in which a guided-inquiry learning activity was developed and conducted to complement recorded, previously viewed didactic lectures. The activity was constructed to focus on critical thinking and application of core principles of genetic crosses and pedigree analysis. A combination of independent work and active discussion with volunteer and guided student response provided student-facilitator interaction. Assessment. Student learning was evaluated by comparing pretest and posttest formative assessment results and by the comparison of prior years' examination performance on a subset of content for which no flipped classroom learning activities occurred. There was no significant difference between examination scores between the flipped classroom and previous approaches. An item-by-item analysis of the content reflected a significant change in performance on questions addressed in the flipped classroom exercise. Conclusion. The flipped class instructional model in this project included active-learning activities and formative assessments that provided students spaced and repetitive curricular engagement. The intervention transformed the classroom interactions of faculty members and students and contributed to improved student examination performance.

  9. Flipped classroom improves student learning in health professions education: a meta-analysis.

    Science.gov (United States)

    Hew, Khe Foon; Lo, Chung Kwan

    2018-03-15

    The use of flipped classroom approach has become increasingly popular in health professions education. However, no meta-analysis has been published that specifically examines the effect of flipped classroom versus traditional classroom on student learning. This study examined the findings of comparative articles through a meta-analysis in order to summarize the overall effects of teaching with the flipped classroom approach. We focused specifically on a set of flipped classroom studies in which pre-recorded videos were provided before face-to-face class meetings. These comparative articles focused on health care professionals including medical students, residents, doctors, nurses, or learners in other health care professions and disciplines (e.g., dental, pharmacy, environmental or occupational health). Using predefined study eligibility criteria, seven electronic databases were searched in mid-April 2017 for relevant articles. Methodological quality was graded using the Medical Education Research Study Quality Instrument (MERSQI). Effect sizes, heterogeneity estimates, analysis of possible moderators, and publication bias were computed using the COMPREHENSIVE META-ANALYSIS software. A meta-analysis of 28 eligible comparative studies (between-subject design) showed an overall significant effect in favor of flipped classrooms over traditional classrooms for health professions education (standardized mean difference, SMD = 0.33, 95% confidence interval, CI = 0.21-0.46, p flipped classroom approach was more effective when instructors used quizzes at the start of each in-class session. More respondents reported they preferred flipped to traditional classrooms. Current evidence suggests that the flipped classroom approach in health professions education yields a significant improvement in student learning compared with traditional teaching methods.

  10. Improving the Teaching of ICT Engineering using Flipped Learning: a personalized model and a case study

    Directory of Open Access Journals (Sweden)

    Abdelhak Aqqal

    Full Text Available Abstract In recent years, Flipped Classroom started to be used as an effective way of teaching Engineering among various strategies in higher education. However, enabling and using the flipped learning is a complicated task, not a straightforward goal that can be simply achieved through a combination of face-to-face and online activities. It requires a more sophisticated understanding of effective teaching methods to manage the shift from the traditional to the flipped learning and the optimum adaptation of technology as part of this change. Given this challenge, this research work provides a personalized model of the flipped classroom and investigates through a case study in an Engineering School how our approach can be used to improve teaching of Information and Communication Technology (ICT Engineering. It assesses by using empirically data related to the interaction of the various actors at different levels of abstraction, particularly from a gender perspective, the relevance and the impact of the flipped classroom on student learning and achievement in ICT Engineering Education.

  11. FLIPPED CLASSROOM LEARNING METHOD TO IMPROVE CARING AND LEARNING OUTCOME IN FIRST YEAR NURSING STUDENT

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    Ni Putu Wulan Purnama Sari

    2017-08-01

    Full Text Available Background and Purpose: Caring is the essence of nursing profession. Stimulation of caring attitude should start early. Effective teaching methods needed to foster caring attitude and improve learning achievement. This study aimed to explain the effect of applying flipped classroom learning method for improving caring attitude and learning achievement of new student nurses at nursing institutions in Surabaya. Method: This is a pre-experimental study using the one group pretest posttest and posttest only design. Population was all new student nurses on nursing institutions in Surabaya. Inclusion criteria: female, 18-21 years old, majoring in nursing on their own volition and being first choice during students selection process, status were active in the even semester of 2015/2016 academic year. Sample size was 67 selected by total sampling. Variables: 1 independent: application of flipped classroom learning method; 2 dependent: caring attitude, learning achievement. Instruments: teaching plan, assignment descriptions, presence list, assignment assessment rubrics, study materials, questionnaires of caring attitude. Data analysis: paired and one sample t test. Ethical clearance was available. Results: Most respondents were 20 years old (44.8%, graduated from high school in Surabaya (38.8%, living with parents (68.7% in their homes (64.2%. All data were normally distributed. Flipped classroom learning method could improve caring attitude by 4.13%. Flipped classroom learning method was proved to be effective for improving caring attitude (p=0.021 and learning achievement (p=0.000. Conclusion and Recommendation: Flipped classroom was effective for improving caring attitude and learning achievement of new student nurse. It is recommended to use mix-method and larger sample for further study.

  12. Increased Preclass Preparation Underlies Student Outcome Improvement in the Flipped Classroom.

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    Gross, David; Pietri, Evava S; Anderson, Gordon; Moyano-Camihort, Karin; Graham, Mark J

    2015-01-01

    Active-learning environments such as those found in a flipped classroom are known to increase student performance, although how these gains are realized over the course of a semester is less well understood. In an upper-level lecture course designed primarily for biochemistry majors, we examine how students attain improved learning outcomes, as measured by exam scores, when the course is converted to a more active flipped format. The context is a physical chemistry course catering to life science majors in which approximately half of the lecture material is placed online and in-class problem-solving activities are increased, while total class time is reduced. We find that exam performance significantly improves by nearly 12% in the flipped-format course, due in part to students interacting with course material in a more timely and accurate manner. We also find that the positive effects of the flipped class are most pronounced for students with lower grade point averages and for female students. © 2015 D. Gross et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  13. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

    Science.gov (United States)

    Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

    2017-02-01

    Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

  14. Optimization of Indium Bump Morphology for Improved Flip Chip Devices

    Science.gov (United States)

    Jones, Todd J.; Nikzad, Shouleh; Cunningham, Thomas J.; Blazejewski, Edward; Dickie, Matthew R.; Hoenk, Michael E.; Greer, Harold F.

    2011-01-01

    Flip-chip hybridization, also known as bump bonding, is a packaging technique for microelectronic devices that directly connects an active element or detector to a substrate readout face-to-face, eliminating the need for wire bonding. In order to make conductive links between the two parts, a solder material is used between the bond pads on each side. Solder bumps, composed of indium metal, are typically deposited by thermal evaporation onto the active regions of the device and substrate. While indium bump technology has been a part of the electronic interconnect process field for many years and has been extensively employed in the infrared imager industry, obtaining a reliable, high-yield process for high-density patterns of bumps can be quite difficult. Under the right conditions, a moderate hydrogen plasma exposure can raise the temperature of the indium bump to the point where it can flow. This flow can result in a desirable shape where indium will efficiently wet the metal contact pad to provide good electrical contact to the underlying readout or imager circuit. However, it is extremely important to carefully control this process as the intensity of the hydrogen plasma treatment dramatically affects the indium bump morphology. To ensure the fine-tuning of this reflow process, it is necessary to have realtime feedback on the status of the bumps. With an appropriately placed viewport in a plasma chamber, one can image a small field (a square of approximately 5 millimeters on each side) of the bumps (10-20 microns in size) during the hydrogen plasma reflow process. By monitoring the shape of the bumps in real time using a video camera mounted to a telescoping 12 magnifying zoom lens and associated optical elements, an engineer can precisely determine when the reflow of the bumps has occurred, and can shut off the plasma before evaporation or de-wetting takes place.

  15. Tilt of the radius from forearm rotational axis reliably predicts rotational improvement after corrective osteotomy for malunited forearm fractures.

    Science.gov (United States)

    Tatebe, Masahiro; Shinohara, Takaaki; Okui, Nobuyuki; Yamamoto, Michiro; Kurimoto, Shigeru; Hirata, Hitoshi

    2012-02-01

    Forearm rotation occurs around an axis connecting the center of the radial head and the fovea of the distal ulna. The purpose of the present study was to demonstrate the usefulness of the difference between forearm and proximal radial axis in the treatment of malunited forearm fractures. We reviewed the results of eight corrective osteotomies for malunited fractures of the forearm without dislocations of the wrist or elbow. Subjects were 6 men and 2 women (mean age, 15 years; range, 10-21 years). Corrective osteotomy was performed at the fracture site. Preoperatively and at final follow-up, the are of forearm rotation was recorded and anteroposterior and lateral X-rays were taken. Proximal radius tilt was defined as the angle between the rotational axis of the forearm and the axis of the proximal radius. Corrective osteotomy improved proximal radius tilt in all cases. Three patients were considered to have malrotation. Postoperative rotational are correlated with proximal radial tilt (r = -0.83). No significant difference in rotational arc was evident between malunited cases and the remaining cases. To improve forearm rotation, corrective osteotomy should be planned to minimize proximal radius tilt.

  16. Triple Pelvic Osteotomy and Double Pelvic Osteotomy.

    Science.gov (United States)

    Guevara, Francisco; Franklin, Samuel P

    2017-07-01

    Triple and double pelvic osteotomy (TPO, DPO) are performed with the goal of increasing acetabular ventro-version, increasing femoral head coverage, and decreasing femoral head subluxation. Since the first descriptions of TPO, there have been modifications in technique, most notably omission of the ischial osteotomy for DPO, and improvements in the implants, including availability of locking TPO/DPO bone plates. Associated complication rates seem to have declined accordingly. The most salient questions regarding these procedures remain what selection criteria should be used to identify candidates and whether halting or preventing osteoarthritis is necessary to consider these surgeries clinically beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The Improvement of Flip (2,2 Visual Cryptography Images Using Two Key Images

    Directory of Open Access Journals (Sweden)

    Ratna Dewi

    2016-09-01

    Full Text Available The Flip (2, 2 Visual Cryptography (FVC is one of the techniques used to encrypt the two secret images into two dual purpose transparencies. The two transparencies can be sent to the objective person. The first secret images can be obtained by stacking the two transparencies and the second secret images can be obtained by stacking the one transparency with the flipping other transparency. Unfortunately, the result decryption processes still have noise and the quality of decrypted secret image is not as same as original secret image. This article proposed the new algorithm to improve the quality of decryption secret image. In this process, the two secret images from decryption process were compared with the two original secret images. The different values of each pixel, which was counted from subtraction of decryption image and original secret images, will be inserted to the two key images. The experimental results of this improvement have a good similarity. The noise in decryption process can be eliminated so the two secret images reconstruction similar to the original secret images.

  18. ConfChem Conference on Flipped Classroom: Improving Student Engagement in Organic Chemistry Using the Inverted Classroom Model

    Science.gov (United States)

    Rossi, Robert D.

    2015-01-01

    Improving student engagement in STEM (science, technology, engineering, and mathematics) courses generally, and organic chemistry specifically, has long been a goal for educators. Recently educators at all academic levels have been exploring the "inverted classroom" or "flipped classroom" pedagogical model for improving student…

  19. Active Learning and Flipped Classroom, Hand in Hand Approach to Improve Students Learning in Human Anatomy and Physiology

    Science.gov (United States)

    Entezari, Maria; Javdan, Mohammad

    2016-01-01

    Because Human Anatomy and Physiology (A&P), a gateway course for allied health majors, has high dropout rates nationally, it is challenging to find a successful pedagogical intervention. Reports on the effect of integration of flipped classrooms and whether it improves learning are contradictory for different disciplines. Thus many educators…

  20. How to Flip a Classroom and Improve Student Learning and Engagement: The Case of PSYC1030

    Science.gov (United States)

    Isaias, Pedro; McKimmie, Blake; Bakharia, Aneesha; Zornig, John; Morris, Anna

    2017-01-01

    The flipped classroom's pervasiveness in different educational contexts derives from the growing need to focus on student-centered and active learning approaches. The fact that the flipped classroom allocates the lecture delivery to the outside of the classroom endows teachers with the possibility of using the in-class time to develop active…

  1. The "Flipped Classroom" Approach: Stimulating Positive Learning Attitudes and Improving Mastery of Histology among Medical Students

    Science.gov (United States)

    Cheng, Xin; Ka Ho Lee, Kenneth; Chang, Eric Y.; Yang, Xuesong

    2017-01-01

    Traditional medical education methodologies have been dramatically impacted by the introduction of new teaching approaches over the past few decades. In particular, the "flipped classroom" format has drawn a great deal of attention. However, evidence regarding the effectiveness of the flipped model remains limited due to a lack of…

  2. Quality-Improving Strategies of College English Teaching Based on Microlesson and Flipped Classroom

    Science.gov (United States)

    Zhang, Fan

    2017-01-01

    Microlesson and flipped classroom, which incorporate the educational information technologies, are a new trend of college English teaching. Exploration on how the flipped classroom and microlesson promote innovation and application of educational information technology are of great significance. According to a survey among teachers, strategies…

  3. Flipped Learning

    DEFF Research Database (Denmark)

    Holmboe, Peter; Hachmann, Roland

    I FLIPPED LEARNING – FLIP MED VIDEO kan du læse om, hvordan du som underviser kommer godt i gang med at implementere video i undervisning, der har afsæt i tankerne omkring flipped learning. Bogen indeholder fire dele: I Del 1 fokuserer vi på det metarefleksive i at tænke video ind i undervisningen...

  4. Flipped classroom model improves graduate student performance in cardiovascular, respiratory, and renal physiology.

    Science.gov (United States)

    Tune, Johnathan D; Sturek, Michael; Basile, David P

    2013-12-01

    The purpose of this study was to assess the effectiveness of a traditional lecture-based curriculum versus a modified "flipped classroom" curriculum of cardiovascular, respiratory, and renal physiology delivered to first-year graduate students. Students in both courses were provided the same notes and recorded lectures. Students in the modified flipped classroom were required to watch the prerecorded lectures before class and then attend class, where they received a quiz or homework covering material in each lecture (valued at 25% of the final grade) followed by a question and answer/problem-solving period. In the traditional curriculum, attending lectures was optional and there were no quizzes. Evaluation of effectiveness and student performance was achieved by having students in both courses take the same multiple-choice exams. Within a comparable group of graduate students, participants in the flipped course scored significantly higher (P ≤ 0.05) on the cardiovascular, respiratory, and weighted cumulative sections by an average of >12 percentage points. Exam averages for students in the flipped course also tended to be higher on the renal section by ∼11 percentage points (P = 0.06). Based on our experience and responses obtained in blinded student surveys, we propose that the use of homework and in-class quizzes were critical motivating factors that likely contributed to the increase in student exam performance. Taken together, our findings support that the flipped classroom model is a highly effective means in which to disseminate key physiological concepts to graduate students.

  5. A Modified Implementation of Tristate Inverter Based Static Master-Slave Flip-Flop with Improved Power-Delay-Area Product

    Directory of Open Access Journals (Sweden)

    Kunwar Singh

    2014-01-01

    Full Text Available The paper introduces novel architectures for implementation of fully static master-slave flip-flops for low power, high performance, and high density. Based on the proposed structure, traditional C2MOS latch (tristate inverter/clocked inverter based flip-flop is implemented with fewer transistors. The modified C2MOS based flip-flop designs mC2MOSff1 and mC2MOSff2 are realized using only sixteen transistors each while the number of clocked transistors is also reduced in case of mC2MOSff1. Postlayout simulations indicate that mC2MOSff1 flip-flop shows 12.4% improvement in PDAP (power-delay-area product when compared with transmission gate flip-flop (TGFF at 16X capacitive load which is considered to be the best design alternative among the conventional master-slave flip-flops. To validate the correct behaviour of the proposed design, an eight bit asynchronous counter is designed to layout level. LVS and parasitic extraction were carried out on Calibre, whereas layouts were implemented using IC station (Mentor Graphics. HSPICE simulations were used to characterize the transient response of the flip-flop designs in a 180 nm/1.8 V CMOS technology. Simulations were also performed at 130 nm, 90 nm, and 65 nm to reveal the scalability of both the designs at modern process nodes.

  6. A modified implementation of tristate inverter based static master-slave flip-flop with improved power-delay-area product.

    Science.gov (United States)

    Singh, Kunwar; Tiwari, Satish Chandra; Gupta, Maneesha

    2014-01-01

    The paper introduces novel architectures for implementation of fully static master-slave flip-flops for low power, high performance, and high density. Based on the proposed structure, traditional C(2)MOS latch (tristate inverter/clocked inverter) based flip-flop is implemented with fewer transistors. The modified C(2)MOS based flip-flop designs mC(2)MOSff1 and mC(2)MOSff2 are realized using only sixteen transistors each while the number of clocked transistors is also reduced in case of mC(2)MOSff1. Postlayout simulations indicate that mC(2)MOSff1 flip-flop shows 12.4% improvement in PDAP (power-delay-area product) when compared with transmission gate flip-flop (TGFF) at 16X capacitive load which is considered to be the best design alternative among the conventional master-slave flip-flops. To validate the correct behaviour of the proposed design, an eight bit asynchronous counter is designed to layout level. LVS and parasitic extraction were carried out on Calibre, whereas layouts were implemented using IC station (Mentor Graphics). HSPICE simulations were used to characterize the transient response of the flip-flop designs in a 180 nm/1.8 V CMOS technology. Simulations were also performed at 130 nm, 90 nm, and 65 nm to reveal the scalability of both the designs at modern process nodes.

  7. Efficiency and Droop Improvement in GaN-Based High-Voltage Flip Chip LEDs

    Directory of Open Access Journals (Sweden)

    Yen-Chih Chiang

    2014-01-01

    Full Text Available The GaN-based high-voltage flip chip light-emitting diode (HVFC-LED is designed and developed for the purpose of efficiency enhancement. In our design, the distributed Bragg reflector (DBR is deposited at the bonded substrate to increase the light extraction. After the flip chip process, the general current-voltage characteristics between the flip chip sample and the traditional sample are essentially the same. With the help of great thermal conductive silicon substrate and the bottom DBR, the HVFC-LED is able to enhance the power by 37.1% when compared to the traditional high-voltage LEDs. The wall-plug efficiencies of the HVFC-LED also show good droop reduction as high as 9.9% compared to the traditional devices.

  8. Pelvic reorientation osteotomies and acetabuloplasties in children. Surgical technique.

    Science.gov (United States)

    Sales de Gauzy, J

    2010-11-01

    The objectives of pelvic osteotomies are to improve femoral head coverage and coxofemoral joint stability. The most currently used osteotomies can be divided into reorientation osteotomies (Salter and Pol le Cœur triple osteotomy) and acetabuloplasties (Pemberton and Dega). All these osteotomies share an identical installation on the table and bikini-type incision. The Salter osteotomy uses a single osteotomy line located at the inferior gluteal line. The Pol Le Cœur triple pelvic osteotomy combines innominate osteotomies of the iliopubic and ischiopubic rami via a genitofemoral approach (inguinal). In these two reorientation osteotomies, the acetabulum tilts in retroversion, improving the anterior and lateral coverage but reducing the posterior coverage. In the Pemberton acetabuloplasty, the osteotomy line is incomplete. It begins anteriorly between the iliac spines and ends posteriorly immediately above the triradiate cartilage. The posterior part of the ilium remains intact. The Pemberton acetabuloplasty causes retroversion and plicature of the acetabulum responsible for reducing its diameter. Anterior and lateral coverage of the femoral head is improved and posterior coverage remains unchanged. In the Dega acetabuloplasty, the osteotomy line is incomplete. It begins laterally above the acetabulum and terminates just above the triradiate cartilage. The medial part of the ilium remains intact. The Dega acetabuloplasty reduces the diameter of the acetabulum and improves overall femoral head coverage (anterior, lateral, and posterior). Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  9. Flipped classroom

    DEFF Research Database (Denmark)

    Skov, Tobias Kidde; Jørgensen, Søren

    2016-01-01

    Artiklen beskriver Flipped Classroom som et didaktisk princip, der kan være med til at organisere og tilrettelægge en undervisning, med fokus på forskellige læringsformer. Det handler om at forstå Flipped Classroom som en opdeling i 2 faser og 3 led, som samlet set skaber en didaktisk organisering....

  10. Flipped Learning

    DEFF Research Database (Denmark)

    Hachmann, Roland; Holmboe, Peter

    arbejde med faglige problemstillinger gennem problembaserede og undersøgende didaktiske designs. Flipped Learning er dermed andet og mere end at distribuere digitale materialer til eleverne forud for undervisning. Flipped Learning er i lige så høj grad et syn på, hvordan undervisning med digitale medier...

  11. Flipping Excel

    Science.gov (United States)

    Frydenberg, Mark

    2013-01-01

    The "flipped classroom" model has become increasingly popular in recent years as faculty try new ways to engage students in the classroom. In a flipped classroom setting, students review the lecture online prior to the class session and spend time in class working on problems or exercises that would have been traditionally assigned as…

  12. The Flipped Classroom Improves Student Achievement and Course Satisfaction in a Statistics Course

    Science.gov (United States)

    Peterson, Daniel J.

    2016-01-01

    There are but a handful of experimental or quasi-experimental studies comparing student outcomes from flipped or inverted classrooms to more traditional lecture formats. In the current study, I present cumulative exam performance and student evaluation data from two sections of a statistics course I recently taught: one a traditional lecture (N =…

  13. Medial Tibial Reduction Osteotomy is Associated with Excellent Outcomes and Improved Coronal Alignment

    Directory of Open Access Journals (Sweden)

    J. Ryan Martin

    2017-03-01

    Full Text Available Background: The medial tibial reduction osteotomy (MTRO was introduced to achieve coronal ligamentous balance in total knee arthroplasty (TKA patients with substantial preoperative varus deformity. Limited data exists on the outcomes of patients requiring an MTRO. This study compares outcomes of a matched cohort of patients that either required or did not require an MTRO during TKA. Methods: A retrospective review was performed on 67 patients that underwent an MTRO during primary TKA to achieve coronal balance. This patient population was matched 1:1 to another cohort of TKA patients by age, gender, and BMI that did not require an MTRO. A clinical and radiographic evaluation was utilized to compare the two cohorts. Results: Preoperatively, the tibiofemoral angle was 3.42° valgus versus 6.12° varus in the control and MTRO cohorts respectively (p=0.01. Mean postoperative tibiofemoral angles were 3.40° versus 2.43° valgus respectively. Postoperative Knee Society Scores were superior in the MTRO cohort (183.84 versus 174.58; p=0.04. Intraoperatively, no superficial MCL releases were required to achieve coronal balance in either cohort. Complications were similar and limited in both groups. Medial tibial bone resorption was observed in 64% of MTRO subjects averaging 2.02mm versus only 0.3mm in the control cohort ( p=0.01. Conclusion: Patients requiring an MTRO achieved similar alignment and superior knee scores compared to a control cohort with less varus deformity. This procedure eliminated the need for release of the superficial MCL. Resorption of medial tibial bone was commonly observed, possibly secondary to saw-induced thermal necrosis associated with performing an MTRO.

  14. Improvements from a flipped classroom may simply be the fruits of active learning.

    Science.gov (United States)

    Jensen, Jamie L; Kummer, Tyler A; d M Godoy, Patricia D

    2015-03-02

    The "flipped classroom" is a learning model in which content attainment is shifted forward to outside of class, then followed by instructor-facilitated concept application activities in class. Current studies on the flipped model are limited. Our goal was to provide quantitative and controlled data about the effectiveness of this model. Using a quasi-experimental design, we compared an active nonflipped classroom with an active flipped classroom, both using the 5-E learning cycle, in an effort to vary only the role of the instructor and control for as many of the other potentially influential variables as possible. Results showed that both low-level and deep conceptual learning were equivalent between the conditions. Attitudinal data revealed equal student satisfaction with the course. Interestingly, both treatments ranked their contact time with the instructor as more influential to their learning than what they did at home. We conclude that the flipped classroom does not result in higher learning gains or better attitudes compared with the nonflipped classroom when both utilize an active-learning, constructivist approach and propose that learning gains in either condition are most likely a result of the active-learning style of instruction rather than the order in which the instructor participated in the learning process. © 2015 J. L. Jensen et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  15. Can blended learning and the flipped classroom improve student learning and satisfaction in Saudi Arabia?

    Science.gov (United States)

    Sajid, Muhammad R; Laheji, Abrar F; Abothenain, Fayha; Salam, Yezan; AlJayar, Dina; Obeidat, Akef

    2016-09-04

    To evaluate student academic performance and perception towards blended learning and flipped classrooms in comparison to traditional teaching. This study was conducted during the hematology block on year three students. Five lectures were delivered online only. Asynchronous discussion boards were created where students could interact with colleagues and instructors. A flipped classroom was introduced with application exercises. Summative assessment results were compared with previous year results as a historical control for statistical significance. Student feedback regarding their blended learning experience was collected. A total of 127 responses were obtained. Approximately 22.8% students felt all lectures should be delivered through didactic lecturing, while almost 35% felt that 20% of total lectures should be given online. Students expressed satisfaction with blended learning as a new and effective learning approach. The majority of students reported blended learning was helpful for exam preparation and concept clarification. However, a comparison of grades did not show a statistically significant increase in the academic performance of students taught via the blended learning method. Learning experiences can be enriched by adopting a blended method of instruction at various stages of undergraduate and postgraduate education. Our results suggest that blended learning, a relatively new concept in Saudi Arabia, shows promising results with higher student satisfaction. Flipped classrooms replace passive lecturing with active student-centered learning that enhances critical thinking and application, including information retention.

  16. MathsFlip: Flipped Learning. Evaluation Report and Executive Summary

    Science.gov (United States)

    Rudd, Peter; Aguilera, Alaidde Berenice Villaneuva; Elliott, Louise; Chambers, Bette

    2017-01-01

    The MathsFlip intervention aimed to improve the attainment of pupils in Years 5 and 6. The programme, developed by Shireland Collegiate Academy, used a 'flipped learning' approach involving pupils learning core content online, outside of class time, and then participating in activities in class to reinforce their learning. The programme used an…

  17. [The profile surgery. Mandibular osteotomies].

    Science.gov (United States)

    Sancho, M A; Grande, C; Parri, F J; Rivera, A; Sarget, R; Morales, L

    1996-04-01

    During the years 1987-1994, 31 mandibular osteotomies have been performed in 25 patients, 15 had mandibular alteration alone, 10 of them with prognatism, 2 with microretrognatia and 3 with chin hipoplasia. The other 10 had a combined maxillary-mandibular alteration with hipoplasia and maxillary retrussion. The preoperative work-up included cephalometric and dental study, and a cast model was done to asses the theoretical benefic of the osteotomy. All these patients underwent orthodontic treatment before and after surgery. The results have been good or very good in 96% of the cases. The ortognatic surgery offers significant aesthetic and functional improvement to these patients.

  18. Do changes in torsional magnetic resonance imaging reflect improvement in gait after femoral derotation osteotomy in patients with cerebral palsy?

    NARCIS (Netherlands)

    Braatz, Frank; Wolf, Sebastian I.; Gerber, Annette; Klotz, Matthias C.; Dreher, Thomas

    2013-01-01

    Purpose Femoral derotation osteotomy (FDO) is commonly used to correct internal rotation gait (IRG) in spastic diplegia. The purpose of this study was to investigate whether the extent of intraoperative derotation is reflected in changes in static (clinical ROM and anteversion angle measured on

  19. FLIPPED LEARNING: PRACTICAL ASPECTS

    Directory of Open Access Journals (Sweden)

    Olena Kuzminska

    2016-03-01

    Full Text Available The article is devoted to issues of implementation of the flipped learning technology in the practice of higher education institutions. The article defines the principles of technology and a model of the educational process, it notes the need to establish an information support system. The article defines online platforms and resources; it describes recommendations for the design of electronic training courses and organization of the students in the process of implementing the proposed model, as well as tools for assessing its effectiveness. The article provides a description of flipped learning implementation scenario and formulates suggestions regarding the use of this model as a mechanism to improve the efficiency of the learning process in the ICT-rich environment of high school: use of learning management systems (LMS and personal learning environments (PLE of participants in a learning process. The article provides an example of implementation of the flipped learning model as a part of the Information Technologies course in the National University of Life and Environmental Sciences of Ukraine (NULES. The article gives examples of tasks, resources and services, results of students’ research activity, as well as an example of the personal learning network, established in the course of implementation of the flipped learning model and elements of digital student portfolios. It presents the results of the monitoring of learning activities and students’ feedback. The author describes cautions against the mass introduction of the flipped learning model without monitoring of readiness of the participants of the educational process for its implementation

  20. Locally administrated perindopril improves healing in an ovariectomized rat tibial osteotomy model.

    Directory of Open Access Journals (Sweden)

    Xiong Zhao

    Full Text Available Angiotensin-converting enzyme inhibitors are widely prescribed to regulate blood pressure. High doses of orally administered perindopril have previously been shown to improve fracture healing in a mouse femur fracture model. In this study, perindopril was administered directly to the fracture area with the goal of stimulating fracture repair. Three months after being ovariectomized (OVX, tibial fractures were produced in Sprague-Dawley rats and subsequently stabilized with intramedullary wires. Perindopril (0.4 mg/kg/day was injected locally at the fractured site for a treatment period of 7 days. Vehicle reagent was used as a control. Callus quality was evaluated at 2 and 4 weeks post-fracture. Compared with the vehicle group, perindopril treatment significantly increased bone formation, increased biomechanical strength, and improved microstructural parameters of the callus. Newly woven bone was arranged more tightly and regularly at 4 weeks post-fracture. The ultimate load increased by 66.1 and 76.9% (p<0.01, and the bone volume over total volume (BV/TV increased by 29.9% and 24.3% (p<0.01 at 2 and 4 weeks post-fracture, respectively. These findings suggest that local treatment with perindopril could promote fracture healing in ovariectomized rats.

  1. Flipped Physics

    Science.gov (United States)

    Kettle, Maria

    2013-01-01

    This paper defines flipped learning and then examines its practical implementation in AS and A2 level physics classes, that is, classes for 16-18 year olds. The effect of this teaching style on student learning behaviour and its impact on test results are evaluated. The paper recounts the difficulties of implementing it and evaluates student…

  2. TILT OF THE RADIUS FROM FOREARM ROTATIONAL AXIS RELIABLY PREDICTS ROTATIONAL IMPROVEMENT AFTER CORRECTIVE OSTEOTOMY FOR MALUNITED FOREARM FRACTURES

    OpenAIRE

    TATEBE, MASAHIRO; SHINOHARA, TAKAAKI; OKUI, NOBUYUKI; YAMAMOTO, MICHIRO; KURIMOTO, SHIGERU; HIRATA, HITOSHI

    2012-01-01

    ABSTRACT Forearm rotation occurs around an axis connecting the center of the radial head and the fovea of the distal ulna. The purpose of the present study was to demonstrate the usefulness of the difference between forearm and proximal radial axis in the treatment of malunited forearm fractures. We reviewed the results of eight corrective osteotomies for malunited fractures of the forearm without dislocations of the wrist or elbow. Subjects were 6 men and 2 women (mean age, 15 years; range, ...

  3. The Flipped Journal Club.

    Science.gov (United States)

    Bounds, Richard; Boone, Stephen

    2018-01-01

    Educators struggle to develop a journal club format that promotes active participation from all levels of trainees. The explosion of social media compels residencies to incorporate the evaluation and application of these resources into evidence-based practice. We sought to design an innovative "flipped journal club" to achieve greater effectiveness in meeting goals and objectives among residents and faculty. Each journal club is focused on a specific clinical question based on a landmark article, a background article, and a podcast or blog post. With the "flipped" model, residents are assigned to prepare an in-depth discussion of one of these works based on their level of training. At journal club, trainees break into small groups and discuss their assigned readings with faculty facilitation. Following the small-group discussions, all participants convene to summarize key points. In redesigning our journal club, we sought to achieve specific educational outcomes, and improve participant engagement and overall impressions. Sixty-one residents at our emergency medicine program participated in the flipped journal club during the 2015-2016 academic year, with supervision by core faculty. Program evaluation for the flipped journal club was performed using an anonymous survey, with response rates of 70% and 56% for residents and faculty, respectively. Overall, 95% of resident respondents and 100% of faculty respondents preferred the flipped format. The "flipped journal club" hinges upon well-selected articles, incorporation of social media, and small-group discussions. This format engages all residents, holds learners accountable, and encourages greater participation among residents and faculty.

  4. Assessment of trochanteric osteotomy fragment union after acetabular fracture surgery.

    Science.gov (United States)

    Dubina, Andrew G; Wickramaratne, Niluka; O'Toole, Robert V; Manson, Theodore T

    2017-02-01

    Trochanteric osteotomies are performed in conjunction with standard approaches to improve surgical exposure during open reduction and internal fixation (ORIF) of acetabular fractures. The literature on total hip arthroplasty reports nonunion rates as high as 30% associated with trochanteric osteotomies; however, few data exist regarding the outcomes of trochanteric osteotomies for acetabular fracture surgery. Our hypotheses were 1) patients receiving trochanteric osteotomies during ORIF of acetabular fractures have a low rate of nonunion of the osteotomy fragment, and 2) hip abduction precautions are not necessary with digastric type osteotomies. A retrospective review was conducted to identify patients with acetabular fractures between July 2002 and June 2010 (n=734 fractures) who required trochanteric osteotomies (n=64, 9% of fractures). Forty-seven met inclusion criteria of adequate follow-up (>56days). No excluded patient experienced a complication. Fractures were classified using the Letournel-Judet classification system. Only seven (20%) of 35 patients who received digastric osteotomies had hip abduction precautions applied during the postoperative period. All study patients were shown to have radiographic union at the trochanteric osteotomy site (100% union rate, n=47). Hip abduction precautions intended to protect the osteotomy site and reduce the risk of nonunion and fixation failure were infrequently applied to patients with digastric osteotomies (20%) in this cohort. Multiple protective factors against nonunion were present in this study population compared with previous arthroplasty studies from other institutions. Trochanteric osteotomies are not associated with a significant nonunion rate, and digastric osteotomies might be safely managed without hip abduction precautions. Copyright © 2016. Published by Elsevier Ltd.

  5. Outcome in corrective osteotomy for malunited distal radius fractures.

    Science.gov (United States)

    Samson, Lucjan; Treder, Mariusz; Kolarz, Krzysztof; Lorczyński, Adam

    2007-01-01

    This article reports outcome in osteotomy for malunion of distal radius fractures. We evaluated 12 patients with distal radius malunion (mean age 54), who were treated with corrective osteotomy. Wrist motion and grip strength were evaluated, along with examination of pre and post osteotomy radiographs. The indications for corrections were degree of deformity, limitation of function, pain, and the appearance of the wrist. The radiographic evaluation proved that the restoration of the normal anatomic relationship between the distal radius and ulna leads to significant improvement of the function of the hand, as measured by range of motion and grip strength. Osteotomy of the distal radius in cases of malunion gives favorable outcomes.

  6. Periacetabular osteotomy

    DEFF Research Database (Denmark)

    Klit, Jakob; Hartig-Andreasen, Charlotte; Jacobsen, Steffen

    2013-01-01

    , willingness to repeat surgery, quality of life, abilities in social activities, sports and sex-life, pain, limp, and stability of the hip. Median satisfaction was 5 (range 1-5) and 44 of 49 patients were willing to repeat surgery. Significant improvements were seen in quality of life, ability to do sports......, participate in social activities and sex-life (p values...

  7. Ankle joint pressure changes in a pes cavovarus model: supramalleolar valgus osteotomy versus lateralizing calcaneal osteotomy.

    Science.gov (United States)

    Schmid, Timo; Zurbriggen, Sebastian; Zderic, Ivan; Gueorguiev, Boyko; Weber, Martin; Krause, Fabian G

    2013-09-01

    seen. In patients with fixed cavovarus feet, both SMOT and LCOT provided equally good redistribution of elevated ankle joint contact forces. Increasing the amount of displacement did not seem to equally improve the joint pressures. The site of osteotomy could therefore be chosen on the basis of surgeon's preference, simplicity, or local factors in case of more complex reconstructions.

  8. Severe gummy smile with class II malocclusion treated with LeFort I osteotomy combined with horseshoe osteotomy and intraoral vertical ramus osteotomy.

    Science.gov (United States)

    Shimo, Tsuyoshi; Nishiyama, Akiyoshi; Jinno, Tokiari; Sasaki, Akira

    2013-01-01

    In this article, we report the successful surgical treatment of a patient, 34 years of age, who had a severe gummy smile and a class II malocclusion. The patient had an 11-mm gingival exposure during full smile and a convex profile. A LeFort I osteotomy combined with a horseshoe osteotomy was used for the superior repositioning of the maxilla;then, an intraoral vertical ramus osteotomy (IVRO) and genioplasty were performed for mandibular advancement. The maxilla was acceptably impacted 8mm at the first incisor and 5mm at the first molar. Both the occlusion and facial appearance were significantly improved by this surgical-orthodontic treatment. Our results suggest that the combination of a horseshoe osteotomy with a LeFort I osteotomy is a useful technique for reliable superior repositioning of the maxilla.

  9. Flipping HCI

    Directory of Open Access Journals (Sweden)

    C. Evans

    2016-08-01

    Full Text Available This paper presents the results of two studies involving “flipping the classroom”. Teaching material was delivered via interactive “e-lectures”, allowing face-to-face sessions to focus instead on practice. The e-lectures were designed according to standard usability principles coupled with recent research into the effect of interactivity on learning. The effectiveness of the use of e-lectures was then evaluated using an online survey. The results suggest that students prefer the flexibility offered by e-lectures compared to conventional lectures. The results contribute to our understanding of how this technology fits with face-to-face teaching in the digital age.

  10. A Flipped Classroom Approach to Improving the Quality of Delirium Care Using an Interprofessional Train-the-Trainer Program.

    Science.gov (United States)

    Sockalingam, Sanjeev; James, Sandra-Li; Sinyi, Rebecca; Carroll, Aideen; Laidlaw, Jennifer; Yanofsky, Richard; Sheehan, Kathleen

    2016-01-01

    Given the prevalence and morbidity associated with delirium, there is a need for effective and efficient institutional approaches to delirium training in health care settings. Novel education methods, specifically the "flipped classroom" (FC) and "train-the-trainer" (TTT), have the potential to address these delirium training gaps. This study evaluates the effect of a TTT FC interprofessional delirium training program on participants' perceived ability to manage delirium, delirium knowledge, and clinicians' delirium assessment behaviors. FC Delirium TTT sessions were implemented in a large four-hospital network and consisted of presession online work and a 3-hour in-session component. The 156 TTT interprofessional participants who attended the sessions (ie, trainers) were expected to then deliver delirium training to their patient care units. Delirium care self-efficacy and knowledge test scores were measured before, after, and 6 months after the training session. Clinician delirium assessment rates were measured by chart audits before and 3 months after trainer's implementation of delirium training sessions. Delirium knowledge test scores (7.8 ± 1.6 versus 9.7 ± 1.2, P < .001) and delirium care self-efficacy were significantly higher immediately after the TTT session compared with those of presession and these differences remained significant at 6-month after the TTT session. Trainer sessions significantly improved clinician delirium assessment rates from 53% for pretraining to 66% for posttraining. Our data suggest that a TTT FC delirium training approach can improve participants' perceived delirium care skills and confidence, and delirium knowledge up to 6 months after the session. This approach provides a model for implementing hospitalwide delirium education that can change delirium assessment behavior while minimizing time and personnel requirements.

  11. Distal Metatarsal Osteotomy in Hallux Valgus Surgery: Chevron Osteotomy

    Directory of Open Access Journals (Sweden)

    Fatih Dogar

    2016-04-01

    Full Text Available Aim: Hallux valgus is a complex foot deformity resulting from medial deviation of first metatarsal and lateral deviation of toe. Radiographic and functional outcomes of chevron type distal metatarsal osteotomy applied to symptomatic hallux valgus patients with moderate deformity were assessed in the present study. Chevron osteotomy was applied to 27 feet (13 left, 14 right of 22 patients (12 women and 10 men; mean age: 45±16.7 years. Mean follow-up was 15.4± 4.71 months (range, 10%u201324. Material and Method: The average preoperative AOFAS score of 39.1 ± 8.55 (range, 32%u201357 improved (p < 0.0001 to 87.8 ± 4.7 (range, 82%u201397. The average preoperative hallux valgus angle (HVA of 37.4 ± 5.8 (range, 29%u201350 improved (p < 0.0001 to 14.8 ± 3.1 (range, 10%u201320 , and the average preoperative intermetatarsal 1-2 angle (IMA of 13.1 ± 1.5 (range, 11%u201317 improved (p < 0.0001 to 7.1 ± 1.4 (range, 5%u20139 . The average sesamoid position improved from 2.9 ± 0.2 (range, 2-3 preoperatively to 1.2 ± 0.4 (range, 1-2 (p < 0.0001. Toe hypoesthesia was developed in one patient as a complication. At the end of follow-up, patient satisfaction was found to be excellent in 16 feet (59.2% and good in 11 feet (40.8%. Results: The results of the study that chevron osteotomy yields good radiological result, high degree of postoperative patient satisfaction with minimal complications. Chevron ostoetomy is most effective method in the treatment of moderate hallux valgus.

  12. Flipped learning in science education

    DEFF Research Database (Denmark)

    Andersen, Thomas Dyreborg; Foss, Kristian Kildemoes; Nissen, Stine Karen

    2017-01-01

    ICT in a meaningful way, and make way that the potential of ICT may be unleashed. This poster presentation will present the methodological framework for a study on the implementation of Flipped Learning in science classrooms in the Danish elementary school system – and the research following this. Our...... research questions are “To what extent can teachers using the FL-teaching method improve Danish pupils' learning outcomes in science subject’s physics / chemistry, biology and geography in terms of the results of national tests?” And “What factors influence on whether FL-teaching improves pupils' learning......?” During a 3-year period 84 science teachers at 18 schools will participate in a program where they will lean to conduct teaching based on flipped learning principals. The teachers will undertake a 3 + 1 + 1 day course where essential technical and didactical issues regarding flipped learning...

  13. Flipping for Mastery

    Science.gov (United States)

    Bergmann, Jonathan; Sams, Aaron

    2014-01-01

    What if all students had an opportunity to work through content at their own pace? What if all students had to master content before they moved on? The authors take their flipped-classroom model to the next level by flipping their classroom for mastery. In the flipped-mastery model, the teacher begins by organizing content around specific…

  14. Effectiveness of Percutaneous Proximal Closing Wedge Osteotomy With Akin Osteotomy to Correct Severe Hallux Valgus Determined by Radiographic Parameters.

    Science.gov (United States)

    Kurashige, Toshinori; Suzuki, Seiichi

    2017-04-01

    Some authors reported the results from percutaneous distal metatarsal osteotomy for hallux valgus recently. On the other hand, there are few reports of percutaneous proximal metatarsal osteotomy. The purpose of the present study was to evaluate the radiographic results of percutaneous proximal closing wedge osteotomy with Akin osteotomy for correction of severe hallux valgus and increasing longitudinal arch height. Consecutive 17 feet (mean age = 70.8 years) were investigated. The mean follow-up was 22 months. Excision of medial eminence, distal soft tissue release, and Akin osteotomy were all performed percutaneously and concurrently. Weight-bearing anteroposterior and lateral radiographs of the feet were acquired preoperatively and at final follow-up. On the anteroposterior radiographs, hallux valgus angle, intermetatarsal angle, and first metatarsal shortening were measured. On the lateral radiographs, talometatarsal angle, calcaneal pitch angle, and first metatarsal dorsiflexion were measured. The average improvements in hallux valgus angle and intermetatarsal angle were 27.6° and 9.9°, respectively. The average first metatarsal shortening was 2.7 mm. The first metatarsal dorsiflexion improved by 2.2°; however, other parameters did not improve significantly. In conclusion, percutaneous proximal closing wedge osteotomy with Akin osteotomy corrects severe hallux valgus; however, the procedure does not increase the medial longitudinal arch. Therapeutic, Level IV: Case series.

  15. Periacetabular Osteotomy Redirects the Acetabulum and Improves Pain in Charcot-Marie-Tooth Hip Dysplasia With Higher Complications Compared With Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Novais, Eduardo N; Kim, Young-Jo; Carry, Patrick M; Millis, Michael B

    2016-12-01

    The Bernese periacetabular osteotomy (PAO) is a well-accepted reorientation pelvic osteotomy used to treat symptomatic acetabular dysplasia secondary to developmental dysplasia of the hip (DDH). However, there are limited data regarding PAO in patients with symptomatic hip dysplasia secondary to Charcot-Marie-Tooth disease. We compared patients who underwent PAO for the treatment of Charcot-Marie-Tooth disease hip dysplasia (CMTHD group) with patients who underwent PAO for treatment of hip dysplasia secondary to DDH in terms of (1) modified Harris Hip scores; (2) radiographic correction of acetabular dysplasia; and (3) the rate of complications. Twenty-seven subjects with Charcot-Marie-Tooth disease who underwent a PAO between January 1991 and December 2010 were matched to 54 subjects with DDH on the basis of sex, age, date of surgery, and body mass index. Preoperative and postoperative hip functional scores and radiographic data were collected with a minimum 2-year follow-up. The modified Harris Hip Scores (mHHS) assessed functional hip outcomes. Radiographic variables included lateral (LCEA) and anterior (ACEA) center-edge angles, Tönnis angle and Tönnis grade of arthritis. Postoperative complications were classified according to a modified Dindo-Clavien system. At latest follow-up mHHS improved in the CMTHD group (preoperative median 63; (interquartile range [IQR]=54-70 to postoperative median 88; IQR=74-91); P=0.004) and in the DDH groups (preoperative median 71; IQR=58-83 to postoperative median 86; IQR=73-96; P=0.002) with no difference between the 2 groups (P=0.631). Radiographic improvement (LCEA: mean difference, 36 degrees, 95% confidence interval [CI], 30-41 degrees, P<0.001; ACEA: mean difference, 27 degrees, 95% CI, 20-33 degrees, P<0.001; Tönnis angles: mean difference, 21 degrees, 95% CI, 15-26 degrees, P<0.001) was achieved in the CMTHD group. Similarly, radiographic improvements in LCEA (mean difference, 33 degrees, 95% CI, 29-37 degrees, P<0

  16. Radial head dislocation during proximal radial shaft osteotomy.

    Science.gov (United States)

    Hazel, Antony; Bindra, Randy R

    2014-03-01

    The following case report describes a 48-year-old female patient with a longstanding both-bone forearm malunion, who underwent osteotomies of both the radius and ulna to improve symptoms of pain and lack of rotation at the wrist. The osteotomies were templated preoperatively. During surgery, after performing the planned radial shaft osteotomy, the authors recognized that the radial head was subluxated. The osteotomy was then revised from an opening wedge to a closing wedge with improvement of alignment and rotation. The case report discusses the details of the operation, as well as ways in which to avoid similar shortcomings in the future. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  17. Flipped Classroom Approach

    Directory of Open Access Journals (Sweden)

    Fezile Ozdamli

    2016-07-01

    Full Text Available Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly in the world, is not well recognized in our country. That is why the aim of study is to attract attention to its potential in education field and provide to make it recognize more by educators and researchers. With this aim, in the study what flipped classroom approach is, flipped classroom technology models, its advantages and limitations were explained.

  18. DomFLIP++

    International Nuclear Information System (INIS)

    Hendrysiak, W.; Raggl, A.; Slany, W.

    1996-01-01

    DomFLIP++ is the knowledge engineering module of the *FLIP++ project. *FLIP++ is a tool for optimizing multiple criteria problems. It uses fuzzy constraints to model optimizing criteria and applies algorithms such as Tabu search or genetic algorithms to the problems. DomFLIP++ is a C++ library. It allows the definition of new optimization problems. It helps a domain engineer to design the structure of a new problem. However, there is a domain independent interface to other *FLIP++ modules such as OptiFLIP++, DynaFLIP++, and InterFLIP++. After each iteration in the optimization process, the considered instantiations of the problem are evaluated. Each evaluation produces a list of violated constraints. For each constraint in further iterations of the optimization. A domain can be fine-tuned through modifications of constraints, through editing their repair lists, and through change in the optimizing parameters. A well-tuned domain can be successfully applied for optimization. Object-oriented design and implementation makes this module easy to modify and to reuse. Definition of new domains, system extensions with new optimizing algorithms, and definition of specific domain-dependent repair steps can be done efficiently. DomFLIP++ is tested on real-world example, namely scheduling the steel plant LD3 in Linz, Austria

  19. Flipping primary health care: A personal story.

    Science.gov (United States)

    Mate, Kedar S; Salinas, Gilbert

    2014-12-01

    There is considerable interest in ideas borrowed from education about "flipping the classroom" and how they might be applied to "flipping" aspects of health care to reach the Triple Aim of improved health outcomes, improved experience of care, and reduced costs. There are few real-life case studies of "flipping health care" in practice at the individual patient level. This article describes the experience of one of the authors as he experienced having to "flip" his primary health care. We describe seven inverted practices in his care, report outcomes of this experiment, describe the enabling factors, and derive lessons for patient-centered primary care redesign. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity - A prospective comparative study.

    Science.gov (United States)

    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels; Hansen, Palle Bo; Froekjaer, Johnny

    2016-03-01

    Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal open wedge osteotomy and fixation with plate (Hemax), group 1, or operation with proximal crescentic osteotomy and fixation with a 3mm cannulated screw, group 2. The mean age was 52 years (19-71). Forty-one females and four males were included. Clinical and radiological follow-ups were performed 4 and 12 months after the operation. In group 1 the hallux valgus angle decreased from 39.0̊ to 24.1̊ after 4 months and 27.9̊ after 12 months. In group 2 the angle decreased from 38.3̊ to 21.4̊ after 4 months and 27.0̊ after 12 months. The intermetatarsal angle in group 1 was 19.0̊ preoperatively, 11.6̊ after 4 months and 12.6̊ after 12 months. In group 2 the mean intermetatarsal angle was 18.9̊ preoperatively, 12.0̊ after 4 months and 12.6̊ after 12 months. The AOFAS score improved from 59.3 to 81.5 in group 1 and from 61.8 to 84.8 in group 2 respectively measured 12 months postoperatively. The relative length of the 1 metatarsal compared to 2 metatarsal bone was 0.88 and 0.87 preoperatively and 0.88 and 0.86 for group 1 and 2 respectively measured after 12 months. Crescentic osteotomy and open wedge osteotomy improve AOFAS score and VAS scores on patients operated with severe hallux valgus. No significant difference was found in the two groups looking at the postoperative improvement of HVA and IMA measured 4 and 12 months postoperatively. The postoperative VAS score and AOFAS score were

  1. Flipped Classroom Approach

    Science.gov (United States)

    Ozdamli, Fezile; Asiksoy, Gulsum

    2016-01-01

    Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly…

  2. Discouraging Students’ Academic Dishonesty in Flipped Classroom

    Directory of Open Access Journals (Sweden)

    Lucia Nino Widiasmoro Dewati

    2017-03-01

    Full Text Available Flipped Classroom presents teaching process at home through videos, handouts and listening passages before the class session. While in-class time is mostly devoted for questions and answers session, exercises, projects and discussion. The reason flipped classroom is needed for teachers in this era, simply because at the time students do the assignments inside the classroom, teachers would have the opportunities to observe students’ interaction, activities, improvement and even to solve students’ problem such as academic dishonesty. Thus, the question would be: to what extent is the urgency of implementing flipped classroom as one solution to discourage students’ academic dishonesty in writing classes? The study is conducted by employing Action Research. The findings confirm that performing Flipped Classroom is essential in order to discourage students’ academic dishonesty while assisting the teacher to observe students’ development in writing classes. DOI: https://doi.org/10.24071/llt.2017.200103

  3. Advanced flip chip packaging

    CERN Document Server

    Lai, Yi-Shao; Wong, CP

    2013-01-01

    Advanced Flip Chip Packaging presents past, present and future advances and trends in areas such as substrate technology, material development, and assembly processes. Flip chip packaging is now in widespread use in computing, communications, consumer and automotive electronics, and the demand for flip chip technology is continuing to grow in order to meet the need for products that offer better performance, are smaller, and are environmentally sustainable. This book also: Offers broad-ranging chapters with a focus on IC-package-system integration Provides viewpoints from leading industry executives and experts Details state-of-the-art achievements in process technologies and scientific research Presents a clear development history and touches on trends in the industry while also discussing up-to-date technology information Advanced Flip Chip Packaging is an ideal book for engineers, researchers, and graduate students interested in the field of flip chip packaging.

  4. Injection of Mesenchymal Stem Cells as a Supplementary Strategy of Marrow Stimulation Improves Cartilage Regeneration After Lateral Sliding Calcaneal Osteotomy for Varus Ankle Osteoarthritis: Clinical and Second-Look Arthroscopic Results.

    Science.gov (United States)

    Kim, Yong Sang; Koh, Yong Gon

    2016-05-01

    To compare the clinical and second-look arthroscopic outcomes in patients undergoing arthroscopic marrow stimulation combined with lateral sliding calcaneal osteotomy for varus ankle osteoarthritis, with or without adipose-derived mesenchymal stem cell (MSC) injection. In this retrospective comparative study, 49 patients with varus ankle osteoarthritis underwent second-look arthroscopy after arthroscopic marrow stimulation combined with lateral sliding calcaneal osteotomy between January 2010 and November 2012; 23 ankles underwent marrow stimulation alone (group 1), and 26 underwent marrow stimulation with MSC injection (group 2). The decision whether to receive the MSC injection, which was free of charge, was solely up to the patients. Second-look arthroscopies were performed at a mean of 12.5 months and 12.4 months postoperatively in group 1 and group 2, respectively. Clinical outcome measures included a visual analog scale (VAS) score for pain and the American Orthopaedic Foot & Ankle Society (AOFAS) score. The radiologic outcome variable was the talar tilt angle. On second-look arthroscopy, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. The mean VAS score improved significantly from 7.3 ± 0.9 to 3.9 ± 1.2 in group 1 and from 7.4 ± 0.8 to 3.1 ± 1.5 in group 2 at final follow-up (P osteoarthritis who underwent lateral sliding calcaneal osteotomy, significant improvements in VAS and AOFAS scores, as well as better ICRS grades, were achieved at short-term follow-up after marrow stimulation with additional MSC injection compared with after marrow stimulation alone. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Chiari pelvic osteotomy in treatment of hip dysplasia

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2013-01-01

    Full Text Available Chiari pelvic osteotomy is a surgical procedure having been performed for almost sixty years in patients with the insuffcient coverage of the femoral head. It is most frequently used in young patients with dysplastic acetabular sockets as a part of developmental hip dysplasia. Even though performance of the Chiari osteotomy is associated with positive therapeutical results, above all, its main goal is to delay inevitable degenerative changes. Original surgical technique has been modified and improved over time. Nevertheless, the basic idea has remained unchanged - increasing of the femoral head coverage by medial displacement of the distal part of the pelvis along with capsular interpositioning. Given the complexity of operation, the complication percentage is rather low. Chiari pelvic osteotomy has lost its actuality and importance during this past six decades. The role of Chiari pelvic osteotomy has been considerably taken over by other more efficient and more lasting surgical procedures. Nonetheless, Chiari pelvic osteotomy is still present in modern orthopedic practice, above all as „salvage“ osteotomy. [Projekat Ministarstva nauke Republike Srbije, br. 41004

  6. Flipped Learning in the Workplace

    Science.gov (United States)

    Nederveld, Allison; Berge, Zane L.

    2015-01-01

    Purpose: The purpose of this paper is to serve as a summary of resources on flipped learning for workplace learning professionals. A recent buzzword in the training world is "flipped". Flipped learning and the flipped classroom are hot topics that have emerged in K-12 education, made their way to the university and are now being noticed…

  7. Z-osteotomy in hallux valgus: clinical and radiological outcome after Scarf osteotomy

    Directory of Open Access Journals (Sweden)

    Marcus Jaeger

    2009-05-01

    Full Text Available Correction osteotomies of the first metatarsal are common surgical approaches in treating hallux valgus deformities whereas the Scarf osteotomy has gained popularity. The purpose of this study was to analyze short- and mid-term results in hallux valgus patients who underwent a Scarf osteotomy. The subjective and radiological outcome of 131 Scarf osteotomies (106 hallux valgus patients, mean age: 57.5 years, range: 22-90 years were retrospectively analyzed. Mean follow-up was 22.4 months (range: 6 months-5 years. Surgical indications were: intermetatarsal angle (IMA of 12-23°; increased proximal articular angle (PAA>8°, and range of motion of the metatarsophalangeal joint in flexion and extension >40°. Exclusion criteria were severe osteoporosis and/or osteoarthritis. The mean subjective range of motion (ROM of the great toe post-surgery was 0.8±1.73 points (0: full ROM, 10: total stiffness. The mean subjective cosmetic result was 2.7±2.7 points (0: excellent, 10: poor. The overall post-operative patient satisfaction with the result was high (2.1±2.5 points (0: excellent, 10: poor. The mean hallux valgus angle improvement was 16.6° (pre-operative mean value: 37.5° which was statistically significant (p<0.01. The IMA improved by an average of 5.96° from a pre-operative mean value of 15.4° (p<0.01. Neither osteonecrosis of the distal fragment nor peri-operative fractures were noted during the follow-up. In keeping with our follow-up results, the Scarf osteotomy approach shows potential in the therapy of hallux valgus. 筻

  8. First Metatarsal Proximal Opening Wedge Osteotomy for Correction of Hallux Valgus Deformity: Comparison of Straight versus Oblique Osteotomy

    Science.gov (United States)

    Han, Seung Hwan; Park, Eui Hyun; Jo, Joon; Koh, Yong Gon; Lee, Jin Woo; Choi, Woo Jin

    2015-01-01

    Purpose The aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy. Materials and Methods We retrospectively reviewed 104 consecutive first metatarsal proximal opening wedge osteotomies performed in 95 patients with hallux valgus deformity. Twenty-six feet were treated using straight metatarsal osteotomy (group A), whereas 78 feet were treated using oblique metatarsal osteotomy (group B). The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle, and distance from the first to the second metatarsal (distance) were measured for radiographic evaluation, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used for clinical evaluation. Results Significant corrections in the HVA, IMA, and distance from the first to the second metatarsal were obtained in both groups at the last follow-up (p<0.001). There was no difference in the mean IMA correction between the 2 groups (6.1±2.7° in group A and 6.0±2.1° in group B). However, a greater correction in the HVA and distance from the first to the second metatarsal were found in group B (HVA, 13.2±8.2°; distance, 25.1±0.2 mm) compared to group A (HVA, 20.9±7.7°; distance, 28.1±0.3 mm; p<0.001). AOFAS scores were improved in both groups. However, group B demonstrated a greater improvement relative to group A (p=0.005). Conclusion Compared with a straight first metatarsal osteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes. PMID:25837181

  9. Modified Mitchell osteotomy alone does not have higher rate of residual metatarsalgia than combined first and lesser metatarsal osteotomy

    Directory of Open Access Journals (Sweden)

    Shu-Jung Chen

    2015-04-01

    Full Text Available Transfer metatarsalgia (TM is a common forefoot disorder secondary to hallux valgus (HV. Some authors suggest that a combined lesser metatarsal osteotomy while undergoing HV surgery improves metatarsalgia, whereas others concluded that isolated HV corrective osteotomy can improve symptomatic metatarsalgia. The main purpose of this retrospective study was to compare clinical outcomes in patients with and without combined lesser metatarsal osteotomy while receiving HV correction surgery. We retrospectively reviewed the patients who underwent osteotomy for HV correction between January 2000 and December 2010. All patients underwent HV correction with modified Mitchell osteotomy. Clinical evaluations including the American Orthopaedic Foot and Ankle Society score and residual metatarsalgia were assessed, and radiographic measurements were carried out. Sixty-five patients (83 feet meeting the selection criteria were enrolled. Thirty feet receiving a combined lesser metatarsal osteotomy were classified as the combined surgery (CS group, and the others were classified as the control (CN group (53 feet. The overall rate of persistent symptomatic metatarsalgia was 19.28% after operative treatment. There were six feet with residual metatarsalgia in the CS group, and 10 feet in the CN group. There was no significant difference in the rate of persistent symptoms between the two groups (p = 0.9. According to this result, modified Mitchell osteotomy alone did not have a higher rate of residual metatarsalgia than CS. We also found that the average recovery rate of TM was about 80.7% and those patients whose preoperative HV angle was > 30° had the higher risk of residual metatarsalgia after surgery.

