WorldWideScience

Sample records for fracture control design

  1. Fracture mechanisms and fracture control in composite structures

    Science.gov (United States)

    Kim, Wone-Chul

    Four basic failure modes--delamination, delamination buckling of composite sandwich panels, first-ply failure in cross-ply laminates, and compression failure--are analyzed using linear elastic fracture mechanics (LEFM) and the J-integral method. Structural failures, including those at the micromechanical level, are investigated with the aid of the models developed, and the critical strains for crack propagation for each mode are obtained. In the structural fracture analyses area, the fracture control schemes for delamination in a composite rib stiffener and delamination buckling in composite sandwich panels subjected to in-plane compression are determined. The critical fracture strains were predicted with the aid of LEFM for delamination and the J-integral method for delamination buckling. The use of toughened matrix systems has been recommended for improved damage tolerant design for delamination crack propagation. An experimental study was conducted to determine the onset of delamination buckling in composite sandwich panel containing flaws. The critical fracture loads computed using the proposed theoretical model and a numerical computational scheme closely followed the experimental measurements made on sandwich panel specimens of graphite/epoxy faceskins and aluminum honeycomb core with varying faceskin thicknesses and core sizes. Micromechanical models of fracture in composites are explored to predict transverse cracking of cross-ply laminates and compression fracture of unidirectional composites. A modified shear lag model which takes into account the important role of interlaminar shear zones between the 0 degree and 90 degree piles in cross-ply laminate is proposed and criteria for transverse cracking have been developed. For compressive failure of unidirectional composites, pre-existing defects play an important role. Using anisotropic elasticity, the stress state around a defect under a remotely applied compressive load is obtained. The experimentally

  2. Design and real-time control of a robotic system for fracture manipulation.

    Science.gov (United States)

    Dagnino, G; Georgilas, I; Tarassoli, P; Atkins, R; Dogramadzi, S

    2015-08-01

    This paper presents the design, development and control of a new robotic system for fracture manipulation. The objective is to improve the precision, ergonomics and safety of the traditional surgical procedure to treat joint fractures. The achievements toward this direction are here reported and include the design, the real-time control architecture and the evaluation of a new robotic manipulator system. The robotic manipulator is a 6-DOF parallel robot with the struts developed as linear actuators. The control architecture is also described here. The high-level controller implements a host-target structure composed by a host computer (PC), a real-time controller, and an FPGA. A graphical user interface was designed allowing the surgeon to comfortably automate and monitor the robotic system. The real-time controller guarantees the determinism of the control algorithms adding an extra level of safety for the robotic automation. The system's positioning accuracy and repeatability have been demonstrated showing a maximum positioning RMSE of 1.18 ± 1.14mm (translations) and 1.85 ± 1.54° (rotations).

  3. Design, fracture control, fabrication, and testing of pressurized space-vehicle structures

    Science.gov (United States)

    Babel, H. W.; Christensen, R. H.; Dixon, H. H.

    1974-01-01

    The relationship between analysis, design, fabrication, and testing of thin shells is illustrated by Saturn S-IVB, Thor, Delta, and other single-use and reusable large-size cryogenic aluminum tankage. The analyses and design to meet the design requirements are reviewed and include consideration of fracture control, general instability, and other failure modes. The effect of research and development testing on the structure is indicated. It is shown how fabrication and nondestructive and acceptance testing constrain the design. Finally, qualification testing is reviewed to illustrate the extent of testing used to develop the Saturn S-IVB.

  4. The efficacy of rotational control designs in promoting torsional stability of hip fracture fixation.

    Science.gov (United States)

    Gosiewski, J D; Holsgrove, T P; Gill, H S

    2017-05-01

    Fractures of the proximal femur are a common clinical problem, and a number of orthopaedic devices are available for the treatment of such fractures. The objective of this study was to assess the rotational stability, a common failure predictor, of three different rotational control design philosophies: a screw, a helical blade and a deployable crucifix. Devices were compared in terms of the mechanical work (W) required to rotate the implant by 6° in a bone substitute material. The substitute material used was Sawbones polyurethane foam of three different densities (0.08 g/cm 3 , 0.16 g/cm 3 and 0.24 g/cm 3 ). Each torsion test comprised a steady ramp of 1°/minute up to an angular displacement of 10°. The deployable crucifix design (X-Bolt), was more torsionally stable, compared to both the dynamic hip screw (DHS, p = 0.008) and helical blade (DHS Blade, p= 0.008) designs in bone substitute material representative of osteoporotic bone (0.16 g/cm 3 polyurethane foam). In 0.08 g/cm 3 density substrate, the crucifix design (X-Bolt) had a higher resistance to torsion than the screw (DHS, p = 0.008). There were no significant differences (p = 0.101) between the implants in 0.24 g/cm 3 density bone substitute. Our findings indicate that the clinical standard proximal fracture fixator design, the screw (DHS), was the least effective at resisting torsional load, and a novel crucifix design (X-Bolt), was the most effective design in resisting torsional load in bone substitute material with density representative of osteoporotic bone. At other densities the torsional stability was also higher for the X-Bolt, although not consistently significant by statistical analysis. Cite this article : J. D. Gosiewski, T. P. Holsgrove, H. S. Gill. The efficacy of rotational control designs in promoting torsional stability of hip fracture fixation. Bone Joint Res 2017;6:270-276. DOI: 10.1302/2046-3758.65.BJR-2017-0287.R1. © 2017 Gosiewski et al.

  5. Design guidance for fracture-critical components at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    Streit, R.D.

    1982-01-01

    Fracture is an important design consideration for components whose sudden and catastrophic failure could result in a serious accident. Elements of fracture control and fracture mechanics design methods are reviewed. Design requirements, which are based on the consequences of fracture of a given component, are subsequently developed. Five categories of consequences are defined. Category I is the lowest risk, and relatively lenient design requirements are employed. Category V has the highest potential for injury, release of hazardous material, and damage. Correspondingly, the design requirements for these components are the most stringent. Environmental, loading, and material factors that can affect fracture safety are also discussed

  6. Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures: A matched case-control study.

    Science.gov (United States)

    Sawada, Hideyoshi; Shinohara, Takaaki; Natsume, Tadahiro; Hirata, Hitoshi

    2016-11-01

    Ulnar styloid fractures are often associated with distal radius fractures. However, controversy exists regarding whether to treat ulnar styloid fractures. This study aimed to evaluate clinical effects of internal fixation for ulnar styloid fractures after distal radius fractures were treated with the volar locking plate system. We used prospectively collected data of distal radius fractures. 111 patients were enrolled in this study. A matched case-control study design was used. We selected patients who underwent fixation for ulnar styloid fractures (case group). Three control patients for each patient of the case group were matched on the basis of age, sex, and fracture type of distal radius fractures from among patients who did not undergo fixation for ulnar styloid fractures (control group). The case group included 16 patients (7 men, 9 women; mean age: 52.6 years; classification of ulnar styloid fractures: center, 3; base, 11; and proximal, 2). The control group included 48 patients (15 men, 33 women; mean age: 61.1 years; classification of ulnar styloid fractures: center, 10; base, 31; and proximal, 7). For radiographic examination, the volar tilt angle, radial inclination angle, and ulnar variance length were measured, and the union of ulnar styloid fractures was judged. For clinical examination, the range of motions, grip strength, Hand20 score, and Numeric Rating Scale score were evaluated. There was little correction loss for each radiological parameter of fracture reduction, and these parameters were not significantly different between the groups. The bone-healing rate of ulnar styloid fractures was significantly higher in the case group than in the control group, but the clinical results were not significantly different. We revealed that there was no need to fix ulnar styloid fractures when distal radius fractures were treated via open reduction and internal fixation with a volar locking plate system. Copyright © 2016 The Japanese Orthopaedic Association

  7. Influence of the preparation design and artificial aging on the fracture resistance of monolithic zirconia crowns.

    Science.gov (United States)

    Mitov, Gergo; Anastassova-Yoshida, Yana; Nothdurft, Frank Phillip; von See, Constantin; Pospiech, Peter

    2016-02-01

    The aim of this study was to evaluate the fracture resistance and fracture behavior of monolithic zirconia crowns in accordance with the preparation design and aging simulation method. An upper first molar was prepared sequentially with three different preparation designs: shoulderless preparation, 0.4 mm chamfer and 0.8 mm chamfer preparation. For each preparation design, 30 monolithic zirconia crowns were fabricated. After cementation on Cr-Co alloy dies, the following artificial aging procedures were performed: (1) thermal cycling and mechanical loading (TCML): 5000 cycles of thermal cycling 5℃-55℃ and chewing simulation (1,200,000 cycles, 50 N); (2) Low Temperature Degradation simulation (LTD): autoclave treatment at 137℃, 2 bar for 3 hours and chewing simulation; and (3) no pre-treatment (control group). After artificial aging, the crowns were loaded until fracture. The mean values of fracture resistance varied between 3414 N (LTD; 0.8 mm chamfer preparation) and 5712 N (control group; shoulderless preparation). Two-way ANOVA analysis showed a significantly higher fracture loads for the shoulderless preparation, whereas no difference was found between the chamfer preparations. In contrast to TCML, after LTD simulation the fracture strength of monolithic zirconia crowns decreased significantly. The monolithic crowns tested in this study showed generally high fracture load values. Preparation design and LTD simulation had a significant influence on the fracture strength of monolithic zirconia crowns.

  8. Monitoring Hydraulic Fracturing Using Ground-Based Controlled Source Electromagnetics

    Science.gov (United States)

    Hickey, M. S.; Trevino, S., III; Everett, M. E.

    2017-12-01

    Hydraulic fracturing allows hydrocarbon production in low permeability formations. Imaging the distribution of fluid used to create a hydraulic fracture can aid in the characterization of fracture properties such as extent of plume penetration as well as fracture azimuth and symmetry. This could contribute to improving the efficiency of an operation, for example, in helping to determine ideal well spacing or the need to refracture a zone. A ground-based controlled-source electromagnetics (CSEM) technique is ideal for imaging the fluid due to the change in field caused by the difference in the conductive properties of the fluid when compared to the background. With advances in high signal to noise recording equipment, coupled with a high-power, broadband transmitter we can show hydraulic fracture extent and azimuth with minimal processing. A 3D finite element code is used to model the complete well casing along with the layered subsurface. This forward model is used to optimize the survey design and isolate the band of frequencies with the best response. In the field, the results of the modeling are also used to create a custom pseudorandom numeric (PRN) code to control the frequencies transmitted through a grounded dipole source. The receivers record the surface voltage across two grounded dipoles, one parallel and one perpendicular to the transmitter. The data are presented as the displays of amplitude ratios across several frequencies with the associated spatial information. In this presentation, we show multiple field results in multiple basins in the United States along with the CSEM theory used to create the survey designs.

  9. On the fracture of human dentin: Is it stress- orstrain-controlled?

    Energy Technology Data Exchange (ETDEWEB)

    Nalla, R.K.; Kinney, J.H.; Ritchie, R.O.

    2006-02-01

    Despite substantial clinical interest in the fracture resistance of human dentin, there is little mechanistic information in archival literature that can be usefully used to model such fracture. In fact, although the fracture event indent in, akin to other mineralized tissues like bone, is widely believed to be locally strain-controlled, there has never been any scientific proof to support this belief. The present study seeks to address this issue through the use of a novel set of in vitro experiments in Hanks' balanced salt solution involving a double-notched bend test geometry, which is designed to discern whether the critical failure events involved in the onset of fracture are locally stress- or strain-controlled. Such experiments are further used to characterize the notion of ''plasticity'' in dentin and the interaction of cracks with the salient microstructural features. It is observed that fracture in dentin is indeed locally strain-controlled and that the presence of dentinal tubules does not substantially affect this process of crack initiation and growth. The results presented are believed to be critical steps in the development of a micromechanical model for the fracture of human dentin that takes into consideration the influence of both the microstructure and the local failure mode.

  10. Change in fracture risk and fracture pattern after bariatric surgery: nested case-control study.

    Science.gov (United States)

    Rousseau, Catherine; Jean, Sonia; Gamache, Philippe; Lebel, Stéfane; Mac-Way, Fabrice; Biertho, Laurent; Michou, Laëtitia; Gagnon, Claudia

    2016-07-27

     To investigate whether bariatric surgery increases the risk of fracture.  Retrospective nested case-control study.  Patients who underwent bariatric surgery in the province of Quebec, Canada, between 2001 and 2014, selected using healthcare administrative databases.  12 676 patients who underwent bariatric surgery, age and sex matched with 38 028 obese and 126 760 non-obese controls.  Incidence and sites of fracture in patients who had undergone bariatric surgery compared with obese and non-obese controls. Fracture risk was also compared before and after surgery (index date) within each group and by type of surgery from 2006 to 2014. Multivariate conditional Poisson regression models were adjusted for fracture history, number of comorbidities, sociomaterial deprivation, and area of residence.  Before surgery, patients undergoing bariatric surgery (9169 (72.3%) women; mean age 42 (SD 11) years) were more likely to fracture (1326; 10.5%) than were obese (3065; 8.1%) or non-obese (8329; 6.6%) controls. A mean of 4.4 years after surgery, bariatric patients were more susceptible to fracture (514; 4.1%) than were obese (1013; 2.7%) and non-obese (3008; 2.4%) controls. Postoperative adjusted fracture risk was higher in the bariatric group than in the obese (relative risk 1.38, 95% confidence interval 1.23 to 1.55) and non-obese (1.44, 1.29 to 1.59) groups. Before surgery, the risk of distal lower limb fracture was higher, upper limb fracture risk was lower, and risk of clinical spine, hip, femur, or pelvic fractures was similar in the bariatric and obese groups compared with the non-obese group. After surgery, risk of distal lower limb fracture decreased (relative risk 0.66, 0.56 to 0.78), whereas risk of upper limb (1.64, 1.40 to 1.93), clinical spine (1.78, 1.08 to 2.93), pelvic, hip, or femur (2.52, 1.78 to 3.59) fractures increased. The increase in risk of fracture reached significance only for biliopancreatic diversion.  Patients undergoing bariatric

  11. BMD T-score discriminates trochanteric fractures from unfractured controls, whereas geometry discriminates cervical fracture cases from unfractured controls of similar BMD.

    Science.gov (United States)

    Pulkkinen, P; Partanen, J; Jalovaara, P; Jämsä, T

    2010-07-01

    The ability of bone mineral density (BMD) to discriminate cervical and trochanteric hip fractures was studied. Since the majority of fractures occur among people who are not diagnosed as having osteoporosis, we also examined this population to elucidate whether geometrical risk factors can yield additional information on hip fracture risk beside BMD. The study showed that the T-score criterion was able to discriminate fracture patients from controls in the cases of trochanteric fractures, whereas geometrical measures may discriminate cervical fracture cases in patients with T-score >-2.5. Low bone mineral density (BMD) is a well-established risk factor for hip fracture. However, majority of fractures occur among people not diagnosed as having osteoporosis. We studied the ability of BMD to discriminate cervical and trochanteric hip fractures. Furthermore, we examined whether geometrical measures can yield additional information on the assessment of hip fracture risk in the fracture cases in subjects with T-score >-2.5. Study group consisted of postmenopausal females with non-pathologic cervical (n = 39) or trochanteric (n = 18) hip fracture (mean age 74.2 years) and 40 age-matched controls. BMD was measured at femoral neck, and femoral neck axis length, femoral neck and shaft cortex thicknesses (FNC and FSC), and femoral neck-shaft angle (NSA) were measured from radiographs. BMD T-score threshold of -2.5 was able to discriminate trochanteric fractures from controls (p trochanteric fractures occurred in individuals with T-score fractures. Twenty of these fractures (51.3%) occurred in individuals with BMD in osteoporotic range and 19 (48.7%) in individuals with T-score >-2.5. Within these non-osteoporotic cervical fracture patients (N = 19) and non-osteoporotic controls (N = 35), 83.3% were classified correctly based on a model including NSA and FNC (p trochanteric fractures could be discriminated based on a BMD T-score fracture cases would remain under-diagnosed if

  12. Vision-based real-time position control of a semi-automated system for robot-assisted joint fracture surgery.

    Science.gov (United States)

    Dagnino, Giulio; Georgilas, Ioannis; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

    2016-03-01

    Joint fracture surgery quality can be improved by robotic system with high-accuracy and high-repeatability fracture fragment manipulation. A new real-time vision-based system for fragment manipulation during robot-assisted fracture surgery was developed and tested. The control strategy was accomplished by merging fast open-loop control with vision-based control. This two-phase process is designed to eliminate the open-loop positioning errors by closing the control loop using visual feedback provided by an optical tracking system. Evaluation of the control system accuracy was performed using robot positioning trials, and fracture reduction accuracy was tested in trials on ex vivo porcine model. The system resulted in high fracture reduction reliability with a reduction accuracy of 0.09 mm (translations) and of [Formula: see text] (rotations), maximum observed errors in the order of 0.12 mm (translations) and of [Formula: see text] (rotations), and a reduction repeatability of 0.02 mm and [Formula: see text]. The proposed vision-based system was shown to be effective and suitable for real joint fracture surgical procedures, contributing a potential improvement of their quality.

  13. Fracturing Fluid Leak-off for Deep Volcanic Rock in Zhungeer Basin: Mechanism and Control Method

    Directory of Open Access Journals (Sweden)

    Huang Bo

    2017-01-01

    Full Text Available The deep volcanic reservoir in Zhungeer Basin is buried in over 4000m depth, which is characterized by complex lithology (breccia, andesite, basalt, etc., high elastic modulus and massive natural fractures. During hydraulic fracturing, hydraulic fracture will propagate and natural fractures will be triggered by the increasing net pressure. However, the extension of fractures, especially natural fractures, would aggravate the leak-off effect of fracturing fluid, and consequently decrease the fracturing success rate. 4 out of 12 fracturing wells in the field have failed to add enough proppants due to fluid loss. In order to increase the success rate and efficiency of hydraulic fracturing for deep volcanic reservoir, based on theoretical and experimental method, the mechanism of fracturing fluid leak-off is deeply studied. We propose a dualistic proppant scheme and employ the fluid loss reducer to control the fluid leak-off in macro-fractures and micro-fractures respectively. The proposed technique remarkably improved the success rate in deep volcanic rock fracturing. It bears important theoretical value and practical significance to improve the hydraulic fracturing design for deep volcanic reservoir.

  14. [Fracture resistance of Procera Allceram depending on the framework design--an in vitro study].

    Science.gov (United States)

    Hagmann, Edgar; Marinello, Carlo P; Zitzmann, Nicola U

    2006-01-01

    Procera AllCeram is one of the all-ceramic systems with an aluminium-oxide core employing CAD/CAM technology. The aim of the current study was to investigate the fracture resistance of Procera AllCeram full-ceramic crowns with a reduced core design compared to the conventional method. In addition, a possible influence of the preparation form (molars or premolars) and the cementation material (glas-ionomer or composite) was analyzed. For both preparation forms, 30 ceramic cores with reduced margins (collarless cores, test) and 30 cores with extended cores (control) were veneered with porcelain in a standardized procedure (total 120 crowns). For the test group, Procera-AllCeram-margin ceramic material was used for the porcelain collar. 40 crowns each were cemented on stainless steel dies with either Ketac-Cem Aplicap or Panavia F. The additional 40 crowns were set on polyurethane dies without cementation and occlusally loaded until fracture occurred. Among the molar crowns, no differences were observed in fracture resistance neither for the different core designs (test or control) nor for the cementation materials. For the premolar form, fusing of a porcelain margin was associated with a reduction in fracture resistance, while the use of composite cement was accompanied with an increase. The present in vitro results indicate that for Procera AllCeram crowns with a highly undulating preparation margin, a conventional core design combined with adhesive cementation is preferable, especially in the posterior region due to higher chewing forces; this assumption needs to be proven in clinical studies.

  15. On the fracture of human dentin: Is it stress- orstrain-controlled?

    Energy Technology Data Exchange (ETDEWEB)

    Nalla, R.K.; Kinney, J.H.; Ritchie, R.O.

    2006-02-01

    Despite substantial clinical interest in the fractureresistance of human dentin, there is little mechanistic information inarchival literature that can be usefully used to model such fracture. Infact, although the fracture event indent in, akin to other mineralizedtissues like bone, is widely believed to be locally strain-controlled,there has never been any scientific proof to support this belief. Thepresent study seeks to address this issue through the use of a novel setof in vitro experiments in Hanks' balanced salt solution involving adouble-notched bend test geometry, which is designed to discern whetherthe critical failure events involved in the onset of fracture are locallystress- or strain-controlled. Such experiments are further used tocharacterize the notion of "plasticity" in dentin and the interaction ofcracks with the salient microstructural features. It is observed thatfracture in dentin is indeed locally strain-controlled and that thepresence of dentinal tubules does not substantially affect this processof crack initiation and growth. The results presented are believed to becritical steps in the development ofa micromechanical model for thefracture of human dentin that takes into consideration the influence ofboth the microstructure and the local failure mode.

  16. Sensory impairments and wrist fractures: A case-control study

    Directory of Open Access Journals (Sweden)

    Bergthora Baldursdottir

    2017-12-01

    Full Text Available Objectives: To investigate vestibular function, foot sensation, postural control and functional abilities, and to evaluate whether these variables are associated with fall-related wrist fracture. Methods: A case-control study was conducted with 98 subjects, age range 50–75 years, who had sustained a fall-related wrist fracture. Forty-eight sex-, age- and physical activity-matched individuals, with no previous history of wrist fracture, served as controls. Measurements included: head-shake test (HST, tuning fork, biothesiometer, Semmes-Weinstein monofilaments (MF, Sensory Organization Test (SOT, Five-Times-Sit-to-Stand Test (FTSTS, 10-m walk test (10MWT, Activities-specific Balance Confidence (ABC, and the Dizziness Handicap Inventory (DHI scales. Logistic regression models were used to determine associations of variables with a fall-related wrist fracture. Results: Vestibular asymmetry was apparent in 82% of wrist fracture subjects and 63% of controls (p = 0.012. Plantar pressure sensation (p <0.001, SOT composite scores (p < 0.001, 10MWT (p <0.001, FTSTS (p <0.001, ABC (p <0.001 and DHI (p <0.005 were significantly poorer among cases than controls. A positive HST (odds ratio (OR 5.424; p = 0.008 and monofilament sensation (OR 3.886; p = 0.014 showed the strongest associations with having a fall-related wrist fracture. Conclusion: Asymmetrical vestibular function and reduced plantar pressure sensation are associated with fall-related wrist fractures among the ageing population. These factors are potential targets for future interventions.

  17. A Thermoelastic Hydraulic Fracture Design Tool for Geothermal Reservoir Development

    Energy Technology Data Exchange (ETDEWEB)

    Ahmad Ghassemi

    2003-06-30

    Geothermal energy is recovered by circulating water through heat exchange areas within a hot rock mass. Geothermal reservoir rock masses generally consist of igneous and metamorphic rocks that have low matrix permeability. Therefore, cracks and fractures play a significant role in extraction of geothermal energy by providing the major pathways for fluid flow and heat exchange. Thus, knowledge of conditions leading to formation of fractures and fracture networks is of paramount importance. Furthermore, in the absence of natural fractures or adequate connectivity, artificial fracture are created in the reservoir using hydraulic fracturing. At times, the practice aims to create a number of parallel fractures connecting a pair of wells. Multiple fractures are preferred because of the large size necessary when using only a single fracture. Although the basic idea is rather simple, hydraulic fracturing is a complex process involving interactions of high pressure fluid injections with a stressed hot rock mass, mechanical interaction of induced fractures with existing natural fractures, and the spatial and temporal variations of in-situ stress. As a result it is necessary to develop tools that can be used to study these interactions as an integral part of a comprehensive approach to geothermal reservoir development, particularly enhanced geothermal systems. In response to this need we have set out to develop advanced thermo-mechanical models for design of artificial fractures and rock fracture research in geothermal reservoirs. These models consider the significant hydraulic and thermo-mechanical processes and their interaction with the in-situ stress state. Wellbore failure and fracture initiation is studied using a model that fully couples poro-mechanical and thermo-mechanical effects. The fracture propagation model is based on a complex variable and regular displacement discontinuity formulations. In the complex variable approach the displacement discontinuities are

  18. Physiotherapy Rehabilitation for Osteoporotic Vertebral Fracture (PROVE): study protocol for a randomised controlled trial

    Science.gov (United States)

    2014-01-01

    Background Osteoporosis and vertebral fracture can have a considerable impact on an individual’s quality of life. There is increasing evidence that physiotherapy including manual techniques and exercise interventions may have an important treatment role. This pragmatic randomised controlled trial will investigate the clinical and cost-effectiveness of two different physiotherapy approaches for people with osteoporosis and vertebral fracture, in comparison to usual care. Methods/Design Six hundred people with osteoporosis and a clinically diagnosed vertebral fracture will be recruited and randomly allocated to one of three management strategies, usual care (control - A), an exercise-based physiotherapy intervention (B) or a manual therapy-based physiotherapy intervention (C). Those in the usual care arm will receive a single session of education and advice, those in the active treatment arms (B + C) will be offered seven individual physiotherapy sessions over 12 weeks. The trial is designed as a prospective, adaptive single-blinded randomised controlled trial. An interim analysis will be completed and if one intervention is clearly superior the trial will be adapted at this point to continue with just one intervention and the control. The primary outcomes are quality of life measured by the disease specific QUALLEFO 41 and the Timed Loaded Standing test measured at 1 year. Discussion There are a variety of different physiotherapy packages used to treat patients with osteoporotic vertebral fracture. At present, the indication for each different therapy is not well defined, and the effectiveness of different modalities is unknown. Trial registration Reference number ISRCTN49117867. PMID:24422876

  19. Estimation of the controlling stress in creep fracture

    International Nuclear Information System (INIS)

    Henderson, J.; Ferguson, F.R.

    1975-01-01

    The implementation of correct criterion in creep design, has been shown to be of fundamental significance in the assessment of component life. The present report considers the problem of the means whereby the criterion may be derived for a particular metal without the availability of sophisticated complex-stress testing equipment and procedures such as the combined tension and torsion tests on thin walled tubular specimens employed in the earlier fundamental researches on the subject. By investigating a wide spectrum of engineering metals it was established that for homogeneous stress conditions two criteria appeared to be sufficient to cover all the metals studied for complex-stress creep fracture, either the maximum principal stress or the octahedral shear stress criterion. Further, it was found that those metals which developed random and continuous cracking during creep were controlled with respect to fracture time by the maximum principal stress, while metals which showed virtually no cracking were governed by the octahedral shear stress or second order invariant. The physical nature of the final fracture (transcrystalline or inter-crystalline), contrary to considerable current concepts, was found to be unrelated to which criterion was operative. Having reduced the possible fracture criteria to two, it only remained to develop a simple test method exploiting this finding to achieve the precise identification for a particular metal. Seven metals including aluminium, copper, titanium, cast iron and three steels have been investigated in the present report at temperatures where creep conditions are operative. The results have shown that the method leads to sufficiently accurate prediction of the complex stress creep fracture criterion for the metals studied

  20. Environmental controls on micro fracture processes in shelf ice

    Science.gov (United States)

    Sammonds, Peter

    2013-04-01

    The recent retreat and collapse of the ice shelves on the Antarctic Peninsula has been associated with regional atmospheric warming, oceanic warming, increased summer melt and shelf flexure. Although the cause of collapse is a matter of active discussion, the process is that of fracture of a creep-brittle material, close to its melting point. The environmental controls on how fracturing initiates, at a micro-scale, strongly determine the macroscopic disintegration of ice shelves. In particular the shelf temperature profile controls the plasticity of the ice shelf; the densification of shelf ice due to melting and re-freezing affects the crack tip stress intensity; the accretion of marine ice at the bottom of the shelf imposes a thermal/mechanical discontinuity; saline environments control crack tip stress corrosion; cyclic loading promotes sub-critical crack propagation. These strong environmental controls on shelf ice fracture means that assessing shelf stability is a non-deterministic problem. How these factors may be parameterized in ice shelf models, through the use of fracture mechanisms maps, is discussed. The findings are discussed in relation to the stability of Larsen C.

  1. Controlling fracture cascades through twisting and quenching

    OpenAIRE

    Heisser, Ronald H.; Patil, Vishal P.; Stoop, Norbert; Dunkel, Jörn

    2018-01-01

    Fracture limits the structural stability of macroscopic and microscopic materials, from beams and bones to microtubules and nanotubes. Despite recent progress, fracture control continues to present profound practical and theoretical challenges. A famous longstanding problem posed by Feynman asks why brittle elastic rods appear almost always to fragment into at least three pieces when placed under large bending stresses. Feynman's observation raises fundamental questions about the existence of...

  2. Mechanical design optimization of bioabsorbable fixation devices for bone fractures.

    Science.gov (United States)

    Lovald, Scott T; Khraishi, Tariq; Wagner, Jon; Baack, Bret

    2009-03-01

    Bioabsorbable bone plates can eliminate the necessity for a permanent implant when used to fixate fractures of the human mandible. They are currently not in widespread use because of the low strength of the materials and the requisite large volume of the resulting bone plate. The aim of the current study was to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a standard titanium bone plate. A finite element model of a mandible with a fracture in the body region is subjected to bite loads that are common to patients postsurgery. The model is used first to determine benchmark stress and strain values for a titanium plate. These values are then set as the limits within which the bioabsorbable bone plate must comply. The model is then modified to consider a bone plate made of the polymer poly-L/DL-lactide 70/30. An optimization routine is run to determine the smallest volume of bioabsorbable bone plate that can perform and a titanium bone plate when fixating fractures of this considered type. Two design parameters are varied for the bone plate design during the optimization analysis. The analysis determined that a strut style poly-L-lactide-co-DL-lactide plate of 690 mm2 can provide as much mechanical stability as a similar titanium design structure of 172 mm2. The model has determined a bioabsorbable bone plate design that is as strong as a titanium plate when fixating fractures of the load-bearing mandible. This is an intriguing outcome, considering that the polymer material has only 6% of the stiffness of titanium.

  3. Effects of simplifying fracture network representation on inert chemical migration in fracture-controlled aquifers

    Science.gov (United States)

    Wellman, Tristan; Shapiro, Allen M.; Hill, Mary C.

    2009-01-01

    While it is widely recognized that highly permeable 'large-scale' fractures dominate chemical migration in many fractured aquifers, recent studies suggest that the pervasive 'small-scale' fracturing once considered of less significance can be equally important for characterizing the spatial extent and residence time associated with transport processes. A detailed examination of chemical migration through fracture-controlled aquifers is used to advance this conceptual understanding. The influence of fracture structure is evaluated by quantifying the effects to transport caused by a systematic removal of fractures from three-dimensional discrete fracture models whose attributes are derived from geologic and hydrologic conditions at multiple field sites. Results indicate that the effects to transport caused by network simplification are sensitive to the fracture network characteristics, degree of network simplification, and plume travel distance, but primarily in an indirect sense since correlation to individual attributes is limited. Transport processes can be 'enhanced' or 'restricted' from network simplification meaning that the elimination of fractures may increase or decrease mass migration, mean travel time, dispersion, and tailing of the concentration plume. The results demonstrate why, for instance, chemical migration may not follow the classic advection-dispersion equation where dispersion approximates the effect of the ignored geologic structure as a strictly additive process to the mean flow. The analyses further reveal that the prediction error caused by fracture network simplification is reduced by at least 50% using the median estimate from an ensemble of simplified fracture network models, and that the error from network simplification is at least 70% less than the stochastic variability from multiple realizations. Copyright 2009 by the American Geophysical Union.

  4. Clastic patterned ground in Lomonosov crater, Mars: examining fracture controlled formation mechanisms

    Science.gov (United States)

    Barrett, Alexander M.; Balme, Matthew R.; Patel, Manish R.; Hagermann, Axel

    2017-10-01

    The area surrounding Lomonosov crater on Mars has a high density of seemingly organised boulder patterns. These form seemingly sorted polygons and stripes within kilometre scale blockfields, patches of boulder strewn ground which are common across the Martian high latitudes. Several hypotheses have been suggested to explain the formation of clastic patterned ground on Mars. It has been proposed that these structures could have formed through freeze-thaw sorting, or conversely by the interaction of boulders with underlying fracture polygons. In this investigation a series of sites were examined to evaluate whether boulder patterns appear to be controlled by the distribution of underlying fractures and test the fracture control hypotheses for their formation. It was decided to focus on this suite of mechanisms as they are characterised by a clear morphological relationship, namely the presence of an underlying fracture network which can easily be evaluated over a large area. It was found that in the majority of examples at these sites did not exhibit fracture control. Although fractures were present at many sites there were very few sites where the fracture network appeared to be controlling the boulder distribution. In general these were not the sites with the best examples of organization, suggesting that the fracture control mechanisms are not the dominant geomorphic process organising the boulders in this area.

  5. Prevalence of overweight in children with bone fractures: a case control study.

    Science.gov (United States)

    Valerio, Giuliana; Gallè, Francesca; Mancusi, Caterina; Di Onofrio, Valeria; Guida, Pasquale; Tramontano, Antonino; Ruotolo, Edoardo; Liguori, Giorgio

    2012-10-22

    Children's fractures have been enlisted among orthopaedics complaints of childhood obesity. Unhealthy lifestyle behaviours may contribute to increased risk. This study described the prevalence of overweight/obesity in children and adolescents reporting a recent fracture in relation to gender, dynamic of trauma, and site of fracture. Four-hundred-forty-nine children and adolescents with fracture and 130 fracture-free controls were recruited from a large children's hospital. The interaction between overweight and gender, dynamic of trauma, site of fracture was explored. Sports participation, television viewing, and calcium intake were also investigated. Overweight/obesity rate was increased in girls with fracture either at the upper or the lower limb (p= 0.004), while it was increased only in boys with fracture at the lower limb (p fractures than controls (61.5% vs 34.5%, p =0.015) in the overweight/obese group. The increased prevalence of overweight/obesity in children with fractures is related to gender and site of fracture. Higher levels of sedentary behaviours characterize overweight children reporting fractures.

  6. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

    OpenAIRE

    Nauth, A. (Aaron); Creek, A.T. (Aaron T.); Zellar, A. (Abby); Lawendy, A.-R. (Abdel-Rahman); Dowrick, A. (Adam); Gupta, A. (Ajay); Dadi, A. (Akhil); Kampen, A.; Yee, A. (Albert); Vries, Alexander; de Mol van Otterloo, A. (Alexander); Garibaldi, A. (Alisha); Liew, A. (Allen); McIntyre, A.W. (Allison W.); Prasad, A.S. (Amal Shankar)

    2017-01-01

    textabstractBackground Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a...

  7. Design philosophy and practice of asymmetrical 3D fracturing and random fracturing: A case study of tight sand gas reservoirs in western Sichuan Basin

    Directory of Open Access Journals (Sweden)

    Jianchun Guo

    2015-03-01

    Full Text Available At present two technical models are commonly taken in tight gas reservoir stimulation: conventional massive fracturing and SRV fracturing, but how to select a suitable fracturing model suitable for reservoir characteristics is still a question waiting to be answered. In this paper, based on the analysis of geological characteristics and seepage mechanism of tight gas and shale gas reservoirs, the differences between stimulation philosophy of tight gas reservoirs and shale reservoirs are elucidated, and the concept that a suitable stimulation model should be selected based on reservoir geological characteristics and seepage mechanism aiming at maximally improving the seepage capability of a reservoir. Based on this concept, two fracturing design methods were proposed for two tight gas reservoirs in western Sichuan Basin: asymmetrical 3D fracturing design (A3DF for the middle-shallow Upper Jurassic Penglaizhen Fm stacked reservoirs in which the hydraulic fractures can well match the sand spatial distribution and seepage capability of the reservoirs; SRV fracturing design which can increase fracture randomness in the sandstone and shale laminated reservoirs for the 5th Member of middle-deep Upper Triassic Xujiahe Fm. Compared with that by conventional fracturing, the average production of horizontal wells fractured by A3DF increased by 41%, indicating that A3DF is appropriate for gas reservoir development in the Penglaizhen Fm; meanwhile, the average production per well of the 5th Member of the Xujiahe Fm was 2.25 × 104 m3/d after SRV fracturing, showing that the SRV fracturing is a robust technical means for the development of this reservoir.

  8. Effect of interfragmentary gap on the mechanical behavior of mandibular angle fracture with three fixation designs: A finite element analysis.

    Science.gov (United States)

    Wang, Russell; Liu, Yunfeng; Wang, Joanne Helen; Baur, Dale Allen

    2017-03-01

    The aim of this study was to simulate stress and strain distribution numerically on a normal mandible under physiological occlusal loadings. The results were compared with those of mandibles that had an angle fracture stabilized with different fixation designs under the same loadings. The amount of displacement at two interfragmentary gaps was also studied. A three-dimensional (3D) virtual mandible was reconstructed with an angle fracture that had a fracture gap of either 0.1 or 1 mm. Three types of plate fixation designs were used: Type I, a miniplate was placed across the fracture line following the Champy technique; Type II, two miniplates were used; and Type III, a reconstruction plate was used on the inferior border of the mandible. Loads of 100 and 500 N were applied to the models. The maximum von Mises stress, strain, and displacement were computed using finite element analysis. The results from the control and experimental groups were analyzed and compared. The results demonstrated that high stresses and strains were distributed to the condylar and angular areas regardless of the loading position. The ratio of the plate/bone average stress ranged from 215% (Type II design) to 848% (Type I design) irrespective of the interfragmentary gap size. With a 1-mm fracture gap, the ratio of the plate/bone stress ranged from 204% (Type II design) to 1130% (Type I design). All strains were well below critical bone strain thresholds. Displacement on the cross-sectional mapping at fracture interface indicated that uneven movement occurred in x, y, and z directions. Interfragmentary gaps between 0.1 and 1 mm did not have a substantial effect on the average stress distribution to the fractured bony segments; however, they had a greater effect on the stress distribution to the plates and screws. Type II fixation was the best mechanical design under bite loads. Type I design was the least stable system and had the highest stress distribution and the largest displacement

  9. Can paramedics use FRAX (the WHO Fracture Risk Assessment Tool) to help GPs improve future fracture risk in patients who fall? Protocol for a randomised controlled feasibility study.

    Science.gov (United States)

    Clarke, Shane; Bradley, Rachel; Simmonds, Bethany; Salisbury, Chris; Benger, Jonathan; Marques, Elsa; Greenwood, Rosemary; Shepstone, Lee; Robinson, Maria; Appleby-Fleming, John; Gooberman-Hill, Rachael

    2014-09-03

    Currently identification, and therefore, management of patients at risk of osteoporotic fracture in the UK is suboptimal. As the majority of patients who fracture have fallen, it follows that people who fall can usefully be targeted in any programme that aims to reduce osteoporotic fracture. Targeting vulnerable patients who are likely to benefit from intervention may help shift the management of fracture prevention into primary care, away from emergency departments. Paramedics who attend to patients who have fallen may be well placed to assess future fracture risk, using the Fracture Risk Assessment Tool (FRAX) and communicate that information directly to general practitioners (GPs). This feasibility study takes the form of a pragmatic, randomised controlled trial aimed at exploring and refining issues of study design, recruitment, retention, sample size and acceptability preceding a large-scale study with fracture as the end point. Patients (aged >50) who fall, call an ambulance, are attended by a study paramedic and give verbal consent will be asked FRAX and fall questions. Patients who subsequently formally consent to participation will be randomised to control (usual care) or intervention groups. Intervention will constitute transmission of calculated future fracture risk to the patients' GP with suitable, evidence-based recommendations for investigation or treatment. 3 months after the index fall, data (proportion of patients in each group undergoing investigation or starting new treatment, quality of life and health economic) will be collected and analysed using descriptive statistics. A nested qualitative study will explore issues of acceptability and study design with patients, paramedics and GPs. This protocol was approved by NRES Committee South Central Oxford C in October 2012. Research Ethics Committee ref.12/SC/0604. The study findings will be disseminated through peer-reviewed journals, conference presentations and local public events. A publication

  10. Committee III.2 Fatigue and Fracture

    DEFF Research Database (Denmark)

    Brennan, F. P.; Branner, Kim; den Besten, J.H.

    2015-01-01

    Concern for crack initiation and growth under cyclic loading as well as unstable crack propagation and tearing in ship and offshore structures. Due attention shall be paid to practical application and statistical description of fracture control methods in design, fabrication and service. Consider......Concern for crack initiation and growth under cyclic loading as well as unstable crack propagation and tearing in ship and offshore structures. Due attention shall be paid to practical application and statistical description of fracture control methods in design, fabrication and service...

  11. Nutritional risk assessment for Hip fracture, A Case control study

    OpenAIRE

    Torbergsen, Anne Cathrine

    2016-01-01

    The study was conducted at Oslo University Hospital, Norway. Patients were included from September 2009 until April 2011. In total 116 patients and 73 healthy non-fractured controls participated. The study has 3 parts. In the first part, we studied micronutrients and the risk of hip fracture in a case control study. In the second part, we conducted a randomized controlled nutrition intervention trial and finally, in the third part, we studied if micronutrients were associated with delirium in...

  12. Optimizing fracture and completion design in the Westerose field

    Energy Technology Data Exchange (ETDEWEB)

    Dunn-Norman, S. [Missouri Univ., Rolla, MO (United States); Griffiths, E.; Barnhart, W. [Pan-Canadian Petroleum Ltd., Calgary, AB (Canada); Aunger, D.; Kenny, L.; Halvaci, M.

    1998-12-31

    An experimental study was conducted to determine the feasibility of developing additional gas reserves in the tight sands located between the main bar trends in the Westerose gas field, located 75 km south of Edmonton, Alberta. As part of the study, fracturing and completion alternatives in the Glauconitic `bar` and `interbar` sands were analyzed and compared. Optimal fracture designs for vertical wells were determined for each type of sand. Vertical well performance was compared to stimulated and unstimulated horizontal wells drilled either parallel or perpendicular to the minimum in-situ stress. Results indicated that in-situ permeabilities in the interbar sands were lower than anticipated. It was also shown that over the permeability ranges studied, predicted rates matched actual rates for both vertical fractured and multifractured horizontal wells, suggesting that analytical models can be used to assess anticipated well performance. A further conclusion drawn from the study was that by stimulating a wide variety of permeability ranges, well orientations, anisotropy, fracture orientations and completion options can be determined. 12 refs., 7 tabs., 4 figs.

  13. Fracture Resistance of Zirconia Restorations with a Modified Framework Design

    Directory of Open Access Journals (Sweden)

    sakineh Nikzadjamnani

    2017-12-01

    Full Text Available Objectives: Chipping is one of the concerns related to zirconia crowns. The reasons of chipping have not been completely understood. This in-vitro study aimed to assess the effect of coping design on the fracture resistance of all-ceramic single crowns with zirconia frameworks. Materials and Methods: Two types of zirconia copings were designed (n=12: (1 a standard coping (SC with a 0.5mm uniform thickness and (2 a modified coping (MC consisted of a lingual margin of 1mm thickness and 2mm height connected to a proximal strut of 4mm height and a 0.3mm-wide facial collar. After veneer porcelain firing, the crowns were cemented to metal dies. Afterwards, a static vertical load was applied until failure. The modes of failure were determined. Data were calculated and statistically analyzed by independent samples T-test. P<0.05 was considered statistically significant.Results: The mean and standard deviation (SD of the final fracture resistance equaled to 3519.42±1154.96 N and 3570.01±1224.33 N in SC and MC groups, respectively; the difference was not statistically significant (P=0.9. Also, the mean and SD of the initial fracture resistance equaled to 3345.34±1190.93 N and 3471.52±1228.93 N in SC and MC groups, respectively (P=0.8. Most of the specimens in both groups showed the mixed failure mode. Conclusions: Based on the results, the modified core design may not significantly improve the fracture resistance.

  14. Self-designed femoral neck guide pin locator for femoral neck fractures.

    Science.gov (United States)

    Xia, Shengli; Wang, Ziping; Wang, Minghui; Wu, Zuming; Wang, Xiuhui

    2014-01-01

    Closed reduction and fixation with 3 cannulated screws is a widely accepted surgery for the treatment of femoral neck fractures. However, how to obtain optimal screw placement remains unclear. In the current study, the authors designed a guide pin positioning system for femoral neck fracture cannulated screw fixation and examined its application value by comparing it with freehand guide needle positioning and with general guide pin locator positioning provided by equipment manufacturers. The screw reset rate, screw parallelism, triangle area formed by the link line of the entry point of 3 guide pins, and maximum vertical load bearing of the femoral neck after internal fixation were recorded. As expected, the triangle area was largest in the self-designed positioning group, followed by the general positioning group and the freehand positioning group. The difference among the 3 groups was statistically significant (P.05). The authors’ self-designed guide pin positioning system has the potential to accurately insert cannulated screws in femoral neck fractures and may reduce bone loss and unnecessary radiation.

  15. Topological design of all-ceramic dental bridges for enhancing fracture resistance.

    Science.gov (United States)

    Zhang, Zhongpu; Chen, Junning; Li, Eric; Li, Wei; Swain, Michael; Li, Qing

    2016-06-01

    Layered all-ceramic systems have been increasingly adopted in major dental prostheses. However, ceramics are inherently brittle, and they often subject to premature failure under high occlusion forces especially in the posterior region. This study aimed to develop mechanically sound novel topological designs for all-ceramic dental bridges by minimizing the fracture incidence under given loading conditions. A bi-directional evolutionary structural optimization (BESO) technique is implemented within the extended finite element method (XFEM) framework. Extended finite element method allows modeling crack initiation and propagation inside all-ceramic restoration systems. Following this, BESO searches the optimum distribution of two different ceramic materials, namely porcelain and zirconia, for minimizing fracture incidence. A performance index, as per a ratio of peak tensile stress to material strength, is used as a design objective. In this study, the novel XFEM based BESO topology optimization significantly improved structural strength by minimizing performance index for suppressing fracture incidence in the structures. As expected, the fracture resistance and factor of safety of fixed partial dentures structure increased upon redistributing zirconia and porcelain in the optimal topological configuration. Dental CAD/CAM systems and the emerging 3D printing technology were commercially available to facilitate implementation of such a computational design, exhibiting considerable potential for clinical application in the future. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Sedimentary facies control on mechanical and fracture stratigraphy in turbidites

    NARCIS (Netherlands)

    Ogata, Kei; Storti, Fabrizio; Balsamo, Fabrizio; Tinterri, Roberto; Bedogni, Enrico; Fetter, Marcos; Gomes, Leonardo; Hatushika, Raphael

    2017-01-01

    Natural fracture networks exert a first-order control on the exploitation of resources such as aquifers, hydrocarbons, and geothermal reservoirs, and on environmental issues like underground gas storage and waste disposal. Fractures and the mechanical stratigraphy of layered sequences have been

  17. Partnership for fragility bone fracture care provision and prevention program (P4Bones: study protocol for a secondary fracture prevention pragmatic controlled trial

    Directory of Open Access Journals (Sweden)

    Gaboury Isabelle

    2013-01-01

    Full Text Available Abstract Background Fractures associated with bone fragility in older adults signal the potential for secondary fracture. Fragility fractures often precipitate further decline in health and loss of mobility, with high associated costs for patients, families, society and the healthcare system. Promptly initiating a coordinated, comprehensive pharmacological bone health and falls prevention program post-fracture may improve osteoporosis treatment compliance; and reduce rates of falls and secondary fractures, and associated morbidity, mortality and costs. Methods/design This pragmatic, controlled trial at 11 hospital sites in eight regions in Quebec, Canada, will recruit community-dwelling patients over age 50 who have sustained a fragility fracture to an intervention coordinated program or to standard care, according to the site. Site study coordinators will identify and recruit 1,596 participants for each study arm. Coordinators at intervention sites will facilitate continuity of care for bone health, and arrange fall prevention programs including physical exercise. The intervention teams include medical bone specialists, primary care physicians, pharmacists, nurses, rehabilitation clinicians, and community program organizers. The primary outcome of this study is the incidence of secondary fragility fractures within an 18-month follow-up period. Secondary outcomes include initiation and compliance with bone health medication; time to first fall and number of clinically significant falls; fall-related hospitalization and mortality; physical activity; quality of life; fragility fracture-related costs; admission to a long term care facility; participants’ perceptions of care integration, expectations and satisfaction with the program; and participants’ compliance with the fall prevention program. Finally, professionals at intervention sites will participate in focus groups to identify barriers and facilitating factors for the integrated

  18. Lumbar lordosis and pars interarticularis fractures: a case-control study

    International Nuclear Information System (INIS)

    Bugg, William G.; Lewis, Mark; Juette, Arne; Cahir, John G.; Toms, Andoni P.

    2012-01-01

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9 (SD = 6.5 ) in the pars interarticularis fracture group, and 30.1 (SD = 6.4 ) in the control group. The difference between the two groups was significant (mean difference 6.8 , Student's t test: P < 0.001). The mean angle of sacral tilt measured was 122.2 (SD = 10.16 ) for controls and 136.4 (SD = 10.86 ) for patients with pars defects. The difference in the means of 14.2 was statistically significantly different (P < 0.0001). Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis. (orig.)

  19. Lumbar lordosis and pars interarticularis fractures: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Bugg, William G; Lewis, Mark; Juette, Arne; Cahir, John G; Toms, Andoni P [Cotman Centre, Norwich Radiology Academy, Norwich, Norfolk (United Kingdom)

    2012-07-15

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9 (SD = 6.5 ) in the pars interarticularis fracture group, and 30.1 (SD = 6.4 ) in the control group. The difference between the two groups was significant (mean difference 6.8 , Student's t test: P < 0.001). The mean angle of sacral tilt measured was 122.2 (SD = 10.16 ) for controls and 136.4 (SD = 10.86 ) for patients with pars defects. The difference in the means of 14.2 was statistically significantly different (P < 0.0001). Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis. (orig.)

  20. Lumbar lordosis and pars interarticularis fractures: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Bugg, William G.; Lewis, Mark; Juette, Arne; Cahir, John G.; Toms, Andoni P. [Cotman Centre, Norwich Radiology Academy, Norwich, Norfolk (United Kingdom)

    2012-07-15

    The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures. In this retrospective case-control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control-cases were identified on MRI (16 male, 13 female, age 9-63 years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups. The mean angle of lordosis about the L5 vertebra was 36.9 (SD = 6.5 ) in the pars interarticularis fracture group, and 30.1 (SD = 6.4 ) in the control group. The difference between the two groups was significant (mean difference 6.8 , Student's t test: P < 0.001). The mean angle of sacral tilt measured was 122.2 (SD = 10.16 ) for controls and 136.4 (SD = 10.86 ) for patients with pars defects. The difference in the means of 14.2 was statistically significantly different (P < 0.0001). Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis. (orig.)

  1. Vitamin D and Fracture Risk in Early Childhood: A Case-Control Study

    Science.gov (United States)

    Anderson, Laura N.; Heong, Sze Wing; Chen, Yang; Thorpe, Kevin E.; Adeli, Khosrow; Howard, Andrew; Sochett, Etienne; Birken, Catherine S.; Parkin, Patricia C.; Maguire, Jonathon L.; Abdullah, Kawsari; Anderson, Laura N.; Birken, Catherine S.; Borkhoff, Cornelia M.; Carsley, Sarah; Chen, Yang; Katz-Lavigne, Mikael; Kavikondala, Kanthi; Kowal, Christine; Maguire, Jonathon L.; Mason, Dalah; Omand, Jessica; Parkin, Patricia C.; Persaud, Navindra; van den Heuvel, Meta; Baker, Jillian; Barozzino, Tony; Bonifacio, Joey; Campbell, Douglas; Cheema, Sohail; Chisamore, Brian; Danayan, Karoon; Das, Paul; Derocher, Mary Beth; Do, Anh; Dorey, Michael; Freeman, Sloane; Fung, Keewai; Guiang, Charlie; Handford, Curtis; Hatch, Hailey; Jacobson, Sheila; Kiran, Tara; Knowles, Holly; Kwok, Bruce; Lakhoo, Sheila; Lam-Antoniades, Margarita; Lau, Eddy; Leung, Fok-Han; Loo, Jennifer; Mahmoud, Sarah; Moodie, Rosemary; Morinis, Julia; Naymark, Sharon; Neelands, Patricia; Owen, James; Peer, Michael; Perlmutar, Marty; Persaud, Navindra; Pinto, Andrew; Porepa, Michelle; Ramji, Nasreen; Ramji, Noor; Rosenthal, Alana; Saunderson, Janet; Saxena, Rahul; Sgro, Michael; Shepherd, Susan; Smiltnieks, Barbara; Taylor, Carolyn; Weisdors, Thea; Wijayasinghe, Sheila; Wong, Peter; Ying, Ethel; Young, Elizabeth

    2017-01-01

    Abstract The objective of this study was to evaluate the association of vitamin D intake and serum levels with fracture risk in children under 6 years of age. A case-control study was conducted in Toronto, Ontario, Canada. Cases were recruited from the fracture clinic at the Hospital for Sick Children, and matched controls were obtained from the TARGet Kids! primary-care research network. Controls were matched to cases on age, sex, height, and season. Fracture risk was estimated from conditional logistic regression, with adjustment for skin type, fracture history, waist circumference, outdoor free play, neighborhood income, soda consumption, and child's birth weight. A total of 206 cases were recruited during May 2009–April 2013 and matched to 343 controls. Serum 25-hydroxyvitamin D concentration (per 10-nmol/L increment: adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.88, 1.03) and intake of cow's milk (2 cups/day vs. 2 cups/day: aOR = 1.39 (95% CI: 0.85, 2.23)) were not significantly associated with reduced odds of fracture. A statistically significant association was observed between child use of vitamin D supplements and decreased odds of fracture (yes vs. no: aOR = 0.42, 95% CI: 0.25, 0.69). Vitamin D supplementation, but not serum 25-hydroxyvitamin D level or milk intake, was associated with reduced fracture risk among these healthy young children. PMID:28459987

  2. Impact of Oxidative Dissolution on Black Shale Fracturing: Implication for Shale Fracturing Treatment Design

    Science.gov (United States)

    You, L.; Chen, Q.; Kang, Y.; Cheng, Q.; Sheng, J.

    2017-12-01

    Black shales contain a large amount of environment-sensitive compositions, e.g., clay minerals, carbonate, siderite, pyrite, and organic matter. There have been numerous studies on the black shales compositional and pore structure changes caused by oxic environments. However, most of the studies did not focus on their ability to facilitate shale fracturing. To test the redox-sensitive aspects of shale fracturing and its potentially favorable effects on hydraulic fracturing in shale gas reservoirs, the induced microfractures of Longmaxi black shales exposed to deionized water, hydrochloric acid, and hydrogen peroxide at room-temperature for 240 hours were imaged by scanning electron microscopy (SEM) and CT-scanning in this paper. Mineral composition, acoustic emission, swelling, and zeta potential of the untreated and oxidative treatment shale samples were also recorded to decipher the coupled physical and chemical effects of oxidizing environments on shale fracturing processes. Results show that pervasive microfractures (Fig.1) with apertures ranging from tens of nanometers to tens of microns formed in response to oxidative dissolution by hydrogen peroxide, whereas no new microfracture was observed after the exposure to deionized water and hydrochloric acid. The trajectory of these oxidation-induced microfractures was controlled by the distribution of phyllosilicate framework and flaky or stringy organic matter in shale. The experiments reported in this paper indicate that black shales present the least resistance to crack initiation and subcritical slow propagation in hydrogen peroxide, a process we refer to as oxidation-sensitive fracturing, which are closely related to the expansive stress of clay minerals, dissolution of redox-sensitive compositions, destruction of phyllosilicate framework, and the much lower zeta potential of hydrogen peroxide solution-shale system. It could mean that the injection of fracturing water with strong oxidizing aqueous solution may

  3. Knee-extension strength, postural control and function are related to fracture type and thigh edema in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten T; Bandholm, Thomas; Bencke, Jesper

    2008-01-01

    BACKGROUND: Post-surgery thigh edema, loss of knee-extension strength, and reduced physical performance are common following a hip fracture. It is not known if knee-extension strength and physical performance are related to the edema and fracture type. The aim of this study was to examine...... the influence of fracture type and post-surgery edema on physical performances in patients with hip fracture. METHODS: Fifteen women and five men admitted from their own home to an acute orthopedic hip fracture unit were examined. Ten had cervical and ten had intertrochanteric fractures. Correlations between...... fracture type and thigh edema in the fractured limb (% non-fractured) to physical performances of basic mobility, postural control (sway), and isometric knee-extension strength were examined. All measures, except those of basic mobility, were conducted at the time of discharge, 8.5 days post...

  4. Fracture Mechanics

    International Nuclear Information System (INIS)

    Jang, Dong Il; Jeong, Gyeong Seop; Han, Min Gu

    1992-08-01

    This book introduces basic theory and analytical solution of fracture mechanics, linear fracture mechanics, non-linear fracture mechanics, dynamic fracture mechanics, environmental fracture and fatigue fracture, application on design fracture mechanics, application on analysis of structural safety, engineering approach method on fracture mechanics, stochastic fracture mechanics, numerical analysis code and fracture toughness test and fracture toughness data. It gives descriptions of fracture mechanics to theory and analysis from application of engineering.

  5. Fracture propagation in gas pipelines - relevance to submarine lines

    Energy Technology Data Exchange (ETDEWEB)

    Fearnehough, G D [British Gas Corp., Newcastle upon Tyne. Engineering Research Station

    1976-09-01

    This paper reviews the factors which control fracture propagation in pipes and suggests how they are influenced by submarine environments. If fracture arrest capability is required then these factors should be considered in terms of the design philosophy and the maximum tolerable length of fracture which can be repaired. The paper shows that brittle fracture characteristics of submarine pipelines are probably similar to land based lines and fracture arrest can only be guaranteed by appropriate material toughness specification. Resistance to ductile fracture propagation in submarine lines is enhanced by lower design stresses, thicker pipe, concrete coating and the effect of hydrostatic head on gas dynamics. However, additional factors due to submarine design can be deleterious viz: uncertainty about backfill integrity and a tendency of thicker steels to low fracture resistance arising from 'separation' formation. Attention is drawn to problems which may arise with transportation of gases rich in hydrocarbons and the use of mechanical methods of fracture arrest.

  6. Structural-Diagenetic Controls on Fracture Opening in Tight Gas Sandstone Reservoirs, Alberta Foothills

    Science.gov (United States)

    Ukar, Estibalitz; Eichhubl, Peter; Fall, Andras; Hooker, John

    2013-04-01

    relatively undeformed backlimb strata. Fracture apertures locally increase adjacent to reverse faults without an overall increase in fracture frequency. Fluid inclusion analyses of crack-seal quartz cement indicate both aqueous and methane-rich inclusions are present. Homogenization temperatures of two-phase inclusions indicate synkinematic fracture cement precipitation and fracture opening under conditions at or near maximum burial of 190-210°C in core samples, and 120-160°C in outcrop samples. In comparison with the fracture evolution in other, less deformed tight-gas sandstone reservoirs such as the Piceance and East Texas basins where fracture opening is primarily controlled by gas generation, gas charge, and pore fluid pressure, these results suggest a strong control of regional tectonic processes on fracture generation. In conjunction with timing and rate of gas charge, rates of fracture cement growth, and stratigraphic-lithological controls, these processes determine the overall distribution of open fractures in these reservoirs.

  7. [Effects of Surgically Treated Pelvic Ring and Acetabular Fractures on Postural Control].

    Science.gov (United States)

    Lang, P; Schnegelberger, A; Riesner, H-J; Stuby, F; Friemert, B; Palm, H-G

    2016-04-01

    The aim of surgical treatment of pelvic ring and acetabular fractures is to allow rapid mobilisation of patients in order to restore stance and gait stability (postural control), as this significantly correlates with a positive outcome. The regulation of postural stability is mainly controlled by transmission of proprioceptive stimuli. In addition, the pelvis serves as a connection between the legs and the spine and thus is also of great importance for mechanical stabilisation. It remains unclear whether surgical treatment of pelvic ring and acetabular fractures affects the regulation of postural control. Therefore, the aim of this study was to examine the impact of surgically treated pelvic ring and acetabular fractures on postural stability by means of computerised dynamic posturography (CDP) after a mean of 35 months and to compare the results with a healthy control group. A retrospective case control study of 38 patients with surgically treated pelvic ring and acetabular fractures and 38 healthy volunteers was carried out using CDP. The average time of follow-up was 35 (12-78) months. The most important outcome parameter in this investigation was the overall stability index (OSI). Hip joint mobility, the health-related quality of life (SF-12) and pain were supplementary outcome parameters. It was found that surgically treated pelvic ring and acetabular fractures had no influence on postural stability. The OSI was 2.1 ° in the patient group and 1.9 ° in the control group. There was no significant difference between the groups in hip joint mobility. A total of 52 % of patients showed no or only mild pain. Mean health-related quality of life was the same as in the total population. Surgically treated pelvic ring and acetabular fractures do not lead to deterioration in postural control in the mid term. This is of high prognostic importance for rapid mobilisation of the patients. Therefore no increase in the risk of falling is expected after successfully

  8. Prevalence of overweight in children with bone fractures: a case control study

    Directory of Open Access Journals (Sweden)

    Valerio Giuliana

    2012-10-01

    Full Text Available Abstract Background Children's fractures have been enlisted among orthopaedics complaints of childhood obesity. Unhealthy lifestyle behaviours may contribute to increased risk. This study described the prevalence of overweight/obesity in children and adolescents reporting a recent fracture in relation to gender, dynamic of trauma, and site of fracture. Methods Four-hundred-forty-nine children and adolescents with fracture and 130 fracture-free controls were recruited from a large children’s hospital. The interaction between overweight and gender, dynamic of trauma, site of fracture was explored. Sports participation, television viewing, and calcium intake were also investigated. Results Overweight/obesity rate was increased in girls with fracture either at the upper or the lower limb (p= 0.004, while it was increased only in boys with fracture at the lower limb (p Conclusions The increased prevalence of overweight/obesity in children with fractures is related to gender and site of fracture. Higher levels of sedentary behaviours characterize overweight children reporting fractures.

  9. Robot-Assisted Fracture Surgery: Surgical Requirements and System Design.

    Science.gov (United States)

    Georgilas, Ioannis; Dagnino, Giulio; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

    2018-03-09

    The design of medical devices is a complex and crucial process to ensure patient safety. It has been shown that improperly designed devices lead to errors and associated accidents and costs. A key element for a successful design is incorporating the views of the primary and secondary stakeholders early in the development process. They provide insights into current practice and point out specific issues with the current processes and equipment in use. This work presents how information from a user-study conducted in the early stages of the RAFS (Robot Assisted Fracture Surgery) project informed the subsequent development and testing of the system. The user needs were captured using qualitative methods and converted to operational, functional, and non-functional requirements based on the methods derived from product design and development. This work presents how the requirements inform a new workflow for intra-articular joint fracture reduction using a robotic system. It is also shown how the various elements of the system are developed to explicitly address one or more of the requirements identified, and how intermediate verification tests are conducted to ensure conformity. Finally, a validation test in the form of a cadaveric trial confirms the ability of the designed system to satisfy the aims set by the original research question and the needs of the users.

  10. [Distortion and vertical fracture of the root: effect produced by condenser design].

    Science.gov (United States)

    Dang, D A; Walton, R E

    1990-01-01

    The incidence of vertical root fractures and the amount of root distortion created during lateral condensation of gutta-percha with either D11 spreaders or B-finger pluggers were evaluated in vitro. Fifty-five extracted human, single-rooted teeth were instrumented using the step-back flare technique. Ten teeth served as positive controls (obturation to the point of fracture) and five teeth as negative controls (prepared but not obtured). Strain gauges were attached to the root surfaces. In the experimental group, 20 teeth were obturated using a D11 spreader and 20 with a B-finger plugger. Recordings were made of root distortion (expansion) created during obturation. Then, after sectioning the teeth, root surfaces of obturated samples were examined for fractures under the scanning electron microscope. Only the more tapered spreader, the D11, produces vertical root fractures, although very few in number. Also, the D11 spreader caused greater root distortion than did the B-finger plugger.

  11. Vitamin D and Fracture Risk in Early Childhood: A Case-Control Study.

    Science.gov (United States)

    Anderson, Laura N; Heong, Sze Wing; Chen, Yang; Thorpe, Kevin E; Adeli, Khosrow; Howard, Andrew; Sochett, Etienne; Birken, Catherine S; Parkin, Patricia C; Maguire, Jonathon L

    2017-06-15

    The objective of this study was to evaluate the association of vitamin D intake and serum levels with fracture risk in children under 6 years of age. A case-control study was conducted in Toronto, Ontario, Canada. Cases were recruited from the fracture clinic at the Hospital for Sick Children, and matched controls were obtained from the TARGet Kids! primary-care research network. Controls were matched to cases on age, sex, height, and season. Fracture risk was estimated from conditional logistic regression, with adjustment for skin type, fracture history, waist circumference, outdoor free play, neighborhood income, soda consumption, and child's birth weight. A total of 206 cases were recruited during May 2009-April 2013 and matched to 343 controls. Serum 25-hydroxyvitamin D concentration (per 10-nmol/L increment: adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.88, 1.03) and intake of cow's milk (2 cups/day vs. 2 cups/day: aOR = 1.39 (95% CI: 0.85, 2.23)) were not significantly associated with reduced odds of fracture. A statistically significant association was observed between child use of vitamin D supplements and decreased odds of fracture (yes vs. no: aOR = 0.42, 95% CI: 0.25, 0.69). Vitamin D supplementation, but not serum 25-hydroxyvitamin D level or milk intake, was associated with reduced fracture risk among these healthy young children. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Design of experimental system for supercritical CO2 fracturing under confining pressure conditions

    Science.gov (United States)

    Wang, H.; Lu, Q.; Li, X.; Yang, B.; Zheng, Y.; Shi, L.; Shi, X.

    2018-03-01

    Supercritical CO2 has the characteristics of low viscosity, high diffusion and zero surface tension, and it is considered as a new fluid for non-polluting and non-aqueous fracturing which can be used for shale gas development. Fracturing refers to a method of utilizing the high-pressure fluid to generate fractures in the rock formation so as to improve the oil and gas flow conditions and increase the oil and gas production. In this article, a new type of experimental system for supercritical CO2 fracturing under confining pressure conditions is designed, which is based on characteristics of supercritical CO2, shale reservoir and down-hole environment. The experimental system consists of three sub-systems, including supercritical CO2 generation system, supercritical CO2 fracturing system and data analysis system. It can be used to simulate supercritical CO2 fracturing under geo-stress conditions, thus to study the rock initiation pressure, the formation of the rock fractures, fractured surface morphology and so on. The experimental system has successfully carried out a series of supercritical CO2 fracturing experiments. The experimental results confirm the feasibility of the experimental system and the high efficiency of supercritical CO2 in fracturing tight rocks.

  13. Effects of framework design and layering material on fracture strength of implant-supported zirconia-based molar crowns.

    Science.gov (United States)

    Kamio, Shingo; Komine, Futoshi; Taguchi, Kohei; Iwasaki, Taro; Blatz, Markus B; Matsumura, Hideo

    2015-12-01

    To evaluate the effects of framework design and layering material on the fracture strength of implant-supported zirconia-based molar crowns. Sixty-six titanium abutments (GingiHue Post) were tightened onto dental implants (Implant Lab Analog). These abutment-implant complexes were randomly divided into three groups (n = 22) according to the design of the zirconia framework (Katana), namely, uniform-thickness (UNI), anatomic (ANA), and supported anatomic (SUP) designs. The specimens in each design group were further divided into two subgroups (n = 11): zirconia-based all-ceramic restorations (ZAC group) and zirconia-based restorations with an indirect composite material (Estenia C&B) layered onto the zirconia framework (ZIC group). All crowns were cemented on implant abutments, after which the specimens were tested for fracture resistance. The data were analyzed with the Kruskal-Wallis test and the Mann-Whitney U-test with the Bonferroni correction (α = 0.05). The following mean fracture strength values (kN) were obtained in UNI design, ANA design, and SUP design, respectively: Group ZAC, 3.78, 6.01, 6.50 and Group ZIC, 3.15, 5.65, 5.83. In both the ZAC and ZIC groups, fracture strength was significantly lower for the UNI design than the other two framework designs (P = 0.001). Fracture strength did not significantly differ (P > 0.420) between identical framework designs in the ZAC and ZIC groups. A framework design with standardized layer thickness and adequate support of veneer by zirconia frameworks, as in the ANA and SUP designs, increases fracture resistance in implant-supported zirconia-based restorations under conditions of chewing attrition. Indirect composite material and porcelain perform similarly as layering materials on zirconia frameworks. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Using Chemicals to Optimize Conformance Control in Fractured Reservoirs; TOPICAL

    International Nuclear Information System (INIS)

    Seright, Randall S.; Liang, Jenn-Tai; Schrader, Richard; Hagstrom II, John; Wang, Ying; Kumar, Ananad; Wavrik, Kathryn

    2001-01-01

    This report describes work performed during the third and final year of the project, Using Chemicals to Optimize Conformance Control in Fractured Reservoirs. This research project had three objectives. The first objective was to develop a capability to predict and optimize the ability of gels to reduce permeability to water more than that to oil or gas. The second objective was to develop procedures for optimizing blocking agent placement in wells where hydraulic fractures cause channeling problems. The third objective was to develop procedures to optimize blocking agent placement in naturally fractured reservoirs

  15. Reducing the environmental impact of hydraulic fracturing through design optimisation of positive displacement pumps

    International Nuclear Information System (INIS)

    Josifovic, Aleksandar; Roberts, Jennifer J.; Corney, Jonathan; Davies, Bruce; Shipton, Zoe K.

    2016-01-01

    The current approach to hydraulic fracturing requires large amounts of industrial hardware to be transported, installed and operated in temporary locations. A significant proportion of this equipment is comprised of the fleet of pumps required to provide the high pressures and flows necessary for well stimulation. Studies have shown that over 90% of the emissions of CO_2 and other pollutants that occur during a hydraulic fracturing operation are associated with these pumps. Pollution and transport concerns are of paramount importance for the emerging hydraulic fracturing industry in Europe, and so it is timely to consider these factors when assessing the design of high pressure pumps for the European resources. This paper gives an overview of the industrial plant required to carry out a hydraulic fracturing operation. This is followed by an analysis of the pump's design space that could result in improved pump efficiency. We find that reducing the plunger diameter and running the pump at higher speeds can increase the overall pump efficiency by up to 4.6%. Such changes to the pump's parameters would results in several environmental benefits beyond the obvious economic gains of lower fuel consumption. The paper concludes with a case study that quantifies these benefits. - Highlights: • We develop a parameterized model of hydraulic fracturing pumps. • We explore performance variation to optimise pump efficiency and performance. • New design could increase pump energy efficiency up to 4.6% and improve reliability. • The new design could also reduce environmental and social impacts of pumping. • This illustrates how optimised mechanical design can lower impacts and cost.

  16. Design of a Clinical Decision Support System for Fracture Prediction Using Imbalanced Dataset

    Directory of Open Access Journals (Sweden)

    Yung-Fu Chen

    2018-01-01

    Full Text Available More than 1 billion people suffer from chronic respiratory diseases worldwide, accounting for more than 4 million deaths annually. Inhaled corticosteroid is a popular medication for treating chronic respiratory diseases. Its side effects include decreased bone mineral density and osteoporosis. The aims of this study are to investigate the association of inhaled corticosteroids and fracture and to design a clinical support system for fracture prediction. The data of patients aged 20 years and older, who had visited healthcare centers and been prescribed with inhaled corticosteroids within 2002–2010, were retrieved from the National Health Insurance Research Database (NHIRD. After excluding patients diagnosed with hip fracture or vertebrate fractures before using inhaled corticosteroid, a total of 11645 patients receiving inhaled corticosteroid therapy were included for this study. Among them, 1134 (9.7% were diagnosed with hip fracture or vertebrate fracture. The statistical results showed that demographic information, chronic respiratory diseases and comorbidities, and corticosteroid-related variables (cumulative dose, mean exposed daily dose, follow-up duration, and exposed duration were significantly different between fracture and nonfracture patients. The clinical decision support systems (CDSSs were designed with integrated genetic algorithm (GA and support vector machine (SVM by training and validating the models with balanced training sets obtained by random and cluster-based undersampling methods and testing with the imbalanced NHIRD dataset. Two different objective functions were adopted for obtaining optimal models with best predictive performance. The predictive performance of the CDSSs exhibits a sensitivity of 69.84–77.00% and an AUC of 0.7495–0.7590. It was concluded that long-term use of inhaled corticosteroids may induce osteoporosis and exhibit higher incidence of hip or vertebrate fractures. The accumulated dose of ICS and

  17. Selection of pipeline steels with an engineering fracture mechanical analysis

    Energy Technology Data Exchange (ETDEWEB)

    Stenbacka, N [Swedish State Power Board, Vaellingby

    1985-01-01

    Selection of pipeline steels is discussed on the basis of two mutually independent failure mechanisms: elastic fracture and plastic collapse. The presentation is restricted to axial flaws. A formal analysis shows that brittle fracture in modern pipelines has no high priority in design, since steels used today have a high fracture toughness. Instead, a case of practical concern is tha plastic collapse mode, where failure is flow stress controlled. Conditions governing this design case are specified. In conjunction with this, criterions for material selection with regard to fracture toughness is presented.

  18. Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study

    DEFF Research Database (Denmark)

    Tsiropoulos, Ioannis; Andersen, Morten; Nymark, Tine

    2008-01-01

    PURPOSE: To investigate whether the use of antiepileptic drugs (AEDs) increases the risk of hip fracture. METHODS: We performed a case-control study using data from the Funen County (population 2004: 475,000) hip fracture register. Cases (n = 7,557) were all patients admitted to county hospitals...... with a hip fracture during the period 1996-2004. Controls (n = 27,575) were frequency matched by age and gender. Information on use of AEDs, other drugs, and hospital contacts was available from local registers. Odds ratios (ORs) with 95% confidence intervals (CI) for hip fracture were estimated...

  19. Bone Morphogenetic Protein for the Healing of Tibial Fracture: A Meta-Analysis of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Jiezhi Dai

    Full Text Available To review the evidence from RCTs on clinical outcomes and benefit of acute tibial fracture and nonunion treated with and without BMPs.We searched multiple databases (MEDLINE, EMABSE, BIOSIS and Cochrane central as well as reference lists of articles and contacted authors. Evaluated outcomes included union rate, revision rate, hardware failure and infection. The weighted and standard mean difference (WMD and SMD or the relative risk (RR was calculated for continuous or dichotomous data respectively. The quality of the trial was assessed, and meta-analyses were performed with the Cochrane Collaboration's REVMAN 5.0 software.Eight RCTs involving 1113 patients were included. For acute tibial fracture, BMP group was associated with a higher rate of union (RR, 1.16; 95% CI, 1.04 to 1.30 and a lower rate of revision (RR, 0.68; 95% CI, 0.54 to 0.85 compared with control group. No significant differences were found in rate of hardware failure and infection. The pooled RR for achieving union for tibial fracture nonunion was 0.98 (95% CI, 0.86 to 1.13. There was no significant difference between the two groups in the rate of revision (RR, 0.48; 95% CI, 0.13 to 1.85 and infection (RR, 0.61; 95% CI, 0.37 to 1.02.Study on acute tibial fractures suggests that BMP is more effective that controls, for bone union and for decreasing the rate of surgical revision to achieve union. For the treatment of tibial fracture nonunion, BMP leads to similar results to as autogenous bone grafting. Finally, well-designed RCTs of BMP for tibial fracture treatment are also needed.

  20. An optimal design of cluster spacing intervals for staged fracturing in horizontal shale gas wells based on the optimal SRVs

    Directory of Open Access Journals (Sweden)

    Lan Ren

    2017-09-01

    Full Text Available When horizontal well staged cluster fracturing is applied in shale gas reservoirs, the cluster spacing is essential to fracturing performance. If the cluster spacing is too small, the stimulated area between major fractures will be overlapped, and the efficiency of fracturing stimulation will be decreased. If the cluster spacing is too large, the area between major fractures cannot be stimulated completely and reservoir recovery extent will be adversely impacted. At present, cluster spacing design is mainly based on the static model with the potential reservoir stimulation area as the target, and there is no cluster spacing design method in accordance with the actual fracturing process and targets dynamic stimulated reservoir volume (SRV. In this paper, a dynamic SRV calculation model for cluster fracture propagation was established by analyzing the coupling mechanisms among fracture propagation, fracturing fluid loss and stress. Then, the cluster spacing was optimized to reach the target of the optimal SRVs. This model was applied for validation on site in the Jiaoshiba shale gasfield in the Fuling area of the Sichuan Basin. The key geological engineering parameters influencing the optimal cluster spacing intervals were analyzed. The reference charts for the optimal cluster spacing design were prepared based on the geological characteristics of south and north blocks in the Jiaoshiba shale gasfield. It is concluded that the cluster spacing optimal design method proposed in this paper is of great significance in overcoming the blindness in current cluster perforation design and guiding the optimal design of volume fracturing in shale gas reservoirs. Keywords: Shale gas, Horizontal well, Staged fracturing, Cluster spacing, Reservoir, Stimulated reservoir volume (SRV, Mathematical model, Optimal method, Sichuan basin, Jiaoshiba shale gasfield

  1. Effectiveness of Oral Nutritional Supplementation for Older Women after a Fracture: Rationale, Design and Study of the Feasibility of a Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Lockwood Keri A

    2011-06-01

    Full Text Available Abstract Background Malnutrition is a problem for many older people recovering from a hip and other major fractures. Oral supplementation with high calorie high protein nutrients is a simple intervention that may help older people with fractures to improve their recovery in terms of rehabilitation time, length of hospital stay and mortality. This paper reports a pilot study to test the feasibility of a trial initiated in a hospital setting with an oral supplement to older people with recent fractures. Method A randomized controlled trial with 44 undernourished participants admitted to a hospital following a fracture. The intervention group (n = 23 received a high calorie high protein supplement for forty days in addition to their diet of choice. The control group (n = 21 received high protein milk during their hospital stay in addition to their diet of choice and their usual diet when discharged from hospital. Results All participants were women and their mean age was 85.3 (± 6.1 years. Twenty nine (65% participants had a hip fracture. At baseline no differences were measured between the two groups regarding their nutritional status, their cognitive ability or their abilities in activities of daily living. There were no significant differences between the intervention and control group with reference to nutritional or functional parameters at 40 day and 4 month follow-ups. Median length of stay in hospital was 18.0 days, with 12 participants being readmitted for a median of 7.0 days. Conclusion It is feasible to perform a randomised trial in a hospital and community setting to test the effect of an oral high energy high protein supplement for older people. Due to the limited number of participants and incomplete adherence with use of the supplements no conclusion can be drawn about the efficacy or effectiveness of this intervention.

