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Sample records for generalized joint hypermobility

  1. The functional consequences of Generalized Joint Hypermobility

    DEFF Research Database (Denmark)

    Scheper, Mark C; de Vries, Janneke E; Juul-Kristensen, Birgit;

    2014-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) has been found to be associated with musculoskeletal complaints and disability. For others GJH is seen as a prerequisite in order to excel in certain sports like dance. However, it remains unclear what the role is of GJH in human performance...... among students from the Amsterdam School of Health Professions (ASHP) (n = 36) and the Amsterdam School of Arts (ASA), Academy for dance and theater (n = 36) in Amsterdam, The Netherlands. From each participant the following data was collected: Functional status performance (self-reported Physical...

  2. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature

    DEFF Research Database (Denmark)

    Remvig, Lars; Jensen, Dorte V; Ward, Robert C

    2007-01-01

    This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria.......This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria....

  3. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature

    DEFF Research Database (Denmark)

    Remvig, Lars; Jensen, Dorte V; Ward, Robert C

    2007-01-01

    This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria.......This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria....

  4. Correlations Between General Joint Hypermobility and Joint Hypermobility Syndrome and Injury in Contemporary Dance Students.

    Science.gov (United States)

    Ruemper, Alia; Watkins, Katherine

    2012-12-01

    The first objective of this study was to ascertain the prevalence of general joint hypermobility (GJH) and joint hypermobility syndrome (JHS) in BA Dance Theatre 1st and 3rd year students at a contemporary dance conservatory. The second objective was to determine the statistical correlation between GJH, JHS, and injury in this population. A total of 85 (female, N = 78; male, N = 7) contemporary dance students participated in the study. The Beighton score (with a forward flexion test modification) was used to determine GJH, and the Brighton criteria were used to verify JHS. Participants completed a self-reported injury questionnaire that included type of injury (physical complaint, medical diagnosis, or time-loss) and injury frequency. Statistical analysis (Pearson correlation) was used to correlate GJH, JHS, and frequency-of-injury scores. Overall, 69% of the students were found to have GJH, and 33% had JHS. A statistical correlation of r = + 0.331 (p contemporary dance students and suggests that screening programs should include the Brighton criteria to identify JHS in these dancers. Subsequent injury tracking and injury prevention programs would then provide data for further research in this area.

  5. Lack of consensus on tests and criteria for generalized joint hypermobility, Ehlers-Danlos syndrome

    DEFF Research Database (Denmark)

    Remvig, Lars; Flycht, Lise; Christensen, Karl B;

    2014-01-01

    The objectives of this study were to register clinicians performance and opinion of importance of clinical tests for generalized joint hypermobility (GJH), Ehlers-Danlos syndrome, hypermobility type (EDS-HT) and joint hypermobility syndrome (JHS), and to reach a consensus among clinicians on crit...

  6. Alterations in neuromuscular function in girls with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Melcher, Jesper Sandfeld; Melcher, Pia Grethe Sandfeld;

    2016-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions...... (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. RESULTS: Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee...... adaptation to compensate for hypermobility. Higher medial muscle activation indicated higher levels of medial knee joint compression in girls with GJH. Increased flexion-extension co-activation ratios in GJH were explained by decreased agonist drive to the hamstrings....

  7. Correlation between generalized joint hypermobility and hallux valgus

    Directory of Open Access Journals (Sweden)

    A. A. Kardanov

    2015-01-01

    Full Text Available Purpose: to evaluate correlation between generalized joint hypermobility, forefoot deformities and elasticity of the first ray of the foot. Material and methods. We examined 138 patients with complaints related with deformities at the forefoot level. During this study the medical history was obtained, the elasticity type of the feet was defined and the degree of motion of the medial metatarsal-cuneiform joint was evaluated. Forefoot elasticity was identified by bringing together the heads I and V metatarsal bones with fingers. If convergence occurred with little resistance, those feet were called hyperelastic. The convergence of the heads I and V metatarsal bones of the foot with an average type of elasticity occurred with resistance. It was impossible to converge the heads of I and V metatarsal bones. Due to the results of weight-bearing and non-weight bearing X-ray, analysis of the main radiographic angles of the foot was performed: between I and V metatarsal bones, between the first and second metatarsal bones and between the first metatarsal bone and proximal phalanx of the great toe. Calculation formula of the forefoot flatness index, showing the average ratios of basic radiographic angles of the foot on the x-ray images (weight-bearing and non-weight bearing was created. An assessment of total joint hypermobility using Beighton scale and evaluation of first ray deformity using DuPont scale were performed. Statistical analysis of obtained data was performed, as a result of which significantly strong correlation between total joint hypermobility, forefoot elasticity and valgus deviation of the great toe were revealed. Results. 11% of the feet were hyperelastic. Calculation of the index of forefoot flatness showed that forefoot flatness wasn’t significant for a rigid foot - 5.6 %, for the feet with an average degree of mobility it was 6.0% and it was expressed for hypemobile feet - 12.3 %. Strong correlation relation between the forefeet

  8. Alterations in neuromuscular function in girls with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Melcher, Jesper Sandfeld; Melcher, Pia Grethe Sandfeld

    2016-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions...... (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. RESULTS: Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee...... extensor and calf muscle activation did not differ between groups. Flexion-extension and medial-lateral co-activation ratio during flexions were higher for girls with GJH than NGJH girls. CONCLUSIONS: Girls with GJH had higher capacity to rapidly generate force than NGJH girls which may reflect motor...

  9. The association between generalized joint hypermobility and temporomandibular joint disorders : A systematic review

    NARCIS (Netherlands)

    Dijkstra, PU; Kropmans, TJB; Stegenga, B

    2002-01-01

    To analyze conflicting evidence in the literature for the association between temporomandibular joint disorders (TMD) and generalized joint hypermobility (GJH), we performed a bibliographic search. The methodological quality of the 14 papers found was assessed according to 14 criteria. Papers were i

  10. Does generalized joint hypermobility predict joint injury in sport? A review.

    LENUS (Irish Health Repository)

    Donaldson, Peter R

    2012-02-01

    OBJECTIVE: To determine whether persons with generalized joint hypermobility have an increased risk of lower limb joint injury during sport. DATA SOURCES: PubMed, CINAHL, EMBASE, and SportDiscus were searched through February 2009, without language restrictions, using terms related to risk; hip, ankle, and knee injuries; and joint instability. Reference lists of included studies and relevant reviews were searched by hand. STUDY SELECTION: Selection criteria were peer-reviewed studies with a prospective design that used an objective scale to measure generalized joint hypermobility; the participants were engaged in sport activity, and the injury data were quantitative and based on diagnosis by a health professional, were self-reported, or resulted in time lost to athletic participation. The studies were screened by 1 researcher and checked by a second. Study methods were independently assessed by 2 investigators using the 6-point scale for prognostic studies developed by Pengel. Disagreements were resolved through discussion. Of 4841 studies identified, 18 met inclusion criteria. Of these, 8 were included in random-effects meta-analyses. DATA EXTRACTION: The data extracted by 2 reviewers included participant and sport characteristics and details of joint hypermobility and injury measurements. More detailed data for 4 investigations were obtained from the study authors. Where possible, hypermobility was defined as >\\/=4 of 9 points on the British Society of Rheumatology Scale (BSRS). MAIN RESULTS: Lower limb joint injuries (3 studies, 1047 participants) occurred in 14% of participants. Using the BSRS of joint hypermobility, any lower limb injury was not associated with hypermobility [odds ratio (OR), 1.43; 95% confidence interval (CI), 0.56-3.67]. Using the original authors\\' definitions, hypermobility was associated with risk of knee joint injuries (OR, 2.62; 95% CI, 1.04-6.58) in 5 studies. In 4 studies in which the BSRS could be used (1167 participants; incidence

  11. TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND GENERALIZED JOINT HYPERMOBILITY

    NARCIS (Netherlands)

    DIJKSTRA, PU; DEBONT, LGM; STEGENGA, B; BOERING, G

    1992-01-01

    Peripheral joint mobility of temporomandibular joint (TMJ) osteoarthrosis and internal derangement patients (n = 25) and of a control group (n = 29) was measured according to a rigidly standardized protocol, in order to study the relationships between TMJ osteoarthrosis and internal derangement and

  12. Gait pattern in 9-11-year-old children with generalized joint hypermobility compared with controls

    DEFF Research Database (Denmark)

    Nikolajsen, Helene; Larsen, Peter Kastmand; Simonsen, Erik Bruun;

    2013-01-01

    To study differences in gait patterns in 10-year-old children with Generalized Joint Hypermobility (GJH) and with no GJH (NGJH).......To study differences in gait patterns in 10-year-old children with Generalized Joint Hypermobility (GJH) and with no GJH (NGJH)....

  13. Pediatric generalized joint hypermobility with and without musculoskeletal complaints : A localized or systemic disorder?

    NARCIS (Netherlands)

    Engelbert, RHH; Bank, RA; Sakkers, RJB; Helders, PJM; Beemer, FA; Uiterwaal, CSPM

    2003-01-01

    Objectives. Children with generalized hypermobility of the joints and musculoskeletal complaints frequently visit pediatric clinics, but many show no currently known collagen or other possibly related diseases. Whether the symptoms are confined to the musculoskeletal system is unknown. We assessed w

  14. Measurement properties of clinical assessment methods for classifying generalized joint hypermobility

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Schmedling, Karoline; Rombaut, Lies

    2017-01-01

    The purpose was to perform a systematic review of clinical assessment methods for classifying Generalized Joint Hypermobility (GJH), evaluate their clinimetric properties, and perform the best evidence synthesis of these methods. Four test assessment methods (Beighton Score [BS], Carter and Wilki...

  15. Girls with generalized joint hypermobility display changed muscle activity and postural sway during static balance tasks

    DEFF Research Database (Denmark)

    Juul-Kristensen, B; Johansen, Kl; Hendriksen, P;

    2016-01-01

    OBJECTIVES: To study knee muscle activity and static postural sway in girls with generalized joint hypermobility (GJH). METHOD: Sixteen girls with GJH and 11 girls with non-GJH (NGJH) aged 14 years, randomly recruited among schoolchildren, participated in this study. GJH inclusion criteria were: ......, compared with NGJH, static balance tasks with higher medial knee muscle activity relative to the lateral activity, and larger postural sway when vision was eliminated. The short- and long-term consequences should be studied further....

  16. Generalized joint hypermobility in childhood is a possible risk for the development of joint pain in adolescence

    DEFF Research Database (Denmark)

    Sohrbeck-Nøhr, Oline; Kristensen, Jens; Boyle, Eleanor;

    2014-01-01

    BackgroundThere is some evidence that indicates generalized joint hypermobility (GJH) is a risk factor for pain persistence and recurrence in adolescence. However, how early pain develops and whether GJH without pain in childhood is a risk factor for pain development in adolescence is undetermine...

  17. Dynamic balance during gait in children and adults with Generalized Joint Hypermobility

    DEFF Research Database (Denmark)

    Falkerslev, S; Baagø, C; Alkjær, Tine;

    2013-01-01

    compared to 18 control adults. The subjects were tested during normal walking and walking on a line. Kinematics of head, shoulder, spine and pelvis rotations were measured by five digital video cameras in order to assess the segmental stability (angular dispersion) and stabilization strategies (anchoring...... index) in two rotational components: roll and yaw. FINDINGS: Hypermobile children and adults showed decreased lateral trunk stability in both walking conditions. In hypermobile children, it was accompanied with decreased head stability as the head was stabilized by the inferior segment when walking......BACKGROUND: The purpose of the study was to investigate if differences of the head and trunk stability and stabilization strategies exist between subjects classified with Generalized Joint Hypermobility and healthy controls during gait. It was hypothesized that joint hypermobility could lead...

  18. Background factors in craniomandibular disorders with special reference to general joint hypermobility, parafunction, and trauma.

    Science.gov (United States)

    Westling, L; Carlsson, G E; Helkimo, M

    1990-01-01

    Seventy-four female patients referred to a CMD clinic were randomly selected for an examination of general joint mobility according to Beighton. Thirty of the patients (41%) were classified as hypermobile. Eighty-three percent of the patients with generally lax joints had TMJ involvement in comparison to 41% of the patients with no joint laxity. The difference between these groups was statistically significant (P less than 0.001). Parafunctions and trauma were associated with increased symptoms and signs in individuals with lax joints. In nonlax joint patients, trauma to the head and jaw was significantly correlated to TMJ disorders. The results indicate that general joint hypermobility should be taken into consideration in the diagnosis and treatment of CMD.

  19. Joint hypermobility syndrome in rheumatology

    Directory of Open Access Journals (Sweden)

    A. M. Satybaldyev

    2017-01-01

    Full Text Available Joint hypermobility syndrome (JHS is a disease characterized by symptoms of locomotor system involvement in the absence of obvious systemic rheumatic diseases (RDs. JHS accompanied by the symptomatology of RDs should be distinguished from isolated joint hypermobility, in which there are no complaints even in cases of its generalized manifestations and the patients feel virtually healthy. The paper provides an overview of the literature on the JHS. It gives diagnostic criteria for JHS (the Brighton criteria encompasses the Beighton score and the clinical manifestation of damages to the locomotor apparatus, visceral organs, and skin in this syndrome. Autonomic nervous system dysfunction as a possible manifestation of JHS and its impact on the daily life of patients are discussed. Attention is paid to the prevention and treatment of JHS. 

  20. Generalised joint hypermobility and shoulder joint hypermobility, - risk of upper body musculoskeletal symptoms and reduced quality of life in the general population

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Østengaard, Lasse; Hansen, Sebrina

    2017-01-01

    BACKGROUND: Generalised Joint Hypermobility (GJH) is a hereditary condition with an ability to exceed the joints beyond the normal range. The prevalence of GJH in the adult population and its impact on upper body musculoskeletal health and quality of life has mostly been studied in selected popul...

  1. Is Motor Performance in 5.5-Year-Old Children Associated with the Presence of Generalized Joint Hypermobility?

    NARCIS (Netherlands)

    Boer, R.M. de; Vlimmeren, L.A. van; Scheper, M.C.; Sanden, M.W. van der; Engelbert, R.H.

    2015-01-01

    OBJECTIVE: To determine the prevalence of generalized joint hypermobility (GJH) in Dutch children aged 5.5 years, and to examine the association between GJH and motor performance and development over time. STUDY DESIGN: A prospective cohort of 249 children was recruited. GJH was assessed with the Be

  2. Motor competence and physical activity in 8-year-old school children with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Kristensen, Jens Halkjaer; Frausing, Britt;

    2009-01-01

    were clinically examined and tested for motor competence, whereas questionnaire response to items comprising musculoskeletal pain and injuries, in addition to daily level and duration of physical activity, corresponded to 377 (71.9%) children. RESULTS: In total, 29% of the children had GJH4, 19% had...... regarding motor competence, self-reported physical activity, and incidence of musculoskeletal pain and injuries. METHODS: A cross-sectional study of 524 children in the second grade from 10 public schools was performed. A positive response rate was obtained for 416 (79.4%) children, and 411 (78.4%) children......OBJECTIVE: Because the criteria used for diagnosing between generalized joint hypermobility (GJH) and musculoskeletal complaints, as well as relations between GJH and an insufficient motor development and/or a reduced physical activity level differ, the prevalence of GJH varies considerably...

  3. Inter-examiner and inter-method reproducibility of tests and criteria for Generalized Joint Hypermobility in Primary School children

    DEFF Research Database (Denmark)

    Jespersen, Eva; Junge, Tina; Wedderkopp, Niels;

    2010-01-01

    Severe knee injuries can occur due to biomechanical factors such as knee joint laxity. Generalised Joint Hypermobility (GJH) has been proposed as an intrinsic risk factor for knee injuries in adults and adolescents, as individuals with GJH often have knee joint hypermobility. Also, critical knee...

  4. TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND TEMPOROMANDIBULAR-JOINT HYPERMOBILITY

    NARCIS (Netherlands)

    DIJKSTRA, PU; DEBONT, LGM; DELEEUW, R; STEGENGA, B; BOERING, G

    1993-01-01

    For studying the relationship between condylar hypermobility of the temporomandibular joint (TMJ) and osteoarthrosis (OA), 13 patients with bilateral condylar hypermobility were evaluated clinically and radiographically, 30 years after non-surgical treatment. The evaluation included range of motion,

  5. Joint hypermobility, fears, and chocolate consumption.

    Science.gov (United States)

    Pailhez, Guillem; Rosado, Silvia; Bulbena Cabré, Andrea; Bulbena, Antonio

    2011-11-01

    Our purpose was to evaluate joint hypermobility, an inherited disorder of the connective tissue significantly associated with anxiety disorders, in a sample of nonclinical students in relation to the frequency of severe fears and consumption of chocolate, coffee, cigarettes, and alcohol. One hundred fifty students completed the Hakim and Grahame Simple Questionnaire to detect hypermobility and the self-administered modified Wolpe Fear Scale (100 items). Severe fears and daily consumption of cigarettes, alcohol, coffee, and chocolate were compared with the hypermobility scores. We found significant differences when comparing severe fears between the groups with and without hypermobility (7.6 vs. 11; p = 0.001), reinforcing the hypothesis that the intensity of fears is greater in subjects with hypermobility. Only the frequency of chocolate intake was significantly higher among subjects with hypermobility (31.2% vs. 51.2%; p = 0.038) and may correspond to attempts of self-treatment of the collagen condition.

  6. Thorax deformity, joint hypermobility, and anxiety disorders.

    Science.gov (United States)

    Gulsun, Murat; Yilmaz, Mehmet B; Pinar, Murat; Tonbul, Murat; Celik, Cemil; Ozdemir, Barbaros; Dumlu, Kemal; Erbas, Mevlut

    2007-12-01

    To evaluate the association between thorax deformities, panic disorder, and joint hypermobility The study includes 52 males diagnosed with thorax deformity, and 40 healthy male controls without thorax deformity, in Tatvan Bitlis and Isparta, Turkey. The study was carried out from 2004 to 2006. The teleradiographic and thoracic lateral images of the subjects were evaluated to obtain the Beighton scores; subjects' psychiatric conditions were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), and the Hamilton Anxiety Scale (HAM-A) was applied in order to determine the anxiety levels. Both the subjects and controls were compared in sociodemographic, anxiety levels, and joint mobility levels. In addition, males with joint hypermobility and thorax deformity were compared to the group with thorax deformity without joint hypermobility. A significant difference in HAM-A scores was found between the groups with thorax deformity and without. In addition, 21 subjects with thorax deformity met the joint hypermobility criteria in the group with thorax deformity, and 7 subjects without thorax deformity met the joint hypermobility criteria in the group without thorax deformity, according to Beighton scoring. The Beighton scores of the subjects with thorax deformity were significantly different from those of the group without deformity. Additionally, anxiety scores of the males with thorax deformity and joint hypermobility were found higher than males with thorax deformity without joint hypermobility. Anxiety disorders, particularly panic disorder, have a significantly higher distribution in male subjects with thorax deformity compared to the healthy control group. In addition, the anxiety level of males with thorax deformity and joint hypermobility is higher than males with thorax deformity without joint hypermobility.

  7. The effectiveness of interventions focused on functional stability on the level of pain in patients with Joint Hypermobility Syndrome compared to general exercise: a systematic review protocol

    DEFF Research Database (Denmark)

    Holtze, Dorte Buch; Jessen-Winge, Christina; Hansen, Karsten Bruun

    2014-01-01

    The objective of this review is to identify what effect a systematic intervention focused on functional stability has on the level of pain (measured by pain scales) in patients with Joint Hypermobility Syndrome (JHS) compared to general exercise. This review will consider studies that include adu...... syndrome; pain; physical therapy; treatment...