  10. Implementing the Flipped Classroom in Teacher Education: Evidence from Turkey

    Science.gov (United States)

    Kurt, Gökçe

    2017-01-01

    The flipped classroom, a form of blended learning, is an emerging instructional strategy reversing a traditional lecture-based teaching model to improve the quality and efficiency of the teaching and learning process. The present article reports a study that focused on the implementation of the flipped approach in a higher education institution in…

  11. Flipping Preservice Elementary Teachers' Mathematics Anxieties

    Science.gov (United States)

    Dove, Anthony; Dove, Emily

    2017-01-01

    In preparing future elementary educators in mathematics, helping them overcome their anxieties of mathematics and teaching mathematics is paramount. This study examined how different instructional practices (in-class lecture, flipped learning with teacher-created videos, flipped classroom with Khan Academy videos) compared in improving students'…

  12. Performance Improvement of GaN-Based Flip-Chip White Light-Emitting Diodes with Diffused Nanorod Reflector and with ZnO Nanorod Antireflection Layer

    Directory of Open Access Journals (Sweden)

    Hsin-Ying Lee

    2014-01-01

    Full Text Available The GaN-based flip-chip white light-emitting diodes (FCWLEDs with diffused ZnO nanorod reflector and with ZnO nanorod antireflection layer were fabricated. The ZnO nanorod array grown using an aqueous solution method was combined with Al metal to form the diffused ZnO nanorod reflector. It could avoid the blue light emitted out from the Mg-doped GaN layer of the FCWLEDs, which caused more blue light emitted out from the sapphire substrate to pump the phosphor. Moreover, the ZnO nanorod array was utilized as the antireflection layer of the FCWLEDs to reduce the total reflection loss. The light output power and the phosphor conversion efficiency of the FCWLEDs with diffused nanorod reflector and 250 nm long ZnO nanorod antireflection layer were improved from 21.15 mW to 23.90 mW and from 77.6% to 80.1% in comparison with the FCWLEDs with diffused nanorod reflector and without ZnO nanorod antireflection layer, respectively.

  13. [Distal femoral osteotomy using a lateral opening wedge technique].

    Science.gov (United States)

    Feucht, M J; Mehl, J; Forkel, P; Imhoff, A B; Hinterwimmer, S

    2017-08-01

    To shift the weight-bearing axis of the lower limb medially by opening a lateral-based metaphyseal osteotomy at the distal femur. Femoral-based valgus malalignment and symptomatic lateral unicompartimental osteoarthritis, lateral hyperpression syndrome, cartilage therapy of the lateral compartment, lateral meniscal replacement/transplantation, medial instability with valgus thrust, reconstruction of the medial collateral ligament, patellar instability and/or maltracking. Advanced cartilage damage (>grade 2) or subtotal meniscal loss of the medial compartment, age >65 years (relative), nicotine abuse, body mass index >30, flexion contracture >25°, corrections with a wedge base >10 mm in case of congenital deformities, inflammatory or septic arthritis, severe osteoporosis. Lateral approach to the distal femur; biplanar osteotomy (frontal + axial osteotomy), gradual opening of the osteotomy, osteotomy fixation with a locking plate. Free range of motion. Partial weight bearing with 20 kg for 2 weeks, followed by progressive weight bearing thereafter. Mean improvement of knee scores from 20-30 points and mean 10-year survival rate of 80% in patients with lateral unicompartimental osteoarthritis. Mean complication rate of 9%.

  14. Does use of a jig influence the precision of tibial plateau leveling osteotomy surgery?

    Science.gov (United States)

    Bell, Jonathan C; Ness, Malcolm G

    2007-04-01

    To compare the precision of tibial plateau leveling osteotomy (TPLO) surgery when performed with or without a jig. Cadaveric study. Cadaveric, adult greyhound hindlimbs (n=9 pair). TPLO (n=18) was performed on each limb pair; 1 with and 1 without use of a jig. Measurements taken from pre- and postsurgical radiographs were osteotomy position, tibial plateau angle (TPA), varus-valgus malalignment, and tibial torsion. The null hypothesis was that TPLO precision was not affected by use of a jig. Student's t-test was used to investigate differences in TPA, osteotomy location, and frequency and extent of iatrogenic limb malalignment; Pjig. Osteotomy location was significantly more distal when a jig was used (P=.03). Jig use did not improve the precision of TPLO surgery. Performing TPLO without a jig should reduce surgery time, eliminate complications related to placement of the distal jig pin and allow unhindered positioning of the osteotomy.

  15. Extended plantar limb (modified) chevron osteotomy versus scarf osteotomy for hallux valgus correction: A randomised controlled trial.

    Science.gov (United States)

    Mahadevan, Devendra; Lines, Stephen; Hepple, Stephen; Winson, Ian; Harries, William

    2016-06-01

    The purpose of this RCT was to compare the extended plantar limb (modified) chevron osteotomy with the scarf osteotomy in correcting hallux valgus deformity and improving functional scores and patient satisfaction. Patients were randomly assigned and kept blind to surgical allocation. Cases requiring additional procedures including the Akin osteotomy were excluded. Outcomes were measured at 1 year following surgery. 84 patients (109 feet) were analysed (60 modified chevron; 49 Scarf). The mean age was 50.7 years (75F: 9M). Post-operative intermetatarsal angle (IMA) was significantly lower in the modified chevron group (5.8° versus 6.9°, p=0.045). Hallux valgus angle and distal metatarsal articular angle were similar. The magnitude of IMA correction with the modified chevron was also significantly greater (9.1° versus 7.1°, p=0.007). Both osteotomies produced comparable MOxFQ scores and satisfaction ratings. The modified chevron was superior to the scarf osteotomy in correcting IMA in hallux valgus deformity. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  16. Bernese periacetabular osteotomy for hip dysplasia: Surgical technique and indications

    Science.gov (United States)

    Kamath, Atul F

    2016-01-01

    For young, active patients with healthy hip cartilage, pelvic osteotomy is a surgical option in to address hip pain and to improve mechanical loading conditions related to dysplasia. Hip dysplasia may lead to arthrosis at an early age due to poor coverage of the femoral head and abnormal loading of the joint articulation. In patients with symptomatic dysplasia and closed triradiate cartilage (generally over age 10), including adolescents and young adults (generally up to around age 40), the Bernese periacetabular osteotomy (PAO) is a durable technique for addressing underlying structural deformity. The PAO involves a modified Smith-Petersen approach. Advantages of the Bernese osteotomy include preservation of the weight-bearing posterior column of the hemi-pelvis, preservation of the acetabular blood supply, maintenance of the hip abductor musculature, and the ability to effect powerful deformity correction about an ideal center of rotation. There is an increasing body of evidence that preservation of the native hip can be improved through pelvic osteotomy. In contrast to hip osteotomy and joint preservation, the role of total hip arthroplasty in young, active patients with correctable hip deformity remains controversial. Moreover, the durability of hip replacement in young patients is inherently limited. Pelvic osteotomy should be considered the preferred method to address correctable structural deformity of the hip in the young, active patient with developmental dysplasia. The Bernese PAO is technically demanding, yet offers reproducible results with good long-term survivorship in carefully selected patients with preserved cartilage and the ability to meet the demands of rehabilitation. PMID:27190755

  17. Flipping the Classroom

    Science.gov (United States)

    Riendeau, Diane

    2012-11-01

    A recent trend in education is the ``flipped'' or ``reversed'' classroom. In this educational model, students view videos of the lectures as their homework and class time is used for activities and solving problems that might have been assigned as homework in a traditional classroom. Although far from an expert on flipping the classroom, I can see some merit in the idea. When students watch the videos at home, they can start and restart the lecture as often as they like. The lectures are also available for review before the exam. Class time can be used for higher-order questioning, experiments, and problem solving.

  18. Hallux varus following scarf osteotomy.

    Science.gov (United States)

    Akhtar, Shahid; Malek, Sabur; Hariharan, Kartik

    2016-12-01

    Hallux varus is an uncommon condition and majority of the cases are iatrogenic. It can occur as a result of any type of hallux valgus correction surgery and in our cases scarf osteotomy is not an exception. Treatment of this complication can be challenging and it is important to understand the factors that cause this deformity before embarking on surgical correction. Four cases of hallux varus following Scarf osteotomy (1% of our total Scarf osteotomy cases) and discuss the salient features of these patients. The authors ascertained the factors that caused iatrogenic hallux varus and formulated a classification of the nature of the deformity. The management of iatrogenic hallux varus based on our experience and proposed classification system has also been outlined and discussed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  19. Ulnar shortening osteotomy for distal radius malunion.

    Science.gov (United States)

    Kamal, Robin N; Leversedge, Fraser J

    2014-08-01

    Background Malunion is a common complication of distal radius fractures. Ulnar shortening osteotomy (USO) may be an effective treatment for distal radius malunion when appropriate indications are observed. Methods The use of USO for treatment of distal radius fracture malunion is described for older patients (typically patients >50 years) with dorsal or volar tilt less than 20 degrees and no carpal malalignment or intercarpal or distal radioulnar joint (DRUJ) arthritis. Description of Technique Preoperative radiographs are examined to ensure there are no contraindications to ulnar shortening osteotomy. The neutral posteroanterior (PA) radiograph is used to measure ulnar variance and to estimate the amount of ulnar shortening required. An ulnar, mid-sagittal incision is used and the dorsal sensory branch of the ulnar nerve is preserved. An USO-specific plating system with cutting jig is used to create parallel oblique osteotomies to facilitate shortening. Intraoperative fluoroscopy and clinical range of motion are checked to ensure adequate shortening and congruous reduction of the ulnar head within the sigmoid notch. Results Previous outcomes evaluation of USO has demonstrated improvement in functional activities, including average flexion-extension and pronosupination motions, and patient reported outcomes. Conclusion The concept and technique of USO are reviewed for the treatment of distal radius malunion when specific indications are observed. Careful attention to detail related to surgical indications and to surgical technique typically will improve range of motion, pain scores, and patient-reported outcomes and will reduce the inherent risks of the procedure, such as ulnar nonunion or the symptoms related to unrecognized joint arthritis.  Level IV.

  20. Flipping the Classroom Revisited

    Science.gov (United States)

    Riendeau, Diane

    2013-02-01

    I received many emails following the first column on flipping the classroom. Many of my local colleagues also approached me at our physics alliance, Physics Northwest. Teachers are very interested in this new pedagogy. As I result, I wanted to share some more videos to inspire you.

  1. The flipped classroom

    DEFF Research Database (Denmark)

    Triantafyllou, Evangelia

    2015-01-01

    communication and information sharing in such classrooms. Furthermore, it provides guidelines for supporting out-of-class instruction in the flipped model by using quizzes and feedback in Moodle, and comments on the potential to follow student use of resources by using Moodle reports. This paper concludes...

  2. Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents.

    Science.gov (United States)

    Martinelli, Susan M; Chen, Fei; DiLorenzo, Amy N; Mayer, David C; Fairbanks, Stacy; Moran, Kenneth; Ku, Cindy; Mitchell, John D; Bowe, Edwin A; Royal, Kenneth D; Hendrickse, Adrian; VanDyke, Kenneth; Trawicki, Michael C; Rankin, Demicha; Guldan, George J; Hand, Will; Gallagher, Christopher; Jacob, Zvi; Zvara, David A; McEvoy, Matthew D; Schell, Randall M

    2017-08-01

    In a flipped classroom approach, learners view educational content prior to class and engage in active learning during didactic sessions. We hypothesized that a flipped classroom improves knowledge acquisition and retention for residents compared to traditional lecture, and that residents prefer this approach. We completed 2 iterations of a study in 2014 and 2015. Institutions were assigned to either flipped classroom or traditional lecture for 4 weekly sessions. The flipped classroom consisted of reviewing a 15-minute video, followed by 45-minute in-class interactive sessions with audience response questions, think-pair-share questions, and case discussions. The traditional lecture approach consisted of a 55-minute lecture given by faculty with 5 minutes for questions. Residents completed 3 knowledge tests (pretest, posttest, and 4-month retention) and surveys of their perceptions of the didactic sessions. A linear mixed model was used to compare the effect of both formats on knowledge acquisition and retention. Of 182 eligible postgraduate year 2 anesthesiology residents, 155 (85%) participated in the entire intervention, and 142 (78%) completed all tests. The flipped classroom approach improved knowledge retention after 4 months (adjusted mean = 6%; P  = .014; d  = 0.56), and residents preferred the flipped classroom (pre = 46%; post = 82%; P  < .001). The flipped classroom approach to didactic education resulted in a small improvement in knowledge retention and was preferred by anesthesiology residents.

  3. Research, Perspectives, and Recommendations on Implementing the Flipped Classroom.

    Science.gov (United States)

    Rotellar, Cristina; Cain, Jeff

    2016-03-25

    Flipped or inverted classrooms have become increasingly popular, and sometimes controversial, within higher education. Many educators have touted the potential benefits of this model and initial research regarding implementation has been primarily positive. The rationale behind the flipped classroom methodology is to increase student engagement with content, increase and improve faculty contact time with students, and enhance learning. This paper presents a summary of primary literature regarding flipped classrooms, discusses concerns and unanswered questions from both a student and faculty member perspective, and offers recommendations regarding implementation.

  4. A Learning Analytics Approach to Investigating Factors Affecting EFL Students' Oral Performance in a Flipped Classroom

    Science.gov (United States)

    Lin, Chi-Jen; Hwang, Gwo-Jen

    2018-01-01

    Flipped classrooms have been widely adopted and discussed by school teachers and researchers in the past decade. However, few studies have been conducted to formally evaluate the effectiveness of flipped classrooms in terms of improving EFL students' English oral presentation, not to mention investigating factors affecting their flipped learning…

  5. Comparison of three approaches of Bernese periacetabular osteotomy

    Directory of Open Access Journals (Sweden)

    Luo DZ

    2016-01-01

    Full Text Available Dianzhong Luo, Hong Zhang, Weijia Zhang Division of Joint Surgery and Sport Medicine, Department of Orthopaedics, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, People’s Republic of China Background: Developmental dysplasia of the hip is a common disease and treated with various surgical approaches. Improved ilioinguinal (I-I approach, two-incision Smith-Peterson (TSP approach, and modified Smith-Peterson (MSP approach are three main approaches; however, they are rarely compared. The present study compared the operative time, blood loss, intraoperative and postoperative allogeneic blood transfusion, and postoperative complications of these three different approaches. Hypothesis: Surgical approach does not influence the operation time, blood loss, and complications of periacetabular osteotomy. Level of evidence: Level III. Case–control study. Patients and methods: In a total of 101 hips of 95 cases, from February 2010 to July 2011, three different approaches of Bernese periacetabular osteotomy, I-I, TSP, and MSP, were conducted. The operation time, intraoperative bleeding, allogeneic blood transfusion, and early complications in different operation approaches were compared by a retrospective study when there were similar ages, genders, and lesions. Results: Among the three approaches, I-I had less operation time and more blood loss (P<0.05, TSP had less blood loss (P<0.05 but more complications, and MSP had less blood loss (P<0.05 and less complications. Discussion: The MSP approach is superior to the other two approaches in doing periacetabular osteotomy. Keywords: periacetabular osteotomy, operation approaches, complications

  6. Evaluation of a flipped classroom approach to learning introductory epidemiology.

    Science.gov (United States)

    Shiau, Stephanie; Kahn, Linda G; Platt, Jonathan; Li, Chihua; Guzman, Jason T; Kornhauser, Zachary G; Keyes, Katherine M; Martins, Silvia S

    2018-04-02

    Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model. One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N = 72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N = 78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated. There were no statistically significant differences in examination scores or students' assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers. There was no significant difference in students' performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections.

  7. Is McMurray′s osteotomy obsolete?

    Directory of Open Access Journals (Sweden)

    Phaltankar P

    1995-10-01

    Full Text Available A review of the method of performing, advantages, disadvantages of McMurray′s displacement osteotomy with regard to treatment of nonunion of transcervical fracture neck femur with viable femoral head was carried out in this study of ten cases, in view of the abandonment of the procedure in favour of angulation osteotomy. Good results obtained in the series attest to the usefulness of McMurray′s osteotomy in the difficult problem of nonunion of transcervical fracture neck femur in well selected cases with certain advantages over the angulation osteotomy due to the ′Armchair effect′.

  8. Computer assisted SCFE osteotomy planning

    International Nuclear Information System (INIS)

    Drapikowski, Pawel; Tyrakowski, Marcin; Czubak, Jaroslaw; Czwojdzinski, Adam

    2008-01-01

    Slipped capital femoral epiphysis (SCFE) is a common pediatric orthopedic disorder that requires surgical correction. Preoperative planning of a proximal femoral osteotomy is essential in cases of SCFE. This planning is usually done using 2D radiographs, but 3D data can be acquired with CT and analyzed with 3D visualization software. SCFEanalyzer is a computer program developed for preoperative planning of proximal femoral osteotomy to correct SCFE. Computed tomography scans were performed on human bone specimens: one pelvis and two femoral bones (right and left) and volume data of a patient. The CT data were used to test the abilities of the SCFEanalyzer software, which utilizes 3D virtual models of anatomic structures constructed from CT image data. Separation of anatomical bone structures is done by means of ''cutting'' 3D surface model of the pelvis. The software enables qualitative and quantitative spatial analysis of chosen parameters analogous to those done on the basis of plain radiographs. SCFEanalyzer makes it possible to evaluate the function of the hip joint by calculating the range of motion depending on the shape of bone structures based on oriented bounding box object representation. Pelvic and hip CT scans from a patient with SCFE were subjected to femoral geometry analysis and hip joint function assessment. These were done to plan and simulate osteotomy of the proximal femur. Analogous qualitative and quantitative evaluation after performing the virtual surgery were evaluated to determine the potential treatment effects. The use of computer assistance in preoperative planning enable us to increase objectivity and repeatability, and to compare the results of different types of osteotomy on the proximal femur, and thus to choose the optimal operation in each individual case. (orig.)

  9. Complications of intertrochanteric rotational osteotomy

    Energy Technology Data Exchange (ETDEWEB)

    Braunstein, E.M.; Weissman, B.N.; Sosman, J.L.; Drew, M.

    1983-11-01

    Intertrochanteric anterior rotational osteotomy is a recently developed surgical procedure to treat osteonecrosis of the femoral head. We reviewed the radiographic findings in four cases to acquaint radiologists with the usual appearance of the procedure and to assess surgical complications. In all cases, immediate postoperative radiographs showed rotation of the necrotic portion of the femoral head anteriorly so that it was no longer weight-bearing. Clinical and radiologic follow-up ranged from 12 to 30 months. In this time, three patients developed complications, including nonunion of the osteotomy, further osteonecrosis with collapse of the femoral head, and worsening pain in the absence of progressive radiologic change. Radiology provides an important means of assessing rotational osteotomy, particularly in demonstrating sufficient rotation of the femoral head to assure nonweight-bearing by diseased bone. Also, surgical complications such as nonunion and hardware loosening may be identified. Nevertheless, the patient may deteriorate clinically even in the absence of radiologic demonstration of disease pregression, and the absence of radiographic change does not assure a successful surgical outcome.

  10. Complications of intertrochanteric rotational osteotomy

    International Nuclear Information System (INIS)

    Braunstein, E.M.; Weissman, B.N.; Sosman, J.L.; Drew, M.

    1983-01-01

    Intertrochanteric anterior rotational osteotomy is a recently developed surgical procedure to treat osteonecrosis of the femoral head. We reviewed the radiographic findings in four cases to acquaint radiologists with the usual appearance of the procedure and to assess surgical complications. In all cases, immediate postoperative radiographs showed rotation of the necrotic portion of the femoral head anteriorly so that it was no longer weight-bearing. Clinical and radiologic follow-up ranged from 12 to 30 months. In this time, three patients developed complications, including nonunion of the osteotomy, further osteonecrosis with collapse of the femoral head, and worsening pain in the absence of progressive radiologic change. Radiology provides an important means of assessing rotational osteotomy, particularly in demonstrating sufficient rotation of the femoral head to assure nonweight-bearing by diseased bone. Also, surgical complications such as nonunion and hardware loosening may be identified. Nevertheless, the patient may deteriorate clinically even in the absence of radiologic demonstration of disease pregression, and the absence of radiographic change does not assure a successful surgical outcome. (orig.)

  11. The Flipped Classroom in Active Learning: On the Application of Flipped Classroom Methodology in Beginning Chinese Language

    OpenAIRE

    趙, 菁

    2015-01-01

    Since the 2012–2013 academic year, Flipped Classroom has attracted a great deal of attention at the University level in the Japanese education system. This paper reports on an attempt at using the Flipped Classroom method in beginning Chinese Language classes. The results show that this method increased the beginning Chinese Language Learners studying time after each lesson and improved communication among classmates during classroom activities.

  12. Outcome of peri-acetabular osteotomy for hip dysplasia in teenagers.

    Science.gov (United States)

    Sakamoto, Tetsuya; Naito, Masatoshi; Nakamura, Yoshinari

    2015-11-01

    Peri-acetabular osteotomy, especially curved peri-acetabular osteotomy, is an effective surgical procedure for re-orientating the acetabulum. However, there have been few reports on this procedure in teenagers. The purpose of this study was to investigate the treatment outcomes of curved peri-acetabular osteotomy in teenagers. We retrospectively reviewed 33 hips in 27 teenage patients with acetabular dysplasia who underwent curved peri-acetabular osteotomy between 1995 and 2012. The mean age was 17.0 years (range, 14-19 years). The mean follow-up duration at the most recent physical examination was 33.3 months (range, 24-96 months). All hips were evaluated in terms of the Harris hip score, radiographic measurements, and complications. The mean Harris hip score improved from 80.1 points pre-operatively to 95.4 points post-operatively (p teenagers.

  13. Shortening Oblique Osteotomy with Screw Fixation for Correction of the Lesser Metatarsophalangeal Joints of Rheumatoid Forefoot.

    Science.gov (United States)

    Nishida, Keiichiro; Machida, Takahiro; Horita, Masahiro; Hashizume, Kenzo; Nakahara, Ryuichi; Nasu, Yoshihisa; Ohashi, Hideki; Saiga, Kenta; Ozaki, Toshifumi

    2016-12-01

    The metatarsophalangeal (MTP) joints are often and predominantly affected in rheumatoid arthritis. The aim of the current study was to describe surgical techniques of shortening oblique osteotomy for lesser metatarsal bone with screw fixation at the osteotomy site, and to investigate the short-term clinical outcomes of our procedure. Twenty-seven feet (78 toes) of 24 RA patients underwent the shortening oblique osteotomy for the correction of deformity at the lesser MTP joints. The average Japanese Society of Surgery of the Foot (JSSF) standard rating system for the RA foot and ankle scale improved significantly from 59.6 points preoperatively to 88.3 points postoperatively (p<0.001). Twenty-four feet (89% ) were free from metatarsalgia and symptomatic callosities at the lesser MTP joint after surgery. Our present findings showed satisfactory early clinical outcomes of the shortening oblique osteotomy of the metatarsal bone with screw fixation for RA forefoot.

  14. Adventures in Flipping College Algebra

    Science.gov (United States)

    Van Sickle, Jenna

    2015-01-01

    This paper outlines the experience of a university professor who implemented flipped learning in two sections of college algebra courses for two semesters. It details how the courses were flipped, what technology was used, advantages, challenges, and results. It explains what students do outside of class, what they do inside class, and discusses…

  15. Relationships in the Flipped Classroom

    Science.gov (United States)

    McCollum, Brett M.; Fleming, Cassidy L.; Plotnikoff, Kara M.; Skagen, Darlene N.

    2017-01-01

    This study examines the effectiveness of flipped classrooms in chemistry, and identifies relationships as a major factor impacting the success of flipped instruction methods. Examination of student interview data reveals factors that affect the development of peer-peer, peer-peer leader, and peer-expert relationships in firstyear general chemistry…

  16. Total hip replacement fifteen years after pelvic support osteotomy (PSO): a case report and review of the literature.

    Science.gov (United States)

    Thabet, Ahmed M; Catagni, Maurizio A; Guerreschi, Francessco

    2012-08-01

    Treatment of chronic hip instability in children and young adults is challenging. Proximal femoral osteotomy had been suggested to provide pelvic stability and improved abductor function. Total hip replacement after pelvic support osteotomy can be challenging due to altered anatomy due to angulation of the proximal femur in both frontal and sagittal planes. This is a 29-year-old woman who had total hip replacement after pelvic support osteotomy. The patient had pelvic support at the age of 14 years. Pelvic support osteotomy delayed the need for total hip replacement for 15 years. Preoperative planning for total hip replacement with model was used for proper understanding of the anatomy of the proximal femur. Revision of femoral component was necessary due to penetration of the proximal femur. In conclusion, total hip replacement after pelvic support osteotomy is a technically demanding procedure, and careful attention to surgical details is necessary for successful outcome.

  17. Evaluation of a Flipped Drug Literature Evaluation Course.

    Science.gov (United States)

    Giuliano, Christopher Alan; Moser, Lynette R

    2016-05-25

    Objective. To evaluate a flipped drug literature evaluation course for first-year pharmacy students. Design. A drug literature evaluation course was flipped during the 2014 winter semester. Homework from 2013 was transformed into activities and lectures were transformed into multiple short YouTube videos. Assessment. Average examination scores increased from 75.6% to 86.1%. Eighty-two of 94 students completed the postcourse survey in 2014. Compared to traditional lecture, 59.8% of students indicated they preferred the flipped course. Additionally, students felt the course was important, the in-class activities were helpful, and some of the YouTube videos could be improved. We found length of the video to be significantly correlated with the percentage of videos viewed. Conclusion. The flipped model should be considered in drug literature evaluation courses that seek to increase the amount of active learning in the classroom.

  18. An evaluation of flipped e-learning experiences.

    Science.gov (United States)

    Jones-Bonofiglio, Kristen Dawn; Willett, Timothy; Ng, Stella

    2017-12-22

    The "flipped" classroom is an educational strategy gaining popularity for its growing evidence base that suggests it may successfully improve learning outcomes. Also known as reverse instruction, this approach has been typically implemented and studied in in-person post-secondary settings. The utilization of a flipped approach in the healthcare education literature has been examined in a wide range of contexts, but little has been written regarding continuing professional development (CPD). Therefore, with success in other contexts there is potential for the flipped classroom approach to enhance student satisfaction, learner engagement, and learning outcomes in the context of online education for CPD. In this paper, we describe the structure and format of such a course using a qualitative case study framework. This study contributes to a more comprehensive understanding of effective ways of overcoming distributed learning challenges in online CPD using a flipped approach.

  19. What millennial medical students say about flipped learning

    Science.gov (United States)

    Pettit, Robin K; McCoy, Lise; Kinney, Marjorie

    2017-01-01

    Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an “all or nothing” learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide curricular improvements. PMID:28769600

  20. What millennial medical students say about flipped learning.

    Science.gov (United States)

    Pettit, Robin K; McCoy, Lise; Kinney, Marjorie

    2017-01-01

    Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an "all or nothing" learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide curricular improvements.

  1. Flipped classroom model for learning evidence-based medicine.

    Science.gov (United States)

    Rucker, Sydney Y; Ozdogan, Zulfukar; Al Achkar, Morhaf

    2017-01-01

    Journal club (JC), as a pedagogical strategy, has long been used in graduate medical education (GME). As evidence-based medicine (EBM) becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice.

  2. Very Distal Radius Wedge Osteotomy for Kienböck's Disease: Case Series.

    Science.gov (United States)

    Okubo, Hirotaka; Futenma, Chojo; Sunagawa, Hideyuki; Kinjo, Masaki; Kanaya, Fuminori

    2017-12-01

    Radius osteotomy is one of the standard surgical procedures for the treatment of Kienböck's disease. Unfortunately, radius osteotomy can result in an incongruous distal radio-ulnar joint (DRUj) postoperatively, because the procedure is performed proximal to the DRUj. A very distal radius wedge osteotomy was performed as a 15-degree lateral closing wedge osteotomy with the apex of the wedge distal to that of conventional lateral closing wedge osteotomy; this procedure was developed to avoid postoperative incongruous DRUj. We performed this procedure on 6 patients (stage III-A: 1, stage III-B: 5) with a mean age of 49 years. Clinical and radiographic evaluations were performed at a mean follow-up of 32 months. Wrist pain disappeared in all patients. Mean grip strength improved from 35% to 87% of the contralateral side (p = 0.0255). Mean range of motion, measured as flexion-extension arc, improved from 93 to 128 degrees. Nakamura's score was good in all patient. Mean lunate covering ratio increased from 61% to 90% (p = 0.0151) and mean sigmoid notch inclination angle, a radiographic parameter of DRUj congruency, was not significantly different between pre-operative and final follow-up evaluation. No clinical or radiographic DRUj osteoarthritis findings were observed. Our procedure of very distal radius wedge osteotomy provided satisfactory clinical results without an incongruous DRUj. This technique might prevent the occurrence of postoperative DRUj osteoarthritis.

  3. Embeded photonic crystal at the interface of p-GaN and Ag reflector to improve light extraction of GaN-based flip-chip light-emitting diode

    International Nuclear Information System (INIS)

    Zhen, Aigong; Ma, Ping; Zhang, Yonghui; Guo, Enqing; Tian, Yingdong; Liu, Boting; Guo, Shikuan; Shan, Liang; Wang, Junxi; Li, Jinmin

    2014-01-01

    In this experiment, a flip-chip light-emitting diode with photonic crystal was fabricated at the interface of p-GaN and Ag reflector via nanospheres lithography technique. In this structure, photonic crystal could couple with the guide-light efficiently by reason of the little distance between photonic crystal and active region. The light output power of light emitting diode with embedded photonic crystal was 1.42 times larger than that of planar flip-chip light-emitting diode. Moreover, the embedded photonic crystal structure makes the far-field divergence angle decreased by 18° without spectra shift. The three-dimensional finite difference time domain simulation results show that photonic crystal could improve the light extraction, and enhance the light absorption caused by Ag reflector simultaneously, because of the roughed surface. The depth of photonic crystal is the key parameter affecting the light extraction and absorption. Light extraction efficiency increases with the depth photonic crystal structure rapidly, and reaches the maximum at the depth 80 nm, beyond which light extraction decrease drastically

  4. The effects of Mandibular Osteotomy on articulation and resonance

    Directory of Open Access Journals (Sweden)

    Delsa Geffen

    1978-11-01

    Full Text Available Pre- and post-operative speech samples were studied in nine adult cases who received Mandibular Osteotomy. Lateral cephalograms were taken during sustained production of selected sounds and trained listeners judged recordings. In most cases there was an improvement in the general quality of the speech. Considering that the functional  relationships between the speech organs had altered, it would appear that some form of adaptation by the speaker had in fact taken place.

  5. A New Pixels Flipping Method for Huge Watermarking Capacity of the Invoice Font Image

    Directory of Open Access Journals (Sweden)

    Li Li

    2014-01-01

    Full Text Available Invoice printing just has two-color printing, so invoice font image can be seen as binary image. To embed watermarks into invoice image, the pixels need to be flipped. The more huge the watermark is, the more the pixels need to be flipped. We proposed a new pixels flipping method in invoice image for huge watermarking capacity. The pixels flipping method includes one novel interpolation method for binary image, one flippable pixels evaluation mechanism, and one denoising method based on gravity center and chaos degree. The proposed interpolation method ensures that the invoice image keeps features well after scaling. The flippable pixels evaluation mechanism ensures that the pixels keep better connectivity and smoothness and the pattern has highest structural similarity after flipping. The proposed denoising method makes invoice font image smoother and fiter for human vision. Experiments show that the proposed flipping method not only keeps the invoice font structure well but also improves watermarking capacity.

  6. A new pixels flipping method for huge watermarking capacity of the invoice font image.

    Science.gov (United States)

    Li, Li; Hou, Qingzheng; Lu, Jianfeng; Xu, Qishuai; Dai, Junping; Mao, Xiaoyang; Chang, Chin-Chen

    2014-01-01

    Invoice printing just has two-color printing, so invoice font image can be seen as binary image. To embed watermarks into invoice image, the pixels need to be flipped. The more huge the watermark is, the more the pixels need to be flipped. We proposed a new pixels flipping method in invoice image for huge watermarking capacity. The pixels flipping method includes one novel interpolation method for binary image, one flippable pixels evaluation mechanism, and one denoising method based on gravity center and chaos degree. The proposed interpolation method ensures that the invoice image keeps features well after scaling. The flippable pixels evaluation mechanism ensures that the pixels keep better connectivity and smoothness and the pattern has highest structural similarity after flipping. The proposed denoising method makes invoice font image smoother and fiter for human vision. Experiments show that the proposed flipping method not only keeps the invoice font structure well but also improves watermarking capacity.

  7. Comparison of Pharmaceutical Calculations Learning Outcomes Achieved Within a Traditional Lecture or Flipped Classroom Andragogy.

    Science.gov (United States)

    Anderson, H Glenn; Frazier, Lisa; Anderson, Stephanie L; Stanton, Robert; Gillette, Chris; Broedel-Zaugg, Kim; Yingling, Kevin

    2017-05-01

    Objective. To compare learning outcomes achieved from a pharmaceutical calculations course taught in a traditional lecture (lecture model) and a flipped classroom (flipped model). Methods. Students were randomly assigned to the lecture model and the flipped model. Course instructors, content, assessments, and instructional time for both models were equivalent. Overall group performance and pass rates on a standardized assessment (Pcalc OSCE) were compared at six weeks and at six months post-course completion. Results. Student mean exam scores in the flipped model were higher than those in the lecture model at six weeks and six months later. Significantly more students passed the OSCE the first time in the flipped model at six weeks; however, this effect was not maintained at six months. Conclusion. Within a 6 week course of study, use of a flipped classroom improves student pharmacy calculation skill achievement relative to a traditional lecture andragogy. Further study is needed to determine if the effect is maintained over time.

  8. Study and practice of flipped classroom in optoelectronic technology curriculum

    Science.gov (United States)

    Shi, Jianhua; Lei, Bing; Liu, Wei; Yao, Tianfu; Jiang, Wenjie

    2017-08-01

    "Flipped Classroom" is one of the most popular teaching models, and has been applied in more and more curriculums. It is totally different from the traditional teaching model. In the "Flipped Classroom" model, the students should watch the teaching video afterschool, and in the classroom only the discussion is proceeded to improve the students' comprehension. In this presentation, "Flipped Classroom" was studied and practiced in opto-electronic technology curriculum; its effect was analyzed by comparing it with the traditional teaching model. Based on extensive and deep investigation, the phylogeny, the characters and the important processes of "Flipped Classroom" are studied. The differences between the "Flipped Classroom" and the traditional teaching model are demonstrated. Then "Flipped Classroom" was practiced in opto-electronic technology curriculum. In order to obtain high effectiveness, a lot of teaching resources were prepared, such as the high-quality teaching video, the animations and the virtual experiments, the questions that the students should finish before and discussed in the class, etc. At last, the teaching effect was evaluated through analyzing the result of the examination and the students' surveys.

  9. Hallux valgus with Scarf Osteotomy - A revision of 82 cases

    International Nuclear Information System (INIS)

    Mendez Gonzalez, Mauricio; Gamba Sanchez, Carlos Enrique

    2005-01-01

    Descriptive observational study, type series of cases, whose objective was to describe the treatment of hallux valgus with Scarf Osteotomy; this study reviewed the clinical, radiological and subjective aspects of 82 feet, mean age of 49 years, and a mean of 14 degrades and 31 degrades to 9 degrades and 14 degrades (p<0,0001). The mean of the AOFAS scale improved from 49 points preoperatively to 92 points (p<0,0001). 61% of the patients were very satisfied, 34% were satisfied and 5% were not satisfied with the procedure. The recurrence of the deformity appeared in 3% of the patients. The rate of complications was of 6%. The SCARF osteotomy is a safe procedure. We recommended it like an effective technique for the correction of hallux valgus mild, moderate and severe

  10. Flipped GUT Inflation

    CERN Document Server

    Ellis, John; Harz, Julia; Huang, Wei-Chih

    2015-01-01

    We analyse the prospects for constructing hybrid models of inflation that provide a dynamical realisation of the apparent closeness between the supersymmetric GUT scale and the possible scale of cosmological inflation. In the first place, we consider models based on the flipped SU(5)$\\times$U(1) gauge group, which has no magnetic monopoles. In one model, the inflaton is identified with a sneutrino field, and in the other model it is a gauge singlet. In both cases we find regions of the model parameter spaces that are compatible with the experimental magnitudes of the scalar perturbations, $A_s$, and the tilt in the scalar perturbation spectrum, $n_s$, as well as with an indicative upper limit on the tensor-to-scalar perturbation ratio, $r$. We also discuss embeddings of these models into SO(10), which is broken at a higher scale so that its monopoles are inflated away.

  11. Practical quantum coin flipping

    International Nuclear Information System (INIS)

    Pappa, Anna; Diamanti, Eleni; Chailloux, Andre; Kerenidis, Iordanis

    2011-01-01

    We show that in the unconditional security model, a single quantum strong coin flip with security guarantees that are strictly better than in any classical protocol is possible to implement with current technology. Our protocol takes into account all aspects of an experimental implementation, including losses, multiphoton pulses emitted by practical photon sources, channel noise, detector dark counts, and finite quantum efficiency. We calculate the abort probability when both players are honest, as well as the probability of one player forcing his desired outcome. For a channel length up to 21 km and commonly used parameter values, we can achieve honest abort and cheating probabilities that are better than in any classical protocol. Our protocol is, in principle, implementable using attenuated laser pulses, with no need for entangled photons or any other specific resources.

  12. FLIP for FLAG model visualization

    Energy Technology Data Exchange (ETDEWEB)

    Wooten, Hasani Omar [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-11-15

    A graphical user interface has been developed for FLAG users. FLIP (FLAG Input deck Parser) provides users with an organized view of FLAG models and a means for efficiently and easily navigating and editing nodes, parameters, and variables.

  13. Osteotomy irrigation: is it necessary?

    Science.gov (United States)

    Flanagan, Dennis

    2010-06-01

    Surgical placement of dental implants requires an osteotomy. There is suspicion that osseous drilling may generate detrimental heat in the site that may cause localized bone necrosis and, subsequently, failure of the dental implant to osseointegrate. Cooling aqueous irrigation has been advocated to prevent such overheating. However, irrigation can interfere with operator vision and precludes bone shaving collection from the drill flukes for use in autogenous grafting. Small diameter drills may generate more heat than larger diameter drills and may need to be irrigated when smaller diameter implants are to be placed in dense bone. Contemporary larger diameter drills may not generate detrimental heat and may incrementally remove any heat damaged bone from the previous drilling. It may be safe not to use irrigation for less bone dense sites when larger diameter drills are used. In addition, higher drill force and speed may minimize osseous heating by minimizing the time of in-bone drill operation and heat generation. Irrigation to prevent bone heating during the osteotomy may not be necessary when using contemporary drill designs with an expeditious drilling technique.

  14. [APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS].

    Science.gov (United States)

    Wang, Fei; Tao, Huiren; Liu, Zhibin; Zhang, Jianhua; Han, Fangmin

    2015-02-01

    To introduce the application of Photoshop CS16.0 (PS) software in preoperative osteotomy design of ankylosing spondylitis kyphosis (ASK), and to investigate applied values of the preoperative design. Between March 2009 and March 2013, 21 cases of ASK were treated through preoperative osteotomy design by using PS software. There were 16 males and 5 females, aged from 23 to 50 years (mean, 34.2 years). The deformity included thoracolumbar kyphosis in 14 cases, thoracic kyphosis in 2 cases, and lumbar kyphosis in 5 cases. The ultimate osteotomy angle of preoperative plans and the location and extent of osteotomy were determined by the osteotomy design, which guided operation procedures of the surgeon. The actual osteotomy angle was obtained by measuring Cobb angle of osteotomy segment before and after operation. The sagittal parameters of spine and pelvis including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and chin brow-vertical angle (CBVA) were measured at preoperation, at 1 week after operation, and last follow-up. The clinical outcomes were assessed by simplified Chinese Scoliosis Research Society-22 (SRS-22) questionnaire and Oswestry disability index (ODI). No complications occurred in the other cases except 1 case of dural tear during operation and 1 case of nerve injury after operation, and primary healing of incision was obtained. All patients were followed up 14 to 45 months (mean, 26.3 months). The SRS-22 and ODI scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative scores (P 0.05). The preoperative planned osteotomy angle and the postoperative actual osteotomy angle were (34.2 ± 10.5) degrees and (33.7 ± 9.7) degrees respectively, showing no significant difference (t = 0.84, P = 0.42). The CBVA, GK, SVA, PT, and LL were significantly improved when compared with the preoperative values (P 0.05). At last follow-up, no failures

  15. Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short-term clinical results with second-look arthroscopic evaluation.

    Science.gov (United States)

    Kim, Yong Sang; Lee, Moses; Koh, Yong Gon

    2016-12-01

    Supramalleolar osteotomy (SMO) is reported to be an effective treatment for varus ankle osteoarthritis by redistributing the load line within the ankle joint. Mesenchymal stem cells (MSCs) have been proposed as a new treatment option for osteoarthritis on the basis of their cartilage regeneration ability. The purpose of this study was to compare the clinical, radiological, and second-look arthroscopic outcomes between MSC injection with marrow stimulation and marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO. In this retrospective study, 62 patients (64 ankles) with varus ankle osteoarthritis underwent second-look arthroscopy at a mean of 12.8 months after arthroscopic marrow stimulation combined with SMO; 33 ankles were subjected to marrow stimulation alone (group I), and 31 were subjected to marrow stimulation with MSC injection (group II). Clinical outcome measures included a visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiological outcome variables included the tibial-ankle surface (TAS), talar tilt (TT), and tibial-lateral surface (TLS) angles. In second-look arthroscopy, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. The mean VAS score improved significantly from 7.2 ± 1.0 to 4.7 ± 1.4 in group I and from 7.3 ± 0.8 to 3.7 ± 1.5 in group II at the final follow-up (P varus ankle osteoarthritis who have undergone SMO. Furthermore, the ICRS grade is significantly correlated with clinical outcome.

  16. The Comparison of Open Septorhinoplasty Methods with or without Osteotomies Performed in Situations of Traumatic Nasal Deformation

    Directory of Open Access Journals (Sweden)

    Cengiz Eser

    2015-12-01

    Full Text Available Purpose: The aim in this study is to compare the functional results of open septorhinoplasty with and without osteotomies performed with the aim of increasing respiratory functions and healing the deformations in patients with traumatic nasal deformations. Material and Methods: In this prospective and clinical study, 26 patients with traumatic nasal deformation, who applied between 2007 and 2009 were analyzed. The physical examination, medical photographies, the findings of periorbital edema and ecchymosis and changes in respiratory behaviors before and after the operation were recorded. Evident irregularities of nasal dorsum, septum deviation and respiratory distress were identified in all of the patients. Open septorhinoplasty with osteotomy (13 patients and ndash; 50 % and without osteotomy (13 patients and ndash; 50 % were applied to a total of 26 patients. Osteotomy decision was given according to nasal dorsal width and nasal height. All the patients were controlled in the in the first, third, sixth and twelfth months of the postoperative period to analyze the results. The data gathered through these cases were compared with the literature. Results: Functional improvements were observed after open septorhinoplasty operations in all patients. When the post-operative results of the open septorhinoplasty operations with and without osteotomy are compared, it was observed that among the group of patients on which osteotomies were not practiced respiratory complaints improved better, stricture in the nasal passage was not caused, edema and ecchymosis in the postoperative period was lesser. Conclusion: In this study, the attempt was to prove that although open septorhinoplasty operations are classically performed with osteotomy, the operations without osteotomy has not cause stricture in the nasal passage, it causes less edema and ecchymosis in the postoperative period compared to the group with osteotomy. It is an acceptable procedure for

  17. Use of the Flipped Classroom Instructional Model in Higher Education: Instructors' Perspectives

    Science.gov (United States)

    Long, Taotao; Cummins, John; Waugh, Michael

    2017-01-01

    The flipped classroom model is an instructional model in which students learn basic subject matter knowledge prior to in-class meetings, then come to the classroom for active learning experiences. Previous research has shown that the flipped classroom model can motivate students towards active learning, can improve their higher-order thinking…

  18. Why No Difference? A Controlled Flipped Classroom Study for an Introductory Differential Equations Course

    Science.gov (United States)

    Yong, Darryl; Levy, Rachel; Lape, Nancy

    2015-01-01

    Flipped classrooms have the potential to improve student learning and metacognitive skills as a result of increased time for active learning and group work and student control over pacing, when compared with traditional lecture-based courses. We are currently running a 4-year controlled study to examine the impact of flipping an Introductory…

  19. A Quantitative Evaluation of the Flipped Classroom in a Large Lecture Principles of Economics Course

    Science.gov (United States)

    Balaban, Rita A.; Gilleskie, Donna B.; Tran, Uyen

    2016-01-01

    This research provides evidence that the flipped classroom instructional format increases student final exam performance, relative to the traditional instructional format, in a large lecture principles of economics course. The authors find that the flipped classroom directly improves performance by 0.2 to 0.7 standardized deviations, depending on…

  20. Proximal supination osteotomy of the first metatarsal for hallux valgus.

    Science.gov (United States)

    Yasuda, Toshito; Okuda, Ryuzo; Jotoku, Tsuyoshi; Shima, Hiroaki; Hida, Takashi; Neo, Masashi

    2015-06-01

    Risk factors for hallux valgus recurrence include postoperative round-shaped lateral edge of the first metatarsal head and postoperative incomplete reduction of the sesamoids. To prevent the occurrence of such conditions, we developed a proximal supination osteotomy of the first metatarsal. Our aim was to describe this novel technique and report the outcomes in this report. Sixty-six patients (83 feet) underwent a distal soft tissue procedure combined with a proximal supination osteotomy. After the proximal crescentic osteotomy, the proximal fragment was pushed medially, and the distal fragment was abducted, and then the distal fragment of the first metatarsal was manually supinated. Outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and radiographic examinations. The average follow-up duration was 34 (range, 25 to 52) months. The mean AOFAS score improved significantly from 58.0 points preoperatively to 93.8 points postoperatively (P hallux valgus and intermetatarsal angle decreased significantly from 38.6 and 18.0 degrees preoperatively to 11.0 and 7.9 degrees postoperatively, respectively (both, P hallux valgus, defined as a hallux valgus angle ≥ 25 degrees. The rates of occurrence of a positive round sign and incomplete reduction of the sesamoids significantly decreased postoperatively, which may have contributed to the low hallux valgus recurrence rates. We conclude that a proximal supination osteotomy was an effective procedure for correction of hallux valgus and can achieve a low rate of hallux valgus recurrence. Level IV, retrospective case series. © The Author(s) 2015.

  1. SURGICAL TREATMENT OF MALUNITED COLLES’ FRACTURE BY CORRECTIVE OSTEOTOMY

    Directory of Open Access Journals (Sweden)

    Gopinath

    2015-12-01

    Full Text Available BACKGROUND Malunion occurs more often after Colles fracture than any other and can result in considerable disability. Multiple techniques for corrective osteotomy have been developed in recent years with objective of restoring the normal anatomy of distal end of radius and also to evaluate the results with respect to pain, restoration of function of wrist and forearm. MATERIALS AND METHODS A prospective randomized controlled study was conducted in 20 cases of malunited Colles fracture who underwent Corrective osteotomy with a Dorsal Ellis T plate and bone graft. Post operatively all patients were immobilized on a Sugar-Tong splint and followed up at 4, 6 and 12 weeks. RESULTS All measurements of Pain, final range of motion and grip strength significantly improved compared with preoperative measurements. Based on Fernandez et al scoring system we obtained Excellent results in 8 cases, Good in 7 cases, Fair in 3 cases and Poor in 2 cases which was attributed to infection in 1 case and RSD in the other case. Radiologically a mean radial length of 6.14mm (N:10mm, Radial Angle of 21.25⁰ (N:22⁰ and Volar angle of -3.4⁰ (N: +4⁰ was achieved. CONCLUSION Corrective Osteotomy with Bone graft is a preferred and an Ideal procedure if performed after Proper selection of patients i.e in young adults and extra articular malunions with good range of movements.

  2. [How to make your own custom cutting guides for both mandibular and fibular stair step osteotomies?

    Science.gov (United States)

    Rem, K; Bosc, R; De Kermadec, H; Hersant, B; Meningaud, J-P

    2017-12-01

    Using tailored cutting guides for osteocutaneous free fibula flap in complex mandibular reconstruction after cancer resection surgery constitutes a substantial improvement. Autonomously conceiving and manufacturing the cutting guides within a plastic surgery department with computer-aided design (CAD) and three-dimensional (3D) printing allows planning more complex osteotomies, such as stair-step osteotomies, in order to achieve more stable internal fixations. For the past three years, we have been producing by ourselves patient-tailored cutting guides using CAD and 3D printing. Osteotomies were virtually planned, making the cutting lines more complex in order to optimize the internal fixation stability. We also printed reconstructed mandible templates and shaped the reconstruction plates on them. We recorded data including manufacturing techniques and surgical outcomes. Eleven consecutive patients were operated on for an oral cavity cancer. For each patient, we planned the fibular and mandibular stair-step osteotomies and we produced tailored cutting guides. In all patients, we achieved to get immediately stable internal fixations and in 10 patients, a complete bone consolidation after 6 months. Autonomously manufacturing surgical cutting guides for mandibular reconstruction by free fibula flap is a significant improvement, regarding ergonomics and precision. Planning stair-step osteotomies to perform complementary internal fixation increases contact surface and congruence between the bone segments, thus improving the reconstructed mandible stability. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Flipped classrooms and student learning: not just surface gains.

    Science.gov (United States)

    McLean, Sarah; Attardi, Stefanie M; Faden, Lisa; Goldszmidt, Mark

    2016-03-01

    The flipped classroom is a relatively new approach to undergraduate teaching in science. This approach repurposes class time to focus on application and discussion; the acquisition of basic concepts and principles is done on the students' own time before class. While current flipped classroom research has focused on student preferences and comparative learning outcomes, there remains a lack of understanding regarding its impact on students' approaches to learning. Focusing on a new flipped classroom-based course for basic medical sciences students, the purpose of the present study was to evaluate students' adjustments to the flipped classroom, their time on task compared with traditional lectures, and their deep and active learning strategies. Students in this course worked through interactive online learning modules before in-class sessions. Class time focused on knowledge application of online learning module content through active learning methods. Students completed surveys and optional prequiz questions throughout the term to provide data regarding their learning approaches. Our results showed that the majority of students completed their prework in one sitting just before class. Students reported performing less multitasking behavior in the flipped classroom compared with lecture-based courses. Students valued opportunities for peer-peer and peer-instructor interactions and also valued having multiple modes of assessment. Overall, this work suggests that there is the potential for greater educational gains from the flipped classroom than the modest improvements in grades previously demonstrated in the literature; in this implementation of the flipped classroom, students reported that they developed independent learning strategies, spent more time on task, and engaged in deep and active learning. Copyright © 2016 The American Physiological Society.

  4. Minimally Invasive Osteotomies of the Calcaneus.

    Science.gov (United States)

    Guyton, Gregory P

    2016-09-01

    Osteotomies of the calcaneus are powerful surgical tools, representing a critical component of the surgical reconstruction of pes planus and pes cavus deformity. Modern minimally invasive calcaneal osteotomies can be performed safely with a burr through a lateral incision. Although greater kerf is generated with the burr, the effect is modest, can be minimized, and is compatible with many fixation techniques. A hinged jig renders the procedure more reproducible and accessible. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Radiographic Correction Following Reconstruction of Adult Acquired Flat Foot Deformity Using the Cotton Medial Cuneiform Osteotomy.

    Science.gov (United States)

    Aiyer, Amiethab; Dall, Graham F; Shub, Jeffrey; Myerson, Mark S

    2016-05-01

    The Cotton osteotomy has been used to correct residual forefoot supination in flexible flatfoot deformity reconstruction. The purpose of this study was to delineate the radiographic effects of the Cotton osteotomy by controlling for concomitant procedures used for deformity correction. We retrospectively analyzed 67 patients who underwent a Cotton osteotomy as part of a flatfoot reconstructive procedure. We evaluated 12 radiographic parameters including the articular surface angles of the foot, Meary angle, and a newly defined medial arch sag angle (MASA). Twenty-eight of these patients were matched to a cohort that did not undergo a Cotton osteotomy. In all patients who underwent a Cotton osteotomy, there were statistically significant changes in the articular surface angles and medial arch height (P < .05). No radiographic secondary sag of the medial column was seen at final follow-up. Compared to 28 matched controls, the Cotton osteotomy did not improve Meary angle but provided an additional 6.5 degrees correction of the MASA (P = .002). After reliability testing, the intraclass correlation coefficient was found to be substantial for the MASA compared to Meary angle. The data suggest that the MASA was a useful radiographic tool for assessing midfoot collapse in the setting of pes planovalgus. The current study demonstrated the corrective capacity of the Cotton osteotomy on the MASA; at final follow-up, there was no evidence of radiographic instability. This is suggestive that a naviculocuneiform arthrodesis may not be warranted for medial column stabilization in the setting of flatfoot reconstruction. Level III, case control study. © The Author(s) 2015.

  6. Student Performance in a Pharmacotherapy Oncology Module Before and After Flipping the Classroom

    Science.gov (United States)

    Panus, Peter; Stewart, David W.; Hagemeier, Nick E; George, Joshua

    2016-01-01

    Objective. To determine if a flipped classroom improved student examination performance in a pharmacotherapy oncology module. Design. Third-year pharmacy students in 2012 experienced the oncology module as interactive lectures with optional case studies as supplemental homework. In 2013, students experienced the same content in a primarily flipped classroom. Students were instructed to watch vodcasts (video podcasts) before in-class case studies but were not held accountable (ie, quizzed) for preclass preparation. Examination questions were identical in both cohorts. Performance on examination questions was compared between the two cohorts using analysis of covariance (ANCOVA), with prior academic performance variables (grade point average [GPA]) as covariates. Assessment. The students who experienced the flipped classroom approach performed poorer on examination questions than the cohort who experienced interactive lecture, with previous GPA used as a covariate. Conclusion. A flipped classroom does not necessarily improve student performance. Further research is needed to determine optimal classroom flipping techniques. PMID:27073284

  7. To Flip or Not to Flip? An Exploratory Study Comparing Student Performance in Calculus I

    Science.gov (United States)

    Schroeder, Larissa B.; McGivney-Burelle, Jean; Xue, Fei

    2015-01-01

    The purpose of this exploratory, mixed-methods study was to compare student performance in flipped and non-flipped sections of Calculus I. The study also examined students' perceptions of the flipping pedagogy. Students in the flipped courses reported spending, on average, an additional 1-2 hours per week outside of class on course content.…

  8. Hardened Flip-Flop Optimized for Subthreshold Operation Heavy Ion Characterization of a Radiation

    Directory of Open Access Journals (Sweden)

    Eric Bozeman

    2012-05-01

    Full Text Available A novel Single Event Upset (SEU tolerant flip-flop design is proposed, which is well suited for very-low power electronics that operate in subthreshold ( < Vt ≈ 500 mV. The proposed flip-flop along with a traditional (unprotected flip-flop, a Sense-Amplifier-based Rad-hard Flip-Flop (RSAFF and a Dual Interlocked storage Cell (DICE flip-flop were all fabricated in MIT Lincoln Lab’s XLP 0.15 μm fully-depleted SOI CMOS technology—a process optimized for subthreshold operation. At the Cyclotron Institute at Texas A&M University, all four cells were subjected to heavy ion characterization in which the circuits were dynamically updated with alternating data and then checked for SEUs at both subthreshold (450 mV and superthreshold (1.5 V levels. The proposed flip-flop never failed, while the traditional and DICE designs did demonstrate faulty behavior. Simulations were conducted with the XLP process and the proposed flip-flop provided an improved energy delay product relative to the other non-faulty rad-hard flip-flop at subthreshold voltage operation. According to the XLP models operating in subthreshold at 250 mV, performance was improved by 31% and energy consumption was reduced by 27%.

  9. Single-transistor-clocked flip-flop

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Peiyi; Darwish, Tarek; Bayoumi, Magdy

    2005-08-30

    The invention provides a low power, high performance flip-flop. The flip-flop uses only one clocked transistor. The single clocked transistor is shared by the first and second branches of the device. A pulse generator produces a clock pulse to trigger the flip-flop. In one preferred embodiment the device can be made as a static explicit pulsed flip-flop which employs only two clocked transistors.

  10. Experiences in flip chip production of radiation detectors

    International Nuclear Information System (INIS)

    Savolainen-Pulli, Satu; Salonen, Jaakko; Salmi, Jorma; Vaehaenen, Sami

    2006-01-01

    Modern imaging devices often require heterogeneous integration of different materials and technologies. Because of yield considerations, material availability, and various technological limitations, an extremely fine pitch is necessary to realize high-resolution images. Thus, there is a need for a hybridization technology that is able to join together readout amplifiers and pixel detectors at a very fine pitch. This paper describes radiation detector flip chip production at VTT. Our flip chip technology utilizes 25-μm diameter tin-lead solder bumps at a 50-μm pitch and is based on flux-free bonding. When preprocessed wafers are used, as is the case here, the total yield is defined only partly by the flip chip process. Wafer preprocessing done by a third-party silicon foundry and the flip chip process create different process defects. Wafer-level yield maps (based on probing) provided by the customer are used to select good readout chips for assembly. Wafer probing is often done outside of a real clean room environment, resulting in particle contamination and/or scratches on the wafers. Factors affecting the total yield of flip chip bonded detectors are discussed, and some yield numbers of the process are given. Ways to improve yield are considered, and finally guidelines for process planning and device design with respect to yield optimization are given

  11. Flipped classroom model for learning evidence-based medicine

    Directory of Open Access Journals (Sweden)

    Rucker SY

    2017-08-01

    Full Text Available Sydney Y Rucker,1 Zulfukar Ozdogan,1 Morhaf Al Achkar2 1School of Education, Indiana University, Bloomington, IN, 2Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA Abstract: Journal club (JC, as a pedagogical strategy, has long been used in graduate medical education (GME. As evidence-based medicine (EBM becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice. Keywords: evidence-based medicine, flipped classroom, residency education

  12. Student performance in a flipped classroom dental anatomy course.

    Science.gov (United States)

    Chutinan, S; Riedy, C A; Park, S E

    2017-11-09

    The purpose of this study was to assess dental student learning in a dental anatomy module between traditional lecture and flipped classroom cohorts. Two cohorts of predoctoral dental students (N = 70 within each cohort) participated in a dental anatomy module within an Introduction to the Dental Patient (IDP) course ([traditional/lecture cohort: academic year (AY) 2012, 2013] and [flipped classroom cohort: AY 2014, 2015]). For the dental anatomy module, both cohorts were evaluated on pre-clinical tooth waxing exercises immediately after each of five lectures and tooth identification after all lectures were given. Additionally, the cohorts' performance on the overall IDP course examination was compared. The flipped classroom cohort had statistically significant higher waxing scores (dental anatomy module) than students in the traditional classroom. There was no statistically significant difference for tooth identification scores and the overall IDP course examination between the traditional vs flipped approach cohorts. This is due to the latter two assessments conducted at the end of the course gave all students enough time to review the lecture content prior to the assessment resulting in similar scores for both cohorts. The flipped classroom cohort promoted students' individual learning and resulted in improved students' performance on immediate evaluation but not on the end of the course evaluation. Redesign of courses to include a new pedagogical approach should be carefully implemented and evaluated for student's educational success. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. What millennial medical students say about flipped learning

    Directory of Open Access Journals (Sweden)

    Pettit RK

    2017-07-01

    Full Text Available Robin K Pettit, Lise McCoy, Marjorie Kinney School of Osteopathic Medicine in Arizona, A. T. Still University, Mesa, AZ, USA Abstract: Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an “all or nothing” learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide ­curricular improvements. Keywords: flipped classroom, mandatory attendance, medical education, lecture-based, variety

  14. A Flipped Classroom Redesign in General Chemistry

    Science.gov (United States)

    Reid, Scott A.