  2. Bioremediation in fractured rock: 1. Modeling to inform design, monitoring, and expectations

    Science.gov (United States)

    Tiedeman, Claire; Shapiro, Allen M.; Hsieh, Paul A.; Imbrigiotta, Thomas; Goode, Daniel J.; Lacombe, Pierre; DeFlaun, Mary F.; Drew, Scott R.; Johnson, Carole D.; Williams, John H.; Curtis, Gary P.

    2018-01-01

    Field characterization of a trichloroethene (TCE) source area in fractured mudstones produced a detailed understanding of the geology, contaminant distribution in fractures and the rock matrix, and hydraulic and transport properties. Groundwater flow and chemical transport modeling that synthesized the field characterization information proved critical for designing bioremediation of the source area. The planned bioremediation involved injecting emulsified vegetable oil and bacteria to enhance the naturally occurring biodegradation of TCE. The flow and transport modeling showed that injection will spread amendments widely over a zone of lower‐permeability fractures, with long residence times expected because of small velocities after injection and sorption of emulsified vegetable oil onto solids. Amendments transported out of this zone will be diluted by groundwater flux from other areas, limiting bioremediation effectiveness downgradient. At nearby pumping wells, further dilution is expected to make bioremediation effects undetectable in the pumped water. The results emphasize that in fracture‐dominated flow regimes, the extent of injected amendments cannot be conceptualized using simple homogeneous models of groundwater flow commonly adopted to design injections in unconsolidated porous media (e.g., radial diverging or dipole flow regimes). Instead, it is important to synthesize site characterization information using a groundwater flow model that includes discrete features representing high‐ and low‐permeability fractures. This type of model accounts for the highly heterogeneous hydraulic conductivity and groundwater fluxes in fractured‐rock aquifers, and facilitates designing injection strategies that target specific volumes of the aquifer and maximize the distribution of amendments over these volumes.

  3. Design and Implementation of Energized Fracture Treatment in Tight Gas Sands

    Energy Technology Data Exchange (ETDEWEB)

    Mukul Sharma; Kyle Friehauf

    2009-12-31

    , the minimum CO{sub 2} gas quality (volume % of gas) recommended is 30% for moderate differences between fracture and reservoir pressures (2900 psi reservoir, 5300 psi fracture). The minimum quality is reduced to 20% when the difference between pressures is larger, resulting in additional gas expansion in the invaded zone. Inlet fluid temperature, flow rate, and base viscosity did not have a large impact on fracture production. Finally, every stage of the fracturing treatment should be energized with a gas component to ensure high gas saturation in the invaded zone. A second, more general, sensitivity study was conducted. Simulations show that CO{sub 2} outperforms N{sub 2} as a fluid component because it has higher solubility in water at fracturing temperatures and pressures. In fact, all gas components with higher solubility in water will increase the fluid's ability to reduce damage in the invaded zone. Adding methanol to the fracturing solution can increase the solubility of CO{sub 2}. N{sub 2} should only be used if the gas leaks-off either during the creation of the fracture or during closure, resulting in gas going into the invaded zone. Experimental data is needed to determine if the gas phase leaks-off during the creation of the fracture. Simulations show that the bubbles in a fluid traveling across the face of a porous medium are not likely to attach to the surface of the rock, the filter cake, or penetrate far into the porous medium. In summary, this research has created the first compositional fracturing simulator, a useful tool to aid in energized fracture design. We have made several important and original conclusions about the best practices when using energized fluids in tight gas sands. The models and tools presented here may be used in the future to predict behavior of any multi-phase or multi-component fracturing fluid system.

  4. Scintigraphic control of bone-fracture healing under ultrasonic stimulation: An animal experimental study

    International Nuclear Information System (INIS)

    Klug, W.; Franke, W.G.; Knoch, H.G.

    1986-01-01

    In a model of closed lower-leg fracture in rabbits and of secondary bone-fracture healing, scintigraphic control until biological healing was performed. Biological fracture healing was assumed for a region of interest (ROI)-activity ratio close to 1.0. After application of sup(99m)Tc-HEDP, 151 examinations were performed. ROI activity increased significantly until day 14 p.i. and reached the maximum value (Q=6.44) on day 14 postfracture. Sixty-one lower leg fractures were treated by ultrasound from days 14-28 postfractures. These stimulated fractures were biologically healed on day 168 postfracture. The fractures that were not treated by ultrasound could not be detected by scanning after day 203 postfracture. (orig.)

  5. Design and construction of an experiment for two-phase flow in fractured porous media

    Energy Technology Data Exchange (ETDEWEB)

    Ayala, R.E.G.; Aziz, K.

    1993-08-01

    In numerical reservoir simulation naturally fractured reservoirs are commonly divided into matrix and fracture systems. The high permeability fractures are usually entirely responsible for flow between blocks and flow to the wells. The flow in these fractures is modeled using Darcy`s law and its extension to multiphase flow by means of relative permeabilities. The influence and measurement of fracture relative permeability for two-phase flow in fractured porous media have not been studied extensively, and the few works presented in the literature are contradictory. Experimental and numerical work on two-phase flow in fractured porous media has been initiated. An apparatus for monitoring this type of flow was designed and constructed. It consists of an artificially fractured core inside an epoxy core holder, detailed pressure and effluent monitoring, saturation measurements by means of a CT-scanner and a computerized data acquisition system. The complete apparatus was assembled and tested at conditions similar to the conditions expected for the two-phase flow experiments. Fine grid simulations of the experimental setup-were performed in order to establish experimental conditions and to study the effects of several key variables. These variables include fracture relative permeability and fracture capillary pressure. The numerical computations show that the flow is dominated by capillary imbibition, and that fracture relative permeabilities have only a minor influence. High oil recoveries without water production are achieved due to effective water imbibition from the fracture to the matrix. When imbibition is absent, fracture relative permeabilities affect the flow behavior at early production times.

  6. CANDIDATE GENE ANALYSIS IN ISRAELI SOLDIERS WITH STRESS FRACTURES

    Directory of Open Access Journals (Sweden)

    Ran Yanovich

    2012-03-01

    Full Text Available To investigate the association of polymorphisms within candidate genes which we hypothesized may contribute to stress fracture predisposition, a case-control, cross- sectional study design was employed. Genotyping 268 Single Nucleotide Polymorphisms- SNPs within 17 genes in 385 Israeli young male and female recruits (182 with and 203 without stress fractures. Twenty-five polymorphisms within 9 genes (NR3C1, ANKH, VDR, ROR2, CALCR, IL6, COL1A2, CBG, and LRP4 showed statistically significant differences (p < 0.05 in the distribution between stress fracture cases and non stress fracture controls. Seventeen genetic variants were associated with an increased stress fracture risk, and eight variants with a decreased stress fracture risk. None of the SNP associations remained significant after correcting for multiple comparisons (false discovery rate- FDR. Our findings suggest that genes may be involved in stress fracture pathogenesis. Specifically, the CALCR and the VDR genes are intriguing candidates. The putative involvement of these genes in stress fracture predisposition requires analysis of more cases and controls and sequencing the relevant genomic regions, in order to define the specific gene mutations

  7. Use of organic nitrates and the risk of hip fracture: a population-based case-control study.

    Science.gov (United States)

    Pouwels, Sander; Lalmohamed, Arief; van Staa, Tjeerd; Cooper, Cyrus; Souverein, Patrick; Leufkens, Hubertus G; Rejnmark, Lars; de Boer, Anthonius; Vestergaard, Peter; de Vries, Frank

    2010-04-01

    Use of organic nitrates has been associated with increased bone mineral density. Moreover, a large Danish case-control study reported a decreased fracture risk. However, the association with duration of nitrate use, dose frequency, and impact of discontinuation has not been extensively studied. Our objective was to evaluate the association between organic nitrates and hip fracture risk. A case-control study was conducted using the Dutch PHARMO Record Linkage System (1991-2002, n = 6,763 hip fracture cases and 26,341 controls). Cases had their first admission for hip fracture, whereas controls had not sustained any fracture after enrollment. Current users of organic nitrates were patients who had received a prescription within 90 d before the index date. The analyses were adjusted for disease and drug history. Current use of nitrates was not associated with a decreased risk of hip fracture [adjusted odds ratio (OR) = 0.93; 95% confidence interval (CI) = 0.83-1.04]. Those who used as-needed medication only had a lower risk of hip fracture (adjusted OR = 0.83; 95% CI = 0.63-1.08) compared with users of maintenance medication only (adjusted OR = 1.17; 95% CI = 0.97-1.40). No association was found between duration of nitrate use and fracture risk. Our overall analyses showed that risk of a hip fracture was significantly lower among users of as-needed organic nitrates, when compared with users of maintenance medication. Our analyses of hip fracture risks with duration of use did not further support a beneficial effect of organic nitrates on hip fracture, although residual confounding may have masked beneficial effects.

  8. Forefoot Adduction Is a Risk Factor for Jones Fracture.

    Science.gov (United States)

    Fleischer, Adam E; Stack, Rebecca; Klein, Erin E; Baker, Jeffrey R; Weil, Lowell; Weil, Lowell Scott

    Jones fractures are among the most common fractures of the foot; however, much remains unknown about their etiology. The purpose of the present study was to further examine the risk factors of forefoot and hindfoot alignment on Jones fractures using an epidemiologic study design. We used a retrospective, matched, case-control study design. Cases consisted of patients with acute, isolated Jones fractures confirmed on plain film radiographs seen at our institute from January 2009 to December 2013. Patients presenting with pain unrelated to metatarsal fractures served as controls. Controls were matched to cases by age (±2 years), gender, and year of presentation. Weightbearing foot radiographs were assessed for 13 angular relationships by a single rater. Conditional multivariable logistic regression was used to identify important risk factors. Fifty patients with acute Jones fractures and 200 controls were included. The only significant variables in the final multivariable model were the metatarsus adductus angle (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.08 to 1.25) and fourth/fifth intermetatarsal angle (OR 0.69, 95% CI 0.57 to 0.83)-both measures of static forefoot adduction. The presence of metatarsus adductus (defined as >15°) on foot radiographs was associated with a 2.4 times greater risk of a Jones fracture (adjusted OR 2.4, 95% CI 1.2 to 4.8). We have concluded that the risk of Jones fracture increases with an adducted forefoot posture. In our population, which consisted primarily of patients presenting after a fall (10 of 50; 20%) or misstep/inversion injury (19 of 50; 38%), the hindfoot alignment appeared to be a less important factor. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Guidelines for safe design of shipping packages against brittle fracture

    International Nuclear Information System (INIS)

    1993-08-01

    In 1992, the ninth meeting of the Standing Advisory Group on the Safe Transport of Radioactive Materials recommended the publication of this TECDOC in an effort to promote the widest debate on the criteria for the brittle fracture safe design of transport packages. The published IAEA advice on the influence of brittle fracture on material integrity is contained in Appendix IX of the Advisory Material for the IAEA Regulations for the Safety Transport of Radioactive Material (1985 Edition, as amended 1990), Safety Series No. 37. This guidance is limited in scope, dealing only with ferritic steels in general terms. It is becoming more common for designers to specify materials other than austenitic stainless steel for packaging components. The data on ferritic steels cannot be assumed to apply to other metals, hence the need for further guidance on the development of relationships describing material properties at low temperatures. The methods described in this TECDOC will be considered by the Revision Panel for inclusion in the 1996 Edition of the IAEA Regulations for the Safe Transport of Radioactive Material and the supporting documents. If accepted by the Revision Panel, this advice will be a candidate for upgrading to a Safety Practice. In the interim period, this TECDOC offers provisional advice on brittle fracture evaluation. It is acknowledged that, at this stage, the views expressed do not necessarily reflect those of the governments of Member States or organizations under whose auspices this manuscript was produced. Refs and figs

  10. Hydrogen fracture toughness tester completion

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, Michael J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2015-09-30

    The Hydrogen Fracture Toughness Tester (HFTT) is a mechanical testing machine designed for conducting fracture mechanics tests on materials in high-pressure hydrogen gas. The tester is needed for evaluating the effects of hydrogen on the cracking properties of tritium reservoir materials. It consists of an Instron Model 8862 Electromechanical Test Frame; an Autoclave Engineering Pressure Vessel, an Electric Potential Drop Crack Length Measurement System, associated computer control and data acquisition systems, and a high-pressure hydrogen gas manifold and handling system.

  11. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Nauth, A. (Aaron); Creek, A.T. (Aaron T.); Zellar, A. (Abby); Lawendy, A.-R. (Abdel-Rahman); Dowrick, A. (Adam); Gupta, A. (Ajay); Dadi, A. (Akhil); A. van Kampen (A.); Yee, A. (Albert); A.C. de Vries (Alexander); de Mol van Otterloo, A. (Alexander); Garibaldi, A. (Alisha); Liew, A. (Allen); McIntyre, A.W. (Allison W.); Prasad, A.S. (Amal Shankar); Romero, A.W. (Amanda W.); Rangan, A. (Amar); Oatt, A. (Amber); Sanghavi, A. (Amir); Foley, A.L. (Amy L.); Karlsten, A. (Anders); Dolenc, A. (Andrea); Bucknill, A. (Andrew); Chia, A. (Andrew); Evans, A. (Andrew); Gong, A. (Andrew); Schmidt, A.H. (Andrew H.); Marcantonio, A.J. (Andrew J.); Jennings, A. (Andrew); Ward, A. (Angela); Khanna, A. (Angshuman); Rai, A. (Anil); Smits, A.B. (Anke B.); Horan, A.D. (Annamarie D.); Brekke, A.C. (Anne Christine); Flynn, A. (Annette); Duraikannan, A. (Aravin); Stødle, A. (Are); van Vugt, A.B. (Arie B.); Luther, A. (Arlene); Zurcher, A.W. (Arthur W.); Jain, A. (Arvind); Amundsen, A. (Asgeir); Moaveni, A. (Ash); Carr, A. (Ashley); Sharma, A. (Ateet); Hill, A.D. (Austin D.); Trommer, A. (Axel); Rai, B.S. (B. Sachidananda); Hileman, B. (Barbara); Schreurs, B. (Bart); Verhoeven, B. (Bart); Barden, B.B. (Benjamin B.); Flatøy, B. (Bernhard); B.I. Cleffken (Berry); Bøe, B. (Berthe); Perey, B. (Bertrand); Hanusch, B.C. (Birgit C.); Weening, B. (Brad); B. Fioole (Bram); Rijbroek, B. (Bram); Crist, B.D. (Brett D.); Halliday, B. (Brett); Peterson, B. (Brett); Mullis, B. (Brian); Richardson, C.G. (C. Glen); Clark, C. (Callum); Sagebien, C.A. (Carlos A.); C. van der Pol (Carmen); Bowler, C. (Carol); Humphrey, C.A. (Catherine A.); Coady, C. (Catherine); Koppert, C.L. (Cees L.); Coles, C. (Chad); Tannoury, C. (Chadi); DePaolo, C.J. (Charles J.); Gayton, C. (Chris); Herriott, C. (Chris); Reeves, C. (Christina); Tieszer, C. (Christina); Dobb, C. (Christine); Anderson, C.G. (Christopher G.); Sage, C. (Claire); Cuento, C. (Claudine); Jones, C.B. (Clifford B.); Bosman, C.H.R. (Coks H.R.); Linehan, C. (Colleen); C.P. van der Hart (Cor P.); Henderson, C. (Corey); Lewis, C.G. (Courtland G.); Davis, C.A. (Craig A.); Donohue, C. (Craig); Mauffrey, C. (Cyril); Sundaresh, D.C. (D. C.); Farrell, D.J. (Dana J.); Whelan, D.B. (Daniel B.); Horwitz, D. (Daniel); Stinner, D. (Daniel); Viskontas, D. (Darius); Roffey, D.M. (Darren M.); Alexander, D. (David); Karges, D.E. (David E.); Hak, D. (David); Johnston, D. (David); Love, D. (David); Wright, D.M. (David M.); Zamorano, D.P. (David P.); Goetz, D.R. (David R.); Sanders, D. (David); Stephen, D. (David); Yen, D. (David); Bardana, D. (Davide); Olakkengil, D.J. (Davy J); Lawson, D. (Deanna); Maddock, D. (Deborah); Sietsema, D.L. (Debra L.); Pourmand, D. (Deeba); D. den Hartog (Dennis); Donegan, D. (Derek); D. Heels-Ansdell (Diane); Nam, D. (Diane); Inman, D. (Dominic); Boyer, D. (Dory); Li, D. (Doug); Gibula, D. (Douglas); Price, D.M. (Dustin M.); Watson, D.J. (Dylan J.); Hammerberg, E.M. (E. Mark); Tan, E.T.C.H. (Edward T.C.H.); E.J.R. de Graaf (Eelco); Vesterhus, E.B. (Elise Berg); Roper, E. (Elizabeth); Edwards, E. (Elton); E.H. Schemitsch (Emil); E.R. Hammacher (Eric); Henderson, E.R. (Eric R.); Whatley, E. (Erica); Torres, E.T. (Erick T.); Vermeulen, E.G.J. (Erik G.J.); Finn, E. (Erin); E.M.M. van Lieshout (Esther); Wai, E.K. (Eugene K.); Bannister, E.R. (Evan R.); Kile, E. (Evelyn); Theunissen, E.B.M. (Evert B.M.); Ritchie, E.D. (Ewan D.); Khan, F. (Farah); Moola, F. (Farhad); Howells, F. (Fiona); F. de Nies (Frank); F.H.W.M. van der Heijden (Frank); de Meulemeester, F.R.A.J. (Frank R.A.J.); F. Frihagen (Frede); Nilsen, F. (Fredrik); Schmidt, G.B. (G. Ben); Albers, G.H.R. (G.H. Robert); Gudger, G.K. (Garland K.); Johnson, G. (Garth); Gruen, G. (Gary); Zohman, G. (Gary); Sharma, G. (Gaurav); Wood, G. (Gavin); G.W.M. Tetteroo (Geert); Hjorthaug, G. (Geir); Jomaas, G. (Geir); Donald, G. (Geoff); Rieser, G.R. (Geoffrey Ryan); Reardon, G. (Gerald); Slobogean, G.P. (Gerard P.); G.R. Roukema (Gert); Visser, G.A. (Gijs A.); Moatshe, G. (Gilbert); Horner, G. (Gillian); Rose, G. (Glynis); Guyatt, G. (Gordon); Chuter, G. (Graham); Etherington, G. (Greg); Rocca, G.J.D. (Gregory J. Della); Ekås, G. (Guri); Dobbin, G. (Gwendolyn); Lemke, H.M. (H. Michael); Curry, H. (Hamish); H. Boxma (Han); Gissel, H. (Hannah); Kreder, H. (Hans); Kuiken, H. (Hans); H.L.F. Brom; Pape, H.-C. (Hans-Christoph); H.M. van der Vis (Harm); Bedi, H. (Harvinder); Vallier, H.A. (Heather A.); Brien, H. (Heather); Silva, H. (Heather); Newman, H. (Heike); H. Viveiros (Helena); van der Hoeven, H. (Henk); Ahn, H. (Henry); Johal, H. (Herman); H. Rijna; Stockmann, H. (Heyn); Josaputra, H.A. (Hong A.); Carlisle, H. (Hope); van der Brand, I. (Igor); I. Dawson (Imro); Tarkin, I. (Ivan); Wong, I. (Ivan); Parr, J.A. (J. Andrew); Trenholm, J.A. (J. Andrew); J.C. Goslings (Carel); Amirault, J.D. (J. David); Broderick, J.S. (J. Scott); Snellen, J.P. (Jaap P.); Zijl, J.A.C. (Jacco A.C.); Ahn, J. (Jaimo); Ficke, J. (James); Irrgang, J. (James); Powell, J. (James); Ringler, J.R. (James R.); Shaer, J. (James); Monica, J.T. (James T.); J. Biert (Jan); Bosma, J. (Jan); Brattgjerd, J.E. (Jan Egil); J.P.M. Frölke (Jan Paul); J.C. Wille (Jan); Rajakumar, J. (Janakiraman); Walker, J.E. (Jane E.); Baker, J.K. (Janell K.); Ertl, J.P. (Janos P.); de Vries, J.P.P.M. (Jean Paul P.M.); Gardeniers, J.W.M. (Jean W.M.); May, J. (Jedediah); Yach, J. (Jeff); Hidy, J.T. (Jennifer T.); Westberg, J.R. (Jerald R.); Hall, J.A. (Jeremy A.); van Mulken, J. (Jeroen); McBeth, J.C. (Jessica Cooper); Hoogendoorn, J. (Jochem); Hoffman, J.M. (Jodi M.); Cherian, J.J. (Joe Joseph); Tanksley, J.A. (John A.); Clarke-Jenssen, J. (John); Adams, J.D. (John D.); Esterhai, J. (John); Tilzey, J.F. (John F.); Murnaghan, J. (John); Ketz, J.P. (John P.); Garfi, J.S. (John S.); Schwappach, J. (John); Gorczyca, J.T. (John T.); Wyrick, J. (John); Rydinge, J. (Jonas); Foret, J.L. (Jonathan L.); Gross, J.M. (Jonathan M.); Keeve, J.P. (Jonathan P.); Meijer, J. (Joost); J.J. Scheepers (Joris J.); Baele, J. (Joseph); O'Neil, J. (Joseph); Cass, J.R. (Joseph R.); Hsu, J.R. (Joseph R.); Dumais, J. (Jules); Lee, J. (Julia); Switzer, J.A. (Julie A.); Agel, J. (Julie); Richards, J.E. (Justin E.); Langan, J.W. (Justin W.); Turckan, K. (Kahn); Pecorella, K. (Kaili); Rai, K. (Kamal); Aurang, K. (Kamran); Shively, K. (Karl); K.J.P. van Wessem; Moon, K. (Karyn); Eke, K. (Kate); Erwin, K. (Katie); Milner, K. (Katrine); K.J. Ponsen (Kees-jan); Mills, K. (Kelli); Apostle, K. (Kelly); Johnston, K. (Kelly); Trask, K. (Kelly); Strohecker, K. (Kent); Stringfellow, K. (Kenya); Kruse, K.K. (Kevin K.); Tetsworth, K. (Kevin); Mitchell, K. (Khalis); Browner, K. (Kieran); Hemlock, K. (Kim); Carcary, K. (Kimberly); Jørgen Haug, K. (Knut); Noble, K. (Krista); Robbins, K. (Kristin); Payton, K. (Krystal); Jeray, K.J. (Kyle J.); Rubino, L.J. (L. Joseph); Nastoff, L.A. (Lauren A.); Leffler, L.C. (Lauren C.); L.P. Stassen (Laurents); O'Malley, L.K. (Lawrence K.); Specht, L.M. (Lawrence M.); L. Thabane (Lehana); Geeraedts, L.M.G. (Leo M.G.); Shell, L.E. (Leslie E.); Anderson, L.K. (Linda K.); Eickhoff, L.S. (Linda S.); Lyle, L. (Lindsey); Pilling, L. (Lindsey); Buckingham, L. (Lisa); Cannada, L.K. (Lisa K.); Wild, L.M. (Lisa M.); Dulaney-Cripe, L. (Liz); L.M.S.J. Poelhekke; Govaert, L. (Lonneke); Ton, L. (Lu); Kottam, L. (Lucksy); L.P.H. Leenen (Luke); Clipper, L. (Lydia); Jackson, L.T. (Lyle T.); Hampton, L. (Lynne); de Waal Malefijt, M.C. (Maarten C.); M.P. Simons; M. van der Elst (Maarten); M.W.G.A. Bronkhorst (Maarten); Bhatia, M. (Mahesh); M.F. Swiontkowski (Marc ); Lobo, M.J. (Margaret J.); Swinton, M. (Marilyn); Pirpiris, M. (Marinis); Molund, M. (Marius); Gichuru, M. (Mark); Glazebrook, M. (Mark); Harrison, M. (Mark); Jenkins, M. (Mark); MacLeod, M. (Mark); M.R. de Vries (Mark); Butler, M.S. (Mark S.); Nousiainen, M. (Markku); van ‘t Riet, M. (Martijne); Tynan, M.C. (Martin C.); Campo, M. (Martin); M.G. Eversdijk (Martin); M.J. Heetveld (Martin); Richardson, M. (Martin); Breslin, M. (Mary); Fan, M. (Mary); Edison, M. (Matt); Napierala, M. (Matthew); Knobe, M. (Matthias); Russ, M. (Matthias); Zomar, M. (Mauri); de Brauw, M. (Maurits); Esser, M. (Max); Hurley, M. (Meghan); Peters, M.E. (Melissa E.); Lorenzo, M. (Melissa); Li, M. (Mengnai); Archdeacon, M. (Michael); Biddulph, M. (Michael); Charlton, M. (Michael); McDonald, M.D. (Michael D.); McKee, M.D. (Michael D.); Dunbar, M. (Michael); Torchia, M.E. (Michael E.); Gross, M. (Michael); Hewitt, M. (Michael); Holt, M. (Michael); Prayson, M.J. (Michael J.); M.J.R. Edwards (Michael); Beckish, M.L. (Michael L.); Brennan, M.L. (Michael L.); Dohm, M.P. (Michael P.); Kain, M.S.H. (Michael S.H.); Vogt, M. (Michelle); Yu, M. (Michelle); M.H.J. Verhofstad (Michiel); Segers, M.J.M. (Michiel J.M.); M.J.M. Segers (Michiel); Siroen, M.P.C. (Michiel P.C.); M.R. Reed (Mike); Vicente, M.R. (Milena R.); M.M.M. Bruijninckx (Milko); Trivedi, M. (Mittal); M. Bhandari (Mohit); Moore, M.M. (Molly M.); Kunz, M. (Monica); Smedsrud, M. (Morten); Palla, N. (Naveen); Jain, N. (Neeraj); Out, N.J.M. (Nico J.M.); Simunovic, N. (Nicole); Simunovic, N. (Nicole); N.W.L. Schep (Niels); Müller, O. (Oliver); Guicherit, O.R. (Onno R.); O.J.F. van Waes (Oscar); Wang, O. (Otis); P. Doornebosch (Pascal); Seuffert, P. (Patricia); Hesketh, P.J. (Patrick J.); Weinrauch, P. (Patrick); Duffy, P. (Paul); Keller, P. (Paul); Lafferty, P.M. (Paul M.); Pincus, P. (Paul); P. Tornetta III (Paul); Zalzal, P. (Paul); McKay, P. (Paula); Cole, P.A. (Peter A.); de Rooij, P.D. (Peter D.); Hull, P. (Peter); Go, P.M.N.Y.M. (Peter M.N.Y.M.); P. Patka (Peter); Siska, P. (Peter); Weingarten, P. (Peter); Kregor, P. (Philip); Stahel, P. (Philip); Stull, P. (Philip); P. Wittich (Philippe); P.A.R. Rijcke (Piet); P.P. Oprel (Pim); Devereaux, P.J. (P. J.); Zhou, Q. (Qi); Lee Murphy, R. (R.); Alosky, R. (Rachel); Clarkson, R. (Rachel); Moon, R. (Raely); Logishetty, R. (Rajanikanth); Nanda, R. (Rajesh); Sullivan, R.J. (Raymond J.); Snider, R.G. (Rebecca G.); Buckley, R.E. (Richard E.); Iorio, R. (Richard); Farrugia, R.J. (Richard J); Jenkinson, R. (Richard); Laughlin, R. (Richard); R.P.R. Groenendijk (Richard); Gurich, R.W. (Richard W.); Worman, R. (Ripley); Silvis, R. (Rob); R. Haverlag (Robert); Teasdall, R.J. (Robert J.); Korley, R. (Robert); McCormack, R. (Robert); Probe, R. (Robert); Cantu, R.V. (Robert V.); Huff, R.B. (Roger B.); R.K.J. Simmermacher; Peters, R. (Rolf); Pfeifer, R. (Roman); Liem, R. (Ronald); Wessel, R.N. (Ronald N.); Verhagen, R. (Ronald); Vuylsteke, R. (Ronald); Leighton, R. (Ross); McKercher, R. (Ross); R.W. Poolman (Rudolf); Miller, R. (Russell); Bicknell, R. (Ryan); Finnan, R. (Ryan); Khan, R.M. (Ryan M.); Mehta, S. (Samir); Vang, S. (Sandy); Singh, S. (Sanjay); Anand, S. (Sanjeev); Anderson, S.A. (Sarah A.); Dawson, S.A. (Sarah A.); Marston, S.B. (Scott B.); Porter, S.E. (Scott E.); Watson, S.T. (Scott T.); S. Festen (Sebastiaan); Lieberman, S. (Shane); Puloski, S. (Shannon); Bielby, S.A. (Shea A.); Sprague, S. (Sheila); Hess, S. (Shelley); MacDonald, S. (Shelley); Evans, S. (Simone); Bzovsky, S. (Sofia); Hasselund, S. (Sondre); Lewis, S. (Sophie); Ugland, S. (Stein); Caminiti, S. (Stephanie); Tanner, S.L. (Stephanie L.); S.M. Zielinski (Stephanie); Shepard, S. (Stephanie); Sems, S.A. (Stephen A.); Walter, S.D. (Stephen D.); Doig, S. (Stephen); Finley, S.H. (Stephen H.); Kates, S. (Stephen); Lindenbaum, S. (Stephen); Kingwell, S.P. (Stephen P.); Csongvay, S. (Steve); Papp, S. (Steve); Buijk, S.E. (Steven E.); S. Rhemrev (Steven); Hollenbeck, S.M. (Steven M.); van Gaalen, S.M. (Steven M.); Yang, S. (Steven); Weinerman, S. (Stuart); Subash, (); Lambert, S. (Sue); Liew, S. (Susan); S.A.G. Meylaerts (Sven); Blokhuis, T.J. (Taco J.); de Vries Reilingh, T.S. (Tammo S.); Lona, T. (Tarjei); Scott, T. (Taryn); Swenson, T.K. (Teresa K.); Endres, T.J. (Terrence J.); Axelrod, T. (Terry); van Egmond, T. (Teun); Pace, T.B. (Thomas B.); Kibsgård, T. (Thomas); Schaller, T.M. (Thomas M.); Ly, T.V. (Thuan V.); Miller, T.J. (Timothy J.); Weber, T. (Timothy); Le, T. (Toan); Oliver, T.M. (Todd M.); T.M. Karsten (Thomas); Borch, T. (Tor); Hoseth, T.M. (Tor Magne); Nicolaisen, T. (Tor); Ianssen, T. (Torben); Rutherford, T. (Tori); Nanney, T. (Tracy); Gervais, T. (Trevor); Stone, T. (Trevor); Schrickel, T. (Tyson); Scrabeck, T. (Tyson); Ganguly, U. (Utsav); Naumetz, V. (V.); Frizzell, V. (Valda); Wadey, V. (Veronica); Jones, V. (Vicki); Avram, V. (Victoria); Mishra, V. (Vimlesh); Yadav, V. (Vineet); Arora, V. (Vinod); Tyagi, V. (Vivek); Borsella, V. (Vivian); W.J. Willems (Jaap); Hoffman, W.H. (W. H.); Gofton, W.T. (Wade T.); Lackey, W.G. (Wesley G.); Ghent, W. (Wesley); Obremskey, W. (William); Oxner, W. (William); Cross, W.W. (William W.); Murtha, Y.M. (Yvonne M.); Murdoch, Z. (Zoe)

    2017-01-01

    textabstractBackground Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled

  12. Effects of medication reviews performed by a physician on treatment with fracture-preventing and fall-risk-increasing drugs in older adults with hip fracture-a randomized controlled study.

    Science.gov (United States)

    Sjöberg, Christina; Wallerstedt, Susanna M

    2013-09-01

    To investigate whether medication reviews increase treatment with fracture-preventing drugs and decrease treatment with fall-risk-increasing drugs. Randomized controlled trial (1:1). Departments of orthopedics, geriatrics, and medicine at Sahlgrenska University Hospital, Gothenburg, Sweden. One hundred ninety-nine consecutive individuals with hip fracture aged 65 and older. Medication reviews, based on assessments of risks of falls and fractures, regarding fracture-preventing and fall-risk-increasing drugs, performed by a physician, conveyed orally and in written form to hospital physicians during the hospital stay, and to general practitioners after discharge. Primary outcomes were changes in treatment with fracture-preventing and fall-risk-increasing drugs 12 months after discharge. Secondary outcomes were falls, fractures, deaths, and physicians' attitudes toward the intervention. At admission, 26% of intervention and 29% of control participants were taking fracture-preventing drugs, and 12% and 11%, respectively, were taking bone-active drugs, predominantly bisphosphonates. After 12 months, 77% of intervention and 58% of control participants were taking fracture-preventing drugs (P = .01), and 29% and 15%, respectively, were taking bone-active drugs (P = .04). Mean number of fall-risk-increasing drugs per participants was 3.1 (intervention) and 3.1 (control) at admission and 2.9 (intervention) and 3.1 (control) at 12 months (P = .62). No significant differences in hard endpoints were found. The responding physicians (n = 65) appreciated the intervention; on a scale from 1 (very bad) to 6 (very good), the median rating was 5 (interquartile range (IQR) 4-6) for the oral part and 5 (IQR 4-5.5) for the text part. Medication reviews performed and conveyed by a physician increased treatment with fracture-preventing drugs but did not significantly decrease treatment with fall-risk-increasing drugs in older adults with hip fracture. Prescribing physicians appreciated

  13. Major factors controlling fracture development in the Middle Permian Lucaogou Formation tight oil reservoir, Junggar Basin, NW China

    Science.gov (United States)

    Zhang, Chen; Zhu, Deyu; Luo, Qun; Liu, Luofu; Liu, Dongdong; Yan, Lin; Zhang, Yunzhao

    2017-09-01

    Natural fractures in seven wells from the Middle Permian Lucaogou Formation in the Junggar Basin were evaluated in light of regional structural evolution, tight reservoir geochemistry (including TOC and mineral composition), carbon and oxygen isotopes of calcite-filled fractures, and acoustic emission (AE). Factors controlling the development of natural fractures were analyzed using qualitative and/or semi-quantitative techniques, with results showing that tectonic factors are the primary control on fracture development in the Middle Permian Lucaogou Formation of the Junggar Basin. Analyses of calcite, dolomite, and TOC show positive correlations with the number of fractures, while deltaic lithofacies appear to be the most favorable for fracture development. Mineral content was found to be a major control on tectonic fracture development, while TOC content and sedimentary facies mainly control bedding fractures. Carbon and oxygen isotopes vary greatly in calcite-filled fractures (δ13C ranges from 0.87‰ to 7.98‰, while δ18O ranges from -12.63‰ to -5.65‰), indicating that fracture development increases with intensified tectonic activity or enhanced diagenetic alteration. By analyzing the cross-cutting relationships of fractures in core, as well as four Kaiser Effect points in the acoustic emission curve, we observed four stages of tectonic fracture development. First-stage fractures are extensional, and were generated in the late Triassic, with calcite fracture fills formed between 36.51 °C and 56.89 °C. Second-stage fractures are shear fractures caused by extrusion stress from the southwest to the northeast, generated by the rapid uplift of the Tianshan in the Middle and Late Jurassic; calcite fracture fills formed between 62.91 °C and 69.88 °C. Third-stage fractures are NNW-trending shear fractures that resulted from north-south extrusion and thrusting in a foreland depression along the front of the Early Cretaceous Bogda Mountains. Calcite fracture

  14. Fracture fixation in the operative management of hip fractures (FAITH) : an international, multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Nauth, Aaron; Creek, Aaron T.; Zellar, Abby; Lawendy, Abdel Rahman; Dowrick, Adam; Gupta, Ajay; Dadi, Akhil; van Kampen, Albert; Yee, Albert; de Vries, Alexander C.; de Mol van Otterloo, Alexander; Garibaldi, Alisha; Liew, Allen; McIntyre, Allison W.; Prasad, Amal Shankar; Romero, Amanda W.; Rangan, Amar; Oatt, Amber; Sanghavi, Amir; Foley, Amy L.; Karlsten, Anders; Dolenc, Andrea; Bucknill, Andrew; Chia, Andrew; Evans, Andrew; Gong, Andrew; Schmidt, Andrew H.; Marcantonio, Andrew J.; Jennings, Andrew; Ward, Angela; Khanna, Angshuman; Rai, Anil; Smits, Anke B; Horan, Annamarie D.; Brekke, Anne Christine; Flynn, Annette; Duraikannan, Aravin; Stødle, Are; van Vugt, Arie B.; Luther, Arlene; Zurcher, Arthur W.; Jain, Arvind; Amundsen, Asgeir; Moaveni, Ash; Carr, Ashley; Sharma, Ateet; Hill, Austin D.; Trommer, Axel; Rai, B. Sachidananda; Hileman, Barbara; Schreurs, Bart; Verhoeven, Bart A N; Barden, Benjamin B.; Flatøy, Bernhard; Cleffken, Berry I.; Bøe, Berthe; Perey, Bertrand; Hanusch, Birgit C.; Weening, Brad; Fioole, Bram; Rijbroek, Bram; Crist, Brett D.; Halliday, Brett; Peterson, Brett; Mullis, Brian; Richardson, C. Glen; Clark, Callum; Sagebien, Carlos A.; van der Pol, Carmen C.; Bowler, Carol; Humphrey, Catherine A.; Coady, Catherine; Koppert, Cees L.; Coles, Chad; Tannoury, Chadi; DePaolo, Charles J.; Gayton, Chris; Herriott, Chris; Reeves, Christina; Tieszer, Christina; Dobb, Christine; Anderson, Christopher G.; Sage, Claire; Cuento, Claudine; Jones, Clifford B.; Bosman, Coks H.R.; Linehan, Colleen; van der Hart, Cor P.; Henderson, Corey; Lewis, Courtland G.; Davis, Craig A.; Donohue, Craig; Mauffrey, Cyril; Sundaresh, D. C.; Farrell, Dana J.; Whelan, Daniel B.; Horwitz, Daniel; Stinner, Daniel; Viskontas, Darius; Roffey, Darren M.; Alexander, David; Karges, David E.; Hak, David; Johnston, David; Love, David; Wright, David M.; Zamorano, David P.; Goetz, David R.; Sanders, David; Stephen, David; Yen, David; Bardana, Davide; Olakkengil, Davy J.; Lawson, Deanna; Maddock, Deborah; Sietsema, Debra L.; Pourmand, Deeba; Den Hartog, Dennis; Donegan, Derek; Heels-Ansdell, Diane; Nam, Diane; Inman, Dominic; Boyer, Dory; Li, Doug; Gibula, Douglas; Price, Dustin M.; Watson, Dylan J.; Hammerberg, E. Mark; Tan, Edward C T H; de Graaf, Eelco J.R.; Vesterhus, Elise Berg; Roper, Elizabeth; Edwards, Elton; Schemitsch, Emil H.; Hammacher, Eric R.; Henderson, Eric R.; Whatley, Erica; Torres, Erick T.; Vermeulen, Erik G.J.; Finn, Erin; Van Lieshout, Esther M M; Wai, Eugene K.; Bannister, Evan R.; Kile, Evelyn; Theunissen, Evert B.M.; Ritchie, Ewan D.; Khan, Farah; Moola, Farhad; Howells, Fiona; de Nies, Frank; van der Heijden, Frank H.W.M.; de Meulemeester, Frank R.A.J.; Frihagen, Frede; Nilsen, Fredrik; Schmidt, G. Ben; Albers, G. H.Robert; Gudger, Garland K.; Johnson, Garth; Gruen, Gary; Zohman, Gary; Sharma, Gaurav; Wood, Gavin; Tetteroo, Geert W.M.; Hjorthaug, Geir; Jomaas, Geir; Donald, Geoff; Rieser, Geoffrey Ryan; Reardon, Gerald; Slobogean, Gerard P.; Roukema, Gert R.; Visser, Gijs A.; Moatshe, Gilbert; Horner, Gillian; Rose, Glynis; Guyatt, Gordon; Chuter, Graham; Etherington, Greg; Rocca, Gregory J.Della; Ekås, Guri; Dobbin, Gwendolyn; Lemke, H. Michael; Curry, Hamish; Boxma, Han; Gissel, Hannah; Kreder, Hans; Kuiken, Hans; Brom, Hans L.F.; Pape, Hans Christoph; van der Vis, Harm M.; Bedi, Harvinder; Vallier, Heather A.; Brien, Heather; Silva, Heather; Newman, Heike; Viveiros, Helena; van der Hoeven, Henk; Ahn, Henry; Johal, Herman; Rijna, Herman; Stockmann, Heyn; Josaputra, Hong A.; Carlisle, Hope; van der Brand, Igor; Dawson, Imro; Tarkin, Ivan; Wong, Ivan; Parr, J. Andrew; Trenholm, J. Andrew; Goslings, J Carel; Amirault, J. David; Broderick, J. Scott; Snellen, Jaap P.; Zijl, Jacco A.C.; Ahn, Jaimo; Ficke, James; Irrgang, James; Powell, James; Ringler, James R.; Shaer, James; Monica, James T.; Biert, Jan; Bosma, Jan; Brattgjerd, Jan Egil; Frölke, Jan Paul M.; Wille, Jan; Rajakumar, Janakiraman; Walker, Jane E.; Baker, Janell K.; Ertl, Janos P.; De Vries, Jean-Paul P. M.; Gardeniers, Jean W.M.; May, Jedediah; Yach, Jeff; Hidy, Jennifer T.; Westberg, Jerald R.; Hall, Jeremy A.; van Mulken, Jeroen; McBeth, Jessica Cooper; Hoogendoorn, Jochem M; Hoffman, Jodi M.; Cherian, Joe Joseph; Tanksley, John A.; Clarke-Jenssen, John; Adams, John D.; Esterhai, John; Tilzey, John F.; Murnaghan, John; Ketz, John P.; Garfi, John S.; Schwappach, John; Gorczyca, John T.; Wyrick, John; Rydinge, Jonas; Foret, Jonathan L.; Gross, Jonathan M.; Keeve, Jonathan P.; Meijer, Joost; Scheepers, Joris J.G.; Baele, Joseph; O'Neil, Joseph; Cass, Joseph R.; Hsu, Joseph R.; Dumais, Jules; Lee, Julia; Switzer, Julie A.; Agel, Julie; Richards, Justin E.; Langan, Justin W.; Turckan, Kahn; Pecorella, Kaili; Rai, Kamal; Aurang, Kamran; Shively, Karl; van Wessem, Karlijn; Moon, Karyn; Eke, Kate; Erwin, Katie; Milner, Katrine; Ponsen, Kees Jan; Mills, Kelli; Apostle, Kelly; Johnston, Kelly; Trask, Kelly; Strohecker, Kent; Stringfellow, Kenya; Kruse, Kevin K.; Tetsworth, Kevin; Mitchell, Khalis; Browner, Kieran; Hemlock, Kim; Carcary, Kimberly; Jørgen Haug, Knut; Noble, Krista; Robbins, Kristin; Payton, Krystal; Jeray, Kyle J.; Rubino, L. Joseph; Nastoff, Lauren A.; Leffler, Lauren C.; Stassen, Laurents P.S.; O'Malley, Lawrence K.; Specht, Lawrence M.; Thabane, Lehana; Geeraedts, Leo M.G.; Shell, Leslie E.; Anderson, Linda K.; Eickhoff, Linda S.; Lyle, Lindsey; Pilling, Lindsey; Buckingham, Lisa; Cannada, Lisa K.; Wild, Lisa M.; Dulaney-Cripe, Liz; Poelhekke, Lodewijk M.S.J.; Govaert, Lonneke; Ton, Lu; Kottam, Lucksy; Leenen, Luke P.H.; Clipper, Lydia; Jackson, Lyle T.; Hampton, Lynne; de Waal Malefijt, Maarten C.; Simons, Maarten P.; van der Elst, Maarten; Bronkhorst, Maarten W.G.A.; Bhatia, Mahesh; Swiontkowski, Marc; Lobo, Margaret J.; Swinton, Marilyn; Pirpiris, Marinis; Molund, Marius; Gichuru, Mark; Glazebrook, Mark; Harrison, Mark; Jenkins, Mark; MacLeod, Mark; de Vries, Mark R.; Butler, Mark S.; Nousiainen, Markku; van ‘t Riet, Martijne; Tynan, Martin C.; Campo, Martin; Eversdijk, Martin G.; Heetveld, Martin J.; Richardson, Martin; Breslin, Mary; Fan, Mary; Edison, Matt; Napierala, Matthew; Knobe, Matthias; Russ, Matthias; Zomar, Mauri; de Brauw, Maurits; Esser, Max; Hurley, Meghan; Peters, Melissa E.; Lorenzo, Melissa; Li, Mengnai; Archdeacon, Michael; Biddulph, Michael; Charlton, Michael R; McDonald, Michael D.; McKee, Michael D.; Dunbar, Michael; Torchia, Michael E.; Gross, Michael; Hewitt, Michael; Holt, Michael; Prayson, Michael J.; Edwards, Michael J R; Beckish, Michael L.; Brennan, Michael L.; Dohm, Michael P.; Kain, Michael S.H.; Vogt, Michelle; Yu, Michelle; Verhofstad, Michiel H J; Segers, Michiel J M; Segers, Michiel J M; Siroen, Michiel P.C.; Reed, Mike; Vicente, Milena R.; Bruijninckx, Milko M.M.; Trivedi, Mittal; Bhandari, Mohit; Moore, Molly M.; Kunz, Monica; Smedsrud, Morten; Palla, Naveen; Jain, Neeraj; Out, Nico J.M.; Simunovic, Nicole; Simunovic, Nicole; Schep, Niels W. L.; Müller, Oliver; Guicherit, Onno R.; Van Waes, Oscar J.F.; Wang, Otis; Doornebosch, Pascal G.; Seuffert, Patricia; Hesketh, Patrick J.; Weinrauch, Patrick; Duffy, Paul; Keller, Paul; Lafferty, Paul M.; Pincus, Paul; Tornetta, Paul; Zalzal, Paul; McKay, Paula; Cole, Peter A.; de Rooij, Peter D.; Hull, Peter; Go, Peter M.N.Y.M.; Patka, Peter; Siska, Peter; Weingarten, Peter; Kregor, Philip; Stahel, Philip; Stull, Philip; Wittich, Philippe; de Rijcke, Piet A.R.; Oprel, Pim; Devereaux, P. J.; Zhou, Qi; Lee Murphy, R.; Alosky, Rachel; Clarkson, Rachel; Moon, Raely; Logishetty, Rajanikanth; Nanda, Rajesh; Sullivan, Raymond J.; Snider, Rebecca G.; Buckley, Richard E.; Iorio, Richard; Farrugia, Richard J.; Jenkinson, Richard; Laughlin, Richard; Groenendijk, Richard P R; Gurich, Richard W.; Worman, Ripley; Silvis, Rob; Haverlag, Robert; Teasdall, Robert J.; Korley, Robert; McCormack, Robert; Probe, Robert; Cantu, Robert V.; Huff, Roger B.; Simmermacher, Rogier K J; Peters, Rolf; Pfeifer, Roman; Liem, Ronald; Wessel, Ronald N.; Verhagen, Ronald; Vuylsteke, Ronald J C L M; Leighton, Ross; McKercher, Ross; Poolman, Rudolf W; Miller, Russell; Bicknell, Ryan; Finnan, Ryan; Khan, Ryan M.; Mehta, Samir; Vang, Sandy; Singh, Sanjay; Anand, Sanjeev; Anderson, Sarah A.; Dawson, Sarah A.; Marston, Scott B.; Porter, Scott E.; Watson, Scott T.; Festen, Sebastiaan; Lieberman, Shane; Puloski, Shannon; Bielby, Shea A.; Sprague, Sheila; Hess, Shelley; MacDonald, Shelley; Evans, Simone; Bzovsky, Sofia; Hasselund, Sondre; Lewis, Sophie; Ugland, Stein; Caminiti, Stephanie; Tanner, Stephanie L.; Zielinski, Stephanie M.; Shepard, Stephanie; Sems, Stephen A.; Walter, Stephen D.; Doig, Stephen; Finley, Stephen H.; Kates, Stephen; Lindenbaum, Stephen; Kingwell, Stephen P.; Csongvay, Steve; Papp, Steve; Buijk, Steven E.; Rhemrev, Steven J.; Hollenbeck, Steven M.; van Gaalen, Steven M.; Yang, Steven; Weinerman, Stuart; Lambert, Sue; Liew, Susan; Meylaerts, Sven A.G.; Blokhuis, Taco J.; de Vries Reilingh, Tammo S.; Lona, Tarjei; Scott, Taryn; Swenson, Teresa K.; Endres, Terrence J.; Axelrod, Terry; van Egmond, Teun; Pace, Thomas B.; Kibsgård, Thomas; Schaller, Thomas M.; Ly, Thuan V.; Miller, Timothy J.; Weber, Timothy; Le, Toan; Oliver, Todd M.; Karsten, Tom M.; Borch, Tor; Hoseth, Tor Magne; Nicolaisen, Tor; Ianssen, Torben; Rutherford, Tori; Nanney, Tracy; Gervais, Trevor; Stone, Trevor; Schrickel, Tyson; Scrabeck, Tyson; Ganguly, Utsav; Naumetz, V.; Frizzell, Valda; Wadey, Veronica; Jones, Vicki; Avram, Victoria; Mishra, Vimlesh; Yadav, Vineet; Arora, Vinod; Tyagi, Vivek; Borsella, Vivian; Willems, W. Jaap; Hoffman, W. H.; Gofton, Wade T.; Lackey, Wesley G.; Ghent, Wesley; Obremskey, William; Oxner, William; Cross, William W.; Murtha, Yvonne M.; Murdoch, Zoe

    2017-01-01

    Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we

  15. Secondary hyperparathyroidism and mortality in hip fracture patients compared to a control group from general practice

    DEFF Research Database (Denmark)

    Madsen, Christian Medom; Jørgensen, Henrik Løvendahl; Lind, Bent

    2012-01-01

    INTRODUCTION: Previously, little attention has been paid as to how disturbances in the parathyroid hormone (PTH)-calcium-vitamin D-axis, such as secondary hyperparathyroidism (SHPT), relate to mortality amongst hip fracture patients. This study aimed to (1) determine if SHPT is associated......) (age=70 years) admitted to a Danish university hospital. The hip fracture patients were prospectively enrolled in a dedicated hip fracture database. Each hip fracture patient was exactly matched according to age and sex with two controls randomly chosen from a control population of 21,778 subjects who...

  16. Fracture mechanics based design for radioactive material transport packagings -- Historical review

    International Nuclear Information System (INIS)

    Smith, J.A.; Salzbrenner, D.; Sorenson, K.; McConnell, P.

    1998-04-01

    The use of a fracture mechanics based design for the radioactive material transport (RAM) packagings has been the subject of extensive research for more than a decade. Sandia National Laboratories (SNL) has played an important role in the research and development of the application of this technology. Ductile iron has been internationally accepted as an exemplary material for the demonstration of a fracture mechanics based method of RAM packaging design and therefore is the subject of a large portion of the research discussed in this report. SNL's extensive research and development program, funded primarily by the U. S. Department of Energy's Office of Transportation, Energy Management and Analytical Services (EM-76) and in an auxiliary capacity, the office of Civilian Radioactive Waste Management, is summarized in this document along with a summary of the research conducted at other institutions throughout the world. In addition to the research and development work, code and standards development and regulatory positions are also discussed

  17. Evaluation of the fracture resistance of computer-aided design/computer-aided manufacturing monolithic crowns prepared in different cement thicknesses.

    Science.gov (United States)

    Sagsoz, N Polat; Yanıkoglu, N

    2018-04-01

    The purpose of this study was to evaluate the fracture resistance of monolithic computer-aided design/computer-aided manufacturing (CAD/CAM) crowns that are prepared with different cement thickness. For this investigation, a human maxillary premolar tooth was selected. Master model preparation was performed with a demand bur under water spray. Master die was taken to fabricate 105 epoxy resin replicas. The crowns were milled using a CEREC 4 CAD/CAM system (Software Version, 4.2.0.57192). CAD/CAM crowns were made using resin nanoceramic, feldspathic glass ceramic, lithium disilicate, and leucite-reinforced ceramics. Each group was subdivided into three groups in accordance with three different cement thicknesses (30, 90, and 150 μm). Crowns milled out. Then RelyX ™ U200 was used as a luting agent to bond the crowns to the prepared samples. After one hour cementations, the specimens were stored in water bath at 37°C for 1 week before testing. Seven unprepared and unrestored teeth were kept and tested as a control group. A universal test machine was used to assume the fracture resistance of all specimens. The compressive load (N) that caused fracture was recorded for each specimen. Fracture resistance data were statistically analyzed by one-way ANOVA and two-factor interaction modeling test (α = 0.001). There are statistically significant differences between fracture resistances of CAD/CAM monolithic crown materials (P cement thickness is not statistically significant for fracture resistance of CAD/CAM monolithic crowns (P > 0.001). CAD/CAM monolithic crown materials affected fracture resistance. Cement thickness (30, 90, and 150 μm) was not effective on fracture resistance of CAD/CAM monolithic crowns.

  18. Anchorage strategies in geriatric hip fracture management

    Directory of Open Access Journals (Sweden)

    Knobe Matthias

    2016-12-01

    Full Text Available There is an enormous humanitarian and socioeconomic need to improve the quality and effectiveness of care for patients with hip fracture. To reduce mechanical complications in the osteosynthesis of proximal femoral fractures, improved fixation techniques have been developed including blade or screw-anchor devices, locked minimally invasive or cement augmentation strategies. However, despite numerous innovations and advances regarding implant design and surgical techniques, systemic and mechanical complication rates remain high. Treatment success depends on secure implant fixation in often-osteoporotic bone as well as on patient-specific factors (fracture stability, bone quality, comorbidity, and gender and surgeon-related factors (experience, correct reduction, and optimal screw placement in the head/neck fragment. For fracture fixation, the anchorage of the lag screw within the femoral head plays a crucial role depending on the implant’s design. Meta-analyses and randomized controlled studies demonstrate that there is a strong trend towards arthroplasty treating geriatric femoral neck fractures. However, for young adults as well as older patients with less compromised bone quality, or in undisplaced fractures, head-preserving therapy is preferred as it is less invasive and associated with good functional results. This review summarizes the evidence for the internal fixation of femoral neck fractures and trochanteric femoral fractures in elderly patients. In addition, biomechanical considerations regarding implant anchorage in the femoral head including rotation, migration, and femoral neck shortening are made. Finally, cement augmentation strategies for hip fracture implants are evaluated critically.

  19. Sedimentological and Stratigraphic Controls on Natural Fracture Distribution in Wajid Group, SW Saudi Arabia

    Science.gov (United States)

    Benaafi, Mohammed; Hariri, Mustafa; Abdullatif, Osman; Makkawi, Mohammed; Korvin, Gabor

    2016-04-01

    The Cambro-Permian Wajid Group, SW Saudi Arabia, is the main groundwater aquifer in Wadi Al-Dawasir and Najran areas. In addition, it has a reservoir potentiality for oil and natural gas in Rub' Al-Khali Basin. Wajid Group divided into four formations, ascending Dibsiyah, Sanamah, Khussyayan and Juwayl. They are mainly sandstone and exposed in an area extend from Wadi Al-Dawasir southward to Najran city and deposited within fluvial, shallow marine and glacial environments. This study aims to investigate the sedimentological and stratigraphic controls on the distribution of natural fractures within Wajid Group outcrops. A scanline sampling method was used to study the natural fracture network within Wajid Group outcrops, where the natural fractures were measured and characterized in 12 locations. Four regional natural fracture sets were observed with mean strikes of 050o, 075o, 345o, and 320o. Seven lithofacies characterized the Wajid Group at these locations and include fine-grained sandstone, coarse to pebbly sandstone, cross-bedded sandstone, massive sandstone, bioturbated sandstone, conglomerate sandstone, and conglomerate lithofacies. We found that the fine-grained and small scale cross-bedded sandstones lithofacies are characterized by high fracture intensity. In contrast, the coarse-grained sandstone and conglomerate lithofacies have low fracture intensity. Therefore, the relative fracture intensity and spacing of natural fractures within Wajid Group in the subsurface can be predicted by using the lithofacies and their depositional environments. In terms of stratigraphy, we found that the bed thickness and the stratigraphic architecture are the main controls on fractures intensity. The outcomes of this study can help to understand and predict the natural fracture distribution within the subsurface fractured sandstone hosting groundwater and hydrocarbon in Wajid and Rub' Al-Khali Basins. Hence, the finding of this study might help to explore and develop the

  20. Vitamin D supplementation and fracture incidence in elderly persons : A randomized, placebo-controlled clinical trial

    NARCIS (Netherlands)

    Lips, Paul; Graafmans, Wilco C.; Ooms, Marcel E.; Bezemer, P. Dick; Bouter, Lex M.

    1996-01-01

    Objective: To determine whether vitamin D supplementation decreases the incidence of hip fractures and other peripheral bone fractures. Design: Prospective, double-blind trial. Setting: Community setting (Amsterdam and surrounding area). Patients: 2578 persons (1916 women, 662 men) 70 years of age

  1. Subtrochanteric femoral fractures treated with the Long Gamma3® nail: A historical control case study versus Long trochanteric Gamma nail®.

    Science.gov (United States)

    Georgiannos, D; Lampridis, V; Bisbinas, I

    2015-10-01

    Gamma nail was developed for the treatment of subtrochanteric hip fractures. Despite its advantages over extramedullary devices, gamma nail has been historically related to significant complications (implant breakage, femoral fractures at the tip of the nail). There is limited data to determine if the rate of these complications was minimized by using a new design of the gamma nail. Therefore we performed a case control study between the long gamma3 nail (LG3N) and the long trochanteric gamma nail (LTGN) to assess if: (1) the complication rate in the treatment of subtrochanteric fractures using the LG3N was lower than the one using the LTGN; (2) the reoperation rate was lower after using the LG3N. The complication rate after fixation of subtrochanteric fracture of the femur is lower with LG3N than with the LTGN. This study prospectively recorded the intra- and postoperative complications of 75 patients with subtrochanteric fractures treated with the LG3N and compared them with those of a historical cohort of 83 patients treated with the LTGN. The two groups were matched regarding age, gender and fracture type. Patients with open, pathological, or impending fractures were excluded. Intraoperative complications in the LG3N group were lower (4 cases, 5.3%) compared with those in the LTGN group (9 cases, 10.8%; P=0.04). The major intraoperative complication encountered with the use of LTGN was fracture of the femur in 3 cases. We encountered in total 9 postoperative complications in LG3N (12%) and 20 in group LTGN (24%). The most frequent complication in both groups was the cut out of the lag screw (3 cases in LG3N and 7 cases in LTGN group). The overall reoperation rate was higher in LTGN group (20.4% vs 10.6%; P=0.03). As a result of the improvement of its mechanical characteristics, LG3N has proved a safe and efficient implant for the treatment of subtochanteric fractures. The new design seems superior to previous generation, giving promising outcomes, reduced

  2. Evidence for tectonic, lithologic, and thermal controls on fracture system geometries in an andesitic high-temperature geothermal field

    Science.gov (United States)

    Massiot, Cécile; Nicol, Andrew; McNamara, David D.; Townend, John

    2017-08-01

    Analysis of fracture orientation, spacing, and thickness from acoustic borehole televiewer (BHTV) logs and cores in the andesite-hosted Rotokawa geothermal reservoir (New Zealand) highlights potential controls on the geometry of the fracture system. Cluster analysis of fracture orientations indicates four fracture sets. Probability distributions of fracture spacing and thickness measured on BHTV logs are estimated for each fracture set, using maximum likelihood estimations applied to truncated size distributions to account for sampling bias. Fracture spacing is dominantly lognormal, though two subordinate fracture sets have a power law spacing. This difference in spacing distributions may reflect the influence of the andesitic sequence stratification (lognormal) and tectonic faults (power law). Fracture thicknesses of 9-30 mm observed in BHTV logs, and 1-3 mm in cores, are interpreted to follow a power law. Fractures in thin sections (˜5 μm thick) do not fit this power law distribution, which, together with their orientation, reflect a change of controls on fracture thickness from uniform (such as thermal) controls at thin section scale to anisotropic (tectonic) at core and BHTV scales of observation. However, the ˜5% volumetric percentage of fractures within the rock at all three scales suggests a self-similar behavior in 3-D. Power law thickness distributions potentially associated with power law fluid flow rates, and increased connectivity where fracture sets intersect, may cause the large permeability variations that occur at hundred meter scales in the reservoir. The described fracture geometries can be incorporated into fracture and flow models to explore the roles of fracture connectivity, stress, and mineral precipitation/dissolution on permeability in such andesite-hosted geothermal systems.

  3. Biomechanical study in vitro on the use of self-designed external fixator in diaphyseal III metacarpal fractures in horses.

    Science.gov (United States)

    Turek, B; Potyński, A; Wajler, C; Szara, T; Czopowicz, M; Drewnowska, O

    2015-01-01

    Diaphyseal fractures of the III metacarpal bone represent 22% of all fractures of the long bones in horses. Treatment of such cases is difficult. The most popular solution used in these types of fractures is two plates applied directly to the bone surface, but they are not applicable on contaminated and infected fractures. External fixators are quite commonly used in human medicine, although in veterinary practice there is no typical stabilizer designed for the treatment of diaphyseal fractures of the III metacarpal bone so far. In this study, an external semicircular fixator of our own design was used and in vitro strength tests were conducted to determine the maximum force which would lead to the destruction of non-fractured bone and fractured bone treated with the stabilizer. On the basis of the strength tests, we can conclude that the stabilizer can be strong enough to allow the horse to stand up after surgery. It also has many favorable features which make it easy to assemble and to take care of a wound, while being safe enough for the animal at the same time.

  4. Comparison of Chamfer and Deep Chamfer Preparation Designs on the Fracture Resistance of Zirconia Core Restorations

    Directory of Open Access Journals (Sweden)

    Ezatollah Jalalian

    2011-06-01

    Full Text Available Background and aims. One of the major problems of all-ceramic restorations is their probable fracture under occlusal force. The aim of the present in vitro study was to compare the effect of two marginal designs (chamfer and deep chamfer on the fracture resistance of all-ceramic restorations, CERCON. Materials and methods. This in vitro study was carried out with single-blind experimental technique. One stainless steel die with 50’ chamfer finish line design (0.8 mm deep was prepared using a milling machine. Ten epoxy resin dies were prepared. The same die was retrieved and 50' chamfer was converted into a deep chamfer design (1 mm. Again ten epoxy resin dies were prepared from the deep chamfer die. Zirconia cores with 0.4 mm thickness and 35 µm cement space were fabricated on the epoxy resin dies (10 chamfer and 10 deep chamfer samples. The zirconia cores were cemented on the epoxy resin dies and underwent a fracture test with a universal testing machine and the samples were investigated from the point of view of the origin of the failure. Results. The mean values of fracture resistance for deep chamfer and chamfer samples were 1426.10±182.60 and 991.75±112.00 N, respectively. Student’s t-test revealed statistically significant differences between the groups. Conclusion. The results indicated a relationship between the marginal design of zirconia cores and their fracture resistance. A deep chamfer margin improved the biomechanical performance of posterior single zirconia crown restorations, which might be attributed to greater thickness and rounded internal angles in deep chamfer margins.

  5. A computer-controlled automated test system for fatigue and fracture testing

    International Nuclear Information System (INIS)

    Nanstad, R.K.; Alexander, D.J.; Swain, R.L.; Hutton, J.T.; Thomas, D.L.

    1989-01-01

    A computer-controlled system consisting of a servohydraulic test machine, an in-house designed test controller, and a desktop computer has been developed for performing automated fracture toughness and fatigue crack growth testing both in the laboratory and in hot cells for remote testing of irradiated specimens. Both unloading compliance and dc-potential drop can be used to monitor crack growth. The test controller includes a dc-current supply programmer, a function generator for driving the servohydraulic test machine to required test outputs, five measurement channels (each consisting of low-pass filter, track/hold amplifier, and 16-bit analog-to-digital converter), and digital logic for various control and data multiplexing functions. The test controller connects to the computer via a 16-bit wide photo-isolated bidirectional bus. The computer, a Hewlett-Packard series 200/300, inputs specimen and test parameters from the operator, configures the test controller, stores test data from the test controller in memory, does preliminary analysis during the test, and records sensor calibrations, specimen and test parameters, and test data on flexible diskette for later recall and analysis with measured initial and final crack length information. During the test, the operator can change test parameters as necessary. 24 refs., 6 figs

  6. Definition of infection after fracture fixation: A systematic review of randomized controlled trials to evaluate current practice.

    Science.gov (United States)

    Metsemakers, W J; Kortram, K; Morgenstern, M; Moriarty, T F; Meex, I; Kuehl, R; Nijs, S; Richards, R G; Raschke, M; Borens, O; Kates, S L; Zalavras, C; Giannoudis, P V; Verhofstad, M H J

    2018-03-01

    One of the most challenging musculoskeletal complications in modern trauma surgery is infection after fracture fixation (IAFF). Although infections are clinically obvious in many cases, a clear definition of the term IAFF is crucial, not only for the evaluation of published research data but also for the establishment of uniform treatment concepts. The aim of this systematic review was to identify the definitions used in the scientific literature to describe infectious complications after internal fixation of fractures. The hypothesis of this study was that the majority of fracture-related literature do not define IAFF. A comprehensive search was performed in Embase, Cochrane, Google Scholar, Medline (OvidSP), PubMed publisher and Web-of-Science for randomized controlled trials (RCTs) on fracture fixation. Data were collected on the definition of infectious complications after fracture fixation used in each study. Study selection was accomplished through two phases. During the first phase, titles and abstracts were reviewed for relevance, and the full texts of relevant articles were obtained. During the second phase, full-text articles were reviewed. All definitions were literally extracted and collected in a database. Then, a classification was designed to rate the quality of the description of IAFF. A total of 100 RCT's were identified in the search. Of 100 studies, only two (2%) cited a validated definition to describe IAFF. In 28 (28%) RCTs, the authors used a self-designed definition. In the other 70 RCTs, (70%) there was no description of a definition in the Methods section, although all of the articles described infections as an outcome parameter in the Results section. This systematic review shows that IAFF is not defined in a large majority of the fracture-related literature. To our knowledge, this is the first study conducted with the objective to explore this important issue. The lack of a consensus definition remains a problem in current orthopedic

  7. Exercise and fall prevention self-management to reduce mobility-related disability and falls after fall-related lower limb fracture in older people: protocol for the RESTORE (Recovery Exercises and STepping On afteR fracturE) randomised controlled trial.

    Science.gov (United States)

    Sherrington, Catherine; Fairhall, Nicola; Kirkham, Catherine; Clemson, Lindy; Howard, Kirsten; Vogler, Constance; Close, Jacqueline C T; Moseley, Anne M; Cameron, Ian D; Mak, Jenson; Sonnabend, David; Lord, Stephen R

    2016-02-02

    Lasting disability and further falls are common and costly problems in older people following fall-related lower limb and pelvic fractures. Exercise interventions can improve mobility after fracture and reduce falls in older people, however the optimal approach to rehabilitation after fall-related lower limb and pelvic fracture is unclear. This randomised controlled trial aims to evaluate the effects of an exercise and fall prevention self-management intervention on mobility-related disability and falls in older people following fall-related lower limb or pelvic fracture. Cost-effectiveness of the intervention will also be investigated. A randomised controlled trial with concealed allocation, assessor blinding for physical performance tests and intention-to-treat analysis will be conducted. Three hundred and fifty people aged 60 years and over with a fall-related lower limb or pelvic fracture, who are living at home or in a low care residential aged care facility and have completed active rehabilitation, will be recruited. Participants will be randomised to receive a 12-month intervention or usual care. The intervention group will receive ten home visits from a physiotherapist to prescribe an individualised exercise program with motivational interviewing, plus fall prevention education through individualised advice from the physiotherapist or attendance at the group based "Stepping On" program (seven two-hour group sessions). Participants will be followed for a 12-month period. Primary outcome measures will be mobility-related disability and falls. Secondary outcomes will include measures of balance and mobility, falls risk, physical activity, walking aid use, frailty, pain, nutrition, falls efficacy, mood, positive and negative affect, quality of life, assistance required, hospital readmission, and health-system and community-service contact. This study will determine the effect and cost-effectiveness of this exercise self management intervention on mobility

  8. Early age fracture properties of microstructurally-designed mortars

    DEFF Research Database (Denmark)

    Di Bella, Carmelo; Michel, Alexander; Stang, Henrik

    2017-01-01

    This paper compares the fracture properties as well as crack initiation and propagation of real and equivalent mortars. The development of the elastic modulus, tensile strength, and fracture energy at different hydration stages were determined by inverse analysis of load-displacement curves...... the two mortars. At early age, the moisture content has a considerable influence on the tensile strength and the fracture energy....

  9. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial

    Directory of Open Access Journals (Sweden)

    Poeze Martijn

    2011-05-01

    Full Text Available Abstract Background The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%, non-union (5-21% and early osteo-arthritis (up to 32% which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences. Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. Methods/Design This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning. Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory. Study parameters are clinical consolidation

  10. Effect of Control Mode and Test Rate on the Measured Fracture Toughness of Advanced Ceramics

    Science.gov (United States)

    Hausmann, Bronson D.; Salem, Jonathan A.

    2018-01-01

    The effects of control mode and test rate on the measured fracture toughness of ceramics were evaluated by using chevron-notched flexure specimens in accordance with ASTM C1421. The use of stroke control gave consistent results with about 2% (statistically insignificant) variation in measured fracture toughness for a very wide range of rates (0.005 to 0.5 mm/min). Use of strain or crack mouth opening displacement (CMOD) control gave approx. 5% (statistically significant) variation over a very wide range of rates (1 to 80 µm/m/s), with the measurements being a function of rate. However, the rate effect was eliminated by use of dry nitrogen, implying a stress corrosion effect rather than a stability effect. With the use of a nitrogen environment during strain controlled tests, fracture toughness values were within about 1% over a wide range of rates (1 to 80 micons/m/s). CMOD or strain control did allow stable crack extension well past maximum force, and thus is preferred for energy calculations. The effort is being used to confirm recommendations in ASTM Test Method C1421 on fracture toughness measurement.

  11. The fluid mechanics of channel fracturing flows: experiment

    Science.gov (United States)

    Rashedi, Ahmadreza; Tucker, Zachery; Ovarlez, Guillaume; Hormozi, Sarah

    2017-11-01

    We show our preliminary experimental results on the role of fluid mechanics in channel fracturing flows, particularly yield stress fracturing fluids. Recent trends in the oil industry have included the use of cyclic pumping of a proppant slurry interspersed with a yield stress fracturing fluid, which is found to increase wells productivity, if particles disperse in a certain fashion. Our experimental study aims to investigate the physical mechanisms responsible for dispersing the particles (proppant) within a yield stress carrier fluid, and to measure the dispersion of proppant slugs in various fracturing regimes. To this end we have designed and built a unique experimental setup that resembles a fracture configuration coupled with a particle image/tracking velocimetry setup operating at micro to macro dimensions. Moreover, we have designed optically engineered suspensions of complex fluids with tunable yield stress and consistency, well controlled density match-mismatch properties and refractive indices for both X-rays and visible lights. We present our experimental system and preliminary results. NSF (Grant No. CBET-1554044- CAREER), ACS PRF (Grant No. 55661-DNI9).

  12. Promoting mobility after hip fracture (ProMo: study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people

    Directory of Open Access Journals (Sweden)

    Sipilä Sarianna

    2011-12-01

    Full Text Available Abstract Background To cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture. Methods/Design Population-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women participated in this study and were randomly allocated into control (Standard Care and ProMo intervention groups on average 10 weeks post fracture and 6 weeks after discharged to home. Standard Care included written home exercise program with 5-7 exercises for lower limbs. Of all participants, 12 got a referral to physiotherapy. After discharged to home, only 50% adhered to Standard Care. None of the participants were followed-up for Standard Care or mobility recovery. ProMo-intervention included Standard Care and a year-long program including evaluation/modification of environmental hazards, guidance for safe walking, pain management, progressive home exercise program and physical activity counseling. Measurements included a comprehensive battery of laboratory tests and self-report on mobility limitation, disability, physical functional capacity and health as well as assessments for the key prerequisites for mobility, disability and functional capacity. All assessments were performed blinded at the research laboratory. No significant differences were observed between intervention and control groups in any of the demographic variables. Discussion Ten weeks post hip fracture only half of the participants were compliant to Standard Care. No follow-up for Standard Care or

  13. Fall with and without fracture in elderly: what's different?

    Science.gov (United States)

    Kantayaporn, Choochat

    2012-10-01

    Falling fracture was one of the health problems in elderly. This presentation aimed to identify the factors of fall that caused fractures. The retrospective case-control study was designed. Samples were all who experienced fall within 1 year in Lamphun. Factors included age, gender underlying diseases, chronic drugs used, history of parent fragility fracture, age of menopause, steroid used, body mass index, visual acuity and time up and go test were studied. Multivariate regression analysis was used. 336 cases of fractures in 1,244 cases of fall were found. Significant factors of falling fracture group that were different from fall without fracture group included age, female gender, menopause before age of 45 and visual impairment. Visual impairment was the other key factor rather than osteoporosis that caused fall with fracture. The author suggested that falling fracture prevention programs should be included correction of visual impairment other than osteoporosis treatment.

  14. Calcium intake and risk of fracture: systematic review

    OpenAIRE

    Bolland, Mark J; Leung, William; Tai, Vicky; Bastin, Sonja; Gamble, Greg D; Grey, Andrew; Reid, Ian R

    2015-01-01

    Objective To examine the evidence underpinning recommendations to increase calcium intake through dietary sources or calcium supplements to prevent fractures. Design Systematic review of randomised controlled trials and observational studies of calcium intake with fracture as an endpoint. Results from trials were pooled with random effects meta-analyses. Data sources Ovid Medline, Embase, PubMed, and references from relevant systematic reviews. Initial searches undertaken in July 2013 and upd...

  15. COMPARISON OF THE TRADITIONAL STRENGTH OF MATERIALS APPROACH TO DESIGN WITH THE FRACTURE MECHANICS APPROACH

    International Nuclear Information System (INIS)

    Z. Ceylan

    2002-01-01

    The objective of this activity is to show that the use of the traditional strength of materials approach to the drip shield and the waste package (WP) designs is bounding and appropriate when compared to the fracture mechanics approach. The scope of this activity is limited to determining the failure assessment diagrams for the two materials at issue: Ti-7 and Alloy 22. This calculation is intended for use in support of the license application design of the drip shield and the WP. This activity is associated with the drip shield and the WP designs. The activity evaluation for work package number P32 12234F2, included in ''Technical Work Plan for: Waste Package Design Description for LA'' (Ref. 1, p. A-6), has determined that the development of this document is subject to ''Quality Assurance Requirements and Description'' requirements. The control of the electronic management of data is accomplished in accordance with the methods specified in Reference 1, Section 10. AP-3.124, ''Design Calculations and Analysis'' (Ref. 2), is used to develop and document the calculation

  16. Considerations of the manner of accounting for fast fracture risk in the design of PWR vessels

    International Nuclear Information System (INIS)

    Pellissier-Tanon, A.; Grandemange, J.M.

    1986-01-01

    The French approach to the prevention of fast fracture in PWR vessels is to consider it as a whole and to choose the most convenient way to meet this general goal from an economic and technical point of view. According to this approach, there are no specific limits imposed on such factors as end of life RTsub(NDT) or neutron fluence, which are taken as criteria in other countries. The RCCM design and construction code specifications on chemical content and RTsub(NDT) for beltline and non-irradiated parts establish a sound basis for safety. However, for the most critical parts, the existence of large margins with respect to fast fracture is demonstrated by analysis for all second, third and fourth category design transients. To this aim, the RCCM code needs to demonstrate specified safety margins, depending on the transient category, for reference defects defined in kind and size, in order to bound realistically any defects which have a chance of occurring in the part during manufacture. This approach, which enables the disclosure of the influence of all significant design factors on fracture risk, ensures the most consistent way to improve design safety. (author)

  17. Considerations of the manner of accounting for fast fracture risk in the design of PWR vessels

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    The French approach to the prevention of fast fracture in PWR vessels is to consider it as a whole and to choose the most convenient way to meet this general goal from an economic and technical point of view. According to this approach, there are no specific limits imposed on such factors as end of life RTsub(NDT) or neutron fluence, which are taken as criteria in other countries. The RCCM design and construction code specifications on chemical content and RTsub(NDT) for beltline and non-irradiated parts establish a sound basis for safety. However, for the most critical parts, the existence of large margins with respect to fast fracture is demonstrated by analysis for all second, third and fourth category design transients. To this aim, the RCCM code needs to demonstrate specified safety margins, depending on the transient category, for reference defects defined in kind and size, in order to bound realistically any defects which have a chance of occurring in the part during manufacture. This approach, which enables the disclosure of the influence of all significant design factors on fracture risk, ensures the most consistent way to improve design safety.