  8. Joint hypermobility syndrome and related pain

    Directory of Open Access Journals (Sweden)

    Nilay Sahin

    2016-06-01

    Full Text Available Hypermobility is defined as an abnormally increased range of motion of a joint resulting from the excessive laxity of the soft tissues. This paper is focused on this commonly forgotten cause of several morbidities. The etiology of hypermobility is not very well known. One decade ago, joint hypermobility syndrome was considered as a benign condition, but now it is recognized as a significant contributor to chronic musculoskeletal pain, besides impacting on other organs. Patients with joint hypermobility syndrome often have diffuse, chronic complaints that are inconsistent with the musculoskeletal system. Chronic pain may cause loss of proprioception and so increased sensitivity to microtrauma, premature osteoarthritis de- velopment, soft tissue problems, psychosocial disorders, and neurophysiological deficiencies. Osteoarthritis, pes planus, mechanical low back pain, and soft tissue rheumatisms are frequent musculoskeletal findings as well as subluxations, thoracic outlet syndrome, rectal and uterine prolapses, hernias, and stress incontinence. Joint hypermobility syndrome's treatment is not easy, and nonsteroidal anti-inflammatory drugs are not usually effective or adequate. Proprioceptive and strengthening exercises have been reported to have supportive and therapeutic effects, but we have limited data on this issue. Joint hypermobility syndrome must be accepted as a multisystem connective tissue disorder rather than just joint laxities. As a result; clinicians must be aware of complexities of connective tissue disorders and comorbidities. [Arch Clin Exp Surg 2016; 5(2.000: 105-112

  9. Joint hypermobility: incidence and some clinical symptoms

    Directory of Open Access Journals (Sweden)

    M P Isaev

    2003-01-01

    Full Text Available Objective. To study joint mobility range among urban population aged 18 to 30 years and to assess association of joint and other connective tissue structures disorders clinical signs with hypermobility. Material and methods. 769 randomly selected individuals aged 18 to 30 (mean - 25,56 years (419 female and 350 male were examined. Hypermobility was assessed with 9-point Beighton scale. Examination included skin stretchability evaluation at elbow back surface, determination of flat feet, high palate, joint pain and deformities of knee joints, joint luxation and subluxation, hand and feet vasospastic disturbances, cardiac pain, oculist examination. Methods of variational statistics were used (x2, Student's test, Spirmen's correlation. Results. Hypermobility incidence and joint mobility in population aged 18 to 30 years in Orenburg largely comply with data received in Moscow. Joint mobility up to 5 points in women and up to 4 points in men is usual for persons of this age and in absence of additional clinical symptoms cannot be considered as pathological. Knee joint deformities, presence of high palate, cardiac pain accompanied by signs of vegetative dysfunction, hand and feet vasospastic disturbances are significantly connected with degree of joint mobility and in some cases can help in hypermobility syndrome diagnosis.

  10. Incidence of systemic joint hypermobility and temporomandibular joint hypermobility in pregnancy.

    Science.gov (United States)

    Silveira, Erika B; Rocabado, Mariano; Russo, Adriana K; Cogo, Jose C; Osorio, Rodrigo A L

    2005-04-01

    The purpose of this study was to establish a possible correlation between systemic hypermobility and temporomandibular hypermobility during pregnancy. One hundred (100) healthy pregnant women were evaluated: 7% in the first trimester (1T), 38% in the second trimester (2T), and 55% in the third trimester (3T) of gestation. In the series, the authors analyzed systemic joint hypermobility (SJH), range of mandibular movement (MMR), head and shoulder posture, head lateralization, and the presence of noise, pain, and parafunction in the temporomandibular joint. They observed that pain is present to a mild degree mostly in the head and ears of all pregnant women who presented with pain. Most of the subjects had some type of parafunction, but only 42.8% had noises. Mild SJH was seen in 50% of the 2T and 3T subjects, and in 28.5% of 1T subjects. Mild mandibular hypermobility was found for jaw opening (46%) and lateralization to the right (44%) or to the left (46%). Most of the subjects had hypomobility for jaw protrusion and retraction. The subjects had head protrusion and anterior posture as a result of the change in their center of gravity brought about by pregnancy. The authors found no association between systemic joint hypermobility (SJH) and temporomandibular hypermobility, although hormonal changes and complex factors during pregnancy may represent a risk factor for both types of mobility change.

  11. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type

    DEFF Research Database (Denmark)

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene

    2016-01-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey...

  12. The association between Generalized Joint Hypermobility and shoulder mobility in young, competitive swimmers

    DEFF Research Database (Denmark)

    Knudsen, Hans Kromann; Junge, Tina

    2015-01-01

    of Physiotherapy, University College Lillebaelt, Odense, Denmark 3Health Sciences Research Centre, University College Lillebaelt, Odense, Denmark 4Inter-Faculty Educational Resources, University College Lillebaelt, Odense, Denmark 5Department of Sports Science and Clinical Biomechanics, University of Southern...... Denmark, Odense, Denmark 6Institute of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway Introduction Shoulder overuse injuries frequently occur among competitive swimmers (Wanivenhaus et al, 2012), however, the aetiology of shoulder dysfunction remains unclear.......A. Epidemiology of injuries and prevention strategies in competitive swimmers. Sports Health. 2012 May;4(3):246-51. Zemek, M.J., Magee, D.J. Comparison of glenohumeral joint laxity in elite and recreational swimmers. Clin J Sport Med. 1996 Jan;6(1):40-7....

  13. Joint hypermobility leading to osteoarthrosis and chondrocalcinosis.

    Science.gov (United States)

    Bird, H A; Tribe, C R; Bacon, P A

    1978-06-01

    We have reviewed 21 adults referred to rheumatology clinic and considered to have generalised joint hypermobility by the criteria of Carter and Wilkinson (1964), modified by Beighton et al. (1973). They fell into two categories. 5 patients had a raised plasma viscosity (PV) and in each case a definite pathology was found to account for this, superimposed on hypermobile joints. The remaining 16 had a normal PV and this group was thought to represent the late natural history of hypermobility. 5 of these (aged 32 to 54 years) had no evidence of osteoarthrosis but the remaining 11 (aged 34 to 80 years) had widespread radiological osteoarthrosis. Synovial histology was obtained at arthroscopy in 6 of these patients and 4 (aged 60 to 75) had chondrocalcinosis. This previously undescribed finding may be the end result of hypermobile joints. Hypermobile patients with joint deformity (lax connective tissue), widespread synovial thickening (traumatic), and hot joint effusions (chondrocalcinosis) may mimic rheumatoid arthritis. They must be distinguished from patients who develop rheumatoid arthritis in hypermobile joints.

  14. The impaired proprioception in Ehlers-Danlos Syndrome-Hypermobility Type/Joint hypermobility Syndrome: the rehabilitation role

    Directory of Open Access Journals (Sweden)

    Filippo Camerota

    2015-10-01

    Full Text Available Ehlers-Danlos Syndrome Hypermobility Type/Joint Hypermobility Syndrome (JHS/EDS-HT is an hereditary disorder of the connective tissue mainly manifesting with generalized joint hypermobility and skin hyperextensibility with an involvement of the connective tissue matrix proteins. Collagen alterations may influence the quality of movement in these patients but also movement has a role for the collagen quality: motion has a prevention role in the formation of contractures and adhesions. A poor sense of proprioception correlated with the collagenous connective tissues alterations could explain why people with JHS/EDS-HT become injured, having a lack of sensation of the joint at the end of the range. Rehabilitation approach may consider all these aspects.

  15. Joint Hypermobility: What Causes Loose Joints?

    Science.gov (United States)

    ... disorder, such as Ehlers-Danlos syndrome or Marfan syndrome. With Edward R. Laskowski, M.D. References Hochberg MC, et al. Rheumatology. 5th ed. Philadelphia, Pa.: Elsevier; 2011. ... of the hypermobility syndrome. http://www.uptodate.com/home. Accessed May 7, ...

  16. Motor Performance in Children with Generalized Hypermobility : The Influence of Muscle Strength and Exercise Capacity

    NARCIS (Netherlands)

    Hanewinkel-van Kleef, Yvonne B.; Helders, Paul J. M.; Takken, Tim; Engelbert, Raoul H.

    2009-01-01

    Purpose: The aim of this study was to investigate whether muscle strength and functional exercise capacity (FEC) influence motor performance in children with generalized joint hypermobility. Methods: Forty-one children (mean age: 8.1 years) with symptomatic generalized hypermobility were included. M

  17. Motor Performance in Children with Generalized Hypermobility : The Influence of Muscle Strength and Exercise Capacity

    NARCIS (Netherlands)

    Hanewinkel-van Kleef, Yvonne B.; Helders, Paul J. M.; Takken, Tim; Engelbert, Raoul H.

    2009-01-01

    Purpose: The aim of this study was to investigate whether muscle strength and functional exercise capacity (FEC) influence motor performance in children with generalized joint hypermobility. Methods: Forty-one children (mean age: 8.1 years) with symptomatic generalized hypermobility were included. M

  18. The Influence of the “Straighten Your Back” Command on the Sagittal Spinal Curvatures in Children with Generalized Joint Hypermobility

    Directory of Open Access Journals (Sweden)

    Dariusz Czaprowski

    2017-01-01

    Full Text Available Objectives. The aim of the study was to assess the change of sagittal spinal curvatures in children with generalized joint hypermobility (GJH instructed with “straighten your back” command (SYB. Methods. The study included 56 children with GJH. The control group consisted of 193 children. Sacral slope (SS, lumbar lordosis (LL, global thoracic kyphosis (TK, lower thoracic kyphosis (LK, and upper thoracic kyphosis (UK were assessed with Saunders inclinometer both in spontaneous positions (standing and sitting and after the SYB. Results. Children with GJH after SYB presented the following: in standing, increase in SS and decrease in TK, LK, and UK (P<0.01, with LL not significantly changed; in sitting: decrease in global thoracic kyphosis (35.5° (SD 20.5 versus 21.0° (SD 15.5, P<0.001 below the standards proposed in the literature (30–40° and flattening of its lower part (P<0.001. The same changes were observed in the control group. Conclusions. In children with generalized joint hypermobility, the “straighten your back” command leads to excessive reduction of the global thoracic kyphosis and flattening of its lower part. Therefore, the “straighten your back” command should not be used to achieve the optimal standing and sitting positions.

  19. Phenotypic variability in developmental coordination disorder: Clustering of generalized joint hypermobility with attention deficit/hyperactivity disorder, atypical swallowing and narrative difficulties.

    Science.gov (United States)

    Celletti, Claudia; Mari, Giorgia; Ghibellini, Giulia; Celli, Mauro; Castori, Marco; Camerota, Filippo

    2015-03-01

    Developmental coordination disorder (DCD) is a recognized childhood disorder mostly characterized by motor coordination difficulties. Joint hypermobility syndrome, alternatively termed Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT), is a hereditary connective tissue disorder mainly featuring generalized joint hypermobility (gJHM), musculoskeletal pain, and minor skin features. Although these two conditions seem apparently unrelated, recent evidence highlights a high rate of motor and coordination findings in children with gJHM or JHS/EDS-HT. Here, we investigated the prevalence of gJHM in 41 Italian children with DCD in order to check for the existence of recognizable phenotypic subgroups of DCD in relation to the presence/absence of gJHM. All patients were screened for Beighton score and a set of neuropsychological tests for motor competences (Movement Assessment Battery for Children and Visual-Motor Integration tests), and language and learning difficulties (Linguistic Comprehension Test, Peabody Picture Vocabulary Test, Boston Naming Test, Bus Story Test, and Memoria-Training tests). All patients were also screening for selected JHS/EDS-HT-associated features and swallowing problems. Nineteen (46%) children showed gJHM and 22 (54%) did not. Children with DCD and gJHM showed a significant excess of frequent falls (95 vs. 18%), easy bruising (74 vs. 0%), motor impersistence (89 vs. 23%), sore hands for writing (53 vs. 9%), attention deficit/hyperactivity disorder (89 vs. 36%), constipation (53 vs. 0%), arthralgias/myalgias (58 vs. 4%), narrative difficulties (74 vs. 32%), and atypical swallowing (74 vs. 18%). This study confirms the non-causal association between DCD and gJHM, which, in turn, seems to increase the risk for non-random additional features. The excess of language, learning, and swallowing difficulties in patients with DCD and gJHM suggests a wider effect of lax tissues in the development of the nervous system.

  20. Gait analysis of adults with generalised joint hypermobility

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Tegner, Heidi; Alkjær, Tine;

    2012-01-01

    BACKGROUND: The majority of adults with Generalised Joint Hypermobility experience symptoms such as pain and joint instability, which is likely to influence their gait pattern. Accordingly, the purpose of the present project was to perform a biomechanical gait analysis on a group of patients...... with Generalised Joint Hypermobility and compare them to a group of healthy subjects. METHODS: Seventeen adults clinically classified with Generalised Joint Hypermobility (6 males and 11 females) and seventeen healthy subjects (9 males and 8 females) were included in the project. The subjects walked across three...

  1. [Concomitant diseases in primary joint hypermobility syndrome].

    Science.gov (United States)

    Skoumal, Martin; Haberhauer, Günther; Mayr, Hans

    2004-10-15

    The primary joint hypermobility syndrome (pJH) is an overlap disorder of connective-tissue dysplasias, which incorporates features seen in the Marfan syndromes (MFS), Ehlers-Danlos syndromes (EDS), and osteogenesis imperfecta. Patients with pJH usually present arthralgia, back pain, soft-tissue lesions, recurrent joint dislocation, or subluxation. Extraarticular features may include, e. g., striae cutis, keratoconus, easy bruising, mitral valve prolapse, aortic incompetence, aneurysms, pneumothorax, hernia, urinary incontinence, and pelvic floor prolapse. Due to the high frequency of critical dissection and rupture, the early recognition of rare life-threatening complications such as dilatation of the aortic root and aneurysms is important. Therefore, patients (and their family members) with pJH should also be examined for life-threatening features seen in MFS and EDS.

  2. Gastrointestinal and nutritional issues in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Pascolini, Giulia; Blundo, Carlo; Grammatico, Paola

    2015-03-01

    Gastrointestinal involvement is a well known complication of Ehlers-Danlos syndromes (EDSs), mainly in form of abdominal emergencies due to intestinal/abdominal vessels rupture in vascular EDS. In the last decade, a growing number of works investigated the relationship between a wide spectrum of chronic gastrointestinal complaints and various EDS forms, among which the hypermobility type (a.k.a. joint hypermobility syndrome; JHS/EDS-HT) was the most studied. The emerging findings depict a major role for gastrointestinal involvement in the health status and, consequently, management of JHS/EDS-HT patients. Nevertheless, fragmentation of knowledge limits its impact on practice within the boundaries of highly specialized clinics. In this paper, literature review on gastrointestinal manifestations in JHS/EDS-HT was carried out and identified papers categorized as (i) case-control/cohort studies associating (apparently non-syndromic) joint hypermobility and gastrointestinal involvement, (ii) case-control/cohort studies associating JHS/EDS-HT and gastrointestinal involvement, (iii) case reports/series on various gastrointestinal complications in (presumed) JHS/EDS-HT, and (iv) studies reporting gastrointestinal features in heterogeneous EDS patients' cohorts. Gastrointestinal manifestations of JHS/EDS-HT were organized and discussed in two categories, including structural anomalies (i.e., abdominal/diaphragmatic hernias, internal organ/pelvic prolapses, intestinal intussusceptions) and functional features (i.e., dysphagia, gastro-esophageal reflux, dyspepsia, recurrent abdominal pain, constipation/diarrhea), with emphasis on practice and future implications. In the second part of this paper, a summary of possible nutritional interventions in JHS/EDS-HT was presented. Supplementation strategies were borrowed from data available for general population with minor modifications in the light of recent discoveries in the pathogenesis of selected JHS/EDS-HT features.

  3. Knowledge, assessment, and management of adults with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type among Flemish physiotherapists.

    Science.gov (United States)

    Rombaut, Lies; Deane, Janet; Simmonds, Jane; De Wandele, Inge; De Paepe, Anne; Malfait, Fransiska; Calders, Patrick

    2015-03-01

    Physiotherapy plays a fundamental role in managing adults with the joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT). However, it is a challenge for both the patient and the physiotherapist as the condition is poorly understood and treatment for JHS/EDS-HT is currently undefined. Insight into current practice is, therefore, necessary in order to establish baseline knowledge in this area and in the long term to improve the standard of patient care. Therefore, the purpose of this study was to evaluate current physiotherapists' knowledge of JHS/EDS-HT and to gain insight into current physiotherapy practice with emphasis on assessment, management, and treatment efficacy. Three hundred twenty-five Flemish physiotherapists participated in the study by filling out electronically a modified version of the "Hypermobility and Hypermobility Syndrome Questionnaire" (HHQ), which covered theoretical constructs such as general knowledge, assessment, management, and learning in relation to generalized joint hypermobility and JHS/EDS-HT. The results show that physiotherapists report a low level of confidence with regard to assessment and management of JHS/EDS-HT. Knowledge of hypermobility and JHS/EDS-HT is weak, especially regarding the features associated with JHS/EDS-HT. Many treatment approaches are used by physiotherapists with the majority showing preference for education, reassurance, muscle strengthening, proprioceptive and core stability training. Almost all approaches were perceived as being clinically effective by the physiotherapists, highlighting a lack of consensus. In conclusion, this study in Flemish physiotherapists confirms that JHS/EDS-HT is under-recognized, not well known and deemed difficult to treat. Further education is required and sought by the physiotherapists surveyed, and future research is needed.

  4. Relationship between Fatigue and Gait Abnormality in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type

    Science.gov (United States)

    Celletti, Claudia; Galli, Manuela; Cimolin, Veronica; Castori, Marco; Albertini, Giorgio; Camerota, Filippo

    2012-01-01

    Ehlers-Danlos syndrome (EDS) is a clinically and genetically heterogeneous group of inherited connective tissue disorders characterised by joint hypermobility, skin hyperextensibility and tissue fragility. It has recently been shown that muscle weakness occurs frequently in EDS, and that fatigue is a common and clinically important symptom. The…

  5. Benign Joint Hypermobility Syndrome – not so ‘Benign’

    Directory of Open Access Journals (Sweden)

    Yathish GC

    2015-05-01

    Full Text Available Benign joint hypermobility syndrome (BJHS was earlier considered as a mild or trivial entity, but nowadays it is reported as a multisystem hereditary connective tissue disorder with serious morbidities. In fact, the term ‘Benign’ has been removed, renaming the disease as ‘Joint Hypermobility Syndrome’ (JHS. In addition to the well-known musculoskeletal consequences of joint pain and instability, it can cause chronic widespread pain, gastrointestinal dysmotility, anxiety, phobic states and dysautonomia. We present here the case of a 53-year-old lady who presented with history of irritable bowel syndrome, elbow dislocation, repeated knee injuries, and instability resulting in severe secondary osteoarthritis (OA.

  6. Evaluation of Kinesiophobia and Its Correlations with Pain and Fatigue in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type

    Directory of Open Access Journals (Sweden)

    Claudia Celletti

    2013-01-01

    Full Text Available Ehlers-Danlos syndrome hypermobility type a. k. a. joint hypermobility syndrome (JHS/EDS-HT is a hereditary musculoskeletal disorder associating generalized joint hypermobility with chronic pain. Anecdotal reports suggest a prominent role for kinesiophobia in disease manifestations, but no study has systematically addressed this point. Objective. To investigate the impact of kinesiophobia and its relationship with pain, fatigue, and quality of life in JHS/EDS-HT. Design. Cross-sectional study. Subjects/Patients. 42 patients (40 female and 2 male with JHS/EDS-HT diagnosis following standardized diagnostic criteria were selected. Methods. Disease features were analyzed by means of specific questionnaires and scales evaluating kinesiophobia, pain, fatigue, and quality of life. The relationships among variables were investigated using the Spearman bivariate analysis. Results. Kinesiophobia resulted predominantly in the patients’ sample. The values of kinesiophobia did not correlate with intensity of pain, quality of life, and (or the single component of fatigue. A strong correlation was discovered between kinesiophobia and general severity of fatigue. Conclusions. In JHS/EDS-HT, the onset of pain-avoiding strategies is related to the presence of pain but not to its intensity. The clear-cut correlation between kinesiophobia and severity of fatigue suggests a direct link between musculoskeletal pain and fatigue. In JHS/EDS-HT, the underlying mechanism is likely to be facilitated by primary disease characteristics, including hypotonia.

  7. Is joint hypermobility associated with vesico-ureteral refl ux? An assessment of 50 patients.

    NARCIS (Netherlands)

    Eerde, M. van Albertien; Verhoeven, J.M. Virginie; Jong, P.V.M. de Tom; Putte, M. van de Elise; Giltay, C. Jacques; Engelbert, H.H. Raoul

    2011-01-01

    Recent studies have already shown associations between generalized joint hypermobility (GJH) and voiding and defecation dysfunction and/or slow transit constipation. Changes in extracellular matrix composition in vesico-ureteric junction of vesico-ureteral refl ux (VUR) patients were also observed p

  8. Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type: a revision of the rehabilitative approach

    Directory of Open Access Journals (Sweden)

    Claudia Celletti

    2016-09-01

    Full Text Available Joint hypermobility syndrome (JHS and Ehlers-Danlos syndrome, hypermobility type (EDS-HT are two clinically overlapping heritable connective tissue disorders strongly associating with pain, fatigue and other secondary aspects. No specific treatment exist for this syndrome and rehabilitation play a role in the management of these patients. The aim of this paper is to evaluate what are the evidence in literature about rehabilitation. Research was done using database PUBMED and consist in a revision of the studies published in the last 15 years. All studies agree to the beneficial role of the rehabilitative treatment and physical therapy but it’s necessary to add more further studies to establish a high quality, evidence-based physical therapy for this specific population.