    2016-01-01

    The flipped classroom continues to attract significant attention in higher education. Building upon our recent parallel controlled study of the flipped classroom in a second-term general chemistry course ("J. Chem. Educ.," 2016, 93, 13-23), here we report on a redesign of the flipped course aimed at scaling up total enrollment while…

  15. The Flipped Classroom in Counselor Education

    Science.gov (United States)

    Moran, Kristen; Milsom, Amy

    2015-01-01

    The flipped classroom is proposed as an effective instructional approach in counselor education. An overview of the flipped-classroom approach, including advantages and disadvantages, is provided. A case example illustrates how the flipped classroom can be applied in counselor education. Recommendations for implementing or researching flipped…

  16. Flipping a Calculus Class: One Instructor's Experience

    Science.gov (United States)

    Palmer, Katrina

    2015-01-01

    This paper describes one instructor's experiences during a year of flipping four calculus classes. The first exploration attempts to understand student expectations of a math class and their preference towards a flipped classroom. The second examines success of students from a flipped classroom, and the last investigates relationships with student…

  17. The Marriage of Constructivism and Flipped Learning

    Science.gov (United States)

    Chang, Sau Hou

    2016-01-01

    This report talks about how a constructivist teacher used flipped learning in a college class. To illustrate how to use flipped learning in a constructivist classroom, examples were given with the four pillars of F-L-I-P: Flexible environment, learning culture, intentional content, and professional educator.

  18. Role of high tibial osteotomy in cartilage regeneration – Is correction of malalignment mandatory for success?

    Directory of Open Access Journals (Sweden)

    Matthew Dhanaraj Thambiah

    2017-01-01

    Full Text Available Malalignment of the knee can cause debilitating symptoms such as pain, resulting in a decline in function and mobility. Surgical options that exist to address this problem include realignment osteotomies and joint replacements. Realignment osteotomies are the more appropriate options in certain patient populations, especially with regard to age and level of activity. Since a high tibial osteotomy (HTO was first used to manage malalignment of the knee and osteoarthritis, different techniques involving the use of specialized implants have been developed and further refined to good effect. There has also since been much research into the field of cartilage restoration techniques, both as a standalone treatment option and as an adjunct to a realignment osteotomy. This review attempts to detail the origin and the evolution of HTO, particularly in regard to combining this tried and tested procedure with adjunct cartilage restoration techniques, and the overall patient outcomes. A literature search on PubMed was performed, and articles pertaining to the outcomes of the use of an HTO and cartilage restoration techniques were reviewed. The literature in this field indicates good outcomes in terms of objective measurements of cartilage regeneration (such as arthroscopic visualization and magnetic resonance imaging evaluation and subjective patient outcome scoring systems (such as the International Knee Documentation Committee and Lysholm scores with a realignment osteotomy alone, and studies have shown that patient outcomes can be further improved with the use of a cartilage restoration procedure as an adjunct.

  19. Flexion Osteotomy in Genu Recurvatum Following Post-Polio Syndrome: Use of an Old Technique in a New Condition

    Directory of Open Access Journals (Sweden)

    Abolfazle Bagherifard

    2017-05-01

    Full Text Available Introduction Post-polio syndrome (PPS can have devastating functional effects on the walking ability of patients decades after the acute disease. Genu recurvatum, as a consequence of PPS, is one such disability which can be treated through different measures. Case Presentation A 43-year-old woman with a history of supracondylar extension osteotomy of the left femur at the age of 22 was admitted to our hospital for a flexion contracture of the left knee due to poliomyelitis. She was able to walk without assistance for 20 years after the osteotomy until one year ago, when she started to experience progressive genu recurvatum. In the clinical and laboratory workup, she was diagnosed with PPS. Accordingly, we decided to perform supracondylar flexion osteotomy. Conclusions Supracondylar flexion osteotomy in patients with genu recurvatum, as a consequence of PPS, is a valuable treatment, which can relieve the patients' dependence on walking aids and improve their symptoms.

  20. Flipped Library Instruction Does Not Lead to Learning Gains for First-Year English Students

    Directory of Open Access Journals (Sweden)

    Kimberly Miller

    2017-09-01

    Full Text Available A Review of: Rivera, E. (2017. Flipping the classroom in freshman English library instruction: A comparison study of a flipped class versus a traditional lecture method. New Review of Academic Librarianship, 23(1, 18-27. http://dx.doi.org/10.1080/13614533.2016.1244770 Abstract Objective – To determine whether a flipped classroom approach to freshman English information literacy instruction improves student learning outcomes. Design – Quasi-experimental. Setting – Private suburban university with 7,000 graduate and undergraduate students. Subjects – First-year English students. Methods – Students in six sections of first-year “English 2” received library instruction; three sections received flipped library instruction and three sections received traditional library instruction. Students in the flipped classroom sections were assigned two videos to watch before class, as an introduction to searching the Library’s catalog and key academic databases. These students were also expected to complete pre-class exercises that allowed them to practice what they learned through the videos. The face-to-face classes involved a review of the flipped materials alongside additional activities. Works cited pages from the students’ final papers were collected from all six sections, 31 from the flipped sections and 34 from the non-flipped sections. A rubric was used to rate the works cited pages. The rubric was based on the Association of College and Research Libraries’ Information Literacy Competency Standards for Higher Education (ACRL, 2000, Standard Two, Outcome 3a, and included three criteria: “authority,” “timeliness,” and “variety.” Each criterion was rated at one of three levels: “exemplary,” “competent,” or “developing.” Main Results – Works cited pages from the students who received non-flipped instruction were more likely to score “exemplary” for at least one of the three criteria when compared to works

  1. Flipped Learning fra et elevperspektiv

    DEFF Research Database (Denmark)

    Holmboe, Peter; Hachmann, Roland

    2016-01-01

    Antologi er et resultat af et toårigt udviklingsprojekt om Flipped Learning baseret på et samarbejde mellem IT-Center Fyn og Region Syddanmark. Bidraget her præsenterer en række overvejelser, vi har gjort os på baggrund af observationer af undervisning og interviews med elever i projektet. Vores...... overordnede undersøgelsesspørgsmål var: "Hvilke forhold i undervisning og læringsmiljø fremme hhv. begrænser elevens opfattelse af mening og fagligt udbytte i et Flipped Learning design?"....

  2. The flipped classroom: A learning model to increase student engagement not academic achievement

    Directory of Open Access Journals (Sweden)

    Masha Smallhorn

    2017-07-01

    Full Text Available A decrease in student attendance at lectures both nationally and internationally, has prompted educators to re-evaluate their teaching methods and investigate strategies which promote student engagement. The flipped classroom model, grounded in active learning pedagogy, transforms the face-to-face classroom. Students prepare for the flipped classroom in their own time by watching short online videos and completing readings. Face-to-face time is used to apply learning through problem-solving with peers. To improve the engagement and learning outcomes of our second year cohort, lectures were replaced with short online videos and face-to-face time was spent in a flipped classroom. The impact of the flipped classroom was analysed through surveys, attendance records, learning analytics and exam data before and after the implementation of the flipped classroom. Results suggest an increase in student engagement and a positive attitude towards the learning method. However, there were no measurable increases in student learning outcomes.

  3. Sagittal accuracy of tibial osteotomy position during in vivo tibial plateau levelling osteotomy performed without an alignment jig and cutting guide.

    Science.gov (United States)

    Craig, Andrew; Witte, Philip Georg; Scott, Harry William

    2017-01-16

    To assess the accuracy of tibial osteotomy location for tibial plateau levelling osteotomy (TPLO) in the sagittal plane and its effect on the postoperative tibial plateau angle (TPA), when performed without an alignment jig and saw guide. Also, to document the improvement gained with experience. Medical records and stifle radiographs of dogs undergoing TPLO, without the use of an alignment jig and saw guide, by one surgeon were reviewed (2010-2014). Postoperative radiographs were reviewed to record the distance and direction of eccentricity. Postoperative TPA was also recorded. In a series of 401 TPLO procedures, 231 met the inclusion criteria. The absolute distance of eccentricity (DOE) for all dogs was 3.0 ± 1.6 mm. When evaluating surgical experience, the DOE for the final 77 cases (2.72 ± 1.43 mm), the middle 77 cases (3.18 ± 1.49 mm), and the first 77 cases (3.24 ± 1.7 mm) were not significantly different (p = 0.07157). There was a very weak correlation between DOE and postoperative TPA (R = 0.029). The location of the tibial osteotomy when performing TPLO without an alignment jig and saw guide compared favourably with previously documented use of an alignment jig and saw guide. Whilst the location of the tibial osteotomy has a theoretical impact on the postoperative TPA, other factors appear to be of greater importance. Surgeon experience did not result in significant improvement in accuracy up to 231 procedures.

  4. Total knee arthroplasty after high tibial osteotomy. A systematic review

    NARCIS (Netherlands)

    T.M. van Raaij (Tom); M. Reijman (Max); A. Furlan (Alessandro); J.A.N. Verhaar (Jan)

    2009-01-01

    textabstractBackground: Previous osteotomy may compromise subsequent knee replacement, but no guidelines considering knee arthroplasty after prior osteotomy have been developed. We describe a systematic review of non-randomized studies to analyze the effect of high tibial osteotomy on total knee

  5. The Level of Fibula Osteotomy and Incidence of Peroneal Nerve ...

    African Journals Online (AJOL)

    2010-06-29

    Jun 29, 2010 ... Journal of Surgical Technique and Case Report | Jan-Jun 2010 | Vol-2 | Issue-1. 17. The Level of Fibula Osteotomy and Incidence of Peroneal. Nerve Palsy in Proximal Tibial Osteotomy. A. O. Ogbemudia, P. F. A. Umebese, A. Bafor, E. Igbinovia, P. E. Ogbemudia. INTRODUCTION. Osteotomy of the fibula is ...

  6. Intertrochanteric osteotomy for posttraumatic arthritis after acetabular fractures

    NARCIS (Netherlands)

    Marti, R. K.; Chaldecott, L. R.; Kloen, P.

    2001-01-01

    To evaluate the long-term results of intertrochanteric osteotomies for posttraumatic arthritis after acetabular fractures. Retrospective study of eight patients who underwent a total of ten intertrochanteric osteotomies. Two patients underwent two osteotomies of the same hip. Academic Level I trauma

  7. Shortening Scarf osteotomy for correction of severe hallux valgus. Does shortening affect the outcome?

    Science.gov (United States)

    Karpe, Prasad; Killen, Marie C; Pollock, Raymond D; Limaye, Rajiv

    2016-12-01

    Translation and shortening of Scarf osteotomy allows correction of severe hallux valgus deformity. Shortening may result in transfer metatarsalgia. To evaluate outcome of patients undergoing shortening Scarf osteotomy for severe hallux valgus deformities. Fifteen patients (20feet, mean age 58 years) underwent shortening Scarf osteotomy for severe hallux valgus deformities. Outcomes were pre and postoperative AOFAS scores, IM and HV angles, patient satisfaction. Mean follow-up was 25 months (range 22-30). The IM angle improved from a median of 18.60 (range 13.4-26.20) preoperatively to 9.70 (range 8.0-13.70) postoperatively (8.9; 95% CI=7.6-10.3; phallux valgus deformities with no transfer metatarsalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. University and Flipped Learning TIC & DIL Project: Framework and Design

    Science.gov (United States)

    Pinnelli, Stefania; Fiorucci, Andrea

    2015-01-01

    The flipped classroom approach (FC) is for the educational world a chance of recovery and improvement of pedagogical student-centered model and collaborative teaching methods aimed at optimizing the time resource and to promote personalization and self-learning in a perspective of autonomy. The paper moving from a pedagogical reflection on…

  9. High tibial closing wedge osteotomy for medial compartment osteoarthrosis of knee

    Directory of Open Access Journals (Sweden)

    Tuli S

    2008-01-01

    Full Text Available Background: Most patients of symptomatic osteoarthrosis of knee are associated with varus malalignment that is causative or contributory to painful arthrosis. It is rational to correct the malalignment to transfer the functional load to the unaffected or less affected compartment of the knee to relieve symptoms. We report the outcome of a simple technique of high tibial osteotomy in the medial compartment of osteoarthrosis of the knee. Materials and Methods: Between 1996 and 2004 we performed closing wedge osteotomy in 78 knees in 65 patients. The patients selected for osteotomy were symptomatic essentially due to medial compartment osteoarthrosis associated with moderate genu varum. Of the 19 patients who had bilateral symptomatic disease 11 opted for high tibial osteotomy of their second knee 1-3 years after the first operation. Preoperative grading of osteoarthrosis and postoperative function was assessed using Japanese Orthopaedic Association (JOA rating scale. Results: At a minimum follow-up of 2 years (range 2-9 years 6-10° of valgus correction at the site of osteotomy was maintained, there was significant relief of pain while walking, negotiating stairs, squatting and sitting cross-legged. Walking distance in all patients improved by two to four times their preoperative distance of 200-400 m. No patient lost any preoperative knee function. The mean JOA scoring improved from preoperative 54 (40-65 to 77 (55-85 at final follow-up. Conclusion: Closing wedge high tibial osteotomy performed by our technique can be undertaken in any setup with moderate facilities. Operation related complications are minimal and avoidable. Kirschner wire fixation is least likely to interfere with replacement surgery if it becomes necessary.

  10. Flipped learning in science education

    DEFF Research Database (Denmark)

    Andersen, Thomas Dyreborg; Foss, Kristian Kildemoes; Nissen, Stine Karen

    2017-01-01

    During the last decade, massive investment in ICT has been made in Danish schools. There seems, however, to be a need to rethink how to better integrate ICT in education (Bundgaard et al. 2014 p. 216) Flipped learning might be a didactical approach that could contribute to finding a method to use...

  11. Tibial rotational osteotomy for idiopathic torsion. A comparison of the proximal and distal osteotomy levels.

    Science.gov (United States)

    Krengel, W F; Staheli, L T

    1992-10-01

    A retrospective analysis was done of 52 rotational tibial osteotomies (RTOs) performed on 35 patients with severe idiopathic tibial torsion. Thirty-nine osteotomies were performed at the proximal or midtibial level. Thirteen were performed at the distal tibial level with a technique previously described by one of the authors. Serious complications occurred in five (13%) of the proximal and in none of the distal RTOs. For severe and persisting idiopathic tibial torsion, the authors recommend correction by RTO at the distal level. Proximal level osteotomy is indicated only when a varus or valgus deformity required concurrent correction.

  12. Student learning and perceptions in a flipped linear algebra course

    Science.gov (United States)

    Love, Betty; Hodge, Angie; Grandgenett, Neal; Swift, Andrew W.

    2014-04-01

    The traditional lecture style of teaching has long been the norm in college science, technology, engineering, and mathematics (STEM) courses, but an innovative teaching model, facilitated by recent advances in technology, is gaining popularity across college campuses. This new model inverts or 'flips' the usual classroom paradigm, in that students learn initial course concepts outside of the classroom, while class time is reserved for more active problem-based learning and practice activities. While the flipped classroom model shows promise for improving STEM learning and increasing student interest in STEM fields, discussions to date of the model and its impact are more anecdotal than data driven - very little research has been undertaken to rigorously assess the potential effects on student learning that can result from the flipped classroom environment. This study involved 55 students in 2 sections of an applied linear algebra course, using the traditional lecture format in one section and the flipped classroom model in another. In the latter, students were expected to prepare for the class in some way, such as watching screencasts prepared by the instructor, or reading the textbook or the instructor's notes. Student content understanding and course perceptions were examined. Content understanding was measured by the performance on course exams, and students in the flipped classroom environment had a more significant increase between the sequential exams compared to the students in the traditional lecture section, while performing similarly in the final exam. Course perceptions were represented by an end-of-semester survey that indicated that the flipped classroom students were very positive about their experience in the course, and particularly appreciated the student collaboration and instructional video components.

  13. Scarf-Akin osteotomy correction for hallux valgus: short-term results from a district general hospital.

    Science.gov (United States)

    Kerr, Hui-Ling; Jackson, Rosalyn; Kothari, Paresh

    2010-01-01

    This study assessed the radiological measurements, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and patient satisfaction associated with performance of the scarf osteotomy, combined with an Akin osteotomy, for the treatment of hallux valgus in patients at a general hospital. Thirty-five patients were assessed before surgery, and at 6 months following performance of the scarf first metatarsal osteotomy plus Akin osteotomy. The mean first intermetatarsal and hallux abductus angles reduced from 14.1 degrees +/- 3.5 degrees to 10.0 degrees +/- 3.2 degrees and 32.1 degrees +/- 9.9 degrees to 16.4 degrees +/- 7.9 degrees , respectively, and these differences were statistically significant (P .05). The mean global AOFAS Hallux Metatarsophalangeal-Interphalangeal score increased from 58.8 +/- 11.6 to 86.4 +/- 11.6, and this difference was statistically significant (P surgery. Based on these results, we concluded that the improved radiographic angles and AOFAS scores observed in this study were comparable to previously reported results, and our findings indicated that, in the setting of a general hospital, the scarf osteotomy combined with the Akin osteotomy is a safe, versatile and useful procedure for the treatment of hallux valgus. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Tuberositas osteotomy for total knee arthroplasty: a review of the literature

    NARCIS (Netherlands)

    Zonnenberg, Christian B. L.; Lisowski, Lukas A.; van den Bekerom, Michel P. J.; Nolte, Peter A.

    2010-01-01

    Tibial tubercle osteotomy (TTO) is a well-known technique for improving exposure in difficult total knee arthroplasty (TKA). We have performed a review of the literature concerning this procedure with the purpose of evaluation using the clinical results and complication rates in primary and revision

  15. Patient-tailored plate for bone fixation and accurate 3D positioning in corrective osteotomy

    NARCIS (Netherlands)

    Dobbe, J. G. G.; Vroemen, J. C.; Strackee, S. D.; Streekstra, G. J.

    2013-01-01

    A bone fracture may lead to malunion of bone segments, which gives discomfort to the patient and may lead to chronic pain, reduced function and finally to early osteoarthritis. Corrective osteotomy is a treatment option to realign the bone segments. In this procedure, the surgeon tries to improve

  16. A minimally invasive technique using a modified stoppa approach for periacetabular osteotomy: A preliminary cadaveric study

    Directory of Open Access Journals (Sweden)

    Turgut Akgul

    2017-01-01

    Full Text Available Background: Developmental hip dysplasia is diagnosed when the femoral head is not sufficiently covered by the acetabulum. Anterior and lateral cover deficiency is seen, as a result a dysplastic hip joint. Various incision modifications have been developed because of the muscle dissection and wide wound scar in Smith-Peterson incision, which was originally used in Bernese osteotomy. This study evaluates applicability of the modified Stoppa approach in the performance of Bernese periacetabular osteotomy (PAO. Materials and Methods: Ten hemipelvises of five donor cadavers were used. The transverse Stoppa incision was made 2 cm over the symphysis pubis for quadrilateral surface exposure and pubic and ischial bone osteotomies. The second skin incision, a few centimeters lateral to the original incision, was made along the tensor fascia lata. Iliac bone osteotomy was performed starting just above the rectus femoris insertion. The displacement of the osteotomy was measured clinically and radiographically. Results: The mean anterior coverage calculated with center-edge angle was improved from 22.8° ±2.8 (range 20° min–28° max preoperatively to 44.1° ± 3.7 (range 36° min–48° max. The displacement of the osteotomy at the iliopectineal line calculated on the iliac inlet view radiographs was 22.1 ± 3.4 mm (range 15 mm min–26 mm max. The clinical amount of the anterior displacement on the cadavers was 17.8 ± 3.35 mm (range 11 mm–21 mm and lateral displacement was 20.3 ± 3.23 mm (range 15 mm–24 mm. The amount of the posterior intact bone enlargement at the quadrilateral surface was 5.3 ± 0.48 mm. Conclusion: This less traumatic two-incision exposure is an adequate technique for Bernese PAO, allowing the bone to be cut under direct visual observation and reducing the need to use fluoroscopy.

  17. Surgical Reconstruction of Metatarsal Type Preaxial Polydactyly Using an Amalgamating Osteotomy.

    Science.gov (United States)

    Boyle, Matthew J; Hogue, Grant D; Kasser, James R

    2016-09-01

    Polydactyly of the foot is a relatively common condition. Approximately 15% of cases are preaxial, with one third of these cases involving duplication of the metatarsal [metatarsal type preaxial polydactyly (MTPP)].Surgical reconstruction of polydactyly is indicated to improve shoe tolerance. Reconstruction of MTPP has traditionally involved resection of the hypoplastic lateral ray in addition to soft tissue reconstruction to correct hallux varus. Poor postoperative results have frequently been reported, primarily due to residual hallux varus. We present a novel surgical technique for the treatment of children with MTPP presenting with a cosmetic lateral hallux, involving an amalgamating osteotomy that permits retention of the stable medial metatarsotarsal joint while avoiding the complication of residual hallux varus. This was a retrospective case series describing the surgical technique of an amalgamating osteotomy in the treatment of patients with MTPP and a cosmetic lateral hallux. The surgical technique involves corresponding metatarsal osteotomies of the medial and lateral halluces, with amalgamation of the metatarsals and ablation of the residual medial hallux, without the need for extensive soft tissue reconstruction. Clinical and radiologic outcomes were evaluated at a minimum of 2 years postoperatively in 2 patients who underwent this technique. Two children, 1 female and 1 male, underwent an amalgamating osteotomy at the age of 31 and 18 months, respectively. At latest follow-up, 7.3 and 2.8 years after osteotomy, respectively, both patients displayed an excellent functional result according to the Phelps and Grogan clinical outcome scale. Plain radiographs in both cases demonstrated a well-aligned first ray with no growth abnormality and no hallux varus. We have presented a novel surgical technique for the reconstruction of MTPP presenting with a cosmetic lateral hallux, involving an amalgamating osteotomy without extensive soft tissue reconstruction

  18. Results of Corrective Osteotomy and Treatment Strategy for Ankylosing Spondylitis with Kyphotic Deformity.

    Science.gov (United States)

    Kim, Ki-Tack; Park, Dae-Hyun; Lee, Sang-Hun; Lee, Jung-Hee

    2015-09-01

    To report the radiological and clinical results after corrective osteotomy in ankylosing spondylitis patients. Furthermore, this study intended to classify the types of deformity and to suggest appropriate surgical treatment options. We retrospectively analyzed ankylosing spondylitis patients who underwent corrective osteotomy between 1996 and 2009. The radiographic assessments included the sagittal vertical axis (SVA), spinopelvic alignment parameters, correction angle, correction loss, type of deformity related to the location of the apex, and the craniocervical range of motion (CCROM). The clinical outcomes were assessed by the Oswestry Disability Index (ODI) scores. A total of 292 corrective osteotomies were performed in 248 patients with a mean follow-up of 40.1 months (range, 24 to 78 months). There were 183 cases of single pedicle subtraction osteotomy (PSO), 19 cases of multiple Smith-Petersen osteotomy (SPO), 17 cases of PSO + SPO, 14 cases of single SPO, six cases of posterior vertebral column resection (PVCR), five cases of PSO + partial pedicle subtraction osteotomy (PPSO), and four cases of PPSO. The mean correction angles were 31.9° ± 11.7° with PSO, 14.3° ± 8.4° with SPO, 38.3° ± 12.7° with PVCR, and 19.3° ± 7.1° with PPSO. The thoracolumbar type was the most common. The outcome analysis showed a significant improvement in the ODI score (p ankylosing spondylitis, resulting in satisfactory outcomes with acceptable complications. The CCROM and postoperative SVA were important factors in determining the outcome.

  19. A Predictable Approach for Osteotomy in Rhinoplasty: A New Concept of Open External Osteotomy

    Science.gov (United States)

    Hontanilla, Bernardo; Cabello, Alvaro

    2016-01-01

    Summary: Nasal osteotomies are a cornerstone step for closing an open roof deformity after dorsal hump surgery. Notwithstanding, the optimal method of nasal osteotomy remains controversial, as evidenced by the variety of approaches with no consensus between authors. Moreover, the election of the technique responds to surgeon’s preference. We proposed a new way to perform both medial and lateral osteotomies under direct vision. Direct vision of nasal osteotomies provides more predictable control and precision than blind procedures, making this procedure more reliable and easier for both novel and experienced surgeons. Other advantages include conservation of nasal muscle, angular vasculature, and periosteum, which allow less postoperative ecchymosis and edema and less risk of synechia and lacrimal sac injury. PMID:27482503

  20. Obwegeser II osteotomy (transoral angle osteotomy) for open bite with skeletal class III deformity.

    Science.gov (United States)

    Kwon, Tae-Geon; Na, KwangMyung; Lee, Sang-Han

    2014-10-01

    This study evaluated postoperative stability after Obwegeser II osteotomy (transoral angle osteotomy, first reported by Obwegeser 1973) for severe open bite with mandibular prognathism. This retrospective study reviewed 20 consecutive patients who underwent only mandibular Obwegeser II osteotomy to correct open bite and mandibular prognathism. Lateral cephalograms were evaluated preoperatively (T1), immediate postoperatively (T2) and at least 6 months after the surgery (T3). Surgical and postsurgical changes in cephalometric measurements were evaluated statistically. Open bite with skeletal class III malocclusion was corrected by the Obwegeser II osteotomy alone. After an average of 9.9 ± 5.2 mm of mandibular setback with open bite closure (T2-T1, over-bite change, 5.7 ± 2.4 mm) by counter-clockwise rotation of the mandible, the patients showed 0.8 ± 1.7 mm of horizontal relapse (p > 0.05), 1.1 ± 1.7 mm of vertical relapse at the B point (p = 0.011) and -0.2 ± 1.6 mm of over-bite change postoperatively (T3-T2). With the adequate control of the condylar position with rigid internal fixation, Obwegeser II osteotomy showed acceptable stability after the correction of open bite with mandibular prognathism without a simultaneous maxillary osteotomy. An isolated Obwegeser II osteotomy can be considered a reliable option in cases with moderate to severe open bite with mandibular prognathism when the maxillary osteotomy is not needed if the patients have a well-positioned maxilla. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Pulsed electromagnetic field treatments enhance the healing of fibular osteotomies.

    Science.gov (United States)

    Midura, Ronald J; Ibiwoye, Michael O; Powell, Kimerly A; Sakai, Yoshitada; Doehring, Todd; Grabiner, Mark D; Patterson, Thomas E; Zborowski, Maciej; Wolfman, Alan

    2005-09-01

    This study tested the hypothesis that pulsed electromagnetic field (PEMF) treatments augment and accelerate the healing of bone trauma. It utilized micro-computed tomography imaging of live rats that had received bilateral 0.2 mm fibular osteotomies (approximately 0.5% acute bone loss) as a means to assess the in vivo rate dynamics of hard callus formation and overall callus volume. Starting 5 days post-surgery, osteotomized right hind limbs were exposed 3 h daily to Physio-Stim PEMF, 7 days a week for up to 5 weeks of treatment. The contralateral hind limbs served as sham-treated, within-animal internal controls. Although both PEMF- and sham-treatment groups exhibited similar onset of hard callus at approximately 9 days after surgery, a 2-fold faster rate of hard callus formation was observed thereafter in PEMF-treated limbs, yielding a 2-fold increase in callus volume by 13-20 days after surgery. The quantity of the new woven bone tissue within the osteotomy sites was significantly better in PEMF-treated versus sham-treated fibulae as assessed via hard tissue histology. The apparent modulus of each callus was assessed via a cantilever bend test and indicated a 2-fold increase in callus stiffness in the PEMF-treated over sham-treated fibulae. PEMF-treated fibulae exhibited an apparent modulus at the end of 5-weeks that was approximately 80% that of unoperated fibulae. Overall, these data indicate that Physio-Stim PEMF treatment improved osteotomy repair. These beneficial effects on bone healing were not observed when a different PEMF waveform, Osteo-Stim, was used. This latter observation demonstrates the specificity in the relationship between waveform characteristics and biological outcomes.

  2. Failure of high tibial varus osteotomy for lateral tibio-femoral osteoarthritis with<10° of valgus: Outcomes in 19 patients.

    Science.gov (United States)

    Mirouse, G; Dubory, A; Roubineau, F; Poignard, A; Hernigou, P; Allain, J; Flouzat Lachaniette, C H

    2017-10-01

    Osteotomy is a rational approach to slowing knee osteoarthritis progression by modifying loads, thereby avoiding joint replacement in younger individuals. Varus femoral osteotomy is recommended only in patients with more than 10° of valgus. The objective here was to assess outcomes of tibial varus osteotomy in patients with lateral compartment tibio-femoral osteoarthritis and less than 10° of valgus. The hypothesis was that high tibial varus osteotomy produces satisfactory and long-lasting improvements. A single-centre retrospective study was conducted in 19 consecutive patients managed by high tibial varus osteotomy between January 2005 and May 2012. Mean age was 54.5years. The clinical IKS knee and function scores and radiological parameters were determined pre-operatively then after 6 and 12months and at last follow-up. The primary outcome measure was the global IKS score. Failure was defined as a global IKS score varus osteotomy produced satisfactory and long-lasting improvements in lateral compartment tibio-femoral osteoarthritis. After the mean follow-up of 4.3years (range, 2-9years), 10/19 patients had a global IKS score Varus tibial osteotomy was followed by significant improvements in the IKS knee and function scores from baseline to last follow-up (P10° were associated with poor outcomes. High tibial varus osteotomy produces unsatisfactory medium-term outcomes, with an overall failure rate of 52%. At present, high tibial varus osteotomy has no role in the management of lateral compartment tibio-femoral osteoarthritis with <10° of valgus. IV, retrospective cohort study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. The effect of flipped teaching combined with modified team-based learning on student performance in physiology.

    Science.gov (United States)

    Gopalan, Chaya; Klann, Megan C

    2017-09-01

    Flipped classroom is a hybrid educational format that shifts guided teaching out of class, thus allowing class time for student-centered learning. Although this innovative teaching format is gaining attention, there is limited evidence on the effectiveness of flipped teaching on student performance. We compared student performance and student attitudes toward flipped teaching with that of traditional lectures using a partial flipped study design. Flipped teaching expected students to have completed preclass material, such as assigned reading, instructor-prepared lecture video(s), and PowerPoint slides. In-class activities included the review of difficult topics, a modified team-based learning (TBL) session, and an individual assessment. In the unflipped teaching format, students were given PowerPoint slides and reading assignment before their scheduled lectures. The class time consisted of podium-style lecture, which was captured in real time and was made available for students to use as needed. Comparison of student performance between flipped and unflipped teaching showed that flipped teaching improved student performance by 17.5%. This was true of students in both the upper and lower half of the class. A survey conducted during this study indicated that 65% of the students changed the way they normally studied, and 69% of the students believed that they were more prepared for class with flipped learning than in the unflipped class. These findings suggest that flipped teaching, combined with TBL, is more effective than the traditional lecture. Copyright © 2017 the American Physiological Society.

  4. Development of a biomechanical guidance system for periacetabular osteotomy.

    Science.gov (United States)

    Murphy, Ryan J; Armiger, Robert S; Lepistö, Jyri; Mears, Simon C; Taylor, Russell H; Armand, Mehran

    2015-04-01

    This paper presents and validates a computer-navigated system for performing periacetabular osteotomy (PAO) to treat developmental dysplasia of the hip. The main motivation of the biomechanical guidance system (BGS) is to plan and track the osteotomy fragment in real time during PAO while simplifying the procedure for less-experienced surgeons. The BGS aims at developing a platform for comparing biomechanical states of the joint with the current gold standard geometric assessment of anatomical angles. The purpose of this study was to (1) determine the accuracy with which the BGS tracks the hip joint through repositioning and (2) identify improvements to the workflow. Nineteen cadaveric validation studies quantified system accuracy, verified system application, and helped to refine surgical protocol. In two surgeries, navigation and registration accuracy were computed by affixing fiducials to two cadavers prior to surgery. All scenarios compared anatomical angle measurements and joint positioning as measured intraoperatively to postoperatively. In the two cases with fiducials, computed fragment transformations deviated from measured fiducial transformations by 1.4 and 1.8 mm in translation and 1.0° and 2.2° in rotation, respectively. The additional seventeen surgeries showed strong agreement between intraoperative and postoperative anatomical angles, helped to refine the surgical protocol, and demonstrated system robustness. Estimated accuracy with BGS appeared acceptable for future surgical applications. Several major system requirements were identified and addressed, improving the BGS and making it feasible for clinical studies.

  5. The Big Five, Learning Goals, Exam Preparedness, and Preference for Flipped Classroom Teaching: Evidence from a Large Psychology Undergraduate Cohort

    Science.gov (United States)

    Lyons, Minna; Limniou, Maria; Schermbrucker, Ian; Hands, Caroline; Downes, John J.

    2017-01-01

    Previous research has found that the flipped classroom (i.e., learning prior to the lecture, and using the lecture time for consolidating knowledge) increases students' deep learning, and has an association with improved grades. However, not all students benefit equally from flipping the classroom, and there may be important individual differences…

  6. [Flipped classroom in basic medical education].

    Science.gov (United States)

    Merenmies, Jussi; Niemi-Murola, Leila; Pyörälä, Eeva

    2015-01-01

    Medical education is facing changes in order to improve young doctors' competency to respond better to current needs of the patients and the society. Both curriculum content and teaching methods are revised. In addition to vibrant research in academic medical education, teachers are supported by the improved web-based learning environments and novel technical tools. Flipped classroom, a new paradigm that benefits from technical development, provides many opportunities for medical education. This teaching method always consists of two mutually complementary parts. The first part of the learning action takes place independently off classroom with video lectures or other stimuli for learning. The second part takes place in conjunction with the teacher and other students, and requires student group interactions.

  7. Pharmacy student engagement, performance, and perception in a flipped satellite classroom.

    Science.gov (United States)

    McLaughlin, Jacqueline E; Griffin, LaToya M; Esserman, Denise A; Davidson, Christopher A; Glatt, Dylan M; Roth, Mary T; Gharkholonarehe, Nastaran; Mumper, Russell J

    2013-11-12

    To determine whether "flipping" a traditional basic pharmaceutics course delivered synchronously to 2 satellite campuses would improve student academic performance, engagement, and perception. In 2012, the basic pharmaceutics course was flipped and delivered to 22 satellite students on 2 different campuses. Twenty-five condensed, recorded course lectures were placed on the course Web site for students to watch prior to class. Scheduled class periods were dedicated to participating in active-learning exercises. Students also completed 2 course projects, 3 midterm examinations, 8 graded quizzes, and a cumulative and comprehensive final examination. Results of a survey administered at the beginning and end of the flipped course in 2012 revealed an increase in students' support for learning content prior to class and using class time for more applied learning (p=0.01) and in the belief that learning key foundational content prior to coming to class greatly enhanced in-class learning (p=0.001). Significantly more students preferred the flipped classroom format after completing the course (89.5%) than before completing the course (34.6%). Course evaluation responses and final examination performance did not differ significantly for 2011 when the course was taught using a traditional format and the 2012 flipped-course format. Qualitative findings suggested that the flipped classroom promoted student empowerment, development, and engagement. The flipped pharmacy classroom can enhance the quality of satellite students' experiences in a basic pharmaceutics course through thoughtful course design, enriched dialogue, and promotion of learner autonomy.

  8. Flip-J: Development of the System for Flipped Jigsaw Supported Language Learning

    Science.gov (United States)

    Yamada, Masanori; Goda, Yoshiko; Hata, Kojiro; Matsukawa, Hideya; Yasunami, Seisuke

    2016-01-01

    This study aims to develop and evaluate a language learning system supported by the "flipped jigsaw" technique, called "Flip-J". This system mainly consists of three functions: (1) the creation of a learning material database, (2) allocation of learning materials, and (3) formation of an expert and jigsaw group. Flip-J was…

  9. How to Flip the Classroom--"Productive Failure or Traditional Flipped Classroom" Pedagogical Design?

    Science.gov (United States)

    Song, Yanjie; Kapur, Manu

    2017-01-01

    The paper reports a quasi-experimental study comparing the "traditional flipped classroom" pedagogical design with the "productive failure" (Kapur, 2016) pedagogical design in the flipped classroom for a 2-week curricular unit on polynomials in a Hong Kong Secondary school. Different from the flipped classroom where students…

  10. Flipped Classroom Experiences: Student Preferences and Flip Strategy in a Higher Education Context

    Science.gov (United States)

    McNally, Brenton; Chipperfield, Janine; Dorsett, Pat; Del Fabbro, Letitia; Frommolt, Valda; Goetz, Sandra; Lewohl, Joanne; Molineux, Matthew; Pearson, Andrew; Reddan, Gregory; Roiko, Anne; Rung, Andrea

    2017-01-01

    Despite the popularity of the flipped classroom, its effectiveness in achieving greater engagement and learning outcomes is currently lacking substantial empirical evidence. This study surveyed 563 undergraduate and postgraduate students (61% female) participating in flipped teaching environments and ten convenors of the flipped courses in which…

  11. Flipping the Graduate Qualitative Research Methods Classroom: Did It Lead to Flipped Learning?

    Science.gov (United States)

    Earley, Mark

    2016-01-01

    The flipped, or inverted, classroom has gained popularity in a variety of fields and at a variety of educational levels, from K-12 through higher education. This paper describes the author's positive experience flipping a graduate qualitative research methods classroom. After a review of the current literature on flipped classrooms in higher…

  12. Rotational Corrective Osteotomy for Malunited Distal Diaphyseal Radius Fractures in Children and Adolescents.

    Science.gov (United States)

    Kataoka, Toshiyuki; Oka, Kunihiro; Murase, Tsuyoshi

    2018-03-01

    To report our method of computer-planned rotational corrective osteotomy for malunited distal diaphyseal radius fractures in children and adolescents using a custom jig and to review the results of 4 cases. Four patients (mean age, 13 years; range, 11-16 years) underwent computer-planned rotational corrective osteotomy for malunited distal diaphyseal radius fracture using a custom jig. We retrospectively evaluated their radiographic and clinical data. In patients who had marked restriction of forearm supination before osteotomy, the mean arc of forearm supination improved from 5° before surgery to 79° after surgery. Angular deformity on x-ray, range of forearm rotation, and grip strength all improved after surgery. Mild and moderate pain reported by 1 and 2 patients, respectively, was resolved after surgery. Computer-planned rotational corrective osteotomy for malunited distal diaphyseal radius fracture in children and adolescents using a custom jig is a strategy that facilitates the surgical procedure by accurately correcting both rotational and angular deformities on 1 plane in a single procedure. Therapeutic V. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. Staple fixation for akin proximal phalangeal osteotomy in the treatment of hallux valgus interphalangeus.

    Science.gov (United States)

    Neumann, Julie A; Reay, Kathleen D; Bradley, Kendall E; Parekh, Selene G

    2015-04-01

    The Akin proximal phalangeal osteotomy is commonly used in conjunction with metatarsal osteotomies to treat hallux valgus. Multiple fixation methods including suture, wire, screw, and staple fixation have been described. The aims of this study were to assess the intraoperative and postoperative complications and to evaluate short-term postoperative outcomes in patients who underwent Akin osteotomy with staple fixation. Forty-four patients (51 feet) with painful hallux valgus were retrospectively reviewed at an average of 40.4 ± 15.8 (range, 25.9 to 79.9) weeks following an Akin osteotomy with staple fixation. Patient reported preoperative and postoperative Visual Analog Score (VAS) (0 to 10, 0 = no pain) was recorded. Level of activity was reported postoperatively. Hallux valgus angles (HVAs), intermetatarsal angles (IMAs), and hallux valgus interphalangeus angles (IPAs) were evaluated on preoperative as well as final postoperative radiographs. Postoperative clinical and radiographic examinations were used to evaluate for complications. Mean VAS improved from 4.4 ± 2.6 to 1.0 ± 1.2 (P hallux valgus correction with improvement in pain and hallux valgus deformity with a low risk for complications. Level IV, case series. © The Author(s) 2014.

  14. Triple osteotomy for the correction of severe hallux valgus deformity: Patient reported outcomes and radiological evaluation.

    Science.gov (United States)

    Booth, Sean; Bhosale, Abhijit; Mustafa, Abubakar; Shenoy, Ravi; Pillai, Anand

    2016-08-01

    Symptomatic Hallux valgus can be treated with metatarsal osteotomy combined with proximal phalangeal osteotomy, however this might not be sufficient to treat severe HV deformities. Fifteen feet in eleven female patients treated with double first metatarsal and proximal phalanx osteotomies without lateral release were prospectively studied and outcome measures including radiological angles and validated patient reported outcome scores collected. Mean radiological follow up was 15 months and PROMs data 17 months. Mean hallux valgus and intermetatarsal angles were corrected from 45 to 24.7° and 18.7 to 7.4° respectively. There was an eight degree recurrence of hallux valgus angle. There was no wound problems, non-unions or evidence of avascular necrosis. The EQ-5D descriptive index showed a non-statistically significant improvement. All three elements of the MOxFQ score showed a statistically significant improvement: Forefoot pain (59-26.8), Walking and Stability (49.9-29.6) and Social Interaction (56.4-33.1) CONCLUSION: Triple osteotomy, without a lateral soft tissue release, leads to good radiological and functional outcomes in those with severe hallux valgus deformity. Patients need to be warned of the recovery time and potential for future metalwork removal. The risk of early recurrence suggests that a lateral release should be included in order to maintain a long lasting correction. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Complete Cranial Iliac Osteotomy to Approach the Lumbosacral Foramen

    Directory of Open Access Journals (Sweden)

    Barbara Dyall

    2017-05-01

    Full Text Available An approach using a complete cranial iliac osteotomy (CCIO to access the lumbosacral (LS foramen in dogs from lateral was developed using cadavers and applied in a clinical patient with degenerative lumbosacral stenosis (DLSS. The foraminal enlargement in the cadavers and the patient was documented on postoperative CT scans. The preoperative CT scan of the patient showed moderate cranial telescoping of the sacral roof and a moderate central disk protrusion, leading to moderate to severe compression of the cauda equina. In addition, there was lateral spondylosis with consequential stenosis of the right LS foramen. The right L7 nerve had lost its fat attenuation and appeared thickened. After a routine L7S1 dorsal laminectomy with a partial discectomy, a CCIO was performed, providing good access to the LS foramen and the adhesions around the proximal L7 nerve caudoventral to the foramen. The osteotomy was stabilized with a locking plate and a cerclage wire. The dog recovered well from the procedures and after 36 h, the dog walked normally and was discharged from the hospital. Eight and 16 weeks later, the signs of the DLSS had markedly improved. From these data, it can be concluded that the CCIO is a useful approach to the LS foramen and intervertebral disk in selected patients with DLSS, giving good access to the structures around the LS foramen.

  16. To Flip or Not to Flip? Analysis of a Flipped Classroom Pedagogy in a General Biology Course

    Science.gov (United States)

    Heyborne, William H.; Perrett, Jamis J.

    2016-01-01

    In an attempt to better understand the flipped technique and evaluate its purported superiority in terms of student learning gains, the authors conducted an experiment comparing a flipped classroom to a traditional lecture classroom. Although the outcomes were mixed, regarding the superiority of either pedagogical approach, there does seem to be a…

  17. Triple pelvic osteotomy: effect on limb function and progression of degenerative joint disease

    International Nuclear Information System (INIS)

    Johnson, A.L.; Smith, C.W.; Pijanowski, G.J.; Hungerford, L.L.

    1998-01-01

    The objective of this study was to evaluate prospectively the outcome of 21 clinical patients treated with triple pelvic osteotomies during the year following surgery. Specific aims included documenting the time of and extent of improved limb function as measured by force plate analysis, evaluating the progression of degenerative joint disease (DJD) in the treated and untreated coxofemoral joints, and determining whether or not triple pelvic osteotomy resulted in degenerative joint changes in the ipsilateral stifle and hock. Twelve dogs were treated unilaterally and nine dogs were treated bilaterally with triple pelvic osteotomies. There were no differences in mean anteversion angles, angles of inclination, or preoperative DJD between treated hips and untreated hips. Degenerative joint disease progressed significantly in all hips regardless of treatment. Two cases developed hyperextension of their hocks after the triple pelvic osteotomies. However, no radiographic evidence of DJD was observed for any of the stifles or hocks at any observation time. A significant increase in vertical peak force (VPF) scores was noted for treated legs by two-to-three months after surgery, which continued over time. Untreated legs did not show a significant change in VPF scores over time. No differences were found in progression to higher scores when unilaterally treated legs, first-side treated legs, and second-side treated legs were compared

  18. Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection

    Science.gov (United States)

    Rho, Bong Il; Lee, In Ho

    2016-01-01

    There are two general categories of lateral osteotomy techniques—the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization. PMID:26848452

  19. Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection

    Directory of Open Access Journals (Sweden)

    Bong Il Rho

    2016-01-01

    Full Text Available There are two general categories of lateral osteotomy techniques—the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.

  20. [Valgisation osteotomy in the treatment of osteoarthrosis of the hip: 21 cases (author's transl)].

    Science.gov (United States)

    Kouvalchouk, J F; Balmary, G; Rainaut, J J

    1979-03-24

    Study of 21 cases of femoral valgisation osteotomy, with a minimum follow-up of 5 years, confirms the value of this operation in the treatment of certain types of osteoarthrosis of the hip, and above all those types in which there is an inferior capital osteophyte. The indications depend upon: --clinical features: as in the case of all osteotomies, mobility must be at least equal to 70 degrees flexion. --radiological findings: reposition films in adduction should show widening of the joint space and above all improved congruence. The presence of geodes and lack of cover of the femoral head are not, in themselves, contraindications. The operation involves, in addition to valgisation inter-trochanteric osteotomy, relaxation of the peri-articular muscles (psoas, adductors, gluteus medius) in order that the relative lengthening of the upper end of the femur related to ventricalisation of the neck should not be in contradiction with the usual principles of surgery for osteoarthrosis. Valgisation osteotomy results in an increase in weight-bearing surfaces and thus a decrease in unit pressure. Indicated and performed in this way, this operation gives highly satisfactory and durable results, as shown by the follow-up period of our own cases.

  1. Distal femoral flexion deformity from growth disturbance treated with a two-level osteotomy and internal lengthening nail

    Directory of Open Access Journals (Sweden)

    Austin T. Fragomen

    2017-10-01

    Full Text Available Abstract Salter Harris fractures of the distal femur can lead to growth disturbance with resulting leg length inequality and knee deformity. We have looked at a case series (3 of patients who presented with a distal femur flexion malunion and shortening treated with a distal femoral osteotomy and plating and a proximal femoral osteotomy with a magnetic internal lengthening nail. Does a two-level osteotomy and internal fixation approach provide a reliable result both radiographically and functionally? The average knee extension loss was 12°, LLD 47 mm, PDFA 65°, MAD 2 mm. The patients were treated with an acute, posterior, opening wedge osteotomy of the distal femur stabilized with a lateral plate and screws and grafted with cancellous chips and putty. A second osteotomy was made proximally in the femur percutaneously, and the internal lengthening nail was inserted. Lengthening was done at approximately 1 mm/day. The average extension gain was 12°; amount of lengthening at the proximal site was 40 mm, LLD was 3 mm. The average PDFA was 81°, and MAD 3 mm. There were no complications. Functional results were excellent. Bone healing index was 24 days/cm. The average distance from the distal osteotomy to the joint line was 57 mm. The technique of two-level femur osteotomy stabilized with a plate and lengthening nail yielded excellent results with acceptable correction of deformity, full knee extension, and improved function. There were no complications including implant failure, infection, need for blood transfusion, knee stiffness, nonunion, compartment syndrome, or malunion.

  2. Flipped Classroom Modules for Large Enrollment General Chemistry Courses: A Low Barrier Approach to Increase Active Learning and Improve Student Grades

    Science.gov (United States)

    Eichler, Jack F.; Peeples, Junelyn

    2016-01-01

    In the face of mounting evidence revealing active learning approaches result in improved student learning outcomes compared to traditional passive lecturing, there is a growing need to change the way instructors teach large introductory science courses. However, a large proportion of STEM faculty continues to use traditional instructor-centered…

  3. Comparison of tibial plateau angle changes after tibial plateau leveling osteotomy fixation with conventional or locking screw technology.

    Science.gov (United States)

    Conkling, Amanda L; Fagin, Bennett; Daye, R Mark

    2010-06-01

    To compare the effects of locking and conventional screws on postoperative tibial plateau angle (TPA), osteotomy healing, and complication rate after tibial plateau leveling osteotomy (TPLO) in dogs treated for naturally occurring cranial cruciate ligament (CCL) rupture. Prospective clinical study. Dogs (n=118) with CCL rupture. Dogs (> or =20 kg) with unilateral CCL rupture and sufficient bone stock for TPLO and use of a 3.5-mm-broad or -narrow TPLO plate were sequentially allocated to have plate fixation with locking or conventional screws. Data analyzed included breed, age, sex, body weight, body condition score, limb operated, implants used, meniscal status, operative time, and days to recheck. Preoperative, immediate postoperative, and 8-week recheck mediolateral radiographs were reviewed, and TPA, complications, and healing status were evaluated. Stifles in the locking screw group had significantly less change in postoperative TPA than stifles in the conventional screw group. Locking screw fixation also had significantly higher grades of osteotomy healing, assessed on a mediolateral radiographic view. TPLO plates secured with locking screws are acceptable when compared with those secured with conventional screws; osteotomy healing is improved and TPA better conserved when using locking screws. Locking screw fixation serves to increase stabilization of TPA during TPLO healing and provides improved radiographic evidence of osteotomy healing.

  4. The early functional outcome of Mau osteotomy for the correction of moderate-severe hallux valgus

    Directory of Open Access Journals (Sweden)

    Tanujan Thangarajah

    2013-11-01

    Full Text Available Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy. A retrospective review of 23 patients with moderate-severe hallux valgus treated by Mau osteotomy was conducted. Patients were assessed clinically by the American Orthopedic Foot and Ankle Society (AOFAS scoring system and radiologically by measuring the first intermetatarsal (IM and hallux abductovalgus angles (HAV. The mean AOFAS score had improved from 47 preoperatively to 92 postoperatively (P<0.01. Additionally, preoperative HAV and IM angles improved from 39° and 15° respectively to 15° and 9° respectively (P<0.01. There were no cases of undercorrection or non-union. In this series, the Mau osteotomy was able to achieve good correction of the IM and HAV angles in patients with moderate-severe hallux valgus. This was reflected in a significantly higher postoperative AOFAS score. Contrary to other studies there were no cases of undercorrection and despite allowing patients to fully weight-bear postoperatively there were no cases of non-union.

  5. Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.

    Science.gov (United States)

    Lucas y Hernandez, J; Golanó, P; Roshan-Zamir, S; Darcel, V; Chauveaux, D; Laffenêtre, O

    2016-03-01

    The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy. A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up. The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly.. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx. Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. Its main asset is that it maintains an excellent range of movement. The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy whilst maintaining excellent first MTPJ range of motion. ©2016 The British Editorial Society of Bone & Joint Surgery.

  6. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity

    DEFF Research Database (Denmark)

    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels

    2016-01-01

    BACKGROUND: Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after...... operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. METHODS: Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal...... and 12 months after the operation. RESULTS: In group 1 the hallux valgus angle decreased from 39.0̊ to 24.1̊ after 4 months and 27.9̊ after 12 months. In group 2 the angle decreased from 38.3̊ to 21.4̊ after 4 months and 27.0̊ after 12 months. The intermetatarsal angle in group 1 was 19.0̊ preoperatively...

  7. Root-flipped multiband refocusing pulses.

    Science.gov (United States)

    Sharma, Anuj; Lustig, Michael; Grissom, William A

    2016-01-01

    To design low peak power multiband refocusing radiofrequency pulses, with application to simultaneous multislice spin echo MRI. Multiband Shinnar-Le Roux β polynomials were designed using convex optimization. A Monte Carlo algorithm was used to determine patterns of β polynomial root flips that minimized the peak power of the resulting refocusing pulses. Phase-matched multiband excitation pulses were also designed to obtain linear-phase spin echoes. Simulations compared the performance of the root-flipped pulses with time-shifted and phase-optimized pulses. Phantom and in vivo experiments at 7T validated the function of the root-flipped pulses and compared them to time-shifted spin echo signal profiles. Averaged across number of slices, time-bandwidth product, and slice separation, the root-flipped pulses have 46% shorter durations than time-shifted pulses with the same peak radiofrequency amplitude. Unlike time-shifted and phase-optimized pulses, the root-flipped pulses' excitation errors do not increase with decreasing band separation. Experiments showed that the root-flipped pulses excited the desired slices at the target locations, and that for equivalent slice characteristics, the shorter root-flipped pulses allowed shorter echo times, resulting in higher signal than time-shifted pulses. The proposed root-flipped multiband radiofrequency pulse design method produces low peak power pulses for simultaneous multislice spin echo MRI. © 2015 Wiley Periodicals, Inc.

  8. Conceptualizing "Homework" in Flipped Mathematics Classes

    Science.gov (United States)

    de Araujo, Zandra; Otten, Samuel; Birisci, Salih

    2017-01-01

    Flipped instruction is becoming more common in the United States, particularly in mathematics classes. One of the defining characteristics of this increasingly popular instructional format is the homework teachers assign. In contrast to traditional mathematics classes in which homework consists of problem sets, homework in flipped classes often…

  9. Examining the Flipped Classroom through Action Research

    Science.gov (United States)

    Lo, Chung Kwan

    2017-01-01

    There is a growing interest in using a flipped classroom format in day-to-day teaching. Direct computer-based individual instruction outside the classroom and interactive group learning activities inside the classroom are the two essential components of the flipped classroom model. By watching instructional videos, students can work through some…

  10. Just in Time to Flip Your Classroom

    Science.gov (United States)

    Lasry, Nathaniel; Dugdale, Michael; Charles, Elizabeth

    2014-01-01

    With advocates like Sal Khan and Bill Gates, flipped classrooms are attracting an increasing amount of media and research attention. We had heard Khan's TED talk and were aware of the concept of inverted pedagogies in general. Yet it really hit home when we accidentally flipped our classroom. Our objective was to better prepare our students…

  11. The Flipped Classroom: A Twist on Teaching

    Science.gov (United States)

    Schmidt, Stacy M. P.; Ralph, David L.

    2016-01-01

    The traditional classroom has utilized the "I Do", "We Do", "You Do" as a strategy for teaching for years. The flipped classroom truly flips that strategy. The teacher uses "You Do", "We Do", "I Do" instead. Homework, inquiry, and investigation happen in the classroom. At home students…

  12. Flipped Classroom Instruction for Inclusive Learning

    Science.gov (United States)

    Altemueller, Lisa; Lindquist, Cynthia

    2017-01-01

    The flipped classroom is a teaching methodology that has gained recognition in primary, secondary and higher education settings. The flipped classroom inverts traditional teaching methods, delivering lecture instruction outside class, and devoting class time to problem solving, with the teacher's role becoming that of a learning coach and…

  13. Diverse Perspectives on a Flipped Biostatistics Classroom

    Science.gov (United States)

    Schwartz, Todd A.; Andridge, Rebecca R.; Sainani, Kirstin L.; Stangle, Dalene K.; Neely, Megan L.

    2016-01-01

    "Flipping" the classroom refers to a pedagogical approach in which students are first exposed to didactic content outside the classroom and then actively use class time to apply their newly attained knowledge. The idea of the flipped classroom is not new, but has grown in popularity in recent years as the necessary technology has…

  14. Flipping the Calculus Classroom: An Evaluative Study

    Science.gov (United States)

    Maciejewski, Wes

    2016-01-01

    Classroom flipping is the practice of moving new content instruction out of class time, usually packaging it as online videos and reading assignments for students to cover on their own, and devoting in-class time to interactive engagement activities. Flipping has garnered a large amount of hype from the popular education media and has been adopted…

  15. Repair of femoral trochanteric osteotomy in the dog

    International Nuclear Information System (INIS)

    Whitelock, R.G.; Dyce, J.; Houlton, J.E.F.

    1997-01-01

    The records and radiographs of 24 dogs that underwent femoral trochanteric osteotomy repair were reviewed. Osteotomy repair was performed with either a pin and tension band wire or a lag screw technique. Significant clinical complications associated with the osteotomy were identified in one dog (4 per cent) six weeks after surgery, although abnormal radiographic changes were evident in 15 dogs (62 per cent). The method of repair did not influence healing and there were comparable radiographic complication rates. It is concluded that femoral trochanteric osteotomy is not associated with significant clinical problems, despite a high incidence of abnormal radiographic findings

  16. Implementing the Flipped Classroom Model in the Teaching of History

    Directory of Open Access Journals (Sweden)

    Siti Waznah Abdul Latif

    2017-11-01

    Full Text Available This study investigated the effectiveness in implementing the Flipped Classroom model in teaching History and to identify the students’ perceptions using this approach towards their learning. The chosen History topic was on ‘James Brooke’s activities in Sarawak in the 1840s’. The sample consisted of twelve students from two Year 9 classes in one of the secondary schools in Brunei Darussalam. In adopting the Flipped Classroom approach, the students were required to watch a video lesson outside the classroom setting. To measure its effectiveness, a test instrument was used, and five students were interviewed. The findings revealed that the utilisation of this instructional method was effective in teaching History, as there were improvements in the students’ test results. The analyses of the students’ perceptions using this approach revealed that while some students believed that it helped them improve in their communication and writing skills, others did not perceive it effective for their learning.

  17. Limited flip angle MR imaging: Hemorrhagic applications

    International Nuclear Information System (INIS)

    Drayer, B.P.; Rigamonti, D.; Johnson, P.C.; Spetzler, R.F.; Keller, P.J.; Flom, R.A.; Bird, C.R.; Hodak, J.A.

    1987-01-01

    The authors studied 64 patients with hemorrhagic brain lesions, including vascular malformations (n = 29), hemorrhagic infarctions (n = 9), chronic slit hemorrhagic residua of hypertensive hematoma (n = 10), trauma (n = 8), and gliobastoma multiforme (n = 8). With a 1.5-T MR imaging system, 5-mm sections were obtained at a repetition time of 300 msec (or 500), an echo time of 12.3 msec (or 10 and 40), and a flip angle of 60 0 (or 20 0 ). The limited flip angle study was always extremely sensitive for the detection of hemosiderin. With multiple cavernous angiomas, additional small lesions (in five of 18 patients) were detected only with the limited flip angle technique. The hemosiderin-laden macrophage residua of hemorrhagic infarction and hypertensive hematoma were better seen on limited flip angle images than on T2-weighted spin-echo images. The detection of blood on limited flip angle images permitted the grading of glioma as glioblastoma multiforme

  18. Just in Time to Flip Your Classroom

    Science.gov (United States)

    Lasry, Nathaniel; Dugdale, Michael; Charles, Elizabeth

    2014-01-01

    With advocates like Sal Khan and Bill Gates, flipped classrooms are attracting an increasing amount of media and research attention.2 We had heard Khan's TED talk and were aware of the concept of inverted pedagogies in general. Yet it really hit home when we accidentally flipped our classroom. Our objective was to better prepare our students for class. We set out to effectively move some of our course content outside of class and decided to tweak the Just-in-Time Teaching approach (JiTT).3 To our surprise, this tweak—which we like to call the flip-JiTT—ended up completely flipping our classroom. What follows is narrative of our experience and a procedure that any teacher can use to extend JiTT to a flipped classroom.

  19. Modified french osteotomy for cubitus varus deformity

    International Nuclear Information System (INIS)

    Ahmad, I.; Idrees, M.

    2007-01-01

    To evaluate the outcome of Modified French Osteotomy for correction of cubitus varus deformity. All children, aged 3-12 years, with cubitus varus deformity were included in the study. Pre-operative clinical as well as radiological assessment of upper extremities were done in all cases. Modified French osteotomy was done to correct the deformity. All patients were followed for seven months. Physical examination for the range of motion, scar and post-operative complications were assessed. Antero-posterior and lateral radiographs of the elbow were obtained, and the carrying angles and lateral condylar prominence index were measured and recorded. Out of the total 30 patients, 26 were male and four female. Left side was involved in 24 cases and the right side in six. The average age at the time of osteotomy was seven years (range 3.5-12 years). The average pre-operative carrying angle was 25.2 degree (range 18-30 degree) and the post-operative angle 8.7 degree (range 5-13 degree valgus). The average pre- operative range of motion was 122.6 degree (range 105-135 degree) and the post-operative range 123.86 degree (range 90-135 degree). The average pre-operative lateral condylar prominence index (LCPI) was 175.56 (range 128-232) and the post-operative lateral condylar prominence 156 (range 100-240). Based on Bellmore criteria, 25 patients showed excellent, three good and two a poor result. Modified French technique of supracondylar osteotomy has excellent results in the management of cubitus varus in terms of cosmesis, radiological findings and fewer complications. (author)

  20. Correction of moderate to severe hallux valgus with combined proximal opening wedge and distal chevron osteotomies: a reliable technique.