  18. The important role of martensite laths to fracture toughness for the ductile fracture controlled by the strain in EA4T axle steel

    International Nuclear Information System (INIS)

    Liang, Yilong; Long, Shaolei; Xu, Pingwei; Lu, Yemao; Jiang, Yun; Liang, Yu; Yang, Ming

    2017-01-01

    The Hall-Petch relationship was used to investigate the role of martensite lath on fracture toughness (K IC ) during ductile fracture in a low-carbon EA4T axle steel. The hierarchical structures of lath martensite was clarified by means of optical microscope (OM), field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM) and electron backscattering diffraction (EBSD). Firstly, in such hierarchical structures, packet size (d p ) and block size (d b ) increase significantly with the size of prior austenite (d r ), while the martensite lath width (d l ) decreases. Subsequently, K IC was measured and follows the Hall-Petch relationship with d l . It depends on the rotation, bending and direct shear during crack propagation of laths, confirmed by EBSD. Besides, fracture toughness (K IC ) is proportional to a parameter ε v , the matrix strain, which is related to the plastic deformation of laths. Therefore, the martensite lath in hierarchical structures is the effective control unit of K IC during ductile fracture controlled by the strain.

  19. The important role of martensite laths to fracture toughness for the ductile fracture controlled by the strain in EA4T axle steel

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Yilong, E-mail: liangyilong@126.com [College of Materials Science and Metallurgical Engineering, Guizhou University (China); Guizhou key Laboratory for Mechanical Behavior and Microstructure of Materials (China); National & Local Joint Engineering Laboratory for High-performance Metal Structure Material and Advanced Manufacturing Technology (China); Long, Shaolei; Xu, Pingwei; Lu, Yemao [College of Materials Science and Metallurgical Engineering, Guizhou University (China); Guizhou key Laboratory for Mechanical Behavior and Microstructure of Materials (China); National & Local Joint Engineering Laboratory for High-performance Metal Structure Material and Advanced Manufacturing Technology (China); Jiang, Yun [Guizhou key Laboratory for Mechanical Behavior and Microstructure of Materials (China); National & Local Joint Engineering Laboratory for High-performance Metal Structure Material and Advanced Manufacturing Technology (China); Liang, Yu; Yang, Ming [College of Materials Science and Metallurgical Engineering, Guizhou University (China); Guizhou key Laboratory for Mechanical Behavior and Microstructure of Materials (China); National & Local Joint Engineering Laboratory for High-performance Metal Structure Material and Advanced Manufacturing Technology (China)

    2017-05-17

    The Hall-Petch relationship was used to investigate the role of martensite lath on fracture toughness (K{sub IC}) during ductile fracture in a low-carbon EA4T axle steel. The hierarchical structures of lath martensite was clarified by means of optical microscope (OM), field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM) and electron backscattering diffraction (EBSD). Firstly, in such hierarchical structures, packet size (d{sub p}) and block size (d{sub b}) increase significantly with the size of prior austenite (d{sub r}), while the martensite lath width (d{sub l}) decreases. Subsequently, K{sub IC} was measured and follows the Hall-Petch relationship with d{sub l}. It depends on the rotation, bending and direct shear during crack propagation of laths, confirmed by EBSD. Besides, fracture toughness (K{sub IC}) is proportional to a parameter ε{sub v}, the matrix strain, which is related to the plastic deformation of laths. Therefore, the martensite lath in hierarchical structures is the effective control unit of K{sub IC} during ductile fracture controlled by the strain.

  20. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures.

    Science.gov (United States)

    Pieracci, Fredric M; Lin, Yihan; Rodil, Maria; Synder, Madelyne; Herbert, Benoit; Tran, Dong Kha; Stoval, Robert T; Johnson, Jeffrey L; Biffl, Walter L; Barnett, Carlton C; Cothren-Burlew, Clay; Fox, Charles; Jurkovich, Gregory J; Moore, Ernest E

    2016-02-01

    Previous studies of surgical stabilization of rib fractures (SSRF) have been limited by small sample sizes, retrospective methodology, and inclusion of only patients with flail chest. We performed a prospective, controlled evaluation of SSRF as compared with optimal medical management for severe rib fracture patterns among critically ill trauma patients. We hypothesized that SSRF improves acute outcomes. We conducted a 2-year clinical evaluation of patients with any of the following rib fracture patterns: flail chest, three or more fractures with bicortical displacement, 30% or greater hemithorax volume loss, and either severe pain or respiratory failure despite optimal medical management. In the year 2013, all patients were managed nonoperatively. In the year 2014, all patients were managed operatively. Outcomes included respiratory failure, tracheostomy, pneumonia, ventilator days, tracheostomy, length of stay, daily maximum incentive spirometer volume, narcotic requirements, and mortality. Univariate and multivariable analyses were performed. Seventy patients were included, 35 in each group. For the operative group, time from injury to surgery was 2.4 day, operative time was 1.5 hours, and the ratio of ribs fixed to ribs fractured was 0.6. The operative group had a significantly higher RibScore (4 vs. 3, respectively, p fracture patterns. Therapeutic study, level II.

  1. Control effect of fracture on hard coal cracking in a fully mechanized longwall top coal caving face

    Energy Technology Data Exchange (ETDEWEB)

    Jin-ping Wei; Zhong-hua Li; Pei-miao Sang; Shang-qiang Chen [Henan Polytechnic University, Jiaozuo (China). School of Energy Science and Engineering

    2009-03-15

    Through theoretical analysis, simulation test and practice, the law of a fracture's influence on hard top coal press cracking was studied. The study focused on the relation between fracture and coal strength, top coal caving ability and work face layout. Based on the investigation of the fracture system, the control of press cracking was achieved by matching working face to fracture orientation to improve top-coal caving ability and recovery. The matching principle was pointed out: the top-coal caving working face should be perpendicular to or obliquely cross the primary fracture at a large angle, and cross the secondary fracture at a small angle. The rational match can increase the recovery ratio of top-coal and avoid rib spalling. The application of control technology on hard top coal press cracking was introduced at the longwall top-coal caving face. 10 refs., 2 figs., 1 tab.

  2. Numerical examination of the factors controlling DNAPL migration through a single fracture.

    Science.gov (United States)

    Reynolds, D A; Kueper, B H

    2002-01-01

    The migration of five dense nonaqueous phase liquids (DNAPLs) through a single fracture in a clay aquitard was numerically simulated with the use of a compositional simulator. The effects of fracture aperture, fracture dip, matrix porosity, and matrix organic carbon content on the migration of chlorobenzene, 1,2-dichloroethylene, trichloroethylene, tetra-chloroethylene, and 1,2-dibromoethane were examined. Boundary conditions were chosen such that DNAPL entry into the system was allowed to vary according to the stresses applied. The aperture is the most important factor of those studied controlling the migration rate of DNAPL through a single fracture embedded in a clay matrix. Loss of mass to the matrix through diffusion does not significantly retard the migration rate of the DNAPL, particularly in larger aperture fractures (e.g., 50 microm). With time, the ratio of diffusive loss to the matrix to DNAPL flux into the fracture approaches an asymptotic value lower than unity. The implication is that matrix diffusion cannot arrest the migration of DNAPL in a single fracture. The complex relationships between density, viscosity, and solubility that, to some extent, govern the migration of DNAPL through these systems prevent accurate predictions without the use of numerical models. The contamination potential of the migrating DNAPL is significantly increased through the transfer of mass to the matrix. The occurrence of opposite concentration gradients within the matrix can cause dissolved phase contamination to exist in the system for more than 1000 years after the DNAPL has been completely removed from the fracture.

  3. Computer-aided, single-specimen controlled bending test for fracture-kinetics measurement in ceramics

    International Nuclear Information System (INIS)

    Borovik, V.G.; Chushko, V.M.; Kovalev, S.P.

    1995-01-01

    Fracture testing of ceramics by using controlled crack growth is proposed to allow study of crack-kinetics behavior under a given loading history. A computer-aided, real-time data acquisition system improves the quality of crack-growth parameters obtained in a simple, single-specimen bend test. Several ceramic materials were tested in the present study: aluminum nitride as a linear-elastic material; and alumina and yttria-stabilized zirconia, both representative of ceramics with microstructure-dependent nonlinear fracture properties. Ambiguities in the crack-growth diagrams are discussed to show the importance of accounting for crack-growth history in correctly describing nonequilibrium fracture behavior

  4. Cross-education for improving strength and mobility after distal radius fractures: a randomized controlled trial.

    Science.gov (United States)

    Magnus, Charlene R A; Arnold, Cathy M; Johnston, Geoffrey; Dal-Bello Haas, Vanina; Basran, Jenny; Krentz, Joel R; Farthing, Jonathan P

    2013-07-01

    To evaluate the effects of cross-education (contralateral effect of unilateral strength training) during recovery from unilateral distal radius fractures on muscle strength, range of motion (ROM), and function. Randomized controlled trial (26-wk follow-up). Hospital, orthopedic fracture clinic. Women older than 50 years with a unilateral distal radius fracture. Fifty-one participants were randomized and 39 participants were included in the final data analysis. Participants were randomized to standard rehabilitation (Control) or standard rehabilitation plus strength training (Train). Standard rehabilitation included forearm casting for 40.4±6.2 days and hand exercises for the fractured extremity. Nonfractured hand strength training for the training group began immediately postfracture and was conducted at home 3 times/week for 26 weeks. The primary outcome measure was peak force (handgrip dynamometer). Secondary outcomes were ROM (flexion/extension; supination/pronation) via goniometer and the Patient Rated Wrist Evaluation questionnaire score for the fractured arm. For the fractured hand, the training group (17.3±7.4kg) was significantly stronger than the control group (11.8±5.8kg) at 12 weeks postfracture (P<.017). There were no significant strength differences between the training and control groups at 9 (12.5±8.2kg; 11.3±6.9kg) or 26 weeks (23.0±7.6kg; 19.6±5.5kg) postfracture, respectively. Fractured hand ROM showed that the training group had significantly improved wrist flexion/extension (100.5°±19.2°) than the control group (80.2°±18.7°) at 12 weeks postfracture (P<.017). There were no significant differences between the training and control groups for flexion/extension ROM at 9 (78.0°±20.7°; 81.7°±25.7°) or 26 weeks (104.4°±15.5°; 106.0°±26.5°) or supination/pronation ROM at 9 (153.9°±23.9°; 151.8°±33.0°), 12 (170.9°±9.3°; 156.7°±20.8°) or 26 weeks (169.4°±11.9°; 162.8°±18.1°), respectively. There were no

  5. Mathematical and computational analyses of cracking formation fracture morphology and its evolution in engineering materials and structures

    CERN Document Server

    Sumi, Yoichi

    2014-01-01

    This book is about the pattern formation and the evolution of crack propagation in engineering materials and structures, bridging mathematical analyses of cracks based on singular integral equations, to computational simulation of engineering design. The first two parts of this book focus on elasticity and fracture and provide the basis for discussions on fracture morphology and its numerical simulation, which may lead to a simulation-based fracture control in engineering structures. Several design concepts are discussed for the prevention of fatigue and fracture in engineering structures, including safe-life design, fail-safe design, damage tolerant design. After starting with basic elasticity and fracture theories in parts one and two, this book focuses on the fracture morphology that develops due to the propagation of brittle cracks or fatigue cracks.   In part three, the mathematical analysis of a curved crack is precisely described, based on the perturbation method. The stability theory of interactive ...

  6. Nurse case-manager vs multifaceted intervention to improve quality of osteoporosis care after wrist fracture: randomized controlled pilot study.

    Science.gov (United States)

    Majumdar, S R; Johnson, J A; Bellerose, D; McAlister, F A; Russell, A S; Hanley, D A; Garg, S; Lier, D A; Maksymowych, W P; Morrish, D W; Rowe, B H

    2011-01-01

    Few outpatients with fractures are treated for osteoporosis in the years following fracture. In a randomized pilot study, we found a nurse case-manager could double rates of osteoporosis testing and treatment compared with a proven efficacious quality improvement strategy directed at patients and physicians (57% vs 28% rates of appropriate care). Few patients with fractures are treated for osteoporosis. An intervention directed at wrist fracture patients (education) and physicians (guidelines, reminders) tripled osteoporosis treatment rates compared to controls (22% vs 7% within 6 months of fracture). More effective strategies are needed. We undertook a pilot study that compared a nurse case-manager to the multifaceted intervention using a randomized trial design. The case-manager counseled patients, arranged bone mineral density (BMD) tests, and prescribed treatments. We included controls from our first trial who remained untreated for osteoporosis 1-year post-fracture. Primary outcome was bisphosphonate treatment and secondary outcomes were BMD testing, appropriate care (BMD test-treatment if bone mass low), and costs. Forty six patients untreated 1-year after wrist fracture were randomized to case-manager (n = 21) or multifaceted intervention (n = 25). Median age was 60 years and 68% were female. Six months post-randomization, 9 (43%) case-managed patients were treated with bisphosphonates compared with 3 (12%) multifaceted intervention patients (relative risk [RR] 3.6, 95% confidence intervals [CI] 1.1-11.5, p = 0.019). Case-managed patients were more likely than multifaceted intervention patients to undergo BMD tests (81% vs 52%, RR 1.6, 95%CI 1.1-2.4, p = 0.042) and receive appropriate care (57% vs 28%, RR 2.0, 95%CI 1.0-4.2, p = 0.048). Case-management cost was $44 (CDN) per patient vs $12 for the multifaceted intervention. A nurse case-manager substantially increased rates of appropriate testing and treatment for osteoporosis in

  7. Multi-zone coupling productivity of horizontal well fracturing with complex fracture networks in shale gas reservoirs

    Directory of Open Access Journals (Sweden)

    Weiyao Zhu

    2018-02-01

    best. Therefore, it is necessary to control fracturing degree reasonably and optimize fracturing parameters, so as to provide a theoretical support for the optimization design of shale gas reservoir fracturing. Keywords: Shale gas, Reservoir, Fracturing, Horizontal well, Complex fracture network, Multi-zone coupling, Multi-scale, Interference, Productivity capacity

  8. Bisphosphonates for the prevention of fractures in osteogenesis imperfecta: meta-analysis of placebo-controlled trials.

    Science.gov (United States)

    Hald, Jannie D; Evangelou, Evangelos; Langdahl, Bente L; Ralston, Stuart H

    2015-05-01

    Bisphosphonates are widely used off-label in the treatment of patients with osteogenesis imperfecta (OI) with the intention of reducing the risk of fracture. Although there is strong evidence that bisphosphonates increase bone mineral density in osteogenesis imperfecta, the effects on fracture occurrence have been inconsistent. The aim of this study was to gain a better insight into the effects of bisphosphonate therapy on fracture risk in patients with osteogenesis imperfecta by conducting a meta-analysis of randomized controlled trials in which fractures were a reported endpoint. We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials in which the effects of bisphosphonates on fracture risk in osteogenesis imperfecta were compared with placebo and conducted a meta-analysis of these studies using standard methods. Heterogeneity was assessed using the I2 statistic. Six eligible studies were identified involving 424 subjects with 751 patient-years of follow-up. The proportion of patients who experienced a fracture was not significantly reduced by bisphosphonate therapy (Relative Risk [RR] = 0.83 [95% confidence interval 0.69-1.01], p = 0.06) with no heterogeneity between studies (I2  = 0). The fracture rate was reduced by bisphosphonate treatment when all studies were considered (RR = 0.71 [0.52-0.96], p = 0.02), but with considerable heterogeneity (I2  = 36%) explained by one study where a small number of patients in the placebo group experienced a large number of fractures. When this study was excluded, the effects of bisphosphonates on fracture rate was not significant (RR = 0.79 [0.61-1.02], p = 0.07, I2  = 0%). We conclude that the effects of bisphosphonates on fracture prevention in osteogenesis imperfecta are inconclusive. Adequately powered trials with a fracture endpoint are needed to further investigate the risks and benefits of bisphosphonates in this condition. © 2014 American Society for

  9. [Distal radius fractures--retrospective quality control after conservative and operative therapy].

    Science.gov (United States)

    Sommer, C; Brendebach, L; Meier, R; Leutenegger, A

    2001-01-01

    The distal radius fracture is the most frequent fracture in the adult patient. The wide spectrum of different types of fracture and the coexisting factors make the choice for the optimal treatment difficult. As an interne quality control we retrospectively evaluated all patients with distal radius fractures treated in 1995 at our institution. The study included 69 adult patients with 71 distal radius fractures. After on average 26 months 58 patients with 59 fractures were clinically and radiologically evaluated. The patients were asked to give supplementary information about their follow-up treatment as well as any remaining physical difficulties and limitations in the daily life. All x-rays of the broken radius were carefully analysed and compared with the opposite side. The final results were evaluated according to the "Demerit Point System". Patients were treated with five different therapeutical methods. 76.3% of the patients showed a very good/good final result. In 56.7% of the cases secondary fracture dislocation occurred; the dislocation-rate of fractures treated with percutaneous k-wires was 93.3%! A clear correlation between secondary displacement and final results was found. A main factor for an optimal outcome is the anatomic restoration of length and axis of the distal radius as well as of joint congruency, also moderate angular deformities are well tolerated. Our collective showed an unexpected high rate of secondary displacement, especially in the k-wire group. The reasons for this unsatisfactory event are manifold: too optimistic indication, insufficient follow-up examination in the first four to six weeks, inconsequent change to a more stable fixation method in case of a secondary dislocation. The results of this retrospective evaluation had a major impact on our concept of treatment. The dorso-radial double-plate technique combined with bone graft will be more used in the future especially in younger patients. The new standardised concept is the

  10. Primer: Fracture mechanics in the nuclear power industry

    International Nuclear Information System (INIS)

    Wessel, E.T.; Server, W.L.; Kennedy, E.L.

    1990-01-01

    This Primer is intended to familiarize utility engineers with the fracture mechanics technology and to provide the basis for a working knowledge of the subject. It is directed towards all the engineering disciplines that are involved either directly or indirectly with the structural reliability of electrical power generation equipment and systems. These engineering disciplines include such areas as: design and stress analysis, metallurgy and materials, nondestructive inspection and quality control, structural analysis and reliability engineering, chemical engineering and water chemistry control, and architectural engineering. This Primer does not provide a comprehensive, in-depth treatment of all the detailed aspects involved in fracture mechanics. It does, however, provide sufficient information and a common vocabulary that should enable engineers to: read and converse intelligently about the subject, understand and utilize ASME Codes and Regulatory Guides involving fracture mechanics, absorb technical information presented and discussed at various technical meetings, and begin to apply this technology towards actual engineering problems encountered in the course of their work. Example problems are provided to further enhance an understanding of fracture mechanics. Also, Appendix A describes fracture mechanics computer codes available through EPRI to analyze rotors, reactor pressure vessels and piping

  11. Fracture risk in perimenopausal women treated with beta-blockers

    DEFF Research Database (Denmark)

    Rejnmark, Lars; Vestergaard, Peter; Kassem, M.

    2004-01-01

    beta2-Adrenergic receptors have been identified on human osteoblastic and osteoclastic cells, raising the question of a sympathetic regulation of bone metabolism. We investigated effects of treatment with beta-adrenergic receptor antagonists (beta-blockers) on bone turnover, bone mineral density...... (BMD), and fracture risk. Within the Danish Osteoporosis Prevention Study (DOPS) a population based, comprehensive cohort study of 2016 perimenopausal women, associations between treatment with beta-blockers and bone turnover and BMD were assessed in a cross-sectional design at the start of study....... Moreover, in a nested case-control design, fracture risk during the subsequent 5 years was assessed in relation to treatment with beta-blockers at baseline. Multiple regression- and logistic regression-analyses were performed. Treatment with beta-blockers was associated with a threefold increased fracture...

  12. A Study on the Fracture Control of Rock Bolts in High Ground Pressure Roadways of Deep Mines

    Directory of Open Access Journals (Sweden)

    Wen Jinglin

    2015-01-01

    Full Text Available According to the frequent fractures of rock bolts in high ground pressure roadways of deep mines, this paper analyzes the mechanism of fractures and concludes that high ground pressure and material de-fects are main reasons for the fracture of rock bolts. The basic idea of fracture control of rock bolts in high ground pressure roadways of deep mines is to increase the yield load and the limit load of rock bolt materials and reduce the actual load of rock bolts. There are four ways of controlling rock bolt fracture: increasing the rock bolt diameter, strengthening bolt materials, weakening support rigidity and the implementation of double supporting. With the roadway support of the 2302 working face of a coal mine as the project background, this paper carries out a study on the effect of two schemes, increasing the rock bolt diameter and the double supporting technique through methods of theoretical analysis, numerical simulation and so on. It determines the most reasonable diam-eter of rock bolts and the best delay distance of secondary support. Practices indicate that rock bolt fracture can be effectively controlled through the double supporting technique, which strengthens the roof and two sides through the first supporting technique and strengthens side angles through the secondary supporting technique.

  13. Optimizing the design of vertical seismic profiling (VSP) for imaging fracture zones over hardrock basement geothermal environments

    Science.gov (United States)

    Reiser, Fabienne; Schmelzbach, Cedric; Maurer, Hansruedi; Greenhalgh, Stewart; Hellwig, Olaf

    2017-04-01

    A primary focus of geothermal seismic imaging is to map dipping faults and fracture zones that control rock permeability and fluid flow. Vertical seismic profiling (VSP) is therefore a most valuable means to image the immediate surroundings of an existing borehole to guide, for example, the placing of new boreholes to optimize production from known faults and fractures. We simulated 2D and 3D acoustic synthetic seismic data and processed it through to pre-stack depth migration to optimize VSP survey layouts for mapping moderately to steeply dipping fracture zones within possible basement geothermal reservoirs. Our VSP survey optimization procedure for sequentially selecting source locations to define the area where source points are best located for optimal imaging makes use of a cross-correlation statistic, by which a subset of migrated shot gathers is compared with a target or reference image from a comprehensive set of source gathers. In geothermal exploration at established sites, it is reasonable to assume that sufficient à priori information is available to construct such a target image. We generally obtained good results with a relatively small number of optimally chosen source positions distributed over an ideal source location area for different fracture zone scenarios (different dips, azimuths, and distances from the surveying borehole). Adding further sources outside the optimal source area did not necessarily improve the results, but rather resulted in image distortions. It was found that fracture zones located at borehole-receiver depths and laterally offset from the borehole by 300 m can be imaged reliably for a range of the different dips, but more source positions and large offsets between sources and the borehole are required for imaging steeply dipping interfaces. When such features cross-cut the borehole, they are particularly difficult to image. For fracture zones with different azimuths, 3D effects are observed. Far offset source positions

  14. Design considerations of a randomized controlled trial of sedation level during hip fracture repair surgery: a strategy to reduce the incidence of postoperative delirium in elderly patients.

    Science.gov (United States)

    Li, Tianjing; Wieland, L Susan; Oh, Esther; Neufeld, Karin J; Wang, Nae-Yuh; Dickersin, Kay; Sieber, Frederick E

    2017-06-01

    Background Delirium is an acute change in mental status characterized by sudden onset, fluctuating course, inattention, disorganized thinking, and abnormal level of consciousness. The objective of the randomized controlled trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" (STRIDE) is to assess the effectiveness of light versus heavy sedation on delirium and other outcomes in elderly patients undergoing hip fracture repair surgery. Our goal is to describe the design considerations and lessons learned in planning and implementing the STRIDE trial. Methods Discussed are challenges encountered including (1) how to ensure that we quickly identify, assess the eligibility of, and randomize traumatic hip fracture patients; (2) how to implement interventions that involve continuous monitoring and adjustment during the surgery; and (3) how to measure and ascertain the primary outcome, delirium. Results To address the first challenge, we monitored the operating room schedule more actively than anticipated. We constructed and organized eligibility assessment data collection forms by purpose and by source of information needed to complete them. We decided that randomization needs to take place in the operating room. To address the second challenge, we designed and implemented a treatment protocol and covered the bispectral index monitor to prevent the Anesthesiologist/Anesthetist from being influenced by the bispectral index reading while administering the intervention. Finally, clinical assessment of delirium consisted of standardized interviews of the patient using validated instruments, interviews of those caring for the patient, and review of the medical record. A consensus panel made the final determination of a delirium diagnosis. We note that STRIDE is a single-center trial. The decisions we took may have different implications for multi-center trials. Conclusions Lessons learned are likely to provide useful information to others

  15. Fracture mechanics of ceramics. Vol. 8. Microstructure, methods, design, and fatigue

    International Nuclear Information System (INIS)

    Bradt, R.C.; Evans, A.G.; Hasselman, D.P.H.; Lange, F.F.

    1986-01-01

    This paper presents information on the following topics: fracture mechanics and microstructures; non-lubricated sliding wear of Al 2 O 3 , PSZ and SiC; mixed-mode fracture of ceramics; some fracture properties of alumina-containing electrical porcelains; transformation toughening in the Al 2 O 3 -Cr 2 O 3 /ZrO 2 -HfO 2 system; strength toughness relationships for transformation toughened ceramics; tensile strength and notch sensitivity of Mg-PSZ; fracture mechanisms in lead zirconate titanate ceramics; loading-unloading techniques for determining fracture parameters of brittle materials utilizing four-point bend, chevron-notched specimens; application of the potential drop technique to the fracture mechanics of ceramics; ceramics-to-metal bonding from a fracture mechanics perspective; observed changes in fracture strength following laser irradiation and ion beam mixing of Ni overlayers on sintered alpha-SiC; crack growth in single-crystal silicon; a fracture mechanics and non-destructive evaluation investigation of the subcritical-fracture process in rock; slow crack growth in sintered silicon nitride; uniaxial tensile fatigue testing of sintered silicon carbide under cyclic temperature change; and effect of surface corrosion on glass fracture

  16. Controlling rotational deformity in ankle fractures : the Bridgend ...

    African Journals Online (AJOL)

    Management. Recognition of the forces is usually possible by observing the pattern of the fracture lines, especially in the fibula. Abduction and adduction forces cause transverse or short oblique fracture lines near the level of the ankle joint (Fig 1) whereas rotation forces produce spiral fractures of the fibula above the level ...

  17. Effect of mix design on the size-independent fracture energy of normal- and high-strength self-compacting concrete

    International Nuclear Information System (INIS)

    Cifuentes, H.; Ríos, J.D.; Gómez, E.J.

    2018-01-01

    Self-compacting concrete has a characteristic microstructure inherent to its specific composition. The higher content of fine particles in self-compacting concrete relative to the equivalent vibrated concrete produces a different fracture behavior that affects the main fracture parameters. In this work, a comprehensive experimental investigation of the fracture behavior of self-compacting concrete has been carried out. Twelve different self-compacting concrete mixes with compressive strength ranging from 39 to 124 MPa (wider range than in other studies) have been subjected to three-point bending tests in order to determine the specific fracture energy. The influence of the mix design and its composition (coarse aggregate fraction, the water to binder ratio and the paste to solids ratio) on its fracture behavior has been analyzed. Moreover, further evidence of the objectivity of the size-independent fracture energy results, obtained by the two most commonly used methods, has been p [es

  18. Assessing the role of cation exchange in controlling groundwater chemistry during fluid mixing in fractured granite at Aespoe, Sweden

    International Nuclear Information System (INIS)

    Viani, B.E.; Bruton, C.J.

    1996-06-01

    Geochemical modeling was used to simulate the mixing of dilute shallow groundwater with deeper more saline groundwater in the fractured granite of the Redox Zone at the Aespoe underground Hard Rock Laboratory (HRL). Fluid mixing simulations were designed to assess the role that cation exchange plays in controlling the composition of fluids entering the HRL via fracture flow. Mixing simulations included provision for the effects of mineral precipitation and cation exchange on fluid composition. Because the predominant clay mineral observed in fractures in the Redox Zone has been identified as illite or mixed layer illite smectite, an exchanger with the properties of illite was used to simulate cation exchange. Cation exchange on illite was modeled using three exchange sites, a planar or basal plane site with properties similar to smectite, and two edge sites that have very high affinities for K, Rb, and Cs. Each site was assumed to obey an ideal Vanselow exchange model, and exchange energies for each site were taken from the literature. The predicted behaviors of Na, Ca, and Mg during mixing were similar to those reported in a previous study in which smectite was used as the model for the exchanger. The trace elements Cs and Rb were predicted to be strongly associated with the illite exchanger, and the predicted concentrations of Cs in fracture fill were in reasonable agreement with reported chemical analyses of exchangeable Cs in fracture fill. The results of the geochemical modeling suggest that Na, Ca, and Sr concentrations in the fluid phase may be controlled by cation exchange reactions that occur during mixing, but that Mg appears to behave conservatively. There is currently not enough data to make conclusions regarding the behavior of Cs and Rb

  19. Dynamic plantar pressure distribution, strength capacity and postural control after Lisfranc fracture-dislocation

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander T; Walther, Markus; Yilmaz, Tayfun

    2017-01-01

    of life. 17 consecutive patients suffering from a Lisfranc fracture dislocation were registered, underwent open reduction and internal fixation and were followed-up for 50.5±25.7months (Mean±SDM). Biomechanical analysis of muscle strength capacities, postural control and plantar pressure distribution......Substantial progress has been made in the operative treatment of Lisfranc fractures, however, the prognosis remains poor. We hypothesized that Lisfranc injuries change the postural control and muscle strength of the lower limb. Both are suggested to correlate with the clinical outcome and quality...... correlated well with clinical outcome. Altered postural control was evident by a significant reduction in unilateral stance time, from which we calculated a strong correlation between stance time and the isokinetic strength measurement. Plantar pressure measurements revealed a significant reduction in peak...

  20. Hydraulic fracture considerations in oil sand overburden dams

    Energy Technology Data Exchange (ETDEWEB)

    Cameron, R.; Madden, B.; Danku, M. [Syncrude Canada Ltd., Fort McMurray, AB (Canada)

    2008-07-01

    This paper discussed hydraulic fracture potential in the dry-filled temporary dams used in the oil sands industry. Hydraulic fractures can occur when reservoir fluid pressures are greater than the minimum stresses in a dam. Stress and strain conditions are influenced by pore pressures, levels of compaction in adjacent fills as well as by underlying pit floor and abutment conditions. Propagation pressure and crack initiation pressures must also be considered in order to provide improved hydraulic fracture protection to dams. Hydraulic fractures typically result in piping failures. Three cases of hydraulic fracture at oil sands operations in Alberta were presented. The study showed that hydraulic fracture failure modes must be considered in dam designs, particularly when thin compacted lift of dry fill are used to replace wetted clay cores. The risk of hydraulic fractures can be reduced by eliminating in situ bedrock irregularities and abutments. Overpressure heights, abutment sloping, and the sloping of fills above abutments, as well as the dam's width and base conditions must also be considered in relation to potential hydraulic fractures. It was concluded that upstream sand beaches and internal filters can help to prevent hydraulic fractures in dams in compacted control zones. 5 refs., 16 figs.

  1. Acoustic Monitoring of Gravity-Driven Controls on CaCO3 Precipitates in a Fracture

    Science.gov (United States)

    Xu, Z.; Sheets, J.; Zhang, L.; Kim, D.; Kneafsey, T. J.; Cole, D. R.; Jun, Y. S.; Pyrak-Nolte, L. J.

    2017-12-01

    the orientation thus affecting the ability of a fracture to self-heal if oriented vertically. This work was supported by the Center for Nanoscale Controls on Geologic CO (NCGC), an Energy Frontier Research Center funded by the U.S. Department of Energy, Office of Science, Basic Energy Sciences under Award # DE-AC02-05CH11231

  2. A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.

    Science.gov (United States)

    Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E

    2016-06-01

    Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.

  3. Effect of mix design on the size-independent fracture energy of normal- and high-strength self-compacting concrete

    Directory of Open Access Journals (Sweden)

    H. Cifuentes

    2018-02-01

    Full Text Available Self-compacting concrete has a characteristic microstructure inherent to its specific composition. The higher content of fine particles in self-compacting concrete relative to the equivalent vibrated concrete produces a different fracture behavior that affects the main fracture parameters. In this work, a comprehensive experimental investigation of the fracture behavior of self-compacting concrete has been carried out. Twelve different self-compacting concrete mixes with compressive strength ranging from 39 to 124 MPa (wider range than in other studies have been subjected to three-point bending tests in order to determine the specific fracture energy. The influence of the mix design and its composition (coarse aggregate fraction, the water to binder ratio and the paste to solids ratio on its fracture behavior has been analyzed. Moreover, further evidence of the objectivity of the size-independent fracture energy results, obtained by the two most commonly used methods, has been provided on the self-compacting concrete mixes.

  4. A fracture-controlled path-following technique for phase-field modeling of brittle fracture

    NARCIS (Netherlands)

    Singh, N.; Verhoosel, C.V.; De Borst, R.; Van Brummelen, E.H.

    2016-01-01

    In the phase-field description of brittle fracture, the fracture-surface area can be expressed as a functional of the phase field (or damage field). In this work we study the applicability of this explicit expression as a (non-linear) path-following constraint to robustly track the equilibrium path

  5. Nonoperative Treatment of Thoracic and Lumbar Spine Fractures : A Prospective Randomized Study of Different Treatment Options

    NARCIS (Netherlands)

    Stadhouder, Agnita; Buskens, Erik; Vergroesen, Diederik A.; Fidler, Malcolm W.; de Nies, Frank; Oner, F. C.

    Objectives: To evaluate and compare nonoperative treatment methods for traumatic thoracic and lumbar compression fractures and burst fractures. Design: Prospective randomized controlled trial with long-term follow-up. Setting: Two general hospitals in the Netherlands. Patients/Participants: Patients

  6. Fracture resistance and failure modes of polymer infiltrated ceramic endocrown restorations with variations in margin design and occlusal thickness.

    Science.gov (United States)

    Taha, Doaa; Spintzyk, Sebastian; Schille, Christine; Sabet, Ahmed; Wahsh, Marwa; Salah, Tarek; Geis-Gerstorfer, Jürgen

    2017-12-11

    The purpose of this in vitro study was to assess the effect of varying the margin designs and the occlusal thicknesses on the fracture resistance and mode of failures of endodontically treated teeth restored with polymer infiltrated ceramic endocrown restorations. Root canal treated mandibular molars were divided into four groups (n=8) and were prepared to receive Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) fabricated polymer infiltrated ceramic endocrowns (ENAMIC blocks). Group B2 represents teeth prepared with a butt joint design receiving endocrowns with 2mm occlusal thickness and the same for group B3.5 but with 3.5mm occlusal thickness. Group S2 represents teeth prepared with 1mm shoulder finish line receiving endocrowns with 2mm occlusal thickness and the same for group S3.5 but with 3.5mm occlusal thickness. After cementation and thermal aging, fracture resistance test was performed and failure modes were observed. Group S3.5 showed the highest mean fracture load value (1.27±0.31kN). Endocrowns with shoulder finish line had significantly higher mean fracture resistance values than endocrowns with butt margin (p<0.05). However, the results were not statistically significant regarding the restoration thickness. Evaluation of the fracture modes revealed no statistically significant difference between the modes of failure of tested groups. For the restoration of endodontically treated teeth, adding a short axial wall and shoulder finish line can increase the fracture resistance. However, further investigations, especially the fatigue behavior, are needed to ensure this effect applies with small increases of restoration thickness. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  7. Subtrochanteric femoral fracture during trochanteric nailing for the treatment of femoral shaft fracture.

    Science.gov (United States)

    Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

    2013-09-01

    We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nailing for femoral shaft fractures to improve its application and prevent implant-derived complications.

  8. Report About the Design of External Fixator for Treatment of Pelvis and Acetabulum Fractures

    Directory of Open Access Journals (Sweden)

    Martin JANEČKA

    2012-06-01

    Full Text Available Main point in this contribution is the design of external fixators applied in traumatology and orthopaedics. These fixators can be used in the treatment of open and unstable (i.e. complicated fractures of pelvis and its acetabulum. Numerical modelling (i.e. Finite Element Method, together with CAD modelling, experiments, material engineering, and nanotechnology are presented as a support for developing of a new design of external fixators.

  9. Fundamental differences in axial and appendicular bone density in stress fractured and uninjured Royal Marine recruits--a matched case-control study.

    Science.gov (United States)

    Davey, Trish; Lanham-New, Susan A; Shaw, Anneliese M; Cobley, Rosalyn; Allsopp, Adrian J; Hajjawi, Mark O R; Arnett, Timothy R; Taylor, Pat; Cooper, Cyrus; Fallowfield, Joanne L

    2015-04-01

    Stress fracture is a common overuse injury within military training, resulting in significant economic losses to the military worldwide. Studies to date have failed to fully identify the bone density and bone structural differences between stress fractured personnel and controls due to inadequate adjustment for key confounding factors; namely age, body size and physical fitness; and poor sample size. The aim of this study was to investigate bone differences between male Royal Marine recruits who suffered a stress fracture during the 32 weeks of training and uninjured control recruits, matched for age, body weight, height and aerobic fitness. A total of 1090 recruits were followed through training and 78 recruits suffered at least one stress fracture. Bone mineral density (BMD) was measured at the lumbar spine (LS), femoral neck (FN) and whole body (WB) using Dual X-ray Absorptiometry in 62 matched pairs; tibial bone parameters were measured using peripheral Quantitative Computer Tomography in 51 matched pairs. Serum C-terminal peptide concentration was measured as a marker of bone resorption at baseline, week-15 and week-32. ANCOVA was used to determine differences between stress fractured recruits and controls. BMD at the LS, WB and FN sites was consistently lower in the stress fracture group (Pstress fracture recruits and controls were evident in all slices of the tibia, with the most prominent differences seen at the 38% tibial slice. There was a negative correlation between the bone cross-sectional area and BMD at the 38% tibial slice. There was no difference in serum CTx concentration between stress fracture recruits and matched controls at any stage of training. These results show evidence of fundamental differences in bone mass and structure in stress fracture recruits, and provide useful data on bone risk factor profiles for stress fracture within a healthy military population. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  10. Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Ekdahl Charlotte S

    2009-09-01

    Full Text Available Abstract Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group versus usual care (control group after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36, timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028, muscle strength in the plantar flexors (p = 0.029 and dorsiflexors (p = 0.030. Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three

  11. Non-Steroid Anti-Inflammatory Drugs Are Better than Acetaminophen on Fever Control at Acute Stage of Fracture.

    Directory of Open Access Journals (Sweden)

    Kuang-Ting Yeh

    Full Text Available In addition to adequate surgical fixation and an aggressive rehabilitation program, pain relief is one of the most critical factors in the acute stage of fracture treatment. The most common analgesics are nonsteroid anti-inflammatory drugs and Acetaminophen, both of which relieve pain and reduce body temperature. In clinical experiences, they exhibit effective pain control; however, their influence on body temperature remains controversial. This study is aimed at determining the effects of analgesics at the acute stage of traumatic fracture by performing a clinical retrospective study of patients with fractures and a fracture animal model. The retrospective study revealed that, in the acetaminophen group, the mean value of postmedication body temperature (BT was significantly higher than that of the premedication BT. The change in BT was highly related with the medication rather than other risk factors. Forty eight 12-week-old male Wistar rats were divided into 6 groups: a control group, fracture group, fracture-Acetaminophen group, Acetaminophen group, fracture-Arcoxia group, and Arcoxia group. Fracture rats were prepared by breaking their unilateral tibia and fibula. Their inflammation conditions were evaluated by measuring their serum cytokine level and their physiological status was evaluated by estimating their central temperature, heart rate, and mean blood pressure. The hepatic adverse effects were assessed by measuring the serum levels of aspartate aminotransferase (sGOT and alanine aminotransferase (sGPT. The central temperature in the fracture-Acetaminophen group exceeded that in the groups fed normal saline water or Arcoxia. Accumulated hepatic injury was presented as steadily ascending curves of sGOT and sGPT. Inflammation-related cytokine levels were not higher in the Acetaminophen fracture group and were significantly lower in the fracture-Arcoxia group. Fever appeared to be aggravated by acetaminophen and more related to the

  12. Pilot case-control investigation of risk factors for hip fractures in the urban Indian population

    Directory of Open Access Journals (Sweden)

    Malhotra Nidhi

    2010-03-01

    Full Text Available Abstract Background Despite the reported high prevalence of osteoporosis in India, there have been no previous studies examining the risk factors for hip fracture in the Indian population. Methods We carried out a case control investigation comprising 100 case subjects (57 women and 43 men admitted with a first hip fracture into one of three hospitals across New Delhi. The 100 controls were age and sex matched subjects who were either healthy visitors not related to the case patients or hospital staff. Information from all subjects was obtained through a questionnaire based interview. Results There was a significant increase in the number of cases of hip fracture with increasing age. There were significantly more women (57% than men (43%. Univariate analysis identified protective effects for increased activity, exercise, calcium and vitamin supplements, almonds, fish, paneer (cottage cheese, curd (plain yogurt, and milk. However, tea and other caffeinated beverages were significant risk factors. In women, hormone/estrogen therapy appeared to have a marginal protective effect. For all cases, decreased agility, visual impairment, long term medications, chronic illnesses increased the risk of hip fracture. The multivariate analysis confirmed a protective effect of increased activity and also showed a decrease in hip fracture risk with increasing body mass index (odds ratio (OR 0.024, 95% confidence interval (CI 0.006-0.10 & OR 0.81, 95% CI 0.68-0.97 respectively. Individuals who take calcium supplements have a decreased risk of hip fracture (OR 0.076; CI 0.017-0.340, as do individuals who eat fish (OR 0.094; CI 0.020-0.431, and those who eat paneer (OR 0.152; 0.031-0.741. Tea drinkers have a higher risk of hip fracture (OR 22.8; 95% CI 3.73-139.43. Difficulty in getting up from a chair also appears to be an important risk factor for hip fractures (OR 14.53; 95% CI 3.86-54.23. Conclusions In the urban Indian population, dietary calcium, vitamin D

  13. Device for fracturing silicon-carbide coatings on nuclear-fuel particles

    Science.gov (United States)

    Turner, L.J.; Willey, M.G.; Tiegs, S.M.; Van Cleve, J.E. Jr.

    This invention is a device for fracturing particles. It is designed especially for use in hot cells designed for the handling of radioactive materials. In a typical application, the device is used to fracture a hard silicon-carbide coating present on carbon-matrix microspheres containing nuclear-fuel materials, such as uranium or thorium compounds. To promote remote control and facilitate maintenance, the particle breaker is pneumatically operated and contains no moving parts. It includes means for serially entraining the entrained particles on an anvil housed in a leak-tight chamber. The flow rate of the gas is at a value effecting fracture of the particles; preferably, it is at a value fracturing them into product particulates of fluidizable size. The chamber is provided with an outlet passage whose cross-sectional area decreases in the direction away from the chamber. The outlet is connected tangentially to a vertically oriented vortex-flow separator for recovering the product particulates entrained in the gas outflow from the chamber. The invention can be used on a batch or continuous basis to fracture the silicon-carbide coatings on virtually all of the particles fed thereto.

  14. Method for fracturing silicon-carbide coatings on nuclear-fuel particles

    Science.gov (United States)

    Turner, Lloyd J.; Willey, Melvin G.; Tiegs, Sue M.; Van Cleve, Jr., John E.

    1982-01-01

    This invention is a device for fracturing particles. It is designed especially for use in "hot cells" designed for the handling of radioactive materials. In a typical application, the device is used to fracture a hard silicon-carbide coating present on carbon-matrix microspheres containing nuclear-fuel material, such as uranium or thorium compounds. To promote remote control and facilitate maintenance, the particle breaker is pneumatically operated and contains no moving parts. It includes means for serially entraining the entrained particles on an anvil housed in a leak-tight chamber. The flow rate of the gas is at a value effecting fracture of the particles; preferably, it is at a value fracturing them into product particulates of fluidizable size. The chamber is provided with an outlet passage whose cross-sectional area decreases in the direction away from the chamber. The outlet is connected tangentially to a vertically oriented vortex-flow separator for recovering the product particulates entrained in the gas outflow from the chamber. The invention can be used on a batch or continuous basis to fracture the silicon-carbide coatings on virtually all of the particles fed thereto.

  15. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study

    Directory of Open Access Journals (Sweden)

    Bloch Katia V

    2008-08-01

    Full Text Available Abstract Background Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. Methods A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002–2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture. Results Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk. Conclusion Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs.

  16. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study.

    Science.gov (United States)

    Coutinho, Evandro S F; Fletcher, Astrid; Bloch, Katia V; Rodrigues, Laura C

    2008-08-26

    Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002-2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture. Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk. Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs.

  17. Post-discharge management following hip fracture - get you back to B4: A parallel group, randomized controlled trial study protocol

    Directory of Open Access Journals (Sweden)

    Brown Roy A

    2011-06-01

    Full Text Available Abstract Background Fall-related hip fractures result in significant personal and societal consequences; importantly, up to half of older adults with hip fracture never regain their previous level of mobility. Strategies of follow-up care for older adults after fracture have improved investigation for osteoporosis; but managing bone health alone is not enough. Prevention of fractures requires management of both bone health and falls risk factors (including the contributing role of cognition, balance and continence to improve outcomes. Methods/Design This is a parallel group, pragmatic randomized controlled trial to test the effectiveness of a post-fracture clinic compared with usual care on mobility for older adults following their hospitalization for hip fracture. Participants randomized to the intervention will attend a fracture follow-up clinic where a geriatrician and physiotherapist will assess and manage their mobility and other health issues. Depending on needs identified at the clinical assessment, participants may receive individualized and group-based outpatient physiotherapy, and a home exercise program. Our primary objective is to assess the effectiveness of a novel post-discharge fracture management strategy on the mobility of older adults after hip fracture. We will enrol 130 older adults (65 years+ who have sustained a hip fracture in the previous three months, and were admitted to hospital from home and are expected to be discharged home. We will exclude older adults who prior to the fracture were: unable to walk 10 meters; diagnosed with dementia and/or significant comorbidities that would preclude their participation in the clinical service. Eligible participants will be randomly assigned to the Intervention or Usual Care groups by remote allocation. Treatment allocation will be concealed; investigators, measurement team and primary data analysts will be blinded to group allocation. Our primary outcome is mobility

  18. Protocol for the ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation trial: a pragmatic multi-centre randomised controlled trial of surgical versus non-surgical treatment for proximal fracture of the humerus in adults

    Directory of Open Access Journals (Sweden)

    Maffulli Nicola

    2009-11-01

    Full Text Available Abstract Background Proximal humeral fractures, which occur mainly in older adults, account for approximately 4 to 5% of all fractures. Approximately 40% of these fractures are displaced fractures involving the surgical neck. Management of this group of fractures is often challenging and the outcome is frequently unsatisfactory. In particular it is not clear whether surgery gives better outcomes than non-surgical management. Currently there is much variation in the use of surgery and a lack of good quality evidence to inform this decision. Methods/Design We aim to undertake a pragmatic UK-based multi-centre randomised controlled trial evaluating the effectiveness and cost-effectiveness of surgical versus standard non-surgical treatment for adults with an acute closed displaced fracture of the proximal humerus with involvement of the surgical neck. The choice of surgical intervention is left to the surgeon, who must use techniques that they are fully experienced with. This will avoid 'learning curve' problems. We will promote good standards of non-surgical care, similarly insisting on care-provider competence, and emphasize the need for comparable provision of rehabilitation for both groups of patients. We aim to recruit 250 patients from a minimum of 18 NHS trauma centres throughout the UK. These patients will be followed-up for 2 years. The primary outcome is the Oxford Shoulder Score, which will be collected via questionnaires completed by the trial participants at 6, 12 and 24 months. This is a 12-item condition-specific questionnaire providing a total score based on the person's subjective assessment of pain and activities of daily living impairment. We will also collect data for other outcomes, including general health measures and complications, and for an economic evaluation. Additionally, we plan a systematic collection of reasons for non-inclusion of eligible patients who were not recruited into the trial, and their baseline

  19. Subtrochanteric Femoral Fracture during Trochanteric Nailing for the Treatment of Femoral Shaft Fracture

    OpenAIRE

    Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

    2013-01-01

    We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nai...

  20. Mapping the prescriptiome to fractures in men--a national analysis of prescription history and fracture risk

    DEFF Research Database (Denmark)

    Abrahamsen, B; Brixen, K; Abrahamsen, B

    2009-01-01

    SUMMARY: A nationwide case-control study was performed in 62,865 men aged 50+ using fracture data from the national hospital discharge register to screen all redeemed prescriptions in the past 5 years for significant mapping to fracture risk, employing measures to control for false discovery rate....... INTRODUCTION: Osteoporosis in men is frequently related to alcohol abuse, hypogonadism, hypercalciuria, or the use of glucocorticoids. Very limited information is available on the impact of other medications on fracture risk in men. METHODS: We conducted a nationwide population-based case-control study...... collecting fracture data from the Danish National Hospital Discharge Register and prescriptions from the National Prescriptions Database (1995-2000). We included men aged 50+ years, with hospital-treated fractures in the year 2000 (n = 15,716), and age- and sex-matched controls (n = 47,149). RESULTS: We...

  1. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T

    2012-01-01

    Fracture mechanics is a vast and growing field. This book develops the basic elements needed for both fracture research and engineering practice. The emphasis is on continuum mechanics models for energy flows and crack-tip stress- and deformation fields in elastic and elastic-plastic materials. In addition to a brief discussion of computational fracture methods, the text includes practical sections on fracture criteria, fracture toughness testing, and methods for measuring stress intensity factors and energy release rates. Class-tested at Cornell, this book is designed for students, researchers and practitioners interested in understanding and contributing to a diverse and vital field of knowledge. Alan Zehnder joined the faculty at Cornell University in 1988. Since then he has served in a number of leadership roles including Chair of the Department of Theoretical and Applied Mechanics, and Director of the Sibley School of Mechanical and Aerospace Engineering.  He teaches applied mechanics and his research t...

  2. Hip fracture risk and cadmium in erythrocytes: a nested case-control study with prospectively collected samples.

    Science.gov (United States)

    Sommar, Johan Nilsson; Pettersson-Kymmer, Ulrika; Lundh, Thomas; Svensson, Olle; Hallmans, Göran; Bergdahl, Ingvar A

    2014-02-01

    Several studies have investigated the relation between bone mass density and cadmium exposure, but only few studies have been performed on fractures and biomarkers of cadmium. This study analyzed the association between hip fracture risk and cadmium in erythrocytes (Ery-Cd). Prospective samples from the Northern Sweden Health and Disease Study's biobank were used for 109 individuals who later in life had sustained a low-trauma hip fracture, matched with two controls of the same age and gender. The mean concentration of Ery-Cd (±SD) in case samples was 1.3 ± 1.4 versus 0.9 ± 1.0 μg/L in controls. The odds ratio (OR) was 1.63 [95% confidence interval (CI) 1.10-2.42] for suffering a hip fracture for each microgram per liter increase in Ery-Cd. However, when taking smoking into consideration (never, former, or current), neither Ery-Cd nor smoking showed a statistically significant increase in fracture risk. Using multiple conditional logistic regression with BMI, height, and smoking, the estimated OR for a 1-μg/L increase in Ery-Cd was 1.52 (95% CI 0.77-2.97). Subgroup analysis showed an increased fracture risk among women (OR = 1.94, 95% CI 1.18-3.20, for a 1 μg/L increase), which also remained in the multiple analysis (OR = 3.33, 95% CI 1.29-8.56). This study shows that fracture risk is associated with Ery-Cd. It is, however, not possible to draw firm conclusions on whether cadmium is the causal factor or whether other smoking-related factors cause this association. Subgroup analysis shows that cadmium is a risk factor for hip fracture among women.

  3. Anisotropy of strength and deformability of fractured rocks

    Directory of Open Access Journals (Sweden)

    Majid Noorian Bidgoli

    2014-04-01

    Full Text Available Anisotropy of the strength and deformation behaviors of fractured rock masses is a crucial issue for design and stability assessments of rock engineering structures, due mainly to the non-uniform and non-regular geometries of the fracture systems. However, no adequate efforts have been made to study this issue due to the current practical impossibility of laboratory tests with samples of large volumes containing many fractures, and the difficulty for controlling reliable initial and boundary conditions for large-scale in situ tests. Therefore, a reliable numerical predicting approach for evaluating anisotropy of fractured rock masses is needed. The objective of this study is to systematically investigate anisotropy of strength and deformability of fractured rocks, which has not been conducted in the past, using a numerical modeling method. A series of realistic two-dimensional (2D discrete fracture network (DFN models were established based on site investigation data, which were then loaded in different directions, using the code UDEC of discrete element method (DEM, with changing confining pressures. Numerical results show that strength envelopes and elastic deformability parameters of tested numerical models are significantly anisotropic, and vary with changing axial loading and confining pressures. The results indicate that for design and safety assessments of rock engineering projects, the directional variations of strength and deformability of the fractured rock mass concerned must be treated properly with respect to the directions of in situ stresses. Traditional practice for simply positioning axial orientation of tunnels in association with principal stress directions only may not be adequate for safety requirements. Outstanding issues of the present study and suggestions for future study are also presented.

  4. Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System.

    Science.gov (United States)

    Sim, Bo Kyun; Kim, Bongju; Kim, Min Jeong; Jeong, Guk Hyun; Ju, Kyung Won; Shin, Yoo Jin; Kim, Man Yong; Lee, Jong-Ho

    2017-01-01

    The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA) and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA.

  5. Hydraulic fracture propagation modeling and data-based fracture identification

    Science.gov (United States)

    Zhou, Jing

    Successful shale gas and tight oil production is enabled by the engineering innovation of horizontal drilling and hydraulic fracturing. Hydraulically induced fractures will most likely deviate from the bi-wing planar pattern and generate complex fracture networks due to mechanical interactions and reservoir heterogeneity, both of which render the conventional fracture simulators insufficient to characterize the fractured reservoir. Moreover, in reservoirs with ultra-low permeability, the natural fractures are widely distributed, which will result in hydraulic fractures branching and merging at the interface and consequently lead to the creation of more complex fracture networks. Thus, developing a reliable hydraulic fracturing simulator, including both mechanical interaction and fluid flow, is critical in maximizing hydrocarbon recovery and optimizing fracture/well design and completion strategy in multistage horizontal wells. A novel fully coupled reservoir flow and geomechanics model based on the dual-lattice system is developed to simulate multiple nonplanar fractures' propagation in both homogeneous and heterogeneous reservoirs with or without pre-existing natural fractures. Initiation, growth, and coalescence of the microcracks will lead to the generation of macroscopic fractures, which is explicitly mimicked by failure and removal of bonds between particles from the discrete element network. This physics-based modeling approach leads to realistic fracture patterns without using the empirical rock failure and fracture propagation criteria required in conventional continuum methods. Based on this model, a sensitivity study is performed to investigate the effects of perforation spacing, in-situ stress anisotropy, rock properties (Young's modulus, Poisson's ratio, and compressive strength), fluid properties, and natural fracture properties on hydraulic fracture propagation. In addition, since reservoirs are buried thousands of feet below the surface, the

  6. Analytical design method for a truss-bolt system for reinforcement of fractured coal mine roofs - illustrated with a case study

    Energy Technology Data Exchange (ETDEWEB)

    Liu, B.; Yue, Z.Q.; Tham, L.G. [University of Hong Kong, Hong Kong (China). Dept. of Civil Engineering

    2005-02-01

    This paper presents an analytical design method for the truss-bolt system in reinforcing underground fractured rock roofs in coal mines. The analytical design method is based on the mechanical analysis of the fractured rock roof with reinforcement by inclined roof bolts and a horizontal tie-rod. The mechanical analysis for the system includes a non-linear bending model for the laterally inclined roof bolts and three upper and lower bounds. The lateral resistance of the inclined roof bolts in a truss-bolt-supported roadway is examined using classical theory of a non-linear beam in bending. The paper analyses the arching action by lateral behavior of the inclined roof bolts in reinforcing the fractured roof. Based on mechanical models, the design formula concerning the lateral bolt forces, tensions in the tie-rod in the truss system, as well as the reinforcement behavior have been derived. In order to ensure that the roof truss-bolt system reinforces the coal roof effectively, a lower bound of pre-tightening forces must be applied on the tie-rod for stabilizing the fractured roof by arching action. The pre-tightening forces exerted via the tie-rod also cannot be greater than its upper bound, since the excessive tightening force will cause localized failure in the rock near the bolt tail at the abutment of the fractured roof beam. The analytical formulas for both lower and upper bounds for truss pre-tightening forces are put forward in this paper. Furthermore, the paper also presents analytical equations for designing the axial forces and dimensions for bolts in this kind of system.

  7. Validation of a fracture mechanics approach to nuclear transportation cask design through a drop test program

    International Nuclear Information System (INIS)

    Sorenson, K.B.

    1986-01-01

    Sandia National Laboratories (SNL), under contract to the Department of Energy, is conducting a research program to develop and validate a fracture mechanics approach to cask design. A series of drop tests of a transportation cask is planned for the summer of 1986 as the method for benchmarking and, thereby, validating the fracture mechanics approach. This paper presents the drop test plan and background leading to the development of the test plan including structural analyses, material characterization, and non-destructive evaluation (NDE) techniques necessary for defining the test plan properly

  8. Posterior paramedian subrhomboidal analgesia versus thoracic epidural analgesia for pain control in patients with multiple rib fractures.

    Science.gov (United States)

    Shelley, Casey L; Berry, Stepheny; Howard, James; De Ruyter, Martin; Thepthepha, Melissa; Nazir, Niaman; McDonald, Tracy; Dalton, Annemarie; Moncure, Michael

    2016-09-01

    Rib fractures are common in trauma admissions and are associated with an increased risk of pulmonary complications, intensive care unit admissions, and mortality. Providing adequate pain control in patients with multiple rib fractures decreases the risk of adverse events. Thoracic epidural analgesia is currently the preferred method for pain control. This study compared outcomes in patients with multiple acute rib fractures treated with posterior paramedian subrhomboidal (PoPS) analgesia versus thoracic epidural analgesia (TEA). This prospective study included 30 patients with three or more acute rib fractures admitted to a Level I trauma center. Thoracic epidural analgesia or PoPS catheters were placed, and local anesthesia was infused. Data were collected including patients' pain level, adjunct morphine equivalent use, adverse events, length of stay, lung volumes, and discharge disposition. Nonparametric tests were used and two-sided p Pain rating was lower in the PoPS group (2.5 vs. 5; p = 0.03) after initial placement. Overall, there was no other statistically significant difference in pain control or use of oral morphine adjuncts between the groups. Hypotension occurred in eight patients, 75% with TEA and only 25% with PoPS. No difference was found in adverse events, length of stay, lung volumes, or discharge disposition. In patients with rib fractures, PoPS analgesia may provide pain control equivalent to TEA while being less invasive and more readily placed by a variety of hospital staff. This pilot study is limited by its small sample size, and therefore additional studies are needed to prove equivalence of PoPS compared to TEA. Therapeutic study, level IV.

  9. Research and field tests of staged fracturing technology for casing deformation sections in horizontal shale gas wells

    Directory of Open Access Journals (Sweden)

    Shimeng Liao

    2018-02-01

    Full Text Available Horizontal shale gas well fracturing is mostly carried out by pumping bridge plugs. In the case of casing deformation, the bridge plug can not be pumped down to the designated position, so the hole sections below the deformation could not be stimulated according to the design program. About 30% of horizontal shale gas wells in the Changning and Weiyuan Blocks, Sichuan Basin, suffer various casing deformation after fracturing. Previously, the hole sections which could not be stimulated due to casing deformation were generally abandoned. As a result, the resources controlled by shale gas wells weren't exploited effectively and the fracturing effect was impacted greatly. There are a lot of difficulties in investigating casing deformation, such as complex mechanisms, various influencing factors and unpredictable deformation time. Therefore, it is especially important to seek a staged fracturing technology suitable for the casing deformation sections. In this paper, the staged fracturing technology with sand plugs inside fractures and the staged fracturing technology with temporary plugging balls were tested in casing deformation wells. The staged fracturing technology with sand plugs inside fractures was carried out in the mode of single-stage perforation and single-stage fracturing. The staged fracturing technology with temporary plugging balls was conducted in the mode of single perforation, continuous fracturing and staged ball dropping. Then, two kinds of technologies were compared in terms of their advantages and disadvantages. Finally, they were tested on site. According to the pressure response, the pressure monitoring of the adjacent wells and the microseismic monitoring in the process of actual fracturing, both technologies are effective in the stimulation of the casing deformation sections, realizing well control reserves efficiently and guaranteeing fracturing effects. Keywords: Shale gas, Horizontal well, Casing deformation, Staged

  10. Designing tough and fracture resistant polypropylene/multi wall carbon nanotubes nanocomposites by controlling stereo-complexity and dispersion morphology

    International Nuclear Information System (INIS)

    Das, Dibyendu; Satapathy, Bhabani K.

    2014-01-01

    Highlights: • New pathway to improve dispersion and toughness by tacticity modification. • >330% toughness enhancement in PP/MWCNT nanocomposites with stereo-complex PP. • Prominent dispersion and distribution morphology due to matrix stereocomplexity. • Tacticity induced “Semi-ductile-to-tough-to-quasi-brittle” transitions in the PP/MWCNT. • Two-fold reduced steady state CTOD rate in i-PP+s-PP/ MWCNT nanocomposites. - Abstract: A remarkable toughness enhancement (>330%) of multi wall carbon nanotubes (MWCNT) filled stereo-complex polypropylene (PP) matrix i.e. blend of isotactic-PP and syndiotactic-PP (70:30) with differences in stereo-regularity has been observed. The enhancement has been correlated to quantifiable morphological parameters such as free-space lengths concerning dispersion and relatively greater reduction in crystallite size/lamellar thickness. Systematic analysis of glass transition data and estimation of multi wall carbon nanotubes induced reduction in interfacial polymer chain immobilization reiterates susceptibility of polymer segments to ready-mobility. The extent of toughening has quantitatively been analyzed by fracture-energy partitioning, essential work of fracture (EWF), approach enabling the detection of a “semi-ductile-to-tough-to-quasi-brittle” transition in the MWCNT filled stereo-complex polypropylene. Real-time fracture kinetics analysis revealed toughening mechanism to be primarily blunting-assisted; an aspect also corroborated by extensive plastic flow without much energy dissipation in the inner fracture process zone. Thus the study establishes a new pathway of tacticity-defined matrix modification to toughen nanocomposites

  11. Controls on wind abrasion patterns through a fractured bedrock landscape

    Science.gov (United States)

    Perkins, J. P.; Finnegan, N. J.

    2017-12-01

    Wind abrasion is an important geomorphic process for understanding arid landscape evolution on Earth and interpreting the post-fluvial history of Mars. Both the presence and orientation of wind-abraded landforms provide potentially important constraints on paleo-climatic conditions; however, such interpretations can be complicated by lithologic and structural heterogeneity. To explore the influence of pre-existing structure on wind abrasion, we exploit a natural experiment along the 10.2 Ma Lower Rio San Pedro ignimbrite in northern Chile. Here, a 3.2 Ma andesite flow erupted from Cerro de las Cuevas and deposited atop the ignimbrite, supplying wind-transportable sediment and initiating a phase of downwind abrasion. Additionally, the lava flow provides a continually varying degree of upwind topographic shielding along the ignimbrite that is reflected in a range of surface morphologies. Where fully shielded the ignimbrite surface is partially blanketed by sediment. However, as relief decreases the surface morphology shifts from large polygonal structures that emerge due to the concentration of wind abrasion along pre-existing fracture sets, to polygons that are bisected by wind-parallel grooves that cross-cut fracture sets, to linear sets of yardangs. We reconstruct the ignimbrite surface using a high-resolution digital elevation model, and calculate erosion rates ranging from 0.002 to 0.45 mm/kyr that vary strongly with degree of topographic shielding (R2 = 0.97). We use measured abrasion rates together with nearby weather station data to estimate the nondimensional Rouse number and Inertial Parameter for a range of particle sizes. From these calculations, we hypothesize that the change from fracture-controlled to flow-controlled morphology reflects increases in the grain size and inertia of particles in the suspension cloud. Where the ignimbrite experiences persistent high winds, large particles may travel in suspension and are largely insensitive to topographic

  12. Comparison of our self-designed rotary self-locking intramedullary nail and interlocking intramedullary nail in the treatment of long bone fractures.

    Science.gov (United States)

    Liu, Bailian; Xiong, Ying; Deng, Hong; Gu, Shao; Jia, Fu; Li, Qunhui; Wang, Daxing; Gan, Xuewen; Liu, Wei

    2014-07-21

    The purpose of this study is to compare the clinical effects of our self-designed rotary self-locking intramedullary nail (RSIN) and interlocking intramedullary nail (IIN) for long bone fractures. A retrospective study was performed in 1,704 patients who suffered bone fractures and underwent RSIN or IIN operation in our hospital between March 1999 and March 2013, including 494 with femoral fractures, 572 with humeral fractures, and 638 with tibial fractures. Among them, 634 patients were followed up for more than 1 year. The operative time, intraoperative blood loss, postoperative complications, healing rate, and the excellent and good rate of functional recovery were compared between two groups. Compared with IIN group, RSIN group exhibited significantly shorter operative time and less intraoperative blood loss no matter for humeral, femoral, or tibial fractures (all p fractures (both p fracture. In IIN group, nail breakage or loosening occurred in 7 patients with femoral fractures and 16 patients with tibial fractures, radial nerve injury was observed in 8 patients with humeral fractures, and incision infection was present in 2 patients with humeral fractures and 1 patient with femoral fracture. The complication rate of IIN group was significantly higher than that of RSIN group (p knee, and ankle joint functional recovery between RSIN group and IIN group. RSIN may be a reliable and practical alternative method for the treatment of long bone fractures.

  13. Grouting design based on characterization of the fractured rock. Presentation and demonstration of a methodology

    Energy Technology Data Exchange (ETDEWEB)

    Fransson, Aasa (SWECO Environment, Stockholm (Sweden); Chalmers Univ. of Technology, Goeteborg (Sweden))

    2008-12-15

    The design methodology presented in this document is based on an approach that considers the individual fractures. The observations and analyses made during production enable the design to adapt to the encountered conditions. The document is based on previously published material and overview flow charts are used to show the different steps. Parts of or the full methodology has been applied for a number of tunneling experiments and projects. SKB projects in the Aespoe tunnel include a pillar experiment and pre-grouting of a 70 meter long tunnel (TASQ). Further, for Hallandsas railway tunnel (Skaane south Sweden), a field pre-grouting experiment and design and post-grouting of a section of 133 meters have been made. For the Nygard railway tunnel (north of Goeteborg, Sweden), design and grouting of a section of 86 meters (pre-grouting) and 60 meters (post-grouting) have been performed. Finally, grouting work at the Tornskog tunnel (Stockholm, Sweden) included design and grouting along a 100 meter long section of one of the two tunnel tubes. Of importance to consider when doing a design and evaluating the result are: - The identification of the extent of the grouting needed based on inflow requirements and estimates of tunnel inflow before grouting. - The selection of grout and performance of grouting materials including penetration ability and length. The penetration length is important for the fan geometry design. - The ungrouted compared to the grouted and excavated rock mass conditions: estimates of tunnel inflow and (if available) measured inflows after grouting and excavation. Identify if possible explanations for deviations. For the Hallandsas, Nygard and Tornskog tunnel sections, the use of a Pareto distribution and the estimate of tunnel inflow identified a need for sealing small aperture fractures (< 50 - 100 mum) to meet the inflow requirements. The tunneling projects show that using the hydraulic aperture as a basis for selection of grout is a good

  14. Grouting design based on characterization of the fractured rock. Presentation and demonstration of a methodology

    International Nuclear Information System (INIS)

    Fransson, Aasa

    2008-12-01

    The design methodology presented in this document is based on an approach that considers the individual fractures. The observations and analyses made during production enable the design to adapt to the encountered conditions. The document is based on previously published material and overview flow charts are used to show the different steps. Parts of or the full methodology has been applied for a number of tunneling experiments and projects. SKB projects in the Aespoe tunnel include a pillar experiment and pre-grouting of a 70 meter long tunnel (TASQ). Further, for Hallandsas railway tunnel (Skaane south Sweden), a field pre-grouting experiment and design and post-grouting of a section of 133 meters have been made. For the Nygard railway tunnel (north of Goeteborg, Sweden), design and grouting of a section of 86 meters (pre-grouting) and 60 meters (post-grouting) have been performed. Finally, grouting work at the Tornskog tunnel (Stockholm, Sweden) included design and grouting along a 100 meter long section of one of the two tunnel tubes. Of importance to consider when doing a design and evaluating the result are: - The identification of the extent of the grouting needed based on inflow requirements and estimates of tunnel inflow before grouting. - The selection of grout and performance of grouting materials including penetration ability and length. The penetration length is important for the fan geometry design. - The ungrouted compared to the grouted and excavated rock mass conditions: estimates of tunnel inflow and (if available) measured inflows after grouting and excavation. Identify if possible explanations for deviations. For the Hallandsas, Nygard and Tornskog tunnel sections, the use of a Pareto distribution and the estimate of tunnel inflow identified a need for sealing small aperture fractures (< 50 - 100 μm) to meet the inflow requirements. The tunneling projects show that using the hydraulic aperture as a basis for selection of grout is a good

  15. Adherence With Bisphosphonates and Long-Term Risk of Hip Fractures: A Nested Case-Control Study Using Real-World Data.

    Science.gov (United States)

    Shalev, Varda; Sharman Moser, Sarah; Goldshtein, Inbal; Yu, Jingbo; Weil, Clara; Ish-Shalom, Sophia; Rouach, Vanessa; Chodick, Gabriel

    2017-09-01

    Hip fracture is a major complication of osteoporosis. Bisphosphonate medication is the mainstay of treatment for osteoporosis. However, concerns have been raised regarding the effectiveness of bisphosphonates in reducing hip fracture risk after long-term use, particularly among patients with suboptimal adherence. To examine the association between adherence with bisphosphonate therapy and long-term risk of hip fracture. Included in the present nested case-control study were osteoporotic women (n = 14 357) who initiated bisphosphonate therapy in 2000-2010 and were retrospectively followed for incident hip fracture through November 2014. Within this cohort, each case of primary hip fractures was individually matched to 3 controls without a primary hip fracture. Proportion of follow-up days covered (PDC) with bisphosphonates was calculated from bisphosphonate purchases. Adherence was categorized into the following groups: purchase of 1 or 2 months' supply (reference group), at least 3 months' supply to PDC ≤20%, PDC >20% to ≤80%, PDC >80% to ≤100%. Included in the analysis were 426 case-control groups with a mean age (SD) of 73.7 years (7.9). Compared with the reference group, PDC of 80% to 100% with bisphosphonates was associated with a significant reduction in hip fracture risk for patients with 8 to 15 years of follow-up (OR = 0.39; 95% CI = 0.18-0.87). Among patients with a follow-up of up to 3 years, OR was 0.58 (95% CI = 0.31-1.06). Adherence with bisphosphonates among osteoporotic patients is associated with lower risk of hip fracture, with no indication of diminished effectiveness with long-term use.

  16. Modelling of Local Necking and Fracture in Aluminium Alloys

    International Nuclear Information System (INIS)

    Achani, D.; Eriksson, M.; Hopperstad, O. S.; Lademo, O.-G.

    2007-01-01

    Non-linear Finite Element simulations are extensively used in forming and crashworthiness studies of automotive components and structures in which fracture need to be controlled. For thin-walled ductile materials, the fracture-related phenomena that must be properly represented are thinning instability, ductile fracture and through-thickness shear instability. Proper representation of the fracture process relies on the accuracy of constitutive and fracture models and their parameters that need to be calibrated through well defined experiments. The present study focuses on local necking and fracture which is of high industrial importance, and uses a phenomenological criterion for modelling fracture in aluminium alloys. As an accurate description of plastic anisotropy is important, advanced phenomenological constitutive equations based on the yield criterion YLD2000/YLD2003 are used. Uniaxial tensile tests and disc compression tests are performed for identification of the constitutive model parameters. Ductile fracture is described by the Cockcroft-Latham fracture criterion and an in-plane shear tests is performed to identify the fracture parameter. The reason is that in a well designed in-plane shear test no thinning instability should occur and it thus gives more direct information about the phenomenon of ductile fracture. Numerical simulations have been performed using a user-defined material model implemented in the general-purpose non-linear FE code LS-DYNA. The applicability of the model is demonstrated by correlating the predicted and experimental response in the in-plane shear tests and additional plane strain tension tests

  17. Reduction of femoral fractures in long-term care facilities: the Bavarian fracture prevention study.

    Directory of Open Access Journals (Sweden)

    Clemens Becker

    Full Text Available BACKGROUND: Hip fractures are a major public health burden. In industrialized countries about 20% of all femoral fractures occur in care dependent persons living in nursing care and assisted living facilities. Preventive strategies for these groups are needed as the access to medical services differs from independent home dwelling older persons at risk of osteoporotic fractures. It was the objective of the study to evaluate the effect of a fall and fracture prevention program on the incidence of femoral fracture in nursing homes in Bavaria, Germany. METHODS: In a translational intervention study a fall prevention program was introduced in 256 nursing homes with 13,653 residents. The control group consisted of 893 nursing homes with 31,668 residents. The intervention consisted of staff education on fall and fracture prevention strategies, progressive strength and balance training, and on institutional advice on environmental adaptations. Incident femoral fractures served as outcome measure. RESULTS: In the years before the intervention risk of a femoral fracture did not differ between the intervention group (IG and control group (CG. During the one-year intervention period femoral fracture rates were 33.6 (IG and 41.0/1000 person years (CG, respectively. The adjusted relative risk of a femoral fracture was 0.82 (95% CI 0.72-0.93 in residents exposed to the fall and fracture prevention program compared to residents from CG. CONCLUSIONS: The state-wide dissemination of a multi-factorial fall and fracture prevention program was able to reduce femoral fractures in residents of nursing homes.

  18. An evaluation of fracture toughness of bituminous coal

    International Nuclear Information System (INIS)

    Pathan, A.G.

    2005-01-01

    The role of fracture mechanics in the design of rock structures is vitally important. However, because of the complexities of rock structures and lack of understanding of the fundamentals of the failure mechanism, it has become customary to use the engineering properties approach in the design of stable rock structures. Recently considerable attention has been given and attempts are being made to apply the fracture mechanics approach to the design of safe mining structures. In mining engineering the fracture mechanics may be applied to calculate the formation of fracture zones around mine opening, thus estimating support requirements and formulating guide lines for the selection of mine roadway support system. The research work presented here is concerned with the evaluation of fracture toughness of coal under laboratory conditions. Diametral compression test method is used to determine the fracture toughness parameter of coal in the opening model failure. The effect of crack length and dimensionless crack length on the fracture toughness was studied also. A laboratory investigation of fracture toughness of coal in tensile mode failure has led to the conclusion that fracture toughness could be treated as a material property. (author)

  19. Polymer liquids fracture like solids

    DEFF Research Database (Denmark)

    Huang, Qian; Hassager, Ole

    2017-01-01

    While fracture in brittle solids has been studied for centuries until today, there are few studies on fracture in polymer liquids. Recent developments in experimental techniques, especially the combination of controlled filament stretching rheometry and high speed imaging, have opened new windows...... into the detailed study of fracture processes for polymer liquids. High speed imaging shows that polymer liquids fracture like solids with initiation and propagation of an edge fracture. However, remarkable features such as highly reproducible critical stress, independent appearance of multiple fractures...

  20. Advanced composite structures. [metal matrix composites - structural design criteria for spacecraft construction materials

    Science.gov (United States)

    1974-01-01

    A monograph is presented which establishes structural design criteria and recommends practices to ensure the design of sound composite structures, including composite-reinforced metal structures. (It does not discuss design criteria for fiber-glass composites and such advanced composite materials as beryllium wire or sapphire whiskers in a matrix material.) Although the criteria were developed for aircraft applications, they are general enough to be applicable to space vehicles and missiles as well. The monograph covers four broad areas: (1) materials, (2) design, (3) fracture control, and (4) design verification. The materials portion deals with such subjects as material system design, material design levels, and material characterization. The design portion includes panel, shell, and joint design, applied loads, internal loads, design factors, reliability, and maintainability. Fracture control includes such items as stress concentrations, service-life philosophy, and the management plan for control of fracture-related aspects of structural design using composite materials. Design verification discusses ways to prove flightworthiness.

  1. Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) protocol: a pragmatic multi-centre randomised controlled trial of cast treatment versus surgical fixation for the treatment of bi-cortical, minimally displaced fractures of the scaphoid waist in adults.