  9. Hypermobility and joint hypermobility syndrome in Brazilian students and teachers of ballet dance.

    Science.gov (United States)

    Sanches, S B; Oliveira, G M; Osório, F L; Crippa, J A S; Martín-Santos, R

    2015-04-01

    The current literature has been discussing the risks and benefits of joint hypermobility (JHM) for careers in ballet This study aimed to evaluate the prevalence of JHM and joint hypermobility syndrome (JHS) in a group of ballet teachers and students, looking both at aspects related to the flexibility required to dance, as at the risk of injuries when hypermobility is associated with other symptoms, in the case of JHS. We evaluated ballet teachers and ballet students, with age ranging from 18 to 40 years. All participants completed identification and sociodemographic questionnaires and underwent a physical examination. JHM was assessed using the Beighton score with goniometry. Symptoms of JHS were evaluated according to the Brighton criteria. Final sample consisted of 77 participants, being 44 ballet students and 33 ballet teachers. The prevalence of JHM in the sample as a whole was 58 %. Teachers and students had no significant differences regarding the prevalence of JHM (p = 0.74) (OR 1.21; 95 % CI 0.48-3.07). However, the prevalence of JHS was significantly different (p = 0.04) between students (16 %) and teachers (36 %). Teachers were three times more likely than student to have JHS (OR 3.02; 95 % CI 1.03-8.85). Teachers and students also presented differences in the frequency of specific items of Beighton score and Brighton criteria. These data provide elements to discuss the relationship between hypermobility, ballet technique and selection for dance, suggesting that dancers with JHS could find in ballet teaching an alternative to maintain professional activity with dance, while remaining protected from the higher risk of injury that professional dancers may be exposed to.

  10. The differential diagnosis of children with joint hypermobility: a review of the literature

    Directory of Open Access Journals (Sweden)

    Elliott Elizabeth J

    2009-01-01

    Full Text Available Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT. Results 3330 papers were identified: 1534 pertained to instability of a particular joint; 1666 related to the diagnosis of Ehlers Danlos syndromes and 330 related to joint hypermobility. There are inconsistencies in the literature on joint hypermobility and how it relates to and overlaps with milder forms of HDCT. There is no reliable method of differentiating between Joint Hypermobility Syndrome, familial articular hypermobility and Ehlers-Danlos syndrome (hypermobile type, suggesting these three disorders may be different manifestations of the same spectrum of disorders. We describe our approach to children presenting with joint hypermobility and the published evidence and expert opinion on which this is based. Conclusion There is value in identifying both the underlying genetic cause of joint hypermobility in an individual child and those hypermobile children who have symptoms such as pain and fatigue and might benefit from multidisciplinary rehabilitation management. Every effort should be made to diagnose the underlying disorder responsible for joint hypermobility which may only become apparent over time. We recommend that the term "Joint Hypermobility Syndrome" is used for children with symptomatic joint hypermobility resulting from any underlying HDCT and that these children are best described using both the term Joint Hypermobility Syndrome and their HDCT diagnosis.

  11. The differential diagnosis of children with joint hypermobility: a review of the literature

    OpenAIRE

    Elliott Elizabeth J; Tofts Louise J; Munns Craig; Pacey Verity; Sillence David O

    2009-01-01

    Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT). Results 3330 papers were identified: 1534 pertained to instability of a...

  12. Ultrasonographic characteristic of knee joint structures in hypermobility syndrome

    Directory of Open Access Journals (Sweden)

    A. G. Belenky

    2003-01-01

    Full Text Available Objective. To determine structural origin of joint pain in hypermobility syndrome (HS by sonographic scanning. Material and. 48 women aged 16 to 25 years were examined. 21 HS patients of group 1 had knee pain (12 bilateral and 9 unilateral, 33 painful joints, group II consisted of 17 women with HS without knee pain. 10 healthy women were included in control group. Degree of hypermobility was assessed according to Beighton score. Sonographic examination was performed with 5-7,5 MHz linear and convex probes. Thickness of synovial tissue and femur condyles cartilage, presence of synovial fluid, state of menisci, collateral ligaments, m. semimembranosus tendon was estimated. Results. Sonographic changes (mainly collateral ligaments edema and tendinitis of m. semimembranosus tendon were found in 30 of 33 painful joints of group 1, 16 of 34 joints of group II and only 1 of 20 joints of control group. Frequency of tissue changes adjacent to knee joint differed significantly between groups 1 and II (p=0,001, I and III (p=0,000, 2 and 3 (p=0,01. Conclusion. In most cases knee joint pain in HS is accompanied by sonographic signs of soft tissue damage - mainly collateral ligaments edema and tendinitis of m. semimembranosus tendon. These changes in HS may be asymptomatic.

  13. Addressing the confounding role of joint hypermobility syndrome and gastrointestinal involvement in postural orthostatic tachycardia syndrome.

    Science.gov (United States)

    Farmer, Adam D; Fikree, Asma; Aziz, Qasim

    2014-06-01

    Quantitative and qualitative abnormalities in visceral function have been demonstrated in postural orthostatic tachycardia syndrome. Joint hypermobility is frequently associated with both postural orthostatic tachycardia syndrome and gastrointestinal symptoms. Future studies in this area should appropriately and systematically control for the presence of joint hypermobility syndrome.

  14. Prevalence of Generalised Joint Hypermobility, Artralgia and Motor Competence in 10-year old school children

    DEFF Research Database (Denmark)

    Remvig, Lars; Kümmel, Christina; Halkjær-Kristensen, Jens

    2011-01-01

    Objectives: Diverging results exist for children regarding the relation between generalized joint hypermobility (GJH) and musculoskeletal complaints, as well as relations between GJH and insufficient motor development, and/or reduced physical activity level. The main purposes were to (1) survey...... the prevalence of GJH and of benign joint hypermobility syndrome (BJHS) in 10-year-old children, (2) compare children with and without GJH and BJHS regarding motor competence, physical activity, and musculoskeletal pain and injuries. Subjects and methods: All fourth-grade children in a Copenhagen municipality...... were invited to be clinically examined and tested for motor competence, and to answer a questionnaire about musculoskeletal pain, injuries, and physical activity. Results: The final cohort comprised 315 Caucasian children, 50.5% girls and 54% boys. GJH prevalence was 35.6, 16.8, or 11.1%, depending...

  15. Joint hypermobility in patients with chondromalacia patellae.

    Science.gov (United States)

    al-Rawi, Z; Nessan, A H

    1997-12-01

    The relationship between joint mobility and chondromalacia patellae was reported in a prospective study. A total of 115 patients with chondromalacia patellae were compared with 110 healthy individuals without chondromalacia patellae, matched for age and sex, who served as a control group. The degree of joint mobility was scored on a scale of 0-9. The number of individuals with hypermobile joints and the total mobility scores were significantly higher in patients with chondromalacia patellae when compared to the control group (P chondromalacia patellae when compared with the knees of the control group (P Chondromalacia patellae were bilateral in 57% of our patients. It occurred more frequently in the longer leg and was associated with quadriceps muscle wasting in 50% of patients. Flat feet and backache were reported significantly more often in patients compared with the control group (P chondromalacia patellae.

  16. Differential diagnosis and diagnostic flow chart of joint hypermobility syndrome/ehlers-danlos syndrome hypermobility type compared to other heritable connective tissue disorders.

    Science.gov (United States)

    Colombi, Marina; Dordoni, Chiara; Chiarelli, Nicola; Ritelli, Marco

    2015-03-01

    Joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT) is an evolving and protean disorder mostly recognized by generalized joint hypermobility and without a defined molecular basis. JHS/EDS-HT also presents with other connective tissue features affecting a variety of structures and organs, such as skin, eye, bone, and internal organs. However, most of these signs are present in variable combinations and severity in many other heritable connective tissue disorders. Accordingly, JHS/EDS-HT is an "exclusion" diagnosis which needs the absence of any consistent feature indicative of other partially overlapping connective tissue disorders. While both Villefranche and Brighton criteria include such an exclusion as a mandatory item, a systematic approach for reaching a stringent clinical diagnosis of JHS/EDS-HT is still lacking. The absence of a consensus on the diagnostic approach to JHS/EDS-HT concerning its clinical boundaries with similar conditions contribute to limit our actual understanding of the pathologic and molecular bases of this disorder. In this review, we revise the differential diagnosis of JHS/EDS-HT with those heritable connective tissue disorders which show a significant overlap with the former and mostly include EDS classic, vascular and kyphoscoliotic types, osteogenesis imperfecta, Marfan syndrome, Loeys-Dietz syndrome, arterial tortuosity syndrome, and lateral meningocele syndrome. A diagnostic flow chart is also offered with the attempt to support the less experienced clinician in stringently recognizing JHS/EDS-HT and stimulate the debate in the scientific community for both management and research purposes.

  17. Orthostatic Intolerance and Postural Orthostatic Tachycardia Syndrome in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome, Hypermobility Type: Neurovegetative Dysregulation or Autonomic Failure?

    Directory of Open Access Journals (Sweden)

    Claudia Celletti

    2017-01-01

    Full Text Available Background. Joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT, is a hereditary connective tissue disorder mainly characterized by generalized joint hypermobility, skin texture abnormalities, and visceral and vascular dysfunctions, also comprising symptoms of autonomic dysfunction. This study aims to further evaluate cardiovascular autonomic involvement in JHS/EDS-HT by a battery of functional tests. Methods. The response to cardiovascular reflex tests comprising deep breathing, Valsalva maneuver, 30/15 ratio, handgrip test, and head-up tilt test was studied in 35 JHS/EDS-HT adults. Heart rate and blood pressure variability was also investigated by spectral analysis in comparison to age and sex healthy matched group. Results. Valsalva ratio was normal in all patients, but 37.2% of them were not able to finish the test. At tilt, 48.6% patients showed postural orthostatic tachycardia, 31.4% orthostatic intolerance, 20% normal results. Only one patient had orthostatic hypotension. Spectral analysis showed significant higher baroreflex sensitivity values at rest compared to controls. Conclusions. This study confirms the abnormal cardiovascular autonomic profile in adults with JHS/EDS-HT and found the higher baroreflex sensitivity as a potential disease marker and clue for future research.

  18. Management of pain and fatigue in the joint hypermobility syndrome (a.k.a. Ehlers-Danlos syndrome, hypermobility type): principles and proposal for a multidisciplinary approach.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Celletti, Claudia; Celli, Mauro; Morrone, Aldo; Colombi, Marina; Camerota, Filippo; Grammatico, Paola

    2012-08-01

    Joint hypermobility syndrome (JHS), or Ehlers-Danlos syndrome (EDS) hypermobility type (EDS-HT), is a underdiagnosed heritable connective tissue disorder characterized by generalized joint hypermobility and a wide range of visceral, pelvic, neurologic, and cognitive dysfunctions. Deterioration of quality of life is mainly associated with pain and fatigue. Except for the recognized effectiveness of physiotherapy for some musculoskeletal features, there are no standardized guidelines for the assessment and treatment of pain and fatigue. In this work, a practical classification of pain presentations and factors contributing in generating painful sensations in JHS/EDS-HT is proposed. Pain can be topographically classified in articular limb (acute/subacute and chronic), muscular limb (myofascial and fibromyalgia), neuropathic limb, back/neck, abdominal and pelvic pain, and headache. For selected forms of pain, specific predisposing characteristics are outlined. Fatigue appears as the result of multiple factors, including muscle weakness, respiratory insufficiency, unrefreshing sleep, dysautonomia, intestinal malabsorption, reactive depression/anxiety, and excessive use of analgesics. A set of lifestyle recommendations to instruct patients as well as specific investigations aimed at characterizing pain and fatigue are identified. Available treatment options are discussed in the set of a structured multidisciplinary approach based on reliable outcome tools.

  19. Association Between Joint Hypermobility Syndrome and Developmental Coordination Disorder – A Review.

    OpenAIRE

    2012-01-01

    Introduction: The term joint hypermobility syndrome (JHS) was adopted after clinicians became aware of the\\ud myriad of symptoms associated with this multisystemic condition. JHS is an inherited disorder of connective tissues affecting the musculoskeletal and visceral systems which may contribute to a reduction in health related physical fitness. Pain associated with JHS may be influenced by hypermobility and biomechanical dysfunction. Biomechanical dysfunction observed in patients with JHS m...

  20. Effects of Neoprene Wrist/Hand Splints on Handwriting for Students with Joint Hypermobility Syndrome: A Single System Design Study

    Science.gov (United States)

    Frohlich, Lauren; Wesley, Alison; Wallen, Margaret; Bundy, Anita

    2012-01-01

    Purpose: Pain associated with hypermobility of wrist and hand joints can contribute to decreased handwriting output. This study examined the effectiveness of a neoprene wrist/hand splint in reducing pain and increasing handwriting speed and endurance for students with joint hypermobility syndrome. Methods: Multiple baseline, single system design…

  1. Shoulder function, pain and health related quality of life in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type.

    Science.gov (United States)

    Johannessen, Elise Christine; Reiten, Helle Sundnes; Løvaas, Helene; Maeland, Silje; Juul-Kristensen, Birgit

    2016-07-01

    Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p pain intensity (NRS: 6.4 versus 2.7; p shoulder joints were rated as primary painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain.

  2. The examination of the musculoskeletal system based only on the evaluation of pelvic-hip complex muscle and trunk flexibility may lead to failure to screen children for generalized joint hypermobility.

    Directory of Open Access Journals (Sweden)

    Dariusz Czaprowski

    Full Text Available The aim of the study was to evaluate whether the clinical assessment of the pelvic-hip complex muscle and trunk flexibility is sufficient for diagnosing generalized joint hypermobility (GJH.A cross-sectional study.Center of Body Posture in Olsztyn, North East Poland.The study included 136 females and 113 males aged 10-13 years.In order to assess muscle flexibility, the straight leg raise (SLR test (for hamstring and modified Thomas test for one- (O-JHF and two-joint (T-JHF hip flexors were performed. To evaluate trunk flexibility the fingertip-to-floor (FTF and lateral trunk flexion (LTF tests were used. The GJH occurrence was assessed with the use of nine-point Beighton scale (threshold value ≥5 points for females, ≥4 for males. The analysis was carried out separately for females and males.There were no significant differences between females with versus without GJH, and males with versus without GJH regarding SLR (p = 0.86, p = 0.19 for females and males, respectively, O-JHF (p = 0.89, p = 0.35 for females and males, respectively, T-JHF (p = 0.77, p = 0.4 for females and males, respectively, FTF (p = 0.19, p = 0.84 for females and males, respectively and LTF (p = 0.58, p = 0.35 for females and males, respectively tests results.Clinical examination of the pelvic-hip complex muscles and trunk flexibility by use of SLR, O-JHF, T-JHF, FTF and LTF revealed to be insufficient in diagnosing GJH in children aged 10-13 years. Thus, the Beighton scale should be considered a standard element of physiotherapeutic examination of the musculoskeletal system in children and youth.

  3. Knee function in 10-year-old children and adults with Generalised Joint Hypermobility

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Hansen, Henrik; Simonsen, Erik B;

    2012-01-01

    PURPOSE: Knee function is reduced in patients with Benign Joint Hypermobility Syndrome. The aim was to study knee function in children and adults with Generalised Joint Hypermobility (GJH) and Non-GJH (NGJH)). MATERIALS AND METHODS: In a matched comparative study, 39 children and 36 adults (mean...... age children 10.2years; adults 40.3years) were included, comprising 19 children and 18 adults with GJH (Beighton =5/9; Beighton =4/9), minimum one hypermobile knee, no knee pain (children), and 20 children and 18 adults with NGJH (Beighton...

  4. The effectiveness of interventions focused on functional stability on the level of pain in patients with Joint Hypermobility Syndrome compared to general exercise

    DEFF Research Database (Denmark)

    Holtze, Dorte Buch; Jessen-Winge, Christina; Hansen, Karsten Bruun

    2014-01-01

    or historically) and arthralgia in ≥4 joints for more than 3 months while the 8 minor criteria are; considering a lower Beighton- and arthralgia score, dislocation/subluxation in one or more joints, soft tissue rheumatism, Marfanoid habitus, abnormal skin, eye signs and varicose veins, hernia or uterine...... syndrome; pain; physical therapy; treatment...

  5. Gait pattern in 9-11-year-old children with generalized joint hypermobility compared with controls; a cross-sectional study

    DEFF Research Database (Denmark)

    Nikolajsen, Helene

    2013-01-01

    , with at least one hypermobile knee joint; for NGJH a Beighton score of ≤4, and no hypermobile knees and for both groups no knee pain during the previous week. All children were recorded by five video cameras, while they walked across three force platforms. Net joint moments were calculated in 3D by inverse...

  6. Joint hypermobility as a distinctive feature in the differential diagnosis of myopathies.

    NARCIS (Netherlands)

    Voermans, N.C.; Bonnemann, C.G.; Hamel, B.C.J.; Jungbluth, H.; Engelen, B.G.M. van

    2009-01-01

    Congenital and adult-onset inherited myopathies represent a wide spectrum of syndromes. Classification is based upon clinical features and biochemical and genetic defects. Joint hypermobility is one of the distinctive clinical features that has often been underrecognized so far. We therefore present

  7. Spectrum of mucocutaneous manifestations in 277 patients with joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

    Science.gov (United States)

    Castori, Marco; Dordoni, Chiara; Morlino, Silvia; Sperduti, Isabella; Ritelli, Marco; Valiante, Michele; Chiarelli, Nicola; Zanca, Arianna; Celletti, Claudia; Venturini, Marina; Camerota, Filippo; Calzavara-Pinton, Piergiacomo; Grammatico, Paola; Colombi, Marina

    2015-03-01

    Cutaneous manifestations are a diagnostic criterion of Ehlers-Danlos syndrome, hypermobility type (EDS-HT) and joint hypermobility syndrome (JHS). These two conditions, originally considered different disorders, are now accepted as clinically indistinguishable and often segregate as a single-familial trait. EDS-HT and JHS are still exclusion diagnoses not supported by any specific laboratory test. Accuracy of clinical diagnosis is, therefore, crucial for appropriate patients' classification and management, but it is actually hampered by the low consistency of many applied criteria including the cutaneous one. We report on mucocutaneous findings in 277 patients with JHS/EDS-HT with both sexes and various ages. Sixteen objective and five anamnestic items were selected and ascertained in two specialized outpatient clinics. Feature rates were compared by sex and age by a series of statistical tools. Data were also used for a multivariate correspondence analysis with the attempt to identify non-causal associations of features depicting recognizable phenotypic clusters. Our findings identified a few differences between sexes and thus indicated an attenuated sexual dimorphism for mucocutaneous features in JHS/EDS-HT. Ten features showed significantly distinct rates at different ages and this evidence corroborated the concept of an evolving phenotype in JHS/EDS-HT also affecting the skin. Multivariate correspondence analysis identified three relatively discrete phenotypic profiles, which may represent the cutaneous counterparts of the three disease phases previously proposed for JHS/EDS-HT. These findings could be used for revising the cutaneous criterion in a future consensus for the clinical diagnosis of JHS/EDS-HT.

  8. Biomechanics of first ray hypermobility: an investigation on joint force during walking using finite element analysis.

    Science.gov (United States)

    Wong, Duo Wai-Chi; Zhang, Ming; Yu, Jia; Leung, Aaron Kam-Lun

    2014-11-01

    Hypermobility of the first ray is suggested to contribute to hallux valgus. The investigation of first ray hypermobility focused on the mobility and range of motion that based on manual examination. The load transfer mechanism of the first ray is important to understand the development and pathomechanism of hallux valgus. In this study, we investigated the immediate effect of the joint hypermobility on the metatarsocuneiform and metatarsophalangeal joint loading through a reduction of the stiffness of the foot ligaments. A three-dimensional foot model was constructed from a female aged 28 via MRI. All foot and ankle bones, including two sesamoids and the encapsulated bulk tissue were modeled as 3D solid parts, linking with ligaments of shell elements and muscles connectors. The stance phase of walking was simulated by the boundary and loading conditions obtained from gait analysis of the same subject. Compared with the normal foot, the hypermobile foot had higher resultant metatarsocuneiform and metatarsophalangeal joint forces. The increases accounted for 18.6% and 3.9% body weight. There was also an abrupt change of metatarsocuneiform joint force in the medial-lateral direction. The predicted results represented possible risk of joint problems and metatarsus primus varus.

  9. Prevalence of Musculoskeletal Pain and Generalised Joint Hypermobility among Jazz Musicians in Swedish Big Bands

    OpenAIRE

    2015-01-01

    Aims: The aim of this study was to investigate the prevalence of musculoskeletal pain and generalised joint hypermobility (GJH) among professional jazz musicians in Swedish big bands and to investigate possible associations between GJH and pain.Methods: An existing health questionnaire developed for professional orchestra musicians, including the 5-part questionnaire for GJH [1], the standardised Nordic questionnaire for musculoskeletal pain disorders [2] and additional specific questions abo...

  10. Physiotherapy management of joint hypermobility syndrome - a focus group study of patient and health professional perspectives.