    Science.gov (United States)

    Jeyaseelan, L; Chandrashekar, S; Mulligan, A; Bosman, H A; Watson, A J S

    2016-09-01

    The mainstay of surgical correction of hallux valgus is first metatarsal osteotomy, either proximally or distally. We present a technique of combining a distal chevron osteotomy with a proximal opening wedge osteotomy, for the correction of moderate to severe hallux valgus. We reviewed 45 patients (49 feet) who had undergone double osteotomy. Outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and the Short Form (SF) -36 Health Survey scores. Radiological measurements were undertaken to assess the correction. The mean age of the patients was 60.8 years (44.2 to 75.3). The mean follow-up was 35.4 months (24 to 51). The mean AOFAS score improved from 54.7 to 92.3 (p hallux valgus and intermetatarsal angles were improved from 41.6(o) to 12.8(o) (p < 0.001) and from 22.1(o) to 7.1(o), respectively (p < 0.001). The mean distal metatarsal articular angle improved from 23(o) to 9.7(o). The mean sesamoid position, as described by Hardy and Clapham, improved from 6.8 to 3.5. The mean length of the first metatarsal was unchanged. The overall rate of complications was 4.1% (two patients). These results suggest that a double osteotomy of the first metatarsal is a reliable, safe technique which, when compared with other metatarsal osteotomies, provides strong angular correction and excellent outcomes with a low rate of complications. Cite this article: Bone Joint J 2016;98-B:1202-7. ©2016 The British Editorial Society of Bone & Joint Surgery.

  1. [Single-stage bilateral Pemberton's pericapsular osteotomy in bilateral developmental dysplasia of the hip].

    Science.gov (United States)

    Zorer, Gazi; Bagatur, A Erdem

    2002-01-01

    This study was designed to evaluate the results of single-stage bilateral Pemberton's pericapsular osteotomy with or without open reduction and to demonstrate its advantages over two separate consecutive interventions in bilateral developmental dysplasia of the hip (DDH). This prospective study included 20 patients (14 girls, 6 boys; mean age 30 months; range 12 to 60 months) with bilateral DDH, who underwent single-stage bilateral Pemberton's pericapsular osteotomy with (14 patients, group A1) or without (6 patients, group A2) open reduction. Twenty patients (16 girls, 4 boys; mean age 24 months; range 13 to 47 months) with unilateral DDH, who underwent Pemberton's pericapsular osteotomy with (12 patients, group B1) or without (8 patients, group B2) open reduction were enrolled into the study as controls. Single- and two-stage procedures were compared with regard to improvement in the acetabular index, complications, mean duration of anesthesia, perioperative need for blood transfusion, length of hospital stay, initiation of walking, overall cost of antibiotic prophylaxis, and total hospital charge. There were no significant differences between A1 and B1, A2 and B2 groups with respect to mean age, gender, pre- and postoperative acetabular indices, and recovery times. However, duration of anesthesia, length of hospital stay, cost of antibiotic prophylaxis, and total hospital charges differed significantly. The amount of blood transfusion differed significantly only between groups A1 and B1. The length of hospital stay and cost of antibiotic prophylaxis in group A2 was twice as much as that of group B2. Increases in other parameters ranged between 22% to 37%. No early or late complications were encountered. Single-stage bilateral Pemberton's pericapsular osteotomy in patients with bilateral DDH seems to have significant advantages over two separate consecutive interventions. However, increased risks of bilateral osteotomies require that sufficiently equipped and

  2. Midterm outcome after correction of hallux valgus deformity using scarf osteotomy in adult population

    Directory of Open Access Journals (Sweden)

    Laura Ibrahim Alolayan

    2017-01-01

    Full Text Available Context: Determining the efficacy of any surgical treatment is the key to achieve better practice and best outcomes for patients. Aims: This study is designed to address midterm outcome in adult patients with moderate-to-severe hallux valgus (HV, who underwent scarf osteotomy from 2012 to 2014. Settings and Design: This is a retrospective cohort study in which charts of all adult patients with moderate-to-severe HV who underwent scarf osteotomy from 2011 to 2014 were reviewed. Subjects and Methods: Between 2011 and 2014, 39 patients (41 feet who underwent scarf osteotomy for correction of HV deformity were retrospectively evaluated. Standard weight-bearing dorsoplantar radiographs were obtained pre- and postoperatively. HV angle (HVA, intermetatarsal angle (IMA and distal metatarsal articular angles (DMAA were measured pre- and postoperatively to evaluate the efficacy of the surgery. The complication rate was reported. The average follow-up was 13.5 months, and the patients' mean age was 37 years. Statistical Analysis Used: Data were compared using Chi-square test or Fisher's exact test whichever was appropriate. All tests were two-sided, and a P> 0.01 was considered statistically significant. Results: The average preoperative HVA and IMA were 32° and 14.3°, which improved to 11° and 7.9°, respectively. The changes were statistically significant (P 0.18. Conclusions: This study suggests that scarf osteotomy surgery is a very versatile osteotomy in correcting moderate-to-severe HV deformity. It offers a greater degree of correction and stability, lower rate of complications and good outcome. However, long-term follow-up studies are still needed.

  3. A gross anatomy flipped classroom effects performance, retention, and higher-level thinking in lower performing students.

    Science.gov (United States)

    Day, Leslie J

    2018-01-22

    A flipped classroom is a growing pedagogy in higher education. Many research studies on the flipped classroom have focused on student outcomes, with the results being positive or inconclusive. A few studies have analyzed confounding variables, such as student's previous achievement, or the impact of a flipped classroom on long-term retention and knowledge transfer. In the present study, students in a Doctor of Physical Therapy program in a traditional style lecture of gross anatomy (n = 105) were compared to similar students in a flipped classroom (n = 112). Overall, students in the flipped anatomy classroom had an increase in semester average grades (P = 0.01) and performance on higher-level analytical questions (P flipped anatomy classroom performing at a higher level in kinesiology (P flipped anatomy class, outperformed their traditional anatomy class counterparts in anatomy semester grades (P flipped classroom may benefit lower performing student's knowledge acquisition and transfer to a greater degree than higher performing students. Future studies should explore the underlying reasons for improvement in lower performing students. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

  4. Early weight bearing versus delayed weight bearing in medial opening wedge high tibial osteotomy: a randomized controlled trial.

    Science.gov (United States)

    Lansdaal, Joris Radboud; Mouton, Tanguy; Wascher, Daniel Charles; Demey, Guillaume; Lustig, Sebastien; Neyret, Philippe; Servien, Elvire

    2017-12-01

    The need for a period of non-weight bearing after medial opening wedge high tibial osteotomy remains controversial. It is hypothesized that immediate weight bearing after medial opening wedge high tibial osteotomy would have no difference in functional scores at one year compared to delayed weight bearing. Fifty patients, median age 54 years (range 40-65), with medial compartment osteoarthritis, underwent a medial opening wedge high tibial osteotomy utilizing a locking plate without bone grafting. Patients were randomized into an Immediate or a Delayed (2 months) weight bearing group. All patients were assessed at one-year follow-up and the two groups compared. The primary outcome measure was the IKS score. Secondary outcome measures included the IKDC score, the VAS pain score and rate of complications. The functional scores significantly improved in both groups. The IKS score increased from 142 ± 31 to 171 ± 26 in the Immediate group (p bearing after medial opening wedge high tibial osteotomy had no effect on functional scores at 1 year follow-up and did not significantly increase the complication rate. Immediate weight bearing after medial opening wedge high tibial osteotomy appears to be safe and can allow some patients a quicker return to activities of daily living and a decreased convalescence period. II.

  5. Digital Storytelling in a Flipped Classroom for Effective Learning

    Directory of Open Access Journals (Sweden)

    Clemens Bechter

    2017-06-01

    Full Text Available Conclusive empirical evidence on whether virtual classrooms result in higher performance, satisfaction, or an improvement in problem solving skills when compared with traditional face-to-face lecturing does not exist. Various studies point in different directions. However, blended learning outperforms the traditional classroom in student performance and satisfaction. A flipped classroom is one type of blended learning. For more than 20 years, this approach has been used at a European executive MBA (EMBA program delivering online content combined with six residential weeks where students collaborate and reflect upon their online learning. Our research examined the overall setup of this program, and assessed one course in depth. As part of the course—International Management—an intercultural negotiation project was chosen to highlight the integration of online and offline activities. The flipped classroom is a demonstration of the reform-based teaching approach. The power of reform-based learning in executive education is the engaging combination of practice and theory, which improves the performance of executives. The participants considered the flipped approach exciting, dynamic, and insightful. The emphasis on a negotiation process involving classmates from around the world increased their global understanding. Beginning with a negotiation experience in the digital story project gave them a better appreciation of the relevant theories, techniques, and applications. Focusing on the practice of international negotiation and a cross-cultural analysis with reflection on cultural intelligence improved the competencies of the participants both during the course and after it.

  6. Flipping the Electromagnetic Theory classroom

    Science.gov (United States)

    Berger, Andrew J.

    2017-08-01

    Electromagnetic Theory is a required junior-year course for Optics majors at the University of Rochester. This foundational course gives students their first rigorous exposure to electromagnetic vector fields, dipole radiation patterns, Fresnel reflection/transmission coefficients, waveguided modes, Jones vectors, waveplates, birefringence, and the Lorentz model of refractive index. To increase the percentage of class time devoted to student-centered conceptual reasoning and instructor feedback, this course was recently "flipped". Nearly all of the mathematically-intensive derivations were converted to narrated screencasts ("Khan Academy" style) and made available to students through the course's learning management system. On average, the students were assigned two 10-15 minute videos to watch in advance of each lecture. An electronic survey after each tutorial encouraged reflection and counted towards the student's participation grade. Over the past three years, students have consistently rated the videos as being highly valuable. This presentation will discuss the technical aspects of creating tutorial videos and the educational tradeoffs of flipping a mathematically-intensive upper-level course. The most important advantage is the instructor's increased ability to identify and respond to student confusion, via activities that would consume too much time in a lecture-centered course. Several examples of such activities will be given. Two pitfalls to avoid are the temptation for the instructor not to update the videos from year to year and the tendency of students not to take lecture notes while watching the videos.

  7. Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report.

    Science.gov (United States)

    Santagata, Mario; Sgaramella, Nicola; Ferrieri, Ivo; Corvo, Giovanni; Tartaro, Gianpaolo; D'Amato, Salvatore

    2017-12-01

    A three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue. Based on our knowledge, nobody described before the sandwich osteotomy with tunnel technique to improve the healing of the wound and meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible. A 59-year-old woman with a severely atrophied right mandible was treated with the sandwich osteotomy technique filled with autologous bone graft harvested by a cortical bone collector from the ramus. Clinical examination revealed that the mandible was edentulous bilaterally from the first molar to the second molar region. Radiographically, atrophy of the mandibular alveolar ridge in the same teeth site was observed. We began to treat the right side. A horizontal osteotomy of the edentulous mandibular bone was then made with a piezoelectric device after tunnel technique of the soft tissue. The segmental mandibular sandwich osteotomy (SMSO) was finished by two (mesial and distal) slightly divergent vertical osteotomies. The entire bone fragment was displaced cranially, and the desirable position was obtained. The gap was filled completely with autologous bone chips harvested from the mandibular ramus through a cortical bone collector. No barrier membranes were used to protect the grafts. The vertical incisions were closing with interruptive suturing of the flaps with a resorbable material. In this way, the suture will not fall on the osteotomy line of the jaw; the result will be a better predictability of soft and hard tissue

  8. Flipped classroom: a review of recent literature

    Directory of Open Access Journals (Sweden)

    Huseyin Uzunboylu

    2015-07-01

    Full Text Available The use of learning technologies, especially multimedia provide varied facilities for students’ learning that are not possible with other media. Pedagogical literature has proved that individuals have different learning styles. Flipped classroom is a pedagogical approach which means that activities that have traditionally taken place inside the classroom take place outside the classroom and vice versa. Flipped classroom environment ensures that students become more active participants compared with the traditional classroom. The purpose of this paper is to fulfil the needs regarding the review of recent literature on the use of flipped classroom approach in education. The contribution of flipped classroom to education is discussed in relation to the change of students' and instructors' role. Subsequently, flipped classroom applications in various disciplines of education are illustrated. The recommendations made in the literature for design specifications that integrate flipped classrooms with technology are discussed. The paper concludes that a careful consideration of the warnings and recommendations made in the literature can help to produce effective flipped classroom environments and also this paper attempts to inform those who are thinking of using new technologies and approaches to deliver courses.

  9. Evaluation of the flipped classroom approach in a veterinary professional skills course.

    Science.gov (United States)

    Moffett, Jenny; Mill, Aileen C

    2014-01-01

    The flipped classroom is an educational approach that has had much recent coverage in the literature. Relatively few studies, however, use objective assessment of student performance to measure the impact of the flipped classroom on learning. The purpose of this study was to evaluate the use of a flipped classroom approach within a medical education setting to the first two levels of Kirkpatrick and Kirkpatrick's effectiveness of training framework. This study examined the use of a flipped classroom approach within a professional skills course offered to postgraduate veterinary students. A questionnaire was administered to two cohorts of students: those who had completed a traditional, lecture-based version of the course (Introduction to Veterinary Medicine [IVM]) and those who had completed a flipped classroom version (Veterinary Professional Foundations I [VPF I]). The academic performance of students within both cohorts was assessed using a set of multiple-choice items (n=24) nested within a written examination. Data obtained from the questionnaire were analyzed using Cronbach's alpha, Kruskal-Wallis tests, and factor analysis. Data obtained from student performance in the written examination were analyzed using the nonparametric Wilcoxon rank sum test. A total of 133 IVM students and 64 VPF I students (n=197) agreed to take part in the study. Overall, study participants favored the flipped classroom approach over the traditional classroom approach. With respect to student academic performance, the traditional classroom students outperformed the flipped classroom students on a series of multiple-choice items (IVM mean =21.4±1.48 standard deviation; VPF I mean =20.25±2.20 standard deviation; Wilcoxon test, w=7,578; Pflipped classroom approach. The flipped classroom was rated more positively than the traditional classroom on many different characteristics. This preference, however, did not translate into improved student performance, as assessed by a series of

  10. The Partially Flipped Classroom: The Effects of Flipping a Module on "Junk Science" in a Large Methods Course

    Science.gov (United States)

    Burgoyne, Stephanie; Eaton, Judy

    2018-01-01

    Flipped classrooms are gaining popularity, especially in psychology statistics courses. However, not all courses lend themselves to a fully flipped design, and some instructors might not want to commit to flipping every class. We tested the effectiveness of flipping just one component (a module on junk science) of a large methods course. We…

  11. Comparing the Effectiveness of Blended, Semi-Flipped, and Flipped Formats in an Engineering Numerical Methods Course

    Science.gov (United States)

    Clark, Renee M.; Kaw, Autar; Besterfield-Sacre, Mary

    2016-01-01

    Blended, flipped, and semi-flipped instructional approaches were used in various sections of a numerical methods course for undergraduate mechanical engineers. During the spring of 2014, a blended approach was used; in the summer of 2014, a combination of blended and flipped instruction was used to deliver a semi-flipped course; and in the fall of…

  12. Comparison of Flipped Model to Traditional Classroom Learning in a Professional Pharmacy Course

    Directory of Open Access Journals (Sweden)

    Colleen McCabe

    2017-09-01

    Full Text Available The flipped classroom is an approach to incorporate active learning that is being used in secondary education, higher education, and professional schools. This study investigates its impact on student learning and confidence in a professional degree program course. A quasi-experimental study was conducted to evaluate pharmacy students enrolled in a semester-long didactic traditional classroom course compared to students learning the same material using a flipped model through online self-study modules in a hands-on experiential learning course. Before and after each learning experience, students of each group completed a 16-item knowledge assessment on four topic areas and rated their level of confidence with each topic area on a Likert scale. There was a significant difference in knowledge with students in the traditional course scoring higher than students using flipped approach in the experiential course. Furthermore, the flipped experiential course students did not improve assessment scores from pre-test to post-test. For confidence rating, the traditional course group ranked confidence higher than the flipped experiential group for all topics. These findings challenge the notion that the flipped model using self-study in an experiential setting can be a substitution for didactic delivery of pharmacy education.

  13. Fernandez osteotomy of radio distal with mal united fracture

    International Nuclear Information System (INIS)

    Garcia Herrera, Alvaro; Bocanegra, Sergio; Suarez, Fabio

    2003-01-01

    We review prospectively our experience in the military hospital in Bogota, Colombia, with the opening-wedge osteotomy for the treatment of a mal united fracture of the distal end of the radius in fifty-six consecutive patients from 1990 to 2002. The indications for operation were pain predominantly in the radio-ulnar joint and functional limitation with grip strength loss. Preoperative radiographs revealed an average ulnar inclination of 14 degrees, an average ulnar variance of four millimeters, and increased dorsal tilt (colles deformity) that averaged 28 degrees. All patients had limited function. The average grip strength was a force of fifteen kilograms compared with a force of thirty-one kilograms in the contralateral hand. Postoperatively, all of the patients had substantial improvement in function, relief of pain and grip strength increased. The functional results were rated as very good in eleven patients, good in thirty-six, fair in nine

  14. Modified Chevron osteotomy for hallux valgus deformity in female athletes. A 2-year follow-up study.

    Science.gov (United States)

    Giotis, Dimitrios; Paschos, Nikolaos K; Zampeli, Franceska; Giannoulis, Dionisios; Gantsos, Apostolos; Mantellos, George

    2016-09-01

    Hallux valgus is an increasingly common deformity in young female athletes that constricts their daily athletic activities and influences foot cosmesis. The aim of this study was to evaluate the outcome of modified Chevron osteotomy for hallux valgus deformity in this specific population. Forty-two cases of modified Chevron osteotomies were carried out in 33 patients with mild to moderate hallux valgus deformity. Each participant was evaluated for AOFAS score, pain, range of motion, cosmetic and radiological outcome. Mean AOFAS score improved to 96.3 (phallux valgus deformity in young female athletes, with excellent clinical outcome. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  15. INNOVATIVE TEACHING IN ACCOUNTING SUBJECTS: ANALYSIS OF THE FLIPPED CLASSROOM

    Directory of Open Access Journals (Sweden)

    E. Lubbe

    2016-07-01

    Full Text Available Accounting students often have a negative attitude towards the subject andstruggle to understand core concepts of accounting standards. A large percentageof accounting students do not prepare for class and homework is either not doneor neglected. Many factors contributed to students struggling to prepare for classand complete homework assignments. The flipped classroom approach has grownat a rapid pace and was perceived very successful in many subjects. Little researchhas been done on the effectiveness of this approach for accounting students.Videos was created whereby accounting theory was explained and questions withexamples were given and explained. All contact sessions were transformed into anactive learning environment. During contact sessions, students were provided withquestions. Guidance was given with regards to the interpretation of a practicalcase study. Students had to analyze questions before feedback was provided tothem. Contact sessions commenced with easy questions, and progressedto moredifficult questions.Research was conducted in order to determine whether a flipped classroommethod could improve the learning experience of accounting students at a highereducation institution. The study indicated that students watched the videos beforecontact sessions, they felt more positive about their performance in accountingand improved their time management. The majority of students that completed thesurvey preferred the flipped classroom method. It enables students to learn fromtheir own mistakes in class.

  16. [Treatment of developmental dysplasia of hip by modified Sutherland pelvic osteotomy].

    Science.gov (United States)

    Ma, Jun; Shen, Bin; Yang, Jing; Huang, Qiang; Zhou, Zong-Ke; Kang, Peng-de; Pei, Fu-Xing

    2011-07-01

    To investigate the clinical results of modified Sutherland pelvic osteotomy for developmental dysplasia of hip (DDH). Sutherland pelvic osteotomy were performed in 10 patients (11 hips) with DDH. Among them, there were 3 male (3 hips) and 7 female (8 hips) patients, aged (32 ± 8) years. During operation, arthroscopes were performed additionally to remove the existing hyperplasia tissue in the fossae ovalis and trimming acetabulum and glenoid labrum, thus to insure the better match between the femoral head and the realigned acetabulum. The change of imaging indexes were acquired by comparing the preoperative X-ray with the postoperative X-ray. The change of hip function and life quality were acknowledged according to contrast and analysis Harris hip score and Short Form 12-items Health Survey (SF-12) before and after osteotomy. All patients were followed up for a mean of (5.2 ± 2.3) years, the osteotomy were all union in 3 months. The acetabular head index was 71 ± 8 before operation, and 86 ± 4 after operation. The pre- and post-operative centre edge angle were (7 ± 9)° and (33 ± 9)°, sharp angle were (48 ± 4)° and (37 ± 5)°, acetabular index angle were (24 ± 8)° and (11 ± 5)° respectively. The average Harris score improved from 42 ± 13 preoperatively to 90 ± 5 postoperatively, with 100% excellent and good results. Every domains of SF-12 was improved in the different extents postoperatively, the improvement of physical component summary was more conspicuous than mental component summary. The imaging indexes, Harris and SF-12 were all improved with significant difference (all P load bearing capacity of hip, and improve the quality of life.

  17. Teaching & Learning Tips 6: The flipped classroom.

    Science.gov (United States)

    Shi, Connie R; Rana, Jasmine; Burgin, Susan

    2018-04-01

    Challenge: The "flipped classroom" is a pedagogical model in which instructional materials are delivered to learners outside of class, reserving class time for application of new principles with peers and instructors. Active learning has forever been an elusive ideal in medical education, but the flipped class model is relatively new to medical education. What is the evidence for the "flipped classroom," and how can these techniques be applied to the teaching of dermatology to trainees at all stages of their medical careers? © 2018 The International Society of Dermatology.

  18. Enhancing student engagement using the flipped classroom.

    Science.gov (United States)

    Gilboy, Mary Beth; Heinerichs, Scott; Pazzaglia, Gina

    2015-01-01

    The flipped classroom is an innovative pedagogical approach that focuses on learner-centered instruction. The purposes of this report were to illustrate how to implement the flipped classroom and to describe students' perceptions of this approach within 2 undergraduate nutrition courses. The template provided enables faculty to design before, during, and after class activities and assessments based on objectives using all levels of Bloom's taxonomy. The majority of the 142 students completing the evaluation preferred the flipped method compared with traditional pedagogical strategies. The process described in the report was successful for both faculty and students. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  19. Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

    OpenAIRE

    Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

    2013-01-01

    In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

  20. Base flipping in tn10 transposition: an active flip and capture mechanism.

    Directory of Open Access Journals (Sweden)

    Julien Bischerour

    2009-07-01

    Full Text Available The bacterial Tn5 and Tn10 transposases have a single active site that cuts both strands of DNA at their respective transposon ends. This is achieved using a hairpin intermediate that requires the DNA to change conformation during the reaction. In Tn5 these changes are controlled in part by a flipped nucleoside that is stacked on a tryptophan residue in a hydrophobic pocket of the transposase. Here we have investigated the base flipping mechanism in Tn10 transposition. As in Tn5 transposition, we find that base flipping takes place after the first nick and is required for efficient hairpin formation and resolution. Experiments with an abasic substrate show that the role of base flipping in hairpin formation is to remove the base from the DNA helix. Specific interactions between the flipped base and the stacking tryptophan residue are required for hairpin resolution later in the reaction. We show that base flipping in Tn10 transposition is not a passive reaction in which a spontaneously flipped base is captured and retained by the protein. Rather, it is driven in part by a methionine probe residue that helps to force the flipped base from the base stack. Overall, it appears that base flipping in Tn10 transposition is similar to that in Tn5 transposition.

  1. FLIP the Switch: Regulation of Apoptosis and Necroptosis by cFLIP

    Directory of Open Access Journals (Sweden)

    Yuichi Tsuchiya

    2015-12-01

    Full Text Available cFLIP (cellular FLICE-like inhibitory protein is structurally related to caspase-8 but lacks proteolytic activity due to multiple amino acid substitutions of catalytically important residues. cFLIP protein is evolutionarily conserved and expressed as three functionally different isoforms in humans (cFLIPL, cFLIPS, and cFLIPR. cFLIP controls not only the classical death receptor-mediated extrinsic apoptosis pathway, but also the non-conventional pattern recognition receptor-dependent apoptotic pathway. In addition, cFLIP regulates the formation of the death receptor-independent apoptotic platform named the ripoptosome. Moreover, recent studies have revealed that cFLIP is also involved in a non-apoptotic cell death pathway known as programmed necrosis or necroptosis. These functions of cFLIP are strictly controlled in an isoform-, concentration- and tissue-specific manner, and the ubiquitin-proteasome system plays an important role in regulating the stability of cFLIP. In this review, we summarize the current scientific findings from biochemical analyses, cell biological studies, mathematical modeling, and gene-manipulated mice models to illustrate the critical role of cFLIP as a switch to determine the destiny of cells among survival, apoptosis, and necroptosis.

  2. Front propagation in flipping processes

    International Nuclear Information System (INIS)

    Antal, T; Ben-Avraham, D; Ben-Naim, E; Krapivsky, P L

    2008-01-01

    We study a directed flipping process that underlies the performance of the random edge simplex algorithm. In this stochastic process, which takes place on a one-dimensional lattice whose sites may be either occupied or vacant, occupied sites become vacant at a constant rate and simultaneously cause all sites to the right to change their state. This random process exhibits rich phenomenology. First, there is a front, defined by the position of the leftmost occupied site, that propagates at a nontrivial velocity. Second, the front involves a depletion zone with an excess of vacant sites. The total excess Δ k increases logarithmically, Δ k ≅ ln k, with the distance k from the front. Third, the front exhibits ageing-young fronts are vigorous but old fronts are sluggish. We investigate these phenomena using a quasi-static approximation, direct solutions of small systems and numerical simulations

  3. FLIP celebrates 20th anniversary

    Science.gov (United States)

    Richman, Barbara T.

    During the past 20 years, vessels have often diverted their courses to aid what appeared to be a sinking ship. What they found as they steamed closer, though, was—and still is—an exceptionally stable ocean-going research vessel. Its ability to tip from the conventional horizontal position to a vertical one makes the ship both a stable research platform and a startling sight.The Floating Instrument Platform, better known as FLIP, is the result of a quest during the late 1950's for a ship that would enable oceanographers to perform accurate underwater acoustic experiments. The motion of conventional research ships rolling with the ocean's movements makes such work difficult. Allyn Vine of the Woods Hole Oceanographic Institution suggested a vessel that has the stability of a long, narrow, buoyant object that floats with the long dimension vertical, as does a spar buoy. Under the direction of Fred Spiess, with the support of the Office of Naval Research, the Marine Physical Laboratory (MPL) at the Scripps Institution of Oceanography adapted the spar buoy design idea to the floating platform. Frederick H. Fisher, then a research physicist at MPL and now a research oceanographer and associate director, was the project officer. He, with the assistance of Spiess, the now late Philip Rudnick, and Charles ‘Bud’ Mundy, was largely responsible for developing the shape, size, and capabilities of the vessel. After final design, engineering, and construction, FLIP was launched on June 22, 1962. A ceremony at the Scripps Institution of Oceanography marked its 20th anniversary.

  4. Ratio of lumbar 3-column osteotomy closure: patient-specific deformity characteristics and level of resection impact correction of truncal versus pelvic compensation.

    Science.gov (United States)

    Diebo, Bassel G; Lafage, Renaud; Ames, Christopher P; Bess, Shay; Obeid, Ibrahim; Klineberg, Eric; Cunningham, Matthew E; Smith, Justin S; Hostin, Richard; Liu, Shian; Passias, Peter G; Schwab, Frank J; Lafage, Virginie

    2016-08-01

    The resection point of a lumbar three-column osteotomy (3CO) creates separation of the spino-pelvic complex. This study investigates the impact of patients' baseline deformity and level of 3CO resection on the distribution of correction between the trunk and the pelvis following osteotomy closure. Patients who underwent single lumbar 3CO, upper instrumented vertebra (UIV) T1-T10, and 6 month follow-up were included. The truncal and pelvic closures were calculated based on the vertebrae adjacent to the osteotomy level and the impact of radiographic parameters and level of 3CO on the closures were analyzed. 113 patients were included. Patients who experienced more pelvic correction had significantly higher Pelvic Tilt and lower Sagittal Vertical Axis at baseline. Patients who underwent more caudal osteotomies with higher pelvic compensation with modest SVA sustained more pelvic correction. The osteotomy closure is driven by patient's specific deformity. More caudal osteotomy level leads to greater pelvic tilt improvement. III.

  5. Flip-flops of FK Comae Berenices

    DEFF Research Database (Denmark)

    Hackman, T.; Pelt, J.; Mantere, M. J.

    2013-01-01

    Context.FK Comae Berenices is a rapidly rotating magnetically active star, the light curve of which is modulated by cool spots on its surface. It was the first star where the "flip-flop" phenomenon was discovered. Since then, flip-flops in the spot activity have been reported in many other stars...... of photometric observations with two different time series analysis methods, with a special emphasis on detecting flip-flop type events from the data. Methods. We apply the continuous period search and carrier fit methods on long-term standard Johnson-Cousins V-observations from the years 1995......-2010. The observations were carried out with two automated photometric telescopes, Phoenix-10 and Amadeus T7 located in Arizona. Results. We identify complex phase behaviour in 6 of the 15 analysed data segments. We identify five flip-flop events and two cases of phase jumps, where the phase shift is ¿f

  6. The charge-flipping algorithm in crystallography

    Czech Academy of Sciences Publication Activity Database

    Palatinus, Lukáš

    2013-01-01

    Roč. 69, Jan (2013), s. 1-16 ISSN 2052-5192 Institutional support: RVO:68378271 Keywords : charge-flipping algorithm * dual-space methods * structure solution Subject RIV: BM - Solid Matter Physics ; Magnetism

  7. Flipped Science Inquiry@Crescent Girls' School

    Directory of Open Access Journals (Sweden)

    Peishi Goh

    2017-06-01

    Full Text Available This study shares the findings of a school-based Action Research project to explore how inquiry-based science practical lessons designed using the Flipped Science Inquiry@CGS classroom pedagogical model influence the way students learn scientific knowledge and also students' development of 21st century competencies, in particular, in the area of Knowledge Construction. Taking on a broader definition of the flipped classroom pedagogical model, the Flipped Science Inquiry@CGS framework adopts a structure that inverted the traditional science learning experience. Scientific knowledge is constructed through discussions with their peers, making use of their prior knowledge and their experiences while engaging in hands-on activities. Through the study, it is found that with the use of the Flipped Science Inquiry@CGS framework, learning experiences that are better aligned to the epistemology of science while developing 21st century competencies in students are created.

  8. How we flipped the medical classroom.

    Science.gov (United States)

    Sharma, Neel; Lau, C S; Doherty, Iain; Harbutt, Darren

    2015-04-01

    Flipping the classroom centres on the delivery of print, audio or video based material prior to a lecture or class session. The class session is then dedicated to more active learning processes with application of knowledge through problem solving or case based scenarios. The rationale behind this approach is that teachers can spend their face-to-face time supporting students in deeper learning processes. In this paper we provide a background literature review on the flipped classroom along with a three step approach to flipping the classroom comprising implementing, enacting and evaluating this form of pedagogy. Our three step approach is based on actual experience of delivering a flipped classroom at the University of Hong Kong. This initiative was evaluated with positive results. We hope our experience will be transferable to other medical institutions.

  9. En didaktisk model for Flipped Classroom

    DEFF Research Database (Denmark)

    Levinsen, Henrik; Foss, Kristian Kildemoes; Andersen, Thomas Dyreborg

    2016-01-01

    I artiklen præsenterer vi en model over flipped classroom som didaktisk metode udviklet med henblik på at stilladsere både de lærere, som gerne vil prøve kræfter med en flipped classroom-baseret praksis, og dem som allerede har erfaring, men kan have glæde af at bruge modellen til at kvalificere...... deres flipped classroom-undervisning. Modellen kan bidrage til erkendelsen af, at flipped classroom er noget nær et paradigmeskifte i forståelsen af god undervisning. Her tænkes på det skift i fokus metoden indebærer fra, at læreren er mest aktiv, til at eleverne er de mest aktive. Særligt for den...

  10. Experimental loss-tolerant quantum coin flipping.

    Science.gov (United States)

    Berlín, Guido; Brassard, Gilles; Bussières, Félix; Godbout, Nicolas; Slater, Joshua A; Tittel, Wolfgang

    2011-11-29

    Coin flipping is a cryptographic primitive in which two distrustful parties wish to generate a random bit to choose between two alternatives. This task is impossible to realize when it relies solely on the asynchronous exchange of classical bits: one dishonest player has complete control over the final outcome. It is only when coin flipping is supplemented with quantum communication that this problem can be alleviated, although partial bias remains. Unfortunately, practical systems are subject to loss of quantum data, which allows a cheater to force a bias that is complete or arbitrarily close to complete in all previous protocols and implementations. Here we report on the first experimental demonstration of a quantum coin-flipping protocol for which loss cannot be exploited to cheat better. By eliminating the problem of loss, which is unavoidable in any realistic setting, quantum coin flipping takes a significant step towards real-world applications of quantum communication.

  11. Equine First Aid Information Flip Booklet

    OpenAIRE

    Nay, Karah; Hoopes, Karl

    2017-01-01

    This is a flip chart type booklet with first aid information for horses, including checking vitals, pulse rate, respiration, mucus membrane color and capillary refill, signs of colic, deworming, vaccinations recommended for Utah, hoof care, and dental care.

  12. Curriculum Design of a Flipped Classroom to Enhance Haematology Learning

    Science.gov (United States)

    Porcaro, Pauline A.; Jackson, Denise E.; McLaughlin, Patricia M.; O'Malley, Cindy J.

    2016-06-01

    A common trend in higher education is the "flipped" classroom, which facilitates active learning during class. The flipped approach to teaching was instituted in a haematology `major' class and the students' attitudes and preferences for the teaching materials were surveyed. The curriculum design was explicit and involved four major components (1) the preparation of the students; (2) the weekly pre-class work; (3) the in-class active learning strategies and (4) closing the learning loop using formative quizzes. Each of these components is discussed in detail and was informed by sound pedagogical strategies. Several different sources of information and several freely available software tools to engage the students are discussed. Two iterations are reported here, with improved pass rate for the final examination from 47 to 48 % in the traditional class to 56-65 % in the flipped classroom approach. The majority of students (93 and 89 %) came to the class prepared, after viewing the screencasts and engaged fully with the activities within the face-to-face time. The students perceived that solving case studies (93 %) was the most beneficial activity for their learning and this was closely followed by the production of essay plans (71 %). The majority of students recommended that this approach be repeated the following year (69 and 75 %).

  13. Triple pelvic osteotomy in Legg-Calve-Perthes disease using a single anterolateral incision: a 4-year review.

    LENUS (Irish Health Repository)

    Conroy, Eimear

    2010-07-01

    Femoral head incongruency at skeletal maturity is associated with the development of osteoarthritis in early adulthood. Containment of the femoral head provides a larger surface area for remodelling of the collapsed femoral head and the development of spherical congruency. Triple pelvic osteotomy has a role to play in Legg-Calve-Perthes\\' disease by improving femoral head containment and preventing subluxation. This is traditionally a two-incision approach with significant associated morbidity. In our unit we perform triple osteotomies through a single anterolateral incision. To retrospectively review the clinical and radiographic outcome of children who had triple osteotomies performed through a single incision over a 4-year period. In our unit from 2003 to 2006 we performed eight triple osteotomies through a single incision in children aged between 6 and 12 years with Legg-Calve-Perthes\\' disease. The procedure was performed through a single anterolateral incision made beneath the middle of the iliac crest and carried forward according to Salter\\'s osteotomy. Image intensification was used to confirm iliac, pubic and ischial cuts. After performing a standard Salter\\'s osteotomy the acetabular fragment was free to rotate anteriorly and laterally. None of the children were casted and all were allowed immediate mobilization nonweight bearing with crutches for 6 weeks. Clinical results and hip function were measured preoperatively and postoperatively using the modified Harris hip score. The average length of hospital stay was 4.7 days. None of the children had a nonunion. The centre edge angle of Wiberg was measured on all preoperative and postoperative anteroposterior pelvic radiographs. In all our patients there was an improvement in the centre edge angle of Wiberg and in the modified Harris hip score. The preoperative modified Harris hip scores ranged from 38 to 60 and postoperatively ranged from 77 to 92. The preoperative centre edge angle of Wiberg ranged

  14. Patella height changes post high tibial osteotomy

    Directory of Open Access Journals (Sweden)

    Siew Ghim Gooi

    2017-01-01

    Full Text Available Background: Medial opening wedge high tibial osteotomy (HTO is a well-described treatment in early medial compartmental osteoarthritis of the knee. However, two undesirable sequelae may follow –patella baja and changes in the posterior tibial slope (TS. Materials and Methods: We conducted a retrospective study in patients who underwent HTO in our center between September 2009 and February 2017. Preoperative and 6-week postoperative long-leg weight bearing films and lateral knee radiographs were assessed. Pre- and postoperative radiological measurements include the Caton-Deschamps Index (CDI, the mechanical axis deviation (MAD, and the posterior TS. Independant t-test and Pearson correlation test were performed. Results: A total of 106 knees were recruited. The mean age was 48.8 ± 10.8 years. 66 (62.3% and 40 (37.7% knees were from males and females, respectively. The mean pre- and postoperative measurements was (−9.70° ± 3.67° to 0.08° ± 2.80° (−varus; +valgus for the MAD, (7.14° ± 1.78° to 8.72° ± 3.11° for posterior TS, and (0.93° ± 0.084° to 0.82° ± 0.13° for CDI (P ≤ 0.001 for all. The association between patella height change and the level of osteotomy (supra-tubercle vs. infra-tubercle was statistically significant (P < 0.001. A supra-tubercle osteotomy cut significantly lowering patella height (P = 0.011. There was otherwise no statistically significant correlations between patella height changes and the correction angle (P = 0.187 or posterior TS change (P = 0.744. Conclusions: A medial opening wedge HTO above the tibial tubercle was significantly associated with lowering patella height or reducing CDI postoperatively. Based on our results, we would recommend the use of an infra-tubercle osteotomy during the corrective surgery to prevent the complication of patella baja.

  15. Subtrochanteric femoral shortening osteotomy combined with cementless total hip replacement for Crowe type IV developmental dysplasia: a retrospective study.

    Science.gov (United States)

    Rollo, Giuseppe; Solarino, Giuseppe; Vicenti, Giovanni; Picca, Girolamo; Carrozzo, Massimiliano; Moretti, Biagio

    2017-12-01

    Total hip replacement for high dislocation of the hip presents some difficulties, considering patients' young ages, the abnormal hip anatomy and the high rate of complications. In this study, we present our experience in terms of clinical and radiological results in the treatment of Crowe type IV hips with subtrochanteric femoral shortening osteotomy and cementless total hip replacement. We retrospectively reviewed 15 patients with Crowe type IV hip dysplasia (two bilateral cases for a total of 17 hips) treated with cementless total hip replacement associated with shortening subtrochanteric osteotomies (nine transversal and eight Z-shape osteotomies) between March 2000 to February 2006. The mean follow-up was 88 months (range 63-133). Harris hip score, leg length discrepancy, neurological status, union status of the osteotomy and the component stability were the criteria of the evaluation. All complications were noted. The mean HHS improved from 38.3 (range 32-52) to 85.6 (range 69-90). The mean preoperative leg length discrepancy was of 45 mm (range 38-70) and reduced to a mean of 12 mm (range 9-1.6) postoperatively. All osteotomies resulted healed at an average of 12.3 weeks (range 10-15). No cases of delayed union or nonunion were detected. Two patients (11%) showed early symptoms of sciatic nerve palsy which resolved uneventfully in 6 months. There was no migrations and none of the implants required revision. Cementless THA with shortening subtrochanteric osteotomy is an effective method in the treatment of patients with Crowe type IV development dysplasia of the hip. IV.

  16. EFFECTIVENESS OF FLIPPED CLASSROOM IN MATHEMATICS TEACHING

    OpenAIRE

    Dr. N. Ramakrishnan; Mrs. J. Johnsi Priya

    2016-01-01

    Flipped Classroom is an instructional strategy and a type of blended learning that reverses the traditional learning environment by delivering instructional content, often online, outside of the classroom. It moves activities, including those that may have traditionally been considered homework, into the classroom. In a flipped classroom, students watch online lectures, collaborate in online discussions, or carry out research at home and engage in concepts in the classroom with the guidance o...

  17. Proximal femoral derotation osteotomy for idiopathic excessive femoral anteversion and intoeing gait

    Directory of Open Access Journals (Sweden)

    Naqvi Gohar

    2017-01-01

    Full Text Available Aim: The purpose of this study is to assess the symptoms caused by excessive femoral anteversion and the outcomes of femoral derotation osteotomy. Methods: We reviewed data on patients who underwent proximal femoral derotation osteotomy for symptomatic intoeing gait caused by femoral anteversion. Only symptomatic patients were considered for corrective derotation osteotomy. Degree of femoral anteversion was confirmed on computed tomography (CT scan. Results: Thirty-five extremities were operated in 21 patients with an average age of 13.3 (8–18 years. Mean follow-up was 16 months (6–36 months. Mean femoral anteversion angle was 40.8° (28°–53°. External rotation of extended hips improved significantly, from 30° to 51.8° (p < 0.0001. Mean foot progressing angle improved from 15.2° internally rotated preoperatively to 7.7° externally rotated. Intoeing completely resolved in all except two patients. Thirteen out of 21 children complained about tripping and frequent falling while running and playing sports, eight patients had hip pain while 13 children had knee pain preoperatively. Tripping, falling and hip pain resolved in all patients postoperatively, while three patients whose primary complaint was knee pain failed to improve postsurgery. Eighteen of the 21 parents were satisfied with the decision to perform surgical correction. Conclusion: Excessive femoral anteversion can present with unexplained hip or knee pain refractory to conservative treatments. Careful assessment of lower limb malalignment is a valuable tool in such circumstances and derotation proximal femoral osteotomy can certainly be a procedure of choice in carefully selected cases.

  18. Competency-Based Blended Learning: Flipping Professional Practice Classes to Enhance Competence Development

    Directory of Open Access Journals (Sweden)

    Mark Ragg

    2017-08-01

    Full Text Available In the past decade, health and human service educational programs have transitioned to competence-based outcomes to enhance the quality of graduating professionals. While such outcomes are a critical step in ensuring professional quality, they require curricular and pedagogical adjustments that do not fit easily within university environments. Technology has eased many problems of fit through the development of hybrid and flipped courses that allow on-campus time to be better focused on developing professional skills. This study explored the question: Can flipped delivery improve competence-based outcomes in social work practice classes? The study assessed pedagogical adjustments that integrated competence-based learning principles with flipped classroom delivery. Principles of organizing the class to maximize competence development are explored and illustrated. Improved competence development and student satisfaction were demonstrated in three flipped practice courses with a combined sample size of 269 Bachelor of Social Work (BSW and Masters of Social Work (MSW students. Researchers concluded that using flipped-classroom methods enhanced the students’ capacity to apply concepts and develop skills. In particular, the ability to receive and process feedback on applied skills was improved.

  19. Osteosynthesis techniques used for mandibular sagittal split osteotomy – history of orthognathic procedures and modern practice.

    Science.gov (United States)

    Nowak, Rafał; Trybek, Grzegorz

    Choosing an appropriate fixation technique after maxillary or mandibular osteotomy is one of the key factors affecting the success of orthognathic surgery. In line with the development of new surgical methods and techniques, the surgeons’ approach to the fixation of bone fragments has evolved accordingly, varying from non-fusion to different osteosynthesis techniques. Advances in medical sciences and medical technologies, have changed our attitudes to bone fragment reduction in orthopaedics and traumatology, and also in maxillofacial surgery. The pivotal underlying principle which determines bone healing – that is proper positioning so as to ensure appropriate contact area and immobilisation so as to ensure osteosynthesis – has remained unchanged for centuries. However, over the years, patient comfort and the predictability of treatment outcomes have vastly improved. The paper provides an overview of the techniques and methods used for the fixation of osteotomized fragments after bilateral sagittal split osteotomy since its introduction by Hugo Obwegeser up to the present day.

  20. Double innominate osteotomy and the Smith-Petersen technique in the treatment of developmental hip disorder.

    Science.gov (United States)

    Brdar, R; Petronic, I; Abramovic, D; Nikolic, D; Lukac, M; Cirovic, D

    2011-01-01

    The purpose of our study was to present results of different surgical orthopaedic approaches in the treatment of children with developmental hip disorder. At the University Childrens Hospital in Belgrade, 21 young adults diagnosed with developmental hip disorder were treated with double osteotomy and with a modified Smith-Peterson approach during a period of 10 years, from 1997 to 2007. All patients were clinically and radiographically evaluated. We were successful with 23 hips in 20 patients, since some patients underwent surgery of both hips. The evaluation of improvement was done according to the Merle d'Aubigne and Postel system which indicated very satisfied outcome in five patients, satisfied in 8, fair in 7 and poor in one patient. In this paper we discuss the advantages and disadvantages of double osteotomy procedures compared with others that are used in the correction of developmental hip disorder. The best solution is adequate and timely diagnosis with proper correction of the deformity.

  1. Six first metatarsal shaft osteotomies: mechanical and immobilization comparisons.

    Science.gov (United States)

    Trnka, H J; Parks, B G; Ivanic, G; Chu, I T; Easley, M E; Schon, L C; Myerson, M S

    2000-12-01

    Because malunion (usually with dorsal elevation of the first metatarsal) has been reported after the treatment of severe hallux valgus deformities by proximal osteotomies, the current study was designed to compare the sagittal stability of six different metatarsal shaft osteotomies: the proximal crescentic, proximal chevron, Mau, Scarf, Ludloff, and biplanar closing wedge osteotomies. A plate was used in the biplanar closing wedge osteotomy; all others used screws for fixation. Ten fresh-frozen, human anatomic lower extremity specimens were used for each osteotomy. Failure loads were measured as units of force (newtons) and converted to pressure (kilopascals). Then the F-Scan system, which uses a thin insole to measure plantar pressure, was used to evaluate the pressure under the first metatarsal of seven volunteers using four types of shoes. According to the results, in patients with normal bone stock who are compliant, any of the four shoe types tested may be used after a Ludloff, Scarf, biplanar wedge (plantar screw fixation), or Mau osteotomy, but the wedge-based shoe should be used after a proximal crescentic or chevron osteotomy or for patients with severe osteopenic bone.

  2. A comparison of piezosurgery with conventional techniques for internal osteotomy.

    Science.gov (United States)

    Koçak, I; Doğan, R; Gökler, O

    2017-06-01

    To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p  0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.

  3. Evaluation of the flipped classroom approach in a veterinary professional skills course

    Directory of Open Access Journals (Sweden)

    Moffett J

    2014-11-01

    .001. Conclusion: This study demonstrates that learners seem to prefer a flipped classroom approach. The flipped classroom was rated more positively than the traditional classroom on many different characteristics. This preference, however, did not translate into improved student performance, as assessed by a series of multiple-choice items delivered during a written examination. Keywords: active learning, assessment, didactic, flipped classroom, lecture, professional skills, student perception

  4. Secondary Subacromial Impingement after Valgus Closing-Wedge Osteotomy for Proximal Humerus Varus

    Directory of Open Access Journals (Sweden)

    Hirotaka Sano

    2015-01-01

    Full Text Available A 31-year-old construction worker had been suffering from both the motion pain and the restriction of elevation in his right shoulder due to severe varus deformity of humeral neck, which occurred after proximal humeral fracture. The angle for shoulder flexion and abduction was restricted to 50 and 80 degrees, respectively. Valgus closing-wedge osteotomy followed by the internal fixation using a locking plate was carried out at 12 months after injury. Postoperatively, the head-shaft angle of the humerus improved from 65 to 138 degrees. Active flexion and abduction angles improved from 80 to 135 degrees and from 50 to 135 degrees, respectively. However, the patient complained from a sharp pain with a clicking sound during shoulder abduction even after removal of the locking plate. Since subacromial steroid injection temporarily relieved his shoulder pain, we assumed that the secondary subacromial impingement was provoked after osteotomy. Thus, arthroscopic subacromial decompression was carried out at 27 months after the initial operation, which finally relieved his symptoms. In the valgus closing-wedge osteotomy, surgeons should pay attention to the condition of subacromial space to avoid causing the secondary subacromial impingement.

  5. Does "Flipping" Promote Engagement?: A Comparison of a Traditional, Online, and Flipped Class

    Science.gov (United States)

    Burke, Alison S.; Fedorek, Brian

    2017-01-01

    "Flipped" or inverted classrooms are designed to utilize class time for application and knowledge building, while course content is delivered through the use of online lectures and watched at home on the students' time. It is believed that flipped classrooms promote student engagement and a deeper understanding of the class material. The…

  6. Detection of trans-cis flips and peptide-plane flips in protein structures

    NARCIS (Netherlands)

    Touw, W.G.; Joosten, R.P.; Vriend, G.

    2015-01-01

    A coordinate-based method is presented to detect peptide bonds that need correction either by a peptide-plane flip or by a trans-cis inversion of the peptide bond. When applied to the whole Protein Data Bank, the method predicts 4617 trans-cis flips and many thousands of hitherto unknown

  7. Percutaneous pelvic osteotomy in cerebral palsy patients: Surgical technique and indications.

    Science.gov (United States)

    Canavese, Federico; Rousset, Marie; Samba, Antoine; de Coulon, Geraldo

    2013-01-01

    To describe the surgical technique of and indications for percutaneous pelvic osteotomy in patients with severe cerebral palsy. Twenty-one non-ambulatory children and adolescents (22 hips) were consecutively treated with percutaneous pelvic osteotomy, which was used in conjunction with varus, derotational, shortening femoral osteotomy and soft tissue release, to correct progressive hip subluxation and acetabular dysplasia. The age, gender, Gross Motor Function Classification System level, side(s) of operated hip, total time of follow-up, immediate post-operative immobilization, complications, and the need for revision surgery were recorded for all patients. Seventeen patients (81%) were classified as GMFCS level IV, and 4 (19%) patients were classified as GMFCS level V. At the time of surgery, the mean age was 10.3 years (range: 4-15 years). The mean Reimers' migration percentage improved from 63% (range: 3%-100%) pre-operatively to 6.5% (range: 0%-70%) at the final follow-up (P < 0.05). The mean acetabular angle (AA) improved from 34.1° (range: 19°-50°) pre-operatively to 14.1° (range: 5°-27°) (P < 0.05). Surgical correction of MP and AA was comparable in hips with open (n = 14) or closed (n = 8) triradiate cartilage (P < 0.05). All operated hips were pain-free at the time of the final follow-up visit, although one patient had pain for 6 mo after surgery. We did not observe any cases of bone graft dislodgement or avascular necrosis of the femoral head. Pelvic osteotomy through a less invasive surgical approach appears to be a valid alternative with similar outcomes to those of standard techniques. This method allows for less muscle stripping and blood loss and a shorter operating time.

  8. High Rate of Recurrence Following Proximal Medial Opening Wedge Osteotomy for Correction of Moderate Hallux Valgus.

    Science.gov (United States)

    Iyer, Sravisht; Demetracopoulos, Constantine A; Sofka, Carolyn M; Ellis, Scott J

    2015-07-01

    The proximal medial opening wedge (PMOW) osteotomy has become more popular to treat moderate to severe hallux valgus with the recent development of specifically designed, low-profile modular plates. Despite the promising results previously reported in the literature, we have noted a high incidence of recurrence in patients treated with a PMOW. The purpose of this study was to report the clinical and radiographic outcomes of an initial cohort of patients treated with a PMOW osteotomy for moderate hallux valgus. We retrospectively analyzed prospectively gathered data on a cohort of 17 consecutive patients who were treated by the senior author using a PMOW osteotomy for moderate hallux valgus deformity. Average time to follow-up was 2.4 years (range, 1.0-3.5 years). The intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA) were assessed on standard weightbearing radiographs of the foot preoperatively and at all follow-up visits. The Foot and Ankle Outcome Score (FAOS) was collected on all patients preoperatively and at final follow-up. Despite demonstrating good correction of their deformity initially, 11 of the 17 patients (64.7%) had evidence of recurrence of their hallux valgus deformity at final follow-up. Patients who recurred had a greater preoperative HVA (P = .023) and DMAA (P = .049) than patients who maintained their correction. Improvement in the quality-of-life subscale of the FAOS was noted at final follow-up for all patients (P = .05). There was no significant improvement in any of the other FAOS subscales. There was a high rate of recurrence of the hallux valgus deformity in this cohort of patients. Recurrence was associated with greater preoperative deformity and an increased preoperative DMAA. The PMOW without a concomitant distal metatarsal osteotomy may be best reserved for patients with mild hallux valgus deformity without an increased DMAA. Level IV, retrospective case series. © The Author

  9. Femoral derotation osteotomy in spastic diplegia. Proximal or distal?

    Science.gov (United States)

    Pirpiris, M; Trivett, A; Baker, R; Rodda, J; Nattrass, G R; Graham, H K

    2003-03-01

    We describe the results of a prospective study of 28 children with spastic diplegia and in-toed gait, who had bilateral femoral derotation osteotomies undertaken at either the proximal intertrochanteric or the distal supracondylar level of the femur. Preoperative clinical evaluation and three-dimensional movement analysis determined any additional soft-tissue surgery. Distal osteotomy was faster with significantly lower blood loss than proximal osteotomy. The children in the distal group achieved independent walking earlier than those in the proximal group (6.9 +/- 1.3 v 10.7 +/- 1.7 weeks; p spastic diplegia.

  10. Healthcare students' experiences when integrating e-learning and flipped classroom instructional approaches.

    Science.gov (United States)

    Telford, Mark; Senior, Emma

    2017-06-08

    This article describes the experiences of undergraduate healthcare students taking a module adopting a 'flipped classroom' approach. Evidence suggests that flipped classroom as a pedagogical tool has the potential to enhance student learning and to improve healthcare practice. This innovative approach was implemented within a healthcare curriculum and in a module looking at public health delivered at the beginning of year two of a 3-year programme. The focus of the evaluation study was on the e-learning resources used in the module and the student experiences of these; with a specific aim to evaluate this element of the flipped classroom approach. A mixed-methods approach was adopted and data collected using questionnaires, which were distributed across a whole cohort, and a focus group involving ten participants. Statistical analysis of the data showed the positive student experience of engaging with e-learning. The thematic analysis identified two key themes; factors influencing a positive learning experience and the challenges when developing e-learning within a flipped classroom approach. The study provides guidance for further developments and improvements when developing e-learning as part of the flipped classroom approach.

  11. The Weil osteotomy for treatment of dislocated lesser metatarsophalangeal joints: good outcome in 21 patients with 42 osteotomies.

    Science.gov (United States)

    Trnka, Hans-Jörg; Gebhard, Christoph; Mühlbauer, Michaela; Ivanic, Gerd; Ritschl, Peter

    2002-04-01

    Hardly any surgical methods are available for metatarsalgia caused by a dislocated lesser metatarsophalangeal joint (MTP) that do not sacrifice the joint. We reviewed retrospectively the outcome of 60 metatarsal Weil osteotomies for correction of dislocated lesser MTP joints in 31 patients. Between 1995 and 1996, 31 consecutive patients were treated with a Weil osteotomy at 2 institutions. The Weil osteotomy is an oblique osteotomy of the metatarsal neck and shaft, parallel to the ground surface, that controls shortening of the metatarsal by internal fixation with screws or pins. At an average final follow-up of 30 (24-44) months, all patients were interviewed, using a standardized questionnaire based on the AOFAS Lesser Metatarsophalangeal-Interphalangeal Scale. Recurrent or transfer metatarsalgia, formation of callus, mobility and dislocation of the MTP were noted on physical examination. Dorsoplantar and lateral weightbearing radiographs taken preoperatively and at the time of final follow-up were examined for alignment of the metatarsal heads, subluxation or dislocation and for evidence of nonunion, or malunion of the metatarsal osteotomy. We had excellent results in 21 patients (42 osteotomies). A major complication was plantar penetrating hardware in 10 cases (3 screws and 7 pins). We conclude that the Weil osteotomy is a good method for correcting metatarsalgia caused by dislocation of the MTP joint.

  12. Clinical results of cementless total hip arthroplasty with shortening osteotomy for high dislocation with developmental dysplasia.

    Science.gov (United States)

    Desteli, Engin Eren; Imren, Yunus; Tan, Erkan; Erdoğan, Murat; Özcan, Hüseyin

    2015-03-01

    Total hip arthroplasty for severe developmental dysplasia of the hip is a technically challenging procedure. Subtrochanteric femoral osteotomy enables reducing the femoral head and restoring abductor muscle strength without compromising proximal femoral bone stock in advanced dysplasia.We aimed to retrospectively evaluate Crowe type III or IV developmental dysplasia of the hip who underwent reconstruction with cementless total hip arthroplasty combined with a transverse subtrochanteric femoral osteotomy. Sixty hips of 52 patients (11 male, 49 female) with Crowe type III (n: 37) or IV (n: 23) developmental dysplasia of the hip were included. The average age was 51.4 years. Surgery was performed in lateral decubitis position with posterolateral approach. Subtrochanteric transverse femoral osteotomy were used with cementless components. 40 of the femoral components were Secur-Fit type, and 20 of them were secur-fit plus max type. Ceramic-ceramic coupling was used in 24 cases and metal-polyethylene coupling was used in 36 cases. Merle D'Aubigne and Harris Hip score were used to rate the clinical outcome at the final follow up. All femoral shortening osteotomies were united at a mean of 5.7 months. Mean Merle D'Aubigne pain score was increased from 3.1 to 5.4, and mean Harris Hip score improved from 39 to 92.8, postoperatively (p<0.01). There was no significant difference in time to union between different types of stems. 4 femoral stems had asymptomatic radiolucent lines. There was no significant difference in time to union between different types of stems.

  13. Pre-operative simulation of periacetabular osteotomy via a three-dimensional model constructed from salt

    Directory of Open Access Journals (Sweden)

    Fukushima Kensuke

    2017-01-01

    Full Text Available Introduction: Periacetabular osteotomy (PAO is an effective joint-preserving procedure for young adults with developmental dysplasia of the hip. Although PAO provides excellent radiographic and clinical results, it is a technically demanding procedure with a distinct learning curve that requires careful 3D planning and, above all, has a number of potential complications. We therefore developed a pre-operative simulation method for PAO via creation of a new full-scale model. Methods: The model was prepared from the patient’s Digital Imaging and Communications in Medicine (DICOM formatted data from computed tomography (CT, for construction and assembly using 3D printing technology. A major feature of our model is that it is constructed from salt. In contrast to conventional models, our model provides a more accurate representation, at a lower manufacturing cost, and requires a shorter production time. Furthermore, our model realized simulated operation normally with using a chisel and drill without easy breakage or fissure. We were able to easily simulate the line of osteotomy and confirm acetabular version and coverage after moving to the osteotomized fragment. Additionally, this model allowed a dynamic assessment that avoided anterior impingement following the osteotomy. Results: Our models clearly reflected the anatomical shape of the patient’s hip. Our models allowed for surgical simulation, making realistic use of the chisel and drill. Our method of pre-operative simulation for PAO allowed for the assessment of accurate osteotomy line, determination of the position of the osteotomized fragment, and prevented anterior impingement after the operation. Conclusion: Our method of pre-operative simulation might improve the safety, accuracy, and results of PAO.

  14. A modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus.

    Science.gov (United States)

    Vasso, Michele; Del Regno, Chiara; D'Amelio, Antonio; Schiavone Panni, Alfredo

    2016-03-01

    The purpose of this brief paper is to present the preliminary results of a modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. In this procedure, the dorsal arm of the osteotomy is performed orthogonal to the horizontal plane of the first metatarsal, the main advantage being that this allows much easier and more accurate multiplanar correction of first metatarsal deformities. From 2010 to 2013, 184 consecutive patients with symptomatic hallux valgus and 48 patients with hallux rigidus without severe metatarsophalangeal joint degeneration underwent such modified chevron osteotomy. Mean patient age was 54.9 (range 21-70) years, and mean follow-up duration was 41.7 (range 24-56) months. Ninety-three percent of patients were satisfied with the surgery. Mean American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 56.6 preoperatively to 90.6 at last follow-up, and mean visual analog scale (VAS) pain score decreased from 5.7 preoperatively to 1.6 at final follow-up (p hallux valgus, mean hallux valgus angle decreased from 34.1° preoperatively to 6.2° at final follow-up, and mean intermetatarsal angle decreased from 18.5° preoperatively to 4.1° at final follow-up (p < 0.05). One patient developed postoperative transfer metatarsalgia, treated successfully with second-time percutaneous osteotomy of the minor metatarsals, whilst one patient had wound infection that resolved with systemic antibiotics. Level IV.