    Science.gov (United States)

    Dias, Joseph; Brealey, Stephen; Choudhary, Surabhi; Cook, Liz; Costa, Matthew; Fairhurst, Caroline; Hewitt, Catherine; Hodgson, Stephen; Jefferson, Laura; Jeyapalan, Kanagaratnam; Keding, Ada; Leighton, Paul; Rangan, Amar; Richardson, Gerry; Rothery, Claire; Taub, Nicholas; Thompson, John; Torgerson, David

    2016-06-04

    this. The SWIFFT Trial is a rigorously designed and adequately powered study which aims to contribute to the evidence-base to inform clinical decisions for the treatment of this common fracture in adults. The trial is registered with the International Standard Randomised Controlled Trial Register ( ISRCTN67901257 ). Date registration assigned was 13/02/2013.

  2. Influence of perforation erosion on multiple growing hydraulic fractures in multi-stage fracturing

    Directory of Open Access Journals (Sweden)

    Yongming Li

    2018-02-01

    Full Text Available In multi-stage hydraulic fracturing, the limited-entry method is widely used to promote uniform growth of multiple fractures. However, this method's effectiveness may be lost because the perforations will be eroded gradually during the fracturing period. In order to study the influence of perforation erosion on multiple growing hydraulic fractures, we combined the solid–fluid coupled model of hydraulic fracture growth with an empirical model of perforation erosion to implement numerical simulation. The simulations show clearly that the erosion of perforation will significantly deteriorate the non-uniform growth of multiple fractures. Based on the numerical model, we also studied the influences of proppant concentration and injection rates on perforation erosion in multi-stage hydraulic fracturing. The results indicate that the initial erosion rates become higher with the rising proppant concentration, but the growth of multiple hydraulic fractures is not sensitive to the varied proppant concentration. In addition, higher injection rates are beneficial significantly to the limited-entry design, leading to more uniform growth of fractures. Thus, in multi-stage hydraulic fracturing enough high injection rates are proposed to keep uniform growths. Keywords: Unconventional oil and gas reservoir, Horizontal well, Perforation friction, Perforation erosion, Multi-stage hydraulic fracturing, Numerical simulation, Mathematic model, Uniform growth of fractures

  3. Newly designed anterolateral and posterolateral locking anatomic plates for lateral tibial plateau fractures: a finite element study.

    Science.gov (United States)

    Chen, Pengbo; Lu, Hua; Shen, Hao; Wang, Wei; Ni, Binbin; Chen, Jishizhan

    2017-02-23

    Lateral column tibial plateau fracture fixation with a locking screw plate has higher mechanical stability than other fixation methods. The objectives of the present study were to introduce two newly designed locking anatomic plates for lateral tibial plateau fracture and to demonstrate their characteristics of the fixation complexes under the axial loads. Three different 3D finite element models of the lateral tibial plateau fracture with the bone plates were created. Various axial forces (100, 500, 1000, and 1500 N) were applied to simulate the axial compressive load on an adult knee during daily life. The equivalent maps of displacement and stress were output, and relative displacement was calculated along the fracture lines. The displacement and stresses in the fixation complexes increased with the axial force. The equivalent displacement or stress map of each fixation under different axial forces showed similar distributing characteristics. The motion characteristics of the three models differed, and the max-shear stress of trabecula increased with the axial load. These two novel plates could fix lateral tibial plateau fractures involving anterolateral and posterolateral fragments. Motions after open reduction and stable internal fixation should be advised to decrease the risk of trabecular microfracture. The relative displacement of the posterolateral fragments is different when using anterolateral plate and posterolateral plate, which should be considered in choosing the implants for different posterolateral plateau fractures.

  4. Fluoride in drinking water and risk of hip fracture in the UK: a case-control study.

    Science.gov (United States)

    Hillier, S; Cooper, C; Kellingray, S; Russell, G; Hughes, H; Coggon, D

    2000-01-22

    Although the benefits of water fluoridation for dental health are widely accepted, concerns remain about possible adverse effects, particularly effects on bone. Several investigators have suggested increased rates of hip fracture in places with high concentrations of fluoride in drinking water, but this finding has not been consistent, possibly because of unrecognised confounding effects. We did a case-control study of men and women aged 50 years and older from the English county of Cleveland, and compared patients with hip fracture with community controls. Current addresses were ascertained for all participants; for those who agreed to an interview and who passed a mental test, more detailed information was obtained about lifetime residential history and exposure to other known and suspected risk factors for hip fracture. Exposures to fluoride in water were estimated from the residential histories and from information provided by water suppliers. Analysis was by logistic regression. 914 cases and 1196 controls were identified, of whom 514 and 527, respectively, were interviewed. Among those interviewed, hip fracture was strongly associated with low body-mass index (p for trend water ranged from 0.15 to 1.79 ppm. Current residence in Hartlepool was a good indicator for high lifetime exposure to fluoride. After adjustment for potential confounders, the odds ratio associated with an average lifetime exposure to fluoride > or =0.9 ppm was 1.0 [95% CI 0.7-1.5]. There is a low risk of hip fracture for people ingesting fluoride in drinking water at concentrations of about 1 ppm. This low risk should not be a reason for withholding fluoridation of water supplies.

  5. Effectiveness of joint mobilisation after cast immobilisation for ankle fracture: a protocol for a randomised controlled trial [ACTRN012605000143628

    Directory of Open Access Journals (Sweden)

    Haas Marion

    2006-05-01

    Full Text Available Abstract Background Passive joint mobilisation is a technique frequently used by physiotherapists to reduce pain, improve joint movement and facilitate a return to activities after injury, but its use after ankle fracture is currently based on limited evidence. The primary aim of this trial is to determine if adding joint mobilisation to a standard exercise programme is effective and cost-effective after cast immobilisation for ankle fracture in adults. Methods/Design Ninety participants will be recruited from the physiotherapy departments of three teaching hospitals and randomly allocated to treatment or control groups using a concealed procedure. All participants will perform an exercise programme. Participants in the treatment group will also receive joint mobilisation twice a week for four weeks. Blinded follow-up assessments will be conducted four, 12 and 24 weeks after randomisation. The primary outcome measures will be the Lower Extremity Functional Scale and the Assessment of Quality of Life. Secondary outcomes will include measures of impairments, activity limitation and participation. Data on the use of physiotherapy services and participants' out-of-pocket costs will be collected for the cost-effective and cost-utility analyses. To test the effects of treatment, between-group differences will be examined with analysis of covariance using a regression approach. The primary conclusions will be based on the four-week follow-up data. Discussion This trial incorporates features known to minimise bias. It uses a pragmatic design to reflect clinical practice and maximise generalisability. Results from this trial will contribute to an evidence-based approach for rehabilitation after ankle fracture.

  6. Arrangement for formation perforating and fracturing

    Energy Technology Data Exchange (ETDEWEB)

    Belyaev, B M; Vitsenii, E M; Zheltov, Yu P; Nikolaev, S I

    1962-03-06

    An arrangement for perforating and hydraulic fracturing, to be lowered on a wire line, consists of a chamber with a shaped charge, a head and a nozzle. This arrangement enables carrying out, simultaneously, the operations of perforating and fracturing. The device may be equipped with separate sections with shaped charges and a powder chamber in which powder charges are placed, designed to be ignited in sequence by slow- acting electric igniters. For controlling the gas pressure and strengthening the arrangement in the zone of perforation, the device is equipped with rubber seals which release the ring elements under pressure of explosive gas. Between the walls of the casing and the rubber seals is an annular space through the gas escapes.

  7. Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System

    Directory of Open Access Journals (Sweden)

    Bo Kyun Sim

    2017-01-01

    Full Text Available The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA.

  8. Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System

    Science.gov (United States)

    Kim, Bongju; Shin, Yoo Jin

    2017-01-01

    The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA) and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA. PMID:29065610

  9. Development of carbon/carbon composite control rod for HTTR. 1. Preparation of elements and their fracture tests

    International Nuclear Information System (INIS)

    Eto, Motokuni; Ishiyama, Shintaro; Ugachi, Hirokazu

    1996-08-01

    For the High Temperature Engineering Test Reactor(HTTR) the control rod sleeve is made of Alloy 800H for which a particular process is imposed when the reactor needs to be scrammed. The less restricted operation of the reactor would be attained if there would be the control rod more resistant to high temperature and neutron irradiation. This report summarizes the results which have been obtained as of March 1996 in the course of the development of the C/C composite control rod. Materials used were pitch- or PAN-based fiber-reinforced 2-dimensional carbon composites, from which preforms of the elements of a control rod were fabricated. The preforms were carbonized at 1000degC after being impregnated with pitch. Then they were graphitized at 3000degC, followed by a purification treatment with halogen. The elements included the pellet holder, lace truck and pin. The pin was fabricated by the fiber laminating technique. A control rod is to consist of pellet holders which are connected by the lace trucks with pins. Various strength tests were carried out on these elements. An irradiation of the elements made of PAN-based material was performed in JRR-3 at 900±50degC to a neutron fluence of 1x10 25 n/m 2 (E>29fJ). As for the strength tests on the elements, there were some differences between PAN- and pitch-based composites: In general, elements made of PAN-based composite showed the more plastic behavior before they fractured, whereas those of pitch-based material behaved in the more brittle manner. Fracture tests of the irradiated elements showed that fracture load and fracture displacement enough for assuring the integrity of the control rod structure were maintained even after the irradiation. It was also found that if the applied load was parallel to the fiber felt plane both fracture load and strain increased, whereas the load increase and strain decrease were observed for the applied load against the plane. (J.P.N.)

  10. Development of carbon/carbon composite control rod for HTTR. 1. Preparation of elements and their fracture tests

    Energy Technology Data Exchange (ETDEWEB)

    Eto, Motokuni; Ishiyama, Shintaro; Ugachi, Hirokazu [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1996-08-01

    For the High Temperature Engineering Test Reactor(HTTR) the control rod sleeve is made of Alloy 800H for which a particular process is imposed when the reactor needs to be scrammed. The less restricted operation of the reactor would be attained if there would be the control rod more resistant to high temperature and neutron irradiation. This report summarizes the results which have been obtained as of March 1996 in the course of the development of the C/C composite control rod. Materials used were pitch- or PAN-based fiber-reinforced 2-dimensional carbon composites, from which preforms of the elements of a control rod were fabricated. The preforms were carbonized at 1000degC after being impregnated with pitch. Then they were graphitized at 3000degC, followed by a purification treatment with halogen. The elements included the pellet holder, lace truck and pin. The pin was fabricated by the fiber laminating technique. A control rod is to consist of pellet holders which are connected by the lace trucks with pins. Various strength tests were carried out on these elements. An irradiation of the elements made of PAN-based material was performed in JRR-3 at 900{+-}50degC to a neutron fluence of 1x10{sup 25} n/m{sup 2} (E>29fJ). As for the strength tests on the elements, there were some differences between PAN- and pitch-based composites: In general, elements made of PAN-based composite showed the more plastic behavior before they fractured, whereas those of pitch-based material behaved in the more brittle manner. Fracture tests of the irradiated elements showed that fracture load and fracture displacement enough for assuring the integrity of the control rod structure were maintained even after the irradiation. It was also found that if the applied load was parallel to the fiber felt plane both fracture load and strain increased, whereas the load increase and strain decrease were observed for the applied load against the plane. (J.P.N.)

  11. Tai Chi for osteopenic women: design and rationale of a pragmatic randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fischer Mary

    2010-03-01

    Full Text Available Abstract Background Post-menopausal osteopenic women are at increased risk for skeletal fractures. Current osteopenia treatment guidelines include exercise, however, optimal exercise regimens for attenuating bone mineral density (BMD loss, or for addressing other fracture-related risk factors (e.g. poor balance, decreased muscle strength are not well-defined. Tai Chi is an increasingly popular weight bearing mind-body exercise that has been reported to positively impact BMD dynamics and improve postural control, however, current evidence is inconclusive. This study will determine the effectiveness of Tai Chi in reducing rates of bone turnover in post-menopausal osteopenic women, compared with standard care, and will preliminarily explore biomechanical processes that might inform how Tai Chi impacts BMD and associated fracture risks. Methods/Design A total of 86 post-menopausal women, aged 45-70y, T-score of the hip and/or spine -1.0 and -2.5, have been recruited from primary care clinics of a large healthcare system based in Boston. They have been randomized to a group-based 9-month Tai Chi program plus standard care or to standard care only. A unique aspect of this trial is its pragmatic design, which allows participants randomized to Tai Chi to choose from a pre-screened list of community-based Tai Chi programs. Interviewers masked to participants' treatment group assess outcomes at baseline and 3 and 9 months after randomization. Primary outcomes are serum markers of bone resorption (C-terminal cross linking telopeptide of type I collagen, bone formation (osteocalcin, and BMD of the lumbar spine and proximal femur (dual-energy X-ray absorptiometry. Secondary outcomes include health-related quality-of-life, exercise behavior, and psychological well-being. In addition, kinetic and kinematic characterization of gait, standing, and rising from a chair are assessed in subset of participants (n = 16 to explore the feasibility of modeling skeletal

  12. Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis.

    NARCIS (Netherlands)

    Hundepool, A.C.; Willemsen, M.A.A.P.; Koudstaal, M.J.; Wal, K.G.H. van der

    2012-01-01

    The aim of this study was to compare the postoperative results of open reduction versus endoscopically controlled reconstructions of orbital floor fractures. The medical records of 83 patients, treated between January 2000 and December 2008, were reviewed for enophthalmos, diplopia and

  13. CAPILLARY BARRIERS IN UNSATURATED FRACTURED ROCKS OF YUCCA MOUNTAIN, NEVADA

    International Nuclear Information System (INIS)

    Wu, Y.S.; Zhang, W.; Pan, L.; Hinds, J.; Bodvarsson, G.

    2000-01-01

    This work presents modeling studies investigating the effects of capillary barriers on fluid-flow and tracer-transport processes in the unsaturated zone of Yucca Mountain, Nevada, a potential site for storing high-level radioactive waste. These studies are designed to identify factors controlling the formation of capillary barriers and to estimate their effects on the extent of possible large-scale lateral flow in unsaturated fracture rocks. The modeling approach is based on a continuum formulation of coupled multiphase fluid and tracer transport through fractured porous rock. Flow processes in fractured porous rock are described using a dual-continuum concept. In addition, approximate analytical solutions are developed and used for assessing capillary-barrier effects in fractured rocks. This study indicates that under the current hydrogeologic conceptualization of Yucca Mountain, strong capillary-barrier effects exist for significantly diverting moisture flow

  14. Resolving controversies in hip fracture care: the need for large collaborative trials in hip fractures

    NARCIS (Netherlands)

    Bhandari, Mohit; Sprague, Sheila; Schemitsch, Emil H.; Einhorn, Thomas; Guyatt, Gordon H.; Haidukewych, George; Keating, John; Koval, Kenneth; Rosen, Clifford; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen D.; Motsitsi, Silas; Pei, Fuxing; Yang, Tian-fu; Zhou, Zong-ke; Arora, Shobha; Babhulkar, Sushrut; Bhargava, Rakesh; Desai, Mohan M.; Dhillon, Mandeep S.; Gill, Harpreet Singh; Goel, S. C.; Reddy, A. V. Gurava; Jain, Anil K.; Kalore, Niraj V.; Kammatkar, Nitin; Kumar, Vijay; Malhorta, Rajesh; Marthandam, S. S. K.; Pankaj, Amite; Patinharayil, Gopinathan; Rai, B. Sachidanand; Ramteke, Alankar Ambadas; Sancheti, Parag K.; Thakkar, Navin N.; Thomas, George S.; Robinson, Dror; Steinberg, Ely; Higuchi, Fujio; Kawamura, Sumito; Ohashi, Hirotsugu; Sawaguchi, Takeshi; Park, Myung-Sik; Yun, Ho Hyun; Poduval, Murali; Siddiqui, Ahmed; Chang, Je-Ken; Wang, Gwo-Jaw; Goslings, J. Carel

    2009-01-01

    Hip fractures are a significant cause of morbidity and mortality worldwide and the burden of disability associated with hip fractures globally vindicate the need for high-quality research to advance the care of patients with hip fractures. Historically, large, multi-centre randomized controlled

  15. Fracture mechanics aspects in the safe design of ductile iron shipping and storage containers

    International Nuclear Information System (INIS)

    Sappok, M.; Bounin, D.

    1996-01-01

    Containers made of ductile cast iron provide a safe method for transport of radioactive material. Contrary to widespread opinion ductile cast iron is a very tough material and can be manufactured in heavy sections. The containers are designed to withstand the very high impact loads of accidents like free drops onto unyielding targets. The design is based on postulated undetected crack-like flaws at the highest stressed location. Design must show that applied stress intensities are smaller than fracture toughness and no crack initiation and therefore also no crack propagation can occur. The design procedure followed in this paper is given in a new guideline still being drafted by the International Atomic Energy Agency

  16. Fracture criteria of reactor graphite under multiaxial stresses

    International Nuclear Information System (INIS)

    Sato, S.; Kawamata, K.; Kurumada, A.; Oku, T.

    1987-01-01

    New fracture criteria for graphite under multiaxial stresses are presented for designing core and support materials of a high temperature gas cooled reactor. Different kinds of fracture strength tests are carried out for a near isotropic graphite IG-11. Results show that, under the stress state in which tensile stresses are predominant, the maximum principal stress theory is seen as applicable for brittle fracture. Under the stress state in which compressive stresses are predominant there may be two fracture modes for brittle fracture, namely, slipping fracture and mode II fracture. For the former fracture mode the maximum shear stress criterion is suitable, but for the latter fracture mode a new mode II fracture criterion including a restraint effect for cracks is verified to be applicable. Also a statistical correction for brittle fracture criteria under multiaxial stresses is discussed. By considering the allowable stress values for safe design, the specified minimum ultimate strengths corresponding to a survival probability of 99% at the 95% confidence level are presented. (orig./HP)

  17. Geophysical signatures of a fracture controlled U-mineralisation: a case study from Mulapalle area, Cuddapah district, Andhra Pradesh

    International Nuclear Information System (INIS)

    Rao, R.L.N.; Sethuram, S.; Rao, B.N.; Tiku, K.L.; Ram, Subhash

    2000-01-01

    Geophysical methods have been extensively used for delineation of structural features such as fractures and shear zones which often control and host economic mineralisation. Numerous fractures hosting uranium mineralisation and confined to younger intrusives and leucogranites occur within basement gneissic complex on the southwestern margin of the Mesoproterozoic Cuddapah basin. The geophysical signatures of one such mineralised fracture zone near Mulapalle are discussed. Mineralised fractures are mostly confined to a zone of cataclastic rocks characterised by widely varying magnetic character with respect to the surroundings. A strong redox barrier associated with the mineralisation is revealed by self-potential data. The mineralised zone is also indicated by a higher order resistivity attributable to the enrichment of silica in the fracture zone. (author)

  18. Recurrent Hip Fracture Prevention With Osteoporosis Management

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2007-02-01

    Full Text Available Background:Osteoporosis is a major public health threat,and hip fracture is a serious consequence of osteoporosis.Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture.The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods:58 hip fracture patients older than 50yr and BMD < 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment which were also followed for 4 years. Results:72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group.Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6%(p<0.03, respectively.Conclusion:Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.

  19. Statistics and thermodynamics of fracture

    Science.gov (United States)

    Chudnovsky, A.

    1984-01-01

    A probabilistic model of the fracture processes unifying the phenomenological study of long term strength of materials, fracture mechanics and statistical approaches to fracture is briefly outlined. The general framework of irreversible thermodynamics is employed to model the deterministic side of the failure phenomenon. The stochastic calculus is used to account for thg failure mechanisms controlled by chance; particularly, the random roughness of fracture surfaces.

  20. Television, computer, and video viewing; physical activity; and upper limb fracture risk in children: a population-based case control study.

    Science.gov (United States)

    Ma, Deqiong; Jones, Graeme

    2003-11-01

    The effect of physical activity on upper limb fractures was examined in this population-based case control study with 321 age- and gender-matched pairs. Sports participation increased fracture risk in boys and decreased risk in girls. Television viewing had a deleterious dose response association with wrist and forearm fractures while light physical activity was protective. The aim of this population-based case control study was to examine the association between television, computer, and video viewing; types and levels of physical activity; and upper limb fractures in children 9-16 years of age. A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. Television, computer, and video viewing and types and levels of physical activity were determined by interview-administered questionnaire. Bone strength was assessed by DXA and metacarpal morphometry. In general, sports participation increased total upper limb fracture risk in boys and decreased risk in girls. Gender-specific risk estimates were significantly different for total, contact, noncontact, and high-risk sports participation as well as four individual sports (soccer, cricket, surfing, and swimming). In multivariate analysis, time spent television, computer, and video viewing in both sexes was positively associated with wrist and forearm fracture risk (OR 1.6/category, 95% CI: 1.1-2.2), whereas days involved in light physical activity participation decreased fracture risk (OR 0.8/category, 95% CI: 0.7-1.0). Sports participation increased hand (OR 1.5/sport, 95% CI: 1.1-2.0) and upper arm (OR 29.8/sport, 95% CI: 1.7-535) fracture risk in boys only and decreased wrist and forearm fracture risk in girls only (OR 0.5/sport, 95% CI: 0.3-0.9). Adjustment for bone density and metacarpal morphometry did not alter these associations. There is gender discordance with regard to sports participation and fracture risk in children, which may reflect different approaches to sport

  1. Serum vitamin E concentrations among highly functioning hip fracture patients are higher than in nonfracture controls.

    Science.gov (United States)

    D'Adamo, Christopher R; Shardell, Michelle D; Hicks, Gregory E; Orwig, Denise L; Hochberg, Marc C; Semba, Richard D; Yu-Yahiro, Janet A; Ferrucci, Luigi; Magaziner, Jay S; Miller, Ram R

    2011-03-01

    Malnutrition after hip fracture is common and associated with poor outcomes and protracted recovery. Low concentrations of vitamin E have been associated with incident decline in physical function among older adults and may, therefore, be particularly important to functionally compromised patients hip fracture patients. Serum concentrations of α-tocopherol and γ-tocopherol, the 2 major forms of vitamin E, were assessed in 148 female hip fracture patients 65 years or older from the Baltimore Hip Studies cohort 4 around the time of fracture (baseline) and at 2, 6, and 12 month postfracture follow-up visits (recovery). It was hypothesized that mean concentrations of both forms of vitamin E among these hip fracture patients would be lowest at the baseline visit and increase at each study visit during the year after fracture. Linear regression and generalized estimating equations were used to assess changes in vitamin E concentrations after adjustment for covariates and to determine predictors of vitamin E concentrations at baseline and throughout recovery. It was also hypothesized that vitamin E concentrations shortly after hip fracture would be lower than those in nonfracture controls after adjustment for covariates. To evaluate this hypothesis, linear regression was used to perform adjusted comparisons of baseline vitamin E concentrations among Baltimore Hip Studies cohort 4 participants to 1076 older women without history of hip fracture from the Women's Health and Aging Study I, Invecchiare in Chianti Study, and the National Health and Nutrition Examination Surveys. Mean α-tocopherol was lowest at baseline, and time from fracture to blood draw was positively associated with baseline α-tocopherol (P = .005). Mean γ-tocopherol did not change appreciably throughout the year after fracture, although it fluctuated widely within individuals. Serum concentrations of α-tocopherol and γ-tocopherol were highest among the hip fracture population after adjustment (P hip

  2. Lithium use and the risk of fractures

    NARCIS (Netherlands)

    Wilting, Ingeborg; de Vries, Frank; Thio, Brahm M. K. S.; Cooper, Cyrus; Heerdink, Eibert R.; Leutkens, Hubert G. M.; Nolen, Willem A.; Egberts, Antoine C. G.; van Staa, Tjeerd P.

    A recent study reported a decreased risk of fractures among lithium users. We conducted a case-control study within the UK General Practice Research Database, comparing never, ever, current, recent and past lithium use in 231,778 fracture cases to matched controls. In addition, the risk of fractures

  3. Quantifying Fracture Heterogeneity in Different Domains of Folded Carbonate Rocks to Improve Fractured Reservoir Analog Fluid Flow Models

    NARCIS (Netherlands)

    Bisdom, K.; Bertotti, G.; Gauthier, B.D.M.; Hardebol, N.J.

    2013-01-01

    Fluid flow in carbonate reservoirs is largely controlled by multiscale fracture networks. Significant variations of fracture network porosity and permeability are caused by the 3D heterogeneity of the fracture network characteristics, such as intensity, orientation and size. Characterizing fracture

  4. Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks

    Science.gov (United States)

    Chen, Mingjie; Sun, Yunwei; Fu, Pengcheng; Carrigan, Charles R.; Lu, Zhiming; Tong, Charles H.; Buscheck, Thomas A.

    2013-08-01

    Hydraulic fracturing has been used widely to stimulate production of oil, natural gas, and geothermal energy in formations with low natural permeability. Numerical optimization of fracture stimulation often requires a large number of evaluations of objective functions and constraints from forward hydraulic fracturing models, which are computationally expensive and even prohibitive in some situations. Moreover, there are a variety of uncertainties associated with the pre-existing fracture distributions and rock mechanical properties, which affect the optimized decisions for hydraulic fracturing. In this study, a surrogate-based approach is developed for efficient optimization of hydraulic fracturing well design in the presence of natural-system uncertainties. The fractal dimension is derived from the simulated fracturing network as the objective for maximizing energy recovery sweep efficiency. The surrogate model, which is constructed using training data from high-fidelity fracturing models for mapping the relationship between uncertain input parameters and the fractal dimension, provides fast approximation of the objective functions and constraints. A suite of surrogate models constructed using different fitting methods is evaluated and validated for fast predictions. Global sensitivity analysis is conducted to gain insights into the impact of the input variables on the output of interest, and further used for parameter screening. The high efficiency of the surrogate-based approach is demonstrated for three optimization scenarios with different and uncertain ambient conditions. Our results suggest the critical importance of considering uncertain pre-existing fracture networks in optimization studies of hydraulic fracturing.

  5. Physical processes that control droplet transport in rock fracture systems

    Science.gov (United States)

    Hay, Katrina Moran

    Aquifer recharge is generally driven by fluids that move from the Earths surface to groundwater through the unsaturated zone, also known as the vadose zone. When the vadose zone is fractured, fluids, which may include contaminants, can move through the fracture network as well as the porous matrix. Such a network of fractures can provide a more rapid path, thereby reducing contact time between the fluid and the matrix. Contact time allows for exchange of solutes between the fluid and the porous matrix, thus being able to quantify contact time is important. In addition, the behavior of fluids within a fracture network has been found to be very complex; large-scale models are yet not able to predict transport paths or flux rates. Because, small-scale flow phenomena can strongly influence the large-scale behavior of fluid movement through systems of fractures, it is important that small-scale dynamics be properly understood in order to improve our predictive capabilities in these complex systems. Relevant flow dynamics includes the impact of boundary conditions, fluid modes that evolve in time and space and transitions between modes. This thesis presents three investigations aimed at understanding the physical processes governing fluid movement in unsaturated fractures, with the ultimate goal of improving predictive relationships for fluid transport in rock fracture systems. These investigations include a theoretical analysis of the wetting of a rough surface, an experimental study of the dynamics of fluid droplets (or liquid bridges) moving in a single fracture and a theoretical analysis of the movement of a fluid droplet encountering a fracture intersection. Each investigation is motivated by environmental applications. Development of an analytical equation for the wetting of a rough surface is based on a balance between capillary forces and frictional resistive forces. The resulting equation predicts movement of the liquid invasion front driven solely by the

  6. Comparison of Marginal Fit and Fracture Strength of a CAD/CAM Zirconia Crown with Two Preparation Designs

    Directory of Open Access Journals (Sweden)

    Hamid Jalali

    2016-08-01

    Full Text Available Objectives: The purpose of this in vitro study was to compare the marginal adaptation and fracture resistance of a zirconia-based all-ceramic restoration with two preparation designs.Materials and Methods: Twenty-four mandibular premolars were randomly divided into two groups (n=12; the conventional group received a peripheral shoulder preparation and the modified group received a buccal shoulder and proximal/lingual chamfer preparation. The marginal fit of the zirconia crowns (Cercon was evaluated using a stereomicroscope. After cementation, load was applied to the crowns. The mean fracture load and the mean marginal gap for each group were analyzed using t-test (P=0.05.Results: The mean marginal gap was 71±16µm in the conventional group and 80±10µm in the modified group, with no significant difference (P=0.161. The mean fracture strength was 830±153N for the conventional group and 775±125N for the modified group, with no significant difference (P=0.396. All but one fracture occurred in the veneering ceramic.Conclusion: Less aggressive preparation of proximal and lingual finish lines for the preservation of tooth structure in all-ceramic restorations does not adversely affect the marginal adaptation or fracture strength of the final restoration.

  7. Designing a Prognostic Scoring System for Predicting the Outcomes of Proximal Fifth Metatarsal Fractures at 20 Weeks

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Tahririan

    2015-03-01

    Full Text Available Background: Fractures of the proximal fifth metatarsal bone are among the most common fractures observed in the foot and their classification and management has been subject to much discussion and disagreement. In this study, we aim to identify and quantify the effect of possible predictors of the outcome of the treatment of proximal fifth metatarsal fractures. Methods: Patients with established proximal fifth metatarsal fractures were enrolled in this prospective cohort and the outcome of their treatment was assessed using the AOFAS mid foot scale at 6 and 20 weeks. Results: 143 patients were included in the study. Our study showed that displacement, weight and type III fractures were significant independent predictors of poor outcome at 6 weeks while at 20 weeks in addition to these factors, gender and diabetes mellitus were also shown to be significant independent predictors of poor outcome. A scoring system was designed by assigning weight to these factors and it was shown to be a strong predictor of outcome at 20 weeks. Conclusion: We recommend that our scoring system would help surgeons to decide whether patients’ prognostic factors are significant enough for him/her to opt for a surgical approach to treatment rather than a conservative approach.

  8. Fluid driven fracture mechanics in highly anisotropic shale: a laboratory study with application to hydraulic fracturing

    Science.gov (United States)

    Gehne, Stephan; Benson, Philip; Koor, Nick; Enfield, Mark

    2017-04-01

    The finding of considerable volumes of hydrocarbon resources within tight sedimentary rock formations in the UK led to focused attention on the fundamental fracture properties of low permeability rock types and hydraulic fracturing. Despite much research in these fields, there remains a scarcity of available experimental data concerning the fracture mechanics of fluid driven fracturing and the fracture properties of anisotropic, low permeability rock types. In this study, hydraulic fracturing is simulated in a controlled laboratory environment to track fracture nucleation (location) and propagation (velocity) in space and time and assess how environmental factors and rock properties influence the fracture process and the developing fracture network. Here we report data on employing fluid overpressure to generate a permeable network of micro tensile fractures in a highly anisotropic shale ( 50% P-wave velocity anisotropy). Experiments are carried out in a triaxial deformation apparatus using cylindrical samples. The bedding planes are orientated either parallel or normal to the major principal stress direction (σ1). A newly developed technique, using a steel guide arrangement to direct pressurised fluid into a sealed section of an axially drilled conduit, allows the pore fluid to contact the rock directly and to initiate tensile fractures from the pre-defined zone inside the sample. Acoustic Emission location is used to record and map the nucleation and development of the micro-fracture network. Indirect tensile strength measurements at atmospheric pressure show a high tensile strength anisotropy ( 60%) of the shale. Depending on the relative bedding orientation within the stress field, we find that fluid induced fractures in the sample propagate in two of the three principal fracture orientations: Divider and Short-Transverse. The fracture progresses parallel to the bedding plane (Short-Transverse orientation) if the bedding plane is aligned (parallel) with the

  9. Control system design guide

    Energy Technology Data Exchange (ETDEWEB)

    Sellers, David; Friedman, Hannah; Haasl, Tudi; Bourassa, Norman; Piette, Mary Ann

    2003-05-01

    The ''Control System Design Guide'' (Design Guide) provides methods and recommendations for the control system design process and control point selection and installation. Control systems are often the most problematic system in a building. A good design process that takes into account maintenance, operation, and commissioning can lead to a smoothly operating and efficient building. To this end, the Design Guide provides a toolbox of templates for improving control system design and specification. HVAC designers are the primary audience for the Design Guide. The control design process it presents will help produce well-designed control systems that achieve efficient and robust operation. The spreadsheet examples for control valve schedules, damper schedules, and points lists can streamline the use of the control system design concepts set forth in the Design Guide by providing convenient starting points from which designers can build. Although each reader brings their own unique questions to the text, the Design Guide contains information that designers, commissioning providers, operators, and owners will find useful.

  10. [The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation].

    Science.gov (United States)

    Bi, Hong-zheng; Yang, Mao-qing; Tan, Yuan-chao; Fu, Song

    2008-07-01

    To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture. All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups. After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (Pmanual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.

  11. Characterising rock fracture aperture-spacing relationships using power-law relationships: some considerations

    Science.gov (United States)

    Brook, Martin; Hebblewhite, Bruce; Mitra, Rudrajit

    2016-04-01

    The size-scaling of rock fractures is a well-studied problem in geology, especially for permeability quantification. The intensity of fractures may control the economic exploitation of fractured reservoirs because fracture intensity describes the abundance of fractures potentially available for fluid flow. Moreover, in geotechnical engineering, fractures are important for parameterisation of stress models and excavation design. As fracture data is often collected from widely-spaced boreholes where core recovery is often incomplete, accurate interpretation and representation of fracture aperture-frequency relationships from sparse datasets is important. Fracture intensity is the number of fractures encountered per unit length along a sample scanline oriented perpendicular to the fractures in a set. Cumulative frequency of fractures (F) is commonly related to fracture aperture (A) in the form of a power-law (F = aA-b), with variations in the size of the a coefficient between sites interpreted to equate to fracture frequency for a given aperture (A). However, a common flaw in this approach is that even a small change in b can have a large effect on the response of the fracture frequency (F) parameter. We compare fracture data from the Late Permian Rangal Coal Measures from Australia's Bowen Basin, with fracture data from Jurassic carbonates from the Sierra Madre Oriental, northeastern Mexico. Both power-law coefficient a and exponent b control the fracture aperture-frequency relationship in conjunction with each other; that is, power-laws with relatively low a coefficients have relatively high b exponents and vice versa. Hence, any comparison of different power-laws must take both a and b into consideration. The corollary is that different sedimentary beds in the Sierra Madre carbonates do not show ˜8× the fracture frequency for a given fracture aperture, as based solely on the comparison of coefficient a. Rather, power-law "sensitivity factors" developed from both

  12. Association of collagen type I alpha1 (COLIA1) Sp1 polymorphism with osteoporotic fracture in Caucasian post-menopausal women: a meta-analysis.

    LENUS (Irish Health Repository)

    Ji, G-R

    2012-01-06

    This study was designed to summarize quantitatively the evidence for a relationship between collagen type I alpha1 (COLIA1) Sp1 polymorphism and osteoporotic fracture risk in Caucasian post-menopausal women. This meta-analysis included 16 studies, which analysed 2294 patients with fractures and 10 285 controls. The combined results showed that there was a significant difference in genotype distribution (SS odds ratio [OR] 0.72; Ss OR 1.18; ss OR 1.97) between patients with fractures and controls. When stratifying by the fracture site, it was found that: (i) patients with vertebral fractures had a significantly higher frequency of the Ss genotype and a lower frequency of the SS genotype than controls; and (ii) patients with non-vertebral fractures had a significantly higher frequency of the ss genotype and a lower frequency of the SS genotype than controls. This meta-analysis suggests that the COLIA1 Sp1 polymorphism may be associated with osteoporotic fracture in Caucasian post-menopausal women.

  13. Fourier transform infrared imaging of femoral neck bone: reduced heterogeneity of mineral-to-matrix and carbonate-to-phosphate and more variable crystallinity in treatment-naive fracture cases compared with fracture-free controls.

    Science.gov (United States)

    Gourion-Arsiquaud, Samuel; Lukashova, Lyudmilla; Power, Jon; Loveridge, Nigel; Reeve, Jonathan; Boskey, Adele L

    2013-01-01

    After the age of 60 years, hip fracture risk strongly increases, but only a fifth of this increase is attributable to reduced bone mineral density (BMD, measured clinically). Changes in bone quality, specifically bone composition as measured by Fourier transform infrared spectroscopic imaging (FTIRI), also contribute to fracture risk. Here, FTIRI was applied to study the femoral neck and provide spatially derived information on its mineral and matrix properties in age-matched fractured and nonfractured bones. Whole femoral neck cross sections, divided into quadrants along the neck's axis, from 10 women with hip fracture and 10 cadaveric controls were studied using FTIRI and micro-computed tomography. Although 3-dimensional micro-CT bone mineral densities were similar, the mineral-to-matrix ratio was reduced in the cases of hip fracture, confirming previous reports. New findings were that the FTIRI microscopic variation (heterogeneity) of the mineral-to-matrix ratio was substantially reduced in the fracture group as was the heterogeneity of the carbonate-to-phosphate ratio. Conversely, the heterogeneity of crystallinity was increased. Increased variation of crystallinity was statistically associated with reduced variation of the carbonate-to-phosphate ratio. Anatomical variation in these properties between the different femoral neck quadrants was reduced in the fracture group compared with controls. Although our treatment-naive patients had reduced rather than increased bending resistance, these changes in heterogeneity associated with hip fracture are in another way comparable to the effects of experimental bisphosphonate therapy, which decreases heterogeneity and other indicators of bone's toughness as a material. Copyright © 2013 American Society for Bone and Mineral Research.

  14. Carotenoids and risk of fracture: a meta-analysis of observational studies.

    Science.gov (United States)

    Xu, Jiuhong; Song, Chunli; Song, Xiaochao; Zhang, Xi; Li, Xinli

    2017-01-10

    To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture.

  15. Displaced midshaft fractures of the clavicle: non-operative treatment versus plate fixation (Sleutel-TRIAL. A multicentre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Vos Dagmar I

    2011-08-01

    Full Text Available Abstract Background The traditional view that the vast majority of midshaft clavicular fractures heal with good functional outcomes following non-operative treatment may be no longer valid for all midshaft clavicular fractures. Recent studies have presented a relatively high incidence of non-union and identified speciic limitations of the shoulder function in subgroups of patients with these injuries. Aim A prospective, multicentre randomised controlled trial (RCT will be conducted in 21 hospitals in the Netherlands, comparing fracture consolidation and shoulder function after either non-operative treatment with a sling or a plate fixation. Methods/design A total of 350 patients will be included, between 18 and 60 years of age, with a dislocated midshaft clavicular fracture. The primary outcome is the incidence of non-union, which will be determined with standardised X-rays (Antero-Posterior and 30 degrees caudocephalad view. Secondary outcome will be the functional outcome, measured using the Constant Score. Strength of the shoulder muscles will be measured with a handheld dynamometer (MicroFET2. Furthermore, the health-related Quality of Life score (ShortForm-36 and the Disabilities of Arm, Shoulder and Hand (DASH Outcome Measure will be monitored as subjective parameters. Data on complications, bone union, cosmetic aspects and use of painkillers will be collected with follow-up questionnaires. The follow-up time will be two years. All patients will be monitored at regular intervals over the subsequent twelve months (two and six weeks, three months and one year. After two years an interview by telephone and a written survey will be performed to evaluate the two-year functional and mechanical outcomes. All data will be analysed on an intention-to-treat basis, using univariate and multivariate analyses. Discussion This trial will provide level-1 evidence for the comparison of consolidation and functional outcome between two standardised

  16. Preliminary analysis of force-torque measurements for robot-assisted fracture surgery.

    Science.gov (United States)

    Georgilas, Ioannis; Dagnino, Giulio; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

    2015-08-01

    Our group at Bristol Robotics Laboratory has been working on a new robotic system for fracture surgery that has been previously reported [1]. The robotic system is being developed for distal femur fractures and features a robot that manipulates the small fracture fragments through small percutaneous incisions and a robot that re-aligns the long bones. The robots controller design relies on accurate and bounded force and position parameters for which we require real surgical data. This paper reports preliminary findings of forces and torques applied during bone and soft tissue manipulation in typical orthopaedic surgery procedures. Using customised orthopaedic surgical tools we have collected data from a range of orthopaedic surgical procedures at Bristol Royal Infirmary, UK. Maximum forces and torques encountered during fracture manipulation which involved proximal femur and soft tissue distraction around it and reduction of neck of femur fractures have been recorded and further analysed in conjunction with accompanying image recordings. Using this data we are establishing a set of technical requirements for creating safe and dynamically stable minimally invasive robot-assisted fracture surgery (RAFS) systems.

  17. The value of arthroscopy in the treatment of complex ankle fractures - a protocol of a randomised controlled trial.

    Science.gov (United States)

    Braunstein, Mareen; Baumbach, Sebastian F; Regauer, Markus; Böcker, Wolfgang; Polzer, Hans

    2016-05-12

    An anatomical reconstruction of the ankle congruity is the important prerequisite in the operative treatment of acute ankle fractures. Despite anatomic restoration patients regularly suffer from residual symptoms after these fractures. There is growing evidence, that a poor outcome is related to the concomitant traumatic intra-articular pathology. By supplementary ankle arthroscopy anatomic reduction can be confirmed and associated intra-articular injuries can be treated. Nevertheless, the vast majority of complex ankle fractures are managed by open reduction and internal fixation (ORIF) only. Up to now, the effectiveness of arthroscopically assisted fracture treatment (AORIF) has not been conclusively determined. Therefore, a prospective randomised study is needed to sufficiently evaluate the effect of AORIF compared to ORIF in complex ankle fractures. We perform a randomised controlled trial at Munich University Clinic enrolling patients (18-65 years) with an acute ankle fracture (AO 44 A2, A3, B2, B3, C1 - C3 according to AO classification system). Patients meeting the inclusion criteria are randomised to either intervention group (AORIF, n = 37) or comparison group (ORIF, n = 37). Exclusion criteria are fractures classified as AO type 44 A1 or B1, pilon or plafond-variant injury or open fractures. Primary outcome is the AOFAS Score (American Orthopaedic Foot and Ankle Society). Secondary outcome parameter are JSSF Score (Japanese Society of Surgery of the Foot), Olerud and Molander Score, Karlsson Score, Tegner Activity Scale, SF-12, radiographic analysis, arthroscopic findings of intra-articular lesions, functional assessments, time to return to work/sports and complications. This study protocol is accordant to the SPIRIT 2013 recommendation. Statistical analysis will be performed using SPSS 22.0 (IBM). The subjective and functional outcome of complex ankle fractures is regularly unsatisfying. As these injuries are very common it is essential to

  18. Numerical Investigation into the Effect of Natural Fracture Density on Hydraulic Fracture Network Propagation

    Directory of Open Access Journals (Sweden)

    Zhaohui Chong

    2017-07-01

    Full Text Available Hydraulic fracturing is an important method to enhance permeability in oil and gas exploitation projects and weaken hard roofs of coal seams to reduce dynamic disasters, for example, rock burst. It is necessary to fully understand the mechanism of the initiation, propagation, and coalescence of hydraulic fracture network (HFN caused by fluid flow in rock formations. In this study, a coupled hydro-mechanical model was built based on synthetic rock mass (SRM method to investigate the effects of natural fracture (NF density on HFN propagation. Firstly, the geometrical structures of NF obtained from borehole images at the field scale were applied to the model. Secondly, the micro-parameters of the proposed model were validated against the interaction between NF and hydraulic fracture (HF in physical experiments. Finally, a series of numerical simulations were performed to study the mechanism of HFN propagation. In addition, confining pressure ratio (CPR and injection rate were also taken into consideration. The results suggested that the increase of NF density drives the growth of stimulated reservoir volume (SRV, concentration area of injection pressure (CAIP, and the number of cracks caused by NF. The number of tensile cracks caused by rock matrix decrease gradually with the increase of NF density, and the number of shear cracks caused by rock matrix are almost immune to the change of NF density. The propagation orientation of HFN and the breakdown pressure in rock formations are mainly controlled by CPR. Different injection rates would result in a relatively big difference in the gradient of injection pressure, but this difference would be gradually narrowed with the increase of NF density. Natural fracture density is the key factor that influences the percentages of different crack types in HFN, regardless of the value of CPR and injection rate. The proposed model may help predict HFN propagation and optimize fracturing treatment designs in

  19. Analysis of gas migration patterns in fractured coal rocks under actual mining conditions

    Directory of Open Access Journals (Sweden)

    Gao Mingzhong

    2017-01-01

    Full Text Available Fracture fields in coal rocks are the main channels for gas seepage, migration, and extraction. The development, evolution, and spatial distribution of fractures in coal rocks directly affect the permeability of the coal rock as well as gas migration and flow. In this work, the Ji-15-14120 mining face at the No. 8 Coal Mine of Pingdingshan Tian’an Coal Mining Co. Ltd., Pingdingshan, China, was selected as the test site to develop a full-parameter fracture observation instrument and a dynamic fracture observation technique. The acquired video information of fractures in the walls of the boreholes was vectorized and converted to planarly expanded images on a computer-aided design platform. Based on the relative spatial distances between the openings of the boreholes, simultaneous planar images of isolated fractures in the walls of the boreholes along the mining direction were obtained from the boreholes located at various distances from the mining face. Using this information, a 3-D fracture network under mining conditions was established. The gas migration pattern was calculated using a COMSOL computation platform. The results showed that between 10 hours and 1 day the fracture network controlled the gas-flow, rather than the coal seam itself. After one day, the migration of gas was completely controlled by the fractures. The presence of fractures in the overlying rock enables the gas in coal seam to migrate more easily to the surrounding rocks or extraction tunnels situated relatively far away from the coal rock. These conclusions provide an important theoretical basis for gas extraction.

  20. Seismic Characterizations of Fractures: Dynamic Diagnostics

    Science.gov (United States)

    Pyrak-Nolte, L. J.

    2017-12-01

    Fracture geometry controls fluid flow in a fracture, affects mechanical stability and influences energy partitioning that affects wave scattering. Our ability to detect and monitor fracture evolution is controlled by the frequency of the signal used to probe a fracture system, i.e. frequency selects the scales. No matter the frequency chosen, some set of discontinuities will be optimal for detection because different wavelengths sample different subsets of fractures. The select subset of fractures is based on the stiffness of the fractures which in turn is linked to fluid flow. A goal is obtaining information from scales outside the optimal detection regime. Fracture geometry trajectories are a potential approach to drive a fracture system across observation scales, i.e. moving systems between effective medium and scattering regimes. Dynamic trajectories (such as perturbing stress, fluid pressure, chemical alteration, etc.) can be used to perturb fracture geometry to enhance scattering or give rise to discrete modes that are intimately related to the micro-structural evolution of a fracture. However, identification of these signal features will require methods for identifying these micro-structural signatures in complicated scattered fields. Acknowledgment: This material is based upon work supported by the U.S. Department of Energy, Office of Science, Office of Basic Energy Sciences, Geosciences Research Program under Award Number (DE-FG02-09ER16022).

  1. Streaming potential modeling in fractured rock: Insights into the identification of hydraulically active fractures

    Science.gov (United States)

    Roubinet, D.; Linde, N.; Jougnot, D.; Irving, J.

    2016-05-01

    Numerous field experiments suggest that the self-potential (SP) geophysical method may allow for the detection of hydraulically active fractures and provide information about fracture properties. However, a lack of suitable numerical tools for modeling streaming potentials in fractured media prevents quantitative interpretation and limits our understanding of how the SP method can be used in this regard. To address this issue, we present a highly efficient two-dimensional discrete-dual-porosity approach for solving the fluid flow and associated self-potential problems in fractured rock. Our approach is specifically designed for complex fracture networks that cannot be investigated using standard numerical methods. We then simulate SP signals associated with pumping conditions for a number of examples to show that (i) accounting for matrix fluid flow is essential for accurate SP modeling and (ii) the sensitivity of SP to hydraulically active fractures is intimately linked with fracture-matrix fluid interactions. This implies that fractures associated with strong SP amplitudes are likely to be hydraulically conductive, attracting fluid flow from the surrounding matrix.

  2. Analog site for fractured rock characterization. Annual report FY 1995

    International Nuclear Information System (INIS)

    Long, J.C.S.; Loughty, C.; Faybishenko, B.

    1995-10-01

    This report describes the accomplishments of the Analog Site for Fracture Rock Characterization Project during fiscal year 1995. This project is designed to address the problem of characterizing contaminated fractured rock. In order to locate contaminant plumes, develop monitoring schemes, and predict future fate and transport, the project will address the following questions: What parts of the system control flow-geometry of a fracture network? What physical processes control flow and transport? What are the limits on measurements to determine the above? What instrumentation should be used? How should it be designed and implemented? How can field tests be designed to provide information for predicting behavior? What numerical models are good predictors of the behavior of the system? The answers to these question can be used to help plan drilling programs that are likely to intersect plumes and provide effective monitoring of plume movement. The work is done at an open-quotes analogueclose quotes site, i.e., a site that is not contaminated, but has similar geology to sites that are contaminated, in order to develop tools and techniques without the financial, time and legal burdens of a contaminated site. The idea is to develop conceptual models and investigations tools and methodology that will apply to the contaminated sites in the same geologic regimes. The Box Canyon site, chosen for most of this work represents a unique opportunity because the Canyon walls allow us to see a vertical plane through the rock. The work represents a collaboration between the Lawrence Berkeley National Laboratory (LBL), Stanford University (Stanford), Idaho National Engineering Laboratory (INEL) and Parsons Environmental Engineering (Parsons). LBL and Stanford bring extensive experience in research in fractured rock systems. INEL and Parsons bring significant experience with the contamination problem at INEL

  3. External fixation of tibial pilon fractures and fracture healing.

    Science.gov (United States)

    Ristiniemi, Jukka

    2007-06-01

    Distal tibial fractures are rare and difficult to treat because the bones are subcutaneous. External fixation is commonly used, but the method often results in delayed union. The aim of the present study was to find out the factors that affect fracture union in tibial pilon fractures. For this purpose, prospective data collection of tibial pilon fractures was carried out in 1998-2004, resulting in 159 fractures, of which 83 were treated with external fixation. Additionally, 23 open tibial fractures with significant > 3 cm bone defect that were treated with a staged method in 2000-2004 were retrospectively evaluated. The specific questions to be answered were: What are the risk factors for delayed union associated with two-ring hybrid external fixation? Does human recombinant BMP-7 accelerate healing? What is the role of temporary ankle-spanning external fixation? What is the healing potential of distal tibial bone loss treated with a staged method using antibiotic beads and subsequent autogenous cancellous grafting compared to other locations of the tibia? The following risk factors for delayed healing after external fixation were identified: post-reduction fracture gap of >3 mm and fixation of the associated fibula fracture. Fracture displacement could be better controlled with initial temporary external fixation than with early definitive fixation, but it had no significant effect on healing time, functional outcome or complication rate. Osteoinduction with rhBMP-7 was found to accelerate fracture healing and to shorten the sick leave. A staged method using antibiotic beads and subsequent autogenous cancellous grafting proved to be effective in the treatment of tibial bone loss. Healing potential of the bone loss in distal tibia was at least equally good as in other locations of the tibia.

  4. 3-D description of fracture surfaces and stress-sensitivity analysis for naturally fractured reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, S.Q.; Jioa, D.; Meng, Y.F.; Fan, Y.

    1997-08-01

    Three kinds of reservoir cores (limestone, sandstone, and shale with natural fractures) were used to study the effect of morphology of fracture surfaces on stress sensitivity. The cores, obtained from the reservoirs with depths of 2170 to 2300 m, have fractures which are mated on a large scale, but unmated on a fine scale. A specially designed photoelectric scanner with a computer was used to describe the topography of the fracture surfaces. Then, theoretical analysis of the fracture closure was carried out based on the fracture topography generated. The scanning results show that the asperity has almost normal distributions for all three types of samples. For the tested samples, the fracture closure predicted by the elastic-contact theory is different from the laboratory measurements because plastic deformation of the aspirates plays an important role under the testing range of normal stresses. In this work, the traditionally used elastic-contact theory has been modified to better predict the stress sensitivity of reservoir fractures. Analysis shows that the standard deviation of the probability density function of asperity distribution has a great effect on the fracture closure rate.

  5. Minimizing the Fluid Used to Induce Fracturing

    Science.gov (United States)

    Boyle, E. J.

    2015-12-01

    The less fluid injected to induce fracturing means less fluid needing to be produced before gas is produced. One method is to inject as fast as possible until the desired fracture length is obtained. Presented is an alternative injection strategy derived by applying optimal system control theory to the macroscopic mass balance. The picture is that the fracture is constant in aperture, fluid is injected at a controlled rate at the near end, and the fracture unzips at the far end until the desired length is obtained. The velocity of the fluid is governed by Darcy's law with larger permeability for flow along the fracture length. Fracture growth is monitored through micro-seismicity. Since the fluid is assumed to be incompressible, the rate at which fluid is injected is balanced by rate of fracture growth and rate of loss to bounding rock. Minimizing injected fluid loss to the bounding rock is the same as minimizing total injected fluid How to change the injection rate so as to minimize the total injected fluid is a problem in optimal control. For a given total length, the variation of the injected rate is determined by variations in overall time needed to obtain the desired fracture length, the length at any time, and the rate at which the fracture is growing at that time. Optimal control theory leads to a boundary condition and an ordinary differential equation in time whose solution is an injection protocol that minimizes the fluid used under the stated assumptions. That method is to monitor the rate at which the square of the fracture length is growing and adjust the injection rate proportionately.

  6. Back to the future – feasibility of recruitment and retention to patient education and telephone follow-up after hip fracture: a pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Langford DP

    2015-09-01

    Full Text Available Dolores P Langford,1,2 Lena Fleig,3–5 Kristin C Brown,3,4 Nancy J Cho,1,2 Maeve Frost,1 Monique Ledoyen,1 Jayne Lehn,1 Kostas Panagiotopoulos,1,6 Nina Sharpe,1 Maureen C Ashe3,4 1Vancouver Coastal Health, 2Department of Physical Therapy, The University of British Columbia (UBC, 3Department of Family Practice, The University of British Columbia (UBC, 4Centre for Hip Health and Mobility, Vancouver, BC, Canada; 5Freie Universität Berlin, Health Psychology, Berlin, Germany; 6Department of Orthopaedics, The University of British Columbia (UBC, Vancouver, BC, Canada Objectives: Our primary aim of this pilot study was to test feasibility of the planned design, the interventions (education plus telephone coaching, and the outcome measures, and to facilitate a power calculation for a future randomized controlled trial to improve adherence to recovery goals following hip fracture.Design: This is a parallel 1:1 randomized controlled feasibility study.Setting: The study was conducted in a teaching hospital in Vancouver, BC, Canada.Participants: Participants were community-dwelling adults over 60 years of age with a recent hip fracture. They were recruited and assessed in hospital, and then randomized after hospital discharge to the intervention or control group by a web-based randomization service. Treatment allocation was concealed to the investigators, measurement team, and data entry assistants and analysts. Participants and the research physiotherapist were aware of treatment allocation.Intervention: Intervention included usual care for hip fracture plus a 1-hour in-hospital educational session using a patient-centered educational manual and four videos, and up to five postdischarge telephone calls from a physiotherapist to provide recovery coaching. The control group received usual care plus a 1-hour in-hospital educational session using the educational manual and videos.Measurement: Our primary outcome was feasibility, specifically recruitment

  7. Modeling Flow in Naturally Fractured Reservoirs : Effect of Fracture Aperture Distribution on Critical Sub-Network for Flow

    NARCIS (Netherlands)

    Gong, J.; Rossen, W.R.

    2014-01-01

    Fracture network connectivity and aperture (or conductivity) distribution are two crucial features controlling the flow behavior of fractured formations. The effect of connectivity on flow properties is well documented. We focus here on the influence of fracture aperture distribution. We model a

  8. Modeling flow in naturally fractured reservoirs : effect of fracture aperture distribution on dominant sub-network for flow

    NARCIS (Netherlands)

    Gong, J.; Rossen, W.R.

    2017-01-01

    Fracture network connectivity and aperture (or conductivity) distribution are two crucial features controlling flow behavior of naturally fractured reservoirs. The effect of connectivity on flow properties is well documented. In this paper, however, we focus here on the influence of fracture

  9. Social inequality and hip fracture

    DEFF Research Database (Denmark)

    Harvey, N. C.; Hansen, L.; Judge, A.

    2015-01-01

    Social inequality appears to be increasing in many countries. We explored whether risk of hip fracture was associated with markers of inequality and whether these relationships changed with time, using data from Danish Health Registries. Methods: All patients 60 years or older with a primary hip...... fracture (ICD10: S720, S721, S722 and S729) were identified from 1 January 1995 to 31 December 2011. Hip fracture patients were matched 1:1 on age, gender and year of fracture to a non-hip fracture control. An individual's education attainment was defined as basic, secondary or higher, and their income...

  10. Antipsychotic treatment and the risk of hip fracture in subjects with schizophrenia: a 10-year population-based case-control study.

    Science.gov (United States)

    Wu, Chi-Shin; Chang, Chia-Ming; Tsai, Yu-Ting; Huang, Ya-Wen; Tsai, Hui-Ju

    2015-09-01

    To investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia. Among patients with schizophrenia (ICD-9-CM code 295), 605 cases with hip fracture and 2,828 matched controls were identified from 2002 to 2011 using the National Health Insurance Research Database in Taiwan. The authors conducted a nested case-control study to investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia. The modifiable effects of age and gender were evaluated by stratified analysis. In addition, the effects of antipsychotic use, antipsychotic classes, and receptor-binding profiles of antipsychotics, individually, on hip fracture were estimated, and potential confounding factors were adjusted in subsequent analysis. Conditional logistic regressions were applied to determine the effect of antipsychotic treatment on hip fracture. Current antipsychotic use was associated with an increased risk for hip fracture (adjusted odds ratio [AOR] = 1.61; 95% CI, 1.24-2.10). Among current users, new users had a higher risk of hip fracture (AOR = 4.28; 95% CI, 1.76-10.36) than past users (AOR = 1.11; 95% CI, 0.79-1.56). In addition, a significant increased risk of hip fracture was noted in schizophrenia subjects with first-generation antipsychotic use (AOR = 1.59; 95%CI, 1.15-2.20) but not in those with second-generation antipsychotic use (AOR = 1.16; 95% CI, 0.91-1.48). These results extend previous findings and demonstrate an increased risk of hip fracture associated with antipsychotic use in schizophrenia subjects. Further investigation is needed to dissect the underlying mechanisms related to the effect of antipsychotic use on hip fracture in subjects at risk. © Copyright 2015 Physicians Postgraduate Press, Inc.

  11. [Treatment of posterior cruciate ligament avulsion fracture with rivet-assisted hollow nail:a case-control study].

    Science.gov (United States)

    Zhu, Jia-Fu; Ma, Gou-Ping; Xu, Wei-Xing; Guo, Qiao-Feng; Liu, Hong

    2017-04-25

    To retrospectively investigate the clinical effect of the rivet-assisted hollow screw in the treatment of posterior cruciate ligament avulsion fracture. Total 49 patients with knee cruciate ligament avulsion fracture in the ending point of the ligament from January 2010 to December 2014 were divided into the treatment group and the control group. Thirty-one patients in treatment group were treated with rivet-assisted double cannulate nail, including 13 males and 18 females, ranging in age from 38 to 51 years old, with a mean of (40.6±5.1) years old; according to Meyers classification, 23 cases of type 2, 8 cases of type 3; 5 patients were caused by the low energy injury and 26 patients were caused by the high energy injury. Eighteen patients in control group were treated with double gold hollow screw fixation, including 5 males and 13 females, ranging in age from 36 to 52 years old, with an average age of (4.16±4.7) years old; according to Meyers classification, 14 cases of type 2 and 4 cases of type 3;2 patients were caused by the low energy injury and 16 patients were caused by the high energy injury. The operation time, postoperative complications, fracture healing time and the last AKS scoring system were compared between the two groups. All the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 14.2 months. The patients in treatment group had no displacement of fracture fragments and internal fixation failure. The results of AKS score:pain was 48.1±1.5, activity was 21.3±2.7, stability was 20.9±2.5, walking ability was 47.3±1.9, under the stairs ability was 43.4±2.1, the total score was 190.7±2.9. There were 2 cases in control group had fracture fragment displacement and 1 patient had nail withdraw. The results of AKS score:pain was 40.1±2.2, activity was 20.1±0.2, stability was 18.1±3.2, walking ability was 46.3±1.7, under the stairs ability was 40.2 ±1.3, the total score was 180.2±1.4. Therefore, the

  12. Fluid-driven fracture propagation in heterogeneous media: Probability distributions of fracture trajectories.

    Science.gov (United States)

    Santillán, David; Mosquera, Juan-Carlos; Cueto-Felgueroso, Luis

    2017-11-01

    Hydraulic fracture trajectories in rocks and other materials are highly affected by spatial heterogeneity in their mechanical properties. Understanding the complexity and structure of fluid-driven fractures and their deviation from the predictions of homogenized theories is a practical problem in engineering and geoscience. We conduct a Monte Carlo simulation study to characterize the influence of heterogeneous mechanical properties on the trajectories of hydraulic fractures propagating in elastic media. We generate a large number of random fields of mechanical properties and simulate pressure-driven fracture propagation using a phase-field model. We model the mechanical response of the material as that of an elastic isotropic material with heterogeneous Young modulus and Griffith energy release rate, assuming that fractures propagate in the toughness-dominated regime. Our study shows that the variance and the spatial covariance of the mechanical properties are controlling factors in the tortuousness of the fracture paths. We characterize the deviation of fracture paths from the homogenous case statistically, and conclude that the maximum deviation grows linearly with the distance from the injection point. Additionally, fracture path deviations seem to be normally distributed, suggesting that fracture propagation in the toughness-dominated regime may be described as a random walk.

  13. Fracture risk associated with use of antibiotics

    DEFF Research Database (Denmark)

    Vestergaard, Peter

    2018-01-01

    of fractures. The cause for this increase has to be determined but may be related to their use against infections of the bone, the increase thus rather being due to the underlying disease than the drug. Other types of antibiotics especially the fluoroquinolones were not systematically associated......BACKGROUND: Data have pointed at an impaired fracture healing with fluoroquinolones and thus potentially a decreased bone biomechanical competence. OBJECTIVES: To study fracture risk associated with antibiotics. METHODS: Case control study. There were 124,655 fracture cases and 373,962 age...... and gender matched controls. The main exposure was use of various groups of antibiotics. Confounder control was performed for social variables, contacts to hospitals and general practitioners, alcoholism and a number of other variables. RESULTS: An increased risk of any fracture (OR =1. 45, 95% CI: 1. 42 -1...

  14. A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis.

    Science.gov (United States)

    Liu, Yun-Feng; Fan, Ying-Ying; Jiang, Xian-Feng; Baur, Dale A

    2017-11-15

    The purpose of this study was to design a customized fixation plate for mandibular angle fracture using topological optimization based on the biomechanical properties of the two conventional fixation systems, and compare the results of stress, strain and displacement distributions calculated by finite element analysis (FEA). A three-dimensional (3D) virtual mandible was reconstructed from CT images with a mimic angle fracture and a 1 mm gap between two bone segments, and then a FEA model, including volume mesh with inhomogeneous bone material properties, three loading conditions and constraints (muscles and condyles), was created to design a customized plate using topological optimization method, then the shape of the plate was referenced from the stress concentrated area on an initial part created from thickened bone surface for optimal calculation, and then the plate was formulated as "V" pattern according to dimensions of standard mini-plate finally. To compare the biomechanical behavior of the "V" plate and other conventional mini-plates for angle fracture fixation, two conventional fixation systems were used: type A, one standard mini-plate, and type B, two standard mini-plates, and the stress, strain and displacement distributions within the three fixation systems were compared and discussed. The stress, strain and displacement distributions to the angle fractured mandible with three different fixation modalities were collected, respectively, and the maximum stress for each model emerged at the mandibular ramus or screw holes. Under the same loading conditions, the maximum stress on the customized fixation system decreased 74.3, 75.6 and 70.6% compared to type A, and 34.9, 34.1, and 39.6% compared to type B. All maximum von Mises stresses of mandible were well below the allowable stress of human bone, as well as maximum principal strain. And the displacement diagram of bony segments indicated the effect of treatment with different fixation systems. The

  15. Orbital fractures due to domestic violence: an epidemiologic study.

    Science.gov (United States)

    Goldberg, Stuart H.; McRill, Connie M.; Bruno, Christopher R.; Ten Have, Tom; Lehman, Erik

    2000-09-01

    Domestic violence is an important cause of orbital fractures in women. Physicians who treat patients with orbital fractures may not suspect this mechanism of injury. The purpose of this study was to assess the association between domestic violence and orbital fractures. A medical center-based case-control study with matching on age and site of admission was done. Medical center databases were searched using ICD-9 codes to identify all cases of orbital fractures encountered during a three-year period. Medical records of female patients age 13 and older were reviewed along with those of age, gender and site of admission matched controls. A stratified exact test was employed to test the association between domestic violence and orbital fracture. Among 41 adult female cases with orbital fractures treated at our medical center, three (7.3%) reported domestic violence compared to zero among the matched controls (p = 0.037). We believe that domestic violence may be under-reported in both orbital fracture cases and controls. This may result in an underestimate of the orbital fracture versus domestic violence association. Domestic violence is a serious women's health and societal problem. Domestic violence may have a variety of presentations, including illnesses and injuries. Orbital fracture is an identifiable manifestation of domestic violence. Domestic violence is more likely to be detected in adult female hospital patients with orbital fracture than in matched controls with any other diagnosis. Physicians who treat patients with orbital fractures should be familiar with this mechanism of injury.

  16. Fracture properties of ThO2-UO2 pellets by Hertzian indentation technique

    International Nuclear Information System (INIS)

    Kutty, T.R.G.; Rath, B.N.; Balakrishnan, K.S.

    2005-01-01

    Fracture toughness (K Ic ) and fracture surface energy (γ s ) of ThO 2 -UO 2 pellets with varying UO 2 contents were measured using Hertzian indentation technique. The knowledge of fracture toughness (K Ic ) and fracture surface energy values are important for fuel designers since these values are used in fuel modeling. Cracks in nuclear fuel act as a path for fission gas release and enhances fuel cladding mechanical interaction. Microstructural features like grain size and presence of second phase play a significant role in controlling the fracture behavior. Since the fracture properties of nuclear materials are of primary design consideration, it is important that these properties should be evaluated with good precision. There have been several attempts to use Hertzian indentation for evaluating the fracture toughness of brittle materials. The main principle of this method depends on the interaction of the elastic stress field with a pre-existing surface flaw of the sample. One significant advantage of Hertzian indentation over that of Vickers is that the substrate's deformation is entirely elastic until fracture occurs. This avoids the complications arising from the ill-defined residual stress that is normally associated with indentations brought about by pointed indenters like that of Vickers. The material properties that may be determined by this test include (a) fracture toughness and fracture surface energy of the near surface material, (b) the densities and sizes of surface cracks, and (c) residual stresses in the near surface material. This paper deals with experimental procedure for the evaluation of fracture properties of ThO 2 -UO 2 of varying U content and results thus obtained are also presented. The K Ic values thus obtained are explained in terms of their microstructures and the U content. (author)

  17. CURBSIDE CONSULTATION IN FRACTURE MANAGEMENT: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Walter W. Virkus

    2008-12-01

    Full Text Available DESCRIPTION: A user-friendly, unique resource for the treatment of fractures designed in a casual questions and answers format which provides basic knowledge, current information and evidence based expert advices enhanced by images and diagrams and supported by ref-erences.PURPOSE: Designing this book the editor has aimed to prepare not only a source of current knowledge and opin-ions by experienced authors in fracture management for decision making in daily practice but also a brief refer-ence and useful educational resource in orthopedic trauma surgery.FEATURES: Three Sections are composed of 49 sub-jects in a form of the answers of frequently asked ques-tions richly illustrated by images and diagrams and in-cluding references at the end of each subject.The Section I is “UPPER EXTREMITIES” including: Neck fracture; Humerus shaft fracture; Management of radial nerve palsy associated with humeral fracture; Clavicle fractures; Elbow fractures in children; Fasciot-omy technic of the forearm; Distal radius fracture; Indica-tions of radial head replacement, Femur and humeral shaft fractures; Treatment of posterolateral elbow dislocation; The Section II is “LOWER EXTREMITIES” including : Femur fractures; Pelvic fractures; Life threatening pelvic fractures; Decision for surgical treatment in pelvic frac-tures; Treatment of anterior fracture of femoral head and hip joint incongruity; Management of a displaced femoral neck fracture in young patient in ER; Elder patients with displaced femoral head fracture; Patella and tibial plateau fractures; Criteria for compartment syndromes in the tibia; Tricks in nailing proximal and distal tibial fractures; Surgical management of distal tibia spiral fracture in middle aged women; Pilon fracture; Management of syn-desmotic screws in adult patient; The management of minimally displaced posterior malleol in three malleolar fractures; Postoperative management of bimalleolar frac-tures; Management of minimally

  18. Fourier Transformed Infra-Red Imaging of Femoral Neck Bone: Reduced Heterogeneity of Mineral-to-Matrix and Carbonate-to-Phosphate and more Variable Crystallinity in Treatment-Naïve Fracture Cases compared to Fracture-Free Controls

    Science.gov (United States)

    Gourion-Arsiquaud, Samuel; Lukashova, Lyudmilla; Power, Jon; Loveridge, Nigel; Reeve, Jonathan; Boskey, Adele L.

    2012-01-01

    After age 60 hip fracture risk strongly increases, but only a fifth of this increase is attributable to reduced mineral density (BMD, measured clinically). Changes in bone quality, specifically bone composition as measured by Fourier Transform Infrared spectroscopic imaging (FTIRI), also contribute to fracture risk. Here, FTIRI was applied to study the femoral neck and provide spatially derived information on its mineral and matrix properties in age-matched fractured and non-fractured bones. Whole femoral neck cross sections, divided into quadrants along the neck’s axis, from 10 women with hip fracture and 10 cadaveric controls were studied using FTIRI and micro-computed Tomography. Although 3-dimensional micro-CT bone mineral densities were similar, the mineral-to-matrix ratio was reduced in the cases of hip fracture, confirming previous reports. New findings were that the FTIRI microscopic variation (heterogeneity) of the mineral-to-matrix ratio was substantially reduced in the fracture group as was the heterogeneity of the carbonate-to-phosphate ratio. Conversely, the heterogeneity of crystallinity was increased. Increased variation of crystallinity was statistically associated with reduced variation of the carbonate-to-phosphate ratio. Anatomical variation in these properties between the different femoral neck quadrants was reduced in the fracture group compared to controls. While our treatment-naïve patients had reduced rather than increased bending resistance, these changes in heterogeneity associated with hip fracture are in another way comparable to the effects of experimental bisphosphonate therapy, which decreases heterogeneity and other indicators of bone’s toughness as a material. PMID:22865771

  19. Effect of extended physiotherapy and high-dose vitamin D on rate of falls and hospital re-admission after acute hip fracture: a randomized controlled trial

    Science.gov (United States)

    Guidelines for post-fracture care of elderly hip fracture patients are not established despite the significant socio-economic burden of post hip fracture morbidity and mortality. Using a factorial design, we studied the effects of extended physiotherapy (supervised 1 hour per day during acute care p...

  20. Control room design

    International Nuclear Information System (INIS)

    Zinke, H.

    1980-01-01

    To control a 1300 megawatt nuclear power plant, about 15000 plant parameters must be collected together to control and operate the plant. The control room design therefore is of particular importance. The main design criteria are: Required functions of the power plant process - Level of Automation - Ergonomics - Available Technology. Extensive analysis has resulted in a control room design method. This ensures that an objective solution will be reached. Resulting from this methodical approach are: 1. Scope, position and appearance of the instrumentation. 2. Scope, position and appearance of the operator controls. Process analysis dictates what instrumentation and operator controls are needed. The priority and importance of the control and instrumentation (this we define as the utilisation areas), dictates the rough layout of the control room. (orig./RW)

  1. Micromechanical studies of cyclic creep fracture under stress controlled loading

    DEFF Research Database (Denmark)

    van der Giessen, Erik; Tvergaard, Viggo

    1996-01-01

    is based on numerical unit cell analyses for a planar polycrystal model with the grains and grain boundaries modeled individually, in order to investigate the interactions between the mechanisms involved and to account for the build-up of residual stress fields during cycling. The behaviour of a limiting......This paper deals with a study of intergranular failure by creep cavitation under stress-controlled cyclic loading conditions. Loading is assumed to be slow enough that diffusion and creep mechanisms (including grain boundary sliding) dominate, leading to intergranular creep fracture. This study...

  2. Comprehensive evaluation of fracture critical bridges.

    Science.gov (United States)

    2014-02-01

    Two-girder steel bridges are classified as fracture critical bridges based on the definition given in the AASHTO LRFD Bridge Design Specifications. In a fracture critical bridge a failure of a tension member leads to collapse of the bridge. However, ...

  3. Optimized CO{sub 2} miscible hydrocarbon fracturing fluids

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, R.S.; Funkhouser, G.P.; Fyten, G.; Attaway, D.; Watkins, H. [Halliburton Energy Services, Calgary, AB (Canada); Lestz, R.S. [Chevron Canada Resources, Calgary, AB (Canada); Loree, D. [FracEx Inc. (Canada)

    2006-07-01

    Carbon dioxide (CO{sub 2}) miscible hydrocarbon fracturing fluids address issues of fluid retention in low-permeability gas reservoirs, including undersaturated and underpressured reservoirs. An optimized surfactant gel technology using carbon dioxide (CO{sub 2}) hydrocarbon fracturing fluids applicable to all gas-well stimulation applications was discussed in this paper. The crosslinked surfactant gel technology improved proppant transport, leakoff control, and generation of effective fracture half-length. Tests indicated that application of the surfactant cooled the fracture face, which had the effect of extending break times and increasing viscosity during pumping periods. Rapid recovery of the fracturing fluid eliminated the need for swabbing in some cases, and the fluid system was not adversely affected by shear. However, rheological test equipment capable of mixing liquid CO{sub 2} and viscosified hydrocarbons at downhole temperatures is required to determine rheology and required chemical concentrations. It was recommended that to achieve an effective methane-drive cleanup mechanism, treatments should be designed so that the gellant system can be effective with up to 50 per cent CO{sub 2} dissolved in oil. It was concluded that it should be possible to apply the technology to low permeability gas reservoirs. Viscosity curves and friction data were presented. Issues concerning the selection of tubulars and flowback procedures were also discussed. It was suggested that the cost of the hydrocarbon fracturing fluid can be recovered by the sale of recovered load fluid. 6 refs., 4 figs.

  4. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial.

    Science.gov (United States)

    Hannemann, Pascal; Göttgens, Kevin W A; van Wely, Bob J; Kolkman, Karel A; Werre, Andries J; Poeze, Martijn; Brink, Peter R G

    2011-05-06

    The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences.Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning).Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory.Study parameters are clinical consolidation, radiological consolidation evaluated by CT-scanning, functional

  5. Spine fractures caused by horse riding

    OpenAIRE

    Siebenga, Jan; Segers, Michiel J. M.; Elzinga, Matthijs J.; Bakker, Fred C.; Haarman, Henk J. T. M.; Patka, Peter

    2006-01-01

    Study Design: Retrospective study and review of literature. Objectives: Study of demographic data concerning spinal fractures caused by horse riding, classification of fractures according to the AO and Load Sharing classifications, evaluation of mid-term radiological results and long-term functional results. Methods: A review of medical reports and radiological examinations of patients presented to our hospital with horse riding-related spine fractures over a 13-year period; long-term functio...

  6. Does self-efficacy mediate functional change in older adults participating in an exercise program after hip fracture? A randomized control trial

    Science.gov (United States)

    Latham, Nancy K.; Ni, Pengsheng; Jette, Alan M.

    2015-01-01

    Objectives This study examined whether self-efficacy mediated the effect of the HIP Rehab exercise program on activity limitations in older adults after hip fracture, and whether the mediation effect was different between different gender and age groups. Design Randomized controlled trial (RCT) Setting Community Participants Two hundred and thirty two participants aged 79±9.4 years with hip fracture were randomly assigned to intervention (n=120) or attention control (n=112) groups. Interventions The 6-month intervention, the HIP Rehab, is a functionally-oriented, home-based exercise program. Data was collected at baseline, post-intervention (6 months), and follow-up (9 months). Main outcome measure Activity Measure for Post-Acute Care (AM-PAC) Results The mediation effect of the HIP Rehab exercise program on Basic Mobility function through self-efficacy for exercise was significant at 9 months (βindirect=0.21). Similarly, the mediation effect of the intervention on Daily Activity function through self-efficacy for exercise was significant at 9 months (βindirect=0.49). In subgroup analyses, the mediation effect was significant at 9 months in the younger group (≤79 years old) in comparison to the older group, and was significant in females in comparison to males. Conclusion Self-efficacy may play a partial mediating role for the effect on some longer-term functional outcomes in the HIP Rehab intervention. The results suggest that program components that target self-efficacy should be incorporated in the future hip fracture rehabilitation interventions. Age and gender of the targeted participants may also need to be considered when developing interventions. PMID:25701101

  7. A randomized, controlled comparison of home versus institutional rehabilitation of patients with hip fracture.

    Science.gov (United States)

    Kuisma, Raija

    2002-08-01

    To compare ambulation outcomes between home and institutional rehabilitation of patients with hip fracture. Randomized controlled clinical equivalence trial. The Queen Elizabeth Hospital in Hong Kong. Eighty-one patients with hip fracture. Study group patients (40) were discharged directly home from the acute hospital and visited by a physiotherapist an average of 4.6 times. The control group subjects (41) were discharged to a rehabilitation centre for further treatment lasting on average 36.2 days (SD 14.6) and they received physiotherapy daily. Ambulation ability measured on a categorical scale. The mean age of the subjects was 75 years (SD 8.3 years). Females comprised 60% of all the subjects and majority were retired or home makers. Both groups of patients improved in their ambulation ability during their rehabilitation period but neither group achieved their pre-ambulatory status by the time of completion of the study. The study group achieved significantly higher ambulation scores (p institution-based rehabilitation.