    OpenAIRE

    Palmer, S.; Terry, R.; Rimes, K. A.; Clark, Carol J.; Simmonds, J; Horwood, J.

    2016-01-01

    Objective: To develop an understanding of patient and health professional views and experiences of physiotherapy to manage joint hypermobility syndrome (JHS).Design: An explorative qualitative design. Seven focus groups were convened, audio recorded, fully transcribed and analysed using a constant comparative method to inductively derive a thematic account of the data.Setting: Four geographical areas of the UK.Participants: 25 people with JHS and 16 health professionals (14 physiotherapists a...

  11. Temporomandibular disorder and generalized joint hypermobility: application of diagnostic criteria Disfunção têmporo-mandibular e hipermobilidade articular generalizada: aplicação de critérios diagnósticos

    Directory of Open Access Journals (Sweden)

    Fernanda Pasinato

    2011-08-01

    Full Text Available Generalized joint hypermobility (GJH has been considered a predisposing factor for the development of temporomandibular disorder (TMD. AIM: To evaluate clinical and psychosocial aspects in individuals diagnosed with TMD with or without GJH. MATERIALS AND METHODS: Clinical and experimental study, which enrolled 34 women, from 18 to 35 years of age with TMD diagnosed by RDC/TMD. The GJH was assessed by the Beighton score and volunteers were broken down into 2 groups: with GJH (n = 22 and without GJH (n = 12. RESULTS: We found a high percentage of GJH (64. 71%. All participants had myofascial pain; 79. 41% had arthralgia and 41% had disk displacement. There was a correlation between higher GJH scores and higher passive mouth opening amplitude (p=0. 0034, with pain (p=0. 0029 and without pain (p=0. 0081. Greater mandibular range of motion was observed in the group with GJH, except for protrusion. Painful mouth opening was statistically higher in the GJH group (p=0. 0279. CONCLUSIONS: Individuals with TMD associated or not to GJH do not differ significantly regarding clinical and psychosocial aspects, except in the mandibular opening range of motion, which if kept at physiological levels can lead to a late diagnosis of TMD in these individualsA hipermobilidade articular generalizada (HAG é uma condição sistêmica considerada como fator contribuinte para o desenvolvimento de sinais e sintomas da disfunção têmporo-mandibular (DTM. OBJETIVO: Avaliar aspectos clínicos e psicossociais de indivíduos com DTM associada ou não à HAG. Material e Método: Consistiu de um estudo clínico e experimental do qual participaram 34 mulheres, com idades entre 18 e 35 anos, diagnosticadas com DTM pelos Critérios diagnósticos para pesquisa em DTM (RDC/TMD. A HAG foi avaliada pelo Escore de Beighton e os voluntários divididos em 2 grupos: com HAG (n=22 e sem HAG (n=12. RESULTADOS: Verificou-se elevado percentual de HAG (64,71%. Todos os participantes

  12. Joint hypermobility in children with idiopathic scoliosis: SOSORT award 2011 winner

    Directory of Open Access Journals (Sweden)

    Pawłowska Paulina

    2011-10-01

    Full Text Available Abstract Background Generalized joint hypermobility (JHM refers to increased joint mobility with simultaneous absence of any other systemic disease. JHM involves proprioception impairment, increased frequency of pain within joints and tendency to injure soft tissues while performing physical activities. Children with idiopathic scoliosis (IS often undergo intensive physiotherapy requiring good physical capacities. Further, some physiotherapy methods apply techniques that increase joint mobility and thus may be contraindicated. The aim of this paper was to assess JHM prevalence in children with idiopathic scoliosis and to analyze the relationship between JHM prevalence and the clinical and radiological parameters of scoliosis. The methods of assessment of generalized joint hypermobility were also described. Materials and methods This case-control study included 70 subjects with IS, aged 9-18 years (mean 13.2 ± 2.2, Cobb angle range 10°-53° (mean 24.3 ± 11.7, 34 presenting single curve thoracic scoliosis and 36 double curve thoracic and lumbar scoliosis. The control group included 58 children and adolescents aged 9-18 years (mean 12.6 ± 2.1 selected at random. The presence of JHM was determined using Beighton scale complemented with the questionnaire by Hakim and Grahame. The relationship between JHM and the following variables was evaluated: curve severity, axial rotation of the apical vertebra, number of curvatures (single versus double, number of vertebrae within the curvature (long versus short curves, treatment type (physiotherapy versus bracing and age. Statistical analysis was performed with Statistica 8.1 (StatSoft, USA. The Kolmogorov-Smirnov test, U Mann-Whitney test, Chi2 test, Pearson and Spermann correlation rank were conducted. The value p = 0.05 was adopted as the level of significance. Results JHM was diagnosed in more than half of the subjects with idiopathic scoliosis (51.4%, whilst in the control group it was diagnosed in

  13. Do people with benign joint hypermobility syndrome (BJHS) have reduced joint proprioception? A systematic review and meta-analysis.

    Science.gov (United States)

    Smith, Toby O; Jerman, Emma; Easton, Victoria; Bacon, Holly; Armon, Kate; Poland, Fiona; Macgregor, Alex J

    2013-11-01

    Joint proprioceptive deficit is documented in a variety of musculoskeletal conditions including osteoarthritis, ligament and meniscal injuries, and individuals with increased joint hypermobility, such as those with Ehlers-Danlos. No systematic reviews have assessed joint proprioception in people with benign joint hypermobility syndrome (BJHS). This study addresses this to determine whether people with BJHS exhibit reduced joint proprioception, and, if so, whether this is evident in all age groups. The search strategy was conducted on 31st January 2013. The published literature was assessed using the databases: AMED, CINAHL, MEDLINE, EMBASE, PubMed and the Cochrane Library. Unpublished literature and trial registries were assessed including: OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials, the UK National Research Register Archive. All studies comparing the proprioceptive capability of people with and without BJHS were included. Study methodological quality was assessed using the CASP appraisal tool. Meta-analysis techniques were used when study homogeneity permitted. Five studies including 254 people were identified. People with BJHS demonstrated statistically significantly poorer lower limb joint position sense (JPS) (p proprioceptive difference was less clear, with no statistically significant difference between the cohorts for shoulder JPS (p = 0.10), but a statistically significant difference in finger JPS (p proprioceptive capability in those with BJHS (p proprioception is reduced in those with BJHS compared to non-BJHS cohorts, whilst unclear in the upper limb.

  14. Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility.

    Directory of Open Access Journals (Sweden)

    Núria eMallorquí-Bagué

    2014-10-01

    Full Text Available Objective: Anxiety is associated with increased physiological reactivity and also increased ‘interoceptive’ sensitivity to such changes in internal bodily arousal. Joint hypermobility, an expression of a common variation in the connective tissue protein collagen, is increasingly recognized as a risk factor to anxiety and related disorders. This study explored the link between anxiety, interoceptive sensitivity and hypermobility in a sub-clinical population using neuroimaging and psychophysiological evaluation. Methods: Thirty-six healthy volunteers undertook interoceptive sensitivity tests, a clinical examination for hypermobility and completed validated questionnaire measures of state, anxiety and body awareness tendency. Nineteen participants also performed an emotional processing paradigm during functional neuroimaging. Results: We confirmed a significant relationship between state anxiety score and joint hypermobility. Interoceptive sensitivity mediated the relationship between state anxiety and hypermobility. Hypermobile, compared to non-hypermobile, participants displayed heightened neural reactivity to sad and angry scenes within brain regions implicated in anxious feeling states, notably insular cortex. Conclusions: Our findings highlight the dependence of anxiety state on bodily context, and increase our understanding of the mechanisms through which vulnerability to anxiety disorders arises in people bearing a common variant of collagen.

  15. Emotion processing in joint hypermobility : A potential link to the neural bases of anxiety and related somatic symptoms in collagen anomalies

    NARCIS (Netherlands)

    Mallorquí-Bagué, N; Bulbena, A; Roé-Vellvé, N; Hoekzema, E; Carmona, S; Barba-Müller, E; Fauquet, J; Pailhez, G; Vilarroya, O

    2015-01-01

    BACKGROUND: Joint hypermobility syndrome (JHS) has repeatedly been associated with anxiety and anxiety disorders, fibromyalgia, irritable bowel syndrome and temporomandibular joint disorder. However, the neural underpinnings of these associations still remain unclear. This study explored brain respo

  16. United States Physical Therapists' Knowledge About Joint Hypermobility Syndrome Compared with Fibromyalgia and Rheumatoid Arthritis.

    Science.gov (United States)

    Russek, Leslie N; LaShomb, Emily A; Ware, Amy M; Wesner, Sarah M; Westcott, Vanessa

    2016-03-01

    Joint hypermobility syndrome (JHS) is one of the most common inherited connective tissue disorders. It causes significant pain and disability for all age groups, ranging from developmental delay among children to widespread chronic pain in adults. Experts in JHS assert that the condition is under-recognized and poorly managed. The aim of this study was to assess US physical therapists' knowledge about JHS compared with other causes of widespread pain and activity limitations: fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis. Cross-sectional, Internet-based survey of randomly selected members of the American Physical Therapy Association and descriptive statistics were used to explore physical therapists' knowledge about JHS, fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis, and chi square was used to compare knowledge about the different conditions. The response rate was 15.5% (496). Although 36% recognized the Beighton Scale for assessing joint hypermobility, only 26.8% of respondents were familiar with the Brighton Criteria for diagnosing JHS. Few respondents (11-19%) realized that JHS has extra-articular features such as anxiety disorder, fatigue, headache, delayed motor development, easy bruising and sleep disturbance. Physical therapists working in environments most likely to see patients with JHS underestimated the likely prevalence in their patient population. The results suggest that many physical therapists in the United States are not familiar with the diagnostic criteria, prevalence or common clinical presentation of JHS. Copyright © 2014 John Wiley & Sons, Ltd.

  17. The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms.

    Science.gov (United States)

    Barrera-Mora, José Ma; Espinar Escalona, Eduardo; Abalos Labruzzi, Camilo; Llamas Carrera, José Ma; Ballesteros, Emilio Jiménez-Castellanos; Solano Reina, Enrique; Rocabado, Mariano

    2012-04-01

    The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.

  18. Re-writing the natural history of pain and related symptoms in the joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Celletti, Claudia; Ghibellini, Giulia; Bruschini, Michela; Grammatico, Paola; Blundo, Carlo; Camerota, Filippo

    2013-12-01

    Joint hypermobility syndrome (JHS) and Ehlers-Danlos syndrome, hypermobility type (EDS-HT) are two clinically overlapping connective tissue disorders characterized by chronic/recurrent pain, joint instability complications, and minor skin changes. Fatigue and headache are also common, although are not yet considered diagnostic criteria. JHS/EDS-HT is a unexpectedly common condition that remains underdiagnosed by most clinicians and pain specialists. This results in interventions limited to symptomatic and non-satisfactory treatments, lacking reasonable pathophysiologic rationale. In this manuscript the fragmented knowledge on pain, fatigue, and headache in JHS/EDS is presented with review of the available published information and a description of the clinical course by symptoms, on the basis of authors' experience. Pathogenic mechanisms are suggested through comparisons with other functional somatic syndromes (e.g., chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders). The re-writing of the natural history of JHS/EDS-HT is aimed to raise awareness among clinical geneticists and specialists treating chronic pain conditions about pain and other complications of JHS/EDS-HT. Symptoms' clustering by disease stage is proposed to investigate both the molecular causes and the symptoms management of JHS/EDS-HT in future studies.

  19. The role of benign joint hypermobility in the pain experience in Juvenile Fibromyalgia: an observational study

    Directory of Open Access Journals (Sweden)

    Ting Tracy V

    2012-06-01

    Full Text Available Abstract Background Juvenile Fibromyalgia (JFM is characterized by chronic widespread musculoskeletal pain and approximately 40% of children and adolescents with JFM also suffer from benign joint hypermobility (HM. It is not currently known if the presence of HM affects the pain experience of adolescents with JFM. The objective of this study was to examine whether there were any differences in self-reported pain intensity and physiologic pain sensitivity between JFM patients with and without joint HM. Methods One hundred thirty-one adolescent patients with JFM recruited from four pediatric rheumatology clinics completed a daily visual analogue scale (VAS pain rating for one week and underwent a standardized 18-count tender point (TP dolorimeter assessment. Medical records were reviewed for the presence of joint HM. Average pain VAS ratings, tender point count and tender point sensitivity were compared between JFM patients with and without hypermobility (HM+ and HM-. Results Nearly half (48% the sample of JFM patients were found to be HM+. HM+ and HM- patients did not differ in their self-reported pain intensity. However, HM + patients had significantly greater pain sensitivity, with lower TP thresholds (p = 0.002 and a greater number of painful TPs (p = 0.003 compared to HM- patients. Conclusion The presence of HM among adolescent patients with JFM appears to be associated with enhanced physiologic pain sensitivity, but not self-report of clinical pain. Further examination of the mechanisms for increased pain sensitivity associated with HM, especially in adolescents with widespread pain conditions such as JFM is warranted.

  20. Elite level adolescent athletes with Generalised Joint Hypermobility (GJH) display increased lower extremity symptoms and larger postural sway than those without GJH

    DEFF Research Database (Denmark)

    Juul-Kristensen, B; Schmidt, H; Pedersen, T Lykke;

    2015-01-01

    Shoulder overuse injuries frequently occur among competitive swimmers (Wanivenhaus et al, 2012), however, the aetiology of shoulder dysfunction remains unclear (Zemek et al., 1995). Increased shoulder mobility as well as Generalised Joint Hypermobility (GJH), are both suggested being predisposing...

  1. Diagnosis, Management and Assessment of Adults with Joint Hypermobility Syndrome: A UK-Wide Survey of Physiotherapy Practice.

    Science.gov (United States)

    Palmer, Shea; Cramp, Fiona; Lewis, Rachel; Muhammad, Shahid; Clark, Emma

    2015-06-01

    Joint hypermobility syndrome (JHS) is a heritable disorder associated with excessive joint range of motion and pain in the absence of inflammatory joint disease. It is a relatively common cause of musculoskeletal pain but is generally understood to be under-recognized and poorly managed in clinical practice. The present study therefore aimed to identify how JHS is diagnosed, managed and assessed in routine physiotherapy practice. A survey tool was developed from similar physiotherapy surveys of musculoskeletal practice, a review of the literature, and consultation with researchers and clinicians. Paper copies of the final survey were sent to 201 randomly selected secondary care organizations across the UK and an electronic version was advertised through physiotherapy professional networks. A total of 66 responses (80% women) were received from physiotherapists, with a wide range of clinical experience. Only 32% of respondents reported that they had received formal training in JHS management. The Brighton diagnostic criteria for JHS were not often used (only 31% of respondents). The stated aims of physiotherapy and the specific interventions employed seem well matched, with a focus on advice, education, exercise and self-management. Although pain relief was not reported as a high priority in terms of treatment aims, pain was most often assessed as an outcome, suggesting a mismatch between what clinicians aim to achieve and what they measure. The results suggest that reported management strategies are broadly appropriate to long-term musculoskeletal conditions but additional training specific to JHS may be required, particularly in diagnosis and assessment.

  2. Nosology and inheritance pattern(s) of joint hypermobility syndrome and Ehlers-Danlos syndrome, hypermobility type: a study of intrafamilial and interfamilial variability in 23 Italian pedigrees.

    Science.gov (United States)

    Castori, Marco; Dordoni, Chiara; Valiante, Michele; Sperduti, Isabella; Ritelli, Marco; Morlino, Silvia; Chiarelli, Nicola; Celletti, Claudia; Venturini, Marina; Camerota, Filippo; Calzavara-Pinton, Piergiacomo; Grammatico, Paola; Colombi, Marina

    2014-12-01

    Joint hypermobility syndrome (JHS) and Ehlers-Danlos syndrome, hypermobility type (EDS-HT) are two markedly overlapping heritable connective tissue disorders. The cumulative frequency of JHS and EDS-HT seems high, but their recognition remains an exclusion diagnosis based on different sets of diagnostic criteria. Although proposed by a panel of experts, clinical identity between JHS and EDS-HT is still a matter of debate due to unknown molecular basis. We present 23 families with three or more individuals with a diagnosis of JHS and/or EDS-HT. Rough data from the 82 individuals were used to assess the frequency of major and minor criteria, as well as selected additional features. A series of statistical tools were applied to assess intrafamilial and interfamilial variability, emphasizing intergenerational, and intersex differences. This study demonstrates marked heterogeneity within and between families in terms of agreement of available diagnostic criteria. In 21 pedigrees affected individuals belong to two or three phenotypic sub-categories among JHS, EDS-HT, and JHS + EDS-HT overlap. Intergenerational analysis depicts a progressive shifting, also within the same pedigree, from EDS-HT in childhood, to JHS + EDS-HT in early adulthood and JHS later in life. Female-male ratio is 2.1:1, which results lower than previously observed in unselected patients' cohorts. In these pedigrees, JHS, EDS-HT, and JHS + EDS-HT segregate as a single dominant trait with complete penetrance, variable expressivity, and a markedly evolving phenotype. This study represents a formal demonstration that EDS-HT and JHS contitute the same clinical entity, and likely share the same genetic background, at least, in familial cases.

  3. The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome

    DEFF Research Database (Denmark)

    Engelbert, Raoul H; Juul-Kristensen, Birgit; Pacey, Verity

    2017-01-01

    New insights into the phenotype of Joint Hypermobility Syndrome (JHS) and Ehlers-Danlos Syndrome-hypermobile type (hEDS) have raised many issues in relation to classification, diagnosis, assessment, and treatment. Within the multidisciplinary team, physical therapy plays a central role...... in management of individuals with hypermobility related disorders. However, many physical therapists are not familiar with the diagnostic criteria, prevalence, common clinical presentation, and management. This guideline aims to provide practitioners with the state of the art regarding the assessment...

  4. Low tendon stiffness and abnormal ultrastructure distinguish classic Ehlers-Danlos syndrome from benign joint hypermobility syndrome in patients

    DEFF Research Database (Denmark)

    Nielsen, Rie Harboe; Couppé, Christian; Jensen, Jacob Kildevang

    2014-01-01

    There is a clinical overlap between classic Ehlers-Danlos syndrome (cEDS) and benign joint hypermobility syndrome (BJHS), with hypermobility as the main symptom. The purpose of this study was to investigate the role of type V collagen mutations and tendon pathology in these 2 syndromes. In patients...... (cEDS, n=7; BJHS, n=8) and controls (Ctrl, n=8), we measured patellar tendon ultrastructure (transmission electron microscopy), dimensions (magnetic resonance imaging), and biomechanical properties (force and ultrasonographic measurements during a ramped isometric knee extension). Mutation analyses...... (COL5A1 and COL5A2) were performed in the patients. COL5A1 mutations were found in 3 of 4 of the patients with cEDS. Patellar tendon dimensions were similar between the groups, but large, irregular collagen fibrils were in 4 of 5 patients with cEDS. In the cEDS group, tendon stiffness and Young...

  5. Increased tobacco and alcohol use among women with joint hypermobility: a way to cope with anxiety?

    Science.gov (United States)

    Baeza-Velasco, C; Stoebner-Delbarre, A; Cousson-Gélie, F; Pailhez, G; Bulbena, A; Baguet, F; Gély-Nargeot, M C

    2015-01-01

    Joint hypermobility (JH) is a common trait of heritable disorders of the connective tissue which has been identified as a risk factor for anxiety states. Anxiety and other negative emotions lead some people to use tobacco and alcohol as a coping strategy. The purpose of this study was to examine JH in relation to the consumption of these psychoactive substances and the associated anxiety and coping strategies. A cross-sectional sample of 305 female college students completed self-administered questionnaires on JH, tobacco and alcohol use, state and trait anxiety, and coping strategies. The prevalence of JH in the final sample (N = 301) was 51.8 %. The percentage of smokers, smokers using tobacco to calm anxiety, at-risk drinkers, tobacco and alcohol users, and the number of standard drinks consumed per week were significantly higher among females with JH than among those without it. The percentage of participants with severe state anxiety was significantly higher in the JH group, as were the emotion-focused coping score. The results of the logistic regression analysis showed that the odds of being assessed with JH were greater in those who consume tobacco and alcohol. This study provides evidence that women with JH report higher levels of state anxiety than non-JH women and use emotion-focused coping (i.e., efforts to regulate affect) more than any other coping strategies to deal with stress. These factors may help explain the increase in tobacco and alcohol use observed in this population.