  15. Minimally invasive distal first metatarsal osteotomy can be an option for recurrent hallux valgus.

    Science.gov (United States)

    Magnan, Bruno; Negri, Stefano; Maluta, Tommaso; Dall'Oca, Carlo; Samaila, Elena

    2018-01-12

    Recurrence rate of surgical treatment of hallux valgus ranges in the literature from 2.7% to 16%, regardless of used procedure. In this study, long-term results of a minimally invasive distal osteotomy of the first metatarsal bone for treatment of recurrent hallux valgus are described. 32 consecutive percutaneous distal osteotomies of the first metatarsal were performed in 26 patients for treatment of recurrent hallux valgus. Primary surgery had been soft tissue procedures in 8 cases (25%), first metatarsal or phalangeal osteotomies in 19 cases (59.4%) and Keller procedures in 5 cases (15.6%). Patients were assessed with a mean follow-up of 9.8±4.3 years. All patients reported the disappearance or reduction of the pain. The mean overall AOFAS score improved from 46.9±17.8 points to 85.2±14.9 at final follow-up. The mean hallux valgus angle decreased from 26.1±9.1 to 9.7±5.4°, the intermetatarsal angle decreased from 11.5±4.5 to 6.7±4.0°. No major complications were recorded with a re-recurrence rate of 3.1% (1 case). Percutaneous distal osteotomy of the first metatarsal can be a reliable and safe surgical option in the recurrent hallux valgus with low complication rate and the advantages of a minimally invasive surgery. IV, Retrospective Case Series. Copyright © 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  16. Reduction Osteotomy of the Prominent Tibial Tubercle After Osgood-Schlatter Disease.

    Science.gov (United States)

    Pagenstert, Geert; Wurm, Markus; Gehmert, Sebastian; Egloff, Christian

    2017-08-01

    To evaluate the functional and clinical outcome of a new closing-wedge osteotomy for the prominent tibial tubercle after Osgood-Schlatter disease. Between 2010 and 2014, 7 consecutive adults (mean age, 28.6 years; range, 26-35 years) were treated by closing-wedge reduction osteotomy of a painful tibial tubercle. All patients had prior nonsurgical and surgical treatment. Preoperative and postoperative tubercular prominence, Caton-Deschamps index for patellar height, the Kujala Anterior Knee Pain Scale, Lysholm Knee Score as well as visual analog scale score and Tegner activity scores were recorded. Mean follow-up after reduction osteotomy was 31.3 months (27-41 months). The bony prominence of the tibial tubercle was significantly reduced (mean 8 mm, P Osgood-Schlatter disease and consecutively improved the outcome in terms of knee pain and function. Thus, we can recommend this procedure in selected patients. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Comparison of Puddu osteotomy with or without autologous bone grafting: a prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Marcus Ceregatti Passarelli

    Full Text Available ABSTRACT Objectives: To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients undergoing medial opening-wedge high tibial , osteotomy. Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. One group received bone graft, and the other group was left without filling the osteotomy defect. The primary outcome was the Knee Society Score. , Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes., Results: There was no difference in KSS scale between the graft group (64.4 ± 21.8 and the graftless group (61.6 ± 17.3; p= 0.309. There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft, = 184 ± 4.6 degrees, graftless = 183.4 ± 5.1 degrees; p= 1.0, indicating that there is no loss of correction due to the lack of the graft. There was significant aggravation of osteoarthritis in a greater number of patients in a graft group (p= 0.005 . Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study.

  18. Planning for corrective osteotomy of the femoral bone using 3D-modeling. Part I

    Directory of Open Access Journals (Sweden)

    Alexey G Baindurashvili

    2016-09-01

    Full Text Available Introduction. In standard planning for corrective hip osteotomy, a surgical intervention scheme is created on a uniplanar paper medium on the basis of X-ray images. However, uniplanar skiagrams are unable to render real spatial configuration of the femoral bone. When combining three-dimensional and uniplanar models of bone, human errors inevitably occur, causing the distortion of preset parameters, which may lead to glaring errors and, as a result, to repeated operations. Aims. To develop a new three-dimensional method for planning and performing corrective osteotomy of the femoral bone, using visualizing computer technologies. Materials and methods. A new method of planning for corrective hip osteotomy in children with various hip joint pathologies was developed. We examined the method using 27 patients [aged 5–18 years (32 hip joints] with congenital and acquired femoral bone deformation. The efficiency of the proposed method was assessed in comparison with uniplanar planning using roentgenograms. Conclusions. Computerized operation planning using three-dimensional modeling improves treatment results by minimizing the likelihood of human errors and increasing planning and surgical intervention  accuracy.

  19. Minimally Invasive Distal Metatarsal Osteotomy for Mild-to-Moderate Hallux Valgus Deformity

    Directory of Open Access Journals (Sweden)

    Yu-Chuan Lin

    2009-08-01

    Full Text Available Minimally invasive surgery has recently been introduced for foot and ankle surgery, and hallux valgus surgery is no exception. The purpose of our study was to analyze the early results and to present our experience of minimally invasive distal metatarsal osteotomy in correcting mild-to-moderate hallux valgus deformities. Between September 2005 and December 2006, 31 consecutive patients (47 feet with mild-to-moderate hallux valgus deformities underwent minimally invasive distal metatarsal osteotomies. The clinical and radiographic outcomes were assessed. The satisfaction rate was 90.32%. The mean total American Orthopedic Foot and Ankle Society halluxmetatarsophalangeal-interphalangeal scale was 92.7 points. Complications included two (4.26% episodes of stiffness, six (12.77% episodes of pin tract infection, and one (2.13% deep infection. There were no cases with nonunion, malunion, overcorrection, transfer metatarsalgia or osteonecrosis. On weight-bearing anteroposterior foot radiographs, the mean hallux valgus angle and first intermetatarsal angle corrections were 11.8° and 6.3°, respectively, which is a statistically significant difference (p < 0.001 between the preoperative and postoperative status. Here, minimally invasive distal metatarsal osteotomy was associated with good satisfaction, functional improvement and low complication rates. This technique offers an effective, safe and simple way to treat hallux valgus with a first intermetatarsal angle less than 15°.

  20. Evaluation of instability after transtrochanteric anterior rotational osteotomy for nontraumatic osteonecrosis of the femoral head

    International Nuclear Information System (INIS)

    Hiranuma, Yasunari; Atsumi, Takashi; Kajiwara, Toshihisa; Tamaoki, Satoshi; Asakura, Yasuhiro

    2009-01-01

    Transtrochanteric anterior rotational osteotomy results in improvement of joint congruity and prevention of progressive collapse and osteoarthritic changes in patients with femoral head osteonecrosis. However, this procedure remains controversial for patients with extensive collapse due to potential osteoarthritis caused by postoperative instability. The purpose of this study was to evaluate hip instability after osteotomy and determine the relation between instability and radiological and clinical outcomes. In all, 27 hips of 24 patients that were followed up for a mean period of 3.8 years were included. Instability was defined as more than 1 mm translation of the femoral head in transverse computed tomography scans obtained at 0 deg and 45 deg flexion of the hip joint. Hips were divided into instability and stability groups. Eleven hips (40%) developed instability after surgery. Osteophytes on the femoral head in 10 hips of the instability group and 2 hips of the stability group had increased in size at follow-up. There was a significant relation between postoperative instability and osteophyte formation. Joint space narrowing was not seen in any of the cases. There was no significant difference between the groups in either the postoperative intact ratio of the femoral head or the Japanese Orthopaedic Association hip score. Neither instability nor osteophyte formation on the femoral head after transtrochanteric anterior rotational osteotomy correlated with progressive osteoarthritic changes or clinical outcome in the presence of an adequate femoral head intact ratio facing the weight-bearing area. (author)

  1. Management of valgus extra-articular calcaneus fracture malunions with a lateral opening wedge osteotomy.

    Science.gov (United States)

    Aly, Tarek

    2011-01-01

    A total of 34 cases of symptomatic valgus deformity of the hindfoot secondary to a malunited extra-articular calcaneal fracture were corrected with laterally based open wedge calcaneal osteotomy. The pre- and postoperative radiographic parameters were compared, and a postoperative clinical evaluation was performed using the American Orthopedic Foot and Ankle Society ankle and hindfoot scoring system. The mean follow-up period was 56.2 (range 24.1 to 97) months. The most significant radiographic changes were improvement in the talonavicular coverage angle (mean 17.3°) on the anteroposterior view. The mean postoperative American Orthopedic Foot and Ankle Society hindfoot and ankle score was 90, with 23 excellent, 8 good, and 3 poor results. Laterally based opening wedge osteotomy of the calcaneus is effective in the management of a valgus heel resulting from malunited extra-articular calcaneal fractures. Lateral decompression of the peroneal tendons and the sural nerve was achieved indirectly through opening wedge lateral calcaneal osteotomy that shifted the weight-bearing axis laterally. Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Guided Modern Endodontic Surgery: A Novel Approach for Guided Osteotomy and Root Resection.

    Science.gov (United States)

    Strbac, Georg D; Schnappauf, Albrecht; Giannis, Katharina; Moritz, Andreas; Ulm, Christian

    2017-03-01

    Continuous improvements in techniques, instruments, and materials have established modern endodontic microsurgery as a state-of-the-art treatment method. The purpose of this approach was to introduce a new surgical endodontic technique by using a three-dimensional printed template for guided osteotomy and root resection. A 38-year-old patient was diagnosed with periapical lesions of teeth #3 and #4 and extruded gutta-percha material. Three-dimensional radiographic and optical scan files were imported into surgical planning software designed for guided implant surgery. Within the adapted software program the periapical lesions and the extruded gutta-percha were visualized and marked. With the aid of virtually positioned surgical pins and piezoelectric instruments, the osteotomy size, the apical resection level, and the bevel angle were defined before treatment. Three-dimensional surgical templates for each tooth were designed within the software program for a guided treatment approach. This approach comprised the treatment of periapical lesions of teeth #3 and #4 with root-end fillings and the detection and complete removal of the extruded gutta-percha material without perforation of sinus membrane. There were no postoperative complications, and clinical and radiologic assessments verified complete healing of the teeth. The guided microsurgical endodontic treatment presented appears to be a viable technique that allows for predefined osteotomies and root resections. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  3. FlipADAM: a potential new SPECT imaging agent for the serotonin transporter

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Julie L.; Deutsch, Eric C. [Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States); Oya, Shunichi [Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States); Kung, Hank F., E-mail: kunghf@gmail.co [Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States); Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States)

    2010-07-15

    Introduction: Single photon emission computed tomography (SPECT) imaging of the serotonin transporter (SERT) in the brain is a useful tool for examining normal physiological functions and disease states involving the serotonergic system. The goal of this study was to develop an improved SPECT radiotracer with faster kinetics than the current leading SPECT tracer, [{sup 123}I]ADAM, for selective SERT imaging. Methods: The in vitro binding affinities of (2-(2'-((dimethylamino)methyl)-4'-iodophenylthio)benzenamine) (FlipADAM) (1c), were determined using Hampshire pig kidney cells stably overexpressing the serotonin, norepinephrine (NET) or dopamine transporter (DAT). Localization of [{sup 125}I]FlipADAM (1c) was evaluated through biodistribution and autoradiography in male Sprague Dawley rats, and the specificity of binding was assessed by injecting selective SERT or NET inhibitors prior to [{sup 125}I]FlipADAM (1c). Results: FlipADAM (1c) displayed a high binding affinity for SERT (K{sub i}=1.0 nM) and good selectivity over NET and DAT binding (43-fold and 257-fold, respectively). [{sup 125}I]FlipADAM (1c) successfully penetrated the blood brain barrier, as evidenced by the brain uptake at 2 min (1.75% dose/g). [{sup 125}I]FlipADAM(1c) also had a good target to non-target (hypothalamus/cerebellum) ratio of 3.35 at 60 min post-injection. In autoradiography studies, [{sup 125}I]FlipADAM (1c) showed selective localization in SERT-rich brain regions such as the thalamic nuclei, amygdala, dorsal raphe nuclei and other areas. Conclusion: [{sup 125}I]FlipADAM (1c) exhibited faster clearance from the brain and time to binding equilibrium when compared to [{sup 125}I]2-(2'-((dimethylamino)methyl)-phenylthio)-5-iodophenylamine [{sup 125}I]ADAM (1b) and a higher target to non-target ratio when compared to [{sup 125}I]5-iodo-2-(2'-((dimethylamino)methyl)-phenylthio)benzyl alcohol [{sup 125}I]IDAM (1a). Therefore, [{sup 123}I]FlipADAM (1c) may be an improved

  4. Osteochondritis dissecans after rotational acetabular osteotomy for dysplastic hip

    Energy Technology Data Exchange (ETDEWEB)

    Nozawa, Masahiko; Maezawa, Katsuhiko; Yuasa, Takahito; Morimoto, Kouichi; Asakura, Taro; Kurosawa, Hisashi [Juntendo University School of Medicine, Department of Orthopaedic Surgery, Tokyo (Japan)

    2005-12-01

    We encountered a rare case of osteochondritis dissecans of the femoral head after rotational acetabular osteotomy that recovered with conservative treatment 4 years after the detection of characteristic radiological findings. (orig.)

  5. Use of Flipped Classroom Technology in Language Learning

    OpenAIRE

    Evseeva, Arina Mikhailovna; Solozhenko, Anton

    2015-01-01

    The flipped classroom as a key component of blended learning arouses great interest among researchers and educators nowadays. The technology of flipped classroom implies such organization of the educational process in which classroom activities and homework assignments are reversed. The present paper gives the overview of the flipped classroom technology and explores its potential for both teachers and students. The authors present the results obtained from the experience of the flipped class...

  6. Data-driven optimized flip angle selection for T1 estimation from spoiled gradient echo acquisitions.

    Science.gov (United States)

    Lewis, Christina M; Hurley, Samuel A; Meyerand, M Elizabeth; Koay, Cheng Guan

    2016-09-01

    Define criteria for selection of optimal flip angle sets for T1 estimation and evaluate effects on T1 mapping. Flip angle sets for spoiled gradient echo-based T1 mapping were selected by minimizing T1 estimate variance weighted by the joint density of M0 and T1 in an initial acquisition. The effect of optimized flip angle selection on T1 estimate error was measured using simulations and experimental data in the human and rat brain. For two-point acquisitions, optimized angle sets were similar to those proposed by other groups and, therefore, performed similarly. For multipoint acquisitions, optimal angle sets for T1 mapping in the brain consisted of a repetition of two angles. Implementation of optimal angles reduced T1 estimate variance by 30-40% compared with a multipoint acquisition using a range of angles. Performance of the optimal angle set was equivalent to that of a repetition of the two-angle set selected using criteria proposed by other researchers. Repetition of two carefully selected flip angles notably improves the precision of resulting T1 estimates compared with acquisitions using a range of flip angles. This work provides a flexible and widely applicable optimization method of particular use for those who repeatedly perform T1 estimation. Magn Reson Med 76:792-802, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  7. Using the Flipped Classroom to Bridge the Gap to Generation Y.

    Science.gov (United States)

    Gillispie, Veronica

    2016-01-01

    classroom-based instruction. The flipped classroom group consisted of students from Rotation 2 and Rotation 3 of the 2015 academic year who received formal didactics via voice-over presentation and had the weekly problem-based learning sessions. When comparing the students taught by traditional methods to those taught in the flipped classroom model, we saw a statistically significant increase in test scores on the multiple-choice question examination in both the obstetrics and gynecology sections in Rotation 2. While the average score for the flipped classroom group increased in Rotation 3 on the obstetrics section of the multiple-choice question examination, the difference was not statistically significant. Unexpectedly, the average score on the gynecology portion of the multiple-choice question examination decreased among the flipped classroom group compared to the traditional teaching group, and this decrease was statistically significant. For both the obstetrics and the gynecology portions of the OSCE, we saw statistically significant increases in the scores for the flipped classroom group in both Rotation 2 and Rotation 3 compared to the traditional teaching group. With the exception of the gynecology portion of the multiple-choice question examination in Rotation 3, we saw improvement in scores after the implementation of the flipped classroom. The flipped classroom is a feasible and useful alternative to the traditional classroom. It is a method that embraces Generation Y's need for active learning in a group setting while maintaining a traditional classroom method for introducing the information. Active learning increases student engagement and can lead to improved retention of material as demonstrated on standard examinations.

  8. The True Ponte Osteotomy: By the One Who Developed It.

    Science.gov (United States)

    Ponte, Alberto; Orlando, Giuseppe; Siccardi, Gian Luigi

    2018-01-01

    Technique and applications. To define the anatomy, biomechanics, indications, and surgical technique of the true Ponte osteotomy. The Ponte osteotomy, originally developed for thoracic kyphosis, was the first one to obtain posterior shortening of the thoracic spine, maintaining the anterior column load-sharing capacity. It has become a widely applied technique in various types of spine deformities and a frequent topic of presentations at meetings and in scientific articles. Several of them offer unquestionable evidence of an incorrect execution, with consequently distorted outcomes and erroneous conclusions. A clearing up became essential. Our original experience is based on a series of 240 patients with thoracic hyperkyphosis operated in the years 1969-2015, at first with a standard posterior Harrington technique and then by using the Ponte osteotomy with different instrumentations. A series of 78 of them, operated in the years 1987-1997, who had Ponte osteotomies at every level, is presented. The average preoperative kyphosis has been corrected from 80° (range 61°-102°) to 31° (range 15°-50°) by a substantial posterior shortening. A number of publications use the term Ponte osteotomy loosely for by far incomplete resections and mixing it up with Smith-Petersen's osteotomy. The true Ponte osteotomy is capable of producing marked flexibility in extension, flexion and rotation, justifying its wide use in thoracic deformities, mainly in scoliosis. An exact performance of the osteotomy with adequate bony resections, including the laminae, is an absolute condition to take full advantage of its properties. Level IV, therapeutic study. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  9. Minimal Incision/Minimally Invasive Medializing Displacement Calcaneal Osteotomy.

    Science.gov (United States)

    Sherman, Thomas I; Guyton, Gregory P

    2018-01-01

    Minimally invasive techniques are readily applicable to calcaneal osteotomies and have the potential to accomplish hindfoot correction equivalent to open procedures with less morbidity and pain. Use of a guidance jig makes the procedure more predictable. While most anatomic features of the procedure are the same as those with open techniques, special care must be taken to avoid neurovascular injury because there is no open exposure. Anatomic guidelines have been established for appropriately localizing the osteotomy. Level V, expert opinion.

  10. The evidence for 'flipping out': A systematic review of the flipped classroom in nursing education.

    Science.gov (United States)

    Betihavas, Vasiliki; Bridgman, Heather; Kornhaber, Rachel; Cross, Merylin

    2016-03-01

    The flipped classroom has generated interest in higher education providing a student-centred approach to learning. This has the potential to engage nursing students in ways that address the needs of today's students and the complexity of contemporary healthcare. Calls for educational reform, particularly in healthcare programs such as nursing, highlight the need for students to problem-solve, reason and apply theory into practice. The drivers towards student-based learning have manifested in team, problem and case-based learning models. Though there has been a shift towards the flipped classroom, comparatively little is known about how it is used in nursing curricula. The aims of this systematic review were to examine how the flipped classroom has been applied in nursing education and outcomes associated with this style of teaching. Five databases were searched and resulted in the retrieval of 21 papers: PubMed, CINAHL, EMBASE, Scopus and ERIC. After screening for inclusion/exclusion criteria, each paper was evaluated using a critical appraisal tool. Data extraction and analysis were completed on all included studies. This systematic review screened 21 titles and abstracts resulting in nine included studies. All authors critically appraised the quality of the included studies. Five studies were identified and themes identified were: academic performance outcomes, and student satisfaction implementing the flipped classroom. Use of the flipped classroom in higher education nursing programmes yielded neutral or positive academic outcomes and mixed results for satisfaction. Engagement of students in the flipped classroom model was achieved when academics informed and rationalised the purpose of the flipped classroom model to students. However, no studies in this review identified the evaluation of the process of implementing the flipped classroom. Studies examining the process and ongoing evaluation and refinement of the flipped classroom in higher education nursing

  11. Dynamics of spin-flip photon-assisted tunneling

    NARCIS (Netherlands)

    Braakman, F.R.; Danon, J.; Schreiber, L.R.; Wegscheider, W.; Vandersypen, L.M.K.

    2014-01-01

    We present time-resolved measurements of spin-flip photon-assisted tunneling and spin-flip relaxation in a doubly occupied double quantum dot. The photon-assisted excitation rate as a function of magnetic field indicates that spin-orbit coupling is the dominant mechanism behind the spin-flip under

  12. Applying the Flipped Classroom Model to English Language Arts Education

    Science.gov (United States)

    Young, Carl A., Ed.; Moran, Clarice M., Ed.

    2017-01-01

    The flipped classroom method, particularly when used with digital video, has recently attracted many supporters within the education field. Now more than ever, language arts educators can benefit tremendously from incorporating flipped classroom techniques into their curriculum. "Applying the Flipped Classroom Model to English Language Arts…

  13. Deep Exploration of the Flipped Classroom before Implementing

    Science.gov (United States)

    Logan, Brenda

    2015-01-01

    This paper is a review of the literature that attempts to explain and document the literature on the flipped classroom. It examines 49 studies that explain the flipped approach in the classroom. This paper, particularly, delineates the history, the theory, benefits, criticisms, recommended practices, and what the research on flipping reveals.…

  14. Impacts of Flipped Classroom in High School Health Education

    Science.gov (United States)

    Chen, Li-Ling

    2016-01-01

    As advanced technology increasingly infiltrated into classroom, the flipped classroom has come to light in secondary educational settings. The flipped classroom is a new instructional approach that intends to flip the traditional teacher-centered classroom into student centered. The purpose of this research is to investigate the impact of the…

  15. Flipping the statistics classroom in nursing education.

    Science.gov (United States)

    Schwartz, Todd A

    2014-04-01

    Flipped classrooms are so named because they substitute the traditional lecture that commonly encompasses the entire class period with active learning techniques, such as small-group work. The lectures are delivered instead by using an alternative mode--video recordings--that are made available for viewing online outside the class period. Due to this inverted approach, students are engaged with the course material during the class period, rather than participating only passively. This flipped approach is gaining popularity in many areas of education due to its enhancement of student learning and represents an opportunity for utilization by instructors of statistics courses in nursing education. This article presents the author's recent experiences with flipping a statistics course for nursing students in a PhD program, including practical considerations and student outcomes and reaction. This transformative experience deepened the level of student learning in a way that may not have occurred using a traditional format. Copyright 2014, SLACK Incorporated.

  16. Experimental plug and play quantum coin flipping.

    Science.gov (United States)

    Pappa, Anna; Jouguet, Paul; Lawson, Thomas; Chailloux, André; Legré, Matthieu; Trinkler, Patrick; Kerenidis, Iordanis; Diamanti, Eleni

    2014-04-24

    Performing complex cryptographic tasks will be an essential element in future quantum communication networks. These tasks are based on a handful of fundamental primitives, such as coin flipping, where two distrustful parties wish to agree on a randomly generated bit. Although it is known that quantum versions of these primitives can offer information-theoretic security advantages with respect to classical protocols, a demonstration of such an advantage in a practical communication scenario has remained elusive. Here we experimentally implement a quantum coin flipping protocol that performs strictly better than classically possible over a distance suitable for communication over metropolitan area optical networks. The implementation is based on a practical plug and play system, developed by significantly enhancing a commercial quantum key distribution device. Moreover, we provide combined quantum coin flipping protocols that are almost perfectly secure against bounded adversaries. Our results offer a useful toolbox for future secure quantum communications.

  17. Bringing the Flipped Classroom to Day 1: A Novel Didactic Curriculum for Emergency Medicine Intern Orientation.

    Science.gov (United States)

    Barrie, Michael G; Amick, Christopher; Mitzman, Jennifer; Way, David P; King, Andrew M

    2018-01-01

    Most emergency medicine (EM) residency programs provide an orientation program for their incoming interns, with the lecture being the most common education activity during this period. Our orientation program is designed to bridge the gap between undergraduate and graduate medical education by ensuring that all learners demonstrate competency on Level 1 Milestones, including medical knowledge (MK). To teach interns core medical knowledge in EM, we reformulated orientation using the flipped-classroom model by replacing lectures with small group, case-based discussions. Interns demonstrated improvement in medical knowledge through higher scores on a posttest. Evaluation survey results were also favorable for the flipped-classroom teaching format.

  18. Flipping one-shot library instruction: using Canvas and Pecha Kucha for peer teaching

    Directory of Open Access Journals (Sweden)

    Alexander J. Carroll, MSLS

    2016-11-01

    Full Text Available Objective: This study sought to determine whether a flipped classroom that facilitated peer learning would improve undergraduate health sciences students’ abilities to find, evaluate, and use appropriate evidence for research assignments. Methods: Students completed online modules in a learning management system, with librarians facilitating subsequent student-directed, in-person sessions. Mixed methods assessment was used to evaluate program outcomes. Results: Students learned information literacy concepts but did not consistently apply them in research assignments. Faculty interviews revealed strengthened partnerships between librarians and teaching faculty. Conclusion: This pedagogy shows promise for implementing and evaluating a successful flipped information literacy program.

  19. Flipping one-shot library instruction: using Canvas and Pecha Kucha for peer teaching.

    Science.gov (United States)

    Carroll, Alexander J; Tchangalova, Nedelina; Harrington, Eileen G

    2016-04-01

    This study sought to determine whether a flipped classroom that facilitated peer learning would improve undergraduate health sciences students' abilities to find, evaluate, and use appropriate evidence for research assignments. Students completed online modules in a learning management system, with librarians facilitating subsequent student-directed, in-person sessions. Mixed methods assessment was used to evaluate program outcomes. Students learned information literacy concepts but did not consistently apply them in research assignments. Faculty interviews revealed strengthened partnerships between librarians and teaching faculty. This pedagogy shows promise for implementing and evaluating a successful flipped information literacy program.

  20. Blended Course with Flipped Classroom Approach

    DEFF Research Database (Denmark)

    Timcenko, Olga; Purwins, Hendrik; Triantafyllou, Evangelia

    2015-01-01

    This paper presents and analyses design decisions and development process of producing teaching materials for a blended course with flipped classroom approach at bachelor level at Aalborg University in Copenhagen, Denmark. Our experiences, as well as students’ reactions and opinions will be descr......This paper presents and analyses design decisions and development process of producing teaching materials for a blended course with flipped classroom approach at bachelor level at Aalborg University in Copenhagen, Denmark. Our experiences, as well as students’ reactions and opinions...

  1. Just in Time to Flip Your Classroom

    OpenAIRE

    Lasry, Nathaniel; Dugdale, Michael; Charles, Elizabeth

    2013-01-01

    With advocates like Sal Khan and Bill Gates, flipped classrooms are attracting an increasing amount of media and research attention. We had heard Khan's TED talk and were aware of the concept of inverted pedagogies in general. Yet, it really hit home when we accidentally flipped our classroom. Our objective was to better prepare our students for class. We set out to effectively move some of our course content outside of class and decided to tweak the Just-in-Time-Teaching approach (JiTT). To ...

  2. Flipped Classrooms for Advanced Science Courses

    Science.gov (United States)

    Tomory, Annette; Watson, Sunnie Lee

    2015-12-01

    This article explains how issues regarding dual credit and Advanced Placement high school science courses could be mitigated via a flipped classroom instructional model. The need for advanced high school courses will be examined initially, followed by an analysis of advanced science courses and the reform they are experiencing. Finally, it will conclude with an explanation of flipped classes as well as how they may be a solution to the reform challenges teachers are experiencing as they seek to incorporate more inquiry-based activities.

  3. Imaging of the lumbar plexus: Optimized refocusing flip angle train design for 3D TSE.

    Science.gov (United States)

    Cervantes, Barbara; Bauer, Jan S; Zibold, Felix; Kooijman, Hendrik; Settles, Marcus; Haase, Axel; Rummeny, Ernst J; Wörtler, Klaus; Karampinos, Dimitrios C

    2016-04-01

    To study the effects of refocusing angle modulation with 3D turbo spin echo (TSE) on signal and sharpness of small oblique nerves embedded in muscle and suppressed fat in the lumbar plexus. Flip angle trains were generated with extended phase graphs (EPG) for a sequence parameter subspace. Signal loss and width broadening were simulated for a single-pixel nerve embedded in muscle and suppressed fat to prescribe a flip angle modulation that gives the best compromise between signal and sharpness of small nerves. Two flip angle trains were defined based on the simulations of small embedded nerves: design denoted A, predicting maximum global signal, and design denoted B, predicting maximum signal for minimum width broadening. In vivo data of the lumbar plexus in 10 healthy volunteers was acquired at 3.0T with 3D TSE employing flip angle trains A and B. Quantitative and qualitative analyses of the acquired data were made to assess changes in width and signal intensity. Changing flip angle modulation from A to B resulted in: 1) average signal losses of 23% in (larger) L5 nerves and 9% in (smaller) L3 nerves; 2) average width reductions of 4% in L5 nerves and of 16% in L3 nerves; and 3) statistically significant sharpness improvement (P = 0.005) in L3 nerves. An optimized flip angle train in 3D TSE imaging of the lumbar plexus considering geometry-specific blurring effects from both the nerve and the surrounding tissue can improve the delineation of small nerves. © 2015 Wiley Periodicals, Inc.

  4. Comparison of fixed-bearing and mobile-bearing total knee arthroplasty after high tibial osteotomy.

    Science.gov (United States)

    Hernigou, Philippe; Huys, Maxime; Pariat, Jacques; Roubineau, François; Flouzat Lachaniette, Charles Henri; Dubory, Arnaud

    2018-02-01

    There is no information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in the same patients previously treated by high tibial osteotomy. The purpose was therefore to compare fixed-bearing and mobile-bearing total knee replacements in patients treated with previous high tibial osteotomy. We compared the results of 57 patients with osteoarthritis who had received a fixed-bearing prosthesis after high tibial osteotomy with the results of 41 matched patients who had received a rotating platform after high tibial osteotomy. The match was made for length of follow-up period. The mean follow-up was 17 years (range, 15-20 years). The patients were assessed clinically and radiographically. The pre-operative knee scores had no statistically significant differences between the two groups. So was the case with the intra-operative releases, blood loss, thromboembolic complications and infection rates in either group. There was significant improvement in both groups of knees, and no significant difference was observed between the groups (i.e., fixed-bearing and mobile-bearing knees) for the mean Knee Society knee clinical score (95 and 92 points, respectively), or the Knee Society knee functional score (82 and 83 points, respectively) at the latest follow-up. However, the mean post-operative knee motion was higher for the fixed-bearing group (117° versus 110°). In the fixed-bearing group, one knee was revised because of periprosthetic fracture. In the rotating platform mobile-bearing group, one knee was revised because of aseptic loosening of the tibial component. The Kaplan-Meier survivorship for revision at ten years of follow-up was 95.2% for the fixed bearing prosthesis and 91.1% for the rotating platform mobile-bearing prosthesis. Although we did manage to detect significant differences mainly in clinical and radiographic results between the two groups, we found no superiority or inferiority of the mobile

  5. Flipping Core Courses in the Undergraduate Mechanical Engineering Curriculum: Heat Transfer

    Science.gov (United States)

    Schrlau, Michael G.; Stevens, Robert J.; Schley, Sara

    2016-01-01

    Flipped classrooms support learner-centered approaches to improve conceptualization, comprehension, and problem solving skills by delivering content outside the classroom and actively engaging students inside the classroom. While literature in engineering and science education supports and encourages the use of inverted instruction, many core…

  6. Students' Satisfaction with a Blended Instructional Design: The Potential of "Flipped Classroom" in Higher Education

    Science.gov (United States)

    Nanclares, Núria Hernández; Rodríguez, Mónica Pérez

    2016-01-01

    This paper aims to discuss the impact on promoting student satisfaction and improving their involvement in their own learning when applying a "Flipped classroom" design in a first-year bilingual, English-taught module in a non-English-speaking country. "World Economy" is taught in the Faculty of Business and Economics at a…

  7. Can Double Osteotomy Be a Solution for Adult Hallux Valgus Deformity With an Increased Distal Metatarsal Articular Angle?

    Science.gov (United States)

    Park, Chul Hyun; Cho, Jae Ho; Moon, Jeong Jae; Lee, Woo Chun

    2016-01-01

    No previous study has reported the results of double metatarsal osteotomy for adult hallux valgus deformity with an increased distal metatarsal articular angle (DMAA). The purpose of the present study was to evaluate the results after double metatarsal osteotomy in adult patients with incongruent hallux valgus deformity. We retrospectively reviewed 16 cases of consecutive first metatarsal double metatarsal osteotomy without lateral soft tissue release in 14 patients with symptomatic hallux valgus associated with an increased DMAA (≥15° after proximal chevron osteotomy on intraoperative radiographs). Clinical results were assessed using the American Orthopaedic Foot and Ankle Society scale and the visual analog scale. The radiographic results were assessed over time, and changes in the DMAA and the relative length of the first metatarsal were assessed by measuring each value preoperatively and at the last follow-up visit. The American Orthopaedic Foot and Ankle Society and visual analog scale scores were significantly improved after surgery. The hallux valgus angle and intermetatarsal angle were stabilized >3 months after surgery. The sesamoid position did not increase significantly beyond the immediate postoperative period. The mean DMAA was corrected from 21.6° (range 15° to 29°) preoperatively to 11.1° (range -2° to 17°) at the last follow-up visit. The mean amount of shortening of the first metatarsal after surgery was 5.5 (range 4 to 7) mm. In conclusion, double metatarsal osteotomy without lateral soft tissue release in adult hallux valgus deformity results in high postoperative recurrence and complication rates. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  8. A Comparison between External versus Internal Lateral Osteotomy in Rhinoplasty

    Directory of Open Access Journals (Sweden)

    M Hashemi

    2005-01-01

    Full Text Available Background: Lateral osteotomy is a major part of rhinoplasty for remodeling external facet of the nose and narrowing of nasal base and dorsum after removal of the hump. There are two techniques for lateral osteotomy known as external and internal. Each of these provide advantages and impose limitations. The purpose of our study was to compare the severity of postoperative edema and ecchymosis between internal and external osteotomy techniques. Methods: This study was designed as a clinical trial on 30 cases. With randomization, one side of the nasal bone was selected for internal approach, and the other side, for external approach. Then, on the 1st and 7th days after surgery, the patients were scored for the severity of edema and ecchymosis. Results: On the first day after surgery, not only edema, but also ecchymosis was lower with the external osteotomy than with the internal approach (P = 0.037, P = 0.002, respectively. The severity of ecchymosis, on the 7th postoperative day, was lower with the external approach, and the difference was significant (P = 0.011. The severity of both edema and ecchymosis on the first postoperative day was evaluated higher in females, with statistically significant differences (P = 0.05 for edema and P = 0.003 for ecchymosis. The extension of ecchymosis on the 7th postoperative day was higher in women (P = 0.05. There were no significant differences between the two approaches in medialization of the involved bones and no apparent asymmetries either. Conclusion: According to the results of this study, external osteotomy seems to be the approach of choice, provided that the surgeon has enough experience in doing it. Keywords: Rhinoplasty, Internal osteotomy, External osteotomy, Ecchymosis, Edema

  9. Assisted crack tip flipping under Mode I thin sheet tearing

    DEFF Research Database (Denmark)

    Felter, Christian Lotz; Nielsen, Kim Lau

    2017-01-01

    Crack tip flipping, where the fracture surface alternates from side to side in roughly 45° shear bands, seems to be an overlooked propagation mode in Mode I thin sheet tearing. In fact, observations of crack tip flipping is rarely found in the literature. Unlike the already established modes...... such as slanting, cup-cone (rooftop), or cup-cup (bathtub) the flipping crack never settles in a steady-state as the near tip stress/strain field continuously change when the flip successively initiates and develops shear-lips. A recent experimental investigation has revealed new insight by exploiting 3D X......-ray tomography scanning of a developing crack tip flip. But, it remains to be understood what makes the crack flip systematically, what sets the flipping frequency, and under which material conditions this mode occurs. The present study aims at investigating the idea that a slight out-of-plane action (Mode III...

  10. 6 Expert Tips for Flipping the Classroom

    Science.gov (United States)

    Demski, Jennifer

    2013-01-01

    In a flipped classroom, professors assign pre-class homework consisting of brief, recorded lectures and presentations, digital readings with collaborative annotation capabilities, and discussion board participation. This frees up classroom time to promote active learning through collaborative, project-based activities using simple display and…

  11. Flip-flopping binary black holes.

    Science.gov (United States)

    Lousto, Carlos O; Healy, James

    2015-04-10

    We study binary spinning black holes to display the long term individual spin dynamics. We perform a full numerical simulation starting at an initial proper separation of d≈25M between equal mass holes and evolve them down to merger for nearly 48 orbits, 3 precession cycles, and half of a flip-flop cycle. The simulation lasts for t=20 000M and displays a total change in the orientation of the spin of one of the black holes from an initial alignment with the orbital angular momentum to a complete antialignment after half of a flip-flop cycle. We compare this evolution with an integration of the 3.5 post-Newtonian equations of motion and spin evolution to show that this process continuously flip flops the spin during the lifetime of the binary until merger. We also provide lower order analytic expressions for the maximum flip-flop angle and frequency. We discuss the effects this dynamics may have on spin growth in accreting binaries and on the observational consequences for galactic and supermassive binary black holes.

  12. Performance and Perception in the Flipped Classroom

    Science.gov (United States)

    Blair, Erik; Maharaj, Chris; Primus, Simone

    2016-01-01

    Changes in the conceptualisation of higher education have led to instructional methods that embrace technology as a teaching medium. These changes have led to the flipped classroom phenomenon--where content is delivered outside class, through media such as video and podcast, and engagement with the content, through problem-solving and/or group…

  13. Using lightboard to flip the course

    DEFF Research Database (Denmark)

    Timcenko, Olga; Triantafyllou, Evangelia; Nilsson, Niels Chr.

    , and exercises for in-class work. However, the quality of videos that students have to watch before coming to the class is also important. In this paper, we will describe videos prepared for flipped classroom using light board, an invention from 2014. That allows natural flow of presentation, as it combines...

  14. The Flipped Classroom in World History

    Science.gov (United States)

    Gaughan, Judy E.

    2014-01-01

    The flipped Classroom is one in which lectures are presented as homework outside of class in online videos so that class time is reserved for engaging directly with the materials. This technique offers more personalized guidance and interaction with students, instead of lecturing. In this article, Judy Gaughan details her journey through choosing…

  15. Experiences with Flipping the Marketing Capstone Course

    Science.gov (United States)

    Scovotti, Carol

    2016-01-01

    This article reviews the experiences of a flipped classroom approach in a marketing capstone course. Students completed readings, watched lecture videos, took a quiz, and submitted a short assignment for 10 course modules. While a few minutes were devoted to clarifying confusion from lecture topics, class time was used for experiential-learning…

  16. Exploring Flipped Classroom Instruction in Calculus III

    Science.gov (United States)

    Wasserman, Nicholas H.; Quint, Christa; Norris, Scott A.; Carr, Thomas

    2017-01-01

    In an undergraduate Calculus III class, we explore the effect of "flipping" the instructional delivery of content on both student performance and student perceptions. Two instructors collaborated to determine daily lecture notes, assigned the same homework problems, and gave identical exams; however, compared to a more traditional…

  17. Flipping an Agricultural Education Teaching Methods Course

    Science.gov (United States)

    Conner, Nathan W.; Stripling, Christopher T.; Blythe, Jessica M.; Roberts, T. Grady; Stedman, Nicole L. P.

    2014-01-01

    Flipping or inverting a course is a relatively new approach to structuring a course. Using this method, the lectures traditionally delivered during regularly scheduled class time are converted to a media for delivery online, often in the form of videos. Learners are expected to view the online lectures prior to class. Then in turn, in-class time…

  18. Effects of Flipped Learning Using Online Materials in a Surgical Nursing Practicum: A Pilot Stratified Group-Randomized Trial.

    Science.gov (United States)

    Lee, Myung Kyung; Park, Bu Kyung

    2018-01-01

    This study examined the effect of flipped learning in comparison to traditional learning in a surgical nursing practicum. The subjects of this study were 102 nursing students in their third year of university who were scheduled to complete a clinical nursing practicum in an operating room or surgical unit. Participants were randomly assigned to either a flipped learning group (n = 51) or a traditional learning group (n = 51) for the 1-week, 45-hour clinical nursing practicum. The flipped-learning group completed independent e-learning lessons on surgical nursing and received a brief orientation prior to the commencement of the practicum, while the traditional-learning group received a face-to-face orientation and on-site instruction. After the completion of the practicum, both groups completed a case study and a conference. The student's self-efficacy, self-leadership, and problem-solving skills in clinical practice were measured both before and after the one-week surgical nursing practicum. Participants' independent goal setting and evaluation of beliefs and assumptions for the subscales of self-leadership and problem-solving skills were compared for the flipped learning group and the traditional learning group. The results showed greater improvement on these indicators for the flipped learning group in comparison to the traditional learning group. The flipped learning method might offer more effective e-learning opportunities in terms of self-leadership and problem-solving than the traditional learning method in surgical nursing practicums.

  19. Effects of Flipped Learning Using Online Materials in a Surgical Nursing Practicum: A Pilot Stratified Group-Randomized Trial

    Science.gov (United States)

    Lee, Myung Kyung

    2018-01-01

    Objectives This study examined the effect of flipped learning in comparison to traditional learning in a surgical nursing practicum. Methods The subjects of this study were 102 nursing students in their third year of university who were scheduled to complete a clinical nursing practicum in an operating room or surgical unit. Participants were randomly assigned to either a flipped learning group (n = 51) or a traditional learning group (n = 51) for the 1-week, 45-hour clinical nursing practicum. The flipped-learning group completed independent e-learning lessons on surgical nursing and received a brief orientation prior to the commencement of the practicum, while the traditional-learning group received a face-to-face orientation and on-site instruction. After the completion of the practicum, both groups completed a case study and a conference. The student's self-efficacy, self-leadership, and problem-solving skills in clinical practice were measured both before and after the one-week surgical nursing practicum. Results Participants' independent goal setting and evaluation of beliefs and assumptions for the subscales of self-leadership and problem-solving skills were compared for the flipped learning group and the traditional learning group. The results showed greater improvement on these indicators for the flipped learning group in comparison to the traditional learning group. Conclusions The flipped learning method might offer more effective e-learning opportunities in terms of self-leadership and problem-solving than the traditional learning method in surgical nursing practicums. PMID:29503755

  20. Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

    Directory of Open Access Journals (Sweden)

    Elio Hitoshi Shinohara

    2013-01-01

    Full Text Available In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

  1. Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

    Science.gov (United States)

    Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

    2013-01-01

    In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy. PMID:23853472

  2. Open Wedge High Tibial Osteotomy with Distal Tubercle Osteotomy Lessens Change in Patellar Position

    Directory of Open Access Journals (Sweden)

    Hoon Park

    2017-01-01

    Full Text Available The purpose of this study was to investigate the change in patellar position after open wedge high tibial osteotomy (OWHTO with distal tubercle osteotomy (DTO, comparing outcomes of conventional OWHTO in young adults with proximal tibia varus deformity but no arthritic manifestations. Thirty-three patients (mean age, 31.8 years subjected to OWHTO/DTO were matched with 30 patients (mean age, 33.5 years undergoing conventional OWHTO. Patellar position, as measured in pre- and postoperative standing lateral radiographs, was compared. Patellar height was assessed via Insall-Salvati ratio, modified Insall-Salvati ratio, Blackburne-Peel (BP index, Caton-Deschamps (CD index, and modified Miura-Kawamura index. Computed tomography was used to measure lateral patellar tilt and shift. In the OWHTO group, all patellar height indices decreased significantly following surgery. Although mean values of BP and CD indices decreased significantly in the OWHTO/DTO group, other determinants of patellar height showed no significant postoperative differences. Significant postoperative declines in average lateral patellar tilt were also evident in both groups, but pre- and postoperative lateral patellar shift did not differ significantly. OWHTO/DTO can be performed without significant changes in patellar height. The results obtained support that OWHTO/DTO is suitable for relatively young patients with proximal tibia vara but no arthritic change.

  3. Long-Term Results of Total Hip Arthroplasty With Shortening Subtrochanteric Osteotomy in Crowe IV Developmental Dysplasia.

    Science.gov (United States)

    Ollivier, Matthieu; Abdel, Matthew P; Krych, Aaron J; Trousdale, Robert T; Berry, Daniel J

    2016-08-01

    Numerous series have documented short-term successes with cementless total hip arthroplasty (THA) and subtrochanteric shortening osteotomy for Crowe IV developmental dysplasia of the hip (DDH). However, data are lacking regarding long-term implant fixation and patient function. In this study, we aimed to evaluate the 10-year results of cementless THA with simultaneous subtrochanteric shortening osteotomy for Crowe IV DDH. We retrospectively reviewed 28 consecutive primaries cementless THAs performed in 24 patients with Crowe IV DDH between 1992 and 2005. Evaluation was performed through Harris Hip Scores, physical examination, and radiographic analysis. At mean follow-up 10 years, 5 hips were revised, and 3 patients had died leaving 20 hips for clinical analysis. Harris Hip Score was significantly improved compared to preoperative values (43 vs 87 P hip dislocation secondary to dysplasia was associated with high rates of successful implant fixation and stable clinical improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Evaluation of Bernese periacetabular osteotomy: prospective studies examining projected load-bearing area, bone density, cartilage thickness and migration.

    Science.gov (United States)

    Mechlenburg, Inger

    2008-06-01

    The typical dysplastic hip joint is characterised by maldirection of the acetabulum and femoral neck, insufficient coverage of the femoral head focally and globally and erosions of the limbus acetabuli (1). An unknown number of persons with hip dysplasia will suffer from pain in hip or groin, decreased hip function and development of osteoarthritis at a young age. The Bernese periacetabular osteotomy is performed to prevent osteoarthritis in patients with hip dysplasia and has been carried out at Aarhus University Hospital, Denmark since 1996 with more than 500 osteotomies performed. Throughout the years, research and quality improvement of the treatment has taken place and this PhD thesis is part of that process. The aims of this PhD thesis were to evaluate outcome aspects after periacetabular osteotomy in terms of I) estimating the projected loadbearing surface before and after periacetabular osteotomy, II) estimating bone density changes in the acetabulum after periacetabular osteotomy, III) developing a technique to precisely and efficiently estimate the thickness of the articular cartilage in the hip joint and IV) examining the stability of the re-orientated acetabulum after periacetabular osteotomy. In study I, we applied a stereologic method based on 3D computed tomography (CT) to estimate the projected loadbearing surface in six normal hip joints and in six dysplastic hips. The dysplastic hips were CT scanned before and after periacetabular osteotomy. We found that the average area of the projected loadbearing surface of the femoral head preoperatively was 7.4 (range 6.5-8.4) cm2 and postoperatively 11 (9.8-14.3) cm2. The area of the projected loadbearing surface was increased significantly with a mean of 49% (34-70%) postoperatively and thus comparable with the load-bearing surface in the normal control group. Double measurements were performed and the error variance of the mean was estimated to be 1.6%. The effect of overprojection, on the projected

  5. Equivalent correction in scarf and chevron osteotomy in moderate and severe hallux valgus: a randomized controlled trial.

    NARCIS (Netherlands)

    Deenik, A.; Mameren, H. van; Visser, E. de; Waal Malefijt, M.C. de; Draijer, F.; Bie, R. de

    2008-01-01

    BACKGROUND: Chevron osteotomy is a widely accepted osteotomy for correction of hallux valgus.(18) Algorithms were developed to overcome the limitations of distal osteotomies. Scarf osteotomy has become popular as a versatile procedure that should be able to correct most cases of acquired hallux

  6. The history, evolution and basic science of osteotomy techniques

    Directory of Open Access Journals (Sweden)

    John Dabis

    2017-10-01

    Full Text Available Abstract Osteotomy techniques date back to Hippocrates circa 415 BC (Jones Hippocrates collected works I, Harvard University Press, Cambridge, 2006; Brorson in Clin Orthop Relat Res 467(7:1907–1914, 2009. There is debate about the best way to divide the bone surgically and which technique yields the best bone regenerate in lengthening; ensuring predictable new bone formation and healing of the osteotomy are the primary goals. We review the history and techniques of the osteotomy and consider the evidence for optimum bone formation. Methods discussed include variants of the ‘drill and osteotome’ technique, use of the Gigli saw and use of a power saw. Differences in bone formation through the different techniques are covered.

  7. Percutaneous Triple and Double Osteotomies for the Treatment of Hallux Valgus.

    Science.gov (United States)

    Díaz Fernández, Rodrigo

    2017-02-01

    Percutaneous surgery to correct deformities of the forefoot presents the advantages of using a minimal incision, which involves less soft tissue damage and less risk of wound complications. For severe deformities, percutaneous techniques have not been proven as effective. We propose a technique for the treatment of severe hallux valgus. In a sample of 52 feet operated on 48 patients, we performed a double percutaneous osteotomy (closure proximal osteotomy and a distal Akin) or triple when a Reverdin-Isham osteotomy was added. We measured preoperatively the American Orthopaedic Foot & Ankle Society (AOFAS) score at the 1-year and 2-year follow-up, as well as the values of hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular ankle (DMAA), and shortening and elevation of the first metatarsal. The presence of metatarsalgia was recorded before and after the surgery. HVA, IMA, and DMAA improved from 39.3 ± 7.1, 17.0 ± 2.0, and 16 ± 8.7 to 11.2 ± 6.2, 8.4 ± 3.4, and 8.3 ± 6.2, respectively. In 5 cases (10%), there was an elevation of the distal metatarsal bone, but only in 2 cases did a transfer metatarsalgia develop. There were no significant correlations between the amount of shortening and the presence of postoperative metatarsalgia. Scores on the AOFAS scale improved from 47.6 ± 5.6 to 89.7 ± 10.1 points. The results are comparable to those reported with other more established techniques. Transfer metatarsalgia did not correlate with lifting or shortening of the metatarsal. We indicate the percutaneous technique for IMA above 15 degrees and increased DMAA or congruent joints. Level IV, retrospective case series.

  8. [Z-osteotomy of distal fibula to correct widened ankle mortice after fracture].

    Science.gov (United States)

    Tao, Xu; Tang, Kanglai; Zhou, Jianbo

    2012-07-01

    To analyse the clinical outcomes of the Z-osteotomy of the distal fibula to correct widened mortice of the ankle after fracture. Between September 2009 and February 2011, 5 patients (5 feet) with widened ankle mortice after fracture underwent Z-osteotomy. There were 4 males and 1 female, aged from 23 to 58 years (mean, 38 years). At 3 months after operation of internal fixation when function exercises were done, patients got pains. The interval between trauma and operation ranged from 5 to 36 months (mean, 13.2 months). Lateral pressure test showed positive in 2 cases and negative in 3 cases. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 50.2 +/- 17.3. Primary healing of incision was achieved in all cases. Five patients were followed up 9 to 24 months (mean, 15.6 months). Mild to moderate swelling of the affected limb and anterolateral skin numbness of the ipsilateral dorsal foot occurred, and gradually improved. The clinical exam and radiology showed bone union at 12-15 weeks (mean, 13.5 weeks). Postoperative range of motion of ankle had no significant improvement. AOFAS ankle-hindfoot scores were 76.8 +/- 11.2 at 6 months after operation, and 85.4 +/- 3.2 at last follow-up, showing significant differences when compared with preoperative score (P fibula is the main cause of widened ankle mortice after fracture; Z-osteotomy can effectively reduce the width of the ankle mortice, increase the stability of ankle joint, and decrease the complication rate.

  9. [Construction of the study platform for Meridians and Acupoints and the application in the flipped classroom].

    Science.gov (United States)

    Hu, Rong

    2016-11-12

    To construct the study platform for meridians and acupoints by analyzing the status and current problems of teaching Meridians and Acupoints and in accordance with the principles as "knowledge fragmentation, game breakthrough and overall assessment" and observe the application effect in the flipped classroom. Totally two hundred and five 2014 grade bachelor candidates from four classes of the department of acupuncture-moxibustion and tuina were selected from Hunan Junior College of TCM. They were randomized into an observation group (102 cases) and a control group (103 cases). in the observation group, the flipped classroom was performed by adopting the study platform of meridians and acupoints. Additionally, the team cooperation learning and overall assessment were conducted. In the control group, the traditional teaching system was adopted, in which, the mode of "teacher's demonstration-to-discussion in group-to-teachers' assessment" and the operation check at the end of the semester were applied. The learning effect and the self-learning ability were evaluated at the end of semester in the two groups. The satisfaction survey was conducted in the observation group. In the observation group, the drawing of meridian running course and locating the acupoints, as well as the self-learning ability were better than those in the control group, indicating the significant differences (all P flipped classroom and the satisfaction of participation were slightly low. The study platform of learning Meridians and Acupoints was applied in the flipped classroom and has effectively improved the practical manipulation results and self-learning ability. However, the interestingness and interactivity of the platform are expected to be improved. The effective teaching design should be adopted in the flipped classroom to improve the students' desire of participation.

  10. Does the Concept of the "Flipped Classroom" Extend to the Emergency Medicine Clinical Clerkship?

    Science.gov (United States)

    Heitz, Corey; Prusakowski, Melanie; Willis, George; Franck, Christopher

    2015-11-01

    Linking educational objectives and clinical learning during clerkships can be difficult. Clinical shifts during emergency medicine (EM) clerkships provide a wide variety of experiences, some of which may not be relevant to recommended educational objectives. Students can be directed to standardize their clinical experiences, and this improves performance on examinations. We hypothesized that applying a "flipped classroom" model to the clinical clerkship would improve performance on multiple-choice testing when compared to standard learning. Students at two institutions were randomized to complete two of four selected EM clerkship topics in a "flipped fashion," and two others in a standard fashion. For flipped topics, students were directed to complete chief complaint-based asynchronous modules prior to a shift, during which they were directed to focus on the chief complaint. For the other two topics, modules were to be performed at the students' discretion, and shifts would not have a theme. At the end of the four-week clerkship, a 40-question multiple-choice examination was administered with 10 questions per topic. We compared performance on flipped topics with those performed in standard fashion. Students were surveyed on perceived effectiveness, ability to follow the protocol, and willingness of preceptors to allow a chief-complaint focus. Sixty-nine students participated; examination scores for 56 were available for analysis. For the primary outcome, no difference was seen between the flipped method and standard (p=0.494.) A mixed model approach showed no effect of flipped status, protocol adherence, or site of rotation on the primary outcome of exam scores. Students rated the concept of the flipped clerkship highly (3.48/5). Almost one third (31.1%) of students stated that they were unable to adhere to the protocol. Preparation for a clinical shift with pre-assigned, web-based learning modules followed by an attempt at chief-complaint-focused learning during a

  11. 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.

  12. Flipping Classrooms in a School of Public Health

    Science.gov (United States)

    Howard, Steven W.; Scharff, Darcell P.; Loux, Travis M.

    2017-01-01

    Alternative course formats are gaining increasing attention in higher education. The literature provides a number of examples and studies of flipped classrooms in the medical sciences and liberal arts and sciences. However, fewer than five papers on flipped classes in graduate public health courses have been published, and none in health management. Because graduate public health education is competency based, it seems that a flipped approach with its applied nature would be an appropriate form of teaching public health courses. This paper describes three successfully flipped courses taught in a school of public health. We provide a rationale for flipping, description of each course, and lessons learned. Once some of the challenges are overcome, we believe flipping courses can provide an alternative approach that enhances active learning in applied, public health, and health management courses. PMID:28447028

  13. The Flipped Learning Approach in Nursing Education: A Literature Review.

    Science.gov (United States)

    Presti, Carmen Rosa

    2016-05-01

    This integrative review examines the application of the pedagogical methodology-the flipped classroom-in nursing education. A literature search of the CINAHL, ERIC, and the National Library of Medicine (PubMed and MEDLINE) databases was conducted, using the following key words: flipped classroom, inverted classroom, and nursing education. Results of a literature search yielded 94 articles, with 13 meeting the criteria of the flipped classroom approach in nursing education. Themes identified include the theoretical underpinning, strategies for implementation of a flipped classroom, and student satisfaction with and outcomes of the flipped classroom approach. Syntheses of the findings indicate that the flipped classroom approach can yield positive outcomes, but further study of this methodology is needed to guide future implementation. [J Nurs Educ. 2016;55(5):252-257.]. Copyright 2016, SLACK Incorporated.

  14. Flipped Learning With Simulation in Undergraduate Nursing Education.

    Science.gov (United States)

    Kim, HeaRan; Jang, YounKyoung

    2017-06-01

    Flipped learning has proliferated in various educational environments. This study aimed to verify the effects of flipped learning on the academic achievement, teamwork skills, and satisfaction levels of undergraduate nursing students. For the flipped learning group, simulation-based education via the flipped learning method was provided, whereas traditional, simulation-based education was provided for the control group. After completion of the program, academic achievement, teamwork skills, and satisfaction levels were assessed and analyzed. The flipped learning group received higher scores on academic achievement, teamwork skills, and satisfaction levels than the control group, including the areas of content knowledge and clinical nursing practice competency. In addition, this difference gradually increased between the two groups throughout the trial. The results of this study demonstrated the positive, statistically significant effects of the flipped learning method on simulation-based nursing education. [J Nurs Educ. 2017;56(6):329-336.]. Copyright 2017, SLACK Incorporated.

  15. Student Perceptions of a Flipped Pharmacotherapy Course.

    Science.gov (United States)

    Khanova, Julia; McLaughlin, Jacqueline E; Rhoney, Denise H; Roth, Mary T; Harris, Suzanne

    2015-11-25

    To evaluate student perception of the flipped classroom redesign of a required pharmacotherapy course. Key foundational content was packaged into interactive, text-based online modules for self-paced learning prior to class. Class time was used for active and applied-but primarily case-based-learning. For students with a strong preference for traditional lecture learning, the perception of the learning experience was negatively affected by the flipped course design. Module length and time required to complete preclass preparation were the most frequently cited impediments to learning. Students desired instructor-directed reinforcement of independently acquired knowledge to connect foundational knowledge and its application. This study illustrates the challenges and highlights the importance of designing courses to effectively balance time requirements and connect preclass and in-class learning activities. It underscores the crucial role of the instructor in bridging the gap between material learned as independent study and its application.

  16. Flipped neutrino emissivity from strange matter

    International Nuclear Information System (INIS)

    Goyal, A.; Dutta, S.

    1994-01-01

    Energy loss due to wrong helicity sterile neutrinos through spin flip processes leads to rapid cooling of nascent neutron stars. The observed cooling of neutron stars associated with SN 1987A seems to preclude the existence of Dirac neutrinos with a mass in excess of 20 keV. Assuming that nuclear matter in the core of the neutron star undergoes a phase transition to quark matter leading to a strange star or a neutron star with a strange matter core, we examine the emission of flipped Dirac neutrinos for two dominant processes: quark-neutrino scattering [q+ν - (bar ν + )→q+ν + (bar ν - )] and the quark neutrino pair bremsstrahlung process [q+q→q+q+ν - bar ν - (ν+bar ν + )]. We determine the composition of quark matter just after core bounce and examine the effect of neutrino degeneracy on the emission rate and mean free path of the wrong helicity neutrinos

  17. Revisional Surgery for Hallux Valgus with Serial Osteotomies at Two Levels

    Directory of Open Access Journals (Sweden)

    Jason B. T. Lim

    2011-01-01

    Full Text Available The aetiology and form of hallux valgus (HV is varied with many corrective procedures described. We report a 39-year-old woman, previously treated with a Chevron osteotomy, who presented with recurrent right HV, metatarsus primus varus, and associated bunion. Osteotomies were performed at two levels as a revisional procedure. This report highlights (1 limitations of the Chevron osteotomy and (2 the revisional procedure of the two level osteotomies: (i proximal opening-wedge basal osteotomy and (ii distal short Scarf with medial closing wedges. If a Chevron osteotomy is used inappropriately, for example, in an attempt to correct too large a deformity, it may angulate laterally causing a malunion with an increased distal metatarsal articular angle. Secondly, it is feasible to correct this combined deformity using a combination of proximal opening-wedge and distal short Scarf osteotomies.