  8. Parameters controlling fracturing distribution: example of an Upper Jurassic marly-calcareous formation (eastern Paris Basin)

    International Nuclear Information System (INIS)

    Andre, G.; Rebours, H.; Wileveau, Y.; Proudhon, B.

    2006-01-01

    Study of fractures along a 490-m vertical section of marl/limestone alternations in the Upper Jurassic (Meuse/Haute-Marne underground research laboratory-eastern Paris Basin) reveals their organization and the different states of palaeo-stress. Type and extension of tectonic structures seem to be controlled principally by lithology and secondary by depth. Also, it appears deviations of Alpine palaeo-stresses between Kimmeridgian and Oxfordian formations. These deviations are related to the presence of marl/limestone contacts. The vertical evolution of current horizontal maximum stress shows a similar behaviour, with deviations at the walls of Callovo-Oxfordian argilites. These results allow us to point out and to discuss the impact of lithology, rheology and depth on fracturing occurrence and distribution. Furthermore, this study suggests the role of Callovo-Oxfordian as a barrier for fracture development between the limestones of Dogger and Oxfordian formations. (authors)

  9. Effect of in-hospital comprehensive geriatric assessment (CGA in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

    Directory of Open Access Journals (Sweden)

    Taraldsen Kristin

    2011-04-01

    Full Text Available Abstract Background Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit. Methods/design The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival. Discussion We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients. Trials registration ClinicalTrials.gov, NCT00667914

  10. Evaluation of a multidisciplinary rehabilitation programme for elderly patients with hip fracture: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Wing-Hoi Cheung

    2017-12-01

    Full Text Available Objective: To investigate the effectiveness and cost of an 18-month multi-disciplinary Comprehensive Fragility Fracture Management Program (CFFMP for fragility hip fracture patients. Design: Prospective cohort study. Patients: Elderly patients with hip fracture were recruited at their first postoperative follow-up in 2 district hospitals. The intervention group comprised patients from the hospital undergoing CFFMP, and the control group comprised patients from another hospital undergoing conventional care. CFFMP provided geri-orthopaedic co-management, physician consultations, group-exercise and vibration-therapy. Timed-up-and-go test (TUG, Elderly Mobility Scale (EMS, Berg Balance Scale (BBS and fall risk screening (FS were used to assess functional performance. Incidences of falls and secondary fractures, the cost of the programme and related healthcare resources were recorded. Results: A total of 76 patients were included in the intervention group (mean age 77.9 years ((standard deviation; SD 6.1 and 77 in the control group (79.9 (SD 7.2, respectively. The re-fracture rate in the control group (10.39% was significantly higher than in the intervention group (1.32% (p = 0.034. The intervention group improved significantly in TUG, EMS and FS after a 1-year programme. The overall healthcare costs per patient in the intervention and control groups were US$22,450 and US$25,313, respectively. Conclusion: Multi-disciplinary CFFMP is effective, with reduced overall cost, reduced length of hospital stay and reduced secondary fracture rate. The rehabilitation community service favours rehabilitation and improved quality of life of hip fracture patients.

  11. Real-world antidiabetic drug use and fracture risk in 12,277 patients with type 2 diabetes mellitus: a nested case-control study.

    Science.gov (United States)

    Losada, E; Soldevila, B; Ali, M S; Martínez-Laguna, D; Nogués, X; Puig-Domingo, M; Díez-Pérez, A; Mauricio, D; Prieto-Alhambra, D

    2018-06-02

    We conducted a nested case-control study to study the association between antidiabetic treatments (alone or in combination) use and fracture risk among incident type 2 Diabetes mellitus patients. We found an increased risk of bone fracture with insulin therapy compared to metformin monotherapy. Patients with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fractures, to which antidiabetic therapies may contribute. We aimed to characterize the risk of fracture associated with different antidiabetic treatments as usually prescribed to T2DM patients in actual practice conditions. A case-control study was nested within a cohort of incident T2DM patients registered in 2006-2012 in the Information System for Research Development in Primary Care (Catalan acronym, SIDIAP), a database which includes records for > 5.5 million patients in Catalonia (Spain). Each case (incident major osteoporotic fracture) was risk-set matched with up to five same-sex controls by calendar year of T2DM diagnosis and year of birth (± 10 years). Study exposure included previous use of all antidiabetic medications (alone or in combination), as dispensed in the 6 months before the index date, with metformin (MTF) monotherapy, the most commonly used drug, as a reference group (active comparator). Data on 12,277 T2DM patients (2049 cases and 10,228 controls) were analyzed. Insulin use was associated with increased fracture risk (adjusted OR 1.63 (95% CI 1.30-2.04)), as was the combination of MTF and sulfonylurea (SU) (adjusted OR 1.29 (1.07-1.56)), compared with MTF monotherapy. Sensitivity analyses suggest possible causality for insulin therapy but not for the MTF + SU combination association. No significant association was found with any other antidiabetic medications. Insulin monotherapy was associated with an increased fracture risk compared to MTF monotherapy in T2DM patients. Fracture risk should be taken into account when starting a glucose-lowering drug as part

  12. Calcium intake and risk of fracture: systematic review.

    Science.gov (United States)

    Bolland, Mark J; Leung, William; Tai, Vicky; Bastin, Sonja; Gamble, Greg D; Grey, Andrew; Reid, Ian R

    2015-09-29

    To examine the evidence underpinning recommendations to increase calcium intake through dietary sources or calcium supplements to prevent fractures. Systematic review of randomised controlled trials and observational studies of calcium intake with fracture as an endpoint. Results from trials were pooled with random effects meta-analyses. Ovid Medline, Embase, PubMed, and references from relevant systematic reviews. Initial searches undertaken in July 2013 and updated in September 2014. Randomised controlled trials or cohort studies of dietary calcium, milk or dairy intake, or calcium supplements (with or without vitamin D) with fracture as an outcome and participants aged >50. There were only two eligible randomised controlled trials of dietary sources of calcium (n=262), but 50 reports from 44 cohort studies of relations between dietary calcium (n=37), milk (n=14), or dairy intake (n=8) and fracture outcomes. For dietary calcium, most studies reported no association between calcium intake and fracture (14/22 for total, 17/21 for hip, 7/8 for vertebral, and 5/7 for forearm fracture). For milk (25/28) and dairy intake (11/13), most studies also reported no associations. In 26 randomised controlled trials, calcium supplements reduced the risk of total fracture (20 studies, n=58,573; relative risk 0.89, 95% confidence interval 0.81 to 0.96) and vertebral fracture (12 studies, n=48,967. 0.86, 0.74 to 1.00) but not hip (13 studies, n=56,648; 0.95, 0.76 to 1.18) or forearm fracture (eight studies, n=51,775; 0.96, 0.85 to 1.09). Funnel plot inspection and Egger's regression suggested bias toward calcium supplements in the published data. In randomised controlled trials at lowest risk of bias (four studies, n=44,505), there was no effect on risk of fracture at any site. Results were similar for trials of calcium monotherapy and co-administered calcium and vitamin D. Only one trial in frail elderly women in residential care with low dietary calcium intake and vitamin D

  13. Stress fractures in elite cross-country athletes.

    Science.gov (United States)

    Laker, Scott R; Saint-Phard, Deborah; Tyburski, Mark; Van Dorsten, Brent

    2007-04-01

    This retrospective and comparative survey investigates an unusual number of stress fractures seen within a Division I college cross-country team. An anonymous questionnaire-designed to observe factors known to increase stress fracture incidence-was distributed to members of the current and previous seasons' teams. Running surface, sleep hours, intake of calcium, and shoe type were among the factors investigated. Eleven lower extremity stress fractures were found in nine athletes. Athletes with stress fractures reported significantly fewer workouts per week on the new track. All other study parameters had no statistically significant effect on stress fractures in these athletes.

  14. Modelling Laccoliths: Fluid-Driven Fracturing in the Lab

    Science.gov (United States)

    Ball, T. V.; Neufeld, J. A.

    2017-12-01

    Current modelling of the formation of laccoliths neglects the necessity to fracture rock layers for propagation to occur [1]. In magmatic intrusions at depth the idea of fracture toughness is used to characterise fracturing, however an analogue for near surface intrusions has yet to be explored [2]. We propose an analytical model for laccolith emplacement that accounts for the energy required to fracture at the tip of an intrusion. For realistic physical parameters we find that a lag region exists between the fluid magma front and the crack tip where large negative pressures in the tip cause volatiles to exsolve from the magma. Crucially, the dynamics of this tip region controls the spreading due to the competition between viscous forces and fracture energy. We conduct a series of complementary experiments to investigate fluid-driven fracturing of adhered layers and confirm the existence of two regimes: viscosity dominant spreading, controlled by the pressure in the lag region, and fracture energy dominant spreading, controlled by the energy required to fracture layers. Our experiments provide the first observations, and evolution, of a vapour tip. These experiments and our simplified model provide insight into the key physical processes in near surface magmatic intrusions with applications to fluid-driven fracturing more generally. Michaut J. Geophys. Res. 116(B5), B05205. Bunger & Cruden J. Geophys. Res. 116(B2), B02203.

  15. Risk factors for stress fractures.

    Science.gov (United States)

    Bennell, K; Matheson, G; Meeuwisse, W; Brukner, P

    1999-08-01

    Preventing stress fractures requires knowledge of the risk factors that predispose to this injury. The aetiology of stress fractures is multifactorial, but methodological limitations and expediency often lead to research study designs that evaluate individual risk factors. Intrinsic risk factors include mechanical factors such as bone density, skeletal alignment and body size and composition, physiological factors such as bone turnover rate, flexibility, and muscular strength and endurance, as well as hormonal and nutritional factors. Extrinsic risk factors include mechanical factors such as surface, footwear and external loading as well as physical training parameters. Psychological traits may also play a role in increasing stress fracture risk. Equally important to these types of analyses of individual risk factors is the integration of information to produce a composite picture of risk. The purpose of this paper is to critically appraise the existing literature by evaluating study design and quality, in order to provide a current synopsis of the known scientific information related to stress fracture risk factors. The literature is not fully complete with well conducted studies on this topic, but a great deal of information has accumulated over the past 20 years. Although stress fractures result from repeated loading, the exact contribution of training factors (volume, intensity, surface) has not been clearly established. From what we do know, menstrual disturbances, caloric restriction, lower bone density, muscle weakness and leg length differences are risk factors for stress fracture. Other time-honoured risk factors such as lower extremity alignment have not been shown to be causative even though anecdotal evidence indicates they are likely to play an important role in stress fracture pathogenesis.

  16. Hip fracture risk in relation to vitamin D supplementation and serum 25-hydroxyvitamin D levels: a systematic review and meta-analysis of randomised controlled trials and observational studies

    Directory of Open Access Journals (Sweden)

    Roddam Andrew W

    2010-06-01

    Full Text Available Abstract Background Vitamin D supplementation for fracture prevention is widespread despite conflicting interpretation of relevant randomised controlled trial (RCT evidence. This study summarises quantitatively the current evidence from RCTs and observational studies regarding vitamin D, parathyroid hormone (PTH and hip fracture risk. Methods We undertook separate meta-analyses of RCTs examining vitamin D supplementation and hip fracture, and observational studies of serum vitamin D status (25-hydroxyvitamin D (25(OHD level, PTH and hip fracture. Results from RCTs were combined using the reported hazard ratios/relative risks (RR. Results from case-control studies were combined using the ratio of 25(OHD and PTH measurements of hip fracture cases compared with controls. Original published studies of vitamin D, PTH and hip fracture were identified through PubMed and Web of Science databases, searches of reference lists and forward citations of key papers. Results The seven eligible RCTs identified showed no significant difference in hip fracture risk in those randomised to cholecalciferol or ergocalciferol supplementation versus placebo/control (RR = 1.13[95%CI 0.98-1.29]; 801 cases, with no significant difference between trials of 21 (heterogeneity = 51.02, p 216 (heterogeneity = 137.9, p 29 (heterogeneity = 149.68, p Conclusions Neither higher nor lower dose vitamin D supplementation prevented hip fracture. Randomised and observational data on vitamin D and hip fracture appear to differ. The reason for this is unclear; one possible explanation is uncontrolled confounding in observational studies. Post-fracture PTH levels are unrelated to hip fracture risk.

  17. Fracture toughness of zirconia ceramic crowns made by feather-edge tooth preparation design

    Directory of Open Access Journals (Sweden)

    Mirković Nemanja

    2012-01-01

    Full Text Available Background/Aim. Fracture toughness determines functional crown strenght and prevents damages on ceramics during mastication. There is a lack of relevant literature data about fracture toughness of crowns made by feather-edge preparation. Mechanical testing of ceramic samples is supposed to show if feather-edge tooth preparation is a successful method for making ceramic crowns without any risk of reduction of their mechanical properties. This research was done to establish effects of feather-edge tooth preparation on fracture toughness of single zirconia ceramic crowns. Methods. The research was performed as an experimental study. Sixty (60 ceramic crowns were made on non-carious extracted human premolars. Thirty (30 crowns were made on the basis of feather-edge preparation (experimental group I. The group II included 30 crowns made on 1 mm rounded shoulder. Crowns fabrication was executed on a copy mill production system “Zirkonzahn” (Zirkonzahn GMBH, Gais, Germany. The spherical compression test was used to determine fracture toughness, using 6 mm diameter ceramic ball. Fracture load for damaging ceramic crown was recorded on a universal testing machine - Zwick, type 1464, with the speed of 0.05 mm/min. Results. The results of this research introduced significant differences between fracture toughness of ceramic samples in every examined group. However, fracture toughness of crowns from both group was above 2 000 N, what was double beyond a recommended value. The mean value of fracture toughness in the feather-edge group was 2 090 N, and in shoulder group it was 2 214 N. Conclusion. This research showed a high fracture toughness of zirconia crowns made on feather-edge preparation. The examined crowns showed a fracture resistance at a sufficient distance in relation to the minimum values of functional loads. Further research of functional loads of these crown is necessary, as well as research of marginal adaptation of cemented crowns and

  18. Fracture studies on stainless steel straight pipes under earthquake-type cyclic loading

    International Nuclear Information System (INIS)

    Raghava, G.; Vishnuvardhan, S.; Gandhi, P.; Vaze, K.K.

    2014-01-01

    In order to study the crack growth and cyclic fracture behaviour, which are required for realistic assessment of Leak Before Break (LBB) applicability, experimental investigations were carried out on straight pipes under quasi-crystal loading. Totally 13 pipes were tested; three were stainless steel welded (SSW) using conventional shielded metal arc welding (SMAW) technique and the remaining specimens were Narrow Gap Welded (NGW). The fracture tests were carried out under load control, displacement control and combination of the two; the pipes were subjected to different amplitudes of load or load-line displacement (LLD), which were decided based on the response of the pipes under monotonic loading. Cyclic tearing and crack growth studies on eight straight pipes of the same material reported earlier in published literature are also considered for studying the results and understanding the behaviour. Under load control, with almost equal load amplitude, the NGW pipe exhibited improved life in comparison with SMAW pipe when both are subjected to cyclic loading. The crack growth and tearing instability behaviour of the pipes were studied. The same were found to be different for load control, displacement control and combined control tests. Based in the load-controlled experimental results, material specific plot between cyclic load amplitude (as a percentage of maximum load carrying capacity of a specimen under monotonic fracture) and number of cycles to failure was obtained. The results indicate that the piping components subjected to quasi-cyclic loading may fail in very less number of cycles even when the load amplitude is sufficiently below the monotonic fracture/collapse load. These studies will be helpful in designing nuclear power plant (NPP) piping components subjected to earthquake-type cyclic loading. (author)

  19. Experimental Investigation of Damage and Fracture Mechanisms Controlling the Performance of Full Aperture Easy Open Ends for Food Containers

    Science.gov (United States)

    Taylor, D. L. P.; Nagy, G. T.; Owen, D. R. J.

    2011-05-01

    Can manufacturers produce hundreds of millions of cans annually, increasingly, food cans are being opened by lifting a tab on the can end that initiates a fracture, which then propagates around a circumferential score. The damage and fracture mechanisms that lead to crack initiation and propagation in the opening process, however, are not fully understood, therefore optimisation of easy open end scores is largely based on trial and error. This paper presents an experimental analysis that concentrates on the combined shear and bending forces as applied to the particular industrial method concerning full aperture easy open ends. The influence of a gradually increasing gap measured between the score and shear force location on traditional groove geometries and depths are examined for two different packaging steels. Earlier studies have shown that the complete opening cycle depends on fracture modes I, II & III as well as their combination. Experimental results for Modes I, II & III will be presented, however attention will focus on the behaviour of the initial fracture point, whereby prior investigations have shown it to be influenced primarily by mode II shearing. After initial specimen manufacture, where the score is formed by pressing a punch into a thin steel sheet the predeformed scored specimens are loaded in shear to simulate the local stress field found during the initial opening phase. Experiments have been completed using a novel Mode II experimental technique that has been designed for use in the majority of commercially available tensile test machines. Experimental results indicate that opening forces can change radically with different gap sizes and that there is considerable potential for the industrialised process of can end manufacture to be optimised through the efficient management and control of the can ends dimensional parameters.

  20. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study

    OpenAIRE

    Coutinho, Evandro SF; Fletcher, Astrid; Bloch, Katia V; Rodrigues, Laura C

    2008-01-01

    Abstract Background Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. Methods A case-control study was carried out in Rio d...

  1. The risk of fracture in patients with multiple sclerosis: The UK general practice research database

    DEFF Research Database (Denmark)

    Bazelier, Marloes T; van Staa, Tjeerd; Uitdehaag, Bernard Mj

    2011-01-01

    Patients with multiple sclerosis (MS) may be at an increased risk of fracture owing to a greater risk of falling and decreased bone mineral density when compared with the general population. This study was designed to estimate the relative and absolute risk of fracture in patients with MS. We...... were used to derive adjusted hazard ratios (HRs) for fracture associated with MS. Time-dependent adjustments were made for age, comorbidity, and drug use. Absolute 5- and 10-year risks of fracture were estimated for MS patients as a function of age. Compared with controls, MS patients had an almost...... threefold increased risk of hip fracture [HR = 2.79,95% confidence interval (CI) 1.83-4.26] and a risk of osteoporotic fracture that was increased 1.4-fold (HR = 1.35,95% CI 1.13-1.62). Risk was greater in patients who had been prescribed oral/intravenous glucocorticoids (GCs; HR = 1.85, 95% CI 1...

  2. Impaired Fracture Healing after Hemorrhagic Shock

    Directory of Open Access Journals (Sweden)

    Philipp Lichte

    2015-01-01

    Full Text Available Impaired fracture healing can occur in severely injured patients with hemorrhagic shock due to decreased soft tissue perfusion after trauma. We investigated the effects of fracture healing in a standardized pressure controlled hemorrhagic shock model in mice, to test the hypothesis that bleeding is relevant in the bone healing response. Male C57/BL6 mice were subjected to a closed femoral shaft fracture stabilized by intramedullary nailing. One group was additionally subjected to pressure controlled hemorrhagic shock (HS, mean arterial pressure (MAP of 35 mmHg for 90 minutes. Serum cytokines (IL-6, KC, MCP-1, and TNF-α were analyzed 6 hours after shock. Fracture healing was assessed 21 days after fracture. Hemorrhagic shock is associated with a significant increase in serum inflammatory cytokines in the early phase. Histologic analysis demonstrated a significantly decreased number of osteoclasts, a decrease in bone quality, and more cartilage islands after hemorrhagic shock. μCT analysis showed a trend towards decreased bone tissue mineral density in the HS group. Mechanical testing revealed no difference in tensile failure. Our results suggest a delay in fracture healing after hemorrhagic shock. This may be due to significantly diminished osteoclast recruitment. The exact mechanisms should be studied further, particularly during earlier stages of fracture healing.

  3. Advanced Hydraulic Fracturing Technology for Unconventional Tight Gas Reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Stephen Holditch; A. Daniel Hill; D. Zhu

    2007-06-19

    The objectives of this project are to develop and test new techniques for creating extensive, conductive hydraulic fractures in unconventional tight gas reservoirs by statistically assessing the productivity achieved in hundreds of field treatments with a variety of current fracturing practices ranging from 'water fracs' to conventional gel fracture treatments; by laboratory measurements of the conductivity created with high rate proppant fracturing using an entirely new conductivity test - the 'dynamic fracture conductivity test'; and by developing design models to implement the optimal fracture treatments determined from the field assessment and the laboratory measurements. One of the tasks of this project is to create an 'advisor' or expert system for completion, production and stimulation of tight gas reservoirs. A central part of this study is an extensive survey of the productivity of hundreds of tight gas wells that have been hydraulically fractured. We have been doing an extensive literature search of the SPE eLibrary, DOE, Gas Technology Institute (GTI), Bureau of Economic Geology and IHS Energy, for publicly available technical reports about procedures of drilling, completion and production of the tight gas wells. We have downloaded numerous papers and read and summarized the information to build a database that will contain field treatment data, organized by geographic location, and hydraulic fracture treatment design data, organized by the treatment type. We have conducted experimental study on 'dynamic fracture conductivity' created when proppant slurries are pumped into hydraulic fractures in tight gas sands. Unlike conventional fracture conductivity tests in which proppant is loaded into the fracture artificially; we pump proppant/frac fluid slurries into a fracture cell, dynamically placing the proppant just as it occurs in the field. From such tests, we expect to gain new insights into some of the critical

  4. Epidemiology and risk factors of humerus fractures among skiers and snowboarders.

    Science.gov (United States)

    Bissell, Benjamin T; Johnson, Robert J; Shafritz, Adam B; Chase, Derek C; Ettlinger, Carl F

    2008-10-01

    The incidence of humerus fractures while participating in snowboarding and skiing is undefined. Very little is known about the risk factors associated with these fractures. Snowboarders are at increased risk for sustaining humerus fractures when compared with skiers. In addition, the types of fractures, laterality, and risk factors differ between the 2 groups. Case-control study; Level of evidence, 3. At a major ski area clinic, 318 humerus fractures were evaluated over 34 seasons. Radiographs were classified according to the AO and Neer systems. Patient data were analyzed and compared with that of a control population of uninjured skiers and snowboarders to determine incidence and risk factors. The incidence of humerus fractures among snowboarders (0.062 per 1000 snowboarder days) was significantly higher than that of skiers (0.041 per 1000, P Jumping was involved in 28.3% of humerus fractures among snowboarders and in 5.4% among skiers. Skiers with humerus fractures were more skilled, older, and fell less frequently than controls. Snowboarders were less skilled, younger, and fell at a similar rate compared with controls. Snowboarders are at significantly higher risk of sustaining humerus fractures than skiers. In skiers, humerus fractures show no laterality and most often involve the proximal humerus. In contrast, snowboarders more often fracture the left humerus at the diaphysis.

  5. Parameters controlling fracturing distribution: example of an Upper Jurassic marly-calcareous formation (eastern Paris Basin); Parametres controlant la distribution de la fracturation: exemple dans une serie marno-calcaire du Jurassique superieur (Est du bassin de Paris)

    Energy Technology Data Exchange (ETDEWEB)

    Andre, G.; Rebours, H.; Wileveau, Y. [Agence Nationale pour la Gestion des Dechets Radioactifs (ANDRA), Laboratoire de recherche souterrain de Meuse/Haute-Marne, 55 - Bure (France); Proudhon, B. [GEO.TER, 34 - Clapiers (France)

    2006-10-15

    Study of fractures along a 490-m vertical section of marl/limestone alternations in the Upper Jurassic (Meuse/Haute-Marne underground research laboratory-eastern Paris Basin) reveals their organization and the different states of palaeo-stress. Type and extension of tectonic structures seem to be controlled principally by lithology and secondary by depth. Also, it appears deviations of Alpine palaeo-stresses between Kimmeridgian and Oxfordian formations. These deviations are related to the presence of marl/limestone contacts. The vertical evolution of current horizontal maximum stress shows a similar behaviour, with deviations at the walls of Callovo-Oxfordian argilites. These results allow us to point out and to discuss the impact of lithology, rheology and depth on fracturing occurrence and distribution. Furthermore, this study suggests the role of Callovo-Oxfordian as a barrier for fracture development between the limestones of Dogger and Oxfordian formations. (authors)

  6. [Application of the anatomic plate and trapezoid plate in comminuted intertrochanteric fracture combined with trochanteric coronal position fracture: a controlled clinical trial].

    Science.gov (United States)

    Zhen, Ping; Liu, Xing-Yan; Gao, Ming-Xuan; Tian, Qi

    2010-05-01

    To investigate the therapeutic effect and operative characteristic of the anatomic plate and trapezoid plate for treament of the comminuted intertrochanteric fracture combined with trochanteric coronal position fracture. From Jan. 1998 to Mar. 2007, 57 patients suffered from comminuted intertrochanteric fracture combined with trochanteric coronal position fracture were randomly divided into two groups, 21 patients in trapezoid plate group were treated with the trapezoid compression plate, included 11 males and 10 females with an average age of 41.8 years; and 36 patients in anatomic plate group were treated with the anatomic plate, included 17 males and 19 females with an average age of 42.1 years. All of the 57 fractures were A3 type according to AO classification. The functions of hip joints were evaluated according to the Harris hip functional standard score. All 57 patients were followed-up for 5 months to 9 years and 3 months with an average of 4.8 years. The healing time of the fractures was from 8 to 20 weeks with an average of 12.8 weeks. The results of Harris scoring showed the pain scores of the anatomic plate group were higher than that of the trapezoid plate group (P 0.05). In unstable comminuted intertrochanteric fracture combined with trochanteric coronal position fracture, the lateral wall of trochanteric is often destroyed. The anatomic plate and the trapeziod compression plate can provide effective internal fixation, while many othere internal fixation methods were limited in this kind of fracture. As compared with the anatomic plate fixation, the trapezoid compression plate fixation of comminuted intertrochanteric fracture combined with trochanteric coronal position fracture have several advantages, such as fewer complications, faster union of fracture and earlier recovery of joint functions.

  7. Dependence of fracture mechanical and fluid flow properties on fracture roughness and sample size

    International Nuclear Information System (INIS)

    Tsang, Y.W.; Witherspoon, P.A.

    1983-01-01

    A parameter study has been carried out to investigate the interdependence of mechanical and fluid flow properties of fractures with fracture roughness and sample size. A rough fracture can be defined mathematically in terms of its aperture density distribution. Correlations were found between the shapes of the aperture density distribution function and the specific fractures of the stress-strain behavior and fluid flow characteristics. Well-matched fractures had peaked aperture distributions that resulted in very nonlinear stress-strain behavior. With an increasing degree of mismatching between the top and bottom of a fracture, the aperture density distribution broadened and the nonlinearity of the stress-strain behavior became less accentuated. The different aperture density distributions also gave rise to qualitatively different fluid flow behavior. Findings from this investigation make it possible to estimate the stress-strain and fluid flow behavior when the roughness characteristics of the fracture are known and, conversely, to estimate the fracture roughness from an examination of the hydraulic and mechanical data. Results from this study showed that both the mechanical and hydraulic properties of the fracture are controlled by the large-scale roughness of the joint surface. This suggests that when the stress-flow behavior of a fracture is being investigated, the size of the rock sample should be larger than the typical wave length of the roughness undulations

  8. Are bi-axial proximal sesamoid bone fractures in the British Thoroughbred racehorse a bone fatigue related fracture? A histological study.

    Science.gov (United States)

    Kristoffersen, M; Hetzel, U; Parkin, T D H; Singer, E R

    2010-01-01

    To investigate whether microfractures and alterations in the trabecular bone area are associated with catastrophic bi-axial proximal sesamoid bone fractures (PSBF). Proximal sesamoid bones (PSB) from 10 racehorses with PSBF and from 10 control racehorses without musculoskeletal injury were examined using the bulk basic fuchsin method. Bone histomorphometric and microfracture analysis was performed, and cases and controls compared using two-sample t-test, paired t-test, and Mann-Whitney U test. There was no significant difference in the microfracture density and the trabecular bone area between bones from case and control horses, and between fractured and non-fractured bones in case horses. Microfracture density was low in the areas of the PSB examined. Microfracture density was not significantly different between groups, indicating that propagation of micro-cracks is an unlikely predisposing pathologic alteration in PSBF in British racehorses. There was no significant difference in the bone surface area between groups, which one would expect if modelling, adaptation and an increase in bone density were associated with PSBF fracture in the case horses. Therefore, PSBF in the British racehorse does not appear to be associated with microfractures of the trabecular bone of the PSB. The PSB fractures might represent an acute monotonic fracture; however, the aetiology of the fractures remains unknown with additional research required.

  9. Effect of Random Natural Fractures on Hydraulic Fracture Propagation Geometry in Fractured Carbonate Rocks

    Science.gov (United States)

    Liu, Zhiyuan; Wang, Shijie; Zhao, Haiyang; Wang, Lei; Li, Wei; Geng, Yudi; Tao, Shan; Zhang, Guangqing; Chen, Mian

    2018-02-01

    Natural fractures have a significant influence on the propagation geometry of hydraulic fractures in fractured reservoirs. True triaxial volumetric fracturing experiments, in which random natural fractures are created by placing cement blocks of different dimensions in a cuboid mold and filling the mold with additional cement to create the final test specimen, were used to study the factors that influence the hydraulic fracture propagation geometry. These factors include the presence of natural fractures around the wellbore, the dimension and volumetric density of random natural fractures and the horizontal differential stress. The results show that volumetric fractures preferentially formed when natural fractures occurred around the wellbore, the natural fractures are medium to long and have a volumetric density of 6-9%, and the stress difference is less than 11 MPa. The volumetric fracture geometries are mainly major multi-branch fractures with fracture networks or major multi-branch fractures (2-4 fractures). The angles between the major fractures and the maximum horizontal in situ stress are 30°-45°, and fracture networks are located at the intersections of major multi-branch fractures. Short natural fractures rarely led to the formation of fracture networks. Thus, the interaction between hydraulic fractures and short natural fractures has little engineering significance. The conclusions are important for field applications and for gaining a deeper understanding of the formation process of volumetric fractures.

  10. Laser induced damage and fracture in fused silica vacuum windows

    International Nuclear Information System (INIS)

    Campbell, J.H.; Hurst, P.A.; Heggins, D.D.; Steele, W.A.; Bumpas, S.E.

    1996-11-01

    Laser-induced damage, that initiates catastrophic fracture, has been observed in large (≤61 cm dia) fused silica lenses that also serve as vacuum barriers in Nova and Beamlet lasers. If the elastic stored energy in the lens is high enough, the lens will fracture into many pieces (implosion). Three parameters control the degree of fracture in the vacuum barrier window: elastic stored energy (tensile stress), ratio of window thickness to flaw depth, and secondary crack propagation. Fracture experiments were conducted on 15-cm dia fused silica windows that contain surface flaws caused by laser damage. Results, combined with window failure data on Beamlet and Nova, were used to develop design criteria for a ''fail-safe'' lens (that may catastrophically fracture but not implode). Specifically, the window must be made thick enough so that the peak tensile stress is less than 500 psi (3.4 MPa) and the thickness/critical flaw size is less than 6. The air leak through the window fracture and into the vacuum must be rapid enough to reduce the load on the window before secondary crack growth occurs. Finite element stress calculations of a window before and immediately following fracture into two pieces show that the elastic stored energy is redistributed if the fragments ''lock'' in place and thereby bridge the opening. In such cases, the peak stresses at the flaw site can increase, leading to further (i.e. secondary) crack growth

  11. Serum of 25-Hydroxyvitamin D and Intact Parathyroid Hormone Levels in Postmenopausal Women with Hip and Upper Limb Fractures.

    Science.gov (United States)

    Lv, Jiang-Tao; Zhang, Ying-Ying; Tian, Shao-Qi; Sun, Kang

    2016-05-01

    To assess the serum of 25-hydroxyvitamin D (25(OH)D) and intact parathyroid hormone (iPTH) levels in postmenopausal women from northern China with hip and upper limb fractures. Case-control. Affiliated Hospital of Qingdao University. Postmenopausal women diagnosed with hip fracture (n = 335) and matched controls without fracture (n = 335). Between 2011 and 2013, fasting venous samples were analyzed for 25(OH)D, iPTH, alkaline phosphatase (ALP), calcium, and phosphorus. All women completed a standardized questionnaire designed to document putative risk factors for fractures. Eight percent of participants had vitamin D deficiency, and 66.0% had secondary hyperparathyroidism. Serum 25(OH)D levels were significantly (P lower in women with hip fracture than in controls. Multivariate logistic regression analysis adjusted for common risk factors showed that serum 25(OH)D of 20 ng/mL or less was an independent indicator of hip fracture (odds ratio (OR) = 2.98, 95% confidence interval (CI) = 2.11-4.20) and concomitant upper limb fracture in those with existing hip fractures (OR = 4.77, 95% CI = 1.60-10.12). The area under the receiver operating characteristic curve of 25(OH)D was 0.77 (95% CI = 0.68-0.84) for hip fracture and 0.80 (95% CI = 0.72-0.89) for hip and upper limb fractures. Vitamin D insufficiency and secondary hyperparathyroidism were a common problem in postmenopausal women who presented with concomitant hip and upper limb fractures, suggesting that they might contribute to the pathophysiology of fractures in postmenopausal women. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  12. Petrous bone fracture: a virtual trauma analysis.

    Science.gov (United States)

    Montava, Marion; Deveze, Arnaud; Arnoux, Pierre-Jean; Bidal, Samuel; Brunet, Christian; Lavieille, Jean-Pierre

    2012-06-01

    The temporal bone shields sensorineural, nervous, and vascular structures explaining the potential severity and complications of trauma related to road and sport accidents. So far, no clear data are available on the exact mechanisms involved for fracture processes. Modelization of structures helps to answer these concerns. Our objective was to design a finite element model of the petrous bone structure to modelize temporal bone fracture propagation in a scenario of lateral impact. A finite element model of the petrous bone structure was designed based on computed tomography data. A 7-m/s lateral impact was simulated to reproduce a typical lateral trauma. Results of model analysis was based on force recorded, stress level on bone structure up to induce a solution of continuity of the bony structure. Model simulation showed that bone fractures follow the main axes of the petrous bone and occurred in a 2-step process: first, a crush, and second, a massive fissuration of the petrous bone. The lines of fracture obtained by simulation of a lateral impact converge toward the middle ear region. This longitudinal fracture is located at the mastoid-petrous pyramid junction. Using this model, it was possible to map petrous bone fractures including fracture chronology and areas of fusion of the middle ear region. This technique may represent a first step to investigate the pathophysiology of the petrous bone fractures, aiming to define prognostic criteria for patients' care.

  13. Experimental validation of microseismic emissions from a controlled hydraulic fracture in a synthetic layered medium

    Science.gov (United States)

    Roundtree, Russell

    A controlled hydraulic fracture experiment was performed on two medium sized (11" x 11" x 15") synthetic layered blocks of low permeability, low porosity Lyons sandstone sandwiched between cement. The purpose of the research was to better understand and characterize the fracture evolution as the fracture tip impinged upon the layer boundaries between the well bonded layers. It is also one of the first documented uses of passive microseismic used in a laboratory environment to characterize hydraulic fracturing. A relatively low viscosity fluid of 1000 centipoise, compared to properly scaled previous work (Casas 2005, and Athavale 2007), was pumped at a constant rate of 10 mL/minute through a steel cased hole landed and isolated in the sandstone layer. Efforts were made to contain the hydraulic fracture within the confines of the rock specimen to retain the created hydraulic fracture geometry. Two identical samples and treatment schedules were created and differed only in the monitoring system used to characterize the microseismic activity during the fracture treatment. The first block had eight embedded P-wave transducers placed in the sandstone layer to record the passive microseismic emissions and localize the location and time of the acoustic event. The second block had six compressional wave transducers and twelve shear wave transducers embedded in the sandstone layer of the block. The intention was to record and process the seismic data using conventional P-wave to S-wave difference timing techniques well known in industry. While this goal ultimately not possible due to the geometry of the receiver placements and the limitations of the Vallene acquisition processing software, the data received and the events localized from the 18 transducer test were of much higher numbers and quality than on the eight transducer test. This experiment proved conclusively that passive seismic emission recording can yield positive results in the laboratory. Just as in the field

  14. Fracture-dissociation of ceramic liner.

    Science.gov (United States)

    Hwang, Sung Kwan; Oh, Jin-Rok; Her, Man Seung; Shim, Young Jun; Cho, Tae Yeun; Kwon, Sung Min

    2008-08-01

    The use of BIOLOX delta ceramic (CeramTec AG, Plochingen, Germany) has been increasing. This ceramic prevents cracking by restraining the phase transformation due to the insertion of nano-sized, yttria-stabilized tetragonal zirconia into the alumina matrix. This restrains the progress of cracking through the formation of platelet-like crystal or whiskers due to the addition of an oxide additive. We observed a case of BIOLOX delta ceramic liner (CeramTec AG) rim fracture 4 months postoperatively. Radiographs showed that the ceramic liner was subluxated from the acetabular cup. Scratches on the acetabular cup and femoral neck were seen, and the fracture was visible on the rim of the liner. Under electron microscope, metal particle coatings from the ceramic liner were identified. The ceramic liner, fracture fragments, and adjacent tissues were removed and replaced with a ceramic liner and femoral head of the same size and design. We believe the mechanism of the fracture-dissociation of the ceramic liner in this case is similar to a case of separation of the ceramic liner from the polyethylene shell in a sandwich-type ceramic-ceramic joint. To prevent ceramic liner fracture-dissociation, the diameter of the femoral neck needs to be decreased in a new design, while the diameter of the femoral head needs to be increased to ensure an increase in range of motion.

  15. [Petrous bone fracture. Our experience: 1999-2004].

    Science.gov (United States)

    Ramírez Sabio, J B; de Paula Vernetta, C; García Sanchís, J M; Callejo García, F J; Cortés Andrés, O; Quilis Quesada, V; Dualde Beltrán, D; Marco Algarra, J

    2006-12-01

    To review the petrous bone fractures during the last five years (1999-2004) in our hospital, its manage, control, and analysis onf the associated factors. To analyse the managing protocoles and current bibliography. We review 266 temporal bone fractures, 74 with petrous bone association. We analyse these fractures by sex distribution, injurie severity, otorhinolaryngological clinical findings, production mechanism and radiological findings. The cases are discussed and compared with current bibliography. Petrous bone fractures must be always suspected in patients with head trauma, specially if it associates severity and otorrhagia. It is necessary a deep colaboration between neurosurgeons, radiologists and otorhinolaryngologists to obtain a good management, control and follow up of the patients.

  16. Effect of whole-body vibration exercise in preventing falls and fractures

    DEFF Research Database (Denmark)

    Jepsen, Ditte Beck; Thomsen, Katja; Hansen, Stinus

    2017-01-01

    OBJECTIVE: To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age. DESIGN: A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity...... of retrieved publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density......2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA. CONCLUSIONS: WBV reduces fall rate but seems to have no overall effect on BMD...

  17. The effect of whole body vibration on fracture healing – a systematic review

    Directory of Open Access Journals (Sweden)

    J Wang

    2017-09-01

    Full Text Available This systematic review examines the efficacy and safety of whole body vibration (WBV on fracture healing. A systematic literature search was conducted with relevant keywords in PubMed and Embase, independently, by two reviewers. Original animal and clinical studies about WBV effects on fracture healing with available full-text and written in English were included. Information was extracted from the included studies for review. In total, 19 articles about pre-clinical studies were selected. Various vibration regimes are reported; of those, the frequencies of 35 Hz and 50 Hz show better results than others. Most of the studies show positive effects on fracture healing after vibration treatment and the responses to vibration are better in ovariectomised (OVX animals than non-OVX ones. However, several studies provide insufficient evidence to support an improvement of fracture healing after vibration and one study even reports disruption of fracture healing after vibration. In three studies, vibration results in positive effects on angiogenesis at the fracture site and surrounding muscles during fracture healing. No serious complications or side effects of vibration are found in these studies. WBV is suggested to be beneficial in improving fracture healing in animals without safety problem reported. In order to apply vibration on fractured patients, more well-designed randomised controlled clinical trials are needed to examine its efficacy, regimes and safety.

  18. Hip fracture in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Zapatero Antonio

    2013-01-01

    Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  19. Case-control study of high-speed exercise history of Thoroughbred and Quarter Horse racehorses that died related to a complete scapular fracture.

    Science.gov (United States)

    Vallance, S A; Entwistle, R C; Hitchens, P L; Gardner, I A; Stover, S M

    2013-05-01

    Identification of exercise history patterns that are related to catastrophic scapular fracture will facilitate prevention of racehorse fatalities. To determine if exercise patterns are associated with scapular fracture in Thoroughbred (TB) and Quarter Horse (QH) racehorses. High-speed exercise histories for 65 TB and 26 QH racehorses that had a complete scapular fracture (cases) and 2 matched control racehorses were retrospectively studied. Exercise variables were created from lifetime race and official timed workout reports. Associations between exercise variables and scapular fracture were investigated using conditional logistic regression. Thoroughbreds with a scapular fracture had a greater number of workouts, events (combined works and races), and mean event distances than QHs with a scapular fracture. Quarter Horses worked less frequently and accumulated distance at a lower rate than TBs. Breed differences were not found for career race number or length, time between races or lay-up variables for horses with ≥1 lay-up. For both breeds, cases had fewer events, lower recent accumulated distance and fewer active days in training than controls; however, a subset of TB cases with >10 events since lay-up had a longer active career than controls. For QHs that had a lay-up, total and mean lay-up times were greater for cases than controls. Multivariable models revealed that odds ratios (OR) of scapular fracture were greater for TBs that had not yet raced (OR = 23.19; 95% confidence interval (CI) 3.03-177.38) and lower for QHs with more events (OR = 0.71; 95% CI 0.54-0.94). Racehorses that are in early high-speed training but behind that of their training cohort should be examined for signs of scapular stress remodelling. Quarter Horses that had a prolonged lay-up and TBs that have endured high-speed training for a longer duration than that of their training cohort also were at greater risk. © 2012 EVJ Ltd.

  20. Design and Fabrication of Automatic Glass Cutting Machine

    Science.gov (United States)

    Veena, T. R.; Kadadevaramath, R. S.; Nagaraj, P. M.; Madhusudhan, S. V.

    2016-09-01

    This paper deals with the design and fabrication of the automatic glass or mirror cutting machine. In order to increase the accuracy of cut and production rate; and decrease the production time and accidents caused due to manual cutting of mirror or glass, this project aims at development of an automatic machine which uses a programmable logic controller (PLC) for controlling the movement of the conveyer and also to control the pneumatic circuit. In this machine, the work of the operator is to load and unload the mirror. The cutter used in this machine is carbide wheel with its cutting edge ground to a V-shaped profile. The PLC controls the pneumatic cylinder and intern actuates the cutter along the glass, a fracture layer is formed causing a mark to be formed below the fracture layer and a crack to be formed below the rib mark. The machine elements are designed using CATIA V5R20 and pneumatic circuit are designed using FESTO FLUID SIM software.

  1. The Influence of Hydraulic Fracturing on Carbon Storage Performance

    Science.gov (United States)

    Fu, Pengcheng; Settgast, Randolph R.; Hao, Yue; Morris, Joseph P.; Ryerson, Frederick J.

    2017-12-01

    Conventional principles of the design and operation of geologic carbon storage (GCS) require injecting CO2 below the caprock fracturing pressure to ensure the integrity of the storage complex. In nonideal storage reservoirs with relatively low permeability, pressure buildup can lead to hydraulic fracturing of the reservoir and caprock. While the GCS community has generally viewed hydraulic fractures as a key risk to storage integrity, a carefully designed stimulation treatment under appropriate geologic conditions could provide improved injectivity while maintaining overall seal integrity. A vertically contained hydraulic fracture, either in the reservoir rock or extending a limited height into the caprock, provides an effective means to access reservoir volume far from the injection well. Employing a fully coupled numerical model of hydraulic fracturing, solid deformation, and matrix fluid flow, we study the enabling conditions, processes, and mechanisms of hydraulic fracturing during CO2 injection. A hydraulic fracture's pressure-limiting behavior dictates that the near-well fluid pressure is only slightly higher than the fracturing pressure of the rock and is insensitive to injection rate and mechanical properties of the formation. Although a fracture contained solely within the reservoir rock with no caprock penetration, would be an ideal scenario, poroelastic principles dictate that sustaining such a fracture could lead to continuously increasing pressure until the caprock fractures. We also investigate the propagation pattern and injection pressure responses of a hydraulic fracture propagating in a caprock subjected to heterogeneous in situ stress. The results have important implications for the use of hydraulic fracturing as a tool for managing storage performance.

  2. Role of MRI in hip fractures, including stress fractures, occult fractures, avulsion fractures

    International Nuclear Information System (INIS)

    Nachtrab, O.; Cassar-Pullicino, V.N.; Lalam, R.; Tins, B.; Tyrrell, P.N.M.; Singh, J.

    2012-01-01

    MR imaging plays a vital role in the diagnosis and management of hip fractures in all age groups, in a large spectrum of patient groups spanning the elderly and sporting population. It allows a confident exclusion of fracture, differentiation of bony from soft tissue injury and an early confident detection of fractures. There is a spectrum of MR findings which in part is dictated by the type and cause of the fracture which the radiologist needs to be familiar with. Judicious but prompt utilisation of MR in patients with suspected hip fractures has a positive therapeutic impact with healthcare cost benefits as well as social care benefits.

  3. Paratrooper's ankle fracture: posterior malleolar fracture.

    Science.gov (United States)

    Young, Ki Won; Kim, Jin-su; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

    2015-03-01

    We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to

  4. Fracture resistance of computer-aided design and computer-aided manufacturing ceramic crowns cemented on solid abutments.

    Science.gov (United States)

    Stona, Deborah; Burnett, Luiz Henrique; Mota, Eduardo Gonçalves; Spohr, Ana Maria

    2015-07-01

    Because no information was found in the dental literature regarding the fracture resistance of all-ceramic crowns using CEREC (Sirona) computer-aided design and computer-aided manufacturing (CAD-CAM) system on solid abutments, the authors conducted a study. Sixty synOcta (Straumann) implant replicas and regular neck solid abutments were embedded in acrylic resin and randomly assigned (n = 20 per group). Three types of ceramics were used: feldspathic, CEREC VITABLOCS Mark II (VITA); leucite, IPS Empress CAD (Ivoclar Vivadent); and lithium disilicate, IPS e.max CAD (Ivoclar Vivadent). The crowns were fabricated by the CEREC CAD-CAM system. After receiving glaze, the crowns were cemented with RelyX U200 (3M ESPE) resin cement under load of 1 kilogram. For each ceramic, one-half of the specimens were subjected to the fracture resistance testing in a universal testing machine with a crosshead speed of 1 millimeter per minute, and the other half were subjected to the fractured resistance testing after 1,000,000 cyclic fatigue loading at 100 newtons. According to a 2-way analysis of variance, the interaction between the material and mechanical cycling was significant (P = .0001). According to a Tukey test (α = .05), the fracture resistance findings with or without cyclic fatigue loading were as follows, respectively: CEREC VITABLOCKS Mark II (405 N/454 N) was statistically lower than IPS Empress CAD (1169 N/1240 N) and IPS e.max CAD (1378 N/1025 N) (P Empress CAD and IPS e.max CAD did not differ statistically (P > .05). According to a t test, there was no statistical difference in the fracture resistance with and without cyclic fatigue loading for CEREC VITABLOCS Mark II and IPS Empress CAD (P > .05). For IPS e.max CAD, the fracture resistance without cyclic fatigue loading was statistically superior to that obtained with cyclic fatigue loading (P Empress CAD and IPS e.max CAD showed higher fracture resistance compared with CEREC VITABLOCS Mark II. The cyclic

  5. Fracture and Fatigue: Some New Insights

    Indian Academy of Sciences (India)

    It is over nine decades since fracture mechanics found its importance in the design of mechanical, aerospace and civil engineering structures. Its application started in naval structures during the early part of 20th century. The theory of fracture mechanics was initially found ideal to explain the failure of brittle materials like ...

  6. Finnie's notes on fracture mechanics fundamental and practical lessons

    CERN Document Server

    Dharan, C K H; Finnie, Iain

    2016-01-01

    This textbook consists primarily of notes by Iain Finnie who taught a popular course on fracture mechanics at the University of California at Berkeley. It presents a comprehensive and detailed exposition of fracture, the fundamentals of fracture mechanics and procedures for the safe design of engineering components made from metal alloys, brittle materials like glasses and ceramics, and composites. Interesting and practical problems are listed at the end of most chapters to give the student practice in applying the theory. A solutions manual is provided to the instructor. The text presents a unified perspective of fracture with a strong fundamental foundation and practical applications. In addition to its role as a text, this reference would be invaluable for the practicing engineer who is involved in the design and evaluation of components that are fracture critical. This book also: Presents details of derivations of the basic equations of fracture mechanics and the historical context of the development of f...

  7. The impact of in-situ stress and outcrop-based fracture geometry on hydraulic aperture and upscaled permeability in fractured reservoirs

    DEFF Research Database (Denmark)

    Bisdom, Kevin; Bertotti, Giovanni; Nick, Hamid

    2016-01-01

    explicitly, we quantify equivalent permeability, i.e. combined matrix and stress-dependent fracture flow. Fracture networks extracted from a large outcropping pavement form the basis of these models. The results show that the angle between fracture strike and σ 1 has a controlling impact on aperture...

  8. Patients with rett syndrome sustain low-energy fractures

    DEFF Research Database (Denmark)

    Roende, Gitte; Ravn, Kirstine; Fuglsang, Kathrine

    2011-01-01

    We present the first case-control study addressing both fracture occurrence and fracture mechanisms in Rett syndrome (RTT). Two previous studies have shown increased fracture risk in RTT. This was also our hypothesis regarding the Danish RTT population. Therefore, we investigated risk factors...

  9. Fracture occurrence from radionuclides in the skeleton

    Energy Technology Data Exchange (ETDEWEB)

    Lloyd, R.D.; Taylor, G.N.; Miller, S.C.

    2000-06-01

    Because skeletal fractures were an important finding among persons contaminated with {sup 226}Ra, experience with fractures among dogs in the colony was summarized to determine the projected significance for persons contaminated with bone-seeking radionuclides. Comparison by Fisher's Exact Test of lifetime fracture occurrence in the skeletons of beagles injected as young adults suggested that for animals given {sup 226}Ra, {sup 228}Ra, {sup 228}Th, or {sup 239}Pu citrate, there was probably an excess over controls in fractures of the ribs, leg bones, spinous processes, and pelvis (os coxae) plus the mandible for dogs given {sup 226}Ra and the scapulae for dogs given {sup 228}Ra or 228 Th. Regression analysis indicated that significantly elevated fracture occurrence was especially notable at the higher radiation doses, at about 50 Gy average skeletal dose for {sup 239}Pu, 140 Gy for {sup 226}Ra, about 40 Gy for {sup 228}Ra, and more than 15 Gy for {sup 228}Th. The average number of fractures per dog was significantly elevated over that noted in controls for the highest radiation doses of {sup 239}Pu and {sup 226}Ra and for the higher doses of {sup 228}Ra and {sup 228}Th. For those dogs given {sup 90}Sr citrate, there was virtually no important difference from control beagles not given radionuclides, even at group mean cumulative skeletal radiation doses up to 101 Gy. Because of a large proportion of dogs with fractures that died with bone malignancy (even at dosage levels lower than those exhibiting an excess average number of fractures per dog), they conclude that fracture would not be an important endpoint at lower levels of plutonium contamination in humans such as would be expected to occur from occupational or environmental exposure.

  10. Schizophrenia, antipsychotics and risk of hip fracture

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Jensen, Signe O W; Nielsen, Jimmi

    2013-01-01

    In a nationwide study using linkage of Danish hospital registers we examined predictors of hip fracture (ICD-10: S72) in 15,431 patients with schizophrenia (ICD-10: F20 or ICD-8: 295) and 3,807,597 population controls. Shorter education, disability pension, lifetime alcohol abuse, somatic co......-morbidity, antipsychotics (IRR=1.19; 95% CI 1.15-1.24), antidepressant (IRR=1.18; 95% CI 1.16-1.20), anticholinergics (IRR=1.29; 95% CI 1.22-1.36), benzodiazepines (IRR=1.06; 95% CI 1.04-1.08) and corticosteroids (IRR=1.44; 95% CI 1.36-1.53) were significant predictors. In 556 persons with schizophrenia and hip fracture...... (matched to 1:3 to schizophrenia controls without hip fracture), antipsychotic polypharmacy predicted hip fracture. Analyses among antipsychotic monotherapy patients showed no differential effect of individual antipsychotics. A dose-response relationship of hip fracture and lifetime antipsychotics...

  11. Receiver-exciter controller design

    Science.gov (United States)

    Jansma, P. A.

    1982-01-01

    A description of the general design of both the block 3 and block 4 receiver-exciter controllers for the Deep Space Network (DSN) Mark IV-A System is presented along with the design approach. The controllers are designed to enable the receiver-exciter subsystem (RCV) to be configured, calibrated, initialized and operated from a central location via high level instructions. The RECs are designed to be operated under the control of the DMC subsystem. The instructions are in the form of standard subsystem blocks (SSBs) received via the local area network (LAN). The centralized control provided by RECs and other DSCC controllers in Mark IV-A is intended to reduce DSN operations costs from the Mark III era.

  12. Fracture Behavior and Properties of Functionally Graded Fiber-Reinforced Concrete

    International Nuclear Information System (INIS)

    Roesler, Jeffery; Bordelon, Amanda; Gaedicke, Cristian; Park, Kyoungsoo; Paulino, Glaucio

    2008-01-01

    In concrete pavements, a single concrete mixture design is selected to resist mechanical loading without attempting to adversely affect the concrete pavement shrinkage, ride quality, or noise attenuation. An alternative approach is to design distinct layers within the concrete pavement surface which have specific functions thus achieving higher performance at a lower cost. The objective of this research was to address the structural benefits of functionally graded concrete materials (FGCM) for rigid pavements by testing and modeling the fracture behavior of different combinations of layered plain and synthetic fiber-reinforced concrete materials. Fracture parameters and the post-peak softening behavior were obtained for each FGCM beam configuration by the three point bending beam test. The peak loads and initial fracture energy between the plain, fiber-reinforced, and FGCM signified similar crack initiation. The total fracture energy indicated improvements in fracture behavior of FGCM relative to full-depth plain concrete. The fracture behavior of FGCM depended on the position of the fiber-reinforced layer relative to the starter notch. The fracture parameters of both fiber-reinforced and plain concrete were embedded into a finite element-based cohesive zone model. The model successfully captured the experimental behavior of the FGCMs and predicted the fracture behavior of proposed FGCM configurations and structures. This integrated approach (testing and modeling) demonstrates the viability of FGCM for designing layered concrete pavements system

  13. Issues concerning the use of hormone replacement therapy and risk of fracture: a population-based, nested case-control study.

    Science.gov (United States)

    Corrao, Giovanni; Zambon, Antonella; Nicotra, Federica; Conti, Valentino; Nappi, Rossella E; Merlino, Luca

    2008-01-01

    To investigate the effect of duration, how recently it has been used, and age at start of hormone replacement therapy (HRT) and the risk of bone fracture. A population-based, nested case-control study was conducted in Lombardia, Northern Italy. The 78,294 women aged 45-75 years who received at least one HRT prescription during 1998-2000 were followed until 2005. Cases were women who experienced bone fracture during follow-up. Up to six controls were randomly selected for each case from the cohort after matching for age and date of cohort entry. The odds ratio of fracture associated with the use of HRT was estimated by conditional logistic regression. One thousand one hundred and seventy-four cases and 6760 controls were included. Compared with women who took HRT for less than 2 months, those who were treated for more than 20 months had an odds ratio (OR) of 0.80 (95% confidence interval 0.65, 0.99). This risk reduction was still significant among current HRT users (OR 0.71, 95% CI 0.55, 0.90) and in women who began therapy at the age of 55-65 years (OR 0.63, 95% CI 0.42, 0.94) or 65-75 years (OR 0.56, 95% CI 0.32, 0.99). There was no statistical evidence of a protective effect for women who had stopped treatment more than 6 months previously or those who began HRT at the age of 45-55 years. HRT should be continued for long periods to achieve an optimal protection from fracture. The fracture reducing potential of HRT seems to disappear after a few months without treatment and might mainly act in women who begin therapy at older age.

  14. Elastic Rock Heterogeneity Controls Brittle Rock Failure during Hydraulic Fracturing

    Science.gov (United States)

    Langenbruch, C.; Shapiro, S. A.

    2014-12-01

    For interpretation and inversion of microseismic data it is important to understand, which properties of the reservoir rock control the occurrence probability of brittle rock failure and associated seismicity during hydraulic stimulation. This is especially important, when inverting for key properties like permeability and fracture conductivity. Although it became accepted that seismic events are triggered by fluid flow and the resulting perturbation of the stress field in the reservoir rock, the magnitude of stress perturbations, capable of triggering failure in rocks, can be highly variable. The controlling physical mechanism of this variability is still under discussion. We compare the occurrence of microseismic events at the Cotton Valley gas field to elastic rock heterogeneity, obtained from measurements along the treatment wells. The heterogeneity is characterized by scale invariant fluctuations of elastic properties. We observe that the elastic heterogeneity of the rock formation controls the occurrence of brittle failure. In particular, we find that the density of events is increasing with the Brittleness Index (BI) of the rock, which is defined as a combination of Young's modulus and Poisson's ratio. We evaluate the physical meaning of the BI. By applying geomechanical investigations we characterize the influence of fluctuating elastic properties in rocks on the probability of brittle rock failure. Our analysis is based on the computation of stress fluctuations caused by elastic heterogeneity of rocks. We find that elastic rock heterogeneity causes stress fluctuations of significant magnitude. Moreover, the stress changes necessary to open and reactivate fractures in rocks are strongly related to fluctuations of elastic moduli. Our analysis gives a physical explanation to the observed relation between elastic heterogeneity of the rock formation and the occurrence of brittle failure during hydraulic reservoir stimulations. A crucial factor for understanding

  15. Does Alendronate reduce the risk of fracture in men? A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women

    Directory of Open Access Journals (Sweden)

    Papaioannou Alexandra

    2005-07-01

    Full Text Available Abstract Background Alendronate has been found to reduce the risk of fractures in postmenopausal women as demonstrated in multiple randomized controlled trials enrolling thousands of women. Yet there is a paucity of such randomized controlled trials in osteoporotic men. Our objective was to systematically review the anti-fracture efficacy of alendronate in men with low bone mass or with a history of prevalent fracture(s and incorporate prior knowledge of alendronate efficacy in women in the analysis. Methods We examined randomized controlled trials in men comparing the anti-fracture efficacy of alendronate to placebo or calcium or vitamin D, or any combination of these. Studies of men with secondary causes of osteoporosis other than hypogonadism were excluded. We searched the following electronic databases (without language restrictions for potentially relevant citations: Medline, Medline in Process (1966-May 24/2004, and Embase (1996–2004. We also contacted the manufacturer of the drug in search of other relevant trials. Two reviewers independently identified two trials (including 375 men, which met all inclusion criteria. Data were abstracted by one reviewer and checked by another. Results of the male trials were pooled using Bayesian random effects models, incorporating prior information of anti-fracture efficacy from meta-analyses of women. Results The odds ratios of incident fractures in men (with 95% credibility intervals with alendronate (10 mg daily were: vertebral fractures, 0.44 (0.23, 0.83 and non-vertebral fractures, 0.60 (0.29, 1.44. Conclusion In conclusion, alendronate decreases the risk of vertebral fractures in men at risk. There is currently insufficient evidence of a statistically significant reduction of non-vertebral fractures, but the paucity of trials in men limit the statistical power to detect such an effect.

  16. Scintigraphic follow-up of fracture healing in animals

    International Nuclear Information System (INIS)

    Klug, W.; Franke, W.G.; Schulze, M.

    1983-01-01

    Secondary bone fracture heating was analysed by scintigraphic follow-up studies in rabbits using sup(99m)Tc-HEDP. 24 hours after fracture the activity ratio between the fractured and the non-fractured lower limb was 2,2. The maximal count density in the fracture region is found during the 14th and 28th day after fracture. Concomitantly there is a significant increase of bone marrow vessels and content of copper, magnesium, sodium and water in the callus. Although roentgenographic controls and static investigations with respect to consolidation reveal a complete heating already 126 days after fracture, the complete scintigraphic normalisation of the lower limb fracture of the rabbit is found not earlier than at the 203rd day after fracture. (orig.) [de

  17. Scintigraphic follow-up of fracture healing in animals

    Energy Technology Data Exchange (ETDEWEB)

    Klug, W.; Franke, W.G.; Schulze, M.

    1983-08-01

    Secondary bone fracture healing was analysed by scintigraphic follow-up studies in rabbits using sup(99m)Tc-HEDP. 24 hours after fracture the activity ratio between the fractured and the non-fractured lower limb was 2,2. The maximal count density in the fracture region is found during the 14th and 28th day after fracture. Concomitantly there is a significant increase of bone marrow vessels and content of copper, magnesium, sodium and water in the callus. Although roentgenographic controls and static investigations with respect to consolidation reveal a complete healing already 126 days after fracture, the complete scintigraphic normalisation of the lower limb fracture of the rabbit is found not earlier than at the 203rd day after fracture.

  18. Fracture Characterization in Reactive Fluid-Fractured Rock Systems Using Tracer Transport Data

    Science.gov (United States)

    Mukhopadhyay, S.

    2014-12-01

    Fractures, whether natural or engineered, exert significant controls over resource exploitation from contemporary energy sources including enhanced geothermal systems and unconventional oil and gas reserves. Consequently, fracture characterization, i.e., estimating the permeability, connectivity, and spacing of the fractures is of critical importance for determining the viability of any energy recovery program. While some progress has recently been made towards estimating these critical fracture parameters, significant uncertainties still remain. A review of tracer technology, which has a long history in fracture characterization, reveals that uncertainties exist in the estimated parameters not only because of paucity of scale-specific data but also because of knowledge gaps in the interpretation methods, particularly in interpretation of tracer data in reactive fluid-rock systems. We have recently demonstrated that the transient tracer evolution signatures in reactive fluid-rock systems are significantly different from those in non-reactive systems (Mukhopadhyay et al., 2013, 2014). For example, the tracer breakthrough curves in reactive fluid-fractured rock systems are expected to exhibit a long pseudo-state condition, during which tracer concentration does not change by any appreciable amount with passage of time. Such a pseudo-steady state condition is not observed in a non-reactive system. In this paper, we show that the presence of this pseudo-steady state condition in tracer breakthrough patterns in reactive fluid-rock systems can have important connotations for fracture characterization. We show that the time of onset of the pseudo-steady state condition and the value of tracer concentration in the pseudo-state condition can be used to reliably estimate fracture spacing and fracture-matrix interface areas.

  19. The development of a comprehensive multidisciplinary care pathway for patients with a hip fracture: design and results of a clinical trial.

    Science.gov (United States)

    Flikweert, Elvira R; Izaks, Gerbrand J; Knobben, Bas A S; Stevens, Martin; Wendt, Klaus

    2014-05-30

    Hip fractures frequently occur in older persons and severely decrease life expectancy and independence. Several care pathways have been developed to lower the risk of negative outcomes but most pathways are limited to only one aspect of care. The aim of this study was therefore to develop a comprehensive care pathway for older persons with a hip fracture and to conduct a preliminary analysis of its effect. A comprehensive multidisciplinary care pathway for patients aged 60 years or older with a hip fracture was developed by a multidisciplinary team. The new care pathway was evaluated in a clinical trial with historical controls. The data of the intervention group were collected prospectively. The intervention group included all patients with a hip fracture who were admitted to University Medical Center Groningen between 1 July 2009 and 1 July 2011. The data of the control group were collected retrospectively. The control group comprised all patients with a hip fracture who were admitted between 1 January 2006 and 1 January 2008. The groups were compared with the independent sample t-test, the Mann-Whitney U-test or the Chi-squared test (Phi test). The effect of the intervention on fasting time and length of stay was adjusted by linear regression analysis for differences between the intervention and control group. The intervention group included 256 persons (women, 68%; mean age (SD), 78 (9) years) and the control group 145 persons (women, 72%; mean age (SD), 80 (10) years). Median preoperative fasting time and median length of hospital stay were significantly lower in the intervention group: 9 vs. 17 hours (p < 0.001), and 7 vs. 11 days (p < 0.001), respectively. A similar result was found after adjustment for age, gender, living condition and American Society of Anesthesiologists (ASA) classification. In-hospital mortality was also lower in the intervention group: 2% vs. 6% (p < 0.05). There were no statistically significant differences in other

  20. Hip Fracture-Related Pain Strongly Influences Functional Performance of Patients With an Intertrochanteric Fracture Upon Discharge From the Hospital

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange

    2013-01-01

    .7 seconds to perform the TUG. No significant differences were observed in baseline characteristics or pain medication given for patients with a cervical versus an intertrochanteric fracture (P ≥ .22), but patients with an intertrochanteric fracture presented more often with moderate to severe pain during......OBJECTIVE: To examine whether functional performance upon hospital discharge is influenced by pain in the region of the hip fracture or related to the fracture type. DESIGN: Prospective observational study. SETTING: A 20-bed orthopedic hip fracture unit. PATIENTS: Fifty-five cognitively intact...... patients (20 men and 35 women; ages 75.8 ± 10 years), 33 with a cervical hip fracture and 22 with an intertrochanteric hip fracture, all of whom were allowed to bear full weight after surgery. METHODS: All patients were evaluated upon discharge from the hospital to their own homes at a mean of 10 ± 6 days...

  1. Scapular fracture: lower severity and mortality

    Directory of Open Access Journals (Sweden)

    Javad Salimi

    Full Text Available CONTEXT AND OBJECTIVE: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures. DESIGN AND SETTING: Cross-sectional study of trauma patients treated at six general hospitals in Tehran. METHODS: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study. RESULTS: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%. Road traffic accidents (RTAs were the main cause of injury (73.2%; 30/41. Pedestrians accounted for 46.7% (14/30 of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%. Body fractures were the most common type of scapular fractures (80%. Eighteen patients (43.9% had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%. Three patients (7.3% had severe injuries (injury severity score, ISS > 16 which resulted in one death (2.4%. The majority of the patients were treated conservatively (87.8%. CONCLUSIONS: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.

  2. Higher Fish Intake Is Associated with a Lower Risk of Hip Fractures in Chinese Men and Women: A Matched Case-Control Study

    OpenAIRE

    Fan, Fan; Xue, Wen-Qiong; Wu, Bao-Hua; He, Ming-Guang; Xie, Hai-Li; Ouyang, Wei-Fu; Tu, Su-lan; Chen, Yu-Ming

    2013-01-01

    OBJECTIVES: Fish is rich in nutrients that are favorable to bone health, but limited data are available regarding the relationship between fish intake and hip fractures. Our study examined the association between habitual fish intake and risk of hip fractures. METHODS: A case-control study was performed between June 2009 and June 2012 in Guangdong Province, China. Five hundred and eighty-one hip fracture incident cases, aged 55 to 80 years (mean: 71 years), were enrolled from four hospitals. ...

  3. A Biomechanical Study Comparing Helical Blade with Screw Design for Sliding Hip Fixations of Unstable Intertrochanteric Fractures

    Directory of Open Access Journals (Sweden)

    Qiang Luo

    2013-01-01

    Full Text Available Dynamic hip screw (DHS is a well-established conventional implant for treating intertrochanteric fracture. However, revision surgery sometimes still occurs due to the cutting out of implants. A helical blade instead of threaded screw (DHS blade was designed to improve the fixation power of the osteoporotic intertrochanteric fracture. In this study, the biomechanical properties of DHS blade compared to the conventional DHS were evaluated using an unstable AO/OTA 31-A2 intertrochanteric fracture model. Fifty synthetic proximal femoral bone models with such configuration were fixed with DHS and DHS blade in five different positions: centre-centre (CC, superior-centre (SC, inferior-center (IC, centre-anterior (CA, and centre-posterior (CP. All models had undergone mechanical compression test, and the vertical and rotational displacements were recorded. The results showed that DHS blade had less vertical or rotational displacement than the conventional DHS in CC, CA, and IC positions. The greatest vertical and rotational displacements were found at CP position in both groups. Overall speaking, DHS blade was superior in resisting vertical or rotational displacement in comparison to conventional DHS, and the centre-posterior position had the poorest performance in both groups.

  4. The Hip Fracture Surgery in Elderly Patients (HIPELD study: protocol for a randomized, multicenter controlled trial evaluating the effect of xenon on postoperative delirium in older patients undergoing hip fracture surgery

    Directory of Open Access Journals (Sweden)

    Coburn Mark

    2012-09-01

    Full Text Available Abstract Background Strategies to protect the brain from postoperative delirium (POD after hip fracture are urgently needed. The development of delirium often is associated with the loss of independence, poor functional recovery, and increased morbidity, as well as increases in length of hospital stay, discharges to nursing facilities, and healthcare costs. We hypothesize that xenon may reduce the burden of POD, (i by avoiding the need to provide anesthesia with a drug that targets the γ-amino-butyric acid (GABAA receptor and (ii through beneficial anesthetic and organ-protective effects. Methods and design An international, multicenter, phase 2, prospective, randomized, blinded, parallel group and controlled trial to evaluate the incidence of POD, diagnosed with the Confusion Assessment Method (CAM, in older patients undergoing hip fracture surgery under general anesthesia with xenon or sevoflurane, for a period of 4 days post surgery (primary outcome is planned. Secondary objectives are to compare the incidence of POD between xenon and sevoflurane, to evaluate the incidence of POD from day 5 post surgery until discharge from hospital, to determine the time to first POD diagnosis, to evaluate the duration of POD, to evaluate the evolution of the physiological status of the patients in the postoperative period, to evaluate the recovery parameters, to collect preliminary data to evaluate the economical impact of POD in the postoperative period and to collect safety data. Patients are eligible if they are older aged (≥ 75 years and assigned to a planned hip fracture surgery within 48 h after the hip fracture. Furthermore, patients need to be willing and able to complete the requirements of this study including the signature of the written informed consent. A total of 256 randomized patients in the 10 participating centers will be recruited, that is, 128 randomized patients in each of the 2 study groups (receiving either xenon or sevoflurane

  5. Design of mechanical joints

    CERN Document Server

    Blake, Alexander

    2018-01-01

    A cornerstone publication that covers the basic principles and practical considerations of design methodology for joints held by rivets, bolts, weld seams, and adhesive materials, Design of Mechanical Joints gives engineers the practical results and formulas they need for the preliminary design of mechanical joints, combining the essential topics of joint mechanics...strength of materials...and fracture control to provide a complete treatment of problems pertinent to the field of mechanical connections.

  6. Experimental and numerical study of radial lateral fracturing for coalbed methane

    International Nuclear Information System (INIS)

    Fu, Xuan; Li, Gensheng; Huang, Zhongwei; Liang, Yuesong; Xu, Zhengming; Jin, Xiao

    2015-01-01

    Drilling ultra-short radius horizontal laterals in a vertical well and then operating hydraulic fracturing (radial lateral fracturing, abbreviated as RLF) is proposed as a prospective novel method to increase the single-well productivity for coalbed methane (CBM) development. The objective of this article is to find the best fracture network profile RLF can generate and what kind of formation is suitable for this fracturing technique. Experiments using a true tri-axial fracturing simulation system are designed to analyse the influence of different lateral length, count and azimuth on the fracturing initiation and propagation. A numerical simulation is also carried out to study the sensitivity of the coal integrity and in situ stress state on the fracture initiation type. Our work shows that: the best effect of RLF is achieved when it initiates from the bedding plane where the laterals lie and forms a fracture network with one main horizontal fracture connecting multiple vertical fractures; the breakdown and injection pressure will be decreased by increasing the lateral length and count; increasing the lateral length can enlarge the horizontal fracture area; the optimal lateral design for horizontal initiation is four laterals with the phase of 90° and each lateral is at 45° from the horizontal stress; RLF is suitable for the intact coal seams in which cracks or cleats are not well developed and the overburden stress should be close to or less than the maximum horizontal stress. This paper will provide the experimental support and theoretical bases for CBM RLF design. (paper)

  7. Dynamic fracture toughness data for CASTOR registered casks

    International Nuclear Information System (INIS)

    Winkler, H.P.; Trubitz, P.; Pusch, G.; Warnke, E.P.; Beute, K.; Novotny, V.

    2004-01-01

    For the use of cast iron spherical graphite for heavy-sectioned casks for transportation and storage of radiactive materials a complete failure assessment including fracture mechanical analysis is necessary. The casks require an elaborate fracture mechanics design based on fracture mechanics evaluation. The extension of the existing code with respect to dynamic loading takes account new developments to extend the field of applications. It also includes new criteria to design these casks against operating and accident loadings. A fundamental requirement for the realisation of this standard and the calculation of admissible crack lengths of stresses under dynamic loads is the availability of fracture mechanical data. The paper presents-as a part of a large test-program-first results of dynamic fracture-toughness-investigations depending on structure and temperature. The test-program will incorporate investigations on more then 2500 specimens. The investigations that will be done include static and dynamic fracture mechanics tests, dynamic tensile and pressure-tests on different formed specimens. The temperatures and other test conditions follows the IAEA-regulations and the real service conditions. The test-program will be realised in partnership with different institutes

  8. Fracturing Fluid Leak-off for Deep Volcanic Rock in Zhungeer Basin: Mechanism and Control Method

    OpenAIRE

    Huang Bo; Cheng Hao; He Yidong; Fu Yanming

    2017-01-01

    The deep volcanic reservoir in Zhungeer Basin is buried in over 4000m depth, which is characterized by complex lithology (breccia, andesite, basalt, etc.), high elastic modulus and massive natural fractures. During hydraulic fracturing, hydraulic fracture will propagate and natural fractures will be triggered by the increasing net pressure. However, the extension of fractures, especially natural fractures, would aggravate the leak-off effect of fracturing fluid, and consequently decrease the ...

  9. The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)--quality of life during the first 4 months after fracture.

    Science.gov (United States)

    Borgström, F; Lekander, I; Ivergård, M; Ström, O; Svedbom, A; Alekna, V; Bianchi, M L; Clark, P; Curiel, M D; Dimai, H P; Jürisson, M; Kallikorm, R; Lesnyak, O; McCloskey, E; Nassonov, E; Sanders, K M; Silverman, S; Tamulaitiene, M; Thomas, T; Tosteson, A N A; Jönsson, B; Kanis, J A

    2013-03-01

    The quality of life during the first 4 months after fracture was estimated in 2,808 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss. The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS. ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire. The total sample for the analysis was 2,808 patients (1,273 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not. The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries.

  10. Perimenopausal wrist fracture - An opportunity for prevention and ...

    African Journals Online (AJOL)

    Those identified were subjected to further review to establish rates of osteoporosis and/or hip fracture. Osteoporosis and/or hip fracture rates were also determined for a control population. Main outcome measures: Osteoporosis investigation and management rates in controls v, subjects who had experienced a previous ...

  11. Studies on groundwater transport in fractured crystalline rock under controlled conditions using nonradioactive tracers

    International Nuclear Information System (INIS)

    Gustafsson, E.; Klockars, C.-E.

    1981-04-01

    The purpose of the investigation has been study the following parameters along existing fractures between two boreholes: hydraulic properties of rock mass and fractures; adsorptive properties of some selected tracers during transport along fractures; dispersivity and dilution of tracers during transport in fractures; kinematic porosity of fractured bedrock. The procedure has been to determine the hydraulic properties of a rock mass by means of conventional hydraulic testing methods in 100 m deep boreholes, and to study transport mechanisms and properties of selected tracers in a selected fracture zone between two boreholes. (Auth.)

  12. Does self-efficacy mediate functional change in older adults participating in an exercise program after hip fracture? A randomized controlled trial.

    Science.gov (United States)

    Chang, Feng-Hang; Latham, Nancy K; Ni, Pengsheng; Jette, Alan M

    2015-06-01

    To examine whether self-efficacy mediated the effect of the Home-based Post-Hip Fracture Rehabilitation program on activity limitations in older adults after hip fracture and whether the mediating effect was different between sex and age groups. Randomized controlled trial. Community. Participants with hip fracture (N=232; mean age ± SD, 79±9.4y) were randomly assigned to intervention (n=120, 51.7%) and attention control (n=112, 48.3%) groups. The 6-month intervention, the Home-based Post-Hip Fracture Rehabilitation, is a functionally oriented, home-based exercise program. Data were collected at baseline, postintervention (6mo), and follow-up (9mo). Activity Measure for Post-Acute Care. The mediating effect of the Home-based Post-Hip Fracture Rehabilitation program on Basic Mobility function through self-efficacy for exercise was significant at 9 months (βindirect=.21). Similarly, the mediating effect of the intervention on Daily Activity function through self-efficacy for exercise was significant at 9 months (βindirect=.49). In subgroup analyses, the mediating effect was significant at 9 months in the younger group (age, ≤79y) in comparison to the older group and was significant in women in comparison to men. Self-efficacy may play a partial mediating role in the effect on some longer-term functional outcomes in the Home-based Post-Hip Fracture Rehabilitation intervention. The results suggest that program components that target self-efficacy should be incorporated in future hip fracture rehabilitation interventions. Age and sex of the targeted participants may also need to be considered when developing interventions. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Rib fractures in trauma patients: does operative fixation improve outcome?