  6. Gynecologic and obstetric implications of the joint hypermobility syndrome (a.k.a. Ehlers-Danlos syndrome hypermobility type) in 82 Italian patients.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Dordoni, Chiara; Celletti, Claudia; Camerota, Filippo; Ritelli, Marco; Morrone, Aldo; Venturini, Marina; Grammatico, Paola; Colombi, Marina

    2012-09-01

    Joint hypermobility syndrome (JHS) emerges as likely the most common clinical form of Ehlers-Danlos syndrome. Given the striking predominance of affected women, practitioners often face gynecologic and obstetric issues. However, their decisions are still based on personal experience rather than literature due to the lack of a consistent body of evidence. We collected a set of gynecologic and obstetric features in 82 post-puberal women with JHS attending two Italian centers. Common gynecologic findings were dysmenorrhea (82.9%), meno/metrorrhagias (53.7%), irregular menses (46.3%), and dispareunia/vulvodinia (31.7%). Forty women were nulliparous and 42 had one or more pregnancy for a total of 93 diagnosed conceptions. Of them, 16.1% were spontaneous abortions, 6.5% voluntary interruptions, 10.7% preterm deliveries, and 66.7% deliveries at term. Overall outcome of proceeding pregnancies was good with no stillbirth and fetal/neonatal hypoxic/ischemic event. Non-operative vaginal delivery was registered in 72.2%, forceps/vacuum use in 5.5% and cesarean in 22.3%. Local/total anesthesia was successfully performed in 17 pregnancies without any problem. Major post-partum complications included abnormal scar formation after cesarean or episiotomy (46.1%), hemorrhage (19.4%), pelvic prolapses (15.3%), deep venous thrombosis (4.2%), and coccyx dislocation (1.4%). Prolapses were the most clinically relevant complication and associated with episiotomy. Gathered data were discussed for practically oriented considerations.

  7. Keratectasia following laser in situ keratomileusis in a low-risk patient with benign joint hypermobility syndrome

    Directory of Open Access Journals (Sweden)

    Gustavo Galperin

    2014-04-01

    Full Text Available Here we present the case of a 27-year-old woman with benign joint hypermobility (BJHS syndrome who developed keratectasia after laser in situ keratomileusis (LASIK in both eyes. Both eyes had identical low Randleman risk factor scores. To our knowledge, this is the first report of such a complication in a patient with BJHS. It highlights our incomplete knowledge of the risk factors for keratectasia following LASIK and suggests that BJHS should be considered as a risk factor for keratectasia.

  8. Generalised Joint Hypermobility in Caucasian Girls with Idiopathic Scoliosis: Relation with Age, Curve Size, and Curve Pattern

    OpenAIRE

    Dariusz Czaprowski

    2014-01-01

    The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH) in 155 girls with idiopathic scoliosis (IS) (age 9–18 years, mean 13.8 ± 2.3). The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B) test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P = 0.02). The prevalence of GJH was significantly (P = 0.01) lower in IS girls aged 16–18 years in comparison with younger individuals. There was no differenc...

  9. Children with Generalised Joint Hypermobility and Musculoskeletal Complaints: State of the Art on Diagnostics, Clinical Characteristics, and Treatment

    Directory of Open Access Journals (Sweden)

    M. C. Scheper

    2013-01-01

    Full Text Available Introduction. To provide a state of the art on diagnostics, clinical characteristics, and treatment of paediatric generalised joint hypermobility (GJH and joint hypermobility syndrome (JHS. Method. A narrative review was performed regarding diagnostics and clinical characteristics. Effectiveness of treatment was evaluated by systematic review. Searches of Medline and Central were performed and included nonsymptomatic and symptomatic forms of GJH (JHS, collagen diseases. Results. In the last decade, scientific research has accumulated on all domains of the ICF. GJH/JHS can be considered as a clinical entity, which can have serious effects during all stages of life. However research regarding the pathological mechanism has resulted in new potential opportunities for treatment. When regarding the effectiveness of current treatments, the search identified 1318 studies, from which three were included (JHS: n=2, Osteogenesis Imperfecta: n=1. According to the best evidence synthesis, there was strong evidence that enhancing physical fitness is an effective treatment for children with JHS. However this was based on only two studies. Conclusion. Based on the sparsely available knowledge on intervention studies, future longitudinal studies should focus on the effect of physical activity, fitness, and joint stabilisation. In JHS and chronic pain, the effectiveness of a multidisciplinary approach should be investigated.

  10. Altered knee joint neuromuscular control during landing from a jump in 10-15year old children with Generalised Joint Hypermobility. A substudy of the CHAMPS-study Denmark

    DEFF Research Database (Denmark)

    Junge, Tina; Wedderkopp, Niels; Thorlund, Jonas Bloch

    2015-01-01

    Generalised Joint Hypermobility (GJH) is considered an intrinsic risk factor for knee injuries. Knee neuromuscular control during landing may be altered in GJH due to reduced passive stability. The aim was to identify differences in knee neuromuscular control during landing of the Single-Leg-Hop-...

  11. Physiotherapy management of joint hypermobility syndrome--a focus group study of patient and health professional perspectives.

    Science.gov (United States)

    Palmer, S; Terry, R; Rimes, K A; Clark, C; Simmonds, J; Horwood, J

    2016-03-01

    To develop an understanding of patient and health professional views and experiences of physiotherapy to manage joint hypermobility syndrome (JHS). An explorative qualitative design. Seven focus groups were convened, audio recorded, fully transcribed and analysed using a constant comparative method to inductively derive a thematic account of the data. Four geographical areas of the U.K. 25 people with JHS and 16 health professionals (14 physiotherapists and two podiatrists). Both patients and health professionals recognised the chronic heterogeneous nature of JHS and reported a lack of awareness of the condition amongst health professionals, patients and wider society. Diagnosis and subsequent referral to physiotherapy services for JHS was often difficult and convoluted. Referral was often for acute single joint injury, failing to recognise the long-term multi-joint nature of the condition. Health professionals and patients felt that if left undiagnosed, JHS was more difficult to treat because of its chronic nature. When JHS was treated by health professionals with knowledge of the condition patients reported satisfactory outcomes. There was considerable agreement between health professionals and patients regarding an 'ideal' physiotherapy service. Education was reported as an overarching requirement for patients and health care professionals. Physiotherapy should be applied holistically to manage JHS as a long-term condition and should address injury prevention and symptom amelioration rather than cure. Education for health professionals and patients is needed to optimise physiotherapy provision. Further research is required to explore the specific therapeutic actions of physiotherapy for managing JHS. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  12. Generalised Joint Hypermobility in Caucasian Girls with Idiopathic Scoliosis: Relation with Age, Curve Size, and Curve Pattern

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    Dariusz Czaprowski

    2014-01-01

    Full Text Available The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH in 155 girls with idiopathic scoliosis (IS (age 9–18 years, mean 13.8 ± 2.3. The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P=0.02. The prevalence of GJH was significantly (P=0.01 lower in IS girls aged 16–18 years in comparison with younger individuals. There was no difference regarding GJH occurrence between girls with mild (11–24°, moderate (25–40°, and severe scoliosis (>40° (P=0.78, between girls with single thoracic, single lumbar, and double curve scoliosis (P=0.59, and between girls with thoracic scoliosis length ≤7 and >7 vertebrae (P=0.25. No correlation between the number of points in B and the Cobb angle (P=0.93, as well as between the number of points in B and the number of the vertebrae within thoracic scoliosis (P=0.63, was noticed. GJH appeared more often in IS girls than in healthy controls. Its prevalence decreased with age. No relation between GJH prevalence and curve size, curve pattern, or scoliosis length was found.

  13. Generalised joint hypermobility in caucasian girls with idiopathic scoliosis: relation with age, curve size, and curve pattern.

    Science.gov (United States)

    Czaprowski, Dariusz

    2014-01-01

    The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH) in 155 girls with idiopathic scoliosis (IS) (age 9-18 years, mean 13.8±2.3). The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B) test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P=0.02). The prevalence of GJH was significantly (P=0.01) lower in IS girls aged 16-18 years in comparison with younger individuals. There was no difference regarding GJH occurrence between girls with mild (11-24°), moderate (25-40°), and severe scoliosis (>40°) (P=0.78), between girls with single thoracic, single lumbar, and double curve scoliosis (P=0.59), and between girls with thoracic scoliosis length≤7 and >7 vertebrae (P=0.25). No correlation between the number of points in B and the Cobb angle (P=0.93), as well as between the number of points in B and the number of the vertebrae within thoracic scoliosis (P=0.63), was noticed. GJH appeared more often in IS girls than in healthy controls. Its prevalence decreased with age. No relation between GJH prevalence and curve size, curve pattern, or scoliosis length was found.

  14. Chronic pain in hypermobility syndrome and Ehlers–Danlos syndrome (hypermobility type: it is a challenge

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    Scheper MC

    2015-08-01

    Full Text Available Mark C Scheper,1,2 Janneke E de Vries,1–3 Jeanine Verbunt,3,4 Raoul HH Engelbert1,2 1School of Physiotherapy, Amsterdam University of Applied Sciences, Amsterdam, 2Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, 3Department of Rehabilitation Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht; 4Adelante, Center of expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands Abstract: Generalized joint hypermobility (GJH is highly prevalent among patients diagnosed with chronic pain. When GJH is accompanied by pain in ≥4 joints over a period ≥3 months in the absence of other conditions that cause chronic pain, the hypermobility syndrome (HMS may be diagnosed. In addition, GJH is also a clinical sign that is frequently present in hereditary diseases of the connective tissue, such as the Marfan syndrome, osteogenesis imperfecta, and the Ehlers–Danlos syndrome. However, within the Ehlers–Danlos spectrum, a similar subcategory of patients having similar clinical features as HMS but lacking a specific genetic profile was identified: Ehlers–Danlos syndrome hypermobility type (EDS-HT. Researchers and clinicians have struggled for decades with the highly diverse clinical presentation within the HMS and EDS-HT phenotypes (Challenge 1 and the lack of understanding of the pathological mechanisms that underlie the development of pain and its persistence (Challenge 2. In addition, within the HMS/EDS-HT phenotype, there is a high prevalence of psychosocial factors, which again presents a difficult issue that needs to be addressed (Challenge 3. Despite recent scientific advances, many obstacles for clinical care and research still remain. To gain further insight into the phenotype of HMS/EDS-HT and its mechanisms, clearer descriptions of these populations should be made available. Future research and clinical care should revise and create consensus on the

  15. Anxiety and joint hypermobility association: a systematic review Associação entre ansiedade e hipermobilidade articular: uma revisão sistemática

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    Simone H. Bianchi Sanches

    2012-06-01

    Full Text Available BACKGROUND: Anxiety disorders are often associated with several non-psychiatric medical conditions. Among the clinical conditions found in association with anxiety stands out the joint hypermobility (JH. OBJECTIVES: To carry out a systematic review of the clinical association between anxiety disorders and JH. METHOD: A survey was conducted in MEDLINE, PsychINFO, LILACS e SciELO databases up to December 2011. We searched for articles using the keywords 'anxiety', 'joint' and 'hypermobility' and Boolean operators. The review included articles describing empirical studies on the association between JH and anxiety. The reference lists of selected articles were systematically hand-searched for other publications relevant to the review. RESULTS: Seventeen articles were included in the analysis and classified to better extract data. We found heterogeneity between the studies relate to the methodology used. Most of the studies found an association between anxiety features and JH. Panic disorder/agoraphobia was the anxiety disorder associated with JH in several studies. Etiological explanation of the relationship between anxiety and JH is still controversial. CONCLUSION: Future research in large samples from the community and clinical setting and longitudinal studies of the association between anxiety and HA and the underlying biological mechanisms involved in this association are welcome.INTRODUÇÃO: Os transtornos de ansiedade estão frequentemente associados a vários quadros clínicos não psiquiátricos. Dentre os quadros clínicos associados à ansiedade destaca-se a hipermobilidade articular (HA. Objetivo: Realizar uma revisão sistemática da associação entre os transtornos de ansiedade e a HA. MÉTODO: Foi realizada uma pesquisa nos bancos de dados MEDLINE, PsychINFO, LILACS e SciELO em busca de artigos publicados até dezembro de 2011. Usamos as palavras-chave anxiety , joint e hypermobility e os operadores boolianos. A revisão incluiu

  16. Síndrome de Brown bilateral associada com hipermobilidade articular benigna: relato de caso Bilateral Brown's syndrome associated with benign joint hypermobility: a case report

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    David Kirsch

    2007-03-01

    Full Text Available A síndrome de Brown é caracterizada por grande limitação de elevação em adução, elevação ligeiramente diminuída ou normal na abdução, anisotropia em "Y" ou "V", intorção do olho em supraversão e ducção forçada positiva. Sua causa se deve à inelastibilidade do músculo oblíquo superior ou por sua contenção em sua própria bainha. A hipermobilidade articular benigna é doença hereditária do tecido conectivo caracterizada por aumento da mobilidade em diversas articulações. Sua prevalência é muito variável em relação à idade, sexo e etnia, variando de 2 a 35% em homens e de 5 a 57% e mulheres. Neste relato os autores descrevem um caso de síndrome de Brown associada com hipermobilidade articular benigna e atentam para a associação pouco referida na literatura. J.C.S, masculino, 6 anos de idade, pardo, estudante, foi encaminhado à Universidade de Santo Amaro com queixa de exotropia há dois anos que aumentava na supraversão. Paciente com o diagnóstico de síndrome de Brown bilateral teve o diagnóstico de hipermobilidade articular benigna pelo Reumatologista. O paciente com hipermobilidade articular benigna pode desenvolver sintomas articulares como artralgia devido a uma inflamação articular. Acreditamos na possibilidade de que síndrome de Brown possa ter ocorrido devido a processo inflamatório na tróclea que teve início devido a hipermobilidade articular benigna.Brown's syndrome is characterized by a limitation of elevation in adduction, slight or normal limitation of elevation in abduction, divergence in straight upgaze (V-pattern, intorsion in upgaze and positive forced duction. It is caused by a tight or inelastic superior oblique tendon. Benign joint hypermobility is a hereditary disease of the connective tissue characterized by an increase of mobility in diverse joints. Its prevalence is very changeable regarding age range, sex and ethnicity, varying from 2 to 35% in men and 5 to 57% in women. In

  17. Ehlers-Danlos Syndrome, Hypermobility Type, Is Linked to Chromosome 8p22-8p21.1 in an Extended Belgian Family

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    Delfien Syx

    2015-01-01

    Full Text Available Joint hypermobility is a common, mostly benign, finding in the general population. In a subset of individuals, however, it causes a range of clinical problems, mainly affecting the musculoskeletal system. Joint hypermobility often appears as a familial trait and is shared by several heritable connective tissue disorders, including the hypermobility subtype of the Ehlers-Danlos syndrome (EDS-HT or benign joint hypermobility syndrome (BJHS. These hereditary conditions provide unique models for the study of the genetic basis of joint hypermobility. Nevertheless, these studies are largely hampered by the great variability in clinical presentation and the often vague mode of inheritance in many families. Here, we performed a genome-wide linkage scan in a unique three-generation family with an autosomal dominant EDS-HT phenotype and identified a linkage interval on chromosome 8p22-8p21.1, with a maximum two-point LOD score of 4.73. Subsequent whole exome sequencing revealed the presence of a unique missense variant in the LZTS1 gene, located within the candidate region. Subsequent analysis of 230 EDS-HT/BJHS patients resulted in the identification of three additional rare variants. This is the first reported genome-wide linkage analysis in an EDS-HT family, thereby providing an opportunity to identify a new disease gene for this condition.

  18. State changes in posture and arch of the foot in children aged 4 - 6 years with hypermobility of the joints under the influence of rehabilitation activities in schools

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    Kalinichenko I. O.

    2013-08-01

    Full Text Available The effect of the rehabilitation activities in educational institutions on the dynamics of changes in the state and posture of the foot arch in children. The study involved 446 children aged from 4 to 6 years. The rehabilitation program lasted 10 weeks and consisted of 3 periods. Found that 35.88% of healthy children had impaired posture in the sagittal plane. Flatfoot detected in 64.46% of children with joint hypermobility. After the implementation of the rehabilitation program the value of the brachial arch indicators declined in children 3 major groups, respectively, 32.85 cm, 33.24 cm and 33.92 cm in all major groups established downward trend in the proportion of children with kyphotic posture and flat feet. The positive dynamics of changes in the values of posture in the sagittal plane was observed among children of all 3 major groups: shoulder width increased respectively by 1.55%, 3.09%, 4.77%.

  19. Back mobility and interincisor distance ranges in racially diverse North American healthy children and relationship to generalized hypermobility

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    Woolston Sophie L

    2012-06-01

    Full Text Available Abstract Background Given the dearth of normal values, we conducted a cross-sectional study of North American racially diverse children to determine normal values of interincisor distance and lower spine flexion. Methods Demographs of 307 children aged 5–17 seeking treatment emergency care were obtained along with interincisor distance measured by incisor tooth-to-tooth gap, lower spine flexion measured by the Schober and modified Schober measurements, popliteal extension, hypermobility (Beighton score, weight and height. Results Normal range of motion values for the Schober was a mean of 14.3 cm (95% confidence interval (CI was 11.2 to 17. cm and the mean modified Schober’s was 21.6 cm (95% CI 18.4 cm to 24.8 cm. Retained lumbar lordosis on forward flexion was observed in 33%. Back mobility was associated with body mass index (BMI, popliteal angle, and Beighton score but not sex, race or retained lordosis. The mean interincisor distance measurement was 47 mm (95% CI 35 mm to 60 mm and was associated with height and BMI but not sex, race, or Beighton score. Conclusion Normal values for lower back range of motion and interincisor distance were obtained which are needed in pediatric rheumatologic clinics and do not significantly vary as to race or sex. Retained lordosis on forward flexion is a normal variant. Hamstring tightness, hypermobility and BMI need to be considered when ascertaining back mobility.

  20. Anterior disc displacement with reduction and symptomatic hypermobility in the human temporomandibular joint : Prevalence rates and risk factors in children and teenagers

    NARCIS (Netherlands)

    Slater, James J. R. Huddleston; Lobbezoo, Frank; Onland-Moret, N. Charlotte; Naeije, Machiel

    2007-01-01

    Aims: To assess the prevalence rates and risk factors of anterior disc displacement with reduction (ADDR) and symptomatic hypermobility in a large sample of children and teenagers. Prevalence rates were also established in samples of young adults and adults. Methods: Children from 7 Dutch primary an

  1. Generalized joint laxity and its relation with oral habits and temporomandibular disorders in adolescent girls.

    Science.gov (United States)

    Winocur, E; Gavish, A; Halachmi, M; Bloom, A; Gazit, E

    2000-07-01

    A group of 248 girls, aged 15-16 years, were randomly selected and examined both clinically and by questionnaire with regard to the signs and symptoms of temporomandibular disorders (TMD), generalized joint laxity (GJL), range of mandibular opening, temporomandibular joint (TMJ) hypermobility and presence of oral parafunctions. The prevalence of GJL was 43% and that of TMJ hypermobility (TMJH) was 27.3%. A significant, albeit weak, correlation was found between the two. In the presence of joint click, both active and passive opening were significantly larger. When either muscle or joint sensitivity to palpation was present, the difference between the active and passive range of mouth opening increased significantly. The presence of reported clicks was negatively associated with GJL. This association was not valid in the presence of parafunction. Some of the signs and symptoms of TMD affected the range of mouth opening. In the presence of joint clicks, the mean active and passive mandibular opening were significantly larger. In the presence of joint and muscle sensitivity to palpation, the difference between passive and active mouth opening was larger. This was possibly because of the effect of pain on the full active range of opening, which was invalid in the registration of the passive mandibular opening. GJL, when present, did not seem to jeopardize the health of the stomatognathic system as expressed in the signs and symptoms of TMD. There was a negative association between GJL and the presence of reported joint clicks and catch. When a parafunction was present in addition to GJL, this association was invalid but not reversed, as has been previously reported.

  2. The association between Generalized Joint Hypermobility and shoulder mobility in young, competitive swimmers

    DEFF Research Database (Denmark)

    Junge, Tina; Henriksen, P; Knudsen, H K;

    2015-01-01

    risk factors for shoulder injuries (Pink et al., 2000, Zemek et al., 1995). An association between GJH and shoulder mobility among young, competitive swimmers has not been studied. The aim of this study was firstly to evaluate the association between GJH and horizontal shoulder abduction (HSA) in young...... mobility was measured as HSA using an inclinometer in a standardized protocol format. A multiple regression analysis was used to reveal associations between GJH and horizontal shoulder abduction, adjusted for sex and age. Results Overall, significant associations between GJH and HSA were found. An increase....... Conclusion In this study, a significant association was observed between GJH and HSA, as the horizontal shoulder abduction increased with increasing BT scores. The predictive validity of GJH and HSA with respect to shoulder injuries must be assessed in future studies...

  3. Effect of generalized joint hypermobility on knee function and muscle activation in children and adults

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Olesen, Annesofie T.; Pedersen, Mogens Theisen

    2013-01-01

    were evaluated in 39 children and 36 adults during isometric knee extension and flexion. Subjects performed isometric maximum contractions, submaximal contractions at 25% maximum voluntary contraction (MVC), and explosive contractions. Results: Agonist activation was reduced, and coactivation ratio...