  18. The flipped classroom stimulates greater learning and is a modern 21st century approach to teaching today's undergraduates.

    Science.gov (United States)

    Mortensen, C J; Nicholson, A M

    2015-07-01

    Many classrooms in higher education still rely on a transformative approach to teaching where students attend lectures and earn course grades through examination. In the modern age, traditional lectures are argued by some as obsolete and do not address the learning needs of today’s students. An emerging pedagogical approach is the concept of the flipped classroom. The flipped classroom can simply be described as students viewing asynchronous video lectures on their own and then engaging in active learning during scheduled class times. In this study, we examined the flipped classroom teaching environment on student learning gains in an Introduction to Equine Science course. Students (n = 130) were asked to view 7.5 h of recorded lectures divided into 8 learning modules, take online quizzes to enforce lecture viewing, take 3 in-class exams, and prepare to participate in active learning during scheduled class times. Active learning approaches included individual activities, paired activities, informal small groups, and large group activities. When compared to students in the traditional lecture format in earlier years, students in the flipped format scored higher on all 3 exams (P flipped format students were asked to take the Cornell Critical Thinking Exam (version X). Scores improved from the pretest (50.8 ± 0.57) to the posttest (54.4 ± 0.58; P flipped course, no correlations were found with student performance and interactions with online content. Students were asked in class to evaluate their experiences based on a 5-point Likert scale: 1 (strongly disagree) to 5 (strongly agree). The flipped classroom was ranked as an enjoyable learning experience with a mean of 4.4 ± 0.10, while students responded positively to other pointed questions. In formal course evaluations, flipped format students ranked the following higher (P flipped classroom proved to be a positive learning experience for students. As the classroom continues to modernize, pedagogical approaches

  19. The flipped classroom for medical students.

    Science.gov (United States)

    Morgan, Helen; McLean, Karen; Chapman, Chris; Fitzgerald, James; Yousuf, Aisha; Hammoud, Maya

    2015-06-01

    The objectives of this curricular innovation project were to implement a flipped classroom curriculum for the gynaecologic oncology topics of the obstetrics and gynaecology medical student clerkship, and to evaluate student satisfaction with the change. Four short online videos on the topics of endometrial hyperplasia, cervical dysplasia, evaluation of an adnexal mass, and ovarian cancer were created, and students were instructed to view them prior to a class-time active learning session. The Learning Activity Management System (lams) open-source online platform was used to create an active learning class-time activity that consisted of a coached discussion of cases. Student satisfaction with the two aspects of the flipped curriculum was obtained. In addition, lecture assessment for the gynaecologic oncology topics and aggregate student performance on the gynaecological oncology questions of the US National Board of Medical Examiners (NBME) Subject Examination were compared before and after implementation of the curriculum. Eighty-nine students rotated on the clerkship during the pilot period of analysis. Seventy-one students (80%) viewed the videos prior to the class session, and 84 (94%) attended the session. Student satisfaction was very high for both parts of the curriculum. There was no significant difference in aggregate student performance on the gynaecological oncology questions of the NBME Subject Examination. The flipped classroom curriculum demonstrates a promising platform for using technology to make better use of students' time Our implementation of the flipped classroom curriculum for the gynaecologic oncology topics successfully demonstrates a promising platform for using technology to make better use of our students' time, and for increasing their satisfaction with the necessary didactic learning of the clerkship. © 2015 John Wiley & Sons Ltd.

  20. Biomechanical Factors in Planning of Periacetabular Osteotomy

    Directory of Open Access Journals (Sweden)

    Noushin eNiknafs

    2013-12-01

    Full Text Available This study addresses the effects of cartilage thickness distribution and compressive properties in the context of optimal alignment planning for periacetabular osteotomy (PAO. The Biomechanical Guidance System (BGS is a computer-assisted surgical suite assisting surgeon’s in determining the most beneficial new alignment of a patient’s acetabulum. The BGS uses biomechanical analysis of the hip to find this optimal alignment. Articular cartilage is an essential component of this analysis and its physical properties can affect contact pressure outcomes. Patient-specific hip joint models created from CT scans of a cohort of 29 dysplastic subjects were tested with four different cartilage thickness profiles (one uniform and threenonuniform and two sets of compressive characteristics. For each combination of thickness distribution and compressive properties, the optimal alignment of the acetabulum was found; the resultant geometric and biomechanical characterization of the hip were compared among the optimal alignments. There was an average decrease of 49.2 +/- 22.27% in peak contact pressure from the preoperative to the optimal alignment over all patients. We observed an average increase of 19 +/- 7.7 degrees in center-edge angle and an average decrease of 19.5 +/- 8.4 degrees in acetabular index angle from the preoperative case to the optimized plan. The optimal alignment increased the lateral coverage of the femoral head and decreased the obliqueness of the acetabular roof in all patients. These anatomical observations were independent of the choice for either cartilage thickness profile, or compressive properties. While patient-specific acetabular morphology is essential for surgeons in planning PAO, the predicted optimal alignment of the acetabulum was not significantly sensitive to the choice of cartilage thickness distribution over the acetabulum. However, in all groups the biomechanically predicted optimal alignment resulted in decreased

  1. Correction of Hallux Valgus Interphalangeus With an Osteotomy of the Distal End of the Proximal Phalanx (Distal Akin Osteotomy).

    Science.gov (United States)

    Vander Griend, Robert

    2017-02-01

    Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI. All of the patients had other forefoot deformities which were corrected at the same time. Eight of these were revision procedures of prior forefoot operations. The length of follow-up was determined by the associated procedures with a minimum follow-up of 4 months. The preoperative hallux valgus interphalangeus angle averaged 16 degrees of valgus (range 7-32 degrees) and was corrected to an average of 2 degrees of valgus (range 5 degrees valgus to 5 degrees varus). All of the patients were satisfied with the postoperative appearance and function of the first toe. Because of simultaneous correction of numerous other forefoot problems, it was not possible to specifically isolate or evaluate the effects and benefits of this osteotomy using outcomes measures. There was one intraoperative complication resulting in a fracture extending into the adjacent IP joint. Correction of an HVI deformity can be achieved with an osteotomy at the distal end of the proximal phalanx. This was a safe technique with few complications and with good results in terms of both correction and patient satisfaction. Level IV, retrospective case series.

  2. Assessment of learning gains in a flipped biochemistry classroom.

    Science.gov (United States)

    Ojennus, Deanna Dahlke

    2016-01-01

    The flipped classroom has become an increasingly popular pedagogical approach to teaching and learning. In this study, learning gains were assessed in a flipped biochemistry course and compared to gains in a traditional lecture. Although measured learning gains were not significantly different between the two courses, student perception of learning gains did differ and indicates a higher level of satisfaction with the flipped lecture format. © 2015 The International Union of Biochemistry and Molecular Biology.

  3. Student experiences across multiple flipped courses in a single curriculum.

    Science.gov (United States)

    Khanova, Julia; Roth, Mary T; Rodgers, Jo Ellen; McLaughlin, Jacqueline E

    2015-10-01

    The flipped classroom approach has garnered significant attention in health professions education, which has resulted in calls for curriculum-wide implementations of the model. However, research to support the development of evidence-based guidelines for large-scale flipped classroom implementations is lacking. This study was designed to examine how students experience the flipped classroom model of learning in multiple courses within a single curriculum, as well as to identify specific elements of flipped learning that students perceive as beneficial or challenging. A qualitative analysis of students' comments (n = 6010) from mid-course and end-of-course evaluations of 10 flipped courses (in 2012-2014) was conducted. Common and recurring themes were identified through systematic iterative coding and sorting using the constant comparison method. Multiple coders, agreement through consensus and member checking were utilised to ensure the trustworthiness of findings. Several themes emerged from the analysis: (i) the perceived advantages of flipped learning coupled with concerns about implementation; (ii) the benefits of pre-class learning and factors that negatively affect these benefits, such as quality and quantity of learning materials, as well as overall increase in workload, especially in the context of multiple concurrent flipped courses; (iii) the role of the instructor in the flipped learning environment, particularly in engaging students in active learning and ensuring instructional alignment, and (iv) the need for assessments that emphasise the application of knowledge and critical thinking skills. Analysis of data from 10 flipped courses provided insight into common patterns of student learning experiences specific to the flipped learning model within a single curriculum. The study points to the challenges associated with scaling the implementation of the flipped classroom across multiple courses. Several core elements critical to the effective design

  4. Controlling T2 blurring in 3D RARE arterial spin labeling acquisition through optimal combination of variable flip angles and k-space filtering.

    Science.gov (United States)

    Zhao, Li; Chang, Ching-Di; Alsop, David C

    2018-02-09

    To improve the SNR efficiency and reduce the T 2 blurring of 3D rapid acquisition with relaxation enhancement stack-of-spiral arterial spin labeling imaging by using variable refocusing flip angles and k-space filtering. An algorithm for determining the optimal combination of variable flip angles and filtering correction is proposed. The flip angles are designed using extended phase graph physical simulations in an analytical and global optimization framework, with an optional constraint on deposited power. Optimal designs for correcting to Hann and Fermi window functions were compared with conventional constant amplitude or variable flip angle only designs on 6 volunteers. With the Fermi window correction, the proposed optimal designs provided 39.8 and 27.3% higher SNR (P variable flip angle designs. Even when power deposition was limited to 50% of the constant amplitude design, the proposed method outperformed the SNR (P variable flip angles can be derived as the output of an optimization problem. The combined design of variable flip angle and k-space filtering provided superior SNR to designs primarily emphasizing either approach singly. © 2018 International Society for Magnetic Resonance in Medicine.

  5. IoTFLiP: IoT-based flipped learning platform for medical education

    Directory of Open Access Journals (Sweden)

    Maqbool Ali

    2017-08-01

    Full Text Available Case-Based Learning (CBL has become an effective pedagogy for student-centered learning in medical education, which is founded on persistent patient cases. Flippped learning and Internet of Things (IoTs concepts have gained significant attention in recent years. Using these concepts in conjunction with CBL can improve learning ability by providing real evolutionary medical cases. It also enables students to build confidence in their decision making, and efficiently enhances teamwork in the learing environment. We propose an IoT-based Flip Learning Platform, called IoTFLiP, where an IoT infrastructure is exploited to support flipped case-based learning in a cloud environment with state of the art security and privacy measures for personalized medical data. It also provides support for application delivery in private, public, and hybrid approaches. The proposed platform is an extension of our Interactive Case-Based Flipped Learning Tool (ICBFLT, which has been developed based on current CBL practices. ICBFLT formulates summaries of CBL cases through synergy between students' and medical expert knowledge. The low cost and reduced size of sensor device, support of IoTs, and recent flipped learning advancements can enhance medical students' academic and practical experiences. In order to demonstrate a working scenario for the proposed IoTFLiP platform, real-time data from IoTs gadgets is collected to generate a real-world case for a medical student using ICBFLT.

  6. Bridging the gap with flipped classroom

    DEFF Research Database (Denmark)

    Selberg, Hanne; Topperzer, Martha

    Bridging the gap with flipped classroom Hanne Selberg, Metropolitan University College, Copenhagen, Martha Topperzer, University Hospital Rigshospitalet, Copenhagen, Denmark Background and aims Consistent with the strategy of increasing digitization and learner-centred teaching models in the nurs......Bridging the gap with flipped classroom Hanne Selberg, Metropolitan University College, Copenhagen, Martha Topperzer, University Hospital Rigshospitalet, Copenhagen, Denmark Background and aims Consistent with the strategy of increasing digitization and learner-centred teaching models...... in the nursing curriculum, we have reversed selected traditional lectures into simulation based teaching activities embedded in a ten week Pediatric Nursing module for third year nursing students. The current pilot study seeks to explore the impact on students’ learning and commitment when flipping the classroom...... the theoretical knowledge acquired during the course to their participation in the simulations. It is of pivotal importance that all students obtain hands-on experience during the sessions to reduce the theory-practice gap. The ongoing study has been pilot tested during three courses with participation of 90...

  7. Outcomes of Ulnar Shortening for Ulnar Impaction Syndrome Using the 2.7 mm AO Ulna Shortening Osteotomy System.

    Science.gov (United States)

    Finnigan, T; Makaram, N; Baumann, A; Ramesh, K; Mohil, R; Srinivasan, M

    2018-03-01

    Ulnar shortening osteotomy is a well-established treatment for ulnar impaction syndrome. Controversy remains regarding the most effective system to achieve efficient bony union, whilst minimising incidence of complications, particularly hardware irritation. We present outcomes at 2 years using the recently released low profile AO osteotomy system. 32 consecutive patients with significant pain from ulnar impaction syndrome (idiopathic or post-traumatic), without degenerative changes of the distal radio-ulnar joint, were included. Time to union, range of motion, grip strength, pain and complications were recorded. Median time to union was 10.14 weeks (9.27-11.01, 95%CI), with one nonunion. Visual Analogue Pain score, grip strength and range of motion improved significantly. No patient experienced hardware irritation. No plate required removal. Positive ulnar variance was reduced by 3.8 mm (mean). The low profile AO system appears effective in achieving bony union whilst minimising incidence of hardware irritation, at a follow up of 2 years.

  8. Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

    Science.gov (United States)

    Brogan, Kit; Lindisfarne, Edward; Akehurst, Harold; Farook, Usama; Shrier, Will; Palmer, Simon

    2016-11-01

    Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus. Our null hypothesis was that the 2 techniques would yield equivalent clinical and radiographic results at 2 years. This was a retrospective cohort study. Eighty-one consecutive feet (49 MIS and 32 open distal chevron osteotomies) were followed up for a minimum 24 months (range 24-58). All patients were clinically assessed using the Manchester-Oxford Foot Questionnaire. Radiographic measures included hallux valgus angle, the intermetatarsal angle, hallux interphalangeal angle, metatarsal phalangeal joint angle, distal metatarsal articular angle, tibial sesamoid position, shape of the first metatarsal head, and plantar offset. Statistical analysis was done using Student t test or Wilcoxon rank-sum test for continuous data and Pearson chi-square test for categorical data. Clinical and radiologic postoperative scores in all domains were substantially improved in both groups (P .05). There were no significant differences in complications between the 2 groups ( > .5). The midterm results of this third-generation technique show that it was a safe procedure with good clinical outcomes and comparable to traditional open techniques for symptomatic mild-moderate hallux valgus. Level III, retrospective comparative study. © The Author(s) 2016.

  9. Characterisation of hybrid integrated all-optical flip-flop

    DEFF Research Database (Denmark)

    Liu, Y.; McDougall, R.; Seoane, Jorge

    2006-01-01

    We present a fully-packaged, hybrid-integrated all-optical flip-flop with separate optical set and reset operation. The flip-flop can control a wavelength converter to route 40 Gb/s data packets all-optically. The experimental results are given.......We present a fully-packaged, hybrid-integrated all-optical flip-flop with separate optical set and reset operation. The flip-flop can control a wavelength converter to route 40 Gb/s data packets all-optically. The experimental results are given....

  10. Retention of Content Utilizing a Flipped Classroom Approach.

    Science.gov (United States)

    Shatto, Bobbi; LʼEcuyer, Kristine; Quinn, Jerod

    The flipped classroom experience promotes retention and accountability for learning. The authors report their evaluation of a flipped classroom for accelerated second-degree nursing students during their primary medical-surgical nursing course. Standardized HESI® scores were compared between a group of students who experienced the flipped classroom and a previous group who had traditional teaching methods. Short- and long-term retention was measured using standardized exams 3 months and 12 months following the course. Results indicated that short-term retention was greater and long- term retention was significantly great in the students who were taught using flipped classroom methodology.

  11. The flipped classroom: practices and opportunities for health sciences librarians.

    Science.gov (United States)

    Youngkin, C Andrew

    2014-01-01

    The "flipped classroom" instructional model is being introduced into medical and health sciences curricula to provide greater efficiency in curriculum delivery and produce greater opportunity for in-depth class discussion and problem solving among participants. As educators employ the flipped classroom to invert curriculum delivery and enhance learning, health sciences librarians are also starting to explore the flipped classroom model for library instruction. This article discusses how academic and health sciences librarians are using the flipped classroom and suggests opportunities for this model to be further explored for library services.

  12. [Double Osteotomy of the First Metatarsal for Treatment of Juvenile Hallux Valgus Deformity - Our Experience].

    Science.gov (United States)

    Jochymek, J; Peterková, T

    2016-01-01

    The aim of the study was to evaluate the mid-term results in a group of selected patients undergoing corrective surgery for juvenile hallux valgus, using double osteotomy of the first metatarsal. The group included eight patients, seven girls and one boy, with a more severe form of this deformity treated by double osteotomy of the first metatarsal between 2010 and 2013. The indication for corrective surgery was serious pain when walking; all patients had previously undergone conservative treatment with no effect. All patients had pre-operative clinical examination, the affected foot was X-rayed with the patient standing and radiographic assessments of the intermetatarsal and hallux valgus angles were made. The evaluation of treatment outcomes was based on the scoring system of the American Orthopaedic Foot and Ankle Society (AOFAS) and X-ray images of the foot. The average follow-up was 37 months. Post-operatively, none of the patients reported pain while walking, only two of them experienced pain during sports activities. The average post-operative AOFAS score was 92 points. Both the intermetatarsal angle and the hallux valgus angle improved after surgery in all patients, with two reporting only mild hallux valgus deformity. One patient showed postoperative restriction of motion at the first metatarsophalangeal joint. This was the only complication recorded in association with the surgery. Almost all authors dealing with the treatment of hallux valgus deformity primarily prefer conservative therapy. However, this treatment is usually not very effective in severe forms of the disorder. Surgical management is indicated in symptomatic patients or in those with severe juvenile hallux valgus deformity. In paediatric patients it is necessary to respect the presence of an epiphyseal growth plate in the first proximal metatarsal and therefore it is often preferred to use distal first metatarsal osteotomy. At our department, Mitchell's osteotomy for hallux valgus deformity

  13. Computer-Assisted Corrective Osteotomy of Malunited Pediatric Radial Neck Fractures-Three-Dimensional Postoperative Accuracy and Clinical Outcome.

    Science.gov (United States)

    Weigelt, Lizzy; Fürnstahl, Philipp; Schweizer, Andreas

    2017-12-01

    Neglected or incorrect treatment of pediatric radial neck fractures may lead to symptomatic malunions. Computer-assisted corrective osteotomies with patient-specific guides have been proposed as a promising technique for the reconstruction of malunited long bone deformities. The aim of this study was to evaluate the accuracy and clinical outcome of this technique in children with malunited fractures of the radial neck. Four children [2 boys, 2 girls; mean age 12 (10-16) years] underwent computer-assisted closing wedge osteotomy of the radial neck. The contralateral uninjured side was used as a reconstruction template. Computed tomography were performed 8 weeks postoperatively to confirm bony consolidation and to quantify residual 3D rotational and translational displacement error. Clinical outcome [pain, range of motion (ROM)] and overall satisfaction were documented. Preoperative subluxation of the radial head could be corrected in 2 of 3 patients. One patient had to be revised because of secondary traumatic loss of reduction. At the last follow-up [mean 16 (range, 12-24) months], all patients were pain free for activities of daily living (preoperative pain: visual analog scale 6). Pain during sport activities could be substantially reduced (visual analog scale 8→2). Although the procedure failed to improve ROM, none of the patients had limitations regarding work, daily, or sports activities. Yet, restricted ROM was considered as a cosmetic problem in 1 patient. Full consolidation of the osteotomy site, with no signs of avascular necrosis of the radial head, was achieved in all patients. The deformity could be substantially reduced, from a 3D angle of 13-40 degrees to 3-7 degrees (58%-89% deformity correction). Computer-assisted corrective osteotomy is a novel technique for the treatment of radial neck malunions that led to adequate pain reduction and 3D accuracy of deformity correction in our small case series. Despite the lack of improved ROM, all patients

  14. Patient-tailored plate for bone fixation and accurate 3D positioning in corrective osteotomy.

    Science.gov (United States)

    Dobbe, J G G; Vroemen, J C; Strackee, S D; Streekstra, G J

    2013-02-01

    A bone fracture may lead to malunion of bone segments, which gives discomfort to the patient and may lead to chronic pain, reduced function and finally to early osteoarthritis. Corrective osteotomy is a treatment option to realign the bone segments. In this procedure, the surgeon tries to improve alignment by cutting the bone at, or near, the fracture location and fixates the bone segments in an improved position, using a plate and screws. Three-dimensional positioning is very complex and difficult to plan, perform and evaluate using standard 2D fluoroscopy imaging. This study introduces a new technique that uses preoperative 3D imaging to plan positioning and design a patient-tailored fixation plate that only fits in one way and realigns the bone segments as planned. The method is evaluated using artificial bones and renders realignment highly accurate and very reproducible (d(err) < 1.2 ± 0.8 mm and φ(err) < 1.8° ± 2.1°). Application of a patient-tailored plate is expected to be of great value for future corrective osteotomy surgeries.

  15. Trochanteric reduction osteotomy as a treatment for refractory trochanteric bursitis

    NARCIS (Netherlands)

    Govaert, L. H. M.; van der Vis, H. M.; Marti, R. K.; Albers, G. H. R.

    2003-01-01

    We describe a new operative procedure for patients with chronic trochanteric bursitis. Between March 1994 and May 2000, a trochanteric reduction osteotomy was performed on ten patients (12 hips). All had received conservative treatment for at least one year. Previous surgical treatment with a

  16. Horizontal osteotomy for reconstruction of the narrow edentulous mandible

    NARCIS (Netherlands)

    Raghoebar, GM; Batenburg, RHK; Meijer, HJA; Vissink, A

    The aim of this retrospective study was to evaluate the applicability of a horizontal osteotomy procedure for reconstruction of a narrow edentulous mandible in order to enable insertion of implants. In 7 edentulous patients a narrow inferior alveolar ridge was reconstructed with autogenous bone

  17. Mathematical Simulation of Osteotomy, Numerical Analysis and Results

    Czech Academy of Sciences Publication Activity Database

    Nedoma, Jiří; Stehlík, J.

    1995-01-01

    Roč. 63, 1/3 (1995), s. 421-438 ISSN 0377-0427. [Modelling'94. Prague, 29.08.1994-02.09.1994] R&D Projects: GA ČR GA308/95/0304 Keywords : mathematical modelling in orthopeady * osteotomy * contact problems * variational inequality * preconditioned conjugate gradient method Impact factor: 0.373, year: 1995

  18. Sugioka's osteotomy for femoral-head necrosis in young Caucasians.

    NARCIS (Netherlands)

    Rijnen, W.H.C.; Gardeniers, J.W.M.; Westrek, B.; Buma, P.; Schreurs, B.W.

    2005-01-01

    The transtrochanteric rotational osteotomy described by Sugioka is used to preserve the femoral head and to prevent secondary osteoarthritis in young patients with osteonecrosis of the femoral head. Several Japanese studies have shown favourable results, but European and American studies were

  19. Creating a contemporary clerkship curriculum: the flipped classroom model in emergency medicine.

    Science.gov (United States)

    Lew, Edward K

    2016-12-01

    The teaching modality of "flipping the classroom" has garnered recent attention in medical education. In this model, the lecture and homework components are reversed. The flipped classroom lends itself to more interaction in "class" and theoretically improved clinical decision-making. Data is lacking for this model for students in emergency medicine clerkships. We trialed the flipped classroom in our fourth-year student clerkship. Our aim was to learn student and faculty facilitator perceptions of the experience, as it has not been done previously in this setting. We evaluated this in two ways: (1) participant perception of the experience and (2) facilitator (EM physician educator) perception of student preparation, participation, and knowledge synthesis. With permission from its creators, we utilized an online video series derived from the Clerkship Directors in Emergency Medicine. Students were provided the link to these 1 week prior to the classroom experience as the "homework." We developed patient cases generated from the videos that we discussed during class in small-group format. Afterward, students were surveyed about the experience using four-point Likert items and free-text comments and also were evaluated by the facilitator on a nine-point scale. Forty-six clerkship students participated. Students deemed the online modules useful at 2.9 (95 % CI 2.7-3.2). Further, they reported the in-class discussion to be of high value at 3.9 (95 % CI 3.8-4.0), much preferred the flipped classroom to traditional lecturing at 3.8 (95 % CI 3.6-3.9), and rated the overall experience highly at 3.8 (95 % CI 3.7-3.9). Based on preparation, participation, and knowledge synthesis, the facilitator judged participants favorably at 7.4 (95 % CI 7.0-7.8). Students commented that the interactivity, discussion, and medical decision-making were advantages of this format. Students found high value in the flipped classroom and prefer it to traditional lecturing, citing

  20. Comparison between flipped classroom and lecture-based classroom in ophthalmology clerkship.

    Science.gov (United States)

    Tang, Fen; Chen, Chuan; Zhu, Yi; Zuo, Chengguo; Zhong, Yimin; Wang, Nan; Zhou, Lijun; Zou, Yuxian; Liang, Dan

    2017-01-01

    In recent years, the flipped classroom method of teaching has received much attention in health sciences education. However, the application of flipped classrooms in ophthalmology education has not been well investigated. The goal of this study was to investigate the effectiveness and acceptability of the flipped classroom approach to teaching ophthalmology at the clerkship level. Ninety-five fourth year medical students in an ophthalmology clerkship were randomly divided into two groups. An ocular trauma module was chosen for the content of this study. One group (FG (flipped group), n = 48) participated in flipped classroom instruction and was asked to watch a recorded lecture video and to read study materials before a face-to-face class meeting. They used the in-class time for discussion. The other group (TG (traditional group), n = 47) was assigned to traditional lecture-based instruction. These students attended a didactic lecture and completed assigned homework after the lecture. Feedback questionnaires were collected to compare students' perspectives on the teaching approach they experienced and to evaluate students' self-perceived competence and interest in ocular trauma. Pre- and post-tests were performed to assess student learning of the course materials. More students in the FG agreed that the classroom helped to promote their learning motivation, improve their understanding of the course materials, and enhance their communication skill and clinical thinking. However, students in the FG did not show a preference for this method of teaching, and also reported more burden and pressure than those from the TG. Students from the FG performed better on the post test over the ocular trauma-related questions when compared to those from the TG. The flipped classroom approach shows promise in ophthalmology clerkship teaching. However, it has some drawbacks. Further evaluation and modifications are required before it can be widely accepted and implemented

  1. Total mandibular subapical osteotomy and Le Fort I osteotomy using piezosurgery and computer-aided designed and manufactured surgical splints: a favorable combination of three techniques in the management of severe mouth asymmetry in Parry-Romberg syndrome.

    Science.gov (United States)

    Scolozzi, Paolo; Herzog, Georges

    2014-05-01

    Although its pathogenesis remains obscure, Parry-Romberg syndrome (PRS) has been associated with the linear scleroderma en coup de sabre. PRS is characterized by unilateral facial atrophy of the skin, subcutaneous tissue, muscles, and bones with at least 1 dermatome supplied by the trigeminal nerve. Facial asymmetry represents the most common sequela and can involve the soft tissues, craniomaxillofacial skeleton, dentoalveolar area, and temporomandibular joint. Although orthognathic procedures have been reported for skeletal reconstruction, treatment of facial asymmetry has been directed to augmentation of the soft tissue volume on the atrophic side using different recontouring or volumetric augmentation techniques. Total mandibular subapical osteotomy has been used in the management of dentofacial deformities, such as open bite and mandibular dentoalveolar retrusion or protrusion associated with an imbalance between the lower lip and the chin. Management of orthognathic procedures has been improved by the recent introduction of stereolithographic surgical splints using computer-aided design (CAD) and computer-aided manufacturing (CAM) technology and piezosurgery. Piezosurgery has increased security during surgery, especially for delicate procedures associated with a high risk of nerve injury. The present report describes a combined total mandibular subapical osteotomy and Le Fort I osteotomy using piezosurgery and surgical splints fabricated using CAD and CAM for the correction of severe mouth asymmetry related to vertical dentoalveolar disharmony in a patient with PRS. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Posterior trochanteric osteotomy in acetabular fractures for 32 cases.

    Science.gov (United States)

    Niu, Yunfei; An, Xiaofei; Xu, Shuogui; Wu, Dajiang; Zhang, Chuncai; Li, Ming

    2014-11-01

    The aim of this study is to explore the method and clinical outcome of posterior trochanteric osteotomy in acetabular fractures. From January 2000 to January 2008, 32 cases of acetabular fractures involving the dome of acetabulum underwent posterior trochanteric osteotomy for a better exposure and internal fixation with acetabular tridimensional memory fixation system. 28 cases (16 men and 12 women, mean age 39.9 years, range 16-73 years) were followed up with an average of 48.9 months (range of 19-95 months) and four were lost during follow up. Of 28 cases, 19 were fresh fractures and 9 were old fractures. The reduction was evaluated with Matta criteria. Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Motor strength of the abductors was evaluated according to the Medical Research Council grading system. Ectopic ossification was classified according to Brooker criteria. Anatomical reduction was achieved in 17 cases and satisfied reduction in 10 patients. Poor reduction happened in an old fracture. All acetabular fractures got a direct bone union and no displacement and deep infection occurred. All osteotomies healed within 3.5 months without any nonunion, proximal migration of the greater trochanter, loosing or broken of instrumentation, and deep infection. Two superficial infections were healed with a regular dressing. Two patients underwent removal of implants from greater trochanter because of irritation. The strength of the abductors was of Grade 3/5 in two patients, Grade 4/5 in five patients, and normal in the rest. Clinical scoring was excellent to good in 84 %. Ectopic ossification occurred in five patients, grade 1 in two patients, grade 2 in two, and grade 3 in one. But function of hip joint was not seriously affected. Posterior trochanteric osteotomy can provide an adequate exposure of the dome of acetabulum without the associated complications like nonunion, proximal replacement, and weak of the abductors which often occur

  3. Postoperative dysesthesia in lumbar three-column resection osteotomies.

    Science.gov (United States)

    Zhang, Zhengfeng; Wang, Honggang; Zheng, Wenjie

    2016-08-01

    Three-column lumbar spinal resection osteotomies including pedicle subtraction osteotomy (PSO), vertebral column resection (VCR), and total en bloc spondylectomy (TES) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in lumbar spinal resection osteotomies. Between January 2009 and December 2013, 64 patients were treated with lumbar three-column spinal resection osteotomies (PSO, n = 31; VCR, n = 29; TES, n = 4) in investigator group. POD was defined as dysesthetic pain or burning dysesthesia at a proper DRG innervated region, whether spontaneous or evoked. Non-steroidal antiinflammatory drugs, central none-opioid analgesic agent, neuropathic pain drugs and/or intervertebral foramen block were selectively used to treat POD. There were 5 cases of POD (5/64, 7.8 %), which consisted of 1 patient in PSO (1/31, 3.2 %), 3 patients in PVCR (3/29, 10.3 %), and 1 patient in TES (1/4, 25 %). After the treatment by drugs administration plus DRG block, all patients presented pain relief with duration from 8 to 38 days. A gradual pain moving to distal end of a proper DRG innervated region was found as the beginning of end. Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in lumbar spinal resection osteotomies, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovering may be used as a sign for the good prognosis.

  4. Novel TPLO Alignment Jig/Saw Guide Reproduces Freehand and Ideal Osteotomy Positions.

    Science.gov (United States)

    Mariano, Abigail D; Kowaleski, Michael P; Boudrieau, Randy J

    2016-01-01

    To evaluate the ability of an alignment jig/saw guide to reproduce appropriate osteotomy positions in the tibial plateau leveling osteotomy (TPLO) in the dog. Lateral radiographs of 65 clinical TPLO procedures using an alignment jig and freehand osteotomy performed by experienced TPLO surgeons using a 24 mm radial saw blade between Dec 2005-Dec 2007 and Nov 2013-Nov 2015 were reviewed. The freehand osteotomy position was compared to potential osteotomy positions using the alignment jig/saw guide. The proximal and distal jig pin holes on postoperative radiographs were used to align the jig to the bone; saw guide position was selected to most closely match the osteotomy performed. The guide-to-osteotomy fit was categorized by the distance between the actual osteotomy and proposed saw guide osteotomy at its greatest offset (≤1 mm = excellent; ≤2 mm = good; ≤3 mm = satisfactory; >3 mm = poor). Sixty-four of 65 TPLO osteotomies could be matched satisfactorily by the saw guide. Proximal jig pin placement 3-4 mm from the joint surface and pin location in a craniocaudal plane on the proximal tibia were significantly associated with the guide-to-osteotomy fit (P = 0.021 and P = 0.047, respectively). The alignment jig/saw guide can be used to reproduce appropriate freehand osteotomy position for TPLO. Furthermore, an ideal osteotomy position centered on the tibial intercondylar tubercles also is possible. Accurate placement of the proximal jig pin is a crucial step for correct positioning of the saw guide in either instance.

  5. The effects of femoral external derotational osteotomy on frontal plane alignment.

    Science.gov (United States)

    Nelitz, M; Wehner, T; Steiner, M; Dürselen, L; Lippacher, S

    2014-11-01

    Femoral osteotomies are the preferred treatment in significant torsional deformity of the femur. The influence of torsional osteotomies on frontal plane alignment is poorly understood. Therefore, the aim of the present study was to evaluate the effects of external derotational osteotomies on proximal, mid-shaft and distal levels onto frontal plane alignment. The effect of rotation around the anatomical axis of the femur on frontal plane alignment was determined with a 3D computer model, created from CT data of a right human cadaver femur. Virtual torsional osteotomies of 10°, 20° and 30° were performed at proximal, mid-shaft and distal levels under five antecurvatum angles of the femur. The change of the frontal plane alignment was expressed by the mechanical lateral femoral angle. Proximal derotational osteotomies resulted in an increased mechanical lateral distal femoral angle (mLDFA) of 0.8°-2.6° for 10°, of 1.6°-5.1° for 20° and of 2.3-7.9° for 30° derotational osteotomy, indicating an increased varus angulation. Supracondylar derotational osteotomy resulted in a decreased mLDFA of -0.1° to -1.7° for 10°, of -0.2 to -3.7° for 20° and of -0.7 to -6.9° for 30° derotational osteotomy, indicating an increased valgus angulation. The effect increased with the amount of torsional correction and virtually increased antecurvatum angles. Mid-shaft torsional osteotomies had the smallest effect on frontal plane alignment. This three-dimensional computer model study demonstrates the relationship between femoral torsional osteotomies and frontal plane alignment. Proximal external derotational osteotomies tend to result in an increased varus angulation, whilst distal external derotational osteotomies tend to result in an increased valgus angulation. As a clinical consequence, torsional osteotomies have an increased risk of unintentional implications on frontal plane alignment.

  6. Comparison of the Modified McBride Procedure and the Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

    Science.gov (United States)

    Choi, Gi Won; Kim, Hak Jun; Kim, Taik Seon; Chun, Sung Kwang; Kim, Tae Wan; Lee, Yong In; Kim, Kyoung Ho

    2016-01-01

    Distal metatarsal osteotomy and the modified McBride procedure have each been used for the treatment of mild to moderate hallux valgus. However, few studies have compared the results of these 2 procedures for mild to moderate hallux valgus. The purpose of the present study was to compare the results of distal chevron osteotomy and the modified McBride procedure for treatment of mild to moderate hallux valgus according to the severity of the deformity. We analyzed the data from 45 patients (49.5%; 48 feet [49.0%]), who had undergone an isolated modified McBride procedure (McBride group), and 46 patients (50.5%; 50 feet [51.0%]), who had a distal chevron osteotomy (chevron group). We subdivided each group into those with mild and moderate deformity and compared the clinical and radiologic outcomes between the groups in relation to the severity of the deformity. The improvements in the American Orthopaedic Foot and Ankle Society scale score and the visual analog scale for pain were significantly better for the chevron group for both mild and moderate deformity. The chevron group experienced significantly greater correction in the hallux valgus angle and intermetatarsal angle for both mild and moderate deformity. The chevron group experienced a significantly greater decrease in the grade of sesamoid displacement for patients with moderate deformity. The McBride group had a greater risk of recurrence than did the chevron group for moderate deformity (odds ratio 14.00, 95% confidence interval 3.91 to 50.06, p hallux valgus recurrence than did the distal chevron group. Therefore, we recommend distal chevron osteotomy rather than a modified McBride procedure for the treatment of mild and moderate hallux valgus. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Flipping Every Student? A Case Study of Content-Based Flipped Language Classrooms

    Science.gov (United States)

    Sun, Yu-Chih

    2017-01-01

    The study aims to explore university-level foreign language learners' perceptions of the content-based flipped classroom approach and factors influencing their perceptions. The research questions guiding the study are three-fold. (a) What attitudes and perceptions do students have about language and knowledge acquisition in the content-based…

  8. Total hip arthroplasty (S-ROM stem) and subtrochanteric osteotomy for Crowe type IV developmental dysplasia of the hip.

    Science.gov (United States)

    Li, Liangtao; Yu, Mingyang; Yang, Chen; Gu, Guishan

    2016-01-01

    Developmental dysplasia of the hip (DDH) in adults with severe pain and disability is best treated by total hip arthroplasty (THA). The purpose of this study was to retrospectively evaluate the outcomes of subtrochanteric shortening osteotomy combined with THA using S-ROM stem for those severe patients with a special focus on the effect of two shapes in the subtrochanteric osteotomy ends: Oblique and transverse. Twenty one cases with mean age of 43.6 years who met inclusion criteria and were operated between February 2007 and February 2012 were included in the study. Those cases had been divided into two groups (oblique vs. transverse) and all records between the two groups were analyzed. The Harris hip score significantly improved from 30.6 (range 18-59) preoperatively to 91.2 (range 87-98) postoperatively by the latest followup. Complications including one deep venous thrombosis, one intraoperative fracture of femur and two dislocations occurred while they were addressed properly afterward. The oblique group showed significant advantages in operative time, union time and additional fixation in comparison with the transverse group. In the primary THA for the treatment of irreducible DDH, subtrochanteric oblique osteotomy combined with the freely-rotatable S-ROM stem provided favorable short term outcomes by affording both morphological and functional advantages.

  9. Wedgeless 'V' shaped distal femoral osteotomy with internal fixation for genu valgum in adolescents and young adults.

    Science.gov (United States)

    Gupta, Vikas; Kamra, Gaurav; Singh, Davinder; Pandey, Ketan; Arora, Sumit

    2014-06-01

    The treatment of angular malalignment includes restoration of normal mechanical axis alignment and joint orientation.The supracondylar wedgeless distal femoral 'V' osteotomy, as a treatment modality, is sparsely explored in the literature. This study was conducted at a tertiary level teaching referral hospital from October 2010 to September 2012. Forty six lower limbs (in 30 patients) were operated with a wedgeless 'V' osteotomy that was fixed with a buttress 'L' plate. The pre-operative deformity, post-operative correction and knee range of movement were noted. Mobilisation was started at 3 weeks after surgery and full weight-bearing was allowed at 3 months. The knee score by Bostman et al. was used for functional outcome. The mean age of the patients in our study was 16.9 years (range: 15 years to 23 years). The patients were followed up for a mean period of 19.8 months (range, 15 months to 29 months). The mean radiological tibiofemoral angle was 22.2 degrees (range, 16 degrees to 29 degrees) before surgery, that improved to a mean postoperative value of 5.1 degrees (range, 0 degrees to 10 degrees) (p p p V' shaped osteotomy is a simple procedure for the correction of genu valgum in individuals nearing skeletal maturity and is easy to perform. It has the advantage of being wedgeless as it does not cause limb length discrepancy. Internal fixation helps in early rehabilitation after surgery.

  10. Assessing the Flipped Classroom in Operations Management: A Pilot Study

    Science.gov (United States)

    Prashar, Anupama

    2015-01-01

    The author delved into the results of a flipped classroom pilot conducted for an operations management course module. It assessed students' perception of a flipped learning environment after making them experience it in real time. The classroom environment was construed using a case research approach and students' perceptions were studied using…

  11. Flipping College Algebra: Effects on Student Engagement and Achievement

    Science.gov (United States)

    Ichinose, Cherie; Clinkenbeard, Jennifer

    2016-01-01

    This study compared student engagement and achievement levels between students enrolled in a traditional college algebra lecture course and students enrolled in a "flipped" course. Results showed that students in the flipped class had consistently higher levels of achievement throughout the course than did students in the traditional…

  12. Flipping the Calculus Classroom: A Cost-Effective Approach

    Science.gov (United States)

    Young, Andrea

    2015-01-01

    This article discusses a cost-effective approach to flipping the calculus classroom. In particular, the emphasis is on low-cost choices, both monetarily and with regards to faculty time, that make the daunting task of flipping a course manageable for a single instructor. Student feedback and overall impressions are also presented.

  13. Partially Flipped Linear Algebra: A Team-Based Approach

    Science.gov (United States)

    Carney, Debra; Ormes, Nicholas; Swanson, Rebecca

    2015-01-01

    In this article we describe a partially flipped Introductory Linear Algebra course developed by three faculty members at two different universities. We give motivation for our partially flipped design and describe our implementation in detail. Two main features of our course design are team-developed preview videos and related in-class activities.…

  14. Student Perceptions of the Flipped Classroom in College Algebra

    Science.gov (United States)

    Ogden, Lori

    2015-01-01

    The flipped classroom approach was implemented across three semesters of a College Algebra course. This paper is part of a larger design and development research study and focuses on student perceptions of the flipped classroom teaching approach. Qualitative methodology was used to describe how students perceived the instruction of their College…

  15. The Flipped Class: Experience in a University Business Communication Course

    Science.gov (United States)

    Sherrow, Tammy; Lang, Brenda; Corbett, Rod

    2016-01-01

    Business, like many other programs in higher education, continues to rely largely on traditional classroom environments. In this article, another approach to teaching and learning, the flipped classroom, is explored. After a review of relevant literature, the authors present their experience with the flipped classroom approach to teaching and…

  16. Assessment of Learning Gains in a Flipped Biochemistry Classroom

    Science.gov (United States)

    Ojennus, Deanna Dahlke

    2016-01-01

    The flipped classroom has become an increasingly popular pedagogical approach to teaching and learning. In this study, learning gains were assessed in a flipped biochemistry course and compared to gains in a traditional lecture. Although measured learning gains were not significantly different between the two courses, student perception of…

  17. The Implementation of a Flipped Classroom in Foreign Language Teaching

    Science.gov (United States)

    Basal, Ahmet

    2015-01-01

    Alongside the rise of educational technology, many teachers have been taking gradual but innovative steps to redesign their teaching methods. For example, in flipped learning or a flipped classroom, students watch instructional videos outside the classroom and do assignments or engage in activities inside the classroom. Language teachers are one…

  18. Flipped Classroom Research and Trends from Different Fields of Study

    Science.gov (United States)

    Zainuddin, Zamzami; Halili, Siti Hajar

    2016-01-01

    This paper aims to analyse the trends and contents of flipped classroom research based on 20 articles that report on flipped learning classroom initiatives from 2013-2015. The content analysis was used as a methodology to investigate methodologies, area of studies, technology tools or online platforms, the most frequently used keywords and works…

  19. Flipped Classroom: Effects on Education for the Case of Economics

    Science.gov (United States)

    Kurihara, Yutaka

    2016-01-01

    The notion of the flipped classroom has been received much attention in the literature as it may increase learning outcomes and learning effectiveness elementary and secondary education as well as university learning. In the author's class on international finance (economics) features a blended flipped classroom and lecture; questionnaires were…

  20. Exploring Flipped Classroom Effects on Second Language Learners' Cognitive Processing

    Science.gov (United States)

    Kim, Jeong-eun; Park, Hyunjin; Jang, Mijung; Nam, Hosung

    2017-01-01

    This study investigated the cognitive effects of the flipped classroom approach in a content-based instructional context by comparing second language learners' discourse in flipped vs. traditional classrooms in terms of (1) participation rate, (2) content of comments, (3) reasoning skills, and (4) interactional patterns. Learners in two intact…

  1. Malaysian Students' Perceptions of Flipped Classroom: A Case Study

    Science.gov (United States)

    Zainuddin, Zamzami; Attaran, Mohammad

    2016-01-01

    The purpose of this study was to evaluate a class in University of Malaya where flipped learning was applied, and to examine students' perceptions and feedback towards flipped classroom. Data were collected using both quantitative and qualitative methods, i.e. survey, focus group and individual interviews. The results indicated that most students…

  2. Re-Visiting the Flipped Classroom in a Design Context

    Science.gov (United States)

    Coyne, Richard David; Lee, John; Denitsa, Petrova

    2017-01-01

    After explaining our experience with a flipped classroom model of learning, we argue that the approach brings to light the dramaturgical and mediatized aspects of learning experiences that favour a closer connection between recorded content and "live" presentation by the lecturer. We adopted the flipped classroom approach to learning and…

  3. Flipped @ SBU: Student Satisfaction and the College Classroom

    Science.gov (United States)

    Gross, Benjamin; Marinari, Maddalena; Hoffman, Mike; DeSimone, Kimberly; Burke, Peggy

    2015-01-01

    In this paper, the authors find empirical support for the effectiveness of the flipped classroom model. Using a quasi-experimental method, the authors compared students enrolled in flipped courses to their counterparts in more traditional lecture-based ones. A survey instrument was constructed to study how these two different groups of students…

  4. Evaluating the Flipped Classroom: A Randomized Controlled Trial

    Science.gov (United States)

    Wozny, Nathan; Balser, Cary; Ives, Drew

    2018-01-01

    Despite recent interest in flipped classrooms, rigorous research evaluating their effectiveness is sparse. In this study, the authors implement a randomized controlled trial to evaluate the effect of a flipped classroom technique relative to a traditional lecture in an introductory undergraduate econometrics course. Random assignment enables the…

  5. On Flipping First-Semester Calculus: A Case Study

    Science.gov (United States)

    Petrillo, Joseph

    2016-01-01

    High failure rates in calculus have plagued students, teachers, and administrators for decades, while science, technology, engineering, and mathematics programmes continue to suffer from low enrollments and high attrition. In an effort to affect this reality, some educators are "flipping" (or inverting) their classrooms. By flipping, we…

  6. Enhancing the Design and Analysis of Flipped Learning Strategies

    Science.gov (United States)

    Jenkins, Martin; Bokosmaty, Rena; Brown, Melanie; Browne, Chris; Gao, Qi; Hanson, Julie; Kupatadze, Ketevan

    2017-01-01

    There are numerous calls in the literature for research into the flipped learning approach to match the flood of popular media articles praising its impact on student learning and educational outcomes. This paper addresses those calls by proposing pedagogical strategies that promote active learning in "flipped" approaches and improved…

  7. The Flipped Museum: Leveraging Technology to Deepen Learning

    Science.gov (United States)

    Harrell, Michelle H.; Kotecki, Emily

    2015-01-01

    The Flipped Museum is an innovative model in which high school students engage in online learning before and after a museum experience at the North Carolina Museum of Art. This model, inspired by the "flipped classroom," inverts the delivery and application of knowledge in a museum setting. Beginning with an overview of the pedagogical…

  8. Curriculum Design of a Flipped Classroom to Enhance Haematology Learning

    Science.gov (United States)

    Porcaro, Pauline A.; Jackson, Denise E.; McLaughlin, Patricia M.; O'Malley, Cindy J.

    2016-01-01

    A common trend in higher education is the "flipped" classroom, which facilitates active learning during class. The flipped approach to teaching was instituted in a haematology "major" class and the students' attitudes and preferences for the teaching materials were surveyed. The curriculum design was explicit and involved four…

  9. Flipped Classrooms and Student Learning: Not Just Surface Gains

    Science.gov (United States)

    McLean, Sarah; Attardi, Stefanie M.; Faden, Lisa; Goldszmidt, Mark

    2016-01-01

    The flipped classroom is a relatively new approach to undergraduate teaching in science. This approach repurposes class time to focus on application and discussion; the acquisition of basic concepts and principles is done on the students' own time before class. While current flipped classroom research has focused on student preferences and…

  10. Evaluation of a "Flipped Classroom" Approach in Management Education

    Science.gov (United States)

    Bergfjord, Ole Jakob; Heggernes, Tarjei

    2016-01-01

    In this paper, a "flipped classroom" approach is evaluated using three different datasets. We use student evaluations of the "flipped classroom" in particular, in addition to regular course evaluations and exam results for the past three years in order to allow for statistical comparisons. Overall, the results are quite…

  11. Flipping the Classroom: Strategies for Psychiatric-Mental Health Course.

    Science.gov (United States)

    Burden, Marsha L; Carlton, Kay Hodson; Siktberg, Linda; Pavlechko, Gary

    2015-01-01

    Experiences over 2 years substantiate the value of the pedagogical shift of "flipping the classroom" as an effective strategy in preparing students for didactic and clinical experiences in a psychiatric-mental health nursing course. This article describes strategies used to flip the classroom in the course. Student perceptions of the changed pedagogy and implications for nurse educators are presented.

  12. Using Presentation Software to Flip an Undergraduate Analytical Chemistry Course

    Science.gov (United States)

    Fitzgerald, Neil; Li, Luisa

    2015-01-01

    An undergraduate analytical chemistry course has been adapted to a flipped course format. Course content was provided by video clips, text, graphics, audio, and simple animations organized as concept maps using the cloud-based presentation platform, Prezi. The advantages of using Prezi to present course content in a flipped course format are…

  13. Flipped Instruction in a High School Science Classroom

    Science.gov (United States)

    Leo, Jonathan; Puzio, Kelly

    2016-01-01

    This paper reports on a quasi-experimental study examining the effectiveness of flipped instruction in a 9th grade biology classroom. This study included four sections of freshmen-level biology taught by the first author at a private secondary school in the Pacific Northwest. Using a block randomized design, two sections were flipped and two…

  14. Examining Student Perceptions of Flipping an Agricultural Teaching Methods Course

    Science.gov (United States)

    Conner, Nathan W.; Rubenstein, Eric D.; DiBenedetto, Cathy A.; Stripling, Christopher T.; Roberts, T. Grady; Stedman, Nicole L. P.

    2014-01-01

    To meet the needs of the 21st century student, college instructors have been challenged to transform their classrooms from passive to active, "minds-on" learning environments. This qualitative study examined an active learning approach known as a flipped classroom and sought to explore student perceptions of flipping a teaching methods…

  15. COMPARISON OF UPRIGHT AND FLIPPED SPOON PRESENTATIONS TO GUIDE TREATMENT OF FOOD REFUSAL

    Science.gov (United States)

    Sharp, William G; Odom, Ashley; Jaquess, David L

    2012-01-01

    The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral-motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements in inappropriate mealtime behavior and acceptance of bites; however, re-presentation did not reduce expulsion or improve mouth clean. Results showed a lower level of expulsion and higher percentage of mouth clean during flipped spoon presentations and re-presentations for all participants. Findings from follow-up analyses supported transitioning back to an upright spoon in all 3 cases, although the time required for this to occur differed across participants. PMID:22403451

  16. Flipping social determinants on its head: Medical student perspectives on the flipped classroom and simulated patients to teach social determinants of health.

    Science.gov (United States)

    Gostelow, N; Barber, J; Gishen, F; Berlin, A

    2018-02-19

    Inequalities in healthcare are increasing. Engaging medical students to tackle this urgent challenge alongside clinical sciences can be demanding. This study examines medical student perceptions of a flipped approach to health inequalities co-designed by faculty and sixth-year students. A flipped learning session was piloted for year 4 medical students combining an online lesson followed by a tutorial with a simulated patient. A mixed-methods approach collected questionnaire data using 4-point Likert scales and free text answers. A semi-structured group interview was conducted with six voluntary participants. Two hundred and eighty-nine students completed questionnaires. 85% (n = 246) completed the online lesson. Students agreed the session helped their understanding of key concepts (mean 3.2), was improved by having an actor (mean = 3.6), and was enjoyable (mean = 3.2). Thematic analysis of qualitative questionnaire and interview data revealed three themes: engagement; structure; and attitudes towards social determinants of health. The simulation increased clinical relevance and students gained understanding of the impact of health inequalities upon individuals. This paper indicates flipped learning can increase clinical relevance and engagement in population health and person-centered care. Further work could assess changes in practice and attitudes of future doctors in tackling such global health challenges.

  17. uFlip: Understanding Flash IO Patterns

    DEFF Research Database (Denmark)

    Bouganim, Luc; Jonsson, Bjørn; Bonnet, Philippe

    2009-01-01

    want to establish what kind of IOs should be favored (or avoided) when designing algorithms and architectures for flash-based systems. In this paper, we focus on flash IO patterns, that capture relevant distribution of IOs in time and space, and our goal is to quantify their performance. We define u......FLIP, a benchmark for measuring the response time of flash IO patterns. We also present a benchmarking methodology which takes into account the particular characteristics of flash devices. Finally, we present the results obtained by measuring eleven flash devices, and derive a set of design hints that should drive...

  18. Assessing Behavioral Engagement in Flipped and Non-Flipped Mathematics Classrooms: Teacher Abilities and Other Potential Factors

    Science.gov (United States)

    Hodgson, Theodore R.; Cunningham, Abby; McGee, Daniel; Kinne, Lenore J.; Murphy, Teri J.

    2017-01-01

    There is a growing evidence that flipped classrooms are associated with increased levels of student engagement, as compared to engagement in "traditional" settings. Much of this research, however, occurs in post-secondary classrooms and is based upon self-reported engagement data. This study seeks to extend existing flipped classroom…

  19. A Quasi Experiment to Determine the Effectiveness of a "Partially Flipped" versus "Fully Flipped" Undergraduate Class in Genetics and Evolution

    Science.gov (United States)

    Adams, Alison E. M.; Garcia, Jocelyn; Traustadóttir, Tinna

    2016-01-01

    Two sections of Genetics and Evolution were taught by one instructor. One group (the fully flipped section) had the entire class period devoted to active learning (with background material that had to be watched before class), and the other group (the partially flipped section) had just a portion of class time spent on active learning (with the…

  20. Flipping the IS Classroom - Theory-Driven Design for Large-Scale Lectures

    OpenAIRE

    Oeste, Sarah; Lehmann, Katja; Janson, Andreas; Leimeister, Jan Marco

    2014-01-01

    Universities face the challenge of increasing numbers of students leading to increasingly large lectures, and therefore decreasing interaction and collaboration, which are important factors for individual learning success and satisfaction. With this research-in-progress, we therefore propose a conceptual framework for a blended learning flipped classroom to redesign large-scale IS lectures, recognize the important role of peers in the student journey, and improve interaction. We therefore der...

  1. Complications of Internal Continuous and Perforating External Osteotomy in Primary Rhinoplasty

    OpenAIRE

    Motamed, Sadrollah; Saberi, Alireza; Niazi, Feyzollah; Molaei, Hojjat

    2017-01-01

    BACKGROUND Osteotomy is one of the major steps in rhinoplasty. The aim of study was to compare edema and ecchymosis after external and internal lateral osteotomy in patients who underwent rhinoplasty. METHODS Based on a prospective randomized clinical trial, 168 osteotomies were performed through an external route in a perforating fashion and internal route in a continuous fashion at right or left side respectively in any patient. Subjective scoring system was applied to evaluate edema and ec...

  2. Shortening Oblique Osteotomy with Screw Fixation for Correction of the Lesser Metatarsophalangeal Joints of Rheumatoid Forefoot

    OpenAIRE

    Nishida, Keiichiro; Machida, Takahiro; Horita, Masahiro; Hashizume, Kenzo; Nakahara, Ryuichi; Nasu, Yoshihisa; Ohashi, Hideki; Saiga, Kenta; Ozaki, Toshifumi

    2016-01-01

    The metatarsophalangeal (MTP) joints are often and predominantly affected in rheumatoid arthritis. The aim of the current study was to describe surgical techniques of shortening oblique osteotomy for lesser metatarsal bone with screw fixation at the osteotomy site, and to investigate the short-term clinical outcomes of our procedure. Twenty-seven feet (78 toes) of 24 RA patients underwent the shortening oblique osteotomy for the correction of deformity at the lesser MTP joints. The average Ja...

  3. The "Flipped Classroom" Model for Teaching in the Intensive Care Unit.

    Science.gov (United States)

    Tainter, Christopher R; Wong, Nelson L; Cudemus-Deseda, Gaston A; Bittner, Edward A

    2017-03-01

    The intensive care unit (ICU) is a dynamic and complex learning environment. The wide range in trainee's experience, specialty training, fluctuations in patient acuity and volume, limitations in trainee duty hours, and additional responsibilities of the faculty contribute to the challenge in providing a consistent experience with traditional educational strategies. The "flipped classroom" is an educational model with the potential to improve the learning environment. In this paradigm, students gain exposure to new material outside class and then use class time to assimilate the knowledge through problem-solving exercises or discussion. The rationale and pedagogical foundations for the flipped classroom are reviewed, practical considerations are discussed, and an example of successful implementation is provided. An education curriculum was devised and evaluated prospectively for teaching point-of-care echocardiography to residents rotating in the surgical ICU. Preintervention and postintervention scores of knowledge, confidence, perceived usefulness, and likelihood of use the skills improved for each module. The quality of the experience was rated highly for each of the sessions. The flipped classroom education curriculum has many advantages. This pilot study was well received, and learners showed improvement in all areas evaluated, across several demographic subgroups and self-identified learning styles.

  4. Vodcasts and active-learning exercises in a "flipped classroom" model of a renal pharmacotherapy module.

    Science.gov (United States)

    Pierce, Richard; Fox, Jeremy

    2012-12-12

    To implement a "flipped classroom" model for a renal pharmacotherapy topic module and assess the impact on pharmacy students' performance and attitudes. Students viewed vodcasts (video podcasts) of lectures prior to the scheduled class and then discussed interactive cases of patients with end-stage renal disease in class. A process-oriented guided inquiry learning (POGIL) activity was developed and implemented that complemented, summarized, and allowed for application of the material contained in the previously viewed lectures. Students' performance on the final examination significantly improved compared to performance of students the previous year who completed the same module in a traditional classroom setting. Students' opinions of the POGIL activity and the flipped classroom instructional model were mostly positive. Implementing a flipped classroom model to teach a renal pharmacotherapy module resulted in improved student performance and favorable student perceptions about the instructional approach. Some of the factors that may have contributed to students' improved scores included: student mediated contact with the course material prior to classes, benchmark and formative assessments administered during the module, and the interactive class activities.

  5. Friend or Foe? Flipped Classroom for Undergraduate Electrocardiogram Learning: a Randomized Controlled Study.

    Science.gov (United States)

    Rui, Zeng; Lian-Rui, Xiang; Rong-Zheng, Yue; Jing, Zeng; Xue-Hong, Wan; Chuan, Zuo

    2017-03-07

    Interpreting an electrocardiogram (ECG) is not only one of the most important parts of clinical diagnostics but also one of the most difficult topics to teach and learn. In order to enable medical students to master ECG interpretation skills in a limited teaching period, the flipped teaching method has been recommended by previous research to improve teaching effect on undergraduate ECG learning. A randomized controlled trial for ECG learning was conducted, involving 181 junior-year medical undergraduates using a flipped classroom as an experimental intervention, compared with Lecture-Based Learning (LBL) as a control group. All participants took an examination one week after the intervention by analysing 20 ECGs from actual clinical cases and submitting their ECG reports. A self-administered questionnaire was also used to evaluate the students' attitudes, total learning time, and conditions under each teaching method. The students in the experimental group scored significantly higher than the control group (8.72 ± 1.01 vs 8.03 ± 1.01, t = 4.549, P = 0.000) on ECG interpretation. The vast majority of the students in the flipped classroom group held positive attitudes toward the flipped classroom method and also supported LBL. There was no significant difference (4.07 ± 0.96 vs 4.16 ± 0.89, Z = - 0.948, P = 0.343) between the groups. Prior to class, the students in the flipped class group devoted significantly more time than those in the control group (42.33 ± 22.19 vs 30.55 ± 10.15, t = 4.586, P = 0.000), whereas after class, the time spent by the two groups were not significantly different (56.50 ± 46.80 vs 54.62 ± 31.77, t = 0.317, P = 0.752). Flipped classroom teaching can improve medical students' interest in learning and their self-learning abilities. It is an effective teaching model that needs to be further studied and promoted.