    Science.gov (United States)

    Majak, Peter; Næss, Pål A

    2016-12-01

    Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively. Although patient selection and timing of the operation seem crucial for successful outcome, no consensus exists. Mortality reduction has only been shown in a few studies. Most studies are retrospective cohort and case-control studies. Only four randomized control trials exist. Conservative treatment, consisting of respiratory assistance and pain control, is still the treatment of choice in the vast majority of patients with multiple rib fractures. In selected patients, operative fixation of fractured ribs within 72 h postinjury may lead to better outcome. More randomized control trials are needed to further determine who benefits from surgical fixation of rib fractures.

  14. Self-Reported Fractures in Dermatitis Herpetiformis Compared to Coeliac Disease

    Directory of Open Access Journals (Sweden)

    Camilla Pasternack

    2018-03-01

    Full Text Available Dermatitis herpetiformis (DH is a cutaneous manifestation of coeliac disease. Increased bone fracture risk is known to associate with coeliac disease, but this has been only scantly studied in DH. In this study, self-reported fractures and fracture-associated factors in DH were investigated and compared to coeliac disease. Altogether, 222 DH patients and 129 coeliac disease-suffering controls were enrolled in this study. The Disease Related Questionnaire and the Gastrointestinal Symptom Rating Scale and Psychological General Well-Being questionnaires were mailed to participants; 45 out of 222 (20% DH patients and 35 out of 129 (27% of the coeliac disease controls had experienced at least one fracture (p = 0.140. The cumulative lifetime fracture incidence did not differ between DH and coeliac disease patients, but the cumulative incidence of fractures after diagnosis was statistically significantly higher in females with coeliac disease compared to females with DH. The DH patients and the coeliac disease controls with fractures reported more severe reflux symptoms compared to those without, and they also more frequently used proton-pump inhibitor medication. To conclude, the self-reported lifetime bone fracture risk is equal for DH and coeliac disease. After diagnosis, females with coeliac disease have a higher fracture risk than females with DH.

  15. Self-Reported Fractures in Dermatitis Herpetiformis Compared to Coeliac Disease

    Science.gov (United States)

    Pasternack, Camilla; Mansikka, Eriika; Kaukinen, Katri; Hervonen, Kaisa; Reunala, Timo; Collin, Pekka; Mattila, Ville M.

    2018-01-01

    Dermatitis herpetiformis (DH) is a cutaneous manifestation of coeliac disease. Increased bone fracture risk is known to associate with coeliac disease, but this has been only scantly studied in DH. In this study, self-reported fractures and fracture-associated factors in DH were investigated and compared to coeliac disease. Altogether, 222 DH patients and 129 coeliac disease-suffering controls were enrolled in this study. The Disease Related Questionnaire and the Gastrointestinal Symptom Rating Scale and Psychological General Well-Being questionnaires were mailed to participants; 45 out of 222 (20%) DH patients and 35 out of 129 (27%) of the coeliac disease controls had experienced at least one fracture (p = 0.140). The cumulative lifetime fracture incidence did not differ between DH and coeliac disease patients, but the cumulative incidence of fractures after diagnosis was statistically significantly higher in females with coeliac disease compared to females with DH. The DH patients and the coeliac disease controls with fractures reported more severe reflux symptoms compared to those without, and they also more frequently used proton-pump inhibitor medication. To conclude, the self-reported lifetime bone fracture risk is equal for DH and coeliac disease. After diagnosis, females with coeliac disease have a higher fracture risk than females with DH. PMID:29538319

  16. Application of geophysical methods for fracture characterization

    International Nuclear Information System (INIS)

    Lee, K.H.; Majer, E.L.; McEvilly, T.V.; California Univ., Berkeley, CA; Morrison, H.F.; California Univ., Berkeley, CA

    1990-01-01

    One of the most crucial needs in the design and implementation of an underground waste isolation facility is a reliable method for the detection and characterization of fractures in zones away from boreholes or subsurface workings. Geophysical methods may represent a solution to this problem. If fractures represent anomalies in the elastic properties or conductive properties of the rocks, then the seismic and electrical techniques may be useful in detecting and characterizing fracture properties. 7 refs., 3 figs

  17. Flow and fracture of alloys in the fusion environment

    International Nuclear Information System (INIS)

    Wolfer, W.G.

    1982-01-01

    The present paper examines both ductile and brittle fracture models of steels and assesses the impact of the fusion reactor environment on the fracture processes. In particular, the connections between plastic flow properties and fracture modes are reviewed for both ductile and brittle crack propagation. Highly radiation-hardened materials exhibit extreme flow location resulting in channel fracture. Physical models for this phenomon are developed and an estimate for the associated fracture toughness is given. The impact of radiation-hardening and ductility loss on fatigue crack growth is examined. Next, models describing the chemical effects on fatigue and fracture are briefly discussed. Finally, fracture design criteria are proposed for first wall structures in fusion reactors. (orig.)

  18. FRACTURING FLUID CHARACTERIZATION FACILITY

    Energy Technology Data Exchange (ETDEWEB)

    Subhash Shah

    2000-08-01

    Hydraulic fracturing technology has been successfully applied for well stimulation of low and high permeability reservoirs for numerous years. Treatment optimization and improved economics have always been the key to the success and it is more so when the reservoirs under consideration are marginal. Fluids are widely used for the stimulation of wells. The Fracturing Fluid Characterization Facility (FFCF) has been established to provide the accurate prediction of the behavior of complex fracturing fluids under downhole conditions. The primary focus of the facility is to provide valuable insight into the various mechanisms that govern the flow of fracturing fluids and slurries through hydraulically created fractures. During the time between September 30, 1992, and March 31, 2000, the research efforts were devoted to the areas of fluid rheology, proppant transport, proppant flowback, dynamic fluid loss, perforation pressure losses, and frictional pressure losses. In this regard, a unique above-the-ground fracture simulator was designed and constructed at the FFCF, labeled ''The High Pressure Simulator'' (HPS). The FFCF is now available to industry for characterizing and understanding the behavior of complex fluid systems. To better reflect and encompass the broad spectrum of the petroleum industry, the FFCF now operates under a new name of ''The Well Construction Technology Center'' (WCTC). This report documents the summary of the activities performed during 1992-2000 at the FFCF.

  19. Return to Play and Performance After Jones Fracture in National Basketball Association Athletes

    Science.gov (United States)

    Begly, John P.; Guss, Michael; Ramme, Austin J.; Karia, Raj; Meislin, Robert J.

    2015-01-01

    Background: Basketball players are at risk for foot injuries, including Jones fractures. It is unknown how this injury affects the future play and performance of athletes. Hypothesis: National Basketball Association (NBA) players who sustain Jones fractures of the base of the fifth metatarsal have high rates of return to play and do not experience a decrease in performance on return to competition when compared with preinjury and with control-matched peers. Study Design: Retrospective cohort study. Level of Evidence: Level 5. Methods: Data on 26 elite basketball players with Jones fractures over 19 NBA seasons (1994-1995 to 2012-2013) were obtained from injury reports, press releases, player profiles, and online public databases. Variables included age, body mass index (BMI), player position, experience, and surgical treatment. Individual season statistics pre- and postinjury were collected. Twenty-six controls were identified by matched player position, age, and performance statistics. Results: The mean age at the time of injury was 24.8 years, mean BMI was 24.7 kg/m2, and the mean experience prior to injury was 4.1 NBA seasons. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and postinjury performance was compared. When compared with controls, no decline in PER measured performance was identified. Conclusion: The majority of NBA players sustaining a Jones fracture return to their preinjury level of competition. These elite athletes demonstrate no decrease in performance on their return to play. Clinical Relevance: Jones fractures are well-studied injuries in terms of etiology, diagnosis, and management. However, the effect of these injuries on future performance of athletes is unknown. Using the findings of our study, orthopaedic surgeons may be better prepared to counsel and educate elite athletes who sustain a Jones fracture. PMID:26627111

  20. Mandibular ramus fractures: a rarity.

    Science.gov (United States)

    Kale, Tejraj Pundalik; Kotrashetti, S M; Louis, Archana; Lingaraj, J B; Sarvesh, B U

    2013-01-01

    To determine the incidence of mandibular ramus fractures in KLE's PK Hospital and to analyze the outcome of open reduction and internal fixation of these fractures. Using a retrospective study design, records of all trauma patients who reported to the Department of Oral and Maxillofacial Surgery, KLE's PK Hospital Belgaum, between the years January 2006 to October 2011 was obtained from the medical records office. The data variables that were analyzed were the name, age, sex, cause of injury, pretreatment occlusion, treatment given, period of MMF and post-treatment occlusion. Total number of mandibular fracture cases was 298. Ramus fractures were 10 in number which accounted for 3.3% of fractures. The age range of these 10 patients was seen to be between 20 to 80 years with the average age being 35.6 years. Of these 10 patients, 9 were male and 1 was female and 7 patients were treated by open reduction and internal fixation and the remaining 3 by closed reduction. The average period of MMF was 3 days for the patients who underwent open reduction and internal fixation. There was improvement in occlusion in all 10 patients post-treatment and there was no complication reported in any of the cases. Ramus fractures accounted for 3.3% of all mandibular fractures. Open reduction and internal fixation of ramus fractures ensures adequate functional and anatomic reduction. This study makes an attempt to throw a light on the increasing incidence of ramus fractures and a successful management of these fractures by open reduction and internal fixation. How to cite this article: Kale TP, Kotrashetti SM, Louis A, Lingaraj JB, Sarvesh BU. Mandibular Ramus Fractures: A Rarity. J Contemp Dent Pract 2013;14(1):39-42. Source of support: Nil Conflict of interest: None declared.

  1. Hydraulic fracturing in shales: the spark that created an oil and gas boom

    Science.gov (United States)

    Olson, J. E.

    2017-12-01

    In the oil and gas business, one of the valued properties of a shale was its lack of flow capacity (its sealing integrity) and its propensity to provide mechanical barriers to hydraulic fracture height growth when exploiting oil and gas bearing sandstones. The other important property was the high organic content that made shale a potential source rock for oil and gas, commodities which migrated elsewhere to be produced. Technological advancements in horizontal drilling and hydraulic fracturing have turned this perspective on its head, making shale (or other ultra-low permeability rocks that are described with this catch-all term) the most prized reservoir rock in US onshore operations. Field and laboratory results have changed our view of how hydraulic fracturing works, suggesting heterogeneities like bedding planes and natural fractures can cause significant complexity in hydraulic fracture growth, resulting in induced networks of fractures whose details are controlled by factors including in situ stress contrasts, ductility contrasts in the stratigraphy, the orientation and strength of pre-existing natural fractures, injection fluid viscosity, perforation cluster spacing and effective mechanical layer thickness. The stress shadowing and stress relief concepts that structural geologists have long used to explain joint spacing and orthogonal fracture pattern development in stratified sequences are key to understanding optimal injection point spacing and promotion of more uniform length development in induced hydraulic fractures. Also, fracture interaction criterion to interpret abutting vs crossing natural fracture relationships in natural fracture systems are key to modeling hydraulic fracture propagation within natural fractured reservoirs such as shale. Scaled physical experiments provide constraints on models where the physics is uncertain. Numerous interesting technical questions remain to be answered, and the field is particularly appealing in that better

  2. Effect of hormone therapy on the risk of bone fractures: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhu, Linlin; Jiang, Xinyan; Sun, Yuhong; Shu, Wenhuan

    2016-04-01

    The aim of this study was to investigate the association between hormone therapy (HT) use and the development of bone fractures. Using terms related to HT and fractures, we searched PubMed, Embase, and the Cochrane library for randomized controlled trials on HT and the associated risk of fractures published before August 2014. Two evaluators independently selected studies on the basis of predetermined selection criteria, and 28 studies were included in the meta-analysis. Summary estimates were obtained using fixed- or random-effects models as appropriate. A total of 28 studies included 33,426 participants and 2,516 fractures cases. The overall relative risk of HT was 0.74 (95% confidence interval [CI] 0.69-0.80) for total fractures, 0.72 (95% CI 0.53-0.98) for hip fractures, and 0.63 (95% CI 0.44-0.91) for vertebral fractures. In subgroup analyses, women of an age less than 60 years had lower risk of total fractures compared with women of an age more than 60 years (P = 0.003). Estradiol led to greater decrease in the risk of total fractures compared with conjugated equine estrogens (P =  .01). There is greater reduction in total fracture risk in trials of follow-up less than 36 months than that of follow-up more than 36 months (P = 0.003). No increase in the incidence of total cancer events but an increase in the incidence of thrombus was found to be associated with HT. HT is associated with a reduced risk of total, hip, and vertebral fractures, with a possible attenuation of this protection effect after it is stopped or when it is begun after 60 years. However, there may be an increase in the incidence of thrombus formation associated with HT.

  3. Growth Kinematics of Opening-Mode Fractures

    Science.gov (United States)

    Eichhubl, P.; Alzayer, Y.; Laubach, S.; Fall, A.

    2014-12-01

    Fracture aperture is a primary control on flow in fractured reservoirs of low matrix permeability including unconventional oil and gas reservoirs and most geothermal systems. Guided by principles of linear elastic fracture mechanics, fracture aperture is generally assumed to be a linear function of fracture length and elastic material properties. Natural opening-mode fractures with significant preserved aperture are observed in core and outcrop indicative of fracture opening strain accommodated by permanent solution-precipitation creep. Fracture opening may thus be decoupled from length growth if the material effectively weakens after initial elastic fracture growth by either non-elastic deformation processes or changes in elastic properties. To investigate the kinematics of fracture length and aperture growth, we reconstructed the opening history of three opening-mode fractures that are bridged by crack-seal quartz cement in Travis Peak Sandstone of the SFOT-1 well, East Texas. Similar crack-seal cement bridges had been interpreted to form by repeated incremental fracture opening and subsequent precipitation of quartz cement. We imaged crack-seal cement textures for bridges sampled at varying distance from the tips using scanning electron microscope cathodoluminescence, and determined the number and thickness of crack-seal cement increments as a function of position along the fracture length and height. Observed trends in increment number and thickness are consistent with an initial stage of fast fracture propagation relative to aperture growth, followed by a stage of slow propagation and pronounced aperture growth. Consistent with fluid inclusion observations indicative of fracture opening and propagation occurring over 30-40 m.y., we interpret the second phase of pronounced aperture growth to result from fracture opening strain accommodated by solution-precipitation creep and concurrent slow, possibly subcritical, fracture propagation. Similar deformation

  4. Automatic control design procedures for restructurable aircraft control

    Science.gov (United States)

    Looze, D. P.; Krolewski, S.; Weiss, J.; Barrett, N.; Eterno, J.

    1985-01-01

    A simple, reliable automatic redesign procedure for restructurable control is discussed. This procedure is based on Linear Quadratic (LQ) design methodologies. It employs a robust control system design for the unfailed aircraft to minimize the effects of failed surfaces and to extend the time available for restructuring the Flight Control System. The procedure uses the LQ design parameters for the unfailed system as a basis for choosing the design parameters of the failed system. This philosophy alloys the engineering trade-offs that were present in the nominal design to the inherited by the restructurable design. In particular, it alloys bandwidth limitations and performance trade-offs to be incorporated in the redesigned system. The procedure also has several other desirable features. It effectively redistributes authority among the available control effectors to maximize the system performance subject to actuator limitations and constraints. It provides a graceful performance degradation as the amount of control authority lessens. When given the parameters of the unfailed aircraft, the automatic redesign procedure reproduces the nominal control system design.

  5. The IPIRG-1 pipe system fracture tests: Experimental results

    International Nuclear Information System (INIS)

    Scott, P.; Olson, R.J.; Wilkowski, G.M.

    1994-01-01

    As part of the First International Piping Integrity Research Group (IPIRG-1) program, six dynamic pipe system experiments were conducted. The objective of these experiments was to generate experimental data to assess analysis methodologies for characterizing the fracture behavior of circumferentially cracked pipe in a representative piping system subjected to combined inertial and displacement-controlled stresses. A unique experimental facility was designed and constructed. The pipe system evaluated was an expansion loop with over 30 m (100 feet) of 16-inch nominal diameter Schedule 100 pipe. The experimental facility was equipped with special hardware to ensure that system boundary conditions could be appropriately modeled. The test matrix involved one uncracked and five cracked dynamic pipe system experiments. The uncracked-pipe experiment was conducted to evaluate the piping system damping and natural frequency characteristics. The cracked-pipe experiments were conducted to evaluate the fracture behavior, piping system response, and fracture stability characteristics of five different materials. All cracked-pipe experiments were conducted at PWR conditions. Material characterization efforts provided the tensile and fracture toughness properties of the different pipe materials at various strain rates and temperatures. Key results from the six pipe system experiments and material characterization efforts are presented. Detailed analyses will be published in a companion paper

  6. Fracture toughness and fracture behavior of CLAM steel in the temperature range of 450 °C-550 °C

    Science.gov (United States)

    Zhao, Yanyun; Liang, Mengtian; Zhang, Zhenyu; Jiang, Man; Liu, Shaojun

    2018-04-01

    In order to analyze the fracture toughness and fracture behavior (J-R curves) of China Low Activation Martensitic (CLAM) steel under the design service temperature of Test Blanket Module of the International Thermonuclear Experimental Reactor, the quasi-static fracture experiment of CLAM steel was carried out under the temperature range of 450 °C-550 °C. The results indicated that the fracture behavior of CLAM steel was greatly influenced by test temperature. The fracture toughness increased slightly as the temperature increased from 450 °C to 500 °C. In the meanwhile, the fracture toughness at 550 °C could not be obtained due to the plastic deformation near the crack tip zone. The microstructure analysis based on the fracture topography and the interaction between dislocations and lath boundaries showed two different sub-crack propagation modes: growth along 45° of the main crack direction at 450 °C and growth perpendicular to the main crack at 500 °C.

  7. Prevention of brittle fracture of steel structures by controlling the local stress and strain fields

    Directory of Open Access Journals (Sweden)

    Moyseychik Evgeniy Alekseevich

    Full Text Available In the article the author offers a classification of the methods to increase the cold resistance of steel structural shapes with a focus on the regulation of local fields of internal stresses and strains to prevent brittle fracture of steel structures. The need of a computer thermography is highlighted not only for visualization of temperature fields on the surface, but also to control the fields of residual stresses and strains in a controlled element.

  8. Higher fish intake is associated with a lower risk of hip fractures in Chinese men and women: a matched case-control study.

    Science.gov (United States)

    Fan, Fan; Xue, Wen-Qiong; Wu, Bao-Hua; He, Ming-Guang; Xie, Hai-Li; Ouyang, Wei-Fu; Tu, Su-Lan; Chen, Yu-Ming

    2013-01-01

    Fish is rich in nutrients that are favorable to bone health, but limited data are available regarding the relationship between fish intake and hip fractures. Our study examined the association between habitual fish intake and risk of hip fractures. A case-control study was performed between June 2009 and June 2012 in Guangdong Province, China. Five hundred and eighty-one hip fracture incident cases, aged 55 to 80 years (mean: 71 years), were enrolled from four hospitals. 1∶1 matched controls by gender and age (±3 years) were also recruited from communities and hospitals. Face-to-face interviews were used to obtain habitual dietary intake and information on various covariates. Univariate conditional logistic regression analyses showed significantly dose-dependent inverse correlations between the risk of hip fractures and the intake of fresh-water fish, sea fish, mollusca, shellfish, and total fish in all of the subjects (p-trend: water fish (p = 0.553). The ORs (95%CI) of hip fractures for the highest (vs. lowest) quartile were 0.80 (0.48-1.31) for fresh-water fish, 0.31 (0.18-0.52) for sea fish, 0.55 (0.34-0.88) for mollusca and shellfish, and 0.47 (0.28-0.79) for total fish, respectively. Stratified and interaction analyses showed that the association was more significant in males than in females (p-interaction = 0.052). Higher intake of seafood is independently associated with lower risk of hip fractures in elderly Chinese. Increasing consumption of sea fish may benefit the prevention of hip fractures in this population.

  9. Operative Fixation of Rib Fractures Indications, Techniques, and Outcomes.

    Science.gov (United States)

    Galos, David; Taylor, Benjamin; McLaurin, Toni

    2017-01-01

    Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise. Newer techniques use muscle sparing approaches and precontoured locking plate technology to obtain stable fixation and allow improved respiration. Current reports shows that rib fracture fixation offers the benefits of improved respiratory mechanics and improved pain control in the severe chest wall injury with resultant improvement in patient outcomes by decreasing time on the ventilator, time in the intensive care unit, and overall hospital length of stay.

  10. Anatomical Thin Titanium Mesh Plate Structural Optimization for Zygomatic-Maxillary Complex Fracture under Fatigue Testing

    Directory of Open Access Journals (Sweden)

    Yu-Tzu Wang

    2018-01-01

    Full Text Available This study performs a structural optimization of anatomical thin titanium mesh (ATTM plate and optimal designed ATTM plate fabricated using additive manufacturing (AM to verify its stabilization under fatigue testing. Finite element (FE analysis was used to simulate the structural bending resistance of a regular ATTM plate. The Taguchi method was employed to identify the significance of each design factor in controlling the deflection and determine an optimal combination of designed factors. The optimal designed ATTM plate with patient-matched facial contour was fabricated using AM and applied to a ZMC comminuted fracture to evaluate the resting maxillary micromotion/strain under fatigue testing. The Taguchi analysis found that the ATTM plate required a designed internal hole distance to be 0.9 mm, internal hole diameter to be 1 mm, plate thickness to be 0.8 mm, and plate height to be 10 mm. The designed plate thickness factor primarily dominated the bending resistance up to 78% importance. The averaged micromotion (displacement and strain of the maxillary bone showed that ZMC fracture fixation using the miniplate was significantly higher than those using the AM optimal designed ATTM plate. This study concluded that the optimal designed ATTM plate with enough strength to resist the bending effect can be obtained by combining FE and Taguchi analyses. The optimal designed ATTM plate with patient-matched facial contour fabricated using AM provides superior stabilization for ZMC comminuted fractured bone segments.

  11. Hip fracture risk assessment: artificial neural network outperforms conditional logistic regression in an age- and sex-matched case control study.

    Science.gov (United States)

    Tseng, Wo-Jan; Hung, Li-Wei; Shieh, Jiann-Shing; Abbod, Maysam F; Lin, Jinn

    2013-07-15

    Osteoporotic hip fractures with a significant morbidity and excess mortality among the elderly have imposed huge health and economic burdens on societies worldwide. In this age- and sex-matched case control study, we examined the risk factors of hip fractures and assessed the fracture risk by conditional logistic regression (CLR) and ensemble artificial neural network (ANN). The performances of these two classifiers were compared. The study population consisted of 217 pairs (149 women and 68 men) of fractures and controls with an age older than 60 years. All the participants were interviewed with the same standardized questionnaire including questions on 66 risk factors in 12 categories. Univariate CLR analysis was initially conducted to examine the unadjusted odds ratio of all potential risk factors. The significant risk factors were then tested by multivariate analyses. For fracture risk assessment, the participants were randomly divided into modeling and testing datasets for 10-fold cross validation analyses. The predicting models built by CLR and ANN in modeling datasets were applied to testing datasets for generalization study. The performances, including discrimination and calibration, were compared with non-parametric Wilcoxon tests. In univariate CLR analyses, 16 variables achieved significant level, and six of them remained significant in multivariate analyses, including low T score, low BMI, low MMSE score, milk intake, walking difficulty, and significant fall at home. For discrimination, ANN outperformed CLR in both 16- and 6-variable analyses in modeling and testing datasets (p?hip fracture are more personal than environmental. With adequate model construction, ANN may outperform CLR in both discrimination and calibration. ANN seems to have not been developed to its full potential and efforts should be made to improve its performance.

  12. Fracture size and transmissivity correlations: Implications for transport simulations in sparse three-dimensional discrete fracture networks following a truncated power law distribution of fracture size

    Science.gov (United States)

    Hyman, J.; Aldrich, G. A.; Viswanathan, H. S.; Makedonska, N.; Karra, S.

    2016-12-01

    We characterize how different fracture size-transmissivity relationships influence flow and transport simulations through sparse three-dimensional discrete fracture networks. Although it is generally accepted that there is a positive correlation between a fracture's size and its transmissivity/aperture, the functional form of that relationship remains a matter of debate. Relationships that assume perfect correlation, semi-correlation, and non-correlation between the two have been proposed. To study the impact that adopting one of these relationships has on transport properties, we generate multiple sparse fracture networks composed of circular fractures whose radii follow a truncated power law distribution. The distribution of transmissivities are selected so that the mean transmissivity of the fracture networks are the same and the distributions of aperture and transmissivity in models that include a stochastic term are also the same.We observe that adopting a correlation between a fracture size and its transmissivity leads to earlier breakthrough times and higher effective permeability when compared to networks where no correlation is used. While fracture network geometry plays the principal role in determining where transport occurs within the network, the relationship between size and transmissivity controls the flow speed. These observations indicate DFN modelers should be aware that breakthrough times and effective permeabilities can be strongly influenced by such a relationship in addition to fracture and network statistics.

  13. The study of crosslinked fluid leakoff in hydraulic fracturing physical simulations

    Energy Technology Data Exchange (ETDEWEB)

    Grothe, Vinicius Perrud; Ribeiro, Paulo Roberto [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Engenharia Mecanica. Dept. de Engenharia de Petroleo; Sousa, Jose Luiz Antunes de Oliveira e [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Engenharia. Dept. de Estruturas; Fernandes, Paulo Dore [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil). Centro de Pesquisas

    2000-07-01

    The fluid loss plays an important role in the design and execution of hydraulic fracturing treatments. The main objectives of this work were: the study of the fluid loss associated with the propagation of hydraulic fractures generated at laboratory; and the comparison of two distinct methods for estimating leakoff coefficients - Nolte analysis and the filtrate volume vs. square root of time plot. Synthetic rock samples were used as well as crosslinked hydroxypropyl guar (HPG) fluids in different polymer concentrations. The physical simulations comprised the confinement of (0.1 x 0.1 x 0.1) m{sup 3} rock samples in a load cell for the application of an in situ stress field. Different flow rates were employed in order to investigate shear effects on the overall leakoff coefficient. Horizontal radial fractures were hydraulically induced with approximate diameters, what was accomplished by controlling the injection time. Leakoff coefficients determined by means of the pressure decline analysis were compared to coefficients obtained from static filtration tests, considering similar experimental conditions. The research results indicated that the physical simulation of hydraulic fracturing may be regarded as an useful tool for evaluating the effectiveness of fracturing fluids and that it can supply reliable estimates of fluid loss coefficients. (author)

  14. Characteristics of the Foot Static Alignment and the Plantar Pressure Associated with Fifth Metatarsal Stress Fracture History in Male Soccer Players: a Case-Control Study.

    Science.gov (United States)

    Matsuda, Sho; Fukubayashi, Toru; Hirose, Norikazu

    2017-12-01

    There is a large amount of information regarding risk factors for fifth metatarsal stress fractures; however, there are few studies involving large numbers of subjects. This study aimed to compare the static foot alignment and distribution of foot pressure of athletes with and without a history of fifth metatarsal stress fractures. The study participants comprised 335 collegiate male soccer players. Twenty-nine with a history of fifth metatarsal stress fractures were in the fracture group and 306 were in the control group (with subgroups as follows: 30 in the fracture foot group and 28 in the non-fracture group). We measured the foot length, arch height, weight-bearing leg-heel alignment, non-weight-bearing leg-heel alignment, forefoot angle relative to the rearfoot, forefoot angle relative to the horizontal axis, and foot pressure. The non-weight-bearing leg-heel alignment was significantly smaller and the forefoot angle relative to the rearfoot was significantly greater in the fracture foot group than in the control foot group (P = 0.049 and P = 0.038, respectively). With regard to plantar pressure, there were no significant differences among the groups. Midfield players had significantly higher rates of fifth metatarsal stress fracture in their histories, whereas defenders had significantly lower rates (chi-square = 13.2, P stress fractures according to the type of foot (kicking foot vs. pivoting foot) or the severity of ankle sprain. Playing the midfield position and having an everted rearfoot and inverted forefoot alignment were associated with fifth metatarsal stress fractures. This information may be helpful for preventing fifth metatarsal stress fracture recurrence. More detailed load evaluations and a prospective study are needed in the future.

  15. Prototyping qualitative controllers for fuzzy-logic controller design

    International Nuclear Information System (INIS)

    Bakhtiari, S.; Jabedar-Maralani, P.

    1999-05-01

    Qualitative controls can be designed for linear and nonlinear models with the same computational complexity. At the same time they show the general form of the proper control. These properties can help ease the design process for quantitative controls. In this paper qualitative controls are used as prototypes for the design of linear or nonlinear, and in particular Sugeno-type fuzzy, controls. The LMS identification method is used to approximate the qualitative control with the nearest fuzzy control. The method is applied to the problem of position control in a permanent magnet synchronous motor; moreover, the performance and the robustness of the two controllers are compared

  16. Femoral Neck Shaft Angle in Men with Fragility Fractures

    Directory of Open Access Journals (Sweden)

    S. P. Tuck

    2011-01-01

    Full Text Available Introduction. Femoral neck shaft angle (NSA has been reported to be an independent predictor of hip fracture risk in men. We aimed to assess the role of NSA in UK men. Methods. The NSA was measured manually from the DXA scan printout in men with hip (62, 31 femoral neck and 31 trochanteric, symptomatic vertebral (91, and distal forearm (67 fractures and 389 age-matched control subjects. Age, height, weight, and BMD (g/cm2: lumbar spine, femoral neck, and total femur measurements were performed. Results. There was no significant difference in mean NSA between men with femoral neck and trochanteric hip fractures, so all further analyses of hip fractures utilised the combined data. There was no difference in NSA between those with hip fractures and those without (either using the combined data or analysing trochanteric and femoral neck shaft fractures separately, nor between fracture subjects as a whole and controls. Mean NSA was smaller in those with vertebral fractures (129.2° versus 131°: P=0.001, but larger in those with distal forearm fractures (129.8° versus 128.5°: P=0.01. Conclusions. The conflicting results suggest that femoral NSA is not an important determinant of hip fracture risk in UK men.

  17. Applied Control Systems Design

    CERN Document Server

    Mahmoud, Magdi S

    2012-01-01

    Applied Control System Design examines several methods for building up systems models based on real experimental data from typical industrial processes and incorporating system identification techniques. The text takes a comparative approach to the models derived in this way judging their suitability for use in different systems and under different operational circumstances. A broad spectrum of control methods including various forms of filtering, feedback and feedforward control is applied to the models and the guidelines derived from the closed-loop responses are then composed into a concrete self-tested recipe to serve as a check-list for industrial engineers or control designers. System identification and control design are given equal weight in model derivation and testing to reflect their equality of importance in the proper design and optimization of high-performance control systems. Readers’ assimilation of the material discussed is assisted by the provision of problems and examples. Most of these e...

  18. Spatial Differences in the Distribution of Bone Between Femoral Neck and Trochanteric Fractures.

    Science.gov (United States)

    Yu, Aihong; Carballido-Gamio, Julio; Wang, Ling; Lang, Thomas F; Su, Yongbin; Wu, Xinbao; Wang, Manyi; Wei, Jie; Yi, Chen; Cheng, Xiaoguang

    2017-08-01

    There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density, and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared with controls. Using surface-based SPM, we found that compared with controls, both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for

  19. Earthquake design for controlled structures

    Directory of Open Access Journals (Sweden)

    Nikos G. Pnevmatikos

    2017-04-01

    Full Text Available An alternative design philosophy, for structures equipped with control devices, capable to resist an expected earthquake while remaining in the elastic range, is described. The idea is that a portion of the earthquake loading is under¬taken by the control system and the remaining by the structure which is designed to resist elastically. The earthquake forces assuming elastic behavior (elastic forces and elastoplastic behavior (design forces are first calculated ac¬cording to the codes. The required control forces are calculated as the difference from elastic to design forces. The maximum value of capacity of control devices is then compared to the required control force. If the capacity of the control devices is larger than the required control force then the control devices are accepted and installed in the structure and the structure is designed according to the design forces. If the capacity is smaller than the required control force then a scale factor, α, reducing the elastic forces to new design forces is calculated. The structure is redesigned and devices are installed. The proposed procedure ensures that the structure behaves elastically (without damage for the expected earthquake at no additional cost, excluding that of buying and installing the control devices.

  20. [Is Mapuche ethnicity a risk factor for hip fracture in aged?].

    Science.gov (United States)

    Sapunar, Jorge; Bravo, Paulina; Schneider, Hermann; Jiménez, Marcela

    2003-10-01

    Ethnic factors are involved in the risk for osteoporosis and hip fracture. To assess the effect of Mapuche ethnicity on the risk of hip fracture. A case control study. Cases were subjects over 55 years of age admitted, during one year, for hip fracture not associated to major trauma or tumors. Controls were randomly chosen from other hospital services and paired for age with cases. The magnitude of the association between ethnicity and hip fracture was expressed as odds ratio in a logistic regression model. In the study period, 156 cases with hip fracture were admitted. The proportion of subjects with Mapuche origin was significantly lower among cases than controls (11.8 and 26.5% respectively, p Mapuche ethnicity was associated with hip fracture with an odds radio of 0.14 (p = 0.03, 95% CI 0.03-0.8). In this sample, Mapuche ethnicity is a protective factor for hip fracture.

  1. Fracture mechanics evaluation of heavy welded structures

    International Nuclear Information System (INIS)

    Sprung, I.; Ericksson, C.W.; Zilberstein, V.A.

    1982-01-01

    This paper describes some applications of nondestructive examination (NDE) and engineering fracture mechanics to evaluation of flaws in heavy welded structures. The paper discusses not only widely recognized linear elastic fracture mechanics (LEFM) analysis, but also methods of the elastic-plastic fracture mechanics (EPFM), such as COD, J-integral, and Failure Assessment Diagram. Examples are given to highlight the importance of interaction between specialists providing input and the specialists performing the analysis. The paper points out that the critical parameters for as-welded structures when calculated by these methods are conservative since they are based on two pessimistic assumptions: that the magnitude of residual stress is always at the yield strength level, and that the residual stress always acts in the same direction as the applied (mechanical) stress. The suggestion is made that it would be prudent to use the COD or the FAD design curves for a conservative design. The appendix examines a J-design curve modified to include residual stresses

  2. Numerical simulation on ferrofluid flow in fractured porous media based on discrete-fracture model

    Science.gov (United States)

    Huang, Tao; Yao, Jun; Huang, Zhaoqin; Yin, Xiaolong; Xie, Haojun; Zhang, Jianguang

    2017-06-01

    Water flooding is an efficient approach to maintain reservoir pressure and has been widely used to enhance oil recovery. However, preferential water pathways such as fractures can significantly decrease the sweep efficiency. Therefore, the utilization ratio of injected water is seriously affected. How to develop new flooding technology to further improve the oil recovery in this situation is a pressing problem. For the past few years, controllable ferrofluid has caused the extensive concern in oil industry as a new functional material. In the presence of a gradient in the magnetic field strength, a magnetic body force is produced on the ferrofluid so that the attractive magnetic forces allow the ferrofluid to be manipulated to flow in any desired direction through the control of the external magnetic field. In view of these properties, the potential application of using the ferrofluid as a new kind of displacing fluid for flooding in fractured porous media is been studied in this paper for the first time. Considering the physical process of the mobilization of ferrofluid through porous media by arrangement of strong external magnetic fields, the magnetic body force was introduced into the Darcy equation and deals with fractures based on the discrete-fracture model. The fully implicit finite volume method is used to solve mathematical model and the validity and accuracy of numerical simulation, which is demonstrated through an experiment with ferrofluid flowing in a single fractured oil-saturated sand in a 2-D horizontal cell. At last, the water flooding and ferrofluid flooding in a complex fractured porous media have been studied. The results showed that the ferrofluid can be manipulated to flow in desired direction through control of the external magnetic field, so that using ferrofluid for flooding can raise the scope of the whole displacement. As a consequence, the oil recovery has been greatly improved in comparison to water flooding. Thus, the ferrofluid

  3. Model of T-Type Fracture in Coal Fracturing and Analysis of Influence Factors of Fracture Morphology

    Directory of Open Access Journals (Sweden)

    Yuwei Li

    2018-05-01

    Full Text Available Special T-type fractures can be formed when coal is hydraulically fractured and there is currently no relevant theoretical model to calculate and describe them. This paper first establishes the height calculation model of vertical fractures in multi-layered formations and deduces the stress intensity factor (SIF at the upper and lower sides of the fracture in the process of vertical fracture extension. Combined with the fracture tip stress analysis method of fracture mechanics theory, the horizontal bedding is taken into account for tensile and shear failure, and the critical mechanical conditions for the formation of horizontal fracture in coal are obtained. Finally, the model of T-type fracture in coal fracturing is established, and it is verified by fracturing simulation experiments. The model calculation result shows that the increase of vertical fracture height facilitates the increase of horizontal fracture length. The fracture toughness of coal has a significant influence on the length of horizontal fracture and there is a threshold. When the fracture toughness is less than the threshold, the length of horizontal fracture remains unchanged, otherwise, the length of horizontal fracture increases rapidly with the increase of fracture toughness. When the shear strength of the interface between the coalbed and the interlayer increases, the length of the horizontal fracture of the T-type fracture rapidly decreases.

  4. Rib Fracture Fixation: Indications and Outcomes.

    Science.gov (United States)

    Senekjian, Lara; Nirula, Raminder

    2017-01-01

    Rib fractures are a frequently identified injury in the trauma population. Not only are multiple rib fractures painful, but they are associated with an increased risk of adverse outcomes. Pneumonia in particular can be devastating, especially to an elderly patient, but other complications such as prolonged ventilation and increased intensive care and hospital durations of stay have a negative impact on the patient. Computed tomography scan is the best modality to diagnosis rib fractures but the treatment of fractures is still evolving. Currently patient care involves a multidisciplinary approach that includes pain control, aggressive pulmonary therapy, and possibly surgical fixation. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Patients with eating disorders. A high-risk group for fractures

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Emborg, C.; Stoving, R.K.

    2003-01-01

    PURPOSE: To analyze fracture risk and bone mineral density in patients with eating disorders (anorexia nervosa, bulimia nervosa, and other eating disorders). DESIGN: Clinical overview. FINDINGS: Bone mineral density is decreased and fracture risk increased in patients with anorexia nervosa....... In patients with bulimia nervosa, bone mineral is only marginally decreased and fracture risk marginally increased. In patients with other eating disorders (eating disorders not otherwise specified), bone mineral density is decreased and fracture risk increased. CONCLUSIONS: Fracture risk is increased...

  6. Femoral nerve block in a representative sample of elderly people with hip fracture: A randomised controlled trial.

    Science.gov (United States)

    Unneby, Anna; Svensson, Olle; Gustafson, Yngve; Olofsson, Birgitta

    2017-07-01

    The number of elderly people with hip fracture and dementia is increasing, and many of these patients suffer from pain. Opioids are difficult to adjust and side effects are common, especially with increased age and among patients with dementia. Preoperative femoral nerve block is an alternative pain treatment. To investigate whether preoperative femoral nerve block reduced acute pain and opioid use after hip fracture among elderly patients, including those with dementia. In this randomised controlled trial involving patients aged ≥70years with hip fracture (trochanteric and cervical), including those with dementia, we compared femoral nerve block with conventional pain management, with opioid use if required. The primary outcome was preoperative pain, measured at five timepoints using a visual analogue scale (VAS). Preoperative opioid consumption was also registered. The study sample comprised 266 patients admitted consecutively to the Orthopaedic Ward. The mean age was 84.1 (±6.9)years, 64% of participants were women, 44% lived in residential care facilities, and 120 (45.1%) had dementia diagnoses. Patients receiving femoral nerve block had significantly lower self-rated pain scores from baseline to 12h after admission than did controls. Self-rated and proxy VAS pain scores decreased significantly in these patients from baseline to 12h compared with controls (pblock required less opioids than did controls, overall (2.3±4.0 vs. 5.7±5.2mg, pblock had lower pain scores and required less opioids before surgery compared with those receiving conventional pain management. Femoral nerve block seems to be a feasible pain treatment for elderly people, including those with dementia. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Localizing Fracture Hydromechanical Response using Fiber Optic Distributed Acoustic Sensing in a Fractured Bedock Aquifer

    Science.gov (United States)

    Ciervo, C.; Becker, M.; Cole, M. C.; Coleman, T.; Mondanos, M.

    2017-12-01

    Measuring fracture mechanical behavior in response to changes in fluid pressure is critical for understanding flow through petroleum reservoirs, predicting hydrothermal responses in geothermal fields, and monitoring geologic carbon sequestration injection. Distributed acoustic sensing (DAS) is new, but commercially available fiber optic technology that offers a novel approach to characterize fractured bedrock systems. DAS was originally designed to measure the amplitude, frequency, and phase of an acoustic wave, and is therefore capable of detecting strains at exceedingly small scales. Though normally used to measure frequencies in the Hz to kHz range, we adapted DAS to measure fracture displacements in response to periodic hydraulic pulses in the mHz frequency range. A field experiment was conducted in a fractured bedrock aquifer to test the ability of DAS to measure fracture mechanical response to oscillatory well tests. Fiber optic cable was deployed in a well, and coupled to the borehole wall using a flexible impermeable liner designed with an air coupled transducer to measure fluid pressure at the target fracture zone. Two types of cable were tested, a loose tube and tight buffered, to determine the effects of cable construction. Both strain and pressure were measured across the known fracture zone hydraulically connected to a well 30 m away. The companion well was subjected to alternating pumping and injection with periods between 2 and 18 minutes. Raw DAS data were collected as strain rate measured every 0.25 m along the fiber with a gauge length of 10 m, at a sampling rate of 1 kHz. Strain rate was converted to strain by integrating with respect to time. DAS measured periodic strains of less than 1 nm/m in response to periodic injection and pumping at the companion well. Strain was observed by DAS only at the depth of the hydraulically connected fracture zone. Thus, the magnitude and response of the strain could be both localized with depth and measured

  8. Femoral neck stress fractures (fnsf) in military recruits

    International Nuclear Information System (INIS)

    Majeed, N.U.; Naqvi, A.N.; Majeed, H.

    2012-01-01

    Objective: To identify patterns of Femoral Neck Stress Fractures (FNSF), its presentation and outcome of its treatment in PMA (Pakistan Military Academy) cadets. These findings would help suggest guidelines for their appropriate management. Study design: Case Series Place and duration of study: CMH Abbottabad and CMH Rawalpindi from May 2005 to January 2008. Materials and Methods: Twenty cases (20 hips in 18 patients) of FNSF were included in the study. Only male cadets from Pakistan Military Academy (PMA) were included. Diagnosis was made clinically and was confirmed by radiographs or bone scan. Incomplete fractures were managed conservatively where as complete fractures were fixed surgically. Results: All compression fractures healed conservatively where as tension fractures needed surgical fixation in all the cases, except one where fracture remained incomplete. Rest of tension fractures converted from incomplete fractures to complete fractures and hence needed surgical stabilization. There was no problem of avascular necrosis of femoral head (AVNFH) in any patient. Conclusion: FNSF are uncommon injuries with potentially serious complications and are difficult to diagnose clinically. When diagnosed early and managed appropriately, they carry good prognosis. (author)

  9. High prevalence of radiological vertebral fractures in HIV-infected males.

    Science.gov (United States)

    Torti, Carlo; Mazziotti, Gherardo; Soldini, Pier Antonio; Focà, Emanuele; Maroldi, Roberto; Gotti, Daria; Carosi, Giampiero; Giustina, Andrea

    2012-06-01

    Age-related co-morbidities including osteoporosis are relevant in patients responding to combination antiretroviral therapy (cART). Vertebral fractures are common osteoporotic fractures and their diagnosis is useful for managing at-risk individuals. However, there are few data from HIV-infected patients. Therefore, the aim of this study was to determine the prevalence of and factors associated with vertebral fractures in a population of HIV-infected males. A cross-sectional study of 160 HIV-infected patients with available chest X-rays was conducted from 1998 to 2010. One hundred and sixty-three males with comparable age and with no history of HIV infection were recruited as controls. Semi-quantitative evaluation of vertebral heights in lateral chest X-rays and quantitative morphometry assessment of centrally digitized images using dedicated morphometry software were utilized to detect prevalent vertebral fractures. The result showed that the vertebral fractures were detected in 43/160 (26.9%) HIV-infected patients and in 21/163 (12.9%) controls (P = 0.002). In HIV-infected patients with fractures, 27 had two or more fractures and ten patients had severe fractures. The prevalence of any fractures and multiple fractures in HIV-infected patients receiving cART (29.6 and 20.0%) was slightly higher than in HIV-infected patients not exposed to cART (17.1 and 5.7%), but significantly higher than control subjects (12.9 and 3.7%). At multivariable analyses, body mass index and diabetes mellitus were independently correlated with vertebral fractures in HIV-infected patients. We concluded that a significant proportion of HIV-infected males receiving cART showed vertebral fractures. Furthermore, proactive diagnosis of vertebral fragility fractures is particularly relevant in patients who are overweight or suffer from diabetes.

  10. Fluid transport in reaction induced fractures

    Science.gov (United States)

    Ulven, Ole Ivar; Sun, WaiChing; Malthe-Sørenssen, Anders

    2015-04-01

    The process of fracture formation due to a volume increasing chemical reaction has been studied in a variety of different settings, e.g. weathering of dolerites by Røyne et al. te{royne}, serpentinization and carbonation of peridotite by Rudge et al. te{rudge} and replacement reactions in silica-poor igneous rocks by Jamtveit et al. te{jamtveit}. It is generally assumed that fracture formation will increase the net permeability of the rock, and thus increase the reactant transport rate and subsequently the total rate of material conversion, as summarised by Kelemen et al. te{kelemen}. Ulven et al. te{ulven_1} have shown that for fluid-mediated processes the ratio between chemical reaction rate and fluid transport rate in bulk rock controls the fracture pattern formed, and Ulven et al. te{ulven_2} have shown that instantaneous fluid transport in fractures lead to a significant increase in the total rate of the volume expanding process. However, instantaneous fluid transport in fractures is clearly an overestimate, and achievable fluid transport rates in fractures have apparently not been studied in any detail. Fractures cutting through an entire domain might experience relatively fast advective reactant transport, whereas dead-end fractures will be limited to diffusion of reactants in the fluid, internal fluid mixing in the fracture or capillary flow into newly formed fractures. Understanding the feedback process between fracture formation and permeability changes is essential in assessing industrial scale CO2 sequestration in ultramafic rock, but little is seemingly known about how large the permeability change will be in reaction-induced fracturing. In this work, we study the feedback between fracture formation during volume expansion and fluid transport in different fracture settings. We combine a discrete element model (DEM) describing a volume expanding process and the related fracture formation with different models that describe the fluid transport in the

  11. Guidelines for control room design reviews

    International Nuclear Information System (INIS)

    1981-09-01

    The control room design review is part of a broad program being undertaken by the nuclear industry and the government to ensure consideration of human factors in nuclear power plant design and operation. The purpose of the control room design review described by these guidelines is to (1) review and evaluate the control room workspace, instrumentation, controls, and other equipment from a human factors engineering point of view that takes into account both system demands and operator capabilities; and (2) to identify, assess, and implement control room design modifications that correct inadequate or unsuitable items. The scope of the control room design review described by these guidelines covers the human engineering review of completed control rooms; i.e., operational control rooms or those at that stage of the licensing process where control room design and equipment selection are committed. These guidelines should also be of use during the design process for new control rooms. However, additional analyses to optimize the allocation of functions to man and machine, and further examination of advanced control system technology, are recommended for new control rooms. Guidelines and references for comprehensive system analyses designed to incorporate human factors considerations into the design and development of new control rooms are presented in Appendix B. Where possible, a generic approach to the control room design review process is encouraged; for example, when control room designs are replicated wholly or in part in two or more units. Even when designs are not replicated exactly, generic reviews which can be modified to account for specific differences in particular control rooms should be considered. Industry organizations and owners groups are encouraged to coordinate joint efforts and share data to develop generic approaches to the design review process. The control room design review should accomplish the following specific objectives. To determine

  12. An Impulse Control Disorder Case with Penile Fracture and Trichotillomania

    OpenAIRE

    CUMURCU, Birgül ELBOZAN

    2014-01-01

    Penile fractures are classically described as presenting with rapid detumescence of an erection associated with blunt trauma. This clinical finding is due to a tear in the tunica albuginea surrounding the corpora cavernosum. In this study, we report and discuss a case of trichotillomania and penile bending impulse resulting in penile fracture, which was operated in the urology clinic. The possible psychological and psychiatric problems underlying the impulsive behavior are discussed, and the ...

  13. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial.

    Science.gov (United States)

    Prestmo, Anders; Hagen, Gunhild; Sletvold, Olav; Helbostad, Jorunn L; Thingstad, Pernille; Taraldsen, Kristin; Lydersen, Stian; Halsteinli, Vidar; Saltnes, Turi; Lamb, Sarah E; Johnsen, Lars G; Saltvedt, Ingvild

    2015-04-25

    Most patients with hip fractures are characterised by older age (>70 years), frailty, and functional deterioration, and their long-term outcomes are poor with increased costs. We compared the effectiveness and cost-effectiveness of giving these patients comprehensive geriatric care in a dedicated geriatric ward versus the usual orthopaedic care. We did a prospective, single-centre, randomised, parallel-group, controlled trial. Between April 18, 2008, and Dec 30, 2010, we randomly assigned home-dwelling patients with hip-fractures aged 70 years or older who were able to walk 10 m before their fracture, to either comprehensive geriatric care or orthopaedic care in the emergency department, to achieve the required sample of 400 patients. Randomisation was achieved via a web-based, computer-generated, block method with unknown block sizes. The primary outcome, analysed by intention to treat, was mobility measured with the Short Physical Performance Battery (SPPB) 4 months after surgery for the fracture. The type of treatment was not concealed from the patients or staff delivering the care, and assessors were only partly masked to the treatment during follow-up. This trial is registered with ClinicalTrials.gov, number NCT00667914. We assessed 1077 patients for eligibility, and excluded 680, mainly for not meeting the inclusion criteria such as living in a nursing home or being aged less than 70 years. Of the remaining patients, we randomly assigned 198 to comprehensive geriatric care and 199 to orthopaedic care. At 4 months, 174 patients remained in the comprehensive geriatric care group and 170 in the orthopaedic care group; the main reason for dropout was death. Mean SPPB scores at 4 months were 5·12 (SE 0·20) for comprehensive geriatric care and 4·38 (SE 0·20) for orthopaedic care (between-group difference 0·74, 95% CI 0·18-1·30, p=0·010). Immediate admission of patients aged 70 years or more with a hip fracture to comprehensive geriatric care in a dedicated

  14. Randomized, double-blind, placebo-controlled trial using lidocaine patch 5% in traumatic rib fractures.

    Science.gov (United States)

    Ingalls, Nichole K; Horton, Zachary A; Bettendorf, Matthew; Frye, Ira; Rodriguez, Carlos

    2010-02-01

    The lidocaine patch 5% was developed to treat postherpetic neuralgia. Anecdotal experience at our institution suggests the lidocaine patch 5% decreases narcotic usage in patients with traumatic rib fractures. This trial was developed to define the patch's efficacy. Patients with rib fractures admitted to the trauma service at our Level I trauma center were enrolled and randomized in a 1 to 1 double-blind manner to receive a lidocaine patch 5% or placebo patch. Fifty-eight patients who met the inclusion criteria were enrolled from January 2007 to August 2008. Demographic and clinical information were recorded. The primary outcomes variable was total narcotic use, analyzed using the 1-tailed Mann-Whitney test. The secondary outcomes variables included non-narcotic pain medication, average pain score, pulmonary complications, and length of stay. Significance was defined based on a 1-sided test for the primary outcome and 2-sided tests for other comparisons, at p rib fractures, gender, trauma mechanism, preinjury lung disease, smoking history, percent of current smokers, and need for placement of chest tube between the lidocaine patch 5% and placebo groups. There was no difference between the lidocaine patch 5% and placebo groups, respectively, with regard to total IV narcotic usage: median, 0.23 units versus 0.26 units; total oral narcotics: median, 4 units versus 7 units; pain score: 5.6 +/- 0.4 versus 6.0 +/- 0.3 (mean +/- SEM); length of stay: 7.8 +/- 1.1 versus 6.2 +/- 0.7; or percentage of patients with pulmonary complications: 72.7% versus 72.0%. The lidocaine patch 5% does not significantly improve pain control in polytrauma patients with traumatic rib fractures.

  15. Explosively fracturing a productive oil and gas formation

    Energy Technology Data Exchange (ETDEWEB)

    Brandon, C W

    1966-06-23

    In this method of fracturing an oil- or gas-producing strata, a portion of the formation adjacent to, but separated from, the producing strata is fractured. Explosives are then introduced into the fracture in this portion of the formation and thereafter detonated to fracture the productive strata. Also claimed are a method of variably controlling the extent and force of the explosives used, and a method of increasing oil and gas production from a productive strata.

  16. The Behaviour of Fracture Growth in Sedimentary Rocks: A Numerical Study Based on Hydraulic Fracturing Processes

    Directory of Open Access Journals (Sweden)

    Lianchong Li

    2016-03-01

    Full Text Available To capture the hydraulic fractures in heterogeneous and layered rocks, a numerical code that can consider the coupled effects of fluid flow, damage, and stress field in rocks is presented. Based on the characteristics of a typical thin and inter-bedded sedimentary reservoir, China, a series of simulations on the hydraulic fracturing are performed. In the simulations, three points, i.e., (1 confining stresses, representing the effect of in situ stresses, (2 strength of the interfaces, and (3 material properties of the layers on either side of the interface, are crucial in fracturing across interfaces between two adjacent rock layers. Numerical results show that the hydrofracture propagation within a layered sequence of sedimentary rocks is controlled by changing in situ stresses, interface properties, and lithologies. The path of the hydraulic fracture is characterized by numerous deflections, branchings, and terminations. Four types of potential interaction, i.e., penetration, arrest, T-shaped branching, and offset, between a hydrofracture and an interface within the layered rocks are formed. Discontinuous composite fracture segments resulting from out-of-plane growth of fractures provide a less permeable path for fluids, gas, and oil than a continuous planar composite fracture, which are one of the sources of the high treating pressures and reduced fracture volume.

  17. Hip fracture in hospitalized medical patients.

    Science.gov (United States)

    Zapatero, Antonio; Barba, Raquel; Canora, Jesús; Losa, Juan E; Plaza, Susana; San Roman, Jesús; Marco, Javier

    2013-01-08

    The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.Outcome measures included rates of in-hospital fractures, length of stay and cost. A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p patients with a hip fracture (20.7 days vs 9.8 days; p hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49). In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  18. Dynamic fracture toughness data for CASTOR {sup registered} casks

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, H.P. [GNS Gesellschaft fuer Nuklear-Service mbH/GNB, Essen (Germany); Trubitz, P.; Pusch, G. [Technische Univ. Bergakademie Freiberg, Freiberg (Germany); Warnke, E.P. [Siempelkamp GmbH and Co. KG, Krefeld (Germany); Beute, K. [Gontermann-Peipers GmbH, Siegen (Germany); Novotny, V. [SKODA, HUTE, Plzen (Czech Republic)

    2004-07-01

    For the use of cast iron spherical graphite for heavy-sectioned casks for transportation and storage of radiactive materials a complete failure assessment including fracture mechanical analysis is necessary. The casks require an elaborate fracture mechanics design based on fracture mechanics evaluation. The extension of the existing code with respect to dynamic loading takes account new developments to extend the field of applications. It also includes new criteria to design these casks against operating and accident loadings. A fundamental requirement for the realisation of this standard and the calculation of admissible crack lengths of stresses under dynamic loads is the availability of fracture mechanical data. The paper presents-as a part of a large test-program-first results of dynamic fracture-toughness-investigations depending on structure and temperature. The test-program will incorporate investigations on more then 2500 specimens. The investigations that will be done include static and dynamic fracture mechanics tests, dynamic tensile and pressure-tests on different formed specimens. The temperatures and other test conditions follows the IAEA-regulations and the real service conditions. The test-program will be realised in partnership with different institutes.

  19. What controls diffuse fractures in platform carbonates? Insights from Provence (France) and Apulia (Italy)

    Science.gov (United States)

    Lavenu, Arthur P. C.; Lamarche, Juliette

    2018-03-01

    Fractures are widespread in rocks and regional opening-mode arrays are commonly ascribed to major tectonic events. However, fractures occur in otherwise undeformed rocks. Some of these are early-developed features independent of tectonics and forming a background network at regional scale. To overcome this lack of understanding, two hydrocarbon reservoir analogues from platform carbonates have been targeted: the Provence (SE France), and the Apulian platform (SE Italy). In both areas, an early fracturing stage has been observed, made of high-angle-to-bedding opening-mode fractures, and bed-parallel stylolites. These features developed synchronously during the first burial stages and prior to major tectonic events. The fracture sets are not genetically related to the present-day layering. Contrarily, fractures developed in a brittle media where facies transitions were not sharp and did not act as mechanical discontinuities. Carbonate facies distribution and early diagenetic imprint constrained the mechanical stratigraphy when fractures occurred. In addition, we observed that fractures related to late tectonic inversion were partly inhibited. Indeed, rock mechanical properties change through time. Characterizing the temporal evolution of carbonate rocks has revealed that diagenesis and sedimentary facies are the prime actors for brittleness and mechanical layering in carbonates.

  20. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  1. The study on the X-ray correction method of long fracture displacement

    International Nuclear Information System (INIS)

    Jia Bin; Huang Ailing; Chen Fuzhong; Men Chunyan; Sui Chengzong; Cui Yiming; Yang Yundong

    2010-01-01

    Objective: To explore the image correction of fracture displacement by conventional X-ray photography (ortho tropic and lateral) and test by computed tomography (CT). Methods: The correction method of fracture displacement was designed according to geometry of X-ray photography. Selected one midhumeral fracture specimen which designed with lateral shift and angular displacement, and scanned from anteroposterior and position respectively, and also volume scanned using CT, the data obtained from volume scan were processed using multiplanar reconstruction (MPR) and shaded surface display (SSD). The displacement data relied on X-ray image, CT with MPR and SSD processing, actual design of specimens were compared respectively. Results: The direction and degree of displacement among correction data of X-ray images and the data from MPR and SSD, actual design of specimen were little difference, location difference <1.5 mm, degree difference <1.5 degree. Conclusion: It is really reliable for fracture displacement by conventional X-ray photography with coordinate correction, and it is helpful to obviously improve the diagnostic accuracy of the degree of fracture displacement. (authors)

  2. Relationship between vitamin D, osteoporotic fracture and falls.

    Science.gov (United States)

    Candel Romero, Carmen; Forner Cordero, Ángeles; Sánchez Santos, José Cristóbal; Pereiró Berenguer, Inmaculada

    2017-11-22

    Link low levels of vitamin D, osteoporotic fracture and falls. Transversal observational study with the study variables of age, levels of vitamin D, osteoporotic fracture and falls. The study population was patients evaluated by the Rehabilitation Department, Hospital of Sagunto, from January 2013 to December 2014. Of the 242 patients who underwent vitamin D analysis, 70.6% showed levels under 30ng/ml. Forty-eight percent of the patients with below normal levels of vitamin D suffered a fracture, opposed to 32.4% patients with normal levels. Thus, controlling by age, patients with low levels of vitamin D are 4.8 times more likely to suffer a fracture than those with normal levels. Regarding falls, controlling by age, there is a higher risk of falling (adjusted OR 2.68) in those patients with low levels of vitamin D. Patients with low vitamin D levels are more likely to suffer falls and fractures. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. Incidence of fractures in patients with multiple sclerosis: the Danish National Health Registers

    DEFF Research Database (Denmark)

    Bazelier, Marloes T; de Vries, Frank; Bentzen, Joan

    2012-01-01

    Background: Patients with multiple sclerosis (MS) are potentially at high risk of fracture due to falls and osteoporosis. Objective: To estimate incidence rates of fractures in MS patients, stratified by fracture type, sex and age, and to compare these rates with controls. Methods: The case...... population consisted of all patients with an accepted diagnosis of MS in the Danish MS Registry (1949-2007). Data were linked to the National Hospital Discharge Register (1977-2007). Patients with MS (n = 11,157) were 1: 6 matched by year of birth, gender, calendar time and region to persons without MS...... (controls). Incidence rates of fracture were estimated as the number of fractures per 1000 person-years. Incidence rate ratios (IRRs) were calculated by dividing fracture rates in MS patients by fracture rates in controls. Results: Among patients with MS, the incidence rate of any fracture yielded 22.8 per...

  4. Correlation of Hip Fracture with Other Fracture Types: Toward a Rational Composite Hip Fracture Endpoint

    Science.gov (United States)

    Colón-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.

    2016-01-01

    Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123

  5. Influence of core design, production technique, and material selection on fracture behavior of yttria-stabilized tetragonal zirconia polycrystal fixed dental prostheses produced using different multilayer techniques: split-file, over-pressing, and manually built-up veneers.

    Science.gov (United States)

    Mahmood, Deyar Jallal Hadi; Linderoth, Ewa H; Wennerberg, Ann; Vult Von Steyern, Per

    2016-01-01

    To investigate and compare the fracture strength and fracture mode in eleven groups of currently, the most commonly used multilayer three-unit all-ceramic yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) fixed dental prostheses (FDPs) with respect to the choice of core material, veneering material area, manufacturing technique, design of connectors, and radii of curvature of FDP cores. A total of 110 three-unit Y-TZP FDP cores with one intermediate pontic were made. The FDP cores in groups 1-7 were made with a split-file design, veneered with manually built-up porcelain, computer-aided design-on veneers, and over-pressed veneers. Groups 8-11 consisted of FDPs with a state-of-the-art design, veneered with manually built-up porcelain. All the FDP cores were subjected to simulated aging and finally loaded to fracture. There was a significant difference (Pdesigns, but not between the different types of Y-TZP materials. The split-file designs with VITABLOCS(®) (1,806±165 N) and e.max(®) ZirPress (1,854±115 N) and the state-of-the-art design with VITA VM(®) 9 (1,849±150 N) demonstrated the highest mean fracture values. The shape of a split-file designed all-ceramic reconstruction calls for a different dimension protocol, compared to traditionally shaped ones, as the split-file design leads to sharp approximal indentations acting as fractural impressions, thus decreasing the overall strength. The design of a framework is a crucial factor for the load bearing capacity of an all-ceramic FDP. The state-of-the-art design is preferable since the split-file designed cores call for a cross-sectional connector area at least 42% larger, to have the same load bearing capacity as the state-of-the-art designed cores. All veneering materials and techniques tested in the study, split-file, over-press, built-up porcelains, and glass-ceramics are, with a great safety margin, sufficient for clinical use both anteriorly and posteriorly. Analysis of the fracture pattern shows

  6. Studies of Transport Properties of Fractures: Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Stephen R. Brown

    2006-06-30

    We proposed to study several key factors controlling the character and evolution of fracture system permeability and transport processes. We suggest that due to surface roughness and the consequent channeling in single fractures and in fracture intersections, the tendency of a fracture system to plug up, remain permeable, or for permeability to increase due to chemical dissolution/precipitation conditions will depend strongly on the instantaneous flow channel geometry. This geometry will change as chemical interaction occurs, thus changing the permeability through time. To test this hypothesis and advance further understanding toward a predictive capability, we endeavored to physically model and analyze several configurations of flow and transport of inert and chemically active fluids through channels in single fractures and through fracture intersections. This was an integrated program utilizing quantitative observations of fractures and veins in drill core, quantitative and visual observations of flow and chemical dissolution and precipitation within replicas of real rough-walled fractures and fracture intersections, and numerical modeling via lattice Boltzmann methods.

  7. Measuring and Modeling Flow in Welded Fractured Tuffs

    International Nuclear Information System (INIS)

    R. Salve; C. Doughty; J.S. Wang

    2001-01-01

    We have carried out a series of in situ liquid-release experiments in conjunction with a numerical modeling study to examine the effect of the rock matrix on liquid flow and transport occurring primarily through the fracture network. Field experiments were conducted in the highly fractured Topopah Spring welded tuff at a site accessed from the Exploratory Studies Facility (ESFS), an underground laboratory in the unsaturated zone at Yucca Mountain, Nevada. During the experiment, wetting-front movement, flow-field evolution, and drainage of fracture flow paths were evaluated. Modeling was used to aid in experimental design, predict experimental results, and study the physical processes accompanying liquid flow through unsaturated fractured welded tuff. Field experiments and modeling suggest that it may not be sufficient to conceptualize the fractured tuff as consisting of a single network of high-permeability fractures embedded in a low-permeability matrix. The need to include a secondary fracture network is demonstrated by comparison to the liquid flow observed in the field

  8. Quantitative x-ray fractographic analysis of fatigue fractures

    International Nuclear Information System (INIS)

    Saprykin, Yu.V.

    1983-01-01

    The study deals with quantitative X-ray fractographic investigation of fatigue fractures of samples with sharp notches tested at various stresses and temperatures with the purpose of establishing a connection between material crack resistance parameters and local plastic instability zones restraining and controlling the crack growth. At fatigue fractures of notched Kh18N9T steel samples tested at +20 and -196 deg C a zone of sharp ring notch effect being analogous to the zone in which crack growth rate is controlled by the microshifting mechanisms is singled out. The size of the notched effect zone in the investigate steel is unambiguosly bound to to the stress amplitude. This provides the possibility to determine the stress value by the results of quantitative fractographic analysis of notched sample fractures. A possibility of determining one of the threshold values of cyclic material fracture toughness by the results of fatigue testing and fractography of notched sample fractures is shown. Correlation between the size of the hsub(s) crack effect zone in the notched sample, delta material yield limit and characteristic of cyclic Ksub(s) fracture toughness has been found. Such correlation widens the possibilities of quantitative diagnostics of fractures by the methods of X-ray fractography

  9. Flow and transport in hierarchically fractured systems

    International Nuclear Information System (INIS)

    Karasaki, K.

    1993-01-01

    Preliminary results indicate that flow in the saturated zone at Yucca Mountain is controlled by fractures. A current conceptual model assumes that the flow in the fracture system can be approximately by a three-dimensionally interconnected network of linear conduits. The overall flow system of rocks at Yucca Mountain is considered to consist of hierarchically structured heterogeneous fracture systems of multiple scales. A case study suggests that it is more appropriate to use the flow parameters of the large fracture system for predicting the first arrival time, rather than using the bulk average parameters of the total system

  10. Efficacy of menatetrenone (vitamin K2) against non-vertebral and hip fractures in patients with neurological diseases: meta-analysis of three randomized, controlled trials.

    Science.gov (United States)

    Iwamoto, Jun; Matsumoto, Hideo; Takeda, Tsuyoshi

    2009-01-01

    Patients with neurological diseases such as Alzheimer's disease, stroke and Parkinson's disease have been reported to have vitamin K deficiency secondary to malnutrition, which increases the risk of non-vertebral and hip fractures. The purpose of the present study was to clarify the efficacy of menatetrenone (vitamin K(2)) against non-vertebral and hip fractures in patients with neurological diseases. A literature search was conducted on PubMed from January 1995 to July 2008 to identify randomized controlled trials (RCTs) of use of menatetrenone against non-vertebral and hip fractures in patients with neurological diseases. A meta-analysis of all RCTs meeting these criteria was then performed. Three RCTs of patients with Alzheimer's disease (n = 178, mean age 78 years), stroke (n = 99, mean age 66 years) and Parkinson's disease (n = 110, mean age 72 years) met the criteria for meta-analysis. These RCTs did not include placebo controls but did have non-treatment controls. According to the meta-analysis, the overall relative risks (95% confidence intervals) for non-vertebral and hip fractures with menatetrenone treatment compared with non-treatment were 0.13 (0.05, 0.35) and 0.14 (0.05, 0.43), respectively, in patients with neurological diseases. No severe adverse events were reported with menatetrenone treatment. The present meta-analysis of three RCTs suggests that there is efficacy for menatetrenone treatment against non-vertebral and hip fractures among patients with neurological diseases. Further larger placebo-controlled trials are needed to confirm the results of the present study.

  11. Selective perceptions of hydraulic fracturing.

    Science.gov (United States)

    Sarge, Melanie A; VanDyke, Matthew S; King, Andy J; White, Shawna R

    2015-01-01

    Hydraulic fracturing (HF) is a focal topic in discussions about domestic energy production, yet the American public is largely unfamiliar and undecided about the practice. This study sheds light on how individuals may come to understand hydraulic fracturing as this unconventional production technology becomes more prominent in the United States. For the study, a thorough search of HF photographs was performed, and a systematic evaluation of 40 images using an online experimental design involving N = 250 participants was conducted. Key indicators of hydraulic fracturing support and beliefs were identified. Participants showed diversity in their support for the practice, with 47 percent expressing low support, 22 percent high support, and 31 percent undecided. Support for HF was positively associated with beliefs that hydraulic fracturing is primarily an economic issue and negatively associated with beliefs that it is an environmental issue. Level of support was also investigated as a perceptual filter that facilitates biased issue perceptions and affective evaluations of economic benefit and environmental cost frames presented in visual content of hydraulic fracturing. Results suggested an interactive relationship between visual framing and level of support, pointing to a substantial barrier to common understanding about the issue that strategic communicators should consider.

  12. Fracture reduction and primary ankle arthrodesis: a reliable approach for severely comminuted tibial pilon fracture.

    Science.gov (United States)

    Beaman, Douglas N; Gellman, Richard

    2014-12-01

    Posttraumatic arthritis and prolonged recovery are typical after a severely comminuted tibial pilon fracture, and ankle arthrodesis is a common salvage procedure. However, few reports discuss the option of immediate arthrodesis, which may be a potentially viable approach to accelerate overall recovery in patients with severe fracture patterns. (1) How long does it take the fracture to heal and the arthrodesis to fuse when primary ankle arthrodesis is a component of initial fracture management? (2) How do these patients fare clinically in terms of modified American Orthopaedic Foot and Ankle Society (AOFAS) scores and activity levels after this treatment? (3) Does primary ankle arthrodesis heal in an acceptable position when anterior ankle arthrodesis plates are used? During a 2-year period, we performed open fracture reduction and internal fixation in 63 patients. Eleven patients (12 ankles) with severely comminuted high-energy tibial pilon fractures were retrospectively reviewed after surgical treatment with primary ankle arthrodesis and fracture reduction. Average patient age was 58 years, and minimum followup was 6 months (average, 14 months; range, 6-22 months). Anatomically designed anterior ankle arthrodesis plates were used in 10 ankles. Ring external fixation was used in nine ankles with concomitant tibia fracture or in instances requiring additional fixation. Clinical evaluation included chart review, interview, the AOFAS ankle-hindfoot score, and radiographic evaluation. All of the ankle arthrodeses healed at an average of 4.4 months (range, 3-5 months). One patient had a nonunion at the metaphyseal fracture, which healed with revision surgery. The average AOFAS ankle-hindfoot score was 83 with 88% having an excellent or good result. Radiographic and clinical analysis confirmed a plantigrade foot without malalignment. No patients required revision surgery for malunion. Primary ankle arthrodesis combined with fracture reduction for the severely comminuted

  13. Complications of hip fractures: A review

    Science.gov (United States)

    Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

    2014-01-01

    Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum -a major contributor to fracture healing- in the femoral neck. In extracapsular fractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients. PMID:25232517

  14. Fracture in high performance fibre reinforced concrete pavement materials

    CSIR Research Space (South Africa)

    Denneman, E

    2011-05-01

    Full Text Available of the study is that the accuracy of design models for UTCRCP can benefit from the adoption of fracture mechanics concepts. The experimental framework for this study includes fracture experiments under both monotonic and cyclic loading, on specimens...

  15. Reverse shoulder arthroplasty in acute fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig; Rasmussen, Jeppe; Olsen, Bo Sanderhoff

    2013-01-01

    control group of HA. The median constant score was 58 (range 44-68) which is comparable to previous reviews of HA in 4-part fractures. Complications included dislocation, infection, hematoma, instability, neurological injury, reflex sympathetic dystrophy, intraoperative fractures, periprosthetic fractures...

  16. Higher fish intake is associated with a lower risk of hip fractures in Chinese men and women: a matched case-control study.

    Directory of Open Access Journals (Sweden)

    Fan Fan

    Full Text Available OBJECTIVES: Fish is rich in nutrients that are favorable to bone health, but limited data are available regarding the relationship between fish intake and hip fractures. Our study examined the association between habitual fish intake and risk of hip fractures. METHODS: A case-control study was performed between June 2009 and June 2012 in Guangdong Province, China. Five hundred and eighty-one hip fracture incident cases, aged 55 to 80 years (mean: 71 years, were enrolled from four hospitals. 1∶1 matched controls by gender and age (±3 years were also recruited from communities and hospitals. Face-to-face interviews were used to obtain habitual dietary intake and information on various covariates. RESULTS: Univariate conditional logistic regression analyses showed significantly dose-dependent inverse correlations between the risk of hip fractures and the intake of fresh-water fish, sea fish, mollusca, shellfish, and total fish in all of the subjects (p-trend: <0.001-0.016. After adjusting for covariates, the associations were slightly attenuated but remained significant for all (p-trend: <0.001-0.017 except for fresh-water fish (p = 0.553. The ORs (95%CI of hip fractures for the highest (vs. lowest quartile were 0.80 (0.48-1.31 for fresh-water fish, 0.31 (0.18-0.52 for sea fish, 0.55 (0.34-0.88 for mollusca and shellfish, and 0.47 (0.28-0.79 for total fish, respectively. Stratified and interaction analyses showed that the association was more significant in males than in females (p-interaction = 0.052. CONCLUSION: Higher intake of seafood is independently associated with lower risk of hip fractures in elderly Chinese. Increasing consumption of sea fish may benefit the prevention of hip fractures in this population.

  17. Methodology to predict the initiation of multiple transverse fractures from horizontal wellbores

    Energy Technology Data Exchange (ETDEWEB)

    Crosby, D. G.; Yang, Z.; Rahman, S. S. [Univ. of New South Wales (Australia)

    2001-10-01

    The criterion based on Drucker and Prager which is designed to predict the pressure required to initiate secondary multiple transverse fractures in close proximity to primary fractures is discussed. Results based on this criterion compare favorably with those measured during a series of laboratory-scale hydraulic fracture interaction tests. It is concluded that the multiple fracture criterion and laboratory results demonstrate that transversely fractured horizontal wellbores have a limited capacity to resist the initiation of multiple fractures from adjacent perforations, or intersecting induced and natural fractures. 23 refs., 1 tab., 9 figs.

  18. Foal Fractures: Osteochondral Fragmentation, Proximal Sesamoid Bone Fractures/Sesamoiditis, and Distal Phalanx Fractures.

    Science.gov (United States)

    Reesink, Heidi L

    2017-08-01

    Foals are susceptible to many of the same types of fractures as adult horses, often secondary to external sources of trauma. In addition, some types of fractures are specific to foals and occur routinely in horses under 1 year of age. These foal-specific fractures may be due to the unique musculoskeletal properties of the developing animal and may present with distinct clinical signs. Treatment plans and prognoses are tailored specifically to young animals. Common fractures not affecting the long bones in foals are discussed in this article, including osteochondral fragmentation, proximal sesamoid bone fractures/sesamoiditis, and distal phalanx fractures. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Correlation of fracture index with BMD T score in postmenopausal females

    International Nuclear Information System (INIS)

    Chaudhary, U.J.; Osman, S.S.; Moazam, S.; Shah, S.I.A.

    2004-01-01

    Objective: To find the correlation between fracture index and BMD T-score so that fracture index can be used as a predictive tool for fracture risk estimation in post menopausal females. Design: A cross-sectional study was conducted on a sample of 396 women age 50 years and above. BMD T-score measurements using ultrasound and fracture index calculation based on the risk factor assessment were performed. Results: The study results showed that when fracture index increases BMD T-score decreased to osteoporotic range and correlation coefficient is -0.162. Conclusion: When fracture index increases, BMD T-score decreases therefore we can use fracture index as an assessment tool for predicting fracture risk in postmenopausal females. (author)

  20. Odds ratios for hip- and lower forearm fracture using peripheral bone densitometry; a case-control study of postmenopausal women

    DEFF Research Database (Denmark)

    Saleh, M M A; Jørgensen, H L; Lauritzen, J B

    2002-01-01

    concern when using peripheral densitometry is the poor correlation with the central measurements. The main aim of this study is, therefore, to assess the possibility of expressing ultrasound measurements at the heel and bone mineral density (BMD) measured at the distal forearm as fracture odds ratios...... rather than an absolute measure of bone mass. METHODS: A total of 76 women with lower forearm fracture, 47 women with hip fracture and 231 age-matched women (controls) were included. All had broadband ultrasound attenuation (BUA) and speed of sound (SOS) measured at the heel using the DTU-one ultrasound.......8; 5.2) for heel-BUA (T-score cutoff: -2.3), 4.1 (2.3; 7.4) for heel-SOS (-2.1) and 2.2 (1.3; 3.7) for lower forearm BMD (-2.7). The odds ratio for hip fracture was 3.4 (1.5-7.7) for heel-BUA (-2.7), 3.6 (1.6; 8.1) for heel-SOS (-2.6) and 3.2 (1.4; 7.4) for lower forearm BMD (-2.9). CONCLUSION...