  4. Hipermobilidade articular em pacientes com prolapso da valva mitral Hipermovilidad articular en pacientes con prolapso de la válvula mitral Joint hypermobility in patients with mitral valve prolapse

    Directory of Open Access Journals (Sweden)

    Simone Cavenaghi

    2009-09-01

    Full Text Available Estudos sobre hipermobilidade têm despertado grande interesse, nas últimas décadas, por estarem associados a disfunções músculo-esqueléticas, bem como a anormalidades em vários sistemas orgânicos - como, por exemplo, o prolapso da valva mitral. Neste contexto, buscou-se agrupar e atualizar os conhecimentos da relação entre a hipermobilidade articular e o prolapso da valva mitral. Segundo a literatura, estudos mostram que alterações genéticas na composição do colágeno parecem ser a principal causa desta relação.Studies on hypermobility have aroused great interest in the last decades, as they are associated to musculoskeletal disorders, as well as abnormalities in several organic systems, such as the mitral valve prolapse. Therefore, in this study, data on the association between joint hypermobility and the mitral valve prolapse were investigated and reviewed. Studies in the literature have shown that genetic alterations in the collagen composition seem to be the main cause of this association.

  5. Generalized Models for Rock Joint Surface Shapes

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    Shigui Du

    2014-01-01

    Full Text Available Generalized models of joint surface shapes are the foundation for mechanism studies on the mechanical effects of rock joint surface shapes. Based on extensive field investigations of rock joint surface shapes, generalized models for three level shapes named macroscopic outline, surface undulating shape, and microcosmic roughness were established through statistical analyses of 20,078 rock joint surface profiles. The relative amplitude of profile curves was used as a borderline for the division of different level shapes. The study results show that the macroscopic outline has three basic features such as planar, arc-shaped, and stepped; the surface undulating shape has three basic features such as planar, undulating, and stepped; and the microcosmic roughness has two basic features such as smooth and rough.

  6. Muscle strength assessment among children and adolescents with growing pains and joint hypermobility Avaliação da força muscular em crianças e adolescentes com dores de crescimento e hipermobilidade articular

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    ALV Marcolin

    2009-04-01

    Full Text Available OBJECTIVE: To compare the muscle strength of children and adolescents with growing pains, with and without joint hypermobility, to healthy controls by means of quantitative tests. METHOD: Forty-seven children and adolescents were monitored because of growing pains: 24 with joint hypermobility (GP-JH group and 23 without joint hypermobility (GP group. These cases, along with 47 healthy controls matched for age and gender, underwent two quantitative tests for muscle strength evaluation: the Childhood Myositis Assessment Scale (CMAS and the Manual Muscle Strength Test (MMT. Anthropometric data such as height, weight, body mass index, triceps skinfold, mean arm circumference and arm muscle area were compared between the three groups. RESULTS: The three groups did not present any statistical differences in anthropometric measurements. There were significant differences in median CMAS scores, which were lower in the GP (47; range 39-52 and GP-JH (46; range 40-51 groups than the control group (50; range 45-52; pOBJETIVO: Avaliar, por meio de teste quantitativo, a força muscular em crianças e adolescentes com dores de crescimento, associada ou não com hipermobilidade articular e comparadas com controles saudáveis. MÉTODO: Quarenta e sete casos de crianças e adolescentes acompanhados por dores de crescimento, sendo 24 com hipermobilidade articular (DC-HA, 23 sem hipermobilidade articular (DC e 47 controles saudáveis pareados por idade e gênero foram submetidos a dois testes quantitativos para a avaliação da força muscular, o Childhood Myositis Assessment Scale (CMAS e o Manual Muscle Strength Test (MMT. Os dados antropométricos como altura, peso, índice de massa corporal, prega cutânea tricipital, circunferência média do braço e a área muscular do braço foram comparados entre os três grupos. RESULTADOS: Os três grupos não apresentaram diferença estatística entre as medidas antropométricas. Houve diferença significante entre a

  7. Hypermobility in Adolescent Athletes

    DEFF Research Database (Denmark)

    Schmidt, Heidi; Pedersen, Trine Lykke; Junge, Tina

    2017-01-01

    athletes, and to study the association of GJH with pain, function, HRQoL, and musculoskeletal injuries. Methods A total of 132 elite-level adolescent athletes (36 adolescent boys, 96 adolescent girls; mean ± SD age, 14.0 ± 0.9 years), including ballet dancers (n = 22), TeamGym gymnasts (n = 57), and team......-reported questionnaires, and part of physical performance was assessed by 4 postural-sway tests and 2 single-legged hop-for-distance tests. Results Overall prevalence rates for GJH4, GJH5, and GJH6 were 27.3%, 15.9%, and 6.8%, respectively, with a higher prevalence of GJH4 in ballet dancers (68.2%) and TeamGym gymnasts...... significantly larger center-of-pressure path length across sway tests. Conclusion For ballet dancers and TeamGym gymnasts, the prevalence of GJH4 was higher than that of team handball players. For ballet dancers, the prevalence of GJH5 and GJH6 was higher than that of team handball players and the general...

  8. Gait Strategy in Patients with Ehlers-Danlos Syndrome Hypermobility Type: A Kinematic and Kinetic Evaluation Using 3D Gait Analysis

    Science.gov (United States)

    Galli, Manuela; Cimolin, Veronica; Rigoldi, Chiara; Castori, Marco; Celletti, Claudia; Albertini, Giorgio; Camerota, Filippo

    2011-01-01

    The aim of this study was to quantify the gait patterns of adults with joint hypermobility syndrome/Ehlers-Danlos syndrome (JHS/EDS-HT) hypermobility type, using Gait Analysis. We quantified the gait strategy in 12 JHS/EDS-HT adults individuals (age: 43.08 + 6.78 years) compared to 20 healthy controls (age: 37.23 plus or minus 8.91 years), in…

  9. Ehlers–Danlos Syndrome—Hypermobility Type: A Much Neglected Multisystemic Disorder

    Science.gov (United States)

    Gazit, Yael; Jacob, Giris; Grahame, Rodney

    2016-01-01

    Ehlers–Danlos syndrome (EDS)—hypermobility type (HT) is considered to be the most common subtype of EDS and the least severe one; EDS-HT is considered to be identical to the joint hypermobility syndrome and manifests with musculoskeletal complaints, joint instability, and soft tissue overuse injury. Musculoskeletal complaints manifest with joint pain of non-inflammatory origin and/or spinal pain. Joint instability leads to dislocation or subluxation and involves peripheral joints as well as central joints, including the temporomandibular joints, sacroiliac joints, and hip joints. Soft tissue overuse injury may lead to tendonitis and bursitis without joint inflammation in most cases. Ehlers–Danlos syndrome-HT carries a high potential for disability due to recurrent dislocations and subluxations and chronic pain. Throughout the years, extra-articular manifestations have been described, including cardiovascular, autonomic nervous system, gastrointestinal, hematologic, ocular, gynecologic, neurologic, and psychiatric manifestations, emphasizing the multisystemic nature of EDS-HT. Unfortunately, EDS-HT is under-recognized and inadequately managed, leading to neglect of these patients, which may lead to severe disability that almost certainly could have been avoided. In this review article we will describe the known manifestations of the extra-articular systems. PMID:27824552

  10. Ehlers–Danlos Syndrome—Hypermobility Type: A Much Neglected Multisystemic Disorder

    Directory of Open Access Journals (Sweden)

    Yael Gazit

    2016-10-01

    Full Text Available Ehlers–Danlos syndrome (EDS—hypermobility type (HT is considered to be the most common subtype of EDS and the least severe one; EDS-HT is considered to be identical to the joint hypermobility syndrome and manifests with musculoskeletal complaints, joint instability, and soft tissue overuse injury. Musculoskeletal complaints manifest with joint pain of non-inflammatory origin and/or spinal pain. Joint instability leads to dislocation or subluxation and involves peripheral joints as well as central joints, including the temporomandibular joints, sacroiliac joints, and hip joints. Soft tissue overuse injury may lead to tendonitis and bursitis without joint inflammation in most cases. Ehlers–Danlos syndrome-HT carries a high potential for disability due to recurrent dislocations and subluxations and chronic pain. Throughout the years, extra-articular manifestations have been described, including cardiovascular, autonomic nervous system, gastrointestinal, hematologic, ocular, gynecologic, neurologic, and psychiatric manifestations, emphasizing the multisystemic nature of EDS-HT. Unfortunately, EDS-HT is under-recognized and inadequately managed, leading to neglect of these patients, which may lead to severe disability that almost certainly could have been avoided. In this review article we will describe the known manifestations of the extra-articular systems.

  11. Syndrome of occipitoatlantoaxial hypermobility, cranial settling, and chiari malformation type I in patients with hereditary disorders of connective tissue.

    Science.gov (United States)

    Milhorat, Thomas H; Bolognese, Paolo A; Nishikawa, Misao; McDonnell, Nazli B; Francomano, Clair A

    2007-12-01

    Chiari malformation Type I (CM-I) is generally regarded as a disorder of the paraxial mesoderm. The authors report an association between CM-I and hereditary disorders of connective tissue (HDCT) that can present with lower brainstem symptoms attributable to occipitoatlantoaxial hypermobility and cranial settling. The prevalence of HDCT was determined in a prospectively accrued cohort of 2813 patients with CM-I. All patients underwent a detailed medical and neuroradiological workup that included an assessment of articular mobility. Osseous structures composing the craniocervical junction were investigated morphometrically using reconstructed 3D computed tomography and plain x-ray images in 114 patients with HDCT/CM-I, and the results were compared with those obtained in patients with CM-I (55 cases) and healthy control individuals (55 cases). The diagnostic criteria for Ehlers-Danlos syndrome and related HDCT were met in 357 (12.7%) of the 2813 cases. Hereditability was generally compatible with a pattern of autosomal dominant transmission with variable expressivity. The diagnostic features of HDCT/CM-I were distinguished from those of CM-I by clinical stigmata of connective tissue disease, a greater female preponderance (8:1 compared with 3:1, p supine and upright positions in healthy control individuals and patients with CM-I. In patients with HDCT/CM-I, there was a reduction of the basion-dens interval (3.6 mm, p cervical traction or returning to the supine position. The identification of HDCT in 357 patients with CM-I establishes an association between two presumably unrelated mesodermal disorders. Morphometric evidence in this cohort-cranial settling, posterior gliding of the occipital condyles, and reduction of the clivus-axis angle, clivus-atlas angle, and atlas-axis angle in the upright position-suggests that hypermobility of the occipitoatlantal and atlantoaxial joints contributes to retroodontoid pannus formation and symptoms referable to basilar

  12. Pregnancy and delivery in ehlers-danlos syndrome (hypermobility type): review of the literature.

    Science.gov (United States)

    Dutta, Indranil; Wilson, Helen; Oteri, Odiri

    2011-01-01

    Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders which are divided into various distinguishable phenotypes. The type of EDS determines the potential obstetric complications. Due to the spectrum of clinical manifestation and overlap between phenotypes, there are no standardised obstetric management guidelines. Existing literature illustrates different obstetric management in hypermobility type of EDS, including uneventful term vaginal deliveries as well as preterm cesarean section deliveries. This paper discusses obstetric management of a woman with EDS hypermobility type. Cesarean section was deemed the most appropriate delivery method in this patient due to the possible complications including risk of joint dislocation and pain morbidity. No obstetric complications were experienced, and good maternal and neonatal outcomes were achieved.

  13. Pregnancy and Delivery in Ehlers-Danlos Syndrome (Hypermobility Type: Review of the Literature

    Directory of Open Access Journals (Sweden)

    Indranil Dutta

    2011-01-01

    Full Text Available Ehlers-Danlos syndrome (EDS is a group of connective tissue disorders which are divided into various distinguishable phenotypes. The type of EDS determines the potential obstetric complications. Due to the spectrum of clinical manifestation and overlap between phenotypes, there are no standardised obstetric management guidelines. Existing literature illustrates different obstetric management in hypermobility type of EDS, including uneventful term vaginal deliveries as well as preterm cesarean section deliveries. This paper discusses obstetric management of a woman with EDS hypermobility type. Cesarean section was deemed the most appropriate delivery method in this patient due to the possible complications including risk of joint dislocation and pain morbidity. No obstetric complications were experienced, and good maternal and neonatal outcomes were achieved.

  14. Ehlers-Danlos Syndrome, Hypermobility Type: Impact of Somatosensory Orthoses on Postural Control (A Pilot Study

    Directory of Open Access Journals (Sweden)

    Emma G. Dupuy

    2017-06-01

    Full Text Available Elhers-Danlos syndrome (EDS is the clinical manifestation of connective tissue disorders, and comprises several clinical forms with no specific symptoms and selective medical examinations which result in a delay in diagnosis of about 10 years. The EDS hypermobility type (hEDS is characterized by generalized joint hypermobility, variable skin hyperextensibility and impaired proprioception. Since somatosensory processing and multisensory integration are crucial for both perception and action, we put forth the hypothesis that somatosensory deficits in hEDS patients may lead, among other clinical symptoms, to misperception of verticality and postural instability. Therefore, the purpose of this study was twofold: (i to assess the impact of somatosensory deficit on subjective visual vertical (SVV and postural stability; and (ii to quantify the effect of wearing somatosensory orthoses (i.e., compressive garments and insoles on postural stability. Six hEDS patients and six age- and gender-matched controls underwent a SVV (sitting, standing, lying on the right side evaluation and a postural control evaluation on a force platform (Synapsys, with or without visual information (eyes open (EO/eyes closed (EC. These two latter conditions performed either without orthoses, or with compression garments (CG, or insoles, or both. Results showed that patients did not exhibit a substantial perceived tilt of the visual vertical in the direction of the body tilt (Aubert effect as did the control subjects. Interestingly, such differential effects were only apparent when the rod was initially positioned to the left of the vertical axis (opposite the longitudinal body axis. In addition, patients showed greater postural instability (sway area than the controls. The removal of vision exacerbated this instability, especially in the mediolateral (ML direction. The wearing of orthoses improved postural stability, especially in the eyes-closed condition, with a particularly

  15. Ehlers-Danlos Syndrome—Hypermobility Type and Hemorrhoids

    Directory of Open Access Journals (Sweden)

    Timothy P. Plackett

    2014-01-01

    Full Text Available Ehlers-Danlos syndrome-hypermobility type (EDS-HT is a connective tissue disorder associated with chronic musculoskeletal pain. The diagnosis is based on simple clinical examination, although it is easily overlooked. Herein we present a case of EDS-HT associated with hemorrhoids and suggest that there may be an association between the two conditions.

  16. Overcorrection and generalized joint laxity in surgically treated congenital talipes equino-varus.

    Science.gov (United States)

    Haslam, Paul G; Goddard, Martin; Flowers, Mark J; Fernandes, James A

    2006-07-01

    Fifty patients with 70 previously operated clubfeet were assessed for overcorrection (using Tachdjian's flat foot grade) and generalized joint laxity. Twenty-eight patients (40 feet) had signs of generalized joint laxity using the Biro score and of these 25 feet were overcorrected. Of the 22 patients (30 feet) who did not have signs of joint laxity, only three overcorrected. This difference was statistically significant (Pflat foot grade and laxity score (Psurgery, the authors urge caution and recommend a limited surgical release, particularly if joint laxity is suspected, or the Ponseti method of treatment, which will probably avoid this complication.

  17. Generalized Solutions for the joint replenishment problem with correction factor

    NARCIS (Netherlands)

    E. Porras Musalem (Eric); R. Dekker (Rommert)

    2005-01-01

    textabstractIn this paper we give a complete analysis of the joint replenishment problem (JRP) under constant demands and continuous time. We present a solution method for the JRP when a correction is made for empty replenishments, and we test the solution procedures with real data. We show that the

  18. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

    Science.gov (United States)

    Cömert Kiliç, S; Kiliç, N; Sümbüllü, M A

    2015-10-01

    The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Proprioceptive impairments associated with knee osteoarthritis are not generalized to the ankle and elbow joints.

    Science.gov (United States)

    Shanahan, Camille J; Wrigley, Tim V; Farrell, Michael J; Bennell, Kim L; Hodges, Paul W

    2015-06-01

    The mechanisms for proprioceptive changes associated with knee osteoarthritis (OA) remain elusive. Observations of proprioceptive changes in both affected knees and other joints imply more generalized mechanisms for proprioceptive impairment. However, evidence for a generalized effect remains controversial. This study examined whether joint repositioning proprioceptive deficits are localized to the diseased joint (knee) or generalized across other joints (elbow and ankle) in people with knee OA. Thirty individuals with right knee OA (17 female, 66±7 [mean±SD] years) of moderate/severe radiographic disease severity and 30 healthy asymptomatic controls of comparable age (17 female, 65±8years) performed active joint repositioning tests of the knee, ankle and elbow in randomised order in supine. Participants with knee OA had a larger relative error for joint repositioning of the knee than the controls (OA: 2.7±2.1°, control: 1.6±1.7°, p=.03). Relative error did not differ between groups for the ankle (OA: 2.2±2.5°, control: 1.9±1.3°, p=.50) or elbow (OA: 2.5±3.3°, control: 2.9±2.8°, p=.58). These results are consistent with a mechanism for proprioceptive change that is localized to the knee joint. This could be mediated by problems with mechanoreceptors, processing/relay of somatosensory input to higher centers, or joint-specific interference with cognitive processes by pain.

  20. Alterations in collagen structure in hypermobility and Ehlers-Danlos syndromes detected by Raman spectroscopy in vivo

    Science.gov (United States)

    Johansson, Carina K.; Gniadecka, Monika; Ullman, Susanne; Halberg, Poul; Kobayasi, Takasi; Wulf, Hans Christian

    2000-11-01

    Patients with hypermobility syndrome (HS) and Ehlers-Danlos syndrome (EDS) were investigated by means of in vivo near- infrared Fourier-transform Raman spectroscopy. HS is a benign and common condition (up to 5 percent of the population of the Western World). EDS is a rare, inherited connective tissue disease characterized by joint hypermobility, skin hyperextensibility, and other, occasionally serious, organ changes. EDS and HS may be related disorders. We investigated 13 patients with HS, 8 patients with EDS, and 24 healthy volunteers by means of in vivo Raman spectroscopy. The patients were classified according to Beighton and Holzberg et al. No difference in age between the three groups was found (HS 41 (33-49), EDS 36 (25-47), controls 37 (31-42); mean, 95% confidence intervals, respectively). Spectral differences were found in the intensity of the amide-III bands around 1245 and 1270 cm-1 in HS and EDS compared with healthy skin (Kruskal-Wallis, p equals 0,02 for intensity ratios (I1245/I1270) between the investigated groups). To elucidate the character of the alterations in the amide-III bands a curve fitting procedure was applied. In conclusion, Raman spectroscopy may aid in the diagnosis of HS and EDS. Moreover the technique may be useful for analyzing the molecular changes occurring in these syndromes.

  1. General Roy S. Geiger, USMC: Marine Aviator, Joint Force Commander

    Science.gov (United States)

    2007-06-01

    under the wings of their planes. Brigadier General Roy Geiger, with seemingly iron nerves and tireless muscles, forced them back into their planes...that justified a separate service, independent of the Army. The Army, meanwhile, was determined to preserve its force structure in the frenzy of

  2. Generalized Joint Laxity and Ligament Injuries in High School–Aged Female Volleyball Players in Japan

    Science.gov (United States)

    Sueyoshi, Ted; Emoto, Gen; Yuasa, Tomoki

    2016-01-01

    Background: Generalized joint laxity has been linked to ligamentous injuries such as anterior cruciate ligament tear and ankle sprain. Purpose/Hypothesis: The purpose of this study was to investigate generalized joint laxity and incidence of ligament injuries in high school–aged female volleyball players. It was hypothesized that volleyball players with a past history of sprains would have increased generalized joint laxity compared with those without any history and that athletes with multiple sprains would demonstrate with a higher generalized joint laxity score than those who had only 1 sprain. Study Design: Case-control study; Level of evidence, 3. Methods: Forty-seven subjects were tested for generalized joint laxity using the Beighton and Horan Joint Mobility Index (BHJMI). They were categorized into 2 groups based on the presence of past ligament injury: injury group (IG) and noninjury group (NG). The IG group was further divided into 2 groups based on whether they had a single ligamentous injury (IGS) or multiple injuries (IGM) in the past to study whether there was any difference in scores between the subgroups. The collected data were analyzed statistically with 1-way analysis of variance. Results: Subjects in the IG group scored significantly higher on the BHJMI than those in the NG group. The mean score for the IG group was 2.40 ± 1.42, as opposed to 1.24 ± 1.09 for the NG group (P = .006). Eleven subjects in the IG group had suffered multiple injuries or recurrent injuries (IGM) and scored significantly higher than the remaining 19 individuals in the IG group, who had only sustained a single injury (IGS). The mean BHJMI scores were 3.18 ± 1.47 and 1.95 ± 1.22 for IGM and IGS, respectively (P = .02). Conclusion: Female athletes with a high generalized joint laxity score may be more prone to ligament injury and potentially to recurrent ligament injuries. PMID:27761474

  3. Joint Action: Mental Representations, Shared Information and General Mechanisms for Coordinating with Others

    Science.gov (United States)

    Vesper, Cordula; Abramova, Ekaterina; Bütepage, Judith; Ciardo, Francesca; Crossey, Benjamin; Effenberg, Alfred; Hristova, Dayana; Karlinsky, April; McEllin, Luke; Nijssen, Sari R. R.; Schmitz, Laura; Wahn, Basil

    2017-01-01

    In joint action, multiple people coordinate their actions to perform a task together. This often requires precise temporal and spatial coordination. How do co-actors achieve this? How do they coordinate their actions toward a shared task goal? Here, we provide an overview of the mental representations involved in joint action, discuss how co-actors share sensorimotor information and what general mechanisms support coordination with others. By deliberately extending the review to aspects such as the cultural context in which a joint action takes place, we pay tribute to the complex and variable nature of this social phenomenon. PMID:28101077

  4. [Perioperative management of patients during general endoprosthethic operations on the knee joint (a review of literature)].