  6. Re-Envisioning the Archaic Higher Education Learning Environment: Implementation Processes for Flipped Classrooms

    Science.gov (United States)

    Rabidoux, Salena; Rottmann, Amy

    2018-01-01

    Flipped classrooms are often utilized in PK-12 classrooms; however, there is also a growing trend of flipped classrooms in higher education. This paper presents the benefits and limitations of implementing flipped classrooms in higher education as well as resources for integrating a flipped classroom design to instruction. The various technology…

  7. Fair loss-tolerant quantum coin flipping

    International Nuclear Information System (INIS)

    Berlin, Guido; Brassard, Gilles; Bussieres, Felix; Godbout, Nicolas

    2009-01-01

    Coin flipping is a cryptographic primitive in which two spatially separated players, who do not trust each other, wish to establish a common random bit. If we limit ourselves to classical communication, this task requires either assumptions on the computational power of the players or it requires them to send messages to each other with sufficient simultaneity to force their complete independence. Without such assumptions, all classical protocols are so that one dishonest player has complete control over the outcome. If we use quantum communication, on the other hand, protocols have been introduced that limit the maximal bias that dishonest players can produce. However, those protocols would be very difficult to implement in practice because they are susceptible to realistic losses on the quantum channel between the players or in their quantum memory and measurement apparatus. In this paper, we introduce a quantum protocol and we prove that it is completely impervious to loss. The protocol is fair in the sense that either player has the same probability of success in cheating attempts at biasing the outcome of the coin flip. We also give explicit and optimal cheating strategies for both players.

  8. Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2011-02-01

    Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed. The mean Merle-d\\'Aubigné score increased from 12.4 preoperatively to 16 at follow-up. Pre-operatively 73 hips were anteverted and 12 were neutral or retroverted. The mean angle of Wiberg improved from 5 degrees to 21 degrees (p < 0.0001) in anteverted hips, and from 9 degrees to 30 degrees in neutral or retroverted hips. The mean angle of Lequesne and de Sèze improved from 6 degrees to 35 degrees (p < 0.0001) in anteverted hips, and in neutral or retroverted hips from 9 degrees to 30 degrees (p < 0.0001). The acetabular index improved from 26 degrees to 8 degrees (p < 0.0001) in anteverted hips, and from 21 degrees to 7 degrees (p < 0.0001) in neutral or retroverted hips. Over the 7 year period the blood loss and operative time improved from 2000 ml to 900 ml and 4 hours to 2 hours respectively. Four hips (four patients) required conversion to total hip replacement. The radiographic correction and improved clinical scores are similar to those in previous studies. This study shows a survival rate of 94% at 58 months following periacetabular osteotomy. The learning curve and the early results of this procedure performed in our academic unit are encouraging.

  9. Students' Perception of a Flipped Classroom Approach to Facilitating Online Project-Based Learning in Marketing Research Courses

    Science.gov (United States)

    Shih, Wen-Ling; Tsai, Chun-Yen

    2017-01-01

    This study investigated students' perception of a flipped classroom approach to facilitating online project-based learning (FC-OPBL) in a marketing research course at a technical university. This combined strategy was aimed at improving teaching quality and learning efficiency. Sixty-seven students taking a marketing research course were surveyed.…

  10. Measuring the Impact of the Flipped Anatomy Classroom: The Importance of Categorizing an Assessment by Bloom's Taxonomy

    Science.gov (United States)

    Morton, David A.; Colbert-Getz, Jorie M.

    2017-01-01

    The flipped classroom (FC) model has emerged as an innovative solution to improve student-centered learning. However, studies measuring student performance of material in the FC relative to the lecture classroom (LC) have shown mixed results. An aim of this study was to determine if the disparity in results of prior research is due to level of…

  11. Piezosurgical osteotomy for harvesting intraoral block bone graft

    Directory of Open Access Journals (Sweden)

    Mahalingam Lakshmiganthan

    2012-01-01

    Full Text Available The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient′s psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device.

  12. Local anesthetic wound infiltration for pain management after periacetabular osteotomy

    OpenAIRE

    Bech, Rune D; Ovesen, Ole; Lindholm, Peter; Overgaard, Søren

    2014-01-01

    Background and purpose To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine) for postoperative analgesia after PAO. Patients and methods We performed a randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov: NCT00815503) in 53 patients undergoing PAO to evaluate the effec...

  13. Development of a Flipped Medical School Dermatology Module.

    Science.gov (United States)

    Fox, Joshua; Faber, David; Pikarsky, Solomon; Zhang, Chi; Riley, Richard; Mechaber, Alex; O'Connell, Mark; Kirsner, Robert S

    2017-05-01

    The flipped classroom module incorporates independent study in advance of in-class instructional sessions. It is unproven whether this methodology is effective within a medical school second-year organ system module. We report the development, implementation, and effectiveness of the flipped classroom methodology in a second-year medical student dermatology module at the University of Miami Leonard M. Miller School of Medicine. In a retrospective cohort analysis, we compared attitudinal survey data and mean scores for a 50-item multiple-choice final examination of the second-year medical students who participated in this 1-week flipped course with those of the previous year's traditional, lecture-based course. Each group comprised nearly 200 students. Students' age, sex, Medical College Admission Test scores, and undergraduate grade point averages were comparable between the flipped and traditional classroom students. The flipped module students' mean final examination score of 92.71% ± 5.03% was greater than that of the traditional module students' 90.92% ± 5.51% ( P flipped methodology to attending live lectures or watching previously recorded lectures. The flipped classroom can be an effective instructional methodology for a medical school second-year organ system module.

  14. Studenters erfaringer med Flipped Classroom i en helsefagutdanning

    Directory of Open Access Journals (Sweden)

    Christine Tørris

    2015-12-01

    Full Text Available Background: The flipped classroom approach has gained increased attention in educational research literature. The purpose of this study was to investigate how students experience a flipped classroom approach in health education, compared to ordinary lectures. Method: Bachelor students (n=25 who watched the video-based material in the flipped classrooms pre-session, answered a questionnaire to evaluate their flipped classroom experience. The questionnaire consisted of both closed and open questions. Results: Ninety six per cent (24/25 of respondents found the video-based material in the pre-session useful. Seventy six per cent (19/25 of respondents found that the flipped classroom approach resulted in the highest learning outcome, over the traditional approach (16%, 4/25. Barriers to the flipped classroom approach was technical problems with the video-based material, such as screen view. Conclusion: The flipped classroom approach is promising as an acceptable approach for teaching in health science curricular in higher education.

  15. Expectations and implementations of the flipped classroom model in undergraduate mathematics courses

    Science.gov (United States)

    Naccarato, Emilie; Karakok, Gulden

    2015-10-01

    The flipped classroom model is being used more frequently in undergraduate mathematics courses. As with any new teaching model, in-depth investigations of both various implementation styles and how the new model improves student learning are needed. Currently, many practitioners have been sharing their implementations of this model. However, there has not yet been an investigation of the various implementations of the model to discern general trends in this movement. With this research goal in mind, we conducted a study exploring various implementations of the flipped classroom model by interviewing 19 faculty members who experienced using this model at 14 different institutes. Results indicate that participants had similar motivations for implementation; however, subsequent implementations were different. In addition, we share participants' perspectives on (a) student learning of pre-requisite, procedural and conceptual knowledge, and (b) how this particular model promotes such knowledge developments. Finally, we provide suggestions for future implementations and research regarding this particular teaching model.

  16. The Effectiveness of a Simulation-Based Flipped Classroom in the Acquisition of Laparoscopic Suturing Skills in Medical Students-A Pilot Study.

    Science.gov (United States)

    Chiu, Hsin-Yi; Kang, Yi-No; Wang, Wei-Lin; Huang, Hung-Chang; Wu, Chien-Chih; Hsu, Wayne; Tong, Yiu-Shun; Wei, Po-Li

    To evaluate the effectiveness of a simulation-based flipped classroom in gaining the laparoscopic skills in medical students. An intervention trial. Taipei Medical University Hospital, an academic teaching hospital. Fifty-nine medical students participating in a 1-hour laparoscopic skill training session were randomly assigned to a conventional classroom (n = 29) or a flipped classroom approach (n = 30) based on their registered order. At the end of the session, instructors assessed participants' performance in laparoscopic suturing and intracorporeal knot-tying using the assessment checklist based on a modified Objective Structured Assessment of Technical Skills tool. Students in the flipped group completed more numbers of stitches (mean [M] = 0.47; standard deviation [SD] = 0.507) than those in the conventional group (M = 0.10; SD = 0.310) (mean difference: 0.37; 95% CI: 0.114-582; p = 0.002). Moreover, students in the flipped group also had higher stitch quality scores (M = 7.17; SD = 2.730) than those in the conventional group (M = 5.14; SD = 1.767) (mean difference = 2.03; 95% CI: 0.83-3.228; p = 0.001). Meanwhile, students in the flipped group had higher pass rates for the second throw (p flipped classroom approach may improve laparoscopic intracorporeal knot-tying skill acquisition in medical students. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Ring flips revisited: (13)C relaxation dispersion measurements of aromatic side chain dynamics and activation barriers in basic pancreatic trypsin inhibitor.

    Science.gov (United States)

    Weininger, Ulrich; Modig, Kristofer; Akke, Mikael

    2014-07-22

    Intramolecular motions of proteins are critical for biological function. Transient structural fluctuations underlie a wide range of processes, including enzyme catalysis, ligand binding to buried sites, and generic protein motions, such as 180° rotation of aromatic side chains in the protein interior, but remain poorly understood. Understanding the dynamics and molecular nature of concerted motions requires characterization of their rates and energy barriers. Here we use recently developed (13)C transverse relaxation dispersion methods to improve our current understanding of aromatic ring flips in basic pancreatic trypsin inhibitor (BPTI). We validate these methods by benchmarking ring-flip rates against the three previously characterized cases in BPTI, namely, Y23, Y35, and F45. Further, we measure conformational exchange for one additional aromatic ring, F22, which can be interpreted in terms of a flip rate of 666 s(-1) at 5 °C. Upon inclusion of our previously reported result that Y21 also flips slowly [Weininger, U., et al. (2013) J. Phys. Chem. B 117, 9241-9247], the (13)C relaxation dispersion experiments thus reveal relatively slow ring-flip rates for five of eight aromatic residues in BPTI. These results are in contrast with previous reports, which have estimated that all rings, except Y23, Y35, and F45, flip with a high rate at ambient temperature. The (13)C relaxation dispersion data result in an updated rank order of ring-flip rates in BPTI, which agrees considerably better with that estimated from a recent 1 ms molecular dynamics trajectory than do previously published NMR data. However, significant quantitative differences remain between experiment and simulation, in that the latter yields flip rates that are in many cases too fast by 1-2 orders of magnitude. By measuring flip rates across a temperature range of 5-65 °C, we determined the activation barriers of ring flips for Y23, Y35, and F45. Y23 and F45 have identical activation parameters

  18. Neurosensory changes of palatal mucousa following Le Fort I osteotomy

    Directory of Open Access Journals (Sweden)

    Bijan Movahedian Attar

    2009-09-01

    Full Text Available

    • BACKGROUND: This study evaluated the sensation of palatal ucosa before and after Le Fort I osteotomy and compared it based on whether greater palatine nerve has been dissected or not.
    • METHODS: Sixteen patients were studied within one week before  urgery and then one week, 6 weeks, 3 months and 6 months after surgery. Four tests including sharp-blunt discrimination, cold perception, pin prick sensation and electrical stimulation were performed.
    • RESULTS: Mean values of electrical stimulation were significantly higher 6 months after surgery (p < 0.05, on the other hand mean values of pin-prick sensation were significantly lower (p < 0.05. All patients regardless of the condition of greater palatine nerve were responsive to cold perception and sharp-blunt discrimination 6 months after surgery.
    • CONCLUSIONS: Following Le Fort I osteotomy, palatal  esponsiveness to electrical stimulation decreases and mechanical hyper sensitization occurs. Dissection of greater palatine nerve was shown to have no effect on the results.
    • KEYWORDS: Lefort I Osteotomy, Palatal Mocousa, Nerve Recovery.

  19. Use of locking plate and screws for triple pelvic osteotomy.

    Science.gov (United States)

    Rose, Scott A; Bruecker, Ken A; Petersen, Steve W; Uddin, Nizam

    2012-01-01

    To evaluate the efficacy and complication rate associated with use of a purpose-specific locking triple pelvic osteotomy (LTPO) plate. Prospective study. Dogs (n = 9; 15 hips). Physical examination, plain film radiography, computed tomography (CT) of the pelvis, and coxofemoral arthroscopy were performed before unilateral triple pelvic osteotomy (TPO) or staged bilateral TPO. Radiographs were taken after each procedure and 3-5, 6-8, and ≥12 weeks postoperatively. Pelvic width was measured at 3 locations to evaluate pelvic canal narrowing. No screw loosening occurred. Complications occurred in only 1 hip (7%) where pullout of the locking plate-screw construct from the caudal iliac segment occurred because of a fracture of the cis-cortex; the dog made a full recovery after a salvage procedure. There was no significant reduction in the cranial pelvic width but a small reduction at the level of the acetabuli and ischiatic tuberosities was noted 3-5 weeks after the 2nd TPO. The LTPO plate was associated with a lower complication rate than previously reported for TPOs using Slocum canine pelvic osteotomy plates (CPOP) and warrants further investigation. Pullout of the caudal plate-screw construct is a complication specific to LTPO implants. Bicortical screw purchase is recommended to prevent fracture of the cis-cortex and implant pullout. © Copyright 2011 by The American College of Veterinary Surgeons.

  20. Using Flipped Classroom Approach to Explore Deep Learning in Large Classrooms

    Directory of Open Access Journals (Sweden)

    Brenda Danker

    2015-01-01

    Full Text Available This project used two Flipped Classroom approaches to stimulate deep learning in large classrooms during the teaching of a film module as part of a Diploma in Performing Arts course at Sunway University, Malaysia. The flipped classes utilized either a blended learning approach where students first watched online lectures as homework, and then completed their assignments and practical work in class; or utilized a guided inquiry approach at the beginning of class using this same process. During the class the lecturers were present to help the students, and in addition, the students were advantaged by being able to help one another. The in-class learning activities also included inquiry-based learning, active learning, and peer-learning. This project used an action research approach to improve the in-class instructional design progressively to achieve its impact of deep learning among the students. The in-class learning activities that was included in the later flipped classes merged aspects of blended learning with an inquiry-based learning cycle which focused on the exploration of concepts. Data was gathered from questionnaires filled out by the students and from short interviews with the students, as well as from the teacher’s reflective journals. The findings verified that the flipped classrooms were able to remodel large lecture classes into active-learning classes. The results also support the possibility of individualised learning for the students as being high as a result of the teacher’s ability to provide one-on-one tutoring through technology-infused lessons. It is imperative that the in-class learning activities are purposefully designed as the inclusion of the exploratory learning through guided inquiry-based activities in the flipped classes was a successful way to engage students on a deeper level and increased the students’ curiosity and engaged them to develop higher-order thinking skills. This project also concluded that

  1. Comparison of maxillary stability after Le Fort I osteotomy for occlusal cant correction surgery and maxillary advanced surgery.

    Science.gov (United States)

    Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Yoshida, Kan; Shimizu, Chika; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

    2007-07-01

    To compare postoperative maxillary stability following Le Fort I osteotomy for the correction of occlusal cant as compared with conventional Le Fort I osteotomy for maxillary advancement. The subjects were 40 Japanese adults with jaw deformities. Of these, 20 underwent a Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) to correct asymmetric skeletal morphology and inclined occlusal cant. The other 20 patients underwent a Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO) to advance the maxilla. Lateral and posteroanterior cephalograms were taken postoperatively and assessed statistically. Thereafter, the 2 groups were followed for time-course changes. There was no significant difference between the 2 groups with regard to time-course changes during the immediate postoperative period. This suggests that maxillary stability after Le Fort I osteotomy for cant correction does not differ from that after Le Fort I osteotomy for maxillary advancement.

  2. The effects of specific drills on the flip turns of freestyle swimmers based on a kinesiology analysis

    Directory of Open Access Journals (Sweden)

    Wen Yuhong

    2016-09-01

    Full Text Available This research aimed to define the key factors in freestyle flip turns via a kinesiology analysis to diagnose swimmers. Hence, specially designed drills were created to improve swimmers’ flip-turn skills and assess the effects of training. Nine Chinese national modern pentathlon athletes ranging in age from 20 to 26 years with an average of 10 years of training experience were tested and trained in this study. The Kistler Performance Analysis System for Swimming was used for the pre- and post-test analyses. A kinesiology analysis of the data from the pre-test was used for the diagnosis and specific drills were adopted for 10 weeks, 3 times per week before the post-test. The comparison of the pre- and post-test performances was used to assess the effects of training. After 10 weeks of specific drill training for flip turns, participants’ turning skills significantly improved. Speed in approaching, somersaulting, pushing-off and gliding all increased. The angles of the knees and hips as well as the force applied improved, which contributed to swimmers’ increased speed. Since the skills needed for a flip turn are complex and not easily diagnosed via observation alone, this kinesiology analysis will make diagnosis objective and easy.

  3. Implementing A Flipped Classroom: A Case Study of Biology Teaching in A Greek High School

    Directory of Open Access Journals (Sweden)

    Angeliki GARIOU-PAPALEXIOU

    2017-07-01

    Full Text Available The purpose of this study was to investigate the application of the model of the “flipped classroom” as a complementary method to school distance education in junior high school Biology. The “flipped classroom” model attempts a different way of organizing the educational process according to which the traditional methods of learning at school and studying at home are interchanged, the learners’ active involvement is supported, their autonomy is reinforced, ICT is utilized and learning occurs partially by distance (blended learning. We performed an action research implementing flipped classroom in Biology teaching in a class of 17 students attending the1st year of junior high school. The educational platform used was the Learning Activity Management System (LAMS. The findings were evaluated qualitative rather than quantitative, and can provide evidence about the prevailing situation. During the action research, it became evident that time management in the classroom was improved. Furthermore, it was observed that students’ involvement in the educational process was also improved. Students had already familiarized themselves with the cognitive aspect of the lesson before entering the class and they considered the learning process as an individual affair which does not only depend on the teacher. The implementation of digital activities accomplished by distance led to taking action and initiative and finally to active learning. School distance education combined with the radical development of ICT can be complementary with the use of various methods, like the “flipped learning”, and give a new perspective and potential to the limited choices of conventional education in the Greek educational system which is worth further investigation.

  4. Model studies of lipid flip-flop in membranes

    DEFF Research Database (Denmark)

    Parisio, Giulia; Ferrarini, Alberta; Sperotto, Maria Maddalena

    2016-01-01

    , and growth heavily depend. Such transverse motion—commonly called flip-flop—has been studied both experimentally and computationally. Experimental investigations face difficulties related to time-scales and probe-induced membrane perturbation issues. Molecular dynamics simulations play an important role...... for the molecular-level understanding of flip-flop. In this review we present a summary of the state of the art of computational studies of spontaneous flip-flop of phospholipids, sterols and fatty acids. Also, we highlight critical issues and strategies that have been developed to solve them, and what remains...

  5. Physical and transportation requirements for a FLIP fueled TRIGA

    International Nuclear Information System (INIS)

    Johnson, A.G.; Ringle, J.C.; Anderson, T.V.

    1977-01-01

    Several major changes to the OSTR Physical Security Plan were required by the NRC prior to the August 1976 receipt and installation of a new core consisting entirely of FLIP fuel. The general nature of these changes will be reviewed along with several decisions we faced during their implementation. At the previous TRIGA Owners' Conference in Salt Lake City, Utah, we reported on Oregon's regulatory program for research reactor emergency response planning and physical security. The latter program was of particular interest to us in light of the projected FLIP fuel shipments. The impact of the State's program for physical security of FLIP fuel during transportation will be presented. (author)

  6. Fitness Probability Distribution of Bit-Flip Mutation.

    Science.gov (United States)

    Chicano, Francisco; Sutton, Andrew M; Whitley, L Darrell; Alba, Enrique

    2015-01-01

    Bit-flip mutation is a common mutation operator for evolutionary algorithms applied to optimize functions over binary strings. In this paper, we develop results from the theory of landscapes and Krawtchouk polynomials to exactly compute the probability distribution of fitness values of a binary string undergoing uniform bit-flip mutation. We prove that this probability distribution can be expressed as a polynomial in p, the probability of flipping each bit. We analyze these polynomials and provide closed-form expressions for an easy linear problem (Onemax), and an NP-hard problem, MAX-SAT. We also discuss a connection of the results with runtime analysis.

  7. Introducing a Flipped Classroom for a Statistics Course

    DEFF Research Database (Denmark)

    Triantafyllou, Eva; Timcenko, Olga

    2014-01-01

    One of the novel ideas in teaching that heavily relies on current technology is the “flipped classroom” approach, or “inverse teaching”. In a flipped classroom the traditional lecture and homework sessions are inverted. Students are provided with online material in order to gain necessary knowledge...... students in a Bachelor program in Media Technology. The results of the experiment revealed some strengths and weaknesses of this instructional model. We conclude that the flipped classroom can be beneficial for students, provided that it is based on a careful design....

  8. Outcomes in chevron osteotomy for Hallux Valgus in a large cohort.

    Science.gov (United States)

    van Groningen, Bart; van der Steen, M C Marieke; Reijman, Max; Bos, Janneke; Hendriks, Johannes G E

    2016-12-01

    Clinical and radiological related outcomes have been reported for Chevron osteotomy as correction for mild to moderate hallux valgus, but only for relatively small patient series. Moreover, evaluation of the patient's point of view has mostly been conducted by means of more physician-based outcome measures. The goal of this study was to evaluate the effect of the Chevron osteotomy for hallux valgus on patients' daily lives using the Foot and Ankle Outcome Score (FAOS) as a validated and a hallux valgus specific patient reported outcome measure (PROM). Secondary outcome measures were radiological correction, complication rate, and re-operations. All 438 Chevron procedures (336 patients), at two surgical hospital sites in the period between January 2010 and October 2014, were retrospectively evaluated with a follow-up of at least 6 months. Patients were invited to fill in a cross-sectional online FAOS. For the FAOS, a total response of 60% was achieved. The FAOS ranged between 71 and 88 with a follow-up of on average 36 months. Patients with an undercorrection of their hallux valgus (11.6% of the procedures) scored significantly lower on three subscales of the FAOS (range between 61 and 77 versus 72-84). Patients who had a reoperation (12.6% of the procedures) also scored significantly lower on four subscales: 58-100 versus 73-89. Postoperative radiological measurements improved significantly with a mean difference of 6.1 (5.9; 6.4) degrees for the intermetatarsal angle and 13.7 (13.0; 14.5) degrees for the hallux valgus angle. In this large study cohort, Chevron osteotomy for hallux valgus offers good PROM scores on FAOS. These scores were significantly lower in patients with radiological undercorrection or with a reoperation. Results of the FAOS appear to modulate with physician based outcomes and therapeutic incidents. Improvement of outcome may therefore well be possible by increased attention on these surgical details. Copyright © 2016 Elsevier Ltd. All rights

  9. Use of a percutaneous osteotomy with plate fixation in hallux valgus correction.

    Science.gov (United States)

    Díaz Fernández, Rodrigo

    2017-09-20

    With hundreds of operative methods described for correction of hallux valgus we can state that the ideal surgical treatment is still controversial. The Bösch technique has been used as a percutaneous way of correcting hallux valgus deformities with the use of a pin fixation. The aim of this study is to evaluate a new method of fixation by using a percutaneous locking plate. Between June 2013 and January 2015, 24 consecutive percutaneous subcapital osteotomies of the first metatarsal bone were performed for the treatment of painful hallux valgus deformities in 24 patients. Additional surgical procedures included DMMO's (Distal Metatarsal Minimally-Invasive Osteotomies) in 12 of the operated feet (44.44%); minor digits were corrected in 7 cases (25.9%). An Akin procedure was performed in 81% of cases and all cases underwent an adductor hallucis tenotomy. All patients were clinically assessed using the AOFAS score. Radiographic measures included the preoperative and postoperative values of the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), and the Distal Metatarsal Articular Angle (DMAA). The mean correction achieved improved for AHV from 36.57±7.1 to 12.22±8.69°, for IMA from 13.8±1.59 to 7.08±2.72 and for DMAA from 13.98±7.38 to 6.07±4.99. Clinically, scores on the AOFAS scale improved from a 45.8±9.6 to 91.29±9.8. Although healing of the osteotomies was observed radiographically within 6 to 12 weeks, two cases (8.3%) exhibited delayed healing. There were no cases of nonunion. There were no superficial or deep infections or wound healing problems. Plate had to be removed in 3 cases (12.5%). This technique modification is an acceptable procedure to correct hallux valgus in patients with a moderate level of deformity. Level IV. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  10. Return to sport activities after medial displacement calcaneal osteotomy and flexor digitorum longus transfer.

    Science.gov (United States)

    Usuelli, F G; Di Silvestri, C A; D'Ambrosi, R; Maccario, C; Tan, E W

    2018-03-01

    Medial displacement calcaneal osteotomy with flexor digitorum longus transfer is a common treatment for the management of the adult flatfoot associated with posterior tibial tendon dysfunction. In the literature, there is a paucity of information regarding the ability of patients to return to sport and recreational activities after this surgical procedure. The purpose of this retrospective clinical study was to assess the rate and type of athletic activities that patients participated in before and after medial displacement calcaneal osteotomy with flexor digitorum longus transfer. A consecutive series of 42 patients with a mean age at surgery of 41 years (range 19-74 years) was evaluated with a minimum follow-up of 24 months (range 18-31 months). Pre- and post-operative sporting activities were assessed. At final follow-up, patients were asked to complete a Sports Athlete Foot and Ankle Score (SAFAS). Each patient was also evaluated with weight-bearing radiographs of the foot before surgery and at final follow-up. Preoperatively, 27 of 42 (64.3 %) patients were engaged in athletic activities, participating in an average of 1.4 h/week (range 0-6 h/week); post-operatively, 36/42 (85.7 %) participated in sport and recreational activities for an average of 3.5 h/week (range 0-15 h/week). Meary's angle improved significantly from 11.5 ± 6.2 degrees preoperatively to 7.0 ± 5.7 degrees at final follow-up (p < 0.01); calcaneal pitch improved significantly from 16.5 ± 4.6 degrees to 19.0 ± 5.0 degrees (p < 0.01). At final follow-up, patients demonstrated good SAFASs in symptom tolerance (86.4 %), pain tolerance (89.0 %), daily living performance (96.1 %), and sports performance (86.7 %). The majority of patients returned to sports and recreational activity after medial displacement calcaneal osteotomy and flexor digitorum longus for the treatment of adult flatfoot associated with posterior tibial tendon dysfunction. III.

  11. Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH.

    Science.gov (United States)

    Albers, Christoph E; Steppacher, Simon D; Ganz, Reinhold; Tannast, Moritz; Siebenrock, Klaus A

    2013-05-01

    Although periacetabular osteotomy (PAO) for developmental dysplasia of the hip (DDH) provides conceptual advantages compared with other osteotomies and reportedly is associated with joint survivorship of 60% at 20 years, the beneficial effect of proper acetabular reorientation with concomitant arthrotomy and creation of femoral head-neck offset on 10-year hip survivorship remains unclear. We asked the following questions: (1) Does the 10-year survivorship of the hip after PAO improve with proper acetabular reorientation and a spherical femoral head; (2) does the Merle d'Aubigné-Postel score improve; (3) can the progression of osteoarthritis (OA) be slowed; and (4) what factors predict conversion to THA, progression of OA, or a Merle d'Aubigné-Postel score less than 15 points? We retrospectively reviewed 147 patients who underwent 165 PAOs for DDH with two matched groups: Group I (proper reorientation and spherical femoral head) and Group II (improper reorientation and aspherical femoral head). We compared the Kaplan-Meier survivorship, Merle d'Aubigné-Postel scores, and progression of OA in both groups. A Cox regression analysis (end points: THA, OA progression, or Merle d'Aubigné-Postel score less than 15) was performed to detect factors predicting failure. The minimum followup was 10 years (median, 11 years; range, 10-14 years). An increased survivorship was found in Group I. The Merle d'Aubigné-Postel score did not differ. Progression of OA in Group I was slower than in Group II. Factors predicting failure included greater age, lower preoperative Merle d'Aubigné-Postel score, and the presence of a Trendelenburg sign, aspherical head, OA, subluxation, postoperative acetabular retroversion, excessive acetabular anteversion, and undercoverage. Proper acetabular reorientation and the creation of a spherical femoral head improve long-term survivorship and decelerate OA progression in patients with DDH.

  12. The Double Flip: Applying a Flipped Learning Approach to Teach the Teacher and Improve Student Satisfaction

    Science.gov (United States)

    Kehoe, Thomas; Schofield, Penelope; Branigan, Elizabeth; Wilmore, Michael

    2018-01-01

    This paper describes a professional development (PD) program for academics at an Australian university designed to model good blended curriculum design and effective use of contemporary learning technologies. It evaluates a case study from the pilot of this program involving a postgraduate psychology course to illustrate one of the most…

  13. Bit-commitment-based quantum coin flipping

    International Nuclear Information System (INIS)

    Nayak, Ashwin; Shor, Peter

    2003-01-01

    In this paper we focus on a special framework for quantum coin-flipping protocols, bit-commitment-based protocols, within which almost all known protocols fit. We show a lower bound of 1/16 for the bias in any such protocol. We also analyze a sequence of multiround protocols that tries to overcome the drawbacks of the previously proposed protocols in order to lower the bias. We show an intricate cheating strategy for this sequence, which leads to a bias of 1/4. This indicates that a bias of 1/4 might be optimal in such protocols, and also demonstrates that a more clever proof technique may be required to show this optimality

  14. Flip-chip integrated optical wireless transceivers

    Science.gov (United States)

    O'Brien, Dominic C.; Faulkner, Grahame E.; Zyambo, Emmanuel B.; Edwards, David J.; Stavrinou, Paul N.; Parry, Gareth; Bellon, Jacques; Sibley, Martin J. N.; Lalithambika, Vinod A.; Joyner, Valencia M.; Samsudin, Rina J.; Holburn, David M.; Mears, Robert J.

    2002-12-01

    The widespread use of Optical LANs is dependent on the ability to fabricate low cost transceiver components. These are usually complex, and fabrication involves the integration of optoelectronic and electronic devices, as well as optical components. A consortium of four UK universities are currently involved in a project to demonstrate integrated optical wireless transceiver subsystems that can provide eye-safe line of sight in-building communication at 155Mbit/s and above. In this paper we discuss the flip-chip integration of two-dimensional arrays of novel microcavity LEDs with custom CMOS integrated circuits in order to produce solid state tracking emitters. Design, fabrication and integration of these structures are detailed. The scaleability and future capability available given further optimisation and development of these systems is also discussed.

  15. The influence of foot geometry on the calcaneal osteotomy angle based on two-dimensional static force analyses

    NARCIS (Netherlands)

    Reilingh, M.L.; Tuijthof, G.J.M.; Van Dijk, C.N.; Blankevoort, L.

    2011-01-01

    Background: Malalignment of the hindfoot can be corrected with a calcaneal osteotomy (CO). A well-selected osteotomy angle in the sagittal plane will reduce the shear force in the osteotomy plane while walking. The purpose was to determine the presence of a relationship between the foot geometry and

  16. The influence of foot geometry on the calcaneal osteotomy angle based on two-dimensional static force analyses

    NARCIS (Netherlands)

    Reilingh, M. L.; Tuijthof, G. J. M.; van Dijk, C. N.; Blankevoort, L.

    2011-01-01

    Malalignment of the hindfoot can be corrected with a calcaneal osteotomy (CO). A well-selected osteotomy angle in the sagittal plane will reduce the shear force in the osteotomy plane while walking. The purpose was to determine the presence of a relationship between the foot geometry and loading of

  17. Correction accuracy and collateral laxity in open versus closed wedge high tibial osteotomy. A one-year randomised controlled study.

    NARCIS (Netherlands)

    Gaasbeek, R.D.A.; Nicolaas, L.; Rijnberg, W.J.; Loon, C.J.M. van; Kampen, A. van

    2010-01-01

    In a randomised clinical trial in 50 patients with symptomatic osteoarthritis of the medial compartment of the knee, the clinical results of high tibial osteotomy (HTO) according to the open wedge osteotomy (OWO) and closed wedge osteotomy (CWO) were compared. In both groups locked plate fixation

  18. Computer-assisted planning and navigation for corrective distal radius osteotomy, based on pre- and intraoperative imaging

    NARCIS (Netherlands)

    Dobbe, J. G. G.; Strackee, S. D.; Schreurs, A. W.; Jonges, R.; Carelsen, B.; Vroemen, J. C.; Grimbergen, C. A.; Streekstra, G. J.

    2011-01-01

    Malunion after a distal radius fracture is very common and if symptomatic, is treated with a so-called corrective osteotomy. In a traditional distal radius osteotomy, the radius is cut at the fracture site and a wedge is inserted in the osteotomy gap to correct the distal radius pose. The standard

  19. ["Flipped classroom" teaching model into the curriculum of Theories of Different Schools of Acupuncture and Moxibustion:exploration and practice].

    Science.gov (United States)

    Liu, Mailan; Yuan, Yiqin; Chang, Xiaorong; Tang, Yulan; Luo, Jian; Li, Nan; Yu, Jie; Yang, Qianyun; Liu, Mi

    2016-08-12

    The "flipped classroom" teaching model practiced in the teaching of Theories of Different Schools of Acupuncture and Moxibustion curriculum was introduced. Firstly, the roles and responsibilities of teachers were clarified, indicating teachers provided examples and lectures, and a comprehensive assessment system was established. Secondly, the "flipped classroom" teaching model was split into online learning, classroom learning and offline learning. Online learning aimed at forming a study report by a wide search of relevant information, which was submitted to teachers for review and assessment. Classroom learning was designed to communicate study ideas among students and teachers. Offline learning was intended to revise and improve the study report and refined learning methods. Lastly, the teaching practice effects of "flip classroom" were evaluated by comprehensive rating and questionnaire assessment, which assessed the overall performance of students and overall levels of paper; the learning ability was enhanced, and the interest and motivation of learning were also improved. Therefore, "flipped classroom" teaching mode was suitable for the curriculum of Theories of Different Schools of Acupuncture and Moxibustion , and could be recommended into the teaching practice of related curriculum of acupuncture and tuina.

  20. Periacetabular Osteotomy in patients with Hip Dysplasia investigated with Imaging Modalities

    DEFF Research Database (Denmark)

    Mechlenburg, Inger

    2016-01-01

    The minimal invasive periacetabular osteotomy (PAO) is a joint-preserving procedure that effectively corrects hip dysplasia, provides pain relief, improved radiographic results and a low rate of complications. The aim of this doctoral dissertation was to examine biological changes in bone...... research question “Which biological changes take place in bone and cartilage 2-10 years after PAO?”. In Chapter 3, a precise and efficient method for estimating the thickness of the articular cartilage in the hip joint is developed using stereologic methods and Magnetic Resonance Imaging (MRI). The method...... 7 investigates the long-term changes in cartilage thickness and volume of subchondral bone cysts measured with MRI and stereology 10 years after PAO. The second research question “What is the level of changes in blood perfusion and bone formation in the acetabular fragment after PAO?” is evaluated...

  1. Long-Term Results of Cementless Total Hip Arthroplasty With Subtrochanteric Shortening Osteotomy in Crowe Type IV Developmental Dysplasia.

    Science.gov (United States)

    Wang, Duan; Li, Ling-Li; Wang, Hao-Yang; Pei, Fu-Xing; Zhou, Zong-Ke

    2017-04-01

    When surgeons reconstruct hips with a high dislocation related to severe developmental dysplasia of the hip (DDH) in total hip arthroplasty (THA), archiving long-term stable implant fixation and improving patient function and satisfaction remain challenging. The purpose of this study was to evaluate the 10-year outcomes of transverse subtrochanteric shortening osteotomy in cementless, modular THA in Crowe type IV-Hartofilakidis type III DDH. We reviewed 62 patients (76 hips) who underwent cementless THA with transverse subtrochanteric shortening osteotomy from 2002-2010. There were 49 women and 13 men with a mean age of 38.8 years, all of whom had Crowe type IV DDH. Mean follow-up period was 10 years. The acetabular cup was implanted in placement of the anatomical hip center in all hips. The mean Harris Hip Score significantly improved from 38.8 points to 86.1 points. Similarly, modified Merle d'Aubigne and Postel Hip Score, Hip dysfunction and Osteoarthritis Outcome Score, and SF-12 also significantly improved. The mean limb length discrepancy was reduced from 4.3 cm to 1.0 cm. At mean follow-up of 10 years, there were 3 cases of postoperative dislocation, 2 cases of transient nerve palsy, 1 case of nonunion, and 4 cases of intraoperative fracture. Revision surgery was performed in 2 patients due to isolated loosening of acetabular component and femoral stem, respectively. Our data demonstrated that the cementless, modular THA combined with transverse subtrochanteric shortening osteotomy was an effective and reliable technique with high rates of successful fixation of the implants and satisfactory clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. PENGARUH FLIPPED MASTERY CLASSROM TERHADAP PEROLEHAN HASIL BELAJAR KOGNITIF MAHASISWA

    Directory of Open Access Journals (Sweden)

    Muhammad Ridha

    2016-04-01

    Tujuan dari penelitian ini adalah untuk mengetahui pengaruh penerapan strategi flipped mastery classroom terhadap perolehan hasil belajar kognitif mahasiswa pada matakuliah psikologi pendidikan. Subjek dalam penelitian ini adalah mahasiswa Jurusan Teknologi Pendidikan Universitas Negeri Malang semester genap tahun ajaran 2015/2016 pada kelas utuh. Kelas eksperimen dibelajarkan dengan strategi flipped-mastery classroom dan kelas kontrol dibelajarkan dengan strategi tradisional.  Penelitian ini menggunakan rancangan kuasi eksperimen Non Equivalent Control Group Design. Hasil penelitian menunjukkan bahwa penerapan strategi flipped mastery classroom memberikan pengaruh positif terhadap perolehan hasil belajar kognitif mahasiswa. Perolehan hasil belajar kognitif mahasiswa yang dibelajarkan dengan strategi flipped-mastery lebih tinggi secara signifikan dari pada perolehan hasil belajar mahasiswa yang dibelajarkan dengan strategi tradisional.

  3. Online Learning Room for ”Flipped Classroom”

    DEFF Research Database (Denmark)

    Bugge, Ellen Margrethe; Nielsen, Linda Susanna Hauschildt

    2014-01-01

    learning with learning in the classroom. The learning room must support the students’ unassisted learning, their preparation for class and their preparation for supervision in both a motivating and clear way. At the Nursing Education Programme at University College Lillebaelt in Denmark, we have been...... working actively and innovatively to create a didactic design in our online learning rooms in our LMS that satisfy the demands for flipped learning and at the same time adapted to the special needs of each learning module at the nursing education programme. Keywords: Online learning, flipped classroom......Abstract The “flipped classroom” learning concept is an alternative way of teaching & learning. The fundamental idea of the "flipped classroom" is to change the way students prepare for classes and the work that takes place when the students are together in the classroom. This integrates online...

  4. Teachers' development and reflection in the flipped classroom

    DEFF Research Database (Denmark)

    Triantafyllou, Evangelia; Timcenko, Olga; Kofoed, Lise

    2017-01-01

    The flipped classroom is an instruction method that has gained momentum during the last years due to technological advances allowing the online sharing of teaching material and learning activities. Bishop and Verleger defined the flipped classroom as “...an educational technique that consists....... Our experience has shown that teachers reflected on their own teaching even before the event of teaching, because the design of a flipped classroom requires careful consideration of the course structure and content. In many cases, the teachers had to come up with new activities or redesign the whole...... course in order to adjust it to the flipped classroom model. We have also seen that these considerations have forced teachers to also reconsider the learning objectives of specific activities. Another aspect that promoted reflection was the production of video lectures. Finally, teachers reflected...

  5. Polymer Flip Chips with Extreme Temperature Stability in Space Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of the proposed SBIR Phase I program is to develop highly thermally and electrically conductive nanocomposites for space-based flip chips for...

  6. Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one-year results

    NARCIS (Netherlands)

    Marti, R. K.; Verhagen, R. A.; Kerkhoffs, G. M.; Moojen, T. M.

    2001-01-01

    Although high tibial osteotomy has been proved effective for the treatment of painful osteoarthritis of the medial compartment of the knee, the role of proximal tibial varus osteotomy for the treatment of painful osteoarthritis of the lateral compartment still remains controversial. From 1974 to

  7. Multi directional intertrochanteric osteotomy for primary and secondary osteoarthritis--results after 15 to 29 years

    NARCIS (Netherlands)

    Haverkamp, D.; Eijer, H.; Patt, T. W.; Marti, R. K.

    2006-01-01

    Between 1974 and 1987, 276 intertrochanteric osteotomies were performed in 217 patients. In 48 hips the osteotomy was done for idiopathic osteoarthritis. In 166 hips the osteoarthritis was secondary to acetabular dysplasia, in 23 to trauma, in 14 to slipped capital femoral epiphysis, in five to

  8. Using a flipped classroom in an algebra-based physics course

    Science.gov (United States)

    Smith, Leigh

    2013-03-01

    The algebra-based physics course is taken by Biology students, Pre-Pharmacy, Pre-Medical, and other health related majors such as medical imaging, physical therapy, and so on. Nearly 500 students take the course each Semester. Student learning is adversely impacted by poor math backgrounds as well as extensive work schedules outside of the classroom. We have been researching the use of an intensive flipped-classroom approach where students spend one to two hours each week preparing for class by reading the book, completing a series of conceptual problems, and viewing videos which describe the material. In class, the new response system Learning Catalytics is used which allows much richer problems to be posed in class and includes sketching figures, numerical or symbolic entries, short answers, highlighting text, etc in addition to the standard multiple choice questions. We make direct comparison of student learning for 1200 sudents who have taken the same tests, 25% of which used the flipped classroom approach, and 75% who took a more standard lecture. There is significant evidence of improvements in student learning for students taking the flipped classroom approach over standard lectures. These benefits appear to impact students at all math backgrounds.

  9. Pharmacy Students’ Performance and Perceptions in a Flipped Teaching Pilot on Cardiac Arrhythmias

    Science.gov (United States)

    Ip, Eric J.; Lopes, Ingrid; Rajagopalan, Vanishree

    2014-01-01

    Objective. To implement the flipped teaching method in a 3-class pilot on cardiac arrhythmias and to assess the impact of the intervention on academic performance and student perceptions. Design. An intervention group of 101 first-year pharmacy students, who took the class with the flipped teaching method, were supplied with prerecorded lectures prior to their 3 classes (1 class in each of the following subjects: basic sciences, pharmacology, and therapeutics) on cardiac arrhythmias. Class time was focused on active-learning and case-based exercises. Students then took a final examination that included questions on cardiac arrhythmias. The examination scores of the intervention group were compared to scores of the Spring 2011 control group of 105 first-year students who took the class with traditional teaching methods. An online survey was conducted to assess student feedback from the intervention group. Assessment. The mean examination scores of the intervention group were significantly higher than the mean examination scores of the control group for the cardiac arrhythmia classes in pharmacology (with 89.6 ± 2.0% vs 56.8 ± 2.2%, respectively) and therapeutics (89.2 ± 1.4% vs 73.7 ± 2.1%, respectively). The survey indicated higher student satisfaction for flipped classes with highly rated learning objectives, recordings, and in-class activities. Conclusion. Use of the flipped teaching method in a 3-class pilot on cardiac arrhythmias improved examination scores for 2 of the 3 classes (pharmacology and therapeutics). Student satisfaction was influenced by the quality of the learning objectives, prerecorded lectures, and inclass active-learning activities. PMID:25657372

  10. Pharmacy students' performance and perceptions in a flipped teaching pilot on cardiac arrhythmias.

    Science.gov (United States)

    Wong, Terri H; Ip, Eric J; Lopes, Ingrid; Rajagopalan, Vanishree

    2014-12-15

    To implement the flipped teaching method in a 3-class pilot on cardiac arrhythmias and to assess the impact of the intervention on academic performance and student perceptions. An intervention group of 101 first-year pharmacy students, who took the class with the flipped teaching method, were supplied with prerecorded lectures prior to their 3 classes (1 class in each of the following subjects: basic sciences, pharmacology, and therapeutics) on cardiac arrhythmias. Class time was focused on active-learning and case-based exercises. Students then took a final examination that included questions on cardiac arrhythmias. The examination scores of the intervention group were compared to scores of the Spring 2011 control group of 105 first-year students who took the class with traditional teaching methods. An online survey was conducted to assess student feedback from the intervention group. The mean examination scores of the intervention group were significantly higher than the mean examination scores of the control group for the cardiac arrhythmia classes in pharmacology (with 89.6 ± 2.0% vs 56.8 ± 2.2%, respectively) and therapeutics (89.2 ± 1.4% vs 73.7 ± 2.1%, respectively). The survey indicated higher student satisfaction for flipped classes with highly rated learning objectives, recordings, and in-class activities. Use of the flipped teaching method in a 3-class pilot on cardiac arrhythmias improved examination scores for 2 of the 3 classes (pharmacology and therapeutics). Student satisfaction was influenced by the quality of the learning objectives, prerecorded lectures, and inclass active-learning activities.

  11. Ontology-Navigated Tutoring System for Flipped-Mastery Model

    OpenAIRE

    Masao Okabe

    2016-01-01

    Nowadays, in Japan, variety of students get into a university and one of the main roles of introductory courses for freshmen is to make such students well prepared for subsequent intermediate courses. For that purpose, the flipped-mastery model is not enough because videos usually used in a flipped classroom is not adaptive and does not fit all freshmen with different academic performances. This paper proposes an ontology-navigated tutoring system called EduGraph. Using EduGraph, students can...

  12. Pengaruh Flipped Mastery Classrom Terhadap Perolehan Hasil Belajar Kognitif Mahasiswa

    OpenAIRE

    Ridha, Muhammad; Setyosari, Punaji; Kuswandi, Dedi

    2016-01-01

    This study aims to investigate the effect of flipped mastery classroom towards students learning outcomes on educational psychology subject. Subject of this research are students of Educational Department of State University of Malang academic year 2015/2016 in intact group. Flipped mastery classroom is a strategy uses in experimental group and traditional strategy is a strategy uses in control group. The design of the research is Quasi Experiment Non Equivalent Control Group Design. The resu...

  13. Quantum protocol for cheat-sensitive weak coin flipping.

    Science.gov (United States)

    Spekkens, R W; Rudolph, Terry

    2002-11-25

    We present a quantum protocol for the task of weak coin flipping. We find that, for one choice of parameters in the protocol, the maximum probability of a dishonest party winning the coin flip if the other party is honest is 1/sqrt[2]. We also show that if parties restrict themselves to strategies wherein they cannot be caught cheating, their maximum probability of winning can be even smaller. As such, the protocol offers additional security in the form of cheat sensitivity.

  14. Dynamics of Methylated Cytosine Flipping by UHRF1.

    Science.gov (United States)

    Kilin, Vasyl; Gavvala, Krishna; Barthes, Nicolas P F; Michel, Benoît Y; Shin, Dongwon; Boudier, Christian; Mauffret, Olivier; Yashchuk, Valeriy; Mousli, Marc; Ruff, Marc; Granger, Florence; Eiler, Sylvia; Bronner, Christian; Tor, Yitzhak; Burger, Alain; Mély, Yves

    2017-02-15

    DNA methylation patterns, which are critical for gene expression, are replicated by DNA methyltransferase 1 (DNMT1) and ubiquitin-like containing PHD and RING finger domains 1 (UHRF1) proteins. This replication is initiated by the recognition of hemimethylated CpG sites and further flipping of methylated cytosines (mC) by the Set and Ring Associated (SRA) domain of UHRF1. Although crystallography has shed light on the mechanism of mC flipping by SRA, tools are required to monitor in real time how SRA reads DNA and flips the modified nucleobase. To accomplish this aim, we have utilized two distinct fluorescent nucleobase surrogates, 2-thienyl-3-hydroxychromone nucleoside (3HCnt) and thienoguanosine ( th G), incorporated at different positions into hemimethylated (HM) and nonmethylated (NM) DNA duplexes. Large fluorescence changes were associated with mC flipping in HM duplexes, showing the outstanding sensitivity of both nucleobase surrogates to the small structural changes accompanying base flipping. Importantly, the nucleobase surrogates marginally affected the structure of the duplex and its affinity for SRA at positions where they were responsive to base flipping, illustrating their promise as nonperturbing probes for monitoring such events. Stopped-flow studies using these two distinct tools revealed the fast kinetics of SRA binding and sliding to NM duplexes, consistent with its reader role. In contrast, the kinetics of mC flipping was found to be much slower in HM duplexes, substantially increasing the lifetime of CpG-bound UHRF1, and thus the probability of recruiting DNMT1 to faithfully duplicate the DNA methylation profile. The fluorescence-based approach using these two different fluorescent nucleoside surrogates advances the mechanistic understanding of the UHRF1/DNMT1 tandem and the development of assays for the identification of base flipping inhibitors.

  15. Using the flipped classroom in graduate nursing education.

    Science.gov (United States)

    Critz, Catharine M; Knight, Diane

    2013-01-01

    A flipped classroom is a pedagogical model that involves having students view online lectures, read current evidence-based articles, and complete text readings prior to class. Students then come to class ready to actively engage in collaborative learning through case scenarios, small group discussion, or other meaningful, interactive activities. The flipped classroom model described here was an overwhelming success for both students and faculty.

  16. A cluster expansion for interacting spin-flip processes

    Directory of Open Access Journals (Sweden)

    Campanino Massimo

    2017-01-01

    Full Text Available We consider a system of spin flip processes, one-for each point of ℤ${\\mathbb Z}$, interacting through an Ising type interaction. We construct a cluster expansion and prove that it is convergent when the intensity h of the spin-flip processes is sufficiently high. The system is relevant in the study of the ground state of a quantum Ising process with transverse magnetic field.

  17. Posterior wedge osteotomy and debridement for Andersson lesion with severe kyphosis in ankylosing spondylitis.

    Science.gov (United States)

    Liang, Yan; Tang, Xiangyu; Zhao, Yongfei; Wang, Zheng

    2017-03-31

    Andersson lesion is a well-known complication in ankylosing spondylitis. Recently, owing to the worry about the healing of fracture, some scholars advocated additional anterior surgery or other procedures were necessary, which increase the risk of the nerve injury. The purpose of this study is to introduce our experience and to explore the efficacy and feasibility of posterior wedge osteotomy and debridement through Andersson Lesion for surgical treatment of severe kyphosis in ankylosing spondylitis. From January 2012 to January 2014, a retrospective study of 14 Andersson lesion patients with severe kyphosis in ankylosing spondylitis treated with surgery was completed with an at least 2-year follow-up. The debridement procedure, before posterior wedge osteotomy in posterior approach, must scrape all sclerosis bone until healthy cancellous bone appears. Radiographic and clinical results and complications were assessed with an average follow-up of 24 months. The CT scan was obtained preoperatively and at the final follow-up to assess the displacement of the fracture preoperatively, the safety of screw insertion, the healing of the fracture at the final follow-up. The Bridwell interbody fusion grading system was used to assess the healing of the fracture. Local kyphosis was substantially corrected from 51.7 ± 15.6 to 7.1 ± 19.5, with a mean correction of 44°. The global kyphosis (GK) changed from 60.6 ± 28.3 to 20.3 ± 10.3 (P = 0.000). The mean VAS back pain scores decreased from 6.7 ± 0.8 preoperatively to 0.75 ± 0.6 after a 2-year follow-up (P = 0.000). The ODI score improved from 60.56 ± 15.1% preoperatively to 23.46 ± 8.2% after a 2-year follow-up (P = 0.000). The CT scan showed solid fusion at the level of the AL, and no internal fixation loose. All patients achieved grade 1 fusion. No major complication occurred. The posterior wedge osteotomy and debridement through AL can be used to correct the severe

  18. Medial Displacement Calcaneal Osteotomy: A Comparison of Screw Versus Locking Plate Fixation.

    Science.gov (United States)

    Saxena, Amol; Patel, Rajan

    Locking plate fixation is becoming more popular for fixation of lower extremity osteotomies. The present study evaluated locking plate fixation compared with screw fixation in the medial displacement calcaneal osteotomy procedure, measuring the outcomes and rate of hardware removal. The procedure was performed on 30 patients, 31 times, with 17 undergoing single screw fixation and 14 undergoing locking plate fixation. The return to activity was 6.87 ± 1.43 months, including some patients for whom running was their main activity. No malunions, nonunions, displacements, or infections developed. In 3 patients (21.4%), the locking plate was removed compared with 1 patient (5.9%) who required screw removal. The difference was not significant (p = .30). No differences were found in their postoperative American Orthopaedic Foot and Ankle Scale scores (91.9 ± 7.7 with plates versus 94.4 ± 5.8 with screws; p = .36). The Roles and Maudsley scores were the same in the 2 groups preoperatively at 4.0 ± 0.0, with the postoperative scores improving to 1.50 ± 0.5 and 1.41 ± 0.5 for the plate and screw group, respectively (p = .62). No significant increase was seen for patients undergoing hardware removal, regardless of the adjunctive procedure used (i.e., flexor digitorum longus/Kidner, Lapidus or midfoot fusion, subtalar arthroereisis, and endoscopic gastrocnemius recession). The stage of posterior tibialis dysfunction had no significant difference in the postoperative scores. From the results of the present study, we have concluded that using a locking plate or a single screw for fixation of the medial displacement calcaneal osteotomy provides acceptable patient outcomes and that the differences in the rate of hardware removal were not statistically significant between the 2 groups. Copyright © 2016. Published by Elsevier Inc.

  19. Loss of bone strength after intramedullary nailing. Torsion tests of tibial osteotomies in rabbits.

    Science.gov (United States)

    Kaartinen, E; Paavolainen, P; Holmström, T; Slätis, P

    1985-12-01

    Rigid intramedullary nailing was used in 75 rabbits to stabilize a transverse osteotomy of the midshaft of the tibia. In 36 additional rabbits intramedullary nailing was performed without osteotomy. No additional external immobilization was used postoperatively. After removal of the nail the mechanical strength of the tibiofibular bones was tested torsiometrically in 30 osteotomized and 18 non-osteotomized animals from 3 to 24 weeks after the operation. At 3 weeks the torsional load fractured all osteotomized bones through the osteotomy line. At later stages a spiral fracture occurred either crossing or close to the osteotomy area, usually distal to the tibiofibular junction. The increase in mechanical strength of the osteotomized bones reached a maximum at 6 weeks and then decreased. The strength of the non-osteotomized nailed bones also decreased slightly. The results suggest that rigid intramedullary nailing, although providing good conditions for early consolidation of experimental osteotomy, leads secondarily to deterioration of the mechanical properties of tubular bone.

  20. Complications of Internal Continuous and Perforating External Osteotomy in Primary Rhinoplasty

    Science.gov (United States)

    Motamed, Sadrollah; Saberi, Alireza; Niazi, Feyzollah; Molaei, Hojjat

    2017-01-01

    BACKGROUND Osteotomy is one of the major steps in rhinoplasty. The aim of study was to compare edema and ecchymosis after external and internal lateral osteotomy in patients who underwent rhinoplasty. METHODS Based on a prospective randomized clinical trial, 168 osteotomies were performed through an external route in a perforating fashion and internal route in a continuous fashion at right or left side respectively in any patient. Subjective scoring system was applied to evaluate edema and ecchymosis on 1st, 3rd, 7th, and 30th days after surgery. RESULTS Edema and ecchymosis were the same in both types of osteotomies. CONCLUSION Regarding edema and ecchymosis, there was not any significant difference between external and internal osteotomies in rhinoplasty. PMID:28713706

  1. Flipped Classroom as an Alternative Strategy for Teaching Stoichiometry

    Directory of Open Access Journals (Sweden)

    Norrie E. Gayeta

    2017-11-01

    Full Text Available This study aimed to compare the effectiveness of flipped classroom and traditional classroom instruction in measuring conceptual change and to determine if flipped classroom instruction would be an alternative method of teaching to traditional lecture method. This study covered the level of conceptual understanding of students on stoichiometry and the type of conceptual change before and after exposure to flipped and traditional classroom environment. Qualitative and quantitative research methods were used in the study. Respondents were two sections of third year Bachelor of Secondary Education, Biological Science. Frequency, percentage, ranking, mean, standard deviation, Hake factor test, and t-test were the statistical tools applied to answer specific questions. Results showed profound increase towards conceptual change representing a shift from intuitive understanding to correct incomplete understanding level. Thus, change for the better, in theoretical type was determined from pretest to posttest of students exposed to flipped and traditional classroom. Results also indicated that there is no significant difference on students’ conceptual change on stoichiometry exposed to flipped and traditional classroom environment thus, flipped classroom instruction can be used as an alternative teaching method to traditional lecture method in teaching stoichiometry

  2. Trochanteric osteotomy versus posterolateral approach: function the first year post surgery. A pilot study

    Directory of Open Access Journals (Sweden)

    van Biezen Frans C

    2011-06-01

    Full Text Available Abstract Background Although no prospective studies have compared functional results of trochanteric osteotomy and a non-trochanteric approach, most surgeons feel that trochanteric osteotomy is outdated in simple hip arthroplasty. Reasons not to perform an osteotomy include the fear of longer rehabilitation and worse (final functional outcome. Method This prospective study examines differences in rehabilitation between posterolateral and trochanteric approach one year post-surgery using questionnaires (WOMAC, SF-36, HHS and functional tests (walking, climbing stairs, rising from sitting, and strength tests. Of the 109 patients 24 had a trochanteric osteotomy: the selected approach was based on the surgeon's preference. The trochanteric osteotomy group included more patients with developmental dysplasia of the hip. Before the start of the study no power analysis was performed. Results Data from the questionnaires showed no significant differences between the two groups at 3, 6 and 12-months follow-up. At 3-months follow-up patients in the trochanteric osteotomy group scored lower on the functional tests. This difference had disappeared at 6 and 12-months follow-up, except for abduction force which remained lower in the trochanteric osteotomy group in patients with a non union of the TO. Conclusion For simple hip arthroplasty an approach without osteotomy seems a logical choice. Although the power of this study is low, in experienced hands trochanteric osteotomy seems to give good functional results at 6-12 months post surgery if trochanteric union is obtained. Therefore, one should not hesitate to perform an osteotomy in difficult cases.

  3. Humeral internal rotation osteotomy for the treatment of Erb-Duchenne-type obstetric palsy: clinical and radiographic results

    Science.gov (United States)

    Assunção, Jorge Henrique; Neto, Arnaldo Amado Ferreira; Benegas, Eduardo; Neto, Raul Bolliger; Prada, Flávia Santis; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emilio Conforto; Camanho, Gilberto Luis

    2013-01-01

    OBJECTIVE: To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae. METHOD: A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation. RESULTS: Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001). The correction of retroversion was achieved once the glenoid version ranged from -21.4 to -12 degrees (p<0.001). The humeral head subluxation improved from 6.5 to 35.2% (p<0.001). Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities. CONCLUSION: Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint. PMID:23917655

  4. Humeral internal rotation osteotomy for the treatment of Erb-Duchenne-type obstetric palsy: clinical and radiographic results

    Directory of Open Access Journals (Sweden)

    Jorge Henrique Assunção

    2013-07-01

    Full Text Available OBJECTIVE: To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae. METHOD: A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation. RESULTS: Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001. The correction of retroversion was achieved once the glenoid version ranged from -21.4 to -12 degrees (p<0.001. The humeral head subluxation improved from 6.5 to 35.2% (p<0.001. Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities. CONCLUSION: Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint.

  5. Effect of Computer Navigation on Accuracy and Reliability of Limb Alignment Correction following Open-Wedge High Tibial Osteotomy: A Meta-Analysis

    OpenAIRE

    Han, Seung-Beom; Kim, Hyun Jung; Lee, Dae-Hee

    2017-01-01

    Background It is unclear whether computer navigation can improve the accuracy and reliability of targeted lower limb alignment correction following open-wedge high tibial osteotomy (HTO). This meta-analysis was designed to compare the accuracy and reliability of limb alignment correction between computer navigated and conventional open-wedge HTOs. Methods Studies that compared postoperative coronal alignment, including mechanical axis (MA) and weight bearing line (WBL) ratio, outliers of alig...

  6. Preoperative low level laser therapy in dogs undergoing tibial plateau levelling osteotomy: A blinded, prospective, randomized clinical trial.