  1. Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism.

    Science.gov (United States)

    Barbosa, Ana Paula; Rui Mascarenhas, Mário; Silva, Carlos Francisco; Távora, Isabel; Bicho, Manuel; do Carmo, Isabel; de Oliveira, António Gouveia

    2015-02-01

    Hyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure. This study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism. We conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (n=24) and control (n=24) groups. A group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (n=24) and control (n=24) groups. BMD (g/cm(2)) at L1-L4, hip, radius 33%, and whole body as well as the total body masses (kg) were studied by DXA. VFA was used to detect fractures and those were classified by Genant's semiquantitative method. No patient had previously been treated for hyperthyroidism, osteoporosis, or low bone mass. Adequate statistical tests were used. The mean age, height, and total fat mass were similar in both groups (P≥0.05). The total lean body mass and the mean BMD at lumbar spine, hip, and whole body were significantly decreased in the hyperthyroidism group. In this group, there was also a trend for an increased prevalence of reduced BMD/osteoporosis and osteoporotic vertebral fractures. The results obtained using VFA technology (confirmed by X-ray) suggest that the BMD changes in young men with nontreated hyperthyroidism may lead to the development of osteoporosis and vertebral fractures. This supports the pertinence of using VFA in the routine of osteoporosis assessment to detect silent fractures precociously and consider early treatment. © 2015 European Society of Endocrinology.

  2. Transverse dispersion in heterogeneous fractures

    International Nuclear Information System (INIS)

    Dershowitz, Bill; Shuttle, Dawn; Klise, Kate; Outters, Nils; Hermanson, Jan

    2004-12-01

    This report evaluates the significance of transverse dispersion processes for solute transport in a single fracture. Transverse dispersion is a potentially significant process because it increases the fracture surface area available for sorptive and diffusive properties, and has the potential to transport solute between what would otherwise be distinctive, streamline pathways. Transverse dispersion processes are generally ignored in one-dimensional repository performance assessment approaches. This report provides an initial assessment of the magnitude of transverse dispersion effect in a single heterogeneous fracture on repository safety assessment. This study builds on a previous report which considered the network effects on transport dispersion including streamline routing and mixing at fracture intersections. The project uses FracMan software. This platform has been extensively used by SKB in other projects. FracMan software is designed to generate and analyze DFN's as well as to compute fluid flow in DFN's with the MAFIC Finite element method (FEM) code. Solute transport was modeled using the particle tracking inside MAFIC, the 2-D Laplace Transform Galerkin inside PAWorks/LTG, and the 1-D Laplace Transform approach designed to replicate FARF31 inside GoldSim.The study reported here focuses on a single, 20-meter scale discrete fracture, with simplified boundary conditions intended to represent the position of this fracture within a fracture network. The range of assumptions made regarding fracture heterogeneity were as follows: Base case, Heterogeneous fracture, geostatistical field, correlation length 0.01 m. Case 1a, Homogeneous fracture, transmissivity = 10 -7 m 2 /s. Case 1b, Heterogeneous fracture, non-channeled geostatistical field correlation length 5 m. Case 1c, Heterogeneous fracture, channeled, anisotropic geostatistical field. Case 1d, Heterogeneous fracture, fracture intersection zone (FIZ) permeability enhanced. Case 5, Simple channelized

  3. Numerical Evaluation and Optimization of Multiple Hydraulically Fractured Parameters Using a Flow-Stress-Damage Coupled Approach

    Directory of Open Access Journals (Sweden)

    Yu Wang

    2016-04-01

    Full Text Available Multiple-factor analysis and optimization play a critical role in the the ability to maximizethe stimulated reservoir volume (SRV and the success of economic shale gas production. In this paper, taking the typical continental naturally fractured silty laminae shale in China as anexample, response surface methodology (RSM was employed to optimize multiple hydraulic fracturing parameters to maximize the stimulated area in combination with numerical modeling based on the coupled flow-stress-damage (FSD approach. This paper demonstrates hydraulic fracturing effectiveness by defining two indicesnamelythe stimulated reservoir area (SRA and stimulated silty laminae area (SLA. Seven uncertain parameters, such as laminae thickness, spacing, dip angle, cohesion, internal friction angle (IFA, in situ stress difference (SD, and an operational parameter-injection rate (IR with a reasonable range based on silty Laminae Shale, Southeastern Ordos Basin, are used to fit a response of SRA and SLA as the objective function, and finally identity the optimum design under the parameters based on simultaneously maximizingSRA and SLA. In addition, asensitivity analysis of the influential factors is conducted for SRA and SLA. The aim of the study is to improve the artificial ability to control the fracturing network by means of multi-parameteroptimization. This work promises to provide insights into the effective exploitation of unconventional shale gas reservoirs via optimization of the fracturing design for continental shale, Southeastern Ordos Basin, China.

  4. Supracondylar fracture in children. Rehabilitation in occupational therapy. Yes or no?

    Science.gov (United States)

    Costa, Maria J.; Pires, Mafalda; Neves, Cassiano; Tavares, Delfin; Quintas, Alexandra M.; Ferreira, Ana I.; Espirito Santo, M. J.; Castro, Alexandra; Cabral, M. Salomé; João Gomes, J. F.

    2013-10-01

    The aim of this study was to evaluate the recovery time of elbow range of motion after treatment of Gartland's type II and III supracondylar fractures of distal humerus in children who attended a program of occupational therapy (OT). A randomized control design (RCD) was conducted to compare the two groups (OT group and Control group) and several statistical methodologies have been used to compare them. In all the cases the results point out to a faster recover in the OT group. All the analysis were performed using the package R version 3.0.1.

  5. Risk factors for proximal sesamoid bone fractures associated with exercise history and horseshoe characteristics in Thoroughbred racehorses.

    Science.gov (United States)

    Anthenill, Lucy A; Stover, Susan M; Gardner, Ian A; Hill, Ashley E

    2007-07-01

    To assess individual and combined associations of high-speed exercise and horseshoe characteristics with risk of forelimb proximal sesamoid bone fractures and proximal sesamoid bone midbody fractures in Thoroughbred racehorses. 269 deceased Thoroughbred racehorses. A case-control study design was used to compare 121 horses with a fracture of at least 1 of 4 forelimb proximal sesamoid bones (75 horses had a midbody fracture) and 148 horses without a forelimb proximal sesamoid bone fracture. Univariable and multivariable logistic regression analyses were used to evaluate potential risk factors for association with proximal sesamoid bone fracture. Compared with horses that died without proximal sesamoid bone fractures, horses that died with proximal sesamoid bone fractures were more likely to be sexually intact males, spend more time in active trainingand racing, complete more events, train and race longer since their last layup, have higher exercise intensities during the 12 months prior to death, and have greater cumulative distances for their career. Horses with proximal sesamoid bone midbody fractures were more likely to be sexually intact males, train and race longer since their last layup, and have higher exercise intensities during the 12 months prior to death. Limitingexercise intensity and the continuous time spent in activity duringa horse's career may decrease the frequency of forelimb proximal sesamoid bone fractures in Thoroughbred horses.

  6. Fracture Mechanics of Concrete

    DEFF Research Database (Denmark)

    Ulfkjær, Jens Peder

    Chapter 1 Chapter l contains the introduction to this thesis. The scope of the thesis is partly to investigate different numerical and analytical models based on fracture mechanical ideas, which are able to predict size effects, and partly to perform an experimental investigation on high-strength......Chapter 1 Chapter l contains the introduction to this thesis. The scope of the thesis is partly to investigate different numerical and analytical models based on fracture mechanical ideas, which are able to predict size effects, and partly to perform an experimental investigation on high......-strength concrete. Chapter 2 A description of the factors which influence the strength and cracking of concrete and high strength concrete is made. Then basic linear fracture mechanics is outlined followed by a description and evaluation of the models used to describe concrete fracture in tension. The chapter ends...... and the goveming equations are explicit and simple. These properties of the model make it a very powerful tool, which is applicable for the designing engineer. The method is also extended to reinforced concrete, where the results look very promising. The large experimental investigation on high-strength concrete...

  7. Mode II brittle fracture: recent developments

    Directory of Open Access Journals (Sweden)

    A. Campagnolo

    2017-10-01

    Full Text Available Fracture behaviour of V-notched specimens is assessed using two energy based criteria namely the averaged strain energy density (SED and Finite Fracture Mechanics (FFM. Two different formulations of FFM criterion are considered for fracture analysis. A new formulation for calculation of the control radius Rc under pure Mode II loading is presented and used for prediction of fracture behaviour. The critical Notch Stress Intensity Factor (NSIF at failure under Mode II loading condition can be expressed as a function of notch opening angle. Different formulations of NSIFs are derived using the three criteria and the results are compared in the case of sharp V-notched brittle components under in-plane shear loading, in order to investigate the ability of each method for the fracture assessment. For this purpose, a bulk of experimental data taken from the literature is employed for the comparison among the mentioned criteria

  8. Dry fracture method for simultaneous measurement of in-situ stress state and material properties

    International Nuclear Information System (INIS)

    Serata, S.; Oka, S.; Kikuchi, S.

    1996-01-01

    Based on the dry fracture principle, a computerized borehole probe has been developed to measure stress state and material properties, simultaneously. The probe is designed to obtain a series of measurements in a continuing sequence along a borehole length, without any interruptive measures, such as resetting packers, taking indentation of borehole wall, overcoming, etc. The new dry fracture probe for the single fracture method is designed to overcome the difficulties posed by its ancestor which was based on the double fracture method. The accuracy of the single fracture method is confirmed by a close agreement with the theory, FE modeling and laboratory testing

  9. Process development for 9Cr nanostructured ferritic alloy (NFA) with high fracture toughness

    International Nuclear Information System (INIS)

    Byun, Thak Sang; Yoon, Ji Hyun; Hoelzer, David T.; Lee, Yong Bok; Kang, Suk Hoon; Maloy, Stuart A.

    2014-01-01

    This article is to summarize the process development and key characterization results for the newly-developed Fe–9Cr based nanostructured ferritic alloys (NFAs) with high fracture toughness. One of the major drawbacks from pursuing ultra-high strength in the past development of NFAs is poor fracture toughness at high temperatures although a high fracture toughness is essential to prevent cracking during manufacturing and to mitigate or delay irradiation-induced embrittlement in irradiation environments. A study on fracture mechanism using the NFA 14YWT found that the low-energy grain boundary decohesion in fracture process at a high temperature (>200 °C) resulted in low fracture toughness. Lately, efforts have been devoted to explore an integrated process to enhance grain bonding. Two base materials were produced through mechanical milling and hot extrusion and designated as 9YWTV-PM1 and 9YWTV-PM2. Isothermal annealing (IA) and controlled rolling (CR) treatments in two phase region were used to enhance diffusion across the interfaces and boundaries. The PM2 alloy after CR treatments showed high fracture toughness (K JQ ) at represented temperatures: 240–280 MPa √m at room temperature and 160–220 MPa √m at 500 °C, which indicates that the goal of 100 MPa √m over possible nuclear application temperature range has been well achieved. Furthermore, it is also confirmed by comparison that the CR treatments on 9YWTV-PM2 result in high fracture toughness similar to or higher than those of the conventional ferritic–martensitic steels such as HT9 and NF616

  10. A metamorphic controller for plant control system design

    Directory of Open Access Journals (Sweden)

    Tomasz Klopot

    2016-07-01

    Full Text Available One of the major problems in the design of industrial control systems is the selection and parameterization of the control algorithm. In practice, the most common solution is the PI (proportional-integral controller, which is simple to implement, but is not always the best control strategy. The use of more advanced controllers may result in a better efficiency of the control system. However, the implementation of advanced control algorithms is more time-consuming and requires specialized knowledge from control engineers. To overcome these problems and to support control engineers at the controller design stage, the paper describes a tool, i.e., a metamorphic controller with extended functionality, for selection and implementation of the most suitable control algorithm. In comparison to existing solutions, the main advantage of the metamorphic controller is its possibility of changing the control algorithm. In turn, the candidate algorithms can be tested through simulations and the total time needed to perform all simulations can be less than a few minutes, which is less than or comparable to the design time in the concurrent design approach. Moreover, the use of well-known tuning procedures, makes the system easy to understand and operate even by inexperienced control engineers. The application was implemented in the real industrial programmable logic controller (PLC and tested with linear and nonlinear virtual plants. The obtained simulation results confirm that the change of the control algorithm allows the control objectives to be achieved at lower costs and in less time.

  11. Clinical assessment tools identify functional deficits in fragility fracture patients

    Directory of Open Access Journals (Sweden)

    Ames TD

    2016-05-01

    Full Text Available Tyler D Ames,1 Corinne E Wee,1 Khoi M Le,1 Tiffany L Wang,1 Julie Y Bishop,2 Laura S Phieffer,2 Carmen E Quatman2 1The Ohio State University College of Medicine, 2Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA Purpose: To identify inexpensive, noninvasive, portable, clinical assessment tools that can be used to assess functional performance measures that may put older patients at risk for falls such as balance, handgrip strength, and lumbopelvic control.Patients and methods: Twenty fragility fracture patients and 21 healthy control subjects were evaluated using clinical assessment tools (Nintendo Wii Balance Board [WBB], a handheld dynamometer, and an application for the Apple iPod Touch, the Level Belt that measure functional performance during activity of daily living tasks. The main outcome measurements were balance (WBB, handgrip strength (handheld dynamometer, and lumbopelvic control (iPod Touch Level Belt, which were compared between fragility fracture patients and healthy controls.Results: Fragility fracture patients had lower scores on the vertical component of the WBB Torso Twist task (P=0.042 and greater medial–lateral lumbopelvic sway during a 40 m walk (P=0.026 when compared to healthy controls. Unexpectedly, the fracture patients had significantly higher scores on the left leg (P=0.020 and total components (P=0.010 of the WBB Single Leg Stand task as well as less faults during the left Single Leg Stand task (P=0.003.Conclusion: The clinical assessment tools utilized in this study are relatively inexpensive and portable tools of performance measures capable of detecting differences in postural sway between fragility fracture patients and controls. Keywords: fall risk, geriatric fracture, Nintendo Wii Balance Board, Level Belt, fragility fracture

  12. Acetabular Fracture

    Directory of Open Access Journals (Sweden)

    Chad Correa

    2017-09-01

    Full Text Available History of present illness: A 77-year-old female presented to her primary care physician (PCP with right hip pain after a mechanical fall. She did not lose consciousness or have any other traumatic injuries. She was unable to ambulate post-fall, so X-rays were ordered by her PCP. Her X-rays were concerning for a right acetabular fracture (see purple arrows, so the patient was referred to the emergency department where a computed tomography (CT scan was ordered. Significant findings: The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows, with associated obturator muscle hematoma (blue oval. Discussion: Acetabular fractures are quite rare. There are 37 pelvic fractures per 100,000 people in the United States annually, and only 10% of these involve the acetabulum. They occur more frequently in the elderly totaling an estimated 4,000 per year. High-energy trauma is the primary cause of acetabular fractures in younger individuals and these fractures are commonly associated with other fractures and pelvic ring disruptions. Fractures secondary to moderate or minimal trauma are increasingly of concern in patients of advanced age.1 Classification of acetabular fractures can be challenging. However, the approach can be simplified by remembering the three basic types of acetabular fractures (column, transverse, and wall and their corresponding radiologic views. First, column fractures should be evaluated with coronally oriented CT images. This type of fracture demonstrates a coronal fracture line running caudad to craniad, essentially breaking the acetabulum into two halves: a front half and a back half. Secondly, transverse fractures should be evaluated by sagittally oriented CT images. By definition, a transverse fracture separates the acetabulum into superior and inferior halves with the fracture line extending from anterior to posterior

  13. 3D printing application and numerical simulations in a fracture system

    Science.gov (United States)

    Yoon, H.; Martinez, M. J.

    2017-12-01

    The hydrogeological and mechanical properties in fractured and porous media are fundamental to predicting coupled multiphysics processes in the subsurface. Recent advances in experimental methods and multi-scale imaging capabilities have revolutionized our ability to quantitatively characterize geomaterials and digital counterparts are now routinely used for numerical simulations to characterize petrophysical and mechanical properties across scales. 3D printing is a very effective and creative technique that reproduce the digital images in a controlled way. For geoscience applications, 3D printing can be co-opted to print reproducible porous and fractured structures derived from CT-imaging of actual rocks and theoretical algorithms for experimental testing. In this work we used a stereolithography (SLA) method to create a single fracture network. The fracture in shale was first scanned using a microCT system and then the digital fracture network was printed into two parts and assembled. Aperture ranges from 0.3 to 1 mm. In particular, we discuss the design of single fracture network and the progress of printing practices to reproduce the fracture network system. Printed samples at different scales are used to measure the permeability and surface roughness. Various numerical simulations including (non-)reactive transport and multiphase flow cases are performed to study fluid flow characterization. We will also discuss the innovative advancement of 3D printing techniques applicable for coupled processes in the subsurface. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology & Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

  14. Do bisphosphonates inhibit direct fracture healing?: A laboratory investigation using an animal model.

    Science.gov (United States)

    Savaridas, T; Wallace, R J; Salter, D M; Simpson, A H R W

    2013-09-01

    Fracture repair occurs by two broad mechanisms: direct healing, and indirect healing with callus formation. The effects of bisphosphonates on fracture repair have been assessed only in models of indirect fracture healing. A rodent model of rigid compression plate fixation of a standardised tibial osteotomy was used. Ten skeletally mature Sprague-Dawley rats received daily subcutaneous injections of 1 µg/kg ibandronate (IBAN) and ten control rats received saline (control). Three weeks later a tibial osteotomy was rigidly fixed with compression plating. Six weeks later the animals were killed. Fracture repair was assessed with mechanical testing, radiographs and histology. The mean stress at failure in a four-point bending test was significantly lower in the IBAN group compared with controls (8.69 Nmm(-2) (sd 7.63) vs 24.65 Nmm(-2) (sd 6.15); p = 0.017). On contact radiographs of the extricated tibiae the mean bone density assessment at the osteotomy site was lower in the IBAN group than in controls (3.7 mmAl (sd 0.75) vs 4.6 mmAl (sd 0.57); p = 0.01). In addition, histological analysis revealed progression to fracture union in the controls but impaired fracture healing in the IBAN group, with predominantly cartilage-like and undifferentiated mesenchymal tissue (p = 0.007). Bisphosphonate treatment in a therapeutic dose, as used for risk reduction in fragility fractures, had an inhibitory effect on direct fracture healing. We propose that bisphosphonate therapy not be commenced until after the fracture has united if the fracture has been rigidly fixed and is undergoing direct osteonal healing.

  15. HAMMLAB 1999 experimental control room: design - design rationale - experiences

    International Nuclear Information System (INIS)

    Foerdestroemmen, N. T.; Meyer, B. D.; Saarni, R.

    1999-01-01

    A presentation of HAMMLAB 1999 experimental control room, and the accumulated experiences gathered in the areas of design and design rationale as well as user experiences. It is concluded that HAMMLAB 1999 experimental control room is a realistic, compact and efficient control room well suited as an Advanced NPP Control Room (ml)

  16. The association between osteoporotic hip fractures and actinic lesions as a biomarker for cumulative sun exposure in older people-a retrospective case-control study in Argentina.

    Science.gov (United States)

    Perroud, H A; Dagatti, M S; Amigot, B; Levit, G P; Tomat, M F; Morosano, M E; Masoni, A M; Pezzotto, S M

    2017-05-01

    The aim of this study was to analyze the association between the presence of actinic lesions (solar keratosis and non-melanoma skin cancer) and osteoporotic hip fractures in older patients. Both pathologies are common conditions in this age group. Since cumulative sun exposure is difficult to quantify, the presence of actinic lesions can be used to indirectly analyze the association between ultraviolet radiation and osteoporotic hip fractures. This was an observational case-control study. We reviewed the centralized medical records of patients with hip fracture (cases, n = 51) and patients with other diseases hospitalized in the same institution and period (controls, n = 59). The mean age of the patients was 80 ± 8.3 years (range 50-103 years). Differences in maternal hip fracture history were found between cases and controls (14.8 and 8 %, respectively; p = 0.047). Falls history in the past year was higher in cases than in controls (p < 0.0001). Actinic lesions were observed in 32.7 % of patients (prevalence rate 23.5 % in cases, 40.7 % in controls; p = 0.04). When considering patients with actinic lesions, controls have a higher FRAX score compared with cases. Although sun exposure is recommended for bone health, it represents a risk factor for actinic lesions. The presence of actinic lesions may indicate a lower osteoporotic hip fracture risk. A balance between adequate lifetime sun exposure and protection against its adverse effects is required for each patient, in the context of geographic location.

  17. Fascia iliaca compartment blockade for acute pain control in hip fracture patients

    DEFF Research Database (Denmark)

    Foss, Nicolai B; Kristensen, Billy B; Bundgaard, Morten

    2007-01-01

    Hip fracture patients are in severe pain upon arrival at the emergency department. Pain treatment is traditionally based on systemic opioids. No study has examined the effect of fascia iliaca compartment blockade (FICB) in acute hip fracture pain management within a double-blind, randomized setup....

  18. Divergent effects of obesity on fragility fractures

    Directory of Open Access Journals (Sweden)

    Caffarelli C

    2014-09-01

    Full Text Available Carla Caffarelli, Chiara Alessi, Ranuccio Nuti, Stefano Gonnelli Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy Abstract: Obesity was commonly thought to be advantageous for maintaining healthy bones due to the higher bone mineral density observed in overweight individuals. However, several recent studies have challenged the widespread belief that obesity is protective against fracture and have suggested that obesity is a risk factor for certain fractures. The effect of obesity on fracture risk is site-dependent, the risk being increased for some fractures (humerus, ankle, upper arm and decreased for others (hip, pelvis, wrist. Moreover, the relationship between obesity and fracture may also vary by sex, age, and ethnicity. Risk factors for fracture in obese individuals appear to be similar to those in nonobese populations, although patterns of falling are particularly important in the obese. Research is needed to determine if and how visceral fat and metabolic complications of obesity (type 2 diabetes mellitus, insulin resistance, chronic inflammation, etc are causally associated with bone status and fragility fracture risk. Vitamin D deficiency and hypogonadism may also influence fracture risk in obese individuals. Fracture algorithms such as FRAX® might be expected to underestimate fracture probability. Studies specifically designed to evaluate the antifracture efficacy of different drugs in obese patients are not available; however, literature data may suggest that in obese patients higher doses of the bisphosphonates might be required in order to maintain efficacy against nonvertebral fractures. Therefore, the search for better methods for the identification of fragility fracture risk in the growing population of adult and elderly subjects with obesity might be considered a clinical priority which could improve the prevention of fracture in obese individuals. Keywords: bone mineral density, BMI

  19. HEALING OF ARTICULAR AND PERIARTICULAR METACARPAL AND PHALANGEAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Aleksandar Kruščić

    2003-12-01

    Full Text Available Background. Primary treatment of 779 closed epiphysial, diaphyseal, comminutive, oblique and periarticular fractures of metacarpals and phalanges was carried out with painless reposition and fixation with a plaster splint. In 435 cases, fracture slides occurred after one week. For correction, the ligamentotaxis metod with aluminium (Alu- splint and Softcast plaster was used. This method allows the retaining of a good position of fractured fragments after reposition by neutralization of the pathologic action of kinetic vectors on these fragments. Our goal in using this method is to stabilize the fractured fragments individually with consideration of soft tissues.Methods. In local (in the fracture or Oberst analgesia, a correct size Alu-splint is placed over the wad-protected skin on the volar or dorsal side of the hand. The Alu-splint is fixed with Urgopore proximally and distally from the fracture. Then, correction using the reduction technique over the Alu-splinting is done. Such correction is followed by X-ray control and if the fragments are in good position, the construction is fixed with plaster. One week later, X-ray control verifies the position of broken parts.Results. In the year 2000, 740 outpatients with a total of 779 (100% metacarpal and phalangeal fractures were treated. There were 569 (73% men and 210 (27% women. The incidence in men was highest in the 10–19 years age group with 143 fractures. In the 50–59 years group, the incidence was equal in men and women (69 fractures. The highest prevalence of fracture slides was in the group of proximal phalanx fractures (190 fractures or 44%. X-ray control after one week showed 435 (56% fracture slides in immobilization with plaster. This high percentage is due to a severe damage to skeletal connective tissue. 321 (41% fractures were re-repositioned with ligamentotaxis, 172 (22% fracture slides were treated using other methods (e.g. surgery. 385 (49% fractures treated with

  20. Associations of early premenopausal fractures with subsequent fractures vary by sites and mechanisms of fractures.

    Science.gov (United States)

    Honkanen, R; Tuppurainen, M; Kroger, H; Alhava, E; Puntila, E

    1997-04-01

    In a retrospective population-based study we assessed whether and how self-reported former fractures sustained at the ages of 20-34 are associated with subsequent fractures sustained at the ages of 35-57. The 12,162 women who responded to fracture questions of the baseline postal enquiry (in 1989) of the Kuopio Osteoporosis Study, Finland formed the study population. They reported 589 former and 2092 subsequent fractures. The hazard ratio (HR), with 95% confidence interval (CI), of a subsequent fracture was 1.9 (1.6-2.3) in women with the history of a former fracture compared with women without such a history. A former low-energy wrist fracture was related to subsequent low-energy wrist [HR = 3.7 (2.0-6.8)] and high-energy nonwrist [HR = 2.4 (1.3-4.4)] fractures, whereas former high-energy nonwrist fractures were related only to subsequent high-energy nonwrist [HR = 2.8 (1.9-4.1)] but not to low-energy wrist [HR = 0.7 (0.3-1.8)] fractures. The analysis of bone mineral density (BMD) data of a subsample of premenopausal women who underwent dual x-ray absorptiometry (DXA) during 1989-91 revealed that those with a wrist fracture due to a fall on the same level at the age of 20-34 recorded 6.5% lower spinal (P = 0.140) and 10.5% lower femoral (P = 0.026) BMD than nonfractured women, whereas the corresponding differences for women with a former nonwrist fracture due to high-energy trauma were -1.8% (P = 0.721) and -2.4% (P = 0. 616), respectively. Our results suggest that an early premenopausal, low-energy wrist fracture is an indicator of low peak BMD which predisposes to subsequent fractures in general, whereas early high-energy fractures are mainly indicators of other and more specific extraskeletal factors which mainly predispose to same types of subsequent fractures only.

  1. The Surgical Treatment and Outcome of Nonmetastatic Extremity Osteosarcoma with Pathological Fractures

    Directory of Open Access Journals (Sweden)

    Zhi-Ping Deng

    2015-01-01

    Conclusions: Our study suggests that surgically treated patients with pathologic fractures in osteosarcoma have adequate local control and do not have a poorer outcome compared to patients without a fracture. Though osteosarcoma with a pathologic fracture is not a contraindication for limb salvage, appropriate case selection is important when deciding local control options to ensure adequate oncologic clearance.

  2. Fracture risk associated with use of antiepileptic drugs.

    Science.gov (United States)

    Vestergaard, Peter; Rejnmark, Lars; Mosekilde, Leif

    2004-11-01

    To assess fracture risk associated with different antiepileptic drugs (AEDs). An increased fracture risk has been reported in patients with epilepsy. Classical AEDs have been associated with decreased bone mineral density. The effects of newer AEDs are unknown. We undertook a population-based pharmacoepidemiologic case-control study with any fracture as outcome and use of AEDs as exposure variables (124,655 fracture cases and 373,962 controls). All AEDs were associated with an increased fracture risk in an unadjusted analysis. After adjustment for prior fracture, use (ever) of corticosteroids, comorbidity, social variables, and diagnosis of epilepsy, carbamazepine [CBZ; odds ratio (OR), 1.18; 95% confidence interval (CI), 1.10-1.26], [and oxcarbazepine (OXC; 1.14, 1.03-1.26)], clonazepam (CZP; 1.27, 1.15-1.41), phenobarbital (PB; 1.79, 1.64-1.95), and valproate (VPA; 1.15, 1.05-1.26) were statistically significantly associated with risk of any fracture. Ethosuximide (0.75, 0.37-1.52), lamotrigine (1.04, 0.91-1.19), phenytoin (1.20, 1.00-1.43), primidone (1.18, 0.95-1.48), tiagabine (0.75, 0.40-1.41), topiramate (1.39, 0.99-1.96), and vigabatrin (0.93, 0.70-1.22) were not statistically significantly associated with fracture risk after adjustment for confounders. The relative increase was modest and in the same range for the significant and nonsignificant results. CBZ, PB, OXC, and VPA displayed a dose-response relation. Fracture risk was more increased by liver-inducing AEDs (OR, 1.38; 95% CI, 1.31-1.45) than by noninducing AEDs (1.19; 95% CI, 1.11-1.27). A very limited increased fracture risk is present in users of CBZ, CZP, OXC, PB, and VPA. A limited significant increase cannot be excluded for the other AEDs because of the statistical power.

  3. Reflections on Hip Fracture Recovery From Older Adults Enrolled in a Clinical Trial

    Directory of Open Access Journals (Sweden)

    Sarah Stott-Eveneshen MA

    2017-03-01

    Full Text Available This study describes patients’ perspectives on recovery during participation in a randomized controlled trial that tested a postoperative hip fracture management program (B4 Clinic, compared with usual care, on mobility. Semistructured qualitative interviews were conducted with 50 older adults with hip fracture (from both groups twice over 12 months. A total of 32 women (64% and 18 men (36% participated in the study with a mean age at baseline of 82 (range = 65-98 years. A total of 40 participants reported recovery goals at some point during their recovery from hip fracture but only 18 participants realized their goals within 12 months. Recovering mobility, returning to prefracture activities, and obtaining stable health were the most commonly reported goals. Participants described good social support, access to physiotherapy, and positive perspective as most important to recovery. These factors were influenced by participants’ knowledge, resources, and monthly contact with study staff (perceived as a form of social support. The most frequently reported barriers to participants’ recovery were the onset of complications, pain, and limited access to physiotherapy. Potential implications of these findings include design and modification of new or preexisting fracture programs, prioritizing patient engagement and enhanced knowledge for future clinical research in hip fracture recovery.

  4. Analytical, numerical and experimental investigations of transverse fracture propagation from horizontal wells

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, M.M.; Hossain, M.M.; Crosby, D.G.; Rahman, M.K.; Rahman, S.S. [School of Petroleum Engineering, The University of New South Wales, 2052 Sydney (Australia)

    2002-08-01

    This paper presents results of a comprehensive study involving analytical, numerical and experimental investigations into transverse fracture propagation from horizontal wells. The propagation of transverse hydraulic fractures from horizontal wells is simulated and investigated in the laboratory using carefully designed experimental setups. Closed-form analytical theories for Mode I (opening) stress intensity factors for idealized fracture geometries are reviewed, and a boundary element-based model is used herein to investigate non-planar propagation of fractures. Using the mixed mode fracture propagation criterion of the model, a reasonable agreement is found with respect to fracture geometry, net fracture pressures and fracture propagation paths between the modeled fractures and the laboratory tested fractures. These results suggest that the propagation of multiple fractures requires higher net pressures than a single fracture, the underlying reason of which is theoretically justified on the basis of local stress distribution.

  5. Novel implant for peri-prosthetic proximal tibia fractures.

    Science.gov (United States)

    Tran, Ton; Chen, Bernard K; Wu, Xinhua; Pun, Chung Lun

    2018-03-01

    Repair of peri-prosthetic proximal tibia fractures is very challenging in patients with a total knee replacement or arthroplasty. The tibial component of the knee implant severely restricts the fixation points of the tibial implant to repair peri-prosthetic fractures. A novel implant has been designed with an extended flange over the anterior of tibial condyle to provide additional points of fixation, overcoming limitations of existing generic locking plates used for proximal tibia fractures. Furthermore, the screws fixed through the extended flange provide additional support to prevent the problem of subsidence of tibial component of knee implant. The design methodology involved extraction of bone data from CT scans into a flexible CAD format, implant design and structural evaluation and optimisation using FEM as well as prototype development and manufacture by selective laser melting 3D printing technology with Ti6Al4 V powder. A prototype tibia implant was developed based on a patient-specific bone structure, which was regenerated from the CT images of patient's tibia. The design is described in detail and being applied to fit up to 80% of patients, for both left and right sides based on the average dimensions and shape of the bone structure from a wide range of CT images. A novel tibial implant has been developed to repair peri-prosthetic proximal tibia fractures which overcomes significant constraints from the tibial component of existing knee implant. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. FTRANS, Radionuclide Flow in Groundwater and Fractured Rock

    International Nuclear Information System (INIS)

    Huyakorn, P.; Golis, M.J.

    1987-01-01

    1 - Description of program or function: FTRANS (Fractured flow and Transport of Radionuclides) is a two-dimensional finite-element code designed to simulate ground-water flow and transport of radioactive nuclides in a fractured porous return medium. FTRANS takes into account fluid interactions between the fractures and porous matrix blocks, advective-dispersive transport in the fractures and diffusion in the porous matrix blocks, and chain reactions of radionuclide components. It has the capability to model the fractured system using either the dual-porosity or the discrete- fracture modeling approach or a combination of both. FTRANS can be used to perform two-dimensional near-field or far-field predictive analyses of ground-water flow and to perform risk assessments of radionuclide transport from nuclear waste repository subsystems to the biosphere. 2 - Restrictions on the complexity of the problem: Although FTRANS does cannot account for deformation processes which can affect the flow capacity and velocity field

  7. Functional results following fractures of the proximal humerus. A controlled clinical study comparing two periods of immobilization

    DEFF Research Database (Denmark)

    Kristiansen, B; Angermann, P; Larsen, T K

    1989-01-01

    In order to compare 1 and 3 weeks of immobilization following proximal humeral fractures a prospective controlled trial was performed in 85 patients. Clinical follow-up according to the Neer assessment system was done after 1, 3, 6, 12, and 24 months. One week of immobilization resulted in a better...

  8. Expressing effects of osteoporosis interventions in terms of postponing of fractures

    DEFF Research Database (Denmark)

    Christensen, Palle Mark; Brøsen, Kim; Brixen, Kim

    2002-01-01

    the benefit for those few who actually could benefit. CONCLUSIONS: The benefit in terms of average postponement of hip fractures from osteoporosis intervention was, other things being equal, greatest in women aged 70-90 years. Fracture postponement may represent an alternative to risk reductions in expressing......OBJECTIVE: To estimate the effect from an osteoporosis intervention in terms of postponement of hip fractures. DESIGN: A Markov model using Nordic data on mortality and hip fracture incidence. PATIENTS: Women aged 50 years and older with increased risk of hip fracture. INTERVENTION: A hypothetical...

  9. Controller design for interval plants

    International Nuclear Information System (INIS)

    Al-Sunni, F.M.

    2003-01-01

    We make use of celebrated Kharitoniv theorem to come up with a design procedure for the stabilization of uncertain systems in the parameters using low order controllers. The proposed design is based on classical design methods. A Non-linear programming (NLP) approach for the design of higher order controllers is also presented. We present our results and give illustrating examples. (author)

  10. Practical design control implementation for medical devices

    CERN Document Server

    Justiniano, Jose

    2003-01-01

    Bringing together the concepts of design control and reliability engineering, this book is a must for medical device manufacturers. It helps them meet the challenge of designing and developing products that meet or exceed customer expectations and also meet regulatory requirements. Part One covers motivation for design control and validation, design control requirements, process validation and design transfer, quality system for design control, and measuring design control program effectiveness. Part Two discusses risk analysis and FMEA, designing-in reliability, reliability and design verific

  11. Fracture strengths of chair‑side‑generated veneers cemented with ...

    African Journals Online (AJOL)

    Introduction: CAD/CAM (computer‑aided design and computer‑aided manufacturing) systems have refreshed the idea of chair‑side production of restorations, but the fracture of ceramic veneers remains a problem. Cementation with glass fibers may improve the fracture strengths and affect the failure modes of ...

  12. Arthroplasty for Unreconstructable Acute Fractures and Failed Fracture Fixation About the Hip and Knee in the Active Elderly: A New Paradigm.

    Science.gov (United States)

    Kyle, Richard F; Duwelius, Paul J; Haidukewych, George J; Schmidt, Andrew H

    2017-02-15

    The techniques, materials, and designs for total joint arthroplasty underwent major improvements in the past 30 years. During this time, trauma surgeons classified the severity of fractures as well as identified certain articular fractures that do not have good outcomes and have a high rate of failure after internal fixation. Advanced improvements in arthroplasty have increased its reliability and longevity. Total joint arthroplasty is becoming a standard of care for some acute articular fractures, particularly displaced femoral neck fractures in the active elderly. Total joint arthroplasty also has become the standard of care after failed internal fixation in patients who have very complicated fractures about the knee, hip, and shoulder. As the population ages, fractures worldwide continue to rapidly increase. Elderly patients have a high risk for fractures that result from falls because of their poor bone quality. The current active elderly population participates in higher risk activities than previous elderly populations, which places them at risk for more injuries. This has become both a worldwide healthcare problem and an economic problem. Surgeons need to manage fractures in the active elderly with the latest advancements in technology and patient selection to ensure rapid recovery and the reduction of complications.

  13. Fracture risk in Danish men with prostate cancer

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Nielsen, Morten F; Eskildsen, Peter Claes

    2007-01-01

    To assess the risk of fracture attributable to prostate cancer, and the impact of exposure to prescribed gonadotrophin-releasing hormone agonists and antiandrogens on this risk in a nationwide, population-based case-control study.......To assess the risk of fracture attributable to prostate cancer, and the impact of exposure to prescribed gonadotrophin-releasing hormone agonists and antiandrogens on this risk in a nationwide, population-based case-control study....

  14. Internal fracture heterogeneity in discrete fracture network modelling: Effect of correlation length and textures with connected and disconnected permeability field

    Science.gov (United States)

    Frampton, A.; Hyman, J.; Zou, L.

    2017-12-01

    Analysing flow and transport in sparsely fractured media is important for understanding how crystalline bedrock environments function as barriers to transport of contaminants, with important applications towards subsurface repositories for storage of spent nuclear fuel. Crystalline bedrocks are particularly favourable due to their geological stability, low advective flow and strong hydrogeochemical retention properties, which can delay transport of radionuclides, allowing decay to limit release to the biosphere. There are however many challenges involved in quantifying and modelling subsurface flow and transport in fractured media, largely due to geological complexity and heterogeneity, where the interplay between advective and dispersive flow strongly impacts both inert and reactive transport. A key to modelling transport in a Lagrangian framework involves quantifying pathway travel times and the hydrodynamic control of retention, and both these quantities strongly depend on heterogeneity of the fracture network at different scales. In this contribution, we present recent analysis of flow and transport considering fracture networks with single-fracture heterogeneity described by different multivariate normal distributions. A coherent triad of fields with identical correlation length and variance are created but which greatly differ in structure, corresponding to textures with well-connected low, medium and high permeability structures. Through numerical modelling of multiple scales in a stochastic setting we quantify the relative impact of texture type and correlation length against network topological measures, and identify key thresholds for cases where flow dispersion is controlled by single-fracture heterogeneity versus network-scale heterogeneity. This is achieved by using a recently developed novel numerical discrete fracture network model. Furthermore, we highlight enhanced flow channelling for cases where correlation structure continues across

  15. Frictional stability-permeability relationships for fractures in shales

    Science.gov (United States)

    Fang, Yi; Elsworth, Derek; Wang, Chaoyi; Ishibashi, Takuya; Fitts, Jeffrey P.

    2017-03-01

    There is wide concern that fluid injection in the subsurface, such as for the stimulation of shale reservoirs or for geological CO2 sequestration (GCS), has the potential to induce seismicity that may change reservoir permeability due to fault slip. However, the impact of induced seismicity on fracture permeability evolution remains unclear due to the spectrum of modes of fault reactivation (e.g., stable versus unstable). As seismicity is controlled by the frictional response of fractures, we explore friction-stability-permeability relationships through the concurrent measurement of frictional and hydraulic properties of artificial fractures in Green River shale (GRS) and Opalinus shale (OPS). We observe that carbonate-rich GRS shows higher frictional strength but weak neutral frictional stability. The GRS fracture permeability declines during shearing while an increased sliding velocity reduces the rate of permeability decline. By comparison, the phyllosilicate-rich OPS has lower friction and strong stability while the fracture permeability is reduced due to the swelling behavior that dominates over the shearing induced permeability reduction. Hence, we conclude that the friction-stability-permeability relationship of a fracture is largely controlled by mineral composition and that shale mineral compositions with strong frictional stability may be particularly subject to permanent permeability reduction during fluid infiltration.

  16. Using microstructure observations to quantify fracture properties and improve reservoir simulations. Final report, September 1998

    Energy Technology Data Exchange (ETDEWEB)

    Laubach, S.E.; Marrett, R.; Rossen, W.; Olson, J.; Lake, L.; Ortega, O.; Gu, Y.; Reed, R.

    1999-01-01

    The research for this project provides new technology to understand and successfully characterize, predict, and simulate reservoir-scale fractures. Such fractures have worldwide importance because of their influence on successful extraction of resources. The scope of this project includes creation and testing of new methods to measure, interpret, and simulate reservoir fractures that overcome the challenge of inadequate sampling. The key to these methods is the use of microstructures as guides to the attributes of the large fractures that control reservoir behavior. One accomplishment of the project research is a demonstration that these microstructures can be reliably and inexpensively sampled. Specific goals of this project were to: create and test new methods of measuring attributes of reservoir-scale fractures, particularly as fluid conduits, and test the methods on samples from reservoirs; extrapolate structural attributes to the reservoir scale through rigorous mathematical techniques and help build accurate and useful 3-D models of the interwell region; and design new ways to incorporate geological and geophysical information into reservoir simulation and verify the accuracy by comparison with production data. New analytical methods developed in the project are leading to a more realistic characterization of fractured reservoir rocks. Testing diagnostic and predictive approaches was an integral part of the research, and several tests were successfully completed.

  17. Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS).

    Science.gov (United States)

    Kemmler, W; Bebenek, M; Kohl, M; von Stengel, S

    2015-10-01

    The EFOPS trial clearly established the positive effect of long-term exercise on clinical low-trauma fractures in postmenopausal women at risk. Bearing in mind that the complex anti-fracture exercise protocols also affect a large variety of diseases of increased age, we strongly encourage older adults to perform multipurpose exercise programs. Physical exercise may be an efficient option for autonomous fracture prevention during increasing age. The aim of the study was to evaluate the effect of exercise on clinical overall fracture incidence and bone mineral density (BMD) in elderly subjects at risk. In 1998 initially, 137 early-postmenopausal, osteopenic women living in Erlangen-Nuremberg, Germany, were included in the EFOPS trial. Subjects of the exercise group (EG; n = 86) conducted two supervised group and two home exercise sessions/week while the control group (CG; n = 51) was requested to maintain their physical activity. Primary study endpoints were clinical overall low-trauma fractures determined by questionnaires, structured interviews, and BMD at the lumbar spine and femoral neck assessed by dual-energy X-ray absorptiometry. In 2014, 105 subjects (EG: n = 59 vs. CG: n = 46) representing 1680 participant-years were included in the 16-year follow-up analysis. Risk ratio in the EG for overall low-trauma fractures was 0.51 (95% confidence interval (95% CI) 0.23 to 0.97, p = .046), rate ratio was 0.42 (95% CI 0.20 to 0.86, p = .018). Based on comparable baseline values, lumbar spine (MV -1.5%, 95% CI -0.1 to -2.8 vs. -5.8%, -3.3 to -7.2%) and femoral neck (-6.5%, -5.2 to -7.7 vs. -9.6%, -8.2 to 11.1%) BMD decreased in both groups; however, the reduction was more pronounced in the CG (p ≤ .001). This study clearly evidenced the high anti-fracture efficiency of multipurpose exercise programs. Considering furthermore the favorable effect of exercise on most other risk factors of increasing age, we strongly encourage older adults to perform multipurpose

  18. Displaced Proximal Humerus Fractures: is a Sling as Good as a Plate?

    Science.gov (United States)

    Steinhaus, Michael E; Dare, David M; Gulotta, Lawrence V

    2016-10-01

    The treatment of displaced proximal humerus fractures is challenging and complex, as its success is predicated on multiple factors. While it is clear that a majority of proximal humerus fractures may be treated nonoperatively, it is less clear which patients benefit from surgical management. The PROFHER trial, a randomized controlled study, used patient-reported outcomes to compare surgical to nonsurgical management of displaced proximal humerus fractures. The purpose of this review is to highlight the strengths and weaknesses of the PROFHER trial and to assess the validity of its conclusion in the context of existing literature. The authors found no difference in the Oxford Shoulder Score (OSS) between the surgical and nonsurgical groups. Additionally, no difference was found between groups in any of the secondary outcomes, which included the Short-Form 12 (SF-12) health survey, surgical and fracture-related complications, additional surgery or therapy, inpatient medical complications, and mortality. They concluded that the recent increase in surgical management of proximal humerus fractures is perhaps unwarranted. While the randomization was successful and the pragmatic design may enable greater generalizability, this study possesses numerous flaws inherent in such an ambitious endeavor, including an inability to identify specific factors which explain the lack of superiority of surgical management. Despite its weaknesses, this study is a valuable datapoint which encourages surgeons to reexamine their surgical indications for this injury.

  19. Ballistic fractures: indirect fracture to bone.

    Science.gov (United States)

    Dougherty, Paul J; Sherman, Don; Dau, Nathan; Bir, Cynthia

    2011-11-01

    Two mechanisms of injury, the temporary cavity and the sonic wave, have been proposed to produce indirect fractures as a projectile passes nearby in tissue. The purpose of this study is to evaluate the temporal relationship of pressure waves using strain gauge technology and high-speed video to elucidate whether the sonic wave, the temporary cavity, or both are responsible for the formation of indirect fractures. Twenty-eight fresh frozen cadaveric diaphyseal tibia (2) and femurs (26) were implanted into ordnance gelatin blocks. Shots were fired using 9- and 5.56-mm bullets traversing through the gelatin only, passing close to the edge of the bone, but not touching, to produce an indirect fracture. High-speed video of the impact event was collected at 20,000 frames/s. Acquisition of the strain data were synchronized with the video at 20,000 Hz. The exact time of fracture was determined by analyzing and comparing the strain gauge output and video. Twenty-eight shots were fired, 2 with 9-mm bullets and 26 with 5.56-mm bullets. Eight indirect fractures that occurred were of a simple (oblique or wedge) pattern. Comparison of the average distance of the projectile from the bone was 9.68 mm (range, 3-20 mm) for fractured specimens and 15.15 mm (range, 7-28 mm) for nonfractured specimens (Student's t test, p = 0.036). In this study, indirect fractures were produced after passage of the projectile. Thus, the temporary cavity, not the sonic wave, was responsible for the indirect fractures.

  20. Robust control design with MATLAB

    CERN Document Server

    Gu, Da-Wei; Konstantinov, Mihail M

    2013-01-01

    Robust Control Design with MATLAB® (second edition) helps the student to learn how to use well-developed advanced robust control design methods in practical cases. To this end, several realistic control design examples from teaching-laboratory experiments, such as a two-wheeled, self-balancing robot, to complex systems like a flexible-link manipulator are given detailed presentation. All of these exercises are conducted using MATLAB® Robust Control Toolbox 3, Control System Toolbox and Simulink®. By sharing their experiences in industrial cases with minimum recourse to complicated theories and formulae, the authors convey essential ideas and useful insights into robust industrial control systems design using major H-infinity optimization and related methods allowing readers quickly to move on with their own challenges. The hands-on tutorial style of this text rests on an abundance of examples and features for the second edition: ·        rewritten and simplified presentation of theoretical and meth...

  1. Simulation of a multistage fractured horizontal well in a water-bearing tight fractured gas reservoir under non-Darcy flow

    Science.gov (United States)

    Zhang, Rui-Han; Zhang, Lie-Hui; Wang, Rui-He; Zhao, Yu-Long; Huang, Rui

    2018-06-01

    Reservoir development for unconventional resources such as tight gas reservoirs is in increasing demand due to the rapid decline of production in conventional reserves. Compared with conventional reservoirs, fluid flow in water-bearing tight gas reservoirs is subject to more nonlinear multiphase flow and gas slippage in nano/micro matrix pores because of the strong collisions between rock and gas molecules. Economic gas production from tight gas reservoirs depends on extensive application of water-based hydraulic fracturing of horizontal wells, associated with non-Darcy flow at a high flow rate, geomechanical stress sensitivity of un-propped natural fractures, complex flow geometry and multiscale heterogeneity. How to efficiently and accurately predict the production performance of a multistage fractured horizontal well (MFHW) is challenging. In this paper, a novel multicontinuum, multimechanism, two-phase simulator is established based on unstructured meshes and the control volume finite element method to analyze the production performance of MFHWs. The multiple interacting continua model and discrete fracture model are coupled to integrate the unstimulated fractured reservoir, induced fracture networks (stimulated reservoir volumes, SRVs) and irregular discrete hydraulic fractures. Several simulations and sensitivity analyses are performed with the developed simulator for determining the key factors affecting the production performance of MFHWs. Two widely applied fracturing models, classic hydraulic fracturing which generates long double-wing fractures and the volumetric fracturing aimed at creating large SRVs, are compared to identify which of them can make better use of tight gas reserves.

  2. Radiological controls integrated into design

    Energy Technology Data Exchange (ETDEWEB)

    Kindred, G.W. [Cleveland Electric Illuminating Co., Perry, OH (United States)

    1995-03-01

    Radiological controls are required by law in the design of commercial nuclear power reactor facilities. These controls can be relatively minor or significant, relative to cost. To ensure that radiological controls are designed into a project, the health physicist (radiological engineer) must be involved from the beginning. This is especially true regarding keeping costs down. For every radiological engineer at a nuclear power plant there must be fifty engineers of other disciplines. The radiological engineer cannot be an expert on every discipline of engineering. However, he must be knowledgeable to the degree of how a design will impact the facility from a radiological perspective. This paper will address how to effectively perform radiological analyses with the goal of radiological controls integrated into the design package.

  3. Influence of core design, production technique, and material selection on fracture behavior of yttria-stabilized tetragonal zirconia polycrystal fixed dental prostheses produced using different multilayer techniques: split-file, over-pressing, and manually built-up veneers

    Directory of Open Access Journals (Sweden)

    Mahmood DJH

    2016-02-01

    Full Text Available Deyar Jallal Hadi Mahmood, Ewa H Linderoth, Ann Wennerberg, Per Vult Von Steyern Department of Prosthetic Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden Aim: To investigate and compare the fracture strength and fracture mode in eleven groups of currently, the most commonly used multilayer three-unit all-ceramic yttria-stabilized tetragonal zirconia polycrystal (Y-TZP fixed dental prostheses (FDPs with respect to the choice of core material, veneering material area, manufacturing technique, design of connectors, and radii of curvature of FDP cores. Materials and methods: A total of 110 three-unit Y-TZP FDP cores with one intermediate pontic were made. The FDP cores in groups 1–7 were made with a split-file design, veneered with manually built-up porcelain, computer-aided design-on veneers, and over-pressed veneers. Groups 8–11 consisted of FDPs with a state-of-the-art design, veneered with manually built-up porcelain. All the FDP cores were subjected to simulated aging and finally loaded to fracture. Results: There was a significant difference (P<0.05 between the core designs, but not between the different types of Y-TZP materials. The split-file designs with VITABLOCS® (1,806±165 N and e.max® ZirPress (1,854±115 N and the state-of-the-art design with VITA VM® 9 (1,849±150 N demonstrated the highest mean fracture values. Conclusion: The shape of a split-file designed all-ceramic reconstruction calls for a different dimension protocol, compared to traditionally shaped ones, as the split-file design leads to sharp approximal indentations acting as fractural impressions, thus decreasing the overall strength. The design of a framework is a crucial factor for the load bearing capacity of an all-ceramic FDP. The state-of-the-art design is preferable since the split-file designed cores call for a cross-sectional connector area at least 42% larger, to have the same load bearing capacity as the state-of-the-art designed

  4. A case-control study of surgical site infection following operative fixation of fractures of the ankle in a large U.K. trauma unit.

    Science.gov (United States)

    Korim, M T; Payne, R; Bhatia, M

    2014-05-01

    Most of the literature on surgical site infections following the surgical treatment of fractures of the ankle is based on small series of patients, focusing on diabetics or the elderly. None have described post-operative functional scores in those patients who develop an infection. We performed an age- and gender-matched case-control study to identify patient- and surgery-related risk factors for surgical site infection following open reduction and internal fixation of a fracture of the ankle. Logistic regression analysis was used to identify significant risk factors for infection and to calculate odds ratios (OR). Function was assessed using the Olerud and Molander Ankle Score. The incidence of infection was 4% (29/717) and 1.1% (8/717) were deep infections. The median ankle score was significantly lower in the infection group compared with the control group (60 vs 90, Mann-Whitney test p fractures (OR = 4, p = 0.048) were significant risk factors for infection. A low incidence of infection following open reduction and internal fixation of fractures of the ankle was observed. Both superficial and deep infections result in lower functional scores.

  5. Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures: a systematic review of 13,568 patients.

    Science.gov (United States)

    Norris, Rory; Bhattacharjee, Dhritiman; Parker, Martyn J

    2012-06-01

    A sliding hip screw (SHS) is currently the treatment of choice for trochanteric hip fractures, largely due to the low incidence of complications. An alternative treatment is the use of intramedullary proximal femoral nails. Unfortunately these implants have been associated with a risk of later fracture around the implant. The aim of this study was to see if any improvements have been made to the current intramedullary nails, to reduce the incidence of secondary fracture around the distal tip of the nail. We analysed data related to 13,568 patients from 89 studies, focusing on the incidence of post operative secondary femoral shaft fracture following the use of intramedullary nails in the fixation of trochanteric hip fractures. The overall reported incidence of secondary fracture around the nail was 1.7%. The incidence of fracture has reduced in the 3rd generation Gamma nails when compared to the older Gamma nail (1.7% versus 2.6%, p value 0.03). However, the incidence of secondary fracture in the 3rd generation Gamma nails is still significantly higher than the other brands of short nail (1.7% versus 0.7%, p value 0.0005). Long nails had a slight tendency towards a lower risk of fracture although the difference was not statistically significant (1.1% versus 1.7%, p value 0.28). There was a significantly lower risk of fracture for those nails with a biaxial fixation as opposed to uniaxial fixation (0.6% versus 1.9%, p value fracture around a proximal femoral nail is one of the most significant of fracture healing complications, and this study suggests that continuing design changes to this method of fixation has reduced the risk of this complication occurring. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Incidence of low- and high-energy fractures in persons with and without HIV-infection: a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Hansen, Ann-Brit E; Gerstoft, Jan; Kronborg, Gitte

    2012-01-01

    significantly increased after HAART-exposure, IRR of 1.8 (95% CI; 1.5-2.1). The increased risk in HAART-exposed patients was not associated with CD4 cell count, prior AIDS, tenofovir or efavirenz exposure, but with comorbidity and smoking. CONCLUSIONS:: HIV-infected patients had increased risk of fracture......OBJECTIVE:: To compare fracture risk in persons with and without HIV-infection and to examine the influence of HAART initiation on risk of fracture. DESIGN:: Population-based nationwide cohort study using Danish registries. METHODS:: Outcome measures were time to first fracture at any site, time...... to first low-energy and high-energy fracture in HIV-infected patients (n¿=¿5,306) compared with a general population control cohort (n¿=¿26,530) matched by sex and age during the study period 1995 to 2009. Cox regression analyses were used to estimate incidence rate ratios (IRR). RESULTS:: HIV-infected...

  7. Distinguishing stress fractures from pathologic fractures: a multimodality approach

    International Nuclear Information System (INIS)

    Fayad, Laura M.; Kamel, Ihab R.; Kawamoto, Satomi; Bluemke, David A.; Fishman, Elliot K.; Frassica, Frank J.

    2005-01-01

    Whereas stress fractures occur in normal or metabolically weakened bones, pathologic fractures occur at the site of a bone tumor. Unfortunately, stress fractures may share imaging features with pathologic fractures on plain radiography, and therefore other modalities are commonly utilized to distinguish these entities. Additional cross-sectional imaging with CT or MRI as well as scintigraphy and PET scanning is often performed for further evaluation. For the detailed assessment of a fracture site, CT offers a high-resolution view of the bone cortex and periosteum which aids the diagnosis of a pathologic fracture. The character of underlying bone marrow patterns of destruction can also be ascertained along with evidence of a soft tissue mass. MRI, however, is a more sensitive technique for the detection of underlying bone marrow lesions at a fracture site. In addition, the surrounding soft tissues, including possible involvement of adjacent muscle, can be well evaluated with MRI. While bone scintigraphy and FDG-PET are not specific, they offer a whole-body screen for metastases in the case of a suspected malignant pathologic fracture. In this review, we present select examples of fractures that underscore imaging features that help distinguish stress fractures from pathologic fractures, since accurate differentiation of these entities is paramount. (orig.)

  8. Double segmental tibial fractures - an unusual fracture pattern

    Directory of Open Access Journals (Sweden)

    Bali Kamal

    2012-02-01

    Full Text Available 【Abstract】A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibia and multisegmental fractures of the fibula. Review of the literature revealed that this fracture pattern was unique and only a single case was reported so far. Moreover, we discussed the possible mechanisms which can lead to such an injury. We also discussed the management of segmental tibial fracture and the difficulties encountered with them. This case was managed by modern osteosynthesis tech- nique with a pleasing outcome. Key words: Fracture, bone; Tibia; Fibula; Nails

  9. Microstructural design in quenched and partitioned (Q&P) steels to improve their fracture properties

    International Nuclear Information System (INIS)

    Diego-Calderón, I. de; Sabirov, I.; Molina-Aldareguia, J.M.; Föjer, C.; Thiessen, R.; Petrov, R.H.

    2016-01-01

    Quenching and partitioning (Q&P) is receiving increased attention as a novel heat treatment to produce advanced high strength steels (AHSSs) containing martensite/retained austenite mixtures, with desirable combination of strength, ductility and toughness. Despite the significant body of research on microstructure and mechanical properties of Q&P steels, there is still a significant lack of knowledge on the effect of complex microstructure on their mechanical performance. This work addresses the effect of microstructural architecture in multiphase Q&P steels on their fracture behavior at macro- and micro-scales. It is demonstrated that the RA volume fraction does not affect significantly the local fracture initiation toughness, whereas it can greatly improve the total crack growth resistance in Q&P steels. In addition, matrix conditions can play an important role in the fracture behavior of Q&P steels. Based on the analysis of the experimental results, a general recipe to tailor fracture properties of Q&P steels is proposed.

  10. Malnutrition in hip fracture patients: an intervention study.

    Science.gov (United States)

    Olofsson, Birgitta; Stenvall, Michael; Lundström, Maria; Svensson, Olle; Gustafson, Yngve

    2007-11-01

    To investigate whether a nutritional intervention in older women and men with femoral neck fracture had an effect on postoperative complications during hospitalization and on nutritional status at a four-month follow-up. The design was a randomized controlled trial. The present study sample consisted of 157 patients aged 70 years and above with femoral neck fracture. The nutritional intervention included, among other things, a nutritional journal to detect nutrition deficiencies and protein-enriched meals for at least four days postoperatively. Further, at least two nutritional and protein drinks were served each day during the whole hospitalization and other factors that would influence the patient's nutrition were also considered and dealt with. Postoperative complications were registered and patients were assessed using the Mini Nutritional Assessment (MNA) scale, including body mass index (BMI), on admission and at a four-month follow-up. Malnutrition was common and low MNA scores were associated with postoperative complications such as delirium and decubitus ulcers. There were significantly fewer days of delirium in the intervention group, seven patients in the intervention group developed decubitus ulcers vs. 14 patients in the control group and the total length of hospitalization was shorter. There were no detectable significant improvements regarding nutritional parameters between the intervention and the control group at the four-month follow-up but men improved their mean BMI, body weight and MNA scores in both the intervention and the control groups while women deteriorated in both groups. Malnutrition was common among older people with hip fractures admitted to hospital. The nutritional intervention might have contributed to the patients suffering fewer days with delirium, fewer decubitus ulcers and shorter hospitalization but did not improve the long-term nutritional status, at least not in women. This nutritional intervention, which was included in a

  11. Description of Fracture Systems for External Criticality Reports

    International Nuclear Information System (INIS)

    Nicot, Jean-Philippe

    2001-01-01

    The purpose of this Analysis/Model Report (AMR) is to describe probabilistically the main features of the geometry of the fracture system in the vicinity of the repository. They will be used to determine the quantity of fissile material that could accumulate in the fractured rock underneath a waste package as it degrades. This AMR is to feed the geochemical calculations for external criticality reports. This AMR is done in accordance with the technical work plan (BSC (Bechtel SAIC Company) 2001 b). The scope of this AMR is restricted to the relevant parameters of the fracture system. The main parameters of interest are fracture aperture and fracture spacing distribution parameters. The relative orientation of the different fracture sets is also important because of its impact on criticality, but they will be set deterministically. The maximum accumulation of material depends primarily on the fracture porosity, combination of the fracture aperture, and fracture intensity. However, the fracture porosity itself is not sufficient to characterize the potential for accumulation of a fracture system. The fracture aperture is also important because it controls both the flow through the fracture and the potential plugging of the system. Other features contributing to the void space such as lithophysae are also investigated. On the other hand, no analysis of the matrix porosity is done. The parameters will be used in sensitivity analyses of geochemical calculations providing actinide accumulations and in the subsequent Monte Carlo criticality analyses

  12. Elevated temperature fracture mechanics

    International Nuclear Information System (INIS)

    Tomkins, B.

    1979-01-01

    The application of fracture mechanics concepts to cracks at elevated temperatures is examined. Particular consideration is given to the characterisation of crack tip stress-strain fields and parameters controlling crack extension under static and cyclic loads. (author)

  13. Kinetics and fracture resistance of lithiated silicon nanostructure pairs controlled by their mechanical interaction

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seok Woo; /Stanford U., Geballe Lab.; Lee, Hyun-Wook; /Stanford U., Materials Sci. Dept.; Ryu, Ill; /Brown U.; Nix, William D.; /Stanford U., Materials Sci. Dept.; Gao, Huajian; /Brown U.; Cui, Yi; /Stanford U., Materials Sci. Dept. /SLAC

    2015-06-01

    Following an explosion of studies of silicon as a negative electrode for Li-ion batteries, the anomalous volumetric changes and fracture of lithiated single Si particles have attracted significant attention in various fields, including mechanics. However, in real batteries, lithiation occurs simultaneously in clusters of Si in a confined medium. Hence, understanding how the individual Si structures interact during lithiation in a closed space is necessary. Herein, we demonstrate physical/mechanical interactions of swelling Si structures during lithiation using well-defined Si nanopillar pairs. Ex situ SEM and in situ TEM studies reveal that compressive stresses change the reaction kinetics so that preferential lithiation occurs at free surfaces when the pillars are mechanically clamped. Such mechanical interactions enhance the fracture resistance of This material is based upon work supported by the U.S. Department of Energy, Office of Science, Office of Basic Energy Sciences, Division of Materials Sciences and Engineering, under Contract No. DE-AC02-76SF00515. SLAC-PUB-16300 2 lithiated Si by lessening the tensile stress concentrations in Si structures. This study will contribute to improved design of Si structures at the electrode level for high performance Li-ion batteries.

  14. Fractures and the increased risk of suicide.

    Science.gov (United States)

    Chang, C-F; Lai, E C-C; Yeh, M-K

    2018-06-01

    Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients' demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of suicide. In addition, we found that patients who had a lower income, had never married, had lower levels of educational attainment, or had coexistent physical and mental conditions such as anxiety, mood disorders, and psychosis-related disorders had a higher risk of suicide. Conclusion Fractures, specifically those of the hip and spine, were associated with an increased risk of suicide. The findings suggest that greater clinical attention should be given to this risk in patients with fractures, especially for those with additional risk factors. Cite this article: Bone Joint J 2018;100-B:780-6.

  15. The successful use of transverse hydraulic fractures from horizontal wellbores

    Energy Technology Data Exchange (ETDEWEB)

    Crosby, D. G.; Yang, Z.; Rahman, S. S. [New South Wales Univ., NSW (Australia)

    1998-12-31

    Since a significant proportion of the world`s recoverable hydrocarbon resources exist in reservoirs possessing permeabilities of less than one milli-Darcy (mD), some form of permeability enhancement or stimulation is necessary if the hydrocarbons are to be exploited economically. Multi-stage, transversely fractured horizontal wellbores are shown to have the potential to greatly increase production from low permeability formations. To overcome the problems caused by near-wellbore tortuosity, common to wells with multiple fracturing from the same perforated interval, a criterion was devised which predicts the wellbore pressures to initiate secondary multiple transverse hydraulic fractures in close proximity to primary fractures. The criterion, confirmed by laboratory experiments, demonstrates that transversely fractured horizontal wellbores have limited capacities to resist the initiation of multiple fractures from adjacent perforations. This characteristic can be used in designing hydraulic fracture treatments to establish injection pressure limits or threshold pressures, above which additional multiple fractures will initiate and propagate from the wellbore. 23 refs., 1 tab., 10 figs.

  16. Feasibility of progressive strength training implemented in the acute ward after hip fracture surgery.

    Directory of Open Access Journals (Sweden)

    Lise Kronborg

    Full Text Available Patients with a hip fracture lose more than 50% knee-extension strength in the fractured limb within one week of surgery. Hence, immediate progressive strength training following hip fracture surgery may be rational, but the feasibility unknown.To examine the feasibility of in-hospital progressive strength training implemented in the acute ward following hip fracture surgery, based on pre-specified criteria for feasibility.A prospective cohort study conducted in an acute orthopedic hip fracture unit at a university hospital. A consecutive sample of 36 patients, 18 with a cervical and 18 with a trochanteric hip fracture (27 women and 9 men, mean (SD age of 79.4 (8.3 years were included between June and December 2012.A daily (on weekdays program of progressive knee-extension strength training for the fractured limb, using ankle weight cuffs in 3 sets of 10 repetition maximum loadings.The primary outcome was the change in training load (kg during the knee-extension strength training. The secondary outcomes were changes in hip fracture-related pain and maximal isometric knee-extension strength.The strength training was commenced at a mean of 2.4 (0.7 days after surgery. The training loads (kilograms lifted increased from 1.6 (0.8 to 4.3 (1.7 kg over 4.3 (2.2 training sessions (P<.001. The maximal isometric knee-extension strength of the fractured limb increased from 0.37 (0.2 to 0.61 (0.3 Nm/kg (P<.001, while the average strength deficit in the fractured limb decreased from 50% to 32% (% non-fractured, P<.001. Only 3 of 212 sessions were not performed because of severe hip fracture-related pain.Progressive knee-extension strength training of the fractured limb commenced in the acute ward seems feasible, and may reduce strength asymmetry between limbs without hip pain interfering. The clinical efficacy needs confirmation in a randomized controlled design.ClinicalTrials.gov ID: NCT01616030.

  17. Ankle fracture spur sign is pathognomonic for a variant ankle fracture.

    Science.gov (United States)

    Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G

    2015-02-01

    The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.

  18. Association of Ipsilateral Rib Fractures With Displacement of Midshaft Clavicle Fractures.

    Science.gov (United States)

    Stahl, Daniel; Ellington, Matthew; Brennan, Kindyle; Brennan, Michael

    2017-04-01

    To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. Single Level 1 trauma center. These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. Fractures were classified into either 100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from 100% displacement of the fracture compared with only 54% of the CnIR group (P fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  19. [Effect of pneumatic compression in connection with ergotherapeutic treatment of Colles' fracture. A clinical controlled trial].

    Science.gov (United States)

    Svensson, B H; Frellsen, M B; Basse, P N; Bliddal, H; Caspers, J; Parby, K

    1993-02-15

    We followed forty women with functional deficits in the wrist and hand after sustaining a Colles' fracture. The women participated in occupational therapy three times a week for three weeks. At the initial evaluation, after three weeks, and at a three month evaluation, we measured the following: range of joint movement, grip strength, hand volume (oedema), pain and ADL. There was significant improvement in most of the parameters measured after three weeks of occupational therapy, with a less significant improvement from three weeks to three months. Seventeen of the forty women received twenty minutes of intermittent pneumatic compression before occupational therapy. These patients showed significant improvement in wrist extension, compared with the control group of twenty-three patients. Occupational therapy is recommended for patients showing a functional deficit after Colles' fracture. Intermittent pneumatic compression is recommended as a supplement to occupational therapy.

  20. Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D

    Directory of Open Access Journals (Sweden)

    Marcelo Teodoro Ezequiel Guerra

    Full Text Available ABSTRACT OBJECTIVE: To compare serum 25-hydroxyvitamin D (25[OH]D levels, a serum marker of vitamin D3, between patients with and without proximal hip fracture. METHODS: This was a case-control study in which serum samples of 25(OHD were obtained from 110 proximal hip fracture inpatients and 231 control patients without fractures, all over 60 years of age. Levels of 25(OHD lower than or equal to 20 ng/mL were considered deficient; from 21 ng/mL to 29 ng/mL, insufficient; and above 30 ng/mL, sufficient. Sex, age, and ethnicity were considered for association with the study groups and 25(OHD levels. RESULTS: Patients with proximal hip fracture had significantly lower serum 25(OHD levels (21.07 ng/mL than controls (28.59 ng/mL; p = 0.000. Among patients with proximal hip fracture, 54.5% had deficient 25(OHD levels, 27.2% had insufficient levels, and only 18.2% had sufficient levels. In the control group, 30.3% of patients had deficient 25(OHD levels, 30.7% had insufficient levels, and 38.9% had sufficient levels. Female patients had decreased serum 25(OHD levels both in the fracture group and in the control group (19.50 ng/mL vs. 26.94 ng/mL; p = 0.000 when compared with male patients with and without fracture (25.67 ng/mL vs. 33.74 ng/mL; p = 0.017. Regarding age, there was a significant association between 25(OHD levels and risk of fracture only for the age groups 71-75 years and above 80 years. CONCLUSION: Patients with proximal hip fracture had significantly decreased serum 25(OHD levels when compared with the control group. Female patients had significantly lower serum 25(OHD levels in both groups.

  1. Association between polymorphisms of apolipoprotein E, bone mineral density of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in postmenopausal women with hip or lower forearm fracture

    DEFF Research Database (Denmark)

    Sennels, Henriette Pia; Sand, J C; Madsen, B

    2003-01-01

    surgery and age-matched controls from the population register. The APOE genotypes of 327 women were studied: 73 with lower forearm fractures, 43 with hip fractures and 211 age-matched controls. The participants were not receiving antiosteoporotic treatment. Polymerase chain reaction restriction fragment...... are contradictory. The aim of this study was to examine the association between polymorphisms of APOE, BMD of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in a population of postmenopausal women with hip or lower forearm fractures admitted to a department of orthopaedic....... In conclusion, this study showed no association between bone mass parameters (BMD, speed of sound (SOS), broadband ultrasound attenuation (BUA)), hip or lower forearm fracture and APOE genotypes in a population of postmenopausal women and age-matched controls....

  2. Ares I Flight Control System Design

    Science.gov (United States)

    Jang, Jiann-Woei; Alaniz, Abran; Hall, Robert; Bedrossian, Nazareth; Hall, Charles; Ryan, Stephen; Jackson, Mark

    2010-01-01

    The Ares I launch vehicle represents a challenging flex-body structural environment for flight control system design. This paper presents a design methodology for employing numerical optimization to develop the Ares I flight control system. The design objectives include attitude tracking accuracy and robust stability with respect to rigid body dynamics, propellant slosh, and flex. Under the assumption that the Ares I time-varying dynamics and control system can be frozen over a short period of time, the flight controllers are designed to stabilize all selected frozen-time launch control systems in the presence of parametric uncertainty. Flex filters in the flight control system are designed to minimize the flex components in the error signals before they are sent to the attitude controller. To ensure adequate response to guidance command, step response specifications are introduced as constraints in the optimization problem. Imposing these constraints minimizes performance degradation caused by the addition of the flex filters. The first stage bending filter design achieves stability by adding lag to the first structural frequency to phase stabilize the first flex mode while gain stabilizing the higher modes. The upper stage bending filter design gain stabilizes all the flex bending modes. The flight control system designs provided here have been demonstrated to provide stable first and second stage control systems in both Draper Ares Stability Analysis Tool (ASAT) and the MSFC 6DOF nonlinear time domain simulation.

  3. The Hubble Space Telescope nickel-hydrogen battery design

    Science.gov (United States)

    Nawrocki, D. E.; Armantrout, J. D.; Standlee, D. J.; Baker, R. C.; Lanier, J. R.

    1990-01-01

    Details are presented of the HST (Hubble Space Telescope) battery cell, battery package, and module mechanical and electrical designs. Also included are a summary of acceptance, qualification, and vibration tests and thermal vacuum testing. Unique details of battery cell charge retention performance characteristics associated with prelaunch hold conditions are discussed. Special charge control methods to minimize thermal dissipation during pad charging operations are summarized. This module design meets all NASA fracture control requirements for manned missions.

  4. [Surgical approaches to tibial plateau fractures].

    Science.gov (United States)

    Krause, Matthias; Müller, Gunnar; Frosch, Karl-Heinz

    2018-06-06

    Intra-articular tibial plateau fractures can present a surgical challenge due to complex injury patterns and compromised soft tissue. The treatment goal is to spare the soft tissue and an anatomical reconstruction of the tibial articular surface. Depending on the course of the fracture, a fracture-specific access strategy is recommended to provide correct positioning of the plate osteosynthesis. While the anterolateral approach is used in the majority of lateral tibial plateau fractures, only one third of the joint surface is visible; however, posterolateral fragments require an individual approach, e. g. posterolateral or posteromedial. If necessary, osteotomy of the femoral epicondyles can improve joint access for reduction control. Injuries to the posterior columns should be anatomically reconstructed and biomechanically correctly addressed via posterior approaches. Bony posterior cruciate ligament tears can be refixed via a minimally invasive posteromedial approach.

  5. Catastrophic scapular fractures in Californian racehorses: pathology, morphometry and bone density.

    Science.gov (United States)

    Vallance, S A; Spriet, M; Stover, S M

    2011-11-01

    To enhance understanding of the nature and pathogenesis of scapular fractures in racehorses. Scapular fractures in racehorses have a consistent configuration related to sites of pre-existing stress modelling and remodelling. Fractured and intact scapulae collected post mortem were examined visually and with computed tomography (CT). Scapular fracture configuration, bone modelling changes and standardised CT morphometry and density measurements were recorded. Statistical comparisons were made between fractured, nonfractured contralateral and control scapulae. Thirty-nine scapulae from 10 Thoroughbred (TB) and 10 Quarter Horse (QH) racehorses were obtained. All 14 fractured scapulae (from 12 horses) had a consistent comminuted fracture configuration. A complete fracture coursed transversely through the neck of the scapula at the level of the distal aspect of the spine (8.9 ± 0.9 cm proximal to the lateral articular margin of the glenoid cavity). The distal fragment of 13 fractured scapulae was split into 2 major fragments by a fracture in the frontal plane that entered the glenoid cavity (2.8 ± 0.4 cm caudal to the cranial articular margin). Focal areas of periosteal proliferation and/or radiolucency were present in the distal aspect of the scapular spine of all fractured and intact contralateral scapulae, but less commonly (Phorses without a scapular fracture. Fractured scapulae had 7-10% lower mean density and 46-104% greater density heterogeneity in the spine adjacent to the transverse fracture compared to control scapulae (Pfracture configuration that is associated with pre-existing pathology of the distal aspect of the spine. This location is consistent with scapular stress fractures diagnosed in lame TB racehorses. Catastrophic fracture is the acute manifestation of a more chronic process. Consequently, there are opportunities for early detection and prevention of fatalities. © 2010 EVJ Ltd.

  6. Functional recovery of older people with hip fracture: does malnutrition make a difference?

    Science.gov (United States)

    Li, Hsiao-Juan; Cheng, Huey-Shinn; Liang, Jersey; Wu, Chi-Chuan; Shyu, Yea-Ing Lotus

    2013-08-01

    To report a study of the effects of protein-energy malnutrition on the functional recovery of older people with hip fracture who participated in an interdisciplinary intervention. It is not clear whether protein-energy malnutrition is associated with worse functional outcomes or it affects the interdisciplinary intervention program on the functional recovery of older people with hip fracture. A randomized experimental design. Data were collected between 2002-2006 from older people with hip fracture (N = 162) in Taiwan. The generalized estimating equations approach was used to evaluate the effect of malnutrition on the functional recovery of older people with hip fracture. The majority of older patients with hip fracture were malnourished (48/80, 60% in the experimental group vs. 55/82, 67% in the control group) prior to hospital discharge. The results of the generalized estimating equations analysis demonstrated that subjects suffering from protein-energy malnutrition prior to hospital discharge appeared to have significantly worse performance trajectories for their activities of daily living, instrumental activities of daily living, and recovery of walking ability compared with those without protein-energy malnutrition. In addition, it was found that the intervention is more effective on the performance of activities of daily living and recovery of walking ability in malnourished patients than in non-malnourished patients. Healthcare providers should develop a nutritional assessment/management system in their interdisciplinary intervention program to improve the functional recovery of older people with hip fracture. © 2012 Blackwell Publishing Ltd.