    Science.gov (United States)

    Iudin, A M

    2006-01-01

    Arthrosis deformans of the knee joint (gonarthrosis) is a common disease accompanied by pain syndrome and disability. Medical treatment of the disease ensures only a temporary analgesic effect and fails to restore the range of motion in the legs. General endoprosthetic operations on the knee joint can significantly improve the results of treatment, alleviate pain, and restore the patients' working capacity. Most patients undergoing endoprosthetic repair of the knee joint are elderly and senile, who have concomitant multiple organ somatic pathology. Comorbidity, old age, the specific features and traumaticity of a surgical intervention make high requirements for anesthesic maintenance at surgery and for stability of hemodynamic parameters in the perioperative period, and adequate analgesia in the postoperative period. Different approaches to adequate anesthesia are considered in both intra- and postoperative period. Numerous references lead to the conclusion that many widely used anesthetic procedures (general inhalational and intravenous anesthesia, high-conduction anesthesia, etc.) are incompletely adequate during a general endoprosthetic repair of the knee joint. A number of authors state that spinal or combined spinal epidural anesthesia is the most adequate methods of intra- and postoperative anesthesia at general endoprosthetic repair of the knee joint.

  5. Creep simulation of adhesively bonded joints using modified generalized time hardening model

    Energy Technology Data Exchange (ETDEWEB)

    Sadigh, Mohammad Ali Saeimi [Azarbaijan Shahid Madani University, Tabriz (Iran, Islamic Republic of)

    2016-04-15

    Creep behavior of double lap adhesively bonded joints was investigated using experimental tests and numerical analysis. Firstly, uniaxial creep tests were carried out to obtain the creep characteristics and constitutive parameters of the adhesive at different stress and temperature levels. Generalized time hardening model was used to predict the creep behavior of the adhesive. This model was modified to simulate the creep behavior at different stress and temperature levels. Secondly, the developed model was used to simulate the creep behavior of bonded joints using finite element based numerical analysis. Creep deformations of the joints were measured experimentally and good agreement was observed in comparison with the results obtained using numerical simulation. Afterward, stress redistribution due to the creep along the adhesively bonded joint was obtained numerically. It was observed that temperature level had a significant effect on the stress redistribution along the adhesive thickness.

  6. Hypermobility of the first metatarsal bone in patients with Rheumatoid arthritis treated by lapidus procedure

    Directory of Open Access Journals (Sweden)

    Popelka Stanislav

    2012-08-01

    Full Text Available Abstract Background Foot deformities and related problems of the forefoot are very common in patients with rheumatoid arthritis. The laxity of the medial cuneometatarsal joint and its synovitis are important factors in the development of forefoot deformity. The impaired joint causes the first metatarsal bone to become unstable in the frontal and sagittal planes. In this retrospective study we evaluated data of patients with rheumatoid arthritis who underwent Lapidus procedure. We evaluated the role of the instability in a group of patients, focusing mainly on the clinical symptoms and X-ray signs of the instability. Methods The study group included 125 patients with rheumatoid arthritis. The indications of the Lapidus procedure were a hallux valgus deformity greater than 15 degrees and varus deformity of the first metatarsal bone with the intermetatarsal angle greater than 15 degrees on anterio-posterior weight-bearing X-ray. Results Data of 143 Lapidus procedures of 125 patients with rheumatoid arthritis, who underwent surgery between 2004 and 2010 was evaluated. Signs and symptoms of the first metatarsal bone instability was found in 92 feet (64.3% in our group. The AOFAS score was 48.6 before and 87.6 six months after the foot reconstruction. Nonunion of the medial cuneometatarsal joint arthrodesis on X-rays occurred in seven feet (4.9%. Conclusion The Lapidus procedure provides the possibility to correct the first metatarsal bone varus position and its instability, as well as providing the possibility to achieve a painless foot for walking. We recommend using the procedure as a preventive surgery in poorly symptomatic patients with rheumatoid arthritis in case of the first metatarsal bone hypermobility.

  7. Generalized Cross Entropy Method for estimating joint distribution from incomplete information

    Science.gov (United States)

    Xu, Hai-Yan; Kuo, Shyh-Hao; Li, Guoqi; Legara, Erika Fille T.; Zhao, Daxuan; Monterola, Christopher P.

    2016-07-01

    Obtaining a full joint distribution from individual marginal distributions with incomplete information is a non-trivial task that continues to challenge researchers from various domains including economics, demography, and statistics. In this work, we develop a new methodology referred to as "Generalized Cross Entropy Method" (GCEM) that is aimed at addressing the issue. The objective function is proposed to be a weighted sum of divergences between joint distributions and various references. We show that the solution of the GCEM is unique and global optimal. Furthermore, we illustrate the applicability and validity of the method by utilizing it to recover the joint distribution of a household profile of a given administrative region. In particular, we estimate the joint distribution of the household size, household dwelling type, and household home ownership in Singapore. Results show a high-accuracy estimation of the full joint distribution of the household profile under study. Finally, the impact of constraints and weight on the estimation of joint distribution is explored.

  8. Analysis of Financial Ratio to Distinguish Indonesia Joint Venture General Insurance Company Performance using Discriminant Analysis

    Directory of Open Access Journals (Sweden)

    Subiakto Soekarno

    2012-01-01

    Full Text Available Insurance industry stands as a service business that plays a significant role in Indonesiaeconomical condition. The development of insurance industry in Indonesia, both of generalinsurance and life insurance, has increased very fast. The general insurance industry itselfdivided into two major players which are local private company and Joint Venture Company.Lately, the use of statistical techniques and financial ratios models to asses financial institutionsuch as insurance company have been used as one of the appropriate combination inpredicting the performance of an industry. This research aims to distinguish between JointVenture General Insurance Companies that have a good performance and those who are lessperforming well using Discriminant Analysis. Further, the findings led that DiscriminantAnalysis is able to distinguish Joint Venture General Insurance Companies that have a goodperformance and those who are not performing well. There are also six ratios which are RBC,Technical Reserve to Investment Ratio, Debt Ratio, Return on Equity, Loss Ratio, and ExpenseRatio that stand as the most influential ratios to distinguish the performance of joint venturegeneral insurance companies. In addition, the result suggest business people to be concernedtoward those six ratios, to increase their companies’ performance.Key words: general insurance, financial ratio, discriminant analysis

  9. Analysis of Financial Ratio to Distinguish Indonesia Joint Venture General Insurance Company Performance using Discriminant Analysis

    Directory of Open Access Journals (Sweden)

    Subiakto Soekarno

    2012-01-01

    Full Text Available Insurance industry stands as a service business that plays a significant role in Indonesiaeconomical condition. The development of insurance industry in Indonesia, both of generalinsurance and life insurance, has increased very fast. The general insurance industry itselfdivided into two major players which are local private company and Joint Venture Company.Lately, the use of statistical techniques and financial ratios models to asses financial institutionsuch as insurance company have been used as one of the appropriate combination inpredicting the performance of an industry. This research aims to distinguish between JointVenture General Insurance Companies that have a good performance and those who are lessperforming well using Discriminant Analysis. Further, the findings led that DiscriminantAnalysis is able to distinguish Joint Venture General Insurance Companies that have a goodperformance and those who are not performing well. There are also six ratios which are RBC,Technical Reserve to Investment Ratio, Debt Ratio, Return on Equity, Loss Ratio, and ExpenseRatio that stand as the most influential ratios to distinguish the performance of joint venturegeneral insurance companies. In addition, the result suggest business people to be concernedtoward those six ratios, to increase their companies’ performance.Key words: general insurance, financial ratio, discriminant analysis

  10. Generalized dysplasia epiphysealis hemimelica with contralateral sacro-iliac joint involvement

    Energy Technology Data Exchange (ETDEWEB)

    Karam, Adib R.; Birjawi, Ghina A.; Khoury, Nabil J. [American University of Beirut Medical Center, Department of Diagnostic Radiology, Beirut (Lebanon); Saghieh, Said [American University of Beirut Medical Center, Department of Orthopedic Surgery, Beirut (Lebanon); Tawil, Ayman [American University of Beirut Medical Center, Department of Pathology, Beirut (Lebanon)

    2008-12-15

    Dysplasia epiphysealis hemimelica (or Trevor's disease) is a rare developmental bone dysplasia characterized by benign osteocartilaginous overgrowth involving one or multiple epiphyses, usually of a single lower extremity. It is classified as localized form, classical form (most common), and generalized form. In this report we describe a case of generalized form of dysplasia epiphysealis hemimelica with involvement of the contralateral sacroiliac joint, which is an extremely rare presentation. (orig.)

  11. Injuries and disorders among young ice skaters: relationship with generalized joint laxity and tightness

    Directory of Open Access Journals (Sweden)

    Okamura S

    2014-08-01

    Full Text Available Shinobu Okamura,1 Naoki Wada,1 Masayuki Tazawa,1 Makoto Sohmiya,1 Yoko Ibe,1 Toru Shimizu,1 Shigeru Usuda,2 Kenji Shirakura1 1Department of Rehabilitation Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan; 2Department of Physical Therapy, Gunma University School of Health Science, Maebashi, Gunma, Japan Abstract: This study retrospectively investigated 192 teenage speed and figure skaters with prior injuries documented by an athletes’ questionnaire, who underwent a physical examination to assess their muscle tightness and generalized joint laxity. In all athletes, the degree of muscle tightness and joint laxity were measured by a standardized physical examination. A descriptive report of the types of injuries showed a predominance of fractures, ligament injuries, enthesitis, and lower back pain. Approximately 5% of all skaters tested positive for tightness, while 25.8% of figure skaters and 15.2% of speed skaters had generalized ligamentous laxity. Statistical testing showed an association between ankle sprains and muscle tightness, and an association between knee enthesitis and muscle tightness in skating athletes. There was also an association between lower back pain and generalized joint laxity, which held true only for the male skaters. Keywords: sports injury, skating, junior athlete, tightness, joint laxity, medical checkup

  12. 75 FR 62424 - New United Motor Manufacturing, Inc. Formerly a Joint Venture of General Motors Corporation and...

    Science.gov (United States)

    2010-10-08

    ... United Motor Manufacturing, Inc. Formerly a Joint Venture of General Motors Corporation and Toyota Motor Corporation Including On- Site Leased Workers From Corestaff, ABM Janitorial, Toyota Engineering and... Motor Manufacturing, Inc., formerly a joint venture of General Motors Corporation and Toyota...

  13. 75 FR 47632 - New United Motor Manufacturing, Inc., Formerly a Joint Venture of General Motors Corporation and...

    Science.gov (United States)

    2010-08-06

    ... General Motors Corporation and Toyota Motor Corporation, Including On- Site Leased Workers From Corestaff, ABM Janitorial, Toyota Engineering and Manufacturing North America, NPA Coatings, Inc., and Premier... Motor Manufacturing, Inc., formerly a joint venture of General Motors Corporation and Toyota...

  14. Maximum jaw opening capacity in adolescents in relation to general joint mobility.

    Science.gov (United States)

    Westling, L; Helkimo, E

    1992-09-01

    Mandibular jaw opening was related with general joint mobility in a non-patient adolescent group. The angular rotation of the mandible at maximum jaw opening was slightly larger in females than in males and significantly larger in hypermobile individuals. No significant relationship between linear measuring of maximal mandibular opening capacity and peripheral joint mobility was found either at active (AROM) or at passive range of mandibular opening (PROM). PROM was strongly correlated to the mandibular length. Clinical signs in the great jaw closer muscles could not be associated to decreased AROM. The mean value of the difference between PROM-AROM (DPA) was 1.2 mm. Frequent clenching and/or grinding was correlated to increased DPA only in hypermobile adolescents (r = 0.49***). Those with DPA exceeding 5mm had all reciprocal clicking.

  15. BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy.

    Science.gov (United States)

    Mogren, Ingrid M

    2006-07-01

    Low back pain and pelvic pain (LBPP) is common during pregnancy and up to 40% of women still have symptoms half a year after delivery. The aim of the study was to investigate determinants and the prevalence of persistent LBPP after pregnancy in a Swedish cohort. In a previous study 891 women had responded to a questionnaire on risk factors and prevalence of LBPP during pregnancy. Altogether 72% (n=639) of the women had reported LBPP during pregnancy. These respondents were sent a second questionnaire at approximately 6 months after delivery. The response rate was 72.6% (n=464). Independent t-test and Pearson's chi-squared test were used to test the difference between the two groups. In response to the questionnaire, 43.1% of the women reported persistent LBPP 6 months after delivery. Women with persistent LBPP after pregnancy had had significantly earlier onset of pain during pregnancy, higher maternal age, higher body mass index (BMI), and assessed a higher level of pain due to LBPP during pregnancy and after pregnancy, and included a higher proportion of women with joint hyper-mobility. In summary, recurrent or continuous LBPP is prevalent after pregnancy. BMI as well as hyper-mobility are prominent determinants of persistent LBPP after pregnancy. Level and onset of pain during pregnancy were strong predictors of persistent LBPP.

  16. The General Equilibrium Model with Joint Ownership of the Corporation (Voting Stock and the Core),

    Science.gov (United States)

    general equilibrium system. The point specifically is that the Arrow-Debreu treatment of the joint ownership of industry by introducing shares which can be treated, requires further specification. The need for further specification can be seen immediately when this model is examined not for the competitive equilibrium but for the core. It is well known that the competitive equilibrium is contained within the core. However it will be shown that unless extra conditions are imposed on the control of stock the resultant game may have no core whatsoever and hence no competitive

  17. The extent and risk of knee injuries in children aged 9-14 with Generalised Joint Hypermobility and knee joint hypermobility

    DEFF Research Database (Denmark)

    Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit;

    2015-01-01

    /9 on both test rounds. On basis of weekly cell phone surveys of knee pain, children requiring clinical examination were seen. Traumatic and overuse knee injuries were registered by WHO ICD-10 diagnoses. Logistic regression and Poisson regression models with robust standard errors were used to examine...

  18. Gait Strategy in Patients with Ehlers-Danlos Syndrome Hypermobility Type and Down Syndrome

    Science.gov (United States)

    Rigoldi, Chiara; Galli, Manuela; Cimolin, Veronica; Camerota, Filippo; Celletti, Claudia; Tenore, Nunzio; Albertini, Giorgio

    2012-01-01

    People suffering from Ehlers-Danlos syndrome (EDS) hypermobility type present a severe ligament laxity that results in difficulties in muscle force transmission. The same condition is present in people suffering from Down syndrome (DS) even if their clumsy movements are due to cerebral and cognitive impairments. The aim of this study was to…

  19. 75 FR 39045 - New United Motor Manufacturing, Inc., Formerly a Joint Venture of General Motors Corporation and...

    Science.gov (United States)

    2010-07-07

    ... General Motors Corporation and Toyota Motor Corporation, Including On- Site Leased Workers From Corestaff, ABM Janitorial, Toyota Engineering and Manufacturing North America, and NPA Coatings, Inc., and On... Manufacturing, Inc., formerly a joint ] venture of General Motors Corporation and Toyota Motor...

  20. Experience of emplying extracorporal shock-wave therapy for treating limb enthesopathies in patients with articular hypermobility syndrome

    OpenAIRE

    2014-01-01

    Purpose: to study the efficiency of extracorporal shock-wave therapy and the affected area orthopedic relief for treating pain syndrome associated with enthesopathies in patients with articular hypermobility syndrome.75 patients with enthesopathies of various localizations and diagnosed articular hypermobility were observed in 2008-2011, their age varying from 35 to 55 years (median age: 37.5±0.4 years). The treatment mode was out-patient, with a shockwave device PIEZOSON-100 (manufacturer: R...

  1. IRS General Counsel Memorandum threatens some hospital-physician joint ventures.

    Science.gov (United States)

    Driscoll, T L; Schieble, M T

    1992-03-01

    To defend against the heightened scrutiny of hospital-physician relations expected from the IRS, hospital management should closely examine any activities now conducted with physicians to determine whether each activity, as organized and operated, furthers the hospital's charitable mission of promoting the health of its community, rather than merely enhancing the financial health of the institution itself. Any arrangements that do not appear to satisfy the principles enunciated in GCM 39862 should be examined to see if they should be restructured or dissolved. In structuring new transactions and examining existing arrangements, the following principles should be kept in mind: 1. Transactions should not be premised upon increased utilization or physician referrals. Enhancing or protecting market share, even for the purpose of preserving an institution's presence in the community, will likely no longer be accepted as a justification for pursuing joint venture arrangements. In justifying such ventures, management must distinguish between benefit to the community and benefit to the institution. 2. Transactions whereby existing services or equipment are "spun off" to a hospital-physician joint venture run a serious risk of enhanced IRS scrutiny. 3. Transactions creating or providing new facilities or services should be more favorably perceived, particularly where participants other than the hospital take an active role in managing the venture. Where the hospital is the sole general partner and merely manages what it would have managed had there been no physician investors, the question of why physicians are involved will likely be of greater concern than it has been in the past.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. 75 FR 26794 - New United Motor Manufacturing, Inc., Formerly a Joint Venture of General Motors Corporation and...

    Science.gov (United States)

    2010-05-12

    ... Motor Manufacturing, Inc., Formerly a Joint Venture of General Motors Corporation and Toyota Motor... and Toyota Motor Corporation, including on-site leased workers from Corestaff, Fremont, California... assemble the Toyota Corolla and the Toyota Tacoma and used to assemble the Pontiac Vibe. The...

  3. Joint inversion of multiple geophysical and petrophysical data using generalized fuzzy clustering algorithms

    Science.gov (United States)

    Sun, Jiajia; Li, Yaoguo

    2017-02-01

    Joint inversion that simultaneously inverts multiple geophysical data sets to recover a common Earth model is increasingly being applied to exploration problems. Petrophysical data can serve as an effective constraint to link different physical property models in such inversions. There are two challenges, among others, associated with the petrophysical approach to joint inversion. One is related to the multimodality of petrophysical data because there often exist more than one relationship between different physical properties in a region of study. The other challenge arises from the fact that petrophysical relationships have different characteristics and can exhibit point, linear, quadratic, or exponential forms in a crossplot. The fuzzy c-means (FCM) clustering technique is effective in tackling the first challenge and has been applied successfully. We focus on the second challenge in this paper and develop a joint inversion method based on variations of the FCM clustering technique. To account for the specific shapes of petrophysical relationships, we introduce several different fuzzy clustering algorithms that are capable of handling different shapes of petrophysical relationships. We present two synthetic and one field data examples and demonstrate that, by choosing appropriate distance measures for the clustering component in the joint inversion algorithm, the proposed joint inversion method provides an effective means of handling common petrophysical situations we encounter in practice. The jointly inverted models have both enhanced structural similarity and increased petrophysical correlation, and better represent the subsurface in the spatial domain and the parameter domain of physical properties.

  4. Skin extensibility and consistency in patients with Ehlers-Danlos syndrome and benign joint hypermobility syndrome

    DEFF Research Database (Denmark)

    Remvig, L; Duhn, P H; Ullman, S

    2009-01-01

    methods. METHODS: Six EDS, 11 BJHS, and 19 controls completed the trial. We analysed the overall inter-examiner agreement on clinical tests for skin extensibility and consistency, in addition to analyses on suction cup (SC) and soft tissue stiffness meter (STSM) methods. RESULTS: Overall agreement...

  5. The emotional state in benign joint hypermobility syndrome and associated factors

    Directory of Open Access Journals (Sweden)

    Serda Em

    2014-12-01

    Full Text Available Objective: In this study, we aimed to investigate the difference of uric acid levels between metabolically healthy and unhealthy obese individuals. Methods: Patients of internal medicine and endocrinology outpatient clinics who admitted with the complaint of overweight were separated into two groups, by diagnostic criteria for metabolic syndrome, as metabolically healthy obese and metabolically unhealthy obese individuals. Total of 193 women aged between 18 to 70 years were enrolled into study. Results: Statistically significant differences were determined regarding waist circumference (p=0.038, HOMA-IR (p0.05 were not differ between these groups. When patients were separated into two groups according to uric acid median, the rate of metabolic syndrome found to be increased in high uric acid group (p=0.021. A correlation analysis showed that uric acid was significantly associated with number of metabolic syndrome parameters (r=0.270, p<0.001 beyond presence of metabolic syndrome. Conclusion: In the fact of determined relation of uric acid with the insulin resistance and significant difference of uric acid levels between metabolically healthy and non-healthy obese groups, uric acid can be considered as a cheap, accessible and sensitive parameter for metabolic syndrome and cardiovascular risk factor in obese individuals.

  6. Postpartum Postural Orthostatic Tachycardia Syndrome in a Patient with the Joint Hypermobility Syndrome

    Directory of Open Access Journals (Sweden)

    Khalil Kanjwal

    2009-01-01

    Full Text Available Postural orthostatic tachycardia syndrome (POTS commonly affects women of childbearing age. We report on a 37-year-old woman who developed symptoms of recurrent syncope in the postpartum period. Her head up tilt test and clinical presentation was consistent with POTS.

  7. Prevalence of Generalised Joint Hypermobility, Artralgia and Motor Competence in 10-year old school children

    DEFF Research Database (Denmark)

    Remvig, Lars; Kümmel, Christina; Halkjær-Kristensen, Jens

    2011-01-01

    on GJH cut level 4, 5, or 6, without significant motor competence difference between non-GJH and GJH children. Girls with GJH6 compared to non-GJH6 had insignificantly higher vertical jump height, and boys with GJH6 significantly shorter hand reaction time. In total, 108 Caucasian children answered...

  8. Lagrangian Dynamics of Open Multibody Systems with Generalized Holonomic and Nonholonomic Joints

    NARCIS (Netherlands)

    Duindam, Vincent; Stramigioli, Stefano

    2007-01-01

    Standard methods to model multibody systems are aimed at systems with configuration spaces isomorphic to Rn. This limitation leads to singularities and other artifacts in case the configuration space has a different topology, for example in the case of ball joints or a free-floating mechanism. This

  9. Design of joints in steel and composite structures Eurocode 3 : design of steel structures : part 1-8 : design of joints, Eurocode 4 : design of composite steel and concrete structures : part 1-1 : general rules and rules for buildings

    CERN Document Server

    Jaspart, Jean-Pierre

    2016-01-01

    This book details the basic concepts and the design rules included in Eurocode 3 Design of steel structures Part 1-8 Design of joints. Joints in composite construction are also addressed through references to Eurocode 4 Design of composite steel and concrete structures Part 1-1 General rules and rules for buildings. Attention has to be duly paid to the joints when designing a steel or composite structure, in terms of the global safety of the construction, and also in terms of the overall cost, including fabrication, transportation and erection. Therefore, in this book, the design of the joints themselves is widely detailed, and aspects of selection of joint configuration and integration of the joints into the analysis and the design process of the whole construction are also fully covered. Connections using mechanical fasteners, welded connections, simple joints, moment-resisting joints and lattice girder joints are considered. Various joint configurations are treated, including beam-to-column, beam-to-beam, ...

  10. Proprioceptive acuity assessment via joint position matching: from basic science to general practice.

    Science.gov (United States)

    Goble, Daniel J

    2010-08-01

    Over the past several decades, studies of use-dependent plasticity have demonstrated a critical role for proprioceptive feedback in the reorganization, and subsequent recovery, of neuromotor systems. As such, an increasing emphasis has been placed on tests of proprioceptive acuity in both the clinic and the laboratory. One test that has garnered particular interest is joint position matching, whereby individuals must replicate a reference joint angle in the absence of vision (ie, using proprioceptive information). On the surface, this test might seem straightforward in nature. However, the present perspective article informs therapists and researchers alike of multiple insights gained from a recent series of position matching studies by the author and colleagues. In particular, 5 factors are outlined that can assist clinicians in developing well-informed opinions regarding the outcomes of tests of position matching abilities. This information should allow for enhanced diagnosis of proprioceptive deficits within clinical settings in the future.

  11. Primary care approaches to musculoskeletal multiple-site joint pain pharmacological therapy: a survey of general practitioners.

    Science.gov (United States)

    Raja, Rafi; Kingsbury, Sarah R; Wise, Elspeth; Conaghan, Philip G

    2014-10-01

    Chronic multiple-site joint pain (MSJP) due to osteoarthritis and soft tissue disorders is common in people over 50 years old and associated with poor outcomes. This study examined current pharmacological approaches to MSJP management in primary care. One hundred and fifty general practitioners (GPs) attending an educational seminar participated in an electronic survey (mean response rate 96%). Most GPs reported treating multiple painful joints concurrently (78%) compared with focusing on a single joint (21%). The majority believed there was no difference in analgesia for different disorders when selecting paracetamol (84%), non-steroidal anti-inflammatory drugs (NSAID)/COX-2 inhibitors (57%) or opioids (70%). When optimising therapy, intra-class optimisation (increase NSAID dose 41%, change to another NSAID/COX-2 inhibitor 30%) was preferred to inter-class step up therapy (add opioid 23%, change to opioid 6%). For NSAID gastrointestinal intolerance, the preference was to add a gastro-protective agent (74%). There is a need to better characterise MSJP and examine optimal pharmacotherapy regimens.

  12. Hierarchical generalized linear models for multiple groups of rare and common variants: jointly estimating group and individual-variant effects.

    Directory of Open Access Journals (Sweden)

    Nengjun Yi

    2011-12-01

    Full Text Available Complex diseases and traits are likely influenced by many common and rare genetic variants and environmental factors. Detecting disease susceptibility variants is a challenging task, especially when their frequencies are low and/or their effects are small or moderate. We propose here a comprehensive hierarchical generalized linear model framework for simultaneously analyzing multiple groups of rare and common variants and relevant covariates. The proposed hierarchical generalized linear models introduce a group effect and a genetic score (i.e., a linear combination of main-effect predictors for genetic variants for each group of variants, and jointly they estimate the group effects and the weights of the genetic scores. This framework includes various previous methods as special cases, and it can effectively deal with both risk and protective variants in a group and can simultaneously estimate the cumulative contribution of multiple variants and their relative importance. Our computational strategy is based on extending the standard procedure for fitting generalized linear models in the statistical software R to the proposed hierarchical models, leading to the development of stable and flexible tools. The methods are illustrated with sequence data in gene ANGPTL4 from the Dallas Heart Study. The performance of the proposed procedures is further assessed via simulation studies. The methods are implemented in a freely available R package BhGLM (http://www.ssg.uab.edu/bhglm/.

  13. Hierarchical Generalized Linear Models for Multiple Groups of Rare and Common Variants: Jointly Estimating Group and Individual-Variant Effects

    Science.gov (United States)

    Yi, Nengjun; Liu, Nianjun; Zhi, Degui; Li, Jun

    2011-01-01

    Complex diseases and traits are likely influenced by many common and rare genetic variants and environmental factors. Detecting disease susceptibility variants is a challenging task, especially when their frequencies are low and/or their effects are small or moderate. We propose here a comprehensive hierarchical generalized linear model framework for simultaneously analyzing multiple groups of rare and common variants and relevant covariates. The proposed hierarchical generalized linear models introduce a group effect and a genetic score (i.e., a linear combination of main-effect predictors for genetic variants) for each group of variants, and jointly they estimate the group effects and the weights of the genetic scores. This framework includes various previous methods as special cases, and it can effectively deal with both risk and protective variants in a group and can simultaneously estimate the cumulative contribution of multiple variants and their relative importance. Our computational strategy is based on extending the standard procedure for fitting generalized linear models in the statistical software R to the proposed hierarchical models, leading to the development of stable and flexible tools. The methods are illustrated with sequence data in gene ANGPTL4 from the Dallas Heart Study. The performance of the proposed procedures is further assessed via simulation studies. The methods are implemented in a freely available R package BhGLM (http://www.ssg.uab.edu/bhglm/). PMID:22144906

  14. Interface Management between General Practitioners and Rheumatologists-Results of a Survey Defining a Concept for Future Joint Recommendations.

    Directory of Open Access Journals (Sweden)

    Rudolf Puchner

    Full Text Available To measure the views of general practitioners (GPs and rheumatologists in a nationwide evaluation, so as to optimise their cooperation in managing patients with inflammatory rheumatic diseases.A questionnaire covering aspects of collaboration was sent, both by mail and/or by email, to all GPs and rheumatologists in Austria. Topics covered were (i examinations and interventions to be performed before referral, (ii the spectrum of diseases to be referred, and (iii the role of GPs in follow-up and continuous management of patients.1,229 GPs of the 4,016 GPs (31% and 110 of the 180 rheumatologists (61% responded to the questionnaire. In cases of suspected arthritis, 99% of the GPs and 92% of the rheumatologists recommended specific laboratory tests, and 92% and 70%, respectively, recommended X-rays of affected joints before referral. Rheumatoid arthritis and spondyloarthritis, psoriatic arthritis and connective tissue disease were unanimously seen as indications for referral to a rheumatologist. Only 12% of rheumatologists felt responsible for the treatment of hand osteoarthritis and fibromyalgia. 80% of GPs and 85% of rheumatologists were of the opinion that treatment with disease-modifying drugs should be initiated by a specialist. Subsequent drug prescription and administration by GPs was supported by a majority of GPs and rheumatologists, with a concomitant rheumatologist follow-up every three to six months.The considerable consensus between the two professional groups constitutes a solid base for future joint recommendations, with the aim to accelerate the diagnostic process and the initiation of adequate therapy.

  15. Hospital Discharge Information After Elective Total hip or knee Joint Replacement Surgery: A clinical Audit of preferences among general practitioners

    Directory of Open Access Journals (Sweden)

    Andrew M Briggs

    2012-05-01

    Full Text Available AbstractThe demand for elective joint replacement (EJR surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee. GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale. Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate. All discharge information options were ranked as ‘essential’ by a proportion of respondents, ranging from 14.8–88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as ‘useful’ information (47.5–56.7%. GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff

  16. Working out of generalized dynamic model of cargo fixation with cargo pads jointly with flexible and thrust elements under the action spatial force system

    Directory of Open Access Journals (Sweden)

    Khabibulla TURANOV

    2011-01-01

    Full Text Available The article gives an account of the results of working out a generalized dynamic model of fixation of cargo with pads jointly with flexible and thrust elements. Working out a generalized dynamic model of cargo fixation is rather a complicated problem not in the sense of solving differential equations systems but in the sense of presenting them as a complex mechanical system “cargo – pads – flexible elements – thrust bars”. Generalized dynamic model of cargo with pads observed that this model represents technology of joint work of flexible and thrust fastening means of cargo on rolling stock. In particular, on the basis of this model there can be obtained the technology models of joint work of flexible and elastic fastening means of cargo without pads of fastening flexible elements of cargo with pads without thrust bars and also flexible fastening elements of cargo without pads and thrust bars at asymmetrical and/or symmetrical allocation of cargo in the wagon. A specific feature (novelty feature of the proposed dynamic model is inclusion into the model of both cargo pads and thrust bars which are nailed to the wagon floor close to the butt and lateral sides of cargo.

  17. Measuring Regularity of Human Postural Sway Using Approximate Entropy and Sample Entropy in Patients with Ehlers-Danlos Syndrome Hypermobility Type

    Science.gov (United States)

    Rigoldi, Chiara; Cimolin, Veronica; Camerota, Filippo; Celletti, Claudia; Albertini, Giorgio; Mainardi, Luca; Galli, Manuela

    2013-01-01

    Ligament laxity in Ehlers-Danlos syndrome hypermobility type (EDS-HT) patients can influence the intrinsic information about posture and movement and can have a negative effect on the appropriateness of postural reactions. Several measures have been proposed in literature to describe the planar migration of CoP over the base of support, and the…

  18. Inter-rater reliability for measurement of passive physiological movements in lower extremity joints is generally low: a systematic review

    NARCIS (Netherlands)

    E. van Trijffel; R.J. van de Pol; R.A. Oostendorp; C. Lucas

    2010-01-01

    Question: What is the inter-rater reliability for measurements of passive physiological or accessory movements in lower extremity joints? Design: Systematic review of studies of inter-rater reliability. Participants: Individuals with and without lower extremity disorders. Outcome measures: Range of

  19. Inter-rater reliability for measurement of passive physiological movements in lower extremity joints is generally low: a systematic review.

    NARCIS (Netherlands)

    Trijffel, E. van; Pol, R.J. van de; Oostendorp, R.A.B.; Lucas, C.

    2010-01-01

    QUESTION: What is the inter-rater reliability for measurements of passive physiological or accessory movements in lower extremity joints? DESIGN: Systematic review of studies of inter-rater reliability. PARTICIPANTS: Individuals with and without lower extremity disorders. OUTCOME MEASURES: Range of

  20. Human bones obtained from routine joint replacement surgery as a tool for studies of plutonium, americium and {sup 90}Sr body-burden in general public

    Energy Technology Data Exchange (ETDEWEB)

    Mietelski, Jerzy W., E-mail: jerzy.mietelski@ifj.edu.pl [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Edward B. [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Department of Physical Therapy Basics, Faculty of Physical Therapy, Administration College, Bielsko-Biala (Poland); Tomankiewicz, Ewa [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Joanna [Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Nowak, Sebastian [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Szczygiel, Elzbieta [Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Brudecki, Kamil [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland)

    2011-06-15

    The paper presents a new sampling method for studying in-body radioactive contamination by bone-seeking radionuclides such as {sup 90}Sr, {sup 239+240}Pu, {sup 238}Pu, {sup 241}Am and selected gamma-emitters, in human bones. The presented results were obtained for samples retrieved from routine surgeries, namely knee or hip joints replacements with implants, performed on individuals from Southern Poland. This allowed to collect representative sets of general public samples. The applied analytical radiochemical procedure for bone matrix is described in details. Due to low concentrations of {sup 238}Pu the ratio of Pu isotopes which might be used for Pu source identification is obtained only as upper limits other then global fallout (for example Chernobyl) origin of Pu. Calculated concentrations of radioisotopes are comparable to the existing data from post-mortem studies on human bones retrieved from autopsy or exhumations. Human bones removed during knee or hip joint surgery provide a simple and ethical way for obtaining samples for plutonium, americium and {sup 90}Sr in-body contamination studies in general public. - Highlights: > Surgery for joint replacement as novel sampling method for studying in-body radioactive contamination. > Proposed way of sampling is not causing ethic doubts. > It is a convenient way of collecting human bone samples from global population. > The applied analytical radiochemical procedure for bone matrix is described in details. > The opposite patient age correlations trends were found for 90Sr (negative) and Pu, Am (positive).

  1. A comparative study of generalized linear mixed modelling and artificial neural network approach for the joint modelling of survival and incidence of Dengue patients in Sri Lanka

    Science.gov (United States)

    Hapugoda, J. C.; Sooriyarachchi, M. R.

    2017-09-01

    Survival time of patients with a disease and the incidence of that particular disease (count) is frequently observed in medical studies with the data of a clustered nature. In many cases, though, the survival times and the count can be correlated in a way that, diseases that occur rarely could have shorter survival times or vice versa. Due to this fact, joint modelling of these two variables will provide interesting and certainly improved results than modelling these separately. Authors have previously proposed a methodology using Generalized Linear Mixed Models (GLMM) by joining the Discrete Time Hazard model with the Poisson Regression model to jointly model survival and count model. As Aritificial Neural Network (ANN) has become a most powerful computational tool to model complex non-linear systems, it was proposed to develop a new joint model of survival and count of Dengue patients of Sri Lanka by using that approach. Thus, the objective of this study is to develop a model using ANN approach and compare the results with the previously developed GLMM model. As the response variables are continuous in nature, Generalized Regression Neural Network (GRNN) approach was adopted to model the data. To compare the model fit, measures such as root mean square error (RMSE), absolute mean error (AME) and correlation coefficient (R) were used. The measures indicate the GRNN model fits the data better than the GLMM model.

  2. Chondrocyte Deformations as a Function of Tibiofemoral Joint Loading Predicted by a Generalized High-Throughput Pipeline of Multi-Scale Simulations

    Science.gov (United States)

    Sibole, Scott C.; Erdemir, Ahmet

    2012-01-01

    Cells of the musculoskeletal system are known to respond to mechanical loading and chondrocytes within the cartilage are not an exception. However, understanding how joint level loads relate to cell level deformations, e.g. in the cartilage, is not a straightforward task. In this study, a multi-scale analysis pipeline was implemented to post-process the results of a macro-scale finite element (FE) tibiofemoral joint model to provide joint mechanics based displacement boundary conditions to micro-scale cellular FE models of the cartilage, for the purpose of characterizing chondrocyte deformations in relation to tibiofemoral joint loading. It was possible to identify the load distribution within the knee among its tissue structures and ultimately within the cartilage among its extracellular matrix, pericellular environment and resident chondrocytes. Various cellular deformation metrics (aspect ratio change, volumetric strain, cellular effective strain and maximum shear strain) were calculated. To illustrate further utility of this multi-scale modeling pipeline, two micro-scale cartilage constructs were considered: an idealized single cell at the centroid of a 100×100×100 μm block commonly used in past research studies, and an anatomically based (11 cell model of the same volume) representation of the middle zone of tibiofemoral cartilage. In both cases, chondrocytes experienced amplified deformations compared to those at the macro-scale, predicted by simulating one body weight compressive loading on the tibiofemoral joint. In the 11 cell case, all cells experienced less deformation than the single cell case, and also exhibited a larger variance in deformation compared to other cells residing in the same block. The coupling method proved to be highly scalable due to micro-scale model independence that allowed for exploitation of distributed memory computing architecture. The method’s generalized nature also allows for substitution of any macro-scale and/or micro

  3. Chondrocyte deformations as a function of tibiofemoral joint loading predicted by a generalized high-throughput pipeline of multi-scale simulations.

    Directory of Open Access Journals (Sweden)

    Scott C Sibole

    Full Text Available Cells of the musculoskeletal system are known to respond to mechanical loading and chondrocytes within the cartilage are not an exception. However, understanding how joint level loads relate to cell level deformations, e.g. in the cartilage, is not a straightforward task. In this study, a multi-scale analysis pipeline was implemented to post-process the results of a macro-scale finite element (FE tibiofemoral joint model to provide joint mechanics based displacement boundary conditions to micro-scale cellular FE models of the cartilage, for the purpose of characterizing chondrocyte deformations in relation to tibiofemoral joint loading. It was possible to identify the load distribution within the knee among its tissue structures and ultimately within the cartilage among its extracellular matrix, pericellular environment and resident chondrocytes. Various cellular deformation metrics (aspect ratio change, volumetric strain, cellular effective strain and maximum shear strain were calculated. To illustrate further utility of this multi-scale modeling pipeline, two micro-scale cartilage constructs were considered: an idealized single cell at the centroid of a 100×100×100 μm block commonly used in past research studies, and an anatomically based (11 cell model of the same volume representation of the middle zone of tibiofemoral cartilage. In both cases, chondrocytes experienced amplified deformations compared to those at the macro-scale, predicted by simulating one body weight compressive loading on the tibiofemoral joint. In the 11 cell case, all cells experienced less deformation than the single cell case, and also exhibited a larger variance in deformation compared to other cells residing in the same block. The coupling method proved to be highly scalable due to micro-scale model independence that allowed for exploitation of distributed memory computing architecture. The method's generalized nature also allows for substitution of any macro

  4. Joint Distribution of Compound Generalized Poisson Process%复合广义Poisson风险过程的三特征联合分布函数

    Institute of Scientific and Technical Information of China (English)

    刘文震; 王传玉

    2012-01-01

    A risk process for life risk model is probed, where the arrival of the claim is generalized Poisson process. Expressions for the joint distribution function of the time of ruin, the surplus immediately before ruin and the deficit at ruin are obtained. At last, the display expression of ruin probability by using the joint distribution function, when the arrival of the claim is exponential distribution, is also obtained.%研究索赔到达为广义Poisson过程的风险模型.推导出关于破产时间、破产瞬间前的余额、破产赤字三特征的联合分布函数表达式.得到索赔到达服从指数分布时三特征联合分布函数的显式表达式.

  5. General joint frailty model for recurrent event data with a dependent terminal event: Application to follicular lymphoma data.

    Science.gov (United States)

    Mazroui, Yassin; Mathoulin-Pelissier, Simone; Soubeyran, Pierre; Rondeau, Virginie

    2012-05-20

    Many biomedical studies focus on delaying disease relapses and on prolonging survival. Usual methods only consider one event, often the first recurrence or death. However, ignoring the other recurrences may lead to biased results. The whole history of the disease should be considered for