    Science.gov (United States)

    Rogatko, Cleo P; Baltzer, Wendy I; Tennant, Rachel

    2017-01-16

    To evaluate the influence of preoperative low-level laser therapy (LLLT) on therapeutic outcomes of dogs undergoing tibial plateau levelling osteotomy (TPLO). Healthy dogs undergoing TPLO were randomly assigned to receive either a single preoperative LLLT treatment (800-900 nm dual wavelength, 6 W, 3.5 J/cm 2 , 100 cm 2 area) or a sham treatment. Lameness assessment and response to manipulation, as well as force plate analysis, were performed preoperatively, then again at 24 hours, two weeks, and eight weeks postoperatively. Radiographic signs of healing of the osteo-tomy were assessed at eight weeks postoperatively. Twenty-seven dogs (27 stifles) were included and no major complications occurred. At eight weeks postoperatively, a significant difference in peak vertical force analysis was noted between the LLLT (39.6% ± 4.7%) and sham groups (28.9% ± 2.6%), (p dogs in the LLLT group (6.6 ± 1.6 years) was greater than that for the sham group (4.5 ± 2.0, p dogs (5/8) had healed at the eight-week time point than in the sham group (3/12) despite the age difference (p = 0.11) Clinical significance: The results of this study demonstrate that improved peak vertical force could be related to the preoperative use of LLLT for dogs undergoing TPLO at eight weeks postoperatively. The use of LLLT may improve postoperative return to function following canine osteotomies and its use is recommended.

  7. Effectiveness of the Flipped Classroom Model in Anatomy and Physiology Laboratory Courses at a Hispanic Serving Institution

    Science.gov (United States)

    Sanchez, Gerardo

    A flipped laboratory model involves significant preparation by the students on lab material prior to entry to the laboratory. This allows laboratory time to be focused on active learning through experiments. The aim of this study was to observe changes in student performance through the transition from a traditional laboratory format, to a flipped format. The data showed that for both Anatomy and Physiology (I and II) laboratories a more normal distribution of grades was observed once labs were flipped and lecture grade averages increased. Chi square and analysis of variance tests showed grade changes to a statistically significant degree, with a p value of less than 0.05 on both analyses. Regression analyses gave decreasing numbers after the flipped labs were introduced with an r. 2 value of .485 for A&P I, and .564 for A&P II. Results indicate improved scores for the lecture part of the A&P course, decreased outlying scores above 100, and all score distributions approached a more normal distribution.

  8. [Impact of the flipped classroom strategy in the learning environment in surgery: A comparison with the lectures].

    Science.gov (United States)

    Domínguez, Luis Carlos; Vega, Neil Valentín; Espitia, Erik Leonardo; Sanabria, Álvaro Enrique; Corso, Claudia; Serna, Adriana Margarita; Osorio, Camilo

    2015-01-01

    The Facultad de Medicina of the Universidad de La Sabana routinely uses lectures as the major educational strategy in clinical areas. Since 2012, a curriculum in context and a flipped classroom were introduced in the surgery course. To compare the impact of lectures versus the flipped classroom model in the learning environment in surgery. The Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to four cohorts of students. The five domains and the overall scores for both strategies were analyzed, and ANOVA was used to determine the differences among the domains (pflipped classroom, which suggests that this environment had a higher level of excellence. The ANOVA for each domain and the overall scores showed no differences with a flipped classroom. However, significant differences were identified in all domains and the overall scores with lectures (p0.90) for all measurements in both environments, and there was consistency across all cohorts. The flipped classroom strategy showed a higher score than the lecture-based approach according to the DREEM questionnaire. Identifying factors with a negative score is crucial to improving the learning environment. It is necessary to conduct further measurements over time to ensure the quality and success of the strategy.

  9. Screw Versus Plate Fixation for Chevron Osteotomy: A Retrospective Study.

    Science.gov (United States)

    Andrews, Boyd J; Fallat, Lawrence M; Kish, John P

    2016-01-01

    The chevron osteotomy is a popular procedure used for the correction of moderate hallux abducto valgus deformity. Fixation is typically accomplished with Kirschner wires or bone screws; however, in cystic or osteoporotic bone, these could be inadequate, resulting in displacement of the capital fragment. We propose using a locking plate and interfragmental screw for fixation of the chevron osteotomy that could reduce the healing time and decrease the incidence of displacement. We performed a retrospective cohort study for chevron osteotomies on 75 feet (73 patients). The control groups underwent fixation with 1 screw in 30 feet (40%) and 2 screws in 30 feet (40%). A total of 15 feet (20%) were included in the locking plate and interfragmental screw group. The patients were followed up until bone healing was achieved at a median of 7 (range 6 to 14) weeks. Our hypothesis was that those treated with the locking plate and interfragmental screw would have a faster healing time and fewer incidents of capital fragment displacement compared with the 1- or 2-screw groups. The corresponding mean intervals to healing for the 1-screw group was 7.71 ± 1.28 (range 6 to 10) weeks, for the 2-screw group was 7.27 ± 1.57 (range 6 to 14) weeks, and for the locking plate and interfragmental screw group was 7.01 ± 1.00 (range 6 to 9) weeks. One case of capital fragment displacement occurred in the single screw group and one in the 2-screw group. No displacement occurred in the locking plate and interfragmental screw group. Neither finding was statistically significant. However, we believe the locking plate and interfragmental screw could be a viable option in patients with osteoporotic and cystic bone changes for correction of hallux abducto valgus. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Biomechanical analysis of reduction malarplasty with L-shaped osteotomy.

    Science.gov (United States)

    Qiu, Shuang; Gui, Lai; Wang, Meng; Chen, Ying; Niu, Feng; Liu, Jianfeng; Liu, Wei; Zhang, Yankun

    2012-05-01

    Reduction malarplasty with L-shaped osteotomy is widely used for surgical correction of prominent zygoma and bilateral zygomatic asymmetry. One of the keys to this surgery is the formation of the greenstick fracture on the root of the zygomatic arch. However, the greenstick fracture cannot be seen directly both in the postoperative x-ray films and three-dimensional computed tomography images, and it is unknown how the greenstick fracture forms biomechanically. So it is of great concern to both the doctors and patients whether the greenstick fracture can really take place on the root of the zygomatic arch. This study focused on the biomechanism and deformation effects of the surgery by using the method of finite element (FE) analysis. Computed tomography data of 2 patients with prominent malar complex were obtained for three-dimensional reconstruction. The FE models of the zygomatic complex with L-shaped osteotomy were established by using Mimics via thresholding, segmentation techniques, and material properties assignment with gray value conversion. Then simulations including the boundary conditions and the forces of the surgery were performed in ABAQUS. The FE models have fine quality; the first one contains 63,053 units and 100,995 nodes, and the other one contains 70,238 units and 136,219 nodes. Under the loading of pressures, the zygoma and the zygomatic arch inward have deformation displacement. Maximum stress concentration was found just at the root of the zygomatic arch. A appropriate zygomatic pressure will generate a stress concentration to form the greenstick on the root of the zygomatic arch. This study can help surgeons understand and conduct the reduction malarplasty with L-shaped osteotomy from a biomechanical insight.

  11. [Modified Evans osteotomy for the operative treatment of acquired pes planovalgus].

    Science.gov (United States)

    Zwipp, Hans; Rammelt, Stefan

    2006-06-01

    Restoration of the longitudinal arch of the foot and reorientation of the hindfoot for painful decompensating flatfoot (pes planovalgus) due to posterior tibial tendon dysfunction. Passively correctable, painful pes planovalgus of various etiologies such as stage II flatfoot as graded by Johnson & Strom mostly due to degeneration of the posterior tibial tendon in stage II-III as described by Jahss. Fixed pes planovalgus, osteoporosis of the calcaneus, advanced degenerative arthritis of the subtalar, talonavicular or calcaneocuboid joints. Transverse osteotomy of the anterior process of the calcaneus approximately 1.5 cm proximal of and parallel to the calcaneocuboid joint. Lengthening of the lateral column using the sandwich technique by the interposition of one to two autologous, tricortical bone grafts, which are structured to straighten the hindfoot and to move it toward neutral position. If the technique is performed correctly, the talus and the calcaneus are in alignment. When the talar head is externally rotated and the calcaneus is moved toward varus, this results in axial alignment of the abducted forefoot and straightening of the collapsed longitudinal arch of the foot. Between June 1995 and March 2003, 21 patients with stage II painful pes planovalgus as described by Johnson & Strom underwent a modified Evans osteotomy. In one case an arthrodesis of the first tarsometatarsal joint was carried out, and in four cases a lengthening of the gastrocnemius muscle according to Strayer. A replacement of the insufficient posterior tibial tendon was not necessary in any of the cases. With respect to complications one wound edge necrosis and one nonunion were seen. 15 patients (eleven women, four men, average age 54 years) were followed up for an average of 48 months (12-81 months) postoperatively. The Maryland Foot Score improved significantly from 49.6 points preoperatively to 87.8 points postoperatively (p radiographs were corrected to being close to the

  12. Risk factors affecting somatosensory function after sagittal split osteotomy

    DEFF Research Database (Denmark)

    Thygesen, Torben Henrik; Jensen, Allan Bardow; Helleberg, M

    2008-01-01

    Purpose The aim of this study was to evaluate potential individual and intraoperative risk factors associated with bilateral sagittal split osteotomy (BSSO) and to correlate the findings with postoperative changes in somatosensory function. Patients and Methods A total of 18 men and 29 women (mean...... correlations were noted between preoperative values for somatosensory function and changes in these variables after BSSO. Patients with low sensory thresholds before BSSO experienced more impairment than those patients with higher preoperative sensory thresholds. Conclusion These findings imply...... that somatosensory function after BSSO is dependent on both intraoperative risk factors and preoperative sensation levels....

  13. Pedicle subtraction osteotomy in elderly patients with degenerative sagittal imbalance.

    Science.gov (United States)

    Cho, Kyu-Jung; Kim, Ki-Tack; Kim, Whoan-Jeang; Lee, Sang-Hoon; Jung, Jae-Hoon; Kim, Young-Tae; Park, Hae-Bong

    2013-11-15

    Retrospective, radiographical analysis. To evaluate pedicle subtraction osteotomy (PSO) as a means of correcting severe degenerative sagittal imbalance in elderly patients. PSO in patients with degenerative sagittal imbalance is likely to cause more complications than in patients with iatrogenic flatback deformity. This study analyzed 34 patients who underwent fusion to the sacrum, with a minimum 2-year follow-up. Age of the patients were in the range from 58 to 73 with the mean at 65.5 years. PSO was performed at one segment in all cases, consisting of L3 (n = 26), L4 (n = 4), L2 (n = 3), and L1 (n = 1). The average number of levels fused was 8.15. Ten patients had structural interbody fusion at the lumbosacral junction. Applying PSO at one segment, the mean correction of the lordotic angle at the osteotomy site was 33.3°, of which the loss of correction (LOC) was 4.0° at the last visit. The correction of lumbar lordosis was 33.7° and the LOC was 8.5°. The sagittal C7 plumb was 215.9 mm before surgery, corrected to 35.1 mm after surgery, and changed to 95.9 mm by the last visit. The correction of the sagittal C7 plumb was 119.9 mm and the LOC was 60.9 mm. There was substantial LOC in lumbar lordosis and sagittal C7 plumb. In 10 patients with addition of posterior lumbar interbody fusion, the LOC of lumbar lordosis was 7.4°, which was less than 9° in those without it. PSO for the correction of degenerative sagittal imbalance in elderly patients resulted in correction of sagittal alignment with a significant LOC of lumbar lordosis and sagittal C7 plumb. The LOC of lumbar lordosis occurred at both the osteotomy and non-osteotomy site. The addition of anterior column support is helpful to maintain correction and reduce complications. N/A.

  14. Results and complications of percutaneous pelvic osteotomy and intertrochanteric varus shortening osteotomy in 54 consecutively operated GMFCS level IV and V cerebral palsy patients.

    Science.gov (United States)

    Canavese, Federico; Marengo, Lorenza; de Coulon, Geraldo

    2017-05-01

    This retrospective study evaluated mid-to-long-term outcome of a minimally invasive percutaneous pelvic osteotomy (PPO) approach combined with varus derotational shortening osteotomy (VDRSO) and soft tissue release in children with severe CP. A retrospective review was performed of all patients presenting with a diagnosis of CP with hip subluxation or dislocation treated surgically by simultaneous soft tissue release, VDRSO, and PPO between 2002 and 2015. Eligible patients included those with a diagnosis of spastic quadriplegia or CP GMFCS level IV or V with unilateral or bilateral hip subluxation or dislocation and surgical treatment of the deformity by simultaneous soft tissue release, VDRSO and PPO. All anterior-posterior (AP) radiographs of the pelvis were reviewed and Reimers migration percentage (MP) and acetabular angle (AA) were measured. In total, 54 children and adolescents (34 boys, 20 girls) with CP GMFCS level IV and V were treated during study period: 38 (70.4%) classified GMFCS level IV and 16 (29.6%) classified GMFCS level V. A total of 64 consecutive hips underwent simultaneous PPO associated with VDRSO. Overall, at the time of chart and radiograph review, mean age was 9.1 ± 3.3 years (range 4-16.5) and mean follow-up was 43.9 ± 19.5 months (range 3-72). Mean migration percentage improved from 66.8 ± 19.8% (range 33-100) preoperatively to 8.1 ± 16.5% (range 0-70) at last follow-up. Mean acetabular angle improved from 32.7° ± 7.1° (range 20-50) preoperatively to 14° ± 6.7° (range 0-27) at last follow-up. Only one case of bone graft dislodgment was observed. We did not observe any cases of avascular necrosis of the femoral head. All operated hips were pain free at the time of last follow-up. PPO through a less invasive surgical approach offers a valuable alternative to standard techniques as it gives similar outcome but with less muscle stripping and less time in surgery. III.

  15. Clinical and radiological outcome after periacetabular osteotomy

    DEFF Research Database (Denmark)

    Dahl, Line B; Dengsø, Kristine; Bang-Christiansen, Karl

    2014-01-01

    using Tönnis grade. Survival was assessed by the Kaplan-Meier method and predictors of conversion to THA were calculated using Cox regression analysis with THA as defined endpoint. MAIN FINDINGS: Centre-edge angle improved significantly with a mean of 8.7 (95% CI: 7.1; 10.3) preoperatively to a mean...

  16. Implementation of a "Flipped Classroom" for Neurosurgery Resident Education.

    Science.gov (United States)

    Girgis, Fady; Miller, Jonathan P

    2018-01-01

    Engaging residents across a multiyear training spectrum is challenging given the heterogeneity of experience and limited time available for educational activities. A "flipped classroom" model, in which residents prepare ahead of time for mentored topic discussions, has potential advantages. We implemented a curriculum consisting of topics distributed across the specialty. Weekly, each resident was randomly assigned to research a specific aspect of an assigned topic appropriate to his or her level of experience: junior residents about what characterizes each clinical entity, midlevel residents about when to intervene, and chief residents about how to administer treatment. Residents completed an anonymous survey 6 months after implementation. Board examination performance was assessed before and after implementation. A total of 12 residents participated in the program. Weekly, 1.75±0.40 hours were spent in preparation, with senior residents reporting less time than junior residents. All residents indicated that the accumulation of experience across 7 years of residency was a major advantage of this program, and all preferred it to lectures. Performance on the board examination significantly increased after implementation (from 316±36 to 468±45, pflipped classroom is a viable approach to resident education and is associated with increased engagement and improved performance using validated knowledge-assessment tools.

  17. Treatment of Andersson lesion-complicating ankylosing spondylitis via transpedicular subtraction and disc resection osteotomy, a retrospective study.

    Science.gov (United States)

    Zhang, Xuesong; Wang, Yao; Wu, Bing; Hu, Wenhao; Zhang, Zhifa; Wang, Yan

    2016-08-01

    Andersson lesion (AL) can occur in patients with ankylosing spondylitis (AS). Surgical instrumentation and fusion is considered the principle management in symptomatic AL that fails to resolve from a conservative treatment. However, there is significant controversy over the ideal management. The purpose of this study is to introduce our experience and explore the efficacy and feasibility of transpedicular subtraction and disc resection osteotomy technique for patients with AL-complicating AS. From January 2009 to January 2013, 17 consecutive patients with Andersson lesion-complicating ankylosing spondylitis treated with transpedicular subtraction and disc resection osteotomy technique were retrospectively reviewed. All patients completed a follow-up of at least 2 years. The average surgical time was 219 min with a mean intraoperative blood loss of 876 ml. The average preoperative regional angle was 29.1°, 4.9° postoperatively, and 5.9° at the final follow-up. The global angle changed from 59.1° preoperatively to 24.7° after surgery with the sagittal vertical axis (SVA) changed from 153.7 to 41.1 mm. The mean VAS back pain scores decreased from 6.4 preoperatively to 1.1 postoperatively and the ODI score improved from 50.9 preoperatively to 16.9 at the final follow-up. Solid fusion was obtained in all patients. The transpedicular subtraction and disc resection osteotomy achieve satisfactory kyphosis correction, good fusion and favorable clinical outcomes with less blood loss and complications than other approaches, implying an alternative method in patients with Andersson lesion-complicating ankylosing spondylitis.

  18. [Treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy of the first metatarsal bone].

    Science.gov (United States)

    Díaz Fernández, R

    2015-01-01

    To evaluate the clinical and radiological results in the surgical treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy. A retrospective study was conducted on 45 feet of 42 patients diagnosed with moderate-severe hallux valgus, operated on in a single centre and by the same surgeon from May 2009 to March 2013. Two patients were lost to follow-up. Clinical and radiological results were recorded. An improvement from 48.14 ± 4.79 points to 91.28 ± 8.73 points was registered using the American Orthopedic Foot and Ankle Society (AOFAS) scale. A radiological decrease from 16.88 ± 2.01 to 8.18 ± 3.23 was observed in the intermetatarsal angle, and from 40.02 ± 6.50 to 10.51 ± 6.55 in hallux valgus angle. There was one case of hallux varus, one case of non-union, a regional pain syndrome type I, an infection that resolved with antibiotics, and a case of loosening of the osteosynthesis that required an open surgical refixation. Percutaneous distal osteotomy of the first metatarsal when performed as an isolated procedure, show limitations when dealing with cases of moderate and severe hallux valgus. The described technique adds the advantages of minimally invasive surgery by expanding applications to severe deformities. Percutaneous double osteotomy is a reproducible technique for correcting severe deformities, with good clinical and radiological results with a complication rate similar to other techniques with the advantages of shorter surgical times and less soft tissue damage. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  19. Long-term results of rotational acetabular osteotomy for osteonecrosis with collapse of the femoral head in young patients.

    Science.gov (United States)

    Baba, Tomonori; Nozawa, Masahiko; Homma, Yasuhiro; Ochi, Hironori; Ozaki, Yu; Watari, Taiji; Matsumoto, Mikio; Kaneko, Kazuo

    2017-07-01

    The surgical treatment of osteonecrosis with collapse of the femoral head is still controversial. The purpose of this study was to investigate the clinical outcome of rotational acetabular osteotomy by Ninomiya and Tagawa for osteonecrosis of the femoral head in young patients. Rotational acetabular osteotomy was performed in 202 consecutive patients between 1995 and 2003. Among them, rotational acetabular osteotomy with osteonecrosis of the femoral head was performed in 31 patients (42 hips). The mean age at the time of surgery was 31.2 years (range 16-45). The mean duration of follow-up was 16.1 years (range 13.1-21 years). The mean preoperative Japanese Orthopedic Association hip score of 56.8 points improved to a mean of 72.4 points at the final follow-up. The 10-year survival rate with conversion to total hip arthroplasty as an end-point was 91.9%, and the 15-year survival rate was 75.5%, the 20-year survival rate was 67.9%. The conversion to total hip arthroplasty was performed in nine hips. The average time to the conversion to total hip arthroplasty was 12.1 years. Even though the necrotized range is wide, if normal cartilage remains on the lateral side of the femoral head, it can be utilized for the weight-bearing region by laterally rotating the acetabulum. Since the outcome was favorable, we believe that this is a valuable treatment option for this disease.

  20. Constrained Supersymmetric Flipped SU(5) GUT Phenomenology

    CERN Document Server

    Ellis, John; Olive, Keith A

    2011-01-01

    We explore the phenomenology of the minimal supersymmetric flipped SU(5) GUT model (CFSU(5)), whose soft supersymmetry-breaking (SSB) mass parameters are constrained to be universal at some input scale, $M_{in}$, above the GUT scale, $M_{GUT}$. We analyze the parameter space of CFSU(5) assuming that the lightest supersymmetric particle (LSP) provides the cosmological cold dark matter, paying careful attention to the matching of parameters at the GUT scale. We first display some specific examples of the evolutions of the SSB parameters that exhibit some generic features. Specifically, we note that the relationship between the masses of the lightest neutralino and the lighter stau is sensitive to $M_{in}$, as is the relationship between the neutralino mass and the masses of the heavier Higgs bosons. For these reasons, prominent features in generic $(m_{1/2}, m_0)$ planes such as coannihilation strips and rapid-annihilation funnels are also sensitive to $M_{in}$, as we illustrate for several cases with tan(beta)...

  1. Flipping organic chemistry course: Possibilities and challenges

    Science.gov (United States)

    Cha, J.; Kim, H. B.

    2016-06-01

    The flipped classroom approach was applied to an introductory organic chemistry course. A total of 76 video clips (15 hours of running time) were developed and delivered to 41 sophomores (21 females and 20 males) through Youtube in addition to the university's learning management system. The students were asked to preview the lecture contents before each class by watching a pre-class video. For in-class activities, exercise problems were presented to groups of 3-5 students. An instructor and a teaching assistant guided each group to solve problems cooperatively, monitored the students’ group activity and answered their questions. At the end of every chapter, the students were asked to evaluate their group work and personal preparedness for the class and also to write a short reflective journal. The muddiest point of each chapter, i.e., the topic posing the most difficulty to students’ understanding, was surveyed through Google Forms®. The students liked watching the videos before each class and performing student-centered, in-class group activities but a few limitations were also found and reported.

  2. Flipped classroom or an active lecture?

    Science.gov (United States)

    Pickering, James D; Roberts, David J H

    2018-01-01

    Recent changes in anatomy education have seen the introduction of flipped classrooms as a replacement to the traditional didactic lecture. This approach utilizes the increasing availability of digital technology to create learning resources that can be accessed prior to attending class, with face-to-face sessions then becoming more student-centered via discussion, collaborative learning, and problem-solving activities. Although this approach may appear intuitive, this viewpoint commentary presents a counter opinion and highlights a simple alternative that utilizes evidence-based active learning approaches as part of the traditional lecture. The active lecture takes the traditional lecture, and (1) ensures the lecture content is relevant and has clear objectives, (2) contains lecture material that is designed according to the latest evidence-base, (3) complements it with additional supplementary material, (4) creates space to check prior understanding and knowledge levels, and (5) utilizes suitable technology to facilitate continual engagement and interaction. Clin. Anat. 31:118-121, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. The flipped classroom: now or never?

    Science.gov (United States)

    Hawks, Sharon J

    2014-08-01

    Pedagogical changes and new models of delivering educational content should be considered in the effort to address the recommendations of the 2007 Institute of Medicine report and Benner's recommendations on the radical transformation of nursing. Transition to the nurse anesthesia practice doctorate addresses the importance of these recommendations, but educational models and specific strategies on how to implement changes in educational models and systems are still emerging. The flipped classroom (FC) is generating a considerable amount of buzz in academic circles. The FC is a pedagogical model that employs asynchronous video lectures, reading assignments, practice problems, and other digital, technology-based resources outside the classroom, and interactive, group-based, problem-solving activities in the classroom. This FC represents a unique combination of constructivist ideology and behaviorist principles, which can be used to address the gap between didactic education and clinical practice performance. This article reviews recent evidence supporting use of the FC in health profession education and suggests ways to implement the FC in nurse anesthesia educational programs.

  4. Effects of Osteotomy Lengths on the Temperature Rise of the Crestal Bone During Implant Site Preparation.

    Science.gov (United States)

    Katic, Zvonimir; Jukic, Tomislav; Stubljar, David

    2018-02-13

    To compare temperatures of the crestal bone during implant site preparation for different osteotomy lengths and implant systems. Bovine ribs were used to simulate the cortical bone of the human mandible. Three different implant systems were tested: Astra Tech, Ankylos, and XiVE. Six drills per system were performed, meaning each drilling set was used for 2 drills per 3 osteotomy lengths (8, 12, and 16 mm). Drilling force, drilling speed, drilling length, and temperature were recorded. Differences in the maximum temperature of the crestal bone during the first drilling for various osteotomy lengths (P = 0.021) and all implant systems (P = 0.013) were observed. A similar result was showed during the second drilling; osteotomy lengths (P = 0.014) and drilling systems (P = 0.003). Second drillings showed lower temperatures of the crestal bone with statistical differences on all measurements (P Ankylos implant systems showed similar performance; XiVE had lower temperature and higher temperature differences between osteotomy lengths. Different drilling lengths contributed to the variation in temperature regardless of the implant system. Longer drills and osteotomies induced higher temperatures on the crestal bone. The maximum temperature difference between the shortest and the longest osteotomy was under 1°C. Temperature above 47°C that could cause bone necrosis was not recorded at any time. The XiVE system showed the best performance.

  5. Scarf osteotomy - Is it the procedure of choice in hallux valgus surgery? A preliminary report

    Science.gov (United States)

    2007-01-01

    Many procedures are described in the literature for the surgical management of hallux valgus. There are over 130 surgical procedures described but the surgeon usually limits these to a few which he is comfortable with and which gives the best aesthetic and functional result to the patient. There is ever rising enthusiasm among orthopaedic surgeons regarding diaphyseal osteotomy ever since Burutaran described the procedure in 1973. Weil in United States and Barouk in Europe popularized the technique. Scarf is a double chevron diaphyseal osteotomy which is inherently more stable than other osteotomies on the first metatarsal and allows early return to work. The author reports his early experience with SCARF osteotomy, which is a comparatively new technique for hallux valgus correction which was done in Ibri Regional Hospital in the Sultanate of Oman. All patients who presented with symptomatic hallux valgus were taken up and there were three patients who required surgical intervention for hallux valgus. The purpose of this study was to find its effectiveness in terms of stability of the osteotomy and early return to work. Proximal phalangeal osteotomy was not found necessary in none of the three cases operated by us. Scarf osteotomy is safe and found to give better aesthetic and functional result and early return to work. All our three patients had good functional recovery and early return to work. PMID:22400093

  6. Tibial rotational osteotomy and distal tuberosity transfer for patella subluxation secondary to excessive external tibial torsion: surgical technique and clinical outcome.

    Science.gov (United States)

    Drexler, M; Dwyer, T; Dolkart, O; Goldstein, Y; Steinberg, E L; Chakravertty, R; Cameron, J C

    2014-11-01

    Recurrent patella subluxation may be secondary to excessive external tibial torsion. The purpose of this study is to evaluate the clinical and radiographic outcome of patients undergoing tibial derotation osteotomy and tibial tuberosity transfer for recurrent patella subluxation in association with excessive external tibial torsion. A combined tibial derotation osteotomy and tibial tuberosity transfer was performed in 15 knees (12 patients) with recurrent patella subluxation secondary to excessive external tibial torsion. Clinical evaluation was carried out using preoperative and post-operative Knee Society Score (KSS), Kujala Patellofemoral score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, the short form-12 (SF-12) and a visual analogue score (VAS) pain scale. The median follow-up period was 84 months (range 15-156) and median patient age was 34 years (range 19-57 years). The median preoperative external tibial torsion was 62° (range 55°-70°), with a median rotational correction of 36° (range 30°-45°) after surgery. Significant improvement (p 45° who underwent tibial derotation osteotomy and tibial tuberosity transfer achieved a satisfactory outcome in terms of pain relief and improved function. A significant complication was seen in 2/15 patients. Case series, Level IV.

  7. On flipping first-semester calculus: a case study

    Science.gov (United States)

    Petrillo, Joseph

    2016-05-01

    High failure rates in calculus have plagued students, teachers, and administrators for decades, while science, technology, engineering, and mathematics programmes continue to suffer from low enrollments and high attrition. In an effort to affect this reality, some educators are 'flipping' (or inverting) their classrooms. By flipping, we mean administering course content outside of the classroom and replacing the traditional in-class lectures with discussion, practice, group work, and other elements of active learning. This paper presents the major results from a three-year study of a flipped, first-semester calculus course at a small, comprehensive, American university with a well-known engineering programme. The data we have collected help quantify the positive and substantial effects of our flipped calculus course on failure rates, scores on the common final exam, student opinion of calculus, teacher impact on measurable outcomes, and success in second-semester calculus. While flipping may not be suitable for every teacher, every student, and in every situation, this report provides some evidence that it may be a viable option for those seeking an alternative to the traditional lecture model.

  8. [Flipped classroom as a strategy to enhance active learning].

    Science.gov (United States)

    Wakabayashi, Noriyuki

    2015-03-01

    This paper reviews the introduction of a flipped class for fourth grade dentistry students, and analyzes the characteristics of the learning method. In fiscal 2013 and 2014, a series of ten three-hour units for removable partial prosthodontics were completed with the flipped class method; a lecture video of approximately 60 minutes was made by the teacher (author) and uploaded to the university's e-learning website one week before each class. Students were instructed to prepare for the class by watching the streaming video on their PC, tablet, or smartphone. In the flipped class, students were not given a lecture, but were asked to solve short questions displayed on screen, to make a short presentation about a part of the video lecture, and to discuss a critical question related to the main subject of the day. An additional team-based learning (TBL) session with individual and group answers was implemented. The average individual scores were considerably higher in the last two years, when the flipped method was implemented, than in the three previous years when conventional lectures were used. The following learning concepts were discussed: the role of the flipped method as an active learning strategy, the efficacy of lecture videos and short questions, students' participation in the class discussion, present-day value of the method, cooperation with TBL, the significance of active learning in relation with the students' learning ability, and the potential increase in the preparation time and workload for students.

  9. Inverted L osteotomy: a new approach via intraoral access through the advances of virtual surgical planning and custom fixation

    Directory of Open Access Journals (Sweden)

    Peter B. Franco, DMD

    2016-03-01

    Full Text Available We introduce a novel surgical approach via intraoral access to the Inverted L osteotomy utilizing virtual surgical planning (VSP and patient-specific customized mandibular fixation. VSP in orthognathic surgery has been well documented in its ability to increase preoperative and intraoperative efficiency, decrease cost and operating room time, and improve predictability and patient outcomes. In addition to occlusal splints, the adjunctive cutting guides and reference templates generated through computer-aided design and computer-aided manufacturing further aids in the precise transfer of the virtual plan to the intraoperative procedure. As the application of VSP is becoming more prevalent in the surgical treatment dentofacial deformities, 3-D virtual planning is moving beyond cutting jigs and guides and into the fabrication of patient-specific customized mandibular reconstruction plates in both the orthognathic and reconstructive arenas. Orthognathic surgery can be essential for the establishment of sound function and ideal esthetics for individuals who possess a dentofacial deformity. VSP and customized mandibular reconstruction plates have great potential to help safely guide the inverted L osteotomy and produce predictable functional and esthetic results while improving efficiency preoperatively as well as intraoperatively.

  10. A Prospective Study of Distal Metatarsal Chevron Osteotomies with K-Wire Fixations to Treat Hallux Valgus Deformities

    Science.gov (United States)

    Baig, Usman; Tariq, Ali; Din, Robert

    2017-01-01

    Introduction Hallux valgus is one of the most common forefoot deformities worldwide. Females are affected more often than males. The three most common clinical symptoms are the painful bunion, transfer metatarsalgia, and hammer or claw toes. Methods This case series consisted of 20 patients who had chevron osteotomy from January 2015 to January 2016. The clinical assessment was measured by The American Orthopedic Foot and Ankle Score (AOFAS), and radiologic assessment was determined by preoperative and postoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA). Results The patients’ mean age was 56 years. Out of 20 patients, 19 were female, and one was male. The mean AOFAS improved from 51 preoperatively to 82 postoperatively. The HVA improved from 26° preoperatively to 14°. There were five complications including four Kirschner (K)-wire complications. Conclusion Distal chevron osteotomy is a reliable and time-tested procedure. The K-wire fixation has a relatively high complication rate. We planned to use other methods of fixation and then compared them with K-wires fixation results for future studies. PMID:29167752

  11. A Prospective Study of Distal Metatarsal Chevron Osteotomies with K-Wire Fixations to Treat Hallux Valgus Deformities.

    Science.gov (United States)

    Baig, M N; Baig, Usman; Tariq, Ali; Din, Robert

    2017-09-20

    Introduction Hallux valgus is one of the most common forefoot deformities worldwide. Females are affected more often than males. The three most common clinical symptoms are the painful bunion, transfer metatarsalgia, and hammer or claw toes. Methods This case series consisted of 20 patients who had chevron osteotomy from January 2015 to January 2016. The clinical assessment was measured by The American Orthopedic Foot and Ankle Score (AOFAS), and radiologic assessment was determined by preoperative and postoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA). Results The patients' mean age was 56 years. Out of 20 patients, 19 were female, and one was male. The mean AOFAS improved from 51 preoperatively to 82 postoperatively. The HVA improved from 26° preoperatively to 14°. There were five complications including four Kirschner (K)-wire complications. Conclusion Distal chevron osteotomy is a reliable and time-tested procedure. The K-wire fixation has a relatively high complication rate. We planned to use other methods of fixation and then compared them with K-wires fixation results for future studies.

  12. Rate of Union After Segmental Midshaft Shortening Osteotomy of the Lesser Metatarsals.

    Science.gov (United States)

    DeSandis, Bridget; Ellis, Scott J; Levitsky, Matthew; O'Malley, Quinn; Konin, Gabrielle; O'Malley, Martin J

    2015-10-01

    Current literature reports excellent rates of union following various lesser metatarsal osteotomy techniques. However, it is our experience that segmental midshaft shortening osteotomies heal very slowly and have a greater potential for nonunion than has previously been reported. The purpose of this study was to assess union rates and report the time required for segmental midshaft shortening osteotomies to achieve radiographic union. We reviewed the charts and postoperative radiographs of 58 patients (representing 91 osteotomies) who underwent segmental midshaft shortening osteotomies with internal fixation between January 2009 and December 2013. Radiographs were reviewed to determine when union was achieved. Union was defined as the bridging of 2 or more cortices in the anteroposterior, lateral, and oblique radiographic views. Osteotomies were classified as delayed union if they were not healed at 3 months postoperatively and nonunions if they were not healed at 6 months postoperatively. Overall, 27 of 91 osteotomies met our radiographic classification of union and were healed by 3 months (29.7%). Sixty-nine of the 91 osteotomies healed by 6 months (75.8%) and were considered delayed unions. Twenty-two osteotomies were not healed yet and therefore were considered nonunions (24.2%). Of the 22 nonunions, 7 healed in an additional 2 months (8 months) for an overall healing percentage of 83.5%, (76 of 91). By 10 months, 6 more nonunions were healed (overall healing percentage of 90.1%, 82 of 91). Three additional nonunions went on to heal by 12.9 months, yielding a final union rate of 93.4% (85 of 91), while 6 were still considered nonunions (6.6%). We report that a significant percentage of segmental midshaft metatarsal shortening osteotomies experienced delayed unions and nonunions. These findings contrast those previously reported in the literature that metatarsal osteotomies have very low nonunion rates. These results support our hypothesis that these osteotomies

  13. Results of single-staged rotational osteotomy in a child with congenital proximal radioulnar synostosis: subjective and objective evaluation.

    Science.gov (United States)

    Shingade, Viraj U; Shingade, Rashmi V; Ughade, Suresh N

    2014-01-01

    For congenital proximal radioulnar synostosis, both conservative and operative treatments have been described. Most of the studies describing surgical interventions are based on subjective evaluation of the forearm function and have used severe degree of forearm pronation as an indication for surgery. This study describes a single-staged rotational osteotomy of the proximal third ulna and distal third radius. The aim of the study was to assess the utility of the described surgical procedure by subjective and objective evaluations of the forearm function. Forty-eight children with congenital proximal radioulnar synostosis were evaluated by subjective and objective assessments and were followed up prospectively. Subjective evaluation consisted of a set of 12 questions regarding the basic activities of life. Objective evaluation was made using the Jebsen-Taylor hand-function test and a classification system used by Failla and colleagues for 15 tasks described by Morrey and colleagues. Eleven children were treated conservatively. Thirty-six children underwent a single-staged rotational osteotomy of the proximal third ulna and distal third radius. After surgery, the evaluations were repeated. The mean age at surgery was 8.6±3.7 years, and the mean postoperative follow-up period was 54±13 months. All operated forearms showed a statistically significant improvement in functioning after surgery as per the subjective and objective evaluations. The mean time taken to carry out all activities before surgery was 47.7+10.0 seconds, which significantly reduced to 33.3+6.6 seconds after surgery (P=0.0001) as per the results of the Jebsen-Taylor hand-function test. All good (n=19) and fair (n=11) results were converted to excellent (n=30) after surgery as per the modified Failla classification. There were no neurovascular injuries as compared with other published techniques. Only 1 child had delayed union, and 1 had persistent dorsal angulation at the radial osteotomy site. For

  14. "Flipping" the introductory clerkship in radiology: impact on medical student performance and perceptions.

    Science.gov (United States)

    Belfi, Lily M; Bartolotta, Roger J; Giambrone, Ashley E; Davi, Caryn; Min, Robert J

    2015-06-01

    Among methods of "blended learning" (ie, combining online modules with in-class instruction), the "flipped classroom" involves student preclass review of material while reserving class time for interactive knowledge application. We integrated blended learning methodology in a "flipped" introductory clerkship in radiology, and assessed the impact of this approach on the student educational experience (performance and perception). In preparation for the "flipped clerkship," radiology faculty and residents created e-learning modules that were uploaded to an open-source website. The clerkship's 101 rising third-year medical students were exposed to different teaching methods during the course, such as blended learning, traditional lecture learning, and independent learning. Students completed precourse and postcourse knowledge assessments and surveys. Student knowledge improved overall as a result of taking the course. Blended learning achieved greater pretest to post-test improvement of high statistical significance (P value, .0060) compared to lecture learning alone. Blended learning also achieved greater pretest to post-test improvement of borderline statistical significance (P value, .0855) in comparison to independent learning alone. The difference in effectiveness of independent learning versus lecture learning was not statistically significant (P value, .2730). Student perceptions of the online modules used in blended learning portions of the course were very positive. They specifically enjoyed the self-paced interactivity and the ability to return to the modules in the future. Blended learning can be successfully applied to the introductory clerkship in radiology. This teaching method offers educators an innovative and efficient approach to medical student education in radiology. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  15. Attack the tumor counterattack-c-FLIP expression in Jurkat-T-cells protects against apoptosis induced by coculture with SW620 colorectal adenocarcinoma cells.

    Science.gov (United States)

    Steiert, Andreas E; Sendler, Daniel; Burke, Willam F; Choi, Claudia Y; Reimers, Kerstin; Vogt, Peter M

    2012-07-01

    Cancer development relies on a variety of mechanisms that facilitate tumor growth despite the presence of a functioning immune system, employing different mechanisms to escape immune rejection. Tumors may eliminate tumor-infiltrating lymphocytes and suppress anti-tumor immune responses, a process called "tumor counterattack," based on activation-induced cell death via the FAS/FAS-ligand system. To overcome this tumor-cell survival strategy, we examined the hypothesis that the sensitivity of FAS mediated apoptosis of Jurkat-T-cells can be suppressed by FLIP transfection of Jurkat-T-cells. Jurkat-T-cells were transfected with the FLICE-inhibitory protein FLIP in order to bestow them with a resistance to FAS-receptor-mediated apoptosis. FLIP-transfected and non-transfected Jurkat-T-cells were grown in coincubation with SW620 cells and the rates of apoptosis measured via FACS-analysis of Annexin-V. First, the tumor-counterattack described in the literature was confirmed. About 20% of Jurkat-T-Cells underwent apoptosis in coculture with SW620 cells. After coincubation of SW620 cells with FLIP transfected Jurkat-T-cells the apoptotic rate was significant reduced at levels below 4%. Transfection of Jurkat-T-cells with FLIP reduces the sensitivity of Jurkat-T-cells to FAS-mediated apoptosis and may lead to an improved capability to antagonize the inherent tumor survival strategy of SW620 cells. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Identifying Professional Competencies of the Flip-Chip Packaging Engineer in Taiwan

    Science.gov (United States)

    Guu, Y. H.; Lin, Kuen-Yi; Lee, Lung-Sheng

    2014-01-01

    This study employed a literature review, expert interviews, and a questionnaire survey to construct a set of two-tier competencies for a flip-chip packaging engineer. The fuzzy Delphi questionnaire was sent to 12 flip-chip engineering experts to identify professional competencies that a flip-chip packaging engineer must have. Four competencies,…

  17. Scaffolded Semi-Flipped General Chemistry Designed to Support Rural Students' Learning

    Science.gov (United States)

    Lenczewski, Mary S.

    2016-01-01

    Students who lack academic maturity can sometimes feel overwhelmed in a fully flipped classroom. Here an alternative, the Semi-Flipped method, is discussed. Rural students, who face unique challenges in transitioning from high school learning to college-level learning, can particularly profit from the use of the Semi-Flipped method in the General…

  18. The Flipped Classroom in Systems Analysis & Design: Leveraging Technology to Increase Student Engagement

    Science.gov (United States)

    Saulnier, Bruce M.

    2015-01-01

    Problems associated with the ubiquitous presence of technology on college campuses are discussed and the concept of the flipped classroom is explained. Benefits of using the flipped classroom to offset issues associated with the presence of technology in the classroom are explored. Fink's Integrated Course Design is used to develop a flipped class…

  19. Implementing the Flipped Classroom: An Exploration of Study Behaviour and Student Performance

    Science.gov (United States)

    Boevé, Anja J.; Meijer, Rob R.; Bosker, Roel J.; Vugteveen, Jorien; Hoekstra, Rink; Albers, Casper J.

    2017-01-01

    The flipped classroom is becoming more popular as a means to support student learning in higher education by requiring students to prepare before lectures and actively engaging students during lectures. While some research has been conducted into student performance in the flipped classroom, students' study behaviour throughout a flipped course…

  20. [Evaluation of flipped classroom teaching model in undergraduates education of oral and maxillofacial surgery].

    Science.gov (United States)

    Cai, Ming; Cao, Xia; Fang, Xiao; Wang, Xu-dong; Zhang, Li-li; Zheng, Jia-wei; Shen, Guo-fang

    2015-12-01

    Flipped classroom is a new teaching model which is different from the traditional teaching method. The history and characteristics of flipped classroom teaching model were introduced in this paper. A discussion on how to establish flipped classroom teaching protocol in oral and maxillofacial surgery education was carried out. Curriculum transformation, construction of education model and possible challenges were analyzed and discussed.

  1. To What Extent Does 'Flipping' Make Lessons Effective in a Multimedia Production Class?

    Science.gov (United States)

    Choi, Jaeho; Lee, Youngju

    2018-01-01

    This study examines the effects of a flipped classroom in a technology integration course for pre-service teachers. In total, 79 students were randomly assigned into a flipped classroom or a traditional classroom group and given three multimedia production tasks. Students in the flipped group reviewed an e-book for lessons on multimedia…

  2. Present Research on the Flipped Classroom and Potential Tools for the EFL Classroom

    Science.gov (United States)

    Mehring, Jeff

    2016-01-01

    The flipped classroom can support the implementation of a communicative, student-centered learning environment in the English as a foreign language classroom. Unfortunately, there is little research which supports the incorporation of flipped learning in the English as a foreign language classroom. Numerous studies have focused on flipped learning…

  3. Development of gold based solder candidates for flip chip assembly

    DEFF Research Database (Denmark)

    Chidambaram, Vivek; Hald, John; Hattel, Jesper Henri

    2009-01-01

    Flip chip technology is now rapidly replacing the traditional wire bonding interconnection technology in the first level packaging applications due to the miniaturization drive in the microelectronics industry. Flip chip assembly currently involves the use of high lead containing solders...... for interconnecting the chip to a carrier in certain applications due to the unique properties of lead. Despite of all the beneficial attributes of lead, its potential environmental impact when the products are discarded to land fills has resulted in various legislatives to eliminate lead from the electronic products...... based on its notorious legacy as a major health hazard across the spectrum of human generations and cultures. Flip chip assembly is also now increasingly being used for the high-performance (H-P) systems. These H-P systems perform mission-critical operations and are expected to experience virtually...

  4. Strange attractors in a chaotic coin flip simulation

    International Nuclear Information System (INIS)

    Cooper, Crystal

    2006-01-01

    Presented is a computer simulation used to model a variation of the game known as the gambler's ruin. A rich player gambles with a set amount of money m. The poor player starts out with zero capital, and is allowed to flip a coin in order to try to win the money. If the coin is heads, the poor player wins a dollar but if it is tails, the player loses a dollar. The poor player is always allowed to win the first flip, and is allowed to flip n times, even when the amount of money lost reaches zero. The dynamics of this process is chaotic due to fluctuations in the variance of the amount of money

  5. THE IMPLEMENTATION OF FLIPPED CLASSROOM MODEL IN EFL WRITING

    Directory of Open Access Journals (Sweden)

    Rida Afrilyasanti

    2016-10-01

    Full Text Available Flipped classroom is an approach to learning to write that allows teachers to have one-on-one assistance to help learners in the “during writing” stage in the classroom. Theories are given to the students in a video lectures to watch before class. Because problems in writing mostly occur in “during writing” stage, teacher assistance is crucial. This paper aims to share theoretical review and research findings pertaining to the implementation of flipped classroom model to EFL writing. Research findings show that flipped classroom is able to give greater opportunities for interactive sessions in class which focus on the students’ own concerns, questions, and needs. Therefore, students’ difficulties in “during writing” stage can be minimized

  6. Crack Tip Flipping Under Mode I/III Tearing

    DEFF Research Database (Denmark)

    Felter, Christian Lotz; Specht Jensen, Lasse; Nielsen, Kim Lau

    Crack tip flipping, where the fracture surface alternates from side to side in 45° shear bands, seems to be an overlooked propagation mode in Mode I sheet tearing often disregarded as  “transitional” or tied to randomness in the material. In fact, such observations rarely make it to the literature....... However, crack tip flipping is a true propagation mode, but unlike those already established: i) it never settles in a steady-state as the near tip stress/strain field continuously change, and ii) the mechanism governing failure evolves behind the leading crack tip. Recent research has revealed new...... insight into this intriguing behavior of a crack propagating by the void nucleation and growth mechanism, and the work presented compiles both published and unpublished experimental and numerical findings. E.g. in a recent attempt to gain control of the flipping crack a slight Mode III was imposed...

  7. Out of Classroom Instruction in the Flipped Classroom

    DEFF Research Database (Denmark)

    Triantafyllou, Evangelia; Timcenko, Olga

    2015-01-01

    This article presents experiences and student perceptions on the introduction of the flipped classroom model in two consecutive semesters at Media Technology department of Aalborg University, Copenhagen, Denmark. We introduced the flipped instruction model to a statistics course and a mathematics...... workshop. We collected data by two online survey studies, which show support for student perceptions that out-of-classroom instruction with online resources enhances learning, by providing visual and in depth explanations, and can engage the learner. However, students stated that they miss just......-in-time explanations when learning with online resources and they questioned the quality and validity of some of them. Based on these findings and our own experience, we discuss requirements for resources and activities in flipped classrooms in order for the student to engage and learn. Finally, we present a framework...

  8. Flipped Instruction in a High School Science Classroom

    Science.gov (United States)

    Leo, Jonathan; Puzio, Kelly

    2016-10-01

    This paper reports on a quasi-experimental study examining the effectiveness of flipped instruction in a 9th grade biology classroom. This study included four sections of freshmen-level biology taught by the first author at a private secondary school in the Pacific Northwest. Using a block randomized design, two sections were flipped and two remained traditional. The quiz and posttest data were adjusted for pretest differences using ANCOVA. The results suggest that flipped instruction had a positive effect student achievement, with effect sizes ranging from +0.16 to +0.44. In addition, some students reported that they preferred watching video lectures outside of class and appreciated more active approaches to learning.

  9. Graphene Layer Growth Chemistry: Five-Six-Ring Flip Reaction

    Energy Technology Data Exchange (ETDEWEB)

    Whitesides, R.; Domin, D.; Salomon-Ferrer, R.; Lester Jr., W.A.; Frenklach, M.

    2007-12-01

    Reaction pathways are presented for hydrogen-mediated isomerization of a five and six member carbon ring complex on the zigzag edge of a graphene layer. A new reaction sequence that reverses orientation of the ring complex, or 'flips' it, was identified. Competition between the flip reaction and 'ring separation' was examined. Ring separation is the reverse of the five and six member ring complex formation reaction, previously reported as 'ring collision'. The elementary steps of the pathways were analyzed using density-functional theory (DFT). Rate coefficients were obtained by solution of the energy master equation and classical transition state theory utilizing the DFT energies, frequencies, and geometries. The results indicate that the flip reaction pathway dominates the separation reaction and should be competitive with other pathways important to the graphene zigzag edge growth in high temperature environments.

  10. Spin flip of multiqubit states in discrete phase space

    Science.gov (United States)

    Srinivasan, K.; Raghavan, G.

    2017-02-01

    Time reversal and spin flip are discrete symmetry operations of substantial importance to quantum information and quantum computation. Spin flip arises in the context of separability, quantification of entanglement and the construction of universal NOT gates. The present work investigates the relationship between the quantum state of a multiqubit system represented by the discrete Wigner function (DWFs) and its spin-flipped counterpart. The two are shown to be related through a Hadamard matrix that is independent of the choice of the quantum net used for the tomographic reconstruction of the DWF. These results are of interest to cases involving the direct tomographic reconstruction of the DWF from experimental data, and in the analysis of entanglement related properties purely in terms of the DWF.

  11. Comparison of osteotomy technique and jig type in completion of distal femoral osteotomies for correction of medial patellar luxation. An in vitro study.

    Science.gov (United States)

    Olimpo, Matteo; Piras, Lisa A; Peirone, Bruno; Fox, Derek B

    2017-01-16

    Femoral osteotomies are frequently completed to correct malalignment associated with patellar luxation. The objectives of this study were to compare the use of: 1) two different types of jig; and 2) different types of osteotomy in the realignment of canine femoral bone models which possessed various iterations of angular deformity. Models of canine femora possessing distal varus, external torsion and a combination of varus and torsion underwent correction utilizing two alignment jigs (Slocum jig and Deformity Reduction Device) and either a closing wedge ostectomy (CWO) or an opening wedge osteotomy (OWO). Post-correctional alignment was evaluated by radiographic assessment and compared between groups. The use of the Slocum jig resulted in frontal plane overcorrection when used with CWO in models of femoral varus, and when used with OWO in models of femoral varus and external torsion when compared to other techniques. The Deformity Reduction Device tended to realign the frontal plane closer to the post-correction target value in all angulation types. The use of both jigs resulted in undercorrection in the transverse plane in models with varus and torsion. Jig selection and osteotomy type may lead to different post-correctional alignment results when performing distal femoral osteotomies. Whereas OWO allows accurate correction when used with either jig to address frontal plane deformities, the Deformity Reduction Device can be utilized with both CWO and OWO to correct torsion-angulation femoral deformities to optimize frontal plane alignment.

  12. Switched Flip-Flop based Preprocessing Circuit for ISFETs

    Directory of Open Access Journals (Sweden)

    Martin Kollár

    2005-03-01

    Full Text Available In this paper, a preprocessing circuit for ISFETs (Ion-sensitive field-effecttransistors to measure hydrogen-ion concentration in electrolyte is presented. A modifiedflip-flop is the main part of the circuit. The modification consists in replacing the standardtransistors by ISFETs and periodically switching the supply voltage on and off.Concentration of hydrogen ions to be measured discontinues the flip-flop value symmetry,which means that by switching the supply voltage on the flip-flop goes to one of two stablestates, ‘one’ or ‘zero’. The recovery of the value symmetry can be achieved by changing abalanced voltage, which is incorporated to the flip-flop, to bring the flip-flop to a 50%position (probability of ‘one’ equals to probability of ‘zero’. Thus, the balanced voltagereflects the measured concentration of hydrogen ions. Its magnitude is set automatically byusing a feedback circuit whose input is connected to the flip-flop output. The preprocessingcircuit, as the whole, is the well-known δ modulator in which the switched flip-flop servesas a comparator and a sampling circuit. The advantages of this approach in comparison tothose of standard approaches are discussed. Finally, theoretical results are verified bysimulations with TSPICE and a good agreement is reported.

  13. Owner assessment of the outcome of tibial plateau levelling osteotomy without meniscal evaluation for treatment of naturally occurring cranial cruciate ligament rupture: 130 cases (2009 to 2013).

    Science.gov (United States)

    Bureau, S

    2017-08-01

    To evaluate long-term surgical outcome and chronic pain in dogs suffering from naturally occurring cranial cruciate ligament rupture treated by tibial plateau levelling osteotomy without meniscal evaluation. In this retrospective clinical study, data from surgical records of dogs with cranial cruciate ligament rupture that underwent tibial plateau levelling osteotomy without meniscal evaluation between August 2009 and November 2013 were reviewed. An owner questionnaire was used to evaluate the long-term outcome and the prevalence of chronic pain. 107 dogs were included in this study. The long-term follow-up ranged from 1 to 4·5 years (mean 2·5 years). Four dogs developed acute lameness 4 to 21 months after surgery after having shown improvement. Dog behavior was assessed to be normal in 93% of cases and the level of activity was estimated to be normal for 88% of cases. Persistent lameness was reported after surgery in 6% of dogs and might have resulted from undiagnosed meniscal lesions. Considering the low incidence of persistent lameness after surgery and the limits of diagnosis and treatment, the need for routine meniscal examination during tibial plateau levelling osteotomy is questionable. © 2017 British Small Animal Veterinary Association.

  14. THE INFLUENCE OF COMPUTER-ASSISTED SURGERY ON CLINICAL AND RADIOGRAPHIC OUTCOMES OF PERIАRTICULAR FEMUR AND TIBIA OSTEOTOMIES IN OSTEOARTHRITIC PATIENTS (REVIEW

    Directory of Open Access Journals (Sweden)

    P. G. Kochergin

    2017-01-01

    Full Text Available Nowadays the clinical application of digital technologies became a growing trend at every stage of orthopedic patient treatment: from diagnostic procedures and pre-operative planning to intra-operative control of surgical manipulations and evaluation of final results later. The aim of thi sresearch was to analyze the studies dedicated to application of computer-assisted surgery (CAS for femur and tibial osteotomies in patients with gonarthrosis. The hypothesis was that CAS improves the precision of leg alignment correction in frontal and sagittal planes that positively influencing both functional result of treatment and longevity of clinical effect. The PubMed, PubMedCentral, GoogleScholar and eLIBRARY searched for relevant studies using following key words: knee, osteoarthritis, gonarthrosis, osteotomy, CAS, navigation and its russian analogs. The majority of publications favored CAS in comparison to traditional osteotomy techniques both for leg alignment and tibial slope control. Despite generally researchers paid less attention to functional results after CASosteotomies than to precision of surgical manipulations it is possible of confirm that there is strong tendency to better knee scores after navigation while the difference is not always statistically significant. Rare publications dedicated to long term results favor CAS: 10 years survival rate is 97% that correspond to outcomes of modern total knee arthroplasty. Hence, the current literature confirms the hypothesis of our study and don’t reveal increase of complications rate associated with CAS.

  15. Femoral Varus Osteotomy for Hip Instability after Traumatic Fracture Dislocations of the Hip Associated with Femoral Head Fractures: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Shuichi Miyamoto

    2016-01-01

    Full Text Available Fracture of the femoral head and the acetabulum with traumatic dislocation of the hip is a severe injury representing various types and unfavorable outcome. We showed a 45-year-old man with Pipkin type-IV fracture and coxa valga. An immediate closed reduction was achieved followed by open reduction and internal fixation via a posterior approach 6 days later. However, dislocation occurred three times without traumatic events after three weeks. CT demonstrated no displacement of posterior fragments or implant failure. Femoral intertrochanteric varus osteotomy was performed to gain concentric stability and successfully resolved recurrent dislocation. Another 45-year-old woman with Pipkin type-IV fracture and coxa valga also underwent closed reduction initially and then continued conservative treatment. After eight weeks, when she started gait training, progressive pain became symptomatic. Persistent hip pain at weight bearing was not improved in spite of arthroscopic synovectomy and osteochondroplasty. Two years after injury, femoral intertrochanteric varus osteotomy was indicated and her refractory pain was resolved gradually. We suggest that femoral varus osteotomy should be considered for superolateral subluxation associated fracture dislocation of the hip in Pipkin type-IV and coxa valga.

  16. Treatment of Brodie's Syndrome using parasymphyseal distraction through virtual surgical planning and RP assisted customized surgical osteotomy guide-A mock surgery report

    Science.gov (United States)

    Dahake, Sandeep; Kuthe, Abhaykumar; Mawale, Mahesh

    2017-10-01

    This paper aims to describe virtual surgical planning (VSP), computer aided design (CAD) and rapid prototyping (RP) systems for the preoperative planning of accurate treatment of the Brodie's Syndrome. 3D models of the patient's maxilla and mandible were separately generated based on computed tomography (CT) image data and fabricated using RP. During the customized surgical osteotmy guide (CSOG) design process, the correct position was identified and the geometry of the CSOG was generated based on affected mandible of the patient and fabricated by a RP technique. Surgical approach such as preoperative planning and simulation of surgical procedures was performed using advanced software. The VSP and RP assisted CSOG was used to avoid the damage of the adjacent teeth and neighboring healthy tissues. Finally the mock surgery was performed on the biomodel (i.e. diseased RP model) of mandible with reference to the normal maxilla using osteotomy bur with the help of CSOG. Using this CSOG the exact osteotomy of the mandible and the accurate placement of the distractor were obtained. It ultimately improved the accuracy of the surgery in context of the osteotomy and distraction. The time required in cutting the mandible and placement of the distractor was found comparatively less than the regular free hand surgery.

  17. I mål med flipped learning

    DEFF Research Database (Denmark)

    Hachmann, Roland

    2016-01-01

    Kapitlet belyser, hvordan synlige læringsmål og stilladsering er to vigtige elementer i Flipped Learning. Kapitlet belyser en række metoder til at bringe eleven i centrum for sin egen læring og hvorledes underviseren kan differentiere sin undervisning for netop at støtte denne proces......Kapitlet belyser, hvordan synlige læringsmål og stilladsering er to vigtige elementer i Flipped Learning. Kapitlet belyser en række metoder til at bringe eleven i centrum for sin egen læring og hvorledes underviseren kan differentiere sin undervisning for netop at støtte denne proces...

  18. Flip-Flop Recovery System for sounding rocket payloads

    Science.gov (United States)

    Flores, A., Jr.

    1986-01-01

    The design, development, and testing of the Flip-Flop Recovery System, which protects sensitive forward-mounted instruments from ground impact during sounding rocket payload recovery operations, are discussed. The system was originally developed to reduce the impact damage to the expensive gold-plated forward-mounted spectrometers in two existing Taurus-Orion rocket payloads. The concept of the recovery system is simple: the payload is flipped over end-for-end at a predetermined time just after parachute deployment, thus minimizing the risk of damage to the sensitive forward portion of the payload from ground impact.

  19. A Flipped Classroom experience: the lateral instability phenomenon

    OpenAIRE

    Sgambi, Luca; Nowicki, Alexandre; Garavaglia, Elsa; Basso, Noemi; Bath 2017 - Creativity and Collaboration

    2017-01-01

    For a teacher, to inspire creativity and innovation is definitely a big challenge. One of the best ways that a teacher can use to get this result, it is an instructional strategy based on active learning such as the “Flipped Classroom”. This paper describes a small Flipped Classroom experience developed at the school of Architecture of Politecnico di Milano and subsequently at the Université catholique de Louvain. To develop this activity the students of architecture are invited to reflect on...

  20. Controlling spin flips of molecules in an electromagnetic trap

    Science.gov (United States)

    Reens, David; Wu, Hao; Langen, Tim; Ye, Jun

    2017-12-01

    Doubly dipolar molecules exhibit complex internal spin dynamics when electric and magnetic fields are both applied. Near magnetic trap minima, these spin dynamics lead to enhancements in Majorana spin-flip transitions by many orders of magnitude relative to atoms and are thus an important obstacle for progress in molecule trapping and cooling. We conclusively demonstrate and address this with OH molecules in a trap geometry where spin-flip losses can be tuned from over 200 s-1 to below our 2 s-1 vacuum-limited loss rate with only a simple external bias coil and with minimal impact on trap depth and gradient.