  7. Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

    Directory of Open Access Journals (Sweden)

    Hsiu-Nien Shen

    2015-02-01

    Full Text Available Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years physicians (n = 4303 and matched non-medical persons (control were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively, whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively. Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79; by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures.

  8. Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

    Science.gov (United States)

    Shen, Hsiu-Nien; Lin, Wei-Ting; Lu, Chin-Li; Li, Chung-Yi

    2015-01-01

    Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years) physicians (n = 4303) and matched non-medical persons (control) were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR) of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively), whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively). Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79); by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures. PMID:25689999

  9. Surgical interventions to treat humerus shaft fractures: A network meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Jia-Guo Zhao

    Full Text Available There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF, intramedullary nail (IMN fixation, and minimally invasive percutaneous osteosynthesis (MIPO. We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures.MEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016. We only included randomized controlled trials (RCTs comparing two or more of the three surgical procedures, including the ORPF, IMN, and MIPO techniques, for humeral shaft fractures in adults. The methodological quality was evaluated based on the Cochrane risk of bias tool. We used WinBUGS1.4 to conduct this Bayesian network meta-analysis. We used the odd ratios (ORs with 95% confidence intervals (CIs to calculate the dichotomous outcomes and analyzed the percentages of the surface under the cumulative ranking curve.Seventeen eligible publications reporting 16 RCTs were included in this study. Eight hundred and thirty-two participants were randomized to receive one of three surgical procedures. The results showed that shoulder impingement occurred more commonly in the IMN group than with either ORPF (OR, 0.13; 95% CI, 0.03-0.37 or MIPO fixation (OR, 0.08; 95% CI, 0.00-0.69. Iatrogenic radial nerve injury occurred more commonly in the ORPF group than in the MIPO group (OR, 11.09; 95% CI, 1.80-124.20. There were no significant differences among the three procedures in nonunion, delayed union, and infection.Compared with IMN and ORPF, MIPO technique is the preferred treatment method for humeral shaft fractures.

  10. Non-linear imaging condition to image fractures as non-welded interfaces

    NARCIS (Netherlands)

    Minato, S.; Ghose, R.

    2014-01-01

    Hydraulic properties of a fractured reservoir are often controlled by large fractures. In order to seismically detect and characterize them, a high-resolution imaging method is necessary. We apply a non-linear imaging condition to image fractures, considered as non-welded interfaces. We derive the

  11. Use of monocortical miniplates for the intraoral treatment of mandibular fractures.

    Science.gov (United States)

    Chiodo, Thomas A; Milles, Maano

    2009-03-01

    Fixation of mandibular fractures using rigid hardware has gained wide acceptance over the past 3 decades. The goal of rigid internal fixation is to allow for fracture healing with limited, or no, time in maxillo-mandibular fixation. There has been significant evolution in plate and screw materials and design over the past 30 years. The term miniplate is used to describe a fracture plate with a screw diameter of 2.0 mm or less. With correct diagnosis and understanding of the forces affecting mandible fractures, miniplates can be applied transorally in various situations, allowing for less invasive treatment with open reduction of mandible fractures. This article describes the use of monocortical miniplates for the intraoral treatment of mandibular fractures.

  12. Experimental fracture healing: evaluation using radionuclide bone imaging: concise communication

    International Nuclear Information System (INIS)

    Gumerman, L.W.; Fogel, S.R.; Goodman, M.A.; Hanley, E.N. Jr.; Kappakas, G.S.; Rutkowski, R.; Levine, G.

    1978-01-01

    Radionuclide bone imaging was performed in a rabbit model to observe the course of fracture healing and to establish criteria for distinguishing nonunion and delayed healing from normal healing. Sequential gamma-camera images (with pinhole collimator) were collected and subjected to computer analysis. Five groups were established: (a) control--immobilization; (b) control--immobilization plus periosteal stripping; (c) simple fracture--osteotomy; (d) delayed union--osteotomy plus periosteal stripping; and (e) nonunion--osteotomy, periosteal stripping and polymethyl methacrylate interposed between fracture fragments. Histographic representation of absolute count rates along rabbit tibias followed a predictable pattern in the simple-fracture and delayed-union groups. They differed only in the time of appearance of phases. The non-union group demonstrated no recognizable sequential pattern. In this experimental model, serial bone scanning the quantitative data analysis has shown potential for indicating the course of healing in fractures and for serving as a guide to treatment

  13. Fracture mechanics

    International Nuclear Information System (INIS)

    Miannay, D.P.

    1995-01-01

    This book entitle ''Fracture Mechanics'', the first one of the monograph ''Materiologie'' is geared to design engineers, material engineers, non destructive inspectors and safety experts. This book covers fracture mechanics in isotropic homogeneous continuum. Only the monotonic static loading is considered. This book intended to be a reference with the current state of the art gives the fundamental of the issues under concern and avoids the developments too complicated or not yet mastered for not making reading cumbersome. The subject matter is organized as going from an easy to a more complicated level and thus follows the chronological evolution in the field. Similarly the microscopic scale is considered before the macroscopic scale, the physical understanding of phenomena linked to the experimental observation of the material preceded the understanding of the macroscopic behaviour of structures. In this latter field the relatively recent contribution of finite element computations with some analogy with the experimental observation is determining. However more sensitive analysis is not skipped

  14. Are distal radius fractures due to fragility or to falls? A consecutive case-control study of bone mineral density, tendency to fall, risk factors for osteoporosis, and health-related quality of life.

    Science.gov (United States)

    Nordvall, Helena; Glanberg-Persson, Gunhild; Lysholm, Jack

    2007-04-01

    A fracture of the distal radius is considered to indicate an increased risk of future fractures, especially a hip fracture. The main causes may be osteoporosis or a tendency to fall, separately or in combination. 93 women and 5 men with a recent radius fracture and the same number of controls were measured with a heel-DXL and asked to complete one questionnaire on their quality of life (SF-36), and one on risk factors. The mean T-score of the patients was -2.1, and for the controls it was -1.9 (p = 0.3). The patients aged over 64 years had a history of falling more often than the corresponding controls (p = 0.01), but there was no difference in T-score. By contrast, patients 45-64 years of age showed a non-significant, lower T-score (p = 0.09), but there was no difference concerning their history of falling. For all other risk factors, no differences were found between the patients and the controls. There were significant differences between the patients and the controls in some of the functions in the SF-36, due to the radius fracture. This study indicates that the underlying cause of a distal radius fracture may be different in patients aged 45-64 years and those who are more than 64 years old.

  15. Crack and fracture behaviour in tough ductile materials

    International Nuclear Information System (INIS)

    Venter, R.D.; Hoeppner, D.W.

    1985-10-01

    The report describes various approaches and developments pertaining to the understanding of crack and fracture behaviour in tough ductile materials. The fundamental elastic fracture mechanics concepts based on the concepts of energy, stress field, and displacement are introduced and their interrelationships demonstrated. The extension of these concepts to include elasto-plastic fracture mechanics considerations is reviewed in the context of the preferred options available for the development of appropriate design methodologies. The recommendations of the authors are directed towards the continued development of the J-integral concept. This energy-based concept, in its fundamental form, has a sound theoretical basis and as such offers the possibility of incorporating elasto-plastic fracture mechanics considerations in the crack and fracture behaviour of tough ductile materials. It must however be emphasized that the concise defintion of J becomes increasingly suspect as the crack length increases. J is not a material property, as is J IC , but emerges as a useful empirical parameter which is dependent upon the particular geometry and the loading imposed on the structure. It is proposed that 'lowest bound' J-resistance curves and the associated J-T curves be experimentally developed and employed in the design process. Improvements to these 'lowest bounds' can be developed through extensive analysis of the twin J-CTOA criteria and validation of this approach through near full scale tests

  16. Fracture detection, mapping, and analysis of naturally fractured gas reservoirs using seismic technology. Final report, November 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    Many basins in the Rocky Mountains contain naturally fractured gas reservoirs. Production from these reservoirs is controlled primarily by the shape, orientation and concentration of the natural fractures. The detection of gas filled fractures prior to drilling can, therefore, greatly benefit the field development of the reservoirs. The objective of this project was to test and verify specific seismic methods to detect and characterize fractures in a naturally fractured reservoir. The Upper Green River tight gas reservoir in the Uinta Basin, Northeast Utah was chosen for the project as a suitable reservoir to test the seismic technologies. Knowledge of the structural and stratigraphic geologic setting, the fracture azimuths, and estimates of the local in-situ stress field, were used to guide the acquisition and processing of approximately ten miles of nine-component seismic reflection data and a nine-component Vertical Seismic Profile (VSP). Three sources (compressional P-wave, inline shear S-wave, and cross-line, shear S-wave) were each recorded by 3-component (3C) geophones, to yield a nine-component data set. Evidence of fractures from cores, borehole image logs, outcrop studies, and production data, were integrated with the geophysical data to develop an understanding of how the seismic data relate to the fracture network, individual well production, and ultimately the preferred flow direction in the reservoir. The multi-disciplinary approach employed in this project is viewed as essential to the overall reservoir characterization, due to the interdependency of the above factors.

  17. Flow characteristics through a single fracture of artificial fracture system

    International Nuclear Information System (INIS)

    Park, Byoung Yoon; Bae, Dae Seok; Kim, Chun Soo; Kim, Kyung Su; Koh, Young Kwon; Jeon, Seok Won

    2001-04-01

    Fracture flow in rock masses is one of the most important issues in petroleum engineering, geology, and hydrogeology. Especially, in case of the HLW disposal, groundwater flow in fractures is an important factor in the performance assessment of the repository because the radionuclides move along the flowing groundwater through fractures. Recently, the characterization of fractures and the modeling of fluid flow in fractures are studied by a great number of researchers. Among those studies, the hydraulic behavior in a single fracture is one of the basic issues for understanding of fracture flow in rockmass. In this study, a fluid flow test in the single fracture made of transparent epoxy replica was carried out to obtain the practical exponent values proposed from the Cubic law and to estimate the flow rates through a single fracture. Not only the relationship between flow rates and the geometry of fracture was studied, but also the various statistical parameters of fracture geometry were compared to the effective transmissivity data obtained from computer simulation.

  18. Spartan Release Engagement Mechanism (REM) stress and fracture analysis

    Science.gov (United States)

    Marlowe, D. S.; West, E. J.

    1984-01-01

    The revised stress and fracture analysis of the Spartan REM hardware for current load conditions and mass properties is presented. The stress analysis was performed using a NASTRAN math model of the Spartan REM adapter, base, and payload. Appendix A contains the material properties, loads, and stress analysis of the hardware. The computer output and model description are in Appendix B. Factors of safety used in the stress analysis were 1.4 on tested items and 2.0 on all other items. Fracture analysis of the items considered fracture critical was accomplished using the MSFC Crack Growth Analysis code. Loads and stresses were obtaind from the stress analysis. The fracture analysis notes are located in Appendix A and the computer output in Appendix B. All items analyzed met design and fracture criteria.

  19. A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk

    2014-04-01

    Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.

  20. Fault-controlled permeability and fluid flow in low-porosity crystalline rocks: an example from naturally fractured geothermal systems in the Southern Andes

    Science.gov (United States)

    Arancibia, G.; Roquer, T.; Sepúlveda, J.; Veloso, E. A.; Morata, D.; Rowland, J. V.

    2017-12-01

    Fault zones can control the location, emplacement, and evolution of economic mineral deposits and geothermal systems by acting as barriers and/or conduits to crustal fluid flow (e.g. magma, gas, oil, hydro-geothermal and groundwater). The nature of the fault control permeability is critical in the case of fluid flow into low porosity/permeability crystalline rocks, since structural permeability provides the main hydraulic conductivity to generate a natural fractured system. However, several processes accompanying the failure of rocks (i.e. episodic permeability given by cycling ruptures, mineral precipitation from fluids in veins, dissolution of minerals in the vicinity of a fracture) promote a complex time-dependent and enhancing/reducing fault-controlled permeability. We propose the Southern Volcanic Zone (Southern Andes, Chile) as a case study to evaluate the role of the structural permeability in low porosity crystalline rocks belonging to the Miocene North Patagonian Batholith. Recently published studies propose a relatively well-constrained first-order role of two active fault systems, the arc-parallel (NS to NNE trending) Liquiñe Ofqui Fault System and the arc-oblique (NW trending) Andean Transverse Fault Zones, in fluid flow at crustal scales. We now propose to examine the Liquiñe ( 39°S) and Maihue ( 40°S) areas as sites of interaction between these fault systems, in order to evaluate a naturally fractured geothermal system. Preliminary results indicate upwelling of thermal water directly from fractured granite or from fluvial deposits overlying granitoids. Measured temperatures of thermal springs suggest a low- to medium-enthalpy system, which could potentially be harnessed for use in geothermal energy applications (e.g. heating, wood dryer and green house), which are much needed in Southern Chile. Future work will aim to examine the nature of structural permeability from the regional to the microscopic scale connecting the paleo- and current- fluid

  1. 10 CFR 72.146 - Design control.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Design control. 72.146 Section 72.146 Energy NUCLEAR... Design control. (a) The licensee, applicant for a license, certificate holder, and applicant for a CoC... shall establish measures for the identification and control of design interfaces and for coordination...

  2. Impact of comorbidities on hospitalization costs following hip fracture.

    Science.gov (United States)

    Nikkel, Lucas E; Fox, Edward J; Black, Kevin P; Davis, Charles; Andersen, Lucille; Hollenbeak, Christopher S

    2012-01-04

    Hip fractures are common in the elderly, and patients with hip fractures frequently have comorbid illnesses. Little is known about the relationship between comorbid illness and hospital costs or length of stay following the treatment of hip fracture in the United States. We hypothesized that specific individual comorbid illnesses and multiple comorbid illnesses would be directly related to the hospitalization costs and the length of stay for older patients following hip fracture. With use of discharge data from the 2007 Nationwide Inpatient Sample, 32,440 patients who were fifty-five years or older with an isolated, closed hip fracture were identified. Using generalized linear models, we estimated the impact of comorbidities on hospitalization costs and length of stay, controlling for patient, hospital, and procedure characteristics. Hypertension, deficiency anemias, and fluid and electrolyte disorders were the most common comorbidities. The patients had a mean of three comorbidities. Only 4.9% of patients presented without comorbidities. The average estimated cost in our reference patient was $13,805. The comorbidity with the largest increased hospitalization cost was weight loss or malnutrition, followed by pulmonary circulation disorders. Most other comorbidities significantly increased the cost of hospitalization. Compared with internal fixation of the hip fracture, hip arthroplasty increased hospitalization costs significantly. Comorbidities significantly affect the cost of hospitalization and length of stay following hip fracture in older Americans, even while controlling for other variables.

  3. Distinct Element Method modelling of fold-related fractures in a multilayer sequence

    Science.gov (United States)

    Kaserer, Klemens; Schöpfer, Martin P. J.; Grasemann, Bernhard

    2017-04-01

    Natural fractures have a significant impact on the performance of hydrocarbon systems/reservoirs. In a multilayer sequence, both the fracture density within the individual layers and the type of fracture intersection with bedding contacts are key parameters controlling fluid pathways. In the present study the influence of layer stacking and interlayer friction on fracture density and connectivity within a folded sequence is systematically investigated using 2D Distinct Element Method modelling. Our numerical approach permits forward modelling of both fracture nucleation/propagation/arrest and (contemporaneous) frictional slip along bedding planes in a robust and mechanically sound manner. Folding of the multilayer sequence is achieved by enforcing constant curvature folding by means of a velocity boundary condition at the model base, while a constant overburden pressure is maintained at the model top. The modelling reveals that with high bedding plane friction the multilayer stack behaves mechanically as a single layer so that the neutral surface develops in centre of the sequence and fracture spacing is controlled by the total thickness of the folded sequence. In contrast, low bedding plane friction leads to decoupling of the individual layers (flexural slip folding) so that a neutral surface develops in the centre of each layer and fracture spacing is controlled by the thickness of the individual layers. The low interfacial friction models illustrate that stepping of fractures across bedding planes is a common process, which can however have two contrasting origins: The mechanical properties of the interface cause fracture stepping during fracture propagation. Originally through-going fractures are later offset by interfacial slip during folding. A combination of these two different origins may lead to (apparently) inconsistent fracture offsets across bedding planes within a flexural slip fold.

  4. Assessment of fracture toughness of structural steels

    Energy Technology Data Exchange (ETDEWEB)

    Gomes Junyor, José Onésimo; Faria, Stéfanno Bruno; Rocha, Nirlando Antônio; Reis, Emil; Vilela, Jefferson José, E-mail: ze_onezo@hotmail.com, E-mail: sbrunofaria@gmail.com, E-mail: nar@cdtn.br, E-mail: emilr@cdtn.br, E-mail: jjv@cdtn.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Centro Universitário de Belo Horizonte (UNIBH), MG (Brazil); Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2017-11-01

    The fracture toughness parameters are applied to estimate the lifetime of mechanical components and define the criteria of safe failure and tolerable damages. This information allows equipment to be used longer with a high degree of safety. These techniques are applied in the Leak-Before-Break (LBB) concept that is accepted for designing the piping system of the primary circuit of the pressurized water reactor (PWR). In this work, fracture toughness tests such as J{sub IC} and CTOD were performed on some structural steels. The fracture toughness parameters were determined using SE(B) and C(T) test specimens. The fracture toughness values for the same material varied according to the type specimen. The parameter δ{sub 1c} showed different values when it was calculated using the ASTM E1820 standard and using the BS 7448: Part 1 standard. These results indicate that procedures of these standards need to be improved. Two systems with different sensitivity in the force measurement were used that showed similar results for toughness fracture but the dispersion was different. (author)

  5. Outcome of limb fracture repair in rabbits: 139 cases (2007-2015).

    Science.gov (United States)

    Sasai, Hiroshi; Fujita, Daisuke; Seto, Eiko; Denda, Yuki; Imai, Yutaro; Okamoto, Kanako; Okamura, Kensaku; Furuya, Masaru; Tani, Hiroyuki; Sasai, Kazumi

    2018-02-15

    OBJECTIVE To evaluate outcome of limb fracture repair in rabbits. DESIGN Retrospective case series. ANIMALS 139 client-owned rabbits with limb fractures treated between 2007 and 2015. PROCEDURES Medical records were reviewed for information on fracture location, fracture treatment, and time to fracture healing. RESULTS 25 rabbits had fractures involving the distal aspects of the limbs (ie, metacarpal or metatarsal bones, phalanges, and calcaneus or talus). Fractures were treated in 23 of these 25 rabbits (external coaptation, n = 17; external skeletal fixation, 4; and intramedullary pinning, 2) and healed in all 23, with a median healing time of 28 days (range, 20 to 45 days). One hundred ten rabbits had long bone fractures, and fractures were treated in 100 of the 110 (external skeletal fixation, n = 89; bone plating, 1; intramedullary pinning, 3; and external coaptation, 7). The percentage of fractures that healed was significantly lower for open (14/18) than for closed (26/26) tibial fractures and was significantly lower for femoral (19/26) and treated humeral (4/6) fractures than for radial (23/24) or closed tibial (26/26) fractures. Micro-CT was used to assess fracture realignment during external skeletal fixator application and to evaluate fracture healing. CONCLUSIONS AND CLINICAL RELEVANCE The prognosis for rabbits with limb fractures was good, with fractures healing in most rabbits following fracture repair (109/123). Micro-CT was useful in assessing fracture realignment and evaluating fracture healing.

  6. Outlet strut fracture of Björk-Shiley convexo-concave valves: can valve-manufacturing characteristics explain the risk?

    Science.gov (United States)

    Omar, R Z; Morton, L S; Beirne, M; Blot, W J; Lawford, P V; Hose, R; Taylor, K M

    2001-06-01

    Björk-Shiley 60 degrees convexo-concave prosthetic heart valves (Shiley, Inc, Irvine, Calif, a subsidiary of Pfizer, Inc) continue to be a concern for approximately 35,000 nonexplanted patients worldwide, with approximately 600 events reported to the manufacturer to date. Fractures of the outlet struts of the valves began to appear in the early 1980s and have continued to the present, but their causes are only partially understood. A matched case-control study was conducted evaluating manufacturing records for 52 valves with outlet strut fractures and 248 control subjects matched for age at implantation, valve size, and valve position. In addition to the risk factors recognized as determinants of outlet strut fracture, the United Kingdom case-control study has observed 7- to 9-fold increased risk with performance of multiple hook deflection tests. This test was performed more than once, usually after rework on the valve. Six valves in this study underwent multiple hook deflection tests, of which 4 experienced an outlet strut fracture. Cracks and further rework were noted for these valves. Significant associations were also observed between outlet strut fracture and disc-to-strut gap measurements taken before the attachment of the sewing ring. It is our view that a combination of factors related to valve design, manufacturing process, and patient characteristics are responsible for outlet strut fractures of Björk-Shiley convexo-concave valves. Multiple hook deflection tests have emerged as a potential new risk factor for outlet strut fracture in both The Netherlands and the United Kingdom. This factor appears to be correlated with the presence of other abnormalities. A further study is needed to investigate the factors correlated with multiple hook deflection tests. On confirmation of risk, the presence of multiple hook deflection tests may be added to equations, quantifying the risk of outlet strut fracture for comparison against risk of mortality and serious

  7. LMI–based robust controller design approach in aircraft multidisciplinary design optimization problem

    Directory of Open Access Journals (Sweden)

    Qinghua Zeng

    2015-07-01

    Full Text Available This article proposes a linear matrix inequality–based robust controller design approach to implement the synchronous design of aircraft control discipline and other disciplines, in which the variation in design parameters is treated as equivalent perturbations. Considering the complicated mapping relationships between the coefficient arrays of aircraft motion model and the aircraft design parameters, the robust controller designed is directly based on the variation in these coefficient arrays so conservative that the multidisciplinary design optimization problem would be too difficult to solve, or even if there is a solution, the robustness of design result is generally poor. Therefore, this article derives the uncertainty model of disciplinary design parameters based on response surface approximation, converts the design problem of the robust controller into a problem of solving a standard linear matrix inequality, and theoretically gives a less conservative design method of the robust controller which is based on the variation in design parameters. Furthermore, the concurrent subspace approach is applied to the multidisciplinary system with this kind of robust controller in the design loop. A multidisciplinary design optimization of a tailless aircraft as example is shown that control discipline can be synchronous optimal design with other discipline, especially this method will greatly reduce the calculated amount of multidisciplinary design optimization and make multidisciplinary design optimization results more robustness of flight performance.

  8. Hip fracture risk and different gene polymorphisms in the turkish population

    Directory of Open Access Journals (Sweden)

    Ercan Dinçel

    2008-01-01

    Full Text Available BACKGROUND: We aimed to discuss the risk assessments for both patients with hip fractures due to fall-related, low energy traumas and non-fractured control patients by examining bone mineral density and genetic data, two features associated with femoral strength and hip fracture risk. METHODS: Twenty-one osteoporotic patients with proximal femur fractures and non-fractured, osteoporotic, age- and gender-matched controls were included in the study. Bone mineral density measurements were performed with a Lunar DXA. The COL1A1, ESR, VDR, IL-6, and OPG genes were amplified, and labeling of specific gene sequences was performed in a multiplex polymerase chain reaction using the osteo/check PCR kit from the whole blood of all subjects. RESULTS: The bone mineral density (trochanteric and total bone mineral density values of the fracture group was significantly decreased relative to the control group. We were not able to conduct statistical tests for the polymorphisms of the COL1A1, ESR, and VDR genes because our results were expressed in terms of frequency. Although they were not significant, we did examine differences in the IL-6 and OPG genes polymorphisms between the two groups. We concluded that increasing the number of cases will allow us to evaluate racial differences in femoral hip fracture risk by genotypes.

  9. Impact of a community-based osteoporosis and fall prevention program on fracture incidence.

    Science.gov (United States)

    Grahn Kronhed, Ann-Charlotte; Blomberg, Carina; Karlsson, Nadine; Löfman, Owe; Timpka, Toomas; Möller, Margareta

    2005-06-01

    Associations between a 10-year community-based osteoporosis and fall prevention program and fracture incidence amongst middle-aged and elderly residents in an intervention community are studied, and comparisons are made with a control community. A health-education program was provided to all residents in the intervention community, which addressed dietary intake, physical activity, smoking habits and environmental risk factors for osteoporosis and falls. Both communities are small, semi-rural and situated in Ostergotland County in southern Sweden. The analysis is based on incidences of forearm fractures in the population 40 years of age or older, and hip fractures in the population 50 years of age or older. Data for three 5-year periods (pre-, early and late intervention) are accumulated and compared. In the intervention community, forearm fracture incidence decreased in women. There are also tendencies towards decreasing forearm fracture incidence in men, and towards decreasing trochanteric hip fracture incidences in women and in men in the late intervention period. No such changes in fracture incidences are found in the control community. Cervical hip fracture incidence did not change in the intervention and the control communities. Although the reported numbers of fractures are small (a total of 451 forearm and 357 hip fractures), the numbers are based on total community populations and thus represent a true difference. The decrease in forearm fracture incidence among women, and the tendency towards decreasing trochanteric hip fractures, in contrast to the absence of change in cervical hip fractures, might be mainly due to a more rapid effect of fall preventive measures than an increase in bone strength in the population. For the younger age groups an expected time lag between intervention and effect might invalidate the short follow-up period for outcome measurements. Thus, the effect of the 10-year intervention program on fracture incidence should be followed

  10. Excess mortality following hip fracture: a systematic epidemiological review

    DEFF Research Database (Denmark)

    Abrahamsen, B; van Staa, T; Ariely, R

    2009-01-01

    This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter, highlighting th...

  11. Fracture of the styloid process associated with the mandible fracture

    Directory of Open Access Journals (Sweden)

    K N Dubey

    2013-01-01

    Full Text Available Fracture of the styloid process (SP of temporal bone is an uncommon injuries. Fracture of the SP can be associated with the facial injuries including mandible fracture. However, injury to the SP may be concealed and missed diagnosis may lead to the improper or various unnecessary treatments. A rare case of SP fracture associated with the ipsilateral mandibular fracture and also the diagnostic and management considerations of the SP fracture are discussed.

  12. The Relation Between Visual Impairment and Extremity Fractures

    Directory of Open Access Journals (Sweden)

    Berrak Şekeryapan

    2013-08-01

    Full Text Available Purpose: To evaluate the association between the development of extremity fracture and visual impairment in adults. Material and Method: This study included 56 patients (patient group aged 18 years or older who had extremity fractures due to a fall. The control group (n=42 was selected from visitors who had regular medical check-ups at our hospital. Each participant underwent a full ophthalmologic examination. Mean age was compared by Student’s t test. The other variables were compared by chi-square test. Results: The prevalence of subjects with visual impairment was significantly higher in the patients group (78.6% than in the control group (38.1% (p<0.05. The prevalence of treatable eye diseases such as cataract and refractive errors were significantly higher in the patient group than in the control group (p<0.05 for both. Twenty-eight patients (50% in the patient group and 8 subjects in the control group had visual acuities lower than 0.5 (p<0.05. Discussion: We have found that the prevalence of visual impairment was significantly higher in adults with extremity fractures due to falls than in the control group. Hence, we believe that regular ophthalmological examination in adults, providing regular use of eyeglasses in patients with refractive errors, and timely treatment of treatable eye diseases such as cataract could decrease the extremity fractures from falls in adults. (Turk J Ophthalmol 2013; 43: 250-2

  13. Interventions for treating proximal humeral fractures in adults

    DEFF Research Database (Denmark)

    Handoll, Helen H G; Brorson, Stig

    2015-01-01

    supervised exercise in a swimming pool plus home exercise.Eight trials, involving 567 older participants, evaluated surgical intervention for displaced fractures. There was high quality evidence of no clinically important difference in patient-reported shoulder and upper-limb function at one- or two......BACKGROUND: Fracture of the proximal humerus, often termed shoulder fracture, is a common injury in older people. The management of these fractures varies widely. This is an update of a Cochrane Review first published in 2001 and last updated in 2012. OBJECTIVES: To assess the effects (benefits...... and harms) of treatment and rehabilitation interventions for proximal humeral fractures in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and other databases, conference...

  14. Development of a shallow-flaw fracture assessment methodology for nuclear reactor pressure vessels

    International Nuclear Information System (INIS)

    Bass, B.R.; Bryson, J.W.; Dickson, T.L.; McAfee, W.J.; Pennell, W.E.

    1996-01-01

    Shallow-flaw fracture technology is being developed within the Heavy-Section Steel Technology (HSST) Program for application to the safety assessment of radiation-embrittled nuclear reactor pressure vessels (RPVs) containing postulated shallow flaws. Cleavage fracture in shallow-flaw cruciform beam specimens tested under biaxial loading at temperatures in the lower transition temperature range was shown to be strain-controlled. A strain-based dual-parameter fracture toughness correlation was developed and shown to be capable of predicting the effect of crack-tip constraint on fracture toughness for strain-controlled fracture. A probabilistic fracture mechanics (PFM) model that includes both the properties of the inner-surface stainless-steel cladding and a biaxial shallow-flaw fracture toughness correlation gave a reduction in probability of cleavage initiation of more than two orders of magnitude from an ASME-based reference case

  15. Coupled processes in single fractures, double fractures and fractured porous media

    International Nuclear Information System (INIS)

    Tsang, C.F.

    1986-12-01

    The emplacement of a nuclear waste repository in a fractured porous medium provides a heat source of large dimensions over an extended period of time. It also creates a large cavity in the rock mass, changing significantly the stress field. Such major changes induce various coupled thermohydraulic, hydromechanic and hydrochemical transport processes in the environment around a nuclear waste repository. The present paper gives, first, a general overview of the coupled processes involving thermal, mechanical, hydrological and chemical effects. Then investigations of a number of specific coupled processes are described in the context of fluid flow and transport in a single fracture, two intersecting fractures and a fractured porous medium near a nuclear waste repository. The results are presented and discussed

  16. MULTI-ATTRIBUTE SEISMIC/ROCK PHYSICS APPROACH TO CHARACTERIZING FRACTURED RESERVOIRS

    Energy Technology Data Exchange (ETDEWEB)

    Gary Mavko

    2000-10-01

    This project consists of three key interrelated Phases, each focusing on the central issue of imaging and quantifying fractured reservoirs, through improved integration of the principles of rock physics, geology, and seismic wave propagation. This report summarizes the results of Phase I of the project. The key to successful development of low permeability reservoirs lies in reliably characterizing fractures. Fractures play a crucial role in controlling almost all of the fluid transport in tight reservoirs. Current seismic methods to characterize fractures depend on various anisotropic wave propagation signatures that can arise from aligned fractures. We are pursuing an integrated study that relates to high-resolution seismic images of natural fractures to the rock parameters that control the storage and mobility of fluids. Our goal is to go beyond the current state-of-the art to develop and demonstrate next generation methodologies for detecting and quantitatively characterizing fracture zones using seismic measurements. Our study incorporates 3 key elements: (1) Theoretical rock physics studies of the anisotropic viscoelastic signatures of fractured rocks, including up scaling analysis and rock-fluid interactions to define the factors relating fractures in the lab and in the field. (2) Modeling of optimal seismic attributes, including offset and azimuth dependence of travel time, amplitude, impedance and spectral signatures of anisotropic fractured rocks. We will quantify the information content of combinations of seismic attributes, and the impact of multi-attribute analyses in reducing uncertainty in fracture interpretations. (3) Integration and interpretation of seismic, well log, and laboratory data, incorporating field geologic fracture characterization and the theoretical results of items 1 and 2 above. The focal point for this project is the demonstration of these methodologies in the Marathon Oil Company Yates Field in West Texas.

  17. Ductile fracture behaviour of primary heat transport piping material ...

    Indian Academy of Sciences (India)

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

    Abstract. Design of primary heat transport (PHT) piping of pressurised heavy water reactors (PHWR) has to ensure implementation of leak-before-break con- cepts. In order to be able to do so, the ductile fracture characteristics of PHT piping material have to be quantified. In this paper, the fracture resistance of SA333, Grade.

  18. Influence of fracture extension on in-situ stress in tight reservoir

    Science.gov (United States)

    Zhang, Yongping; Wei, Xu; Zhang, Ye; Xing, Libo; Xu, Jianjun

    2018-01-01

    Currently, hydraulic fracturing is an important way to develop low permeability reservoirs. The fractures produced during the fracturing process are the main influencing factors of changing in-situ stress. In this paper, the influence of fracture extension on in-situ stress is studied by establishing a mathematical model to describe the relationship between fracture length and in-situ stress. The results show that the growth rate gradually decreases after the fracture reaches a certain length with the increase of fracturing time; the continuous extension of the fracture is the main factor to change the in-situ stress. In order to reduce the impact on the subsequent fracture extension due to the changing of in-situ stress, controlling fracturing time and fracture length without affecting the stimulated reservoir effect is an important way. The results presented in this study can effectively reduce the impact of changing of in-situ stress on subsequent fracturing construction.

  19. Fracture network topology and characterization of structural permeability

    Science.gov (United States)

    Hansberry, Rowan; King, Rosalind; Holford, Simon

    2017-04-01

    There are two fundamental requirements for successful geothermal development: elevated temperatures at accessible depths, and a reservoir from which fluids can be extracted. The Australian geothermal sector has successfully targeted shallow heat, however, due in part to the inherent complexity of targeting permeability, obtaining adequate flow rates for commercial production has been problematic. Deep sedimentary aquifers are unlikely to be viable geothermal resources due to the effects of diagenetic mineral growth on rock permeability. Therefore, it is likely structural permeability targets, exploiting natural or induced fracture networks will provide the primary means for fluid flow in geothermal, as well as unconventional gas, reservoirs. Recent research has focused on the pattern and generation of crustal stresses across Australia, while less is known about the resultant networks of faults, joints, and veins that can constitute interconnected sub-surface permeability pathways. The ability of a fracture to transmit fluid is controlled by the orientation and magnitude of the in-situ stress field that acts on the fracture walls, rock strength, and pore pressure, as well as fracture properties such as aperture, orientation, and roughness. Understanding the distribution, orientation and character of fractures is key to predicting structural permeability. This project focuses on extensive mapping of fractures over various scales in four key Australian basins (Cooper, Otway, Surat and Perth) with the potential to host geothermal resources. Seismic attribute analysis is used in concert with image logs from petroleum wells, and field mapping to identify fracture networks that are usually not resolved in traditional seismic interpretation. We use fracture network topology to provide scale-invariant characterisation of fracture networks from multiple data sources to assess similarity between data sources, and fracture network connectivity. These results are compared with

  20. Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture

    DEFF Research Database (Denmark)

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik

    2017-01-01

    QUESTION: Is acute in-hospital physiotherapy with additional progressive knee-extension strength training (ST) of the fractured limb more effective in reducing knee-extension strength deficit at follow-up compared to physiotherapy without strength training in patients with a hip fracture? DESIGN......: Assessor blinded, randomised controlled trial with intention-to-treat analysis. PARTICIPANTS: 90 patients with a hip fracture admitted to an acute orthopaedic Hip Fracture Unit at a university hospital between October 2013 and May 2015. INTERVENTION: Daily physiotherapy with or without progressive knee...... strength training from baseline to follow-up. In the per-protocol analysis of non-missing data, significant between-group improvements by 10.5% (95% CI 0.3; 20.7) were found in favour of additional ST. No significant between-group differences were found in any secondary outcome. CONCLUSION: Physiotherapy...

  1. Facial Fractures.

    Science.gov (United States)

    Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy

    2018-06-01

    The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.

  2. Chance Fracture Secondary to a Healed Kyphotic Compression Osteoporotic Fracture

    Directory of Open Access Journals (Sweden)

    Teh KK

    2009-11-01

    Full Text Available Chance fracture is an unstable vertebral fracture, which usually results from a high velocity injury. An elderly lady with a previously healed osteoporotic fracture of the T12 and L1 vertebra which resulted in a severe kyphotic deformity subsequently sustained a Chance fracture of the adjacent L2 vertebrae after a minor fall. The previously fracture left her with a deformity which resulted in significant sagittal imbalance therefore predisposing her to this fracture. This case highlights the importance of aggressive treatment of osteoporotic fractures in order to prevent significant sagittal imbalance from resultant (i.e. kyphotic deformity.

  3. Fracture resistance of Kevlar-reinforced poly(methyl methacrylate) resin: a preliminary study.

    Science.gov (United States)

    Berrong, J M; Weed, R M; Young, J M

    1990-01-01

    The reinforcing effect of Kevlar fibers incorporated in processed poly(methyl methacrylate) resin samples was studied using 0% (controls), 0.5%, 1%, and 2% by weight of the added fibers. The samples were subjected to impact testing to determine fracture resistance, and sample groups were statistically compared using an ANOVA. Each reinforced sample had significantly greater fracture resistance (P less than 0.05) than the control, and no difference was found either within or between control groups. The use of reinforcing Kevlar fibers appears to enhance the fracture resistance of acrylic resin denture base materials.

  4. Hip Fracture

    Science.gov (United States)

    ... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...

  5. Determination of Fracture System Geometry from Well Testing

    International Nuclear Information System (INIS)

    Doe, T.W.

    1994-01-01

    In this paper, the research and development for the description of the hydraulic geometry of fracture networks are discussed. The studies on fracture networks have developed on the premise that the structural geological information on fracture geometries could be used to develop the realistic models of flow. It has been widely recognized that a relatively small portion of natural fracture networks controls a major portion of groundwater flow. The key to efficient network modeling is to identify that portion of networks. It is the main purpose of this paper to discuss the methods for characterizing the hydraulic geometry of fracture flow systems. The methods described in this paper cover three approaches for defining the hydraulic geometry of fracture networks, that is, the determination of conductive fracture frequency in boreholes, the use of transient pressure and flow responses in single holes, and the use of cross hole test to assess connectivity. The information which can be obtained by each test is shown. Flow logging, well test distribution and conductive fracture frequency are discussed. The transient analysis of single hole well test and the cross hole analysis of well test for fracture network geometry are reported. The data taken by various methods together can provide network characterization. (K.I.)

  6. Controller Design Automation for Aeroservoelastic Design Optimization of Wind Turbines

    NARCIS (Netherlands)

    Ashuri, T.; Van Bussel, G.J.W.; Zaayer, M.B.; Van Kuik, G.A.M.

    2010-01-01

    The purpose of this paper is to integrate the controller design of wind turbines with structure and aerodynamic analysis and use the final product in the design optimization process (DOP) of wind turbines. To do that, the controller design is automated and integrated with an aeroelastic simulation

  7. Ankle fractures have features of an osteoporotic fracture.

    Science.gov (United States)

    Lee, K M; Chung, C Y; Kwon, S S; Won, S H; Lee, S Y; Chung, M K; Park, M S

    2013-11-01

    We report the bone attenuation of ankle joint measured on computed tomography (CT) and the cause of injury in patients with ankle fractures. The results showed age- and gender-dependent low bone attenuation and low-energy trauma in elderly females, which suggest the osteoporotic features of ankle fractures. This study was performed to investigate the osteoporotic features of ankle fracture in terms of bone attenuation and cause of injury. One hundred ninety-four patients (mean age 51.0 years, standard deviation 15.8 years; 98 males and 96 females) with ankle fracture were included. All patients underwent CT examination, and causes of injury (high/low-energy trauma) were recorded. Mean bone attenuations of the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis were measured on CT images. Patients were divided into younger age (fractures than the younger age group. With increasing age, bone attenuations tended to decrease and the difference of bone attenuation between the genders tended to increase in the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis. Ankle fracture had features of osteoporotic fracture that is characterized by age- and gender-dependent low bone attenuation. Ankle fracture should not be excluded from the clinical and research interest as well as from the benefit of osteoporosis management.

  8. ACSYNT inner loop flight control design study

    Science.gov (United States)

    Bortins, Richard; Sorensen, John A.

    1993-01-01

    The NASA Ames Research Center developed the Aircraft Synthesis (ACSYNT) computer program to synthesize conceptual future aircraft designs and to evaluate critical performance metrics early in the design process before significant resources are committed and cost decisions made. ACSYNT uses steady-state performance metrics, such as aircraft range, payload, and fuel consumption, and static performance metrics, such as the control authority required for the takeoff rotation and for landing with an engine out, to evaluate conceptual aircraft designs. It can also optimize designs with respect to selected criteria and constraints. Many modern aircraft have stability provided by the flight control system rather than by the airframe. This may allow the aircraft designer to increase combat agility, or decrease trim drag, for increased range and payload. This strategy requires concurrent design of the airframe and the flight control system, making trade-offs of performance and dynamics during the earliest stages of design. ACSYNT presently lacks means to implement flight control system designs but research is being done to add methods for predicting rotational degrees of freedom and control effector performance. A software module to compute and analyze the dynamics of the aircraft and to compute feedback gains and analyze closed loop dynamics is required. The data gained from these analyses can then be fed back to the aircraft design process so that the effects of the flight control system and the airframe on aircraft performance can be included as design metrics. This report presents results of a feasibility study and the initial design work to add an inner loop flight control system (ILFCS) design capability to the stability and control module in ACSYNT. The overall objective is to provide a capability for concurrent design of the aircraft and its flight control system, and enable concept designers to improve performance by exploiting the interrelationships between

  9. Fracture-toughness variations in Alloy 718

    International Nuclear Information System (INIS)

    Mills, W.J.; Blackburn, L.D.

    1983-04-01

    The effect of product-form variations within a single heat on the J Ic fracture toughness behavior of Alloy 718 was examined at 24, 427 and 538 degree C using the multiple-specimen J R -curve method. Three product forms (plate, round bar and upset forging) were tested in both the conventional and modified heat-treatment (CHT and MHT) conditions. In CHT material, the fracture toughness response was different for the three product forms -- plate having the highest toughness, bar the lowest. The MHT was found to improve the overall fracture resistance for each product form. In this condition, plate and forging had very similar toughness values, but J Ic levels for the bar were considerably lower. These results and WHC data previously reported for four other Alloy 718 heats were unalloyed statistically to establish minimum-expected J Ic values based on tolerance limits bracketing 90% of a total population at a 95% confidence level. Metallographic and fractographic examinations of the seven material lots were performed to relate key microstructural features and operative fracture mechanisms to macroscopic properties. Generally, coarse δ precipitates controlled fracture properties in CHT material by initiating secondary dimples that pre-empted growth of the primary dimples nucleated by broken carbide inclusions. The MHT dissolved the coarse δ particles and thereby suppressed secondary microvoid coalescence. This generally enhanced the fracture resistance of Alloy 718, except when alternate secondary fracture mechanism, such as channel fracture and dimple rupture at δ-phase remnants, prematurely interrupted primary microvoid growth. 25 refs., 12 figs., 12 tabs

  10. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

    OpenAIRE

    Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

    2015-01-01

    First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare en...

  11. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures.

    Science.gov (United States)

    Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

    2015-01-01

    First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

  12. Transport of Particle Swarms Through Variable Aperture Fractures

    Science.gov (United States)

    Boomsma, E.; Pyrak-Nolte, L. J.

    2012-12-01

    Particle transport through fractured rock is a key concern with the increased use of micro- and nano-size particles in consumer products as well as from other activities in the sub- and near surface (e.g. mining, industrial waste, hydraulic fracturing, etc.). While particle transport is often studied as the transport of emulsions or dispersions, particles may also enter the subsurface from leaks or seepage that lead to particle swarms. Swarms are drop-like collections of millions of colloidal-sized particles that exhibit a number of unique characteristics when compared to dispersions and emulsions. Any contaminant or engineered particle that forms a swarm can be transported farther, faster, and more cohesively in fractures than would be expected from a traditional dispersion model. In this study, the effects of several variable aperture fractures on colloidal swarm cohesiveness and evolution were studied as a swarm fell under gravity and interacted with the fracture walls. Transparent acrylic was used to fabricate synthetic fracture samples with (1) a uniform aperture, (2) a converging region followed by a uniform region (funnel shaped), (3) a uniform region followed by a diverging region (inverted funnel), and (4) a cast of a an induced fracture from a carbonate rock. All of the samples consisted of two blocks that measured 100 x 100 x 50 mm. The minimum separation between these blocks determined the nominal aperture (0.5 mm to 20 mm). During experiments a fracture was fully submerged in water and swarms were released into it. The swarms consisted of a dilute suspension of 3 micron polystyrene fluorescent beads (1% by mass) with an initial volume of 5μL. The swarms were illuminated with a green (525 nm) LED array and imaged optically with a CCD camera. The variation in fracture aperture controlled swarm behavior. Diverging apertures caused a sudden loss of confinement that resulted in a rapid change in the swarm's shape as well as a sharp increase in its velocity

  13. Orthopaedic resident preparedness for closed reduction and pinning of pediatric supracondylar fractures is improved by e-learning: a multisite randomized controlled study.

    Science.gov (United States)

    Hearty, Thomas; Maizels, Max; Pring, Maya; Mazur, John; Liu, Raymond; Sarwark, John; Janicki, Joseph

    2013-09-04

    There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% ± 6.8% for the test group and 73.5% ± 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a

  14. Bipolar disorder and the risk of fracture: A nationwide population-based cohort study.

    Science.gov (United States)

    Su, Jian-An; Cheng, Bi-Hua; Huang, Yin-Cheng; Lee, Chuan-Pin; Yang, Yao-Hsu; Lu, Mong-Liang; Hsu, Chung-Yao; Lee, Yena; McIntyre, Roger S; Chin Lin, Tzu; Chin-Hung Chen, Vincent

    2017-08-15

    The co-primary aims are: 1) to compare the risk of fracture between adults with bipolar disorder and those without bipolar disorder; and 2) to assess whether lithium, anticonvulsants and antipsychotics reduce risk of fracture among individuals with bipolar disorder. The analysis herein is a population-based retrospective cohort study, utilizing the National Health Insurance (NHI) medical claims data collected between 1997 and 2013 in Taiwan. We identified 3705 cases with incident diagnoses of bipolar disorder during study period and 37,050 matched controls without bipolar diagnoses. Incident diagnosis of fracture was operationalized as any bone fracture after the diagnosis of bipolar disorder or after the matched index date for controls. Bipolar patients had significantly higher risk of facture when compared to matched controls (17.6% versus 11.7%, respectively pbipolar disorder and a prior history of psychiatric hospitalization were had higher risk for bone fracture than those without prior history of psychiatric hospitalization when compared to match controls. Higher cumulative dose of antipsychotics or mood stabilizers did not increase the risk of fracture. The diagnoses of bipolar disorder were not confirmed with structured clinical interview. Drug adherence, exact exposure dosage, smoking, lifestyle, nutrition and exercise habits were unable to be assessed in our dataset. Bipolar disorder is associated with increased risk of fracture, and higher cumulative dose of mood stabilizers and antipsychotics did not further increase the risk of fracture. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Relationships between fractures

    Science.gov (United States)

    Peacock, D. C. P.; Sanderson, D. J.; Rotevatn, A.

    2018-01-01

    Fracture systems comprise many fractures that may be grouped into sets based on their orientation, type and relative age. The fractures are often arranged in a network that involves fracture branches that interact with one another. Interacting fractures are termed geometrically coupled when they share an intersection line and/or kinematically coupled when the displacements, stresses and strains of one fracture influences those of the other. Fracture interactions are characterised in terms of the following. 1) Fracture type: for example, whether they have opening (e.g., joints, veins, dykes), closing (stylolites, compaction bands), shearing (e.g., faults, deformation bands) or mixed-mode displacements. 2) Geometry (e.g., relative orientations) and topology (the arrangement of the fractures, including their connectivity). 3) Chronology: the relative ages of the fractures. 4) Kinematics: the displacement distributions of the interacting fractures. It is also suggested that interaction can be characterised in terms of mechanics, e.g., the effects of the interaction on the stress field. It is insufficient to describe only the components of a fracture network, with fuller understanding coming from determining the interactions between the different components of the network.

  16. Preliminary experience with biodegradable implants for fracture fixation

    Directory of Open Access Journals (Sweden)

    Dhillon Mandeep

    2008-01-01

    Full Text Available Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence this study. Materials and Methods: A prospective study was done to assess the feasibility and surgeon confidence level with biodegradable implants over a 12-month period in an Indian hospital. Fifteen fractures (intra-articular, metaphyseal or small bone fractures were fixed with biodegradable implants. The surgeries were randomly scheduled so that different surgeons with different levels of experience could use the implants for fixation. Results: Three fractures (one humeral condyle, two capitulum, were supplemented by additional K-wires fixation. Trans-articular fixator was applied in two distal radius and two pilon fractures where bio-pins alone were used. All fractures united, but in two cases the fracture displaced partially during the healing phase; one fibula due to early walking, and one radius was deemed unstable even after bio-pin and external fixator. Conclusions: Biodegradable -implants are excellent for carefully selected cases of intra-articular fractures and some small bone fractures. However, limitations for use in long bone fractures persist and no great advantage is gained if a "hybrid" composite is employed. The mechanical properties of biopins and screws in isolation are perceived to be inferior to those of conventional metal implants, leading to low confidence levels regarding the stability of reduced fractures; these implants should be used predominantly in fracture patterns in which internal fixation is subjected to minimal stress.

  17. Locking plate versus external fixation for type C distal radius fractures: A meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Dong Wang

    2018-04-01

    Full Text Available Purpose: Distal radial fracture is one of the most common fractures. Up to now, locking plates (LP and external fixation (EF are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two interventions by this meta-analysis. Methods: We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow: radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results: Seven studies included 162 patients (LP group and 190 patients (EF group. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI (0.17, 3.50, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [(WMD = 3.61, 95% CI (0.00, 7.23, p = 0.05; WMD = 0.05, 95% CI (−0.99, 1.09, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI (−6.88, 26.96, p = 0.24; WMD = 12.53, 95% CI (−9.99, 35.06, p = 0.28]. Conclusion

  18. Use of fracture mechanics in engineering problems

    Energy Technology Data Exchange (ETDEWEB)

    Carter, C S

    1965-02-26

    If an engineering material containing a crack is subjected to a slowly increasing load, applied so that the crack tends to open, a small zone of plastic yielding develops at the crack tip. This zone increases in size with increasing load, and has the effect of resisting the tendency of the crack to extend. The basic concepts of fracture mechanics are outlined and the significance of crack toughness as measured by KDcU and KD1cU which relate the applied stress and crack size for unstable fracture prior to general yielding is discussed. The methods available for crack-toughness evaluation are indicated, and the mathematical expressions describing KDcU and KD1cU for a variety of geometrical situations are quoted. This approach to the design of fracture- resistant structures has been used in a number of fields in the U.S. and could be of value to the British steam turbine, aerospace, and pressure-vessel industries for design, inspection, and material selection. (64 refs.)

  19. A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

  20. Proximal femoral fractures.

    Science.gov (United States)

    Webb, Lawrence X

    2002-01-01

    Fractures of the proximal femur include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region which is exposed to large compressive stresses. Implants used to address these fractures must be able to accommodate significant loads while the fractures consolidate. Complications secondary to these injuries produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

  1. Prevention of distal extension cantilever fracture in mandibular overdentures.

    Science.gov (United States)

    Quirynen, Thomas; Quirynen, Marc; Duyck, Joke

    2015-09-01

    Fractures of distal bar extensions, supporting a mandibular overdenture, do occur with significant functional and economic consequences for the patient. This study therefore aims to evaluate the effect of different bar cross-sectional shapes and surfaces, bar extension lengths and the placement of a support rib under the distal bar extension on fracture resistance. The 2nd moment area and static strength were calculated for 11 frequently used bar designs using finite element analysis (FEA). For two specific designs (Ackermann round Ø 1.8mm and Dolder-Y macro, the former with and without a support rib) additional physical static and fatigue strength tests were included. The FEA static strength data corresponded well to the 2nd moment area (a similar ranking when maximum allowed force was considered). The application of a rib support (Ackermann Ø 1.8mm) and limitations of the bar extension length (6mm for the Ackermann Ø 1.8mm, 8mm for the Dolder-Y macro) allowed the bars to exceed 5 × 10(6) cycles of 120 and 250N, respectively, before fracture. The region of highest stresses in FEA corresponded well with the locations of the fractures observed in static- and fatigue-testing. With some simple guidelines/modifications, the number of bar extension fractures can be reduced significantly. This study focusses on distal bar extensions which improve the positioning of an implant supported overdenture. By combining laboratory testing and finite element simulations we aim to: (1) explain why fractures occur (dependent on physical characteristics of the bar), and (2) give clinical guidelines on how to prevent such fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Understanding hydraulic fracturing: a multi-scale problem

    Science.gov (United States)

    Hyman, J. D.; Jiménez-Martínez, J.; Viswanathan, H. S.; Carey, J. W.; Porter, M. L.; Rougier, E.; Karra, S.; Kang, Q.; Frash, L.; Chen, L.; Lei, Z.; O’Malley, D.; Makedonska, N.

    2016-01-01

    Despite the impact that hydraulic fracturing has had on the energy sector, the physical mechanisms that control its efficiency and environmental impacts remain poorly understood in part because the length scales involved range from nanometres to kilometres. We characterize flow and transport in shale formations across and between these scales using integrated computational, theoretical and experimental efforts/methods. At the field scale, we use discrete fracture network modelling to simulate production of a hydraulically fractured well from a fracture network that is based on the site characterization of a shale gas reservoir. At the core scale, we use triaxial fracture experiments and a finite-discrete element model to study dynamic fracture/crack propagation in low permeability shale. We use lattice Boltzmann pore-scale simulations and microfluidic experiments in both synthetic and shale rock micromodels to study pore-scale flow and transport phenomena, including multi-phase flow and fluids mixing. A mechanistic description and integration of these multiple scales is required for accurate predictions of production and the eventual optimization of hydrocarbon extraction from unconventional reservoirs. Finally, we discuss the potential of CO2 as an alternative working fluid, both in fracturing and re-stimulating activities, beyond its environmental advantages. This article is part of the themed issue ‘Energy and the subsurface’. PMID:27597789

  3. [Comparison of clinical effectiveness of thoracic epidural and intravenous patient-controlled analgesia for the treatment of rib fractures pain in intensive care unit].

    Science.gov (United States)

    Topçu, Ismet; Ekici, Zeynep; Sakarya, Melek

    2007-07-01

    The results of thoracic epidural and systemic patient controlled analgesia practice were evaluated retrospectively in patients with thoracic trauma. Patients who were admitted to the intensive care unit between 1997 and 2003, with a diagnosis of multiple rib fractures related to thoracic trauma were evaluated retrospectively. Data were recorded from 49 patients who met the following criteria; three or more rib fractures, initiation of PCA with I.V. phentanyl or thoracic epidural analgesia with phentanyl and bupivacaine. There were no significant differences between the groups concerning injury severity score. APACHE II score (8.1+/-1.6 and 9.2+/-1.7) and the number of rib fractures (4+/-1.1 and 6.8+/-2.7) were higher in thoracic epidural analgesia group (pPain scores of patients who received thoracic epidural analgesia were significantly lower as from 6th hour during whole therapy (prib fractures who require intensive care.

  4. Controlling radiated emissions by design

    CERN Document Server

    Mardiguian, Michel

    2014-01-01

    The 3rd edition of Controlling Radiated Emissions by Design has been updated to reflect the latest changes in the field. New to this edition is material related to technical advances, specifically super-fast data rates on wire pairs, with no increase in RF interference. Throughout the book, details are given to control RF emissions using EMC design techniques. This book retains the step-by-step approach for incorporating EMC into every new design from the ground up. It describes the selection of quieter IC technologies, their implementation into a noise-free printed circuit layout, and the gathering of these into a low emissions package. Also included is how to design an I/O filter, along with connectors and cable considerations. All guidelines are supported throughout with comprehensive calculated examples. Design engineers, EMC specialists, and technicians will benefit from learning about the development of more efficient and economical control of emissions.

  5. Fracture morphology of AO/OTA 31-A trochanteric fractures: A 3D CT study with an emphasis on coronal fragments.

    Science.gov (United States)

    Cho, Jae-Woo; Kent, William T; Yoon, Yong-Cheol; Kim, Youngwoo; Kim, Hyungon; Jha, Ashutosh; Durai, Senthil Kumar; Oh, Jong-Keon

    2017-02-01

    This study was designed to assess the incidence and morphology of coronal plane fragments in AO/OTA 31-A trochanteric fractures. 156 cases of AO/OTA 31-A trochanteric fractures were retrospectively evaluated. Lateral radiographs were analyzed for the presence of coronal plane fragments followed by analysis of 3D CT reconstructions in these fractures. The incidence of coronal fragments identified on the lateral radiograph and 3D CT reconstructions were both calculated. Coronal fragment morphology was described based upon the origin and exit points of fracture lines and the number of fragments. On plain radiographs, a coronal plane fracture was identified in 59 cases, an incidence of 37.8% (59/156). In comparison, 3D CT reconstructions identified coronal plane fractures in 138 cases for an incidence of 88.4% (138/156). 3D CT reconstructions identified coronal fracture fragments in 81.9% (50/61) of AO/OTA 31-A1 cases, 94.5% (69/73) of 31-A2 cases, and 86.3% (19/22) of 31-A3 cases. Incidence of coronal fractures identified on plain radiographs of 3 AO/OTA 31-A1,A2,A3 groups was lower when compared to the incidence of coronal fractures identified on 3D CT. Of the 138 cases that had coronal plane fracture, 82 cases (59.4%) had a single coronal fragment (GT fragment 35 cases, GLT fragment 19 cases, GLPC fragment 28 cases). The remaining 56 cases (40.5%) had two coronal fragments. There is a high incidence of coronal fragments in intertrochanteric femur fractures when analyzed with 3D CT reconstructions. Our study suggests that these coronal fragments are difficult to identify on plain radiographs. Knowledge of the incidence and morphology of coronal fragments helps to avoid potential intraoperative pitfalls. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Model reduction in integrated controls-structures design

    Science.gov (United States)

    Maghami, Peiman G.

    1993-01-01

    It is the objective of this paper to present a model reduction technique developed for the integrated controls-structures design of flexible structures. Integrated controls-structures design problems are typically posed as nonlinear mathematical programming problems, where the design variables consist of both structural and control parameters. In the solution process, both structural and control design variables are constantly changing; therefore, the dynamic characteristics of the structure are also changing. This presents a problem in obtaining a reduced-order model for active control design and analysis which will be valid for all design points within the design space. In other words, the frequency and number of the significant modes of the structure (modes that should be included) may vary considerably throughout the design process. This is also true as the locations and/or masses of the sensors and actuators change. Moreover, since the number of design evaluations in the integrated design process could easily run into thousands, any feasible order-reduction method should not require model reduction analysis at every design iteration. In this paper a novel and efficient technique for model reduction in the integrated controls-structures design process, which addresses these issues, is presented.

  7. Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women.

    Science.gov (United States)

    Kim, Kyong-Chol; Shin, Dong-Hyuk; Lee, Sei-Young; Im, Jee-Aee; Lee, Duk-Chul

    2010-11-01

    The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture. A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured. After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p related to BMD of all sites (p related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011). In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.

  8. Floor-Fractured Craters through Machine Learning Methods

    Science.gov (United States)

    Thorey, C.

    2015-12-01

    Floor-fractured craters are impact craters that have undergone post impact deformations. They are characterized by shallow floors with a plate-like or convex appearance, wide floor moats, and radial, concentric, and polygonal floor-fractures. While the origin of these deformations has long been debated, it is now generally accepted that they are the result of the emplacement of shallow magmatic intrusions below their floor. These craters thus constitute an efficient tool to probe the importance of intrusive magmatism from the lunar surface. The most recent catalog of lunar-floor fractured craters references about 200 of them, mainly located around the lunar maria Herein, we will discuss the possibility of using machine learning algorithms to try to detect new floor-fractured craters on the Moon among the 60000 craters referenced in the most recent catalogs. In particular, we will use the gravity field provided by the Gravity Recovery and Interior Laboratory (GRAIL) mission, and the topographic dataset obtained from the Lunar Orbiter Laser Altimeter (LOLA) instrument to design a set of representative features for each crater. We will then discuss the possibility to design a binary supervised classifier, based on these features, to discriminate between the presence or absence of crater-centered intrusion below a specific crater. First predictions from different classifier in terms of their accuracy and uncertainty will be presented.

  9. Identifying Fracture Types and Relative Ages Using Fluid Inclusion Stratigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dilley, Lorie M.; Norman, David; Owens, Lara

    2008-06-30

    Enhanced Geothermal Systems (EGS) are designed to recover heat from the subsurface by mechanically creating fractures in subsurface rocks. Understanding the life cycle of a fracture in a geothermal system is fundamental to the development of techniques for creating fractures. Recognizing the stage of a fracture, whether it is currently open and transmitting fluids; if it recently has closed; or if it is an ancient fracture would assist in targeting areas for further fracture stimulation. Identifying dense fracture areas as well as large open fractures from small fracture systems will also assist in fracture stimulation selection. Geothermal systems are constantly generating fractures, and fluids and gases passing through rocks in these systems leave small fluid and gas samples trapped in healed microfractures. Fluid inclusions trapped in minerals as the fractures heal are characteristic of the fluids that formed them, and this signature can be seen in fluid inclusion gas analysis. Our hypothesis is that fractures over their life cycle have different chemical signatures that we can see in fluid inclusion gas analysis and by using the new method of fluid inclusion stratigraphy (FIS) the different stages of fractures, along with an estimate of fracture size can be identified during the well drilling process. We have shown with this study that it is possible to identify fracture locations using FIS and that different fractures have different chemical signatures however that signature is somewhat dependent upon rock type. Open, active fractures correlate with increase concentrations of CO2, N2, Ar, and to a lesser extent H2O. These fractures would be targets for further enhancement. The usefulness of this method is that it is low cost alternative to current well logging techniques and can be done as a well is being drilled.

  10. Femoral Geometry in Male Patients with Atraumatic Hip Fracture - Original Investigation

    Directory of Open Access Journals (Sweden)

    Gülten Tan

    2007-03-01

    Full Text Available Aims: Hip fracture is the most serious complication of osteoporosis and the most disabling type of fracture. In this study, we aimed to compare femoral geometry in hip fractured male patients aged more than 65 years old with age matched controls. Patients and Methods: 20 male patients with a history of nontraumatic hip fracture and 19 age-matched healthy controls were included in this study. Bone mineral density of neck and trochanter of hip were measured by DEXA. In addition to BMD, an experienced radiologist measured proximal femur geometric parameters potentially involved in bone strength. Results: Mean BMDs of trochanteric region were not significantly different between groups, but mean BMDs of neck region were statistically significantly lower in the hip fractured group. Neck shaft angle and femur shaft width were the geometric parameters found to be significantly higher in the hip fractured group. The correlation between femur geometric and the anthropometric measurements was present only in the kontrol group. Conclusion: We concluded that besides femur geometric measurements, correlation between these measurements might be an important factors for the fracture risk. (From the World of Osteoporosis 2007;13:15-8

  11. SUBSURFACE REPOSITORY INTEGRATED CONTROL SYSTEM DESIGN

    International Nuclear Information System (INIS)

    Randle, D.C.

    2000-01-01

    The primary purpose of this document is to develop a preliminary high-level functional and physical control system architecture for the potential repository at Yucca Mountain. This document outlines an overall control system concept that encompasses and integrates the many diverse process and communication systems being developed for the subsurface repository design. This document presents integrated design concepts for monitoring and controlling the diverse set of subsurface operations. The Subsurface Repository Integrated Control System design will be composed of a series of diverse process systems and communication networks. The subsurface repository design contains many systems related to instrumentation and control (I andC) for both repository development and waste emplacement operations. These systems include waste emplacement, waste retrieval, ventilation, radiological and air monitoring, rail transportation, construction development, utility systems (electrical, lighting, water, compressed air, etc.), fire protection, backfill emplacement, and performance confirmation. Each of these systems involves some level of I andC and will typically be integrated over a data communications network throughout the subsurface facility. The subsurface I andC systems will also interface with multiple surface-based systems such as site operations, rail transportation, security and safeguards, and electrical/piped utilities. In addition to the I andC systems, the subsurface repository design also contains systems related to voice and video communications. The components for each of these systems will be distributed and linked over voice and video communication networks throughout the subsurface facility. The scope and primary objectives of this design analysis are to: (1) Identify preliminary system-level functions and interfaces (Section 6.2). (2) Examine the overall system complexity and determine how and on what levels the engineered process systems will be monitored

  12. [Association between hip fractures and risk factors for osteoporosis. Multivariate analysis].

    Science.gov (United States)

    Masoni, Ana; Morosano, Mario; Tomat, María Florencia; Pezzotto, Stella M; Sánchez, Ariel

    2007-01-01

    In this observational, case-control study, 376 inpatients were evaluated in order to determine the association of risk factors (RF) and hip fracture; 151 patients had osteoporotic hip fracture (cases); the remaining were controls. Data were obtained from medical charts, and through a standardized questionnaire about RF. Mean age of the sample (+/- SD) was 80.6 +/- 8.1 years, without statistically significant difference between cases and controls; the female:male ratio was 3:1 in both groups. Fractured women were older than men (82.5 +/- 8.1 vs. 79.7 +/- 7.2 years, respectively; p household duties was a RF (p = 0.007), which was absent in males. In multivariate analysis, the following RF were significantly more frequent: Cognitive impairment (p = 0.001), and previous falls (p < 0.0001); whereas the following protective factors were significantly different from controls: Calcium intake during youth (p < 0.0001), current calcium intake (p < 0.0001), and mechanical aid for walking (p < 0.0001). Evaluation of RF and protective factors may contribute to diminish the probability of hip fracture, through a modification of personal habits, and measures to prevent falls among elderly adults. Present information can help to develop local and national population-based strategies to diminish the burden of hip fractures for the health system.

  13. Dating fractures and fracture movement in the Lac du Bonnet Batholith

    International Nuclear Information System (INIS)

    Gascoyne, M.; Brown, A.; Ejeckam, R.B.; Everitt, R.A.

    1997-04-01

    This report examines and summarizes all work that has been done from 1980 to the present in determining the age of rock crystallization, fracture initiation, fracture reactivation and rates of fracture movement in the Lac du Bonnet Batholith to provide information for Atomic Energy of Canada Limited's (AECL) Canadian Nuclear Fuel Waste Management Program. Geological and petrographical indicators of relative age (e.g. cross-cutting relationships, sequences of fracture infilling minerals, P-T characteristics of primary and secondary minerals) are calibrated with radiometric age determinations on minerals and whole rock samples, using 87 Rb- 87 Sr, 40 K- 39 Ar, 40 Ar- 39 Ar and fission track methods. Most fractures and fracture zones inclined at low angles are found to be ancient features, first formed in the Early Proterozoic under conditions of deuteric alteration. Following some movement on fractures in the Late Proterozoic and Early Paleozoic, reactivation of fractures during the Pleistocene is established from uranium-series dating methods and use of stable isotopic contents of fracture infilling minerals (mainly calcite). Some indication of movement on fracture zones during the Pleistocene is given by electron spin resonance dating techniques on fault gouge. The slow rate of propagation of fractures is indicated by mineral infillings, their P-T characteristics and U-series calcite ages in a fracture in sparsely fractured rock, accessible from AECL's Underground Research Laboratory. These results collectively indicate that deep fractures observed in the batholith are ancient features and the fracturing and jointing in the upper 200 m is relatively recent (< 1 Ma) and largely a result of stress release. (author)

  14. Specimen-specific modeling of hip fracture pattern and repair.

    Science.gov (United States)

    Ali, Azhar A; Cristofolini, Luca; Schileo, Enrico; Hu, Haixiang; Taddei, Fulvia; Kim, Raymond H; Rullkoetter, Paul J; Laz, Peter J

    2014-01-22

    Hip fracture remains a major health problem for the elderly. Clinical studies have assessed fracture risk based on bone quality in the aging population and cadaveric testing has quantified bone strength and fracture loads. Prior modeling has primarily focused on quantifying the strain distribution in bone as an indicator of fracture risk. Recent advances in the extended finite element method (XFEM) enable prediction of the initiation and propagation of cracks without requiring a priori knowledge of the crack path. Accordingly, the objectives of this study were to predict femoral fracture in specimen-specific models using the XFEM approach, to perform one-to-one comparisons of predicted and in vitro fracture patterns, and to develop a framework to assess the mechanics and load transfer in the fractured femur when it is repaired with an osteosynthesis implant. Five specimen-specific femur models were developed from in vitro experiments under a simulated stance loading condition. Predicted fracture patterns closely matched the in vitro patterns; however, predictions of fracture load differed by approximately 50% due to sensitivity to local material properties. Specimen-specific intertrochanteric fractures were induced by subjecting the femur models to a sideways fall and repaired with a contemporary implant. Under a post-surgical stance loading, model-predicted load sharing between the implant and bone across the fracture surface varied from 59%:41% to 89%:11%, underscoring the importance of considering anatomic and fracture variability in the evaluation of implants. XFEM modeling shows potential as a macro-level analysis enabling fracture investigations of clinical cohorts, including at-risk groups, and the design of robust implants. © 2013 Published by Elsevier Ltd.

  15. Uncertainty analysis on probabilistic fracture mechanics assessment methodology

    International Nuclear Information System (INIS)

    Rastogi, Rohit; Vinod, Gopika; Chandra, Vikas; Bhasin, Vivek; Babar, A.K.; Rao, V.V.S.S.; Vaze, K.K.; Kushwaha, H.S.; Venkat-Raj, V.

    1999-01-01

    Fracture Mechanics has found a profound usage in the area of design of components and assessing fitness for purpose/residual life estimation of an operating component. Since defect size and material properties are statistically distributed, various probabilistic approaches have been employed for the computation of fracture probability. Monte Carlo Simulation is one such procedure towards the analysis of fracture probability. This paper deals with uncertainty analysis using the Monte Carlo Simulation methods. These methods were developed based on the R6 failure assessment procedure, which has been widely used in analysing the integrity of structures. The application of this method is illustrated with a case study. (author)

  16. Greater intake of fruit and vegetables is associated with a lower risk of osteoporotic hip fractures in elderly Chinese: a 1:1 matched case-control study.

    Science.gov (United States)

    Xie, H-L; Wu, B-H; Xue, W-Q; He, M-G; Fan, F; Ouyang, W-F; Tu, S-L; Zhu, H-L; Chen, Y-M

    2013-11-01

    In this case-control study, we examined the relationship between the consumption of fruit and vegetables and risk of hip fractures in 646 pairs of incident cases and controls in elderly Chinese. We found that greater consumption of both fruit and vegetables in men and vegetables in women was associated with a lower risk of osteoporotic hip fractures in elderly Chinese. The association between fruit and vegetable consumption and the risk of osteoporotic fractures remains controversial due to limited published evidence. The purpose of this study was to determine whether consuming fruits and vegetables has a protective effect against hip fractures. Between January 2008 and December 2012, 646 (162 males, 484 females) incident cases (70.9 ± 6.8 years) of hip fractures were enrolled from five hospitals, with 646 sex- and age-matched (±3 years) controls (70.7 ± 6.8 years) from hospitals or the community. Face-to-face interviews were conducted to assess habitual dietary intakes using a 79-item food frequency questionnaire and various covariates by structured questionnaires. Multivariate conditional logistic regression analyses showed dose-dependent inverse correlations between the intake of total fruit (p-trend = 0.014), total vegetables (p-trend fruits and vegetables combined (p-trend fruits, vegetables and the combination of fruits and vegetables were 0.53 (0.32-0.87), 0.37 (0.23-0.60) and 0.25 (0.15-0.41), respectively. Stratified analyses showed that the benefits remained significant in males (p = 0.001) but not in females (p = 0.210) (p-interaction 0.045). Among the subcategories of fruits and vegetables, similar associations were observed for all subgroups except light-coloured fruits. Our findings suggest that greater consumption of both fruits and vegetables in men and vegetables in women may decrease the risk of osteoporotic hip fractures in elderly Chinese.

  17. Biaxial loading effects on fracture toughness of reactor pressure vessel steel

    International Nuclear Information System (INIS)

    McAfee, W.J.; Bass, B.R.; Bryson, J.W. Jr.; Pennell, W.E.

    1995-03-01

    The preliminary phases of a program to develop and evaluate fracture methodologies for assessing crack-tip constraint effects on fracture toughness of reactor pressure vessel (RPV) steels have been completed by the Heavy-Section Steel Technology (HSST) Program. Objectives were to investigate effect of biaxial loading on fracture toughness, quantify this effect through existing stress-based, dual-parameter, fracture-toughness correlations, or propose and verify alternate correlations. A cruciform beam specimen with 2-D, shallow, through-thickness flaw and a special loading fixture was designed and fabricated. Tests were performed using biaxial loading ratios of 0:1 (uniaxial), 0.6:1, and 1:1 (equi-biaxial). Critical fracture-toughness values were calculated for each test. Biaxial loading of 0.6:1 resulted in a reduction in the lower bound fracture toughness of ∼12% as compared to that from the uniaxial tests. The biaxial loading of 1:1 yielded two subsets of toughness values; one agreed well with the uniaxial data, while one was reduced by ∼43% when compared to the uniaxial data. Results were evaluated using J-Q theory and Dodds-Anderson (D-A) micromechanical scaling model. The D-A model predicted no biaxial effect, while the J-Q method gave inconclusive results. When applied to the 1:1 biaxial data, these constraint methodologies failed to predict the observed reduction in fracture toughness obtained in one experiment. A strain-based constraint methodology that considers the relationship between applied biaxial load, the plastic zone width in the crack plane, and fracture toughness was formulated and applied successfully to the data. Evaluation of this dual-parameter strain-based model led to the conclusion that it has the capability of representing fracture behavior of RPV steels in the transition region, including the effects of out-of-plane loading on fracture toughness. This report is designated as HSST Report No. 150

  18. The Impact of Disease and Drugs on Hip Fracture Risk

    OpenAIRE

    Leavy, Breiffni; Michaëlsson, Karl; Åberg, Anna Cristina; Melhus, Håkan; Byberg, Liisa

    2017-01-01

    We report the risks of a comprehensive range of disease and drug categories on hip fracture occurrence using a strict population-based cohort design. Participants included the source population of a Swedish county, aged ?50?years (n?=?117,494) including all incident hip fractures during 1?year (n?=?477). The outcome was hospitalization for hip fracture (ICD-10 codes S72.0?S72.2) during 1?year (2009?2010). Exposures included: prevalence of (1) inpatient diseases [International Classification o...

  19. Vitamin K1 and 25(OH)D are independently and synergistically associated with a risk for hip fracture in an elderly population: a case control study.

    Science.gov (United States)

    Torbergsen, Anne C; Watne, Leiv O; Wyller, Torgeir B; Frihagen, Frede; Strømsøe, Knut; Bøhmer, Thomas; Mowe, Morten

    2015-02-01

    The incidence of hip fractures in Oslo is among the highest in the world. Vitamin D, as well as vitamin K, may play an important role in bone metabolism. We examined if vitamin K1 and 25(OH)D were associated with an increased risk of hip fracture, and whether the possible synergistic effect of these two micronutrients is mediated through bone turnover markers. Blood was drawn for vitamin K1, 25(OH)D, and the bone turnover marker osteocalcin upon admission for hip fracture and in healthy controls. Vitamin K1 and 25(OH)D were independently associated with a risk of hip fracture. The adjusted odds ratio (95% CI) per ng/ml increase in vitamin K1 was 0.07 (0.02-0.32), and that per nmol/L increase in 25(OH)D was 0.96 (0.95-0.98). There was a significant interaction between 25(OH)D and vitamin K1 (p vitamin K1 and 25(OH)D (rho = 0.18, p = 0.01; rho = 0.20, p = 0.01, respectively). Vitamin K1 and 25(OH)D are lower in hip fracture patients compared with controls. Vitamin K1 and 25(OH)D are independently and synergistically associated with the risk of hip fracture when adjusting for confounders. Intervention studies should include both vitamins. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  20. Study on imaging analysis using three-dimensional CT system for mandibular condylar fracture. Establishing quantitative classification

    International Nuclear Information System (INIS)

    Kurokawa, Hideto

    1997-01-01

    We examined 13 patients with fractures of the condylar process (7 men, 6 women) by using 3-dimensional images. A break-down of 15 examined joints revealed 11 patients with unilateral and 2 patients with bilateral fractures of the condylar process. Eight joints of healthy control individual (2 men and 2 women) were used as controls. Fractures of the condylar process and healthy controls were compared, which comparison led to the following conclusions: Bone fragments of deviated fractures may move slightly within the joint, preferentially internally and medially; following displaced fractures, internal and downward movement of bone fragments within the joint is observed; after the occurrence of deviated dislocation fractures, bone fragments protrude from the joint and clearly move internally and inferiorly, showing a rotation of the bone fragments; after the occurrence of displaced dislocation fractures, bone fragments also protrude from the joint and clearly move anteriorly and inferiorly; sometimes an internal rotation of the bone fragments is observed; and with linear fractures there is only minimal overall increase in, and characteristic changes are not observed. Regarding diagnosis, the classical classification of fractures of the condylar process does not provide a classification for linear fractures. Thus, this type has to be newly added to the common classification: Fissure fractures (type I), Deviated fractures (type II), Displaced fractures (type III), Deviated dislocation fractures (type IV), Displaced dislocation fractures (type V), Longitudinal (type VI). (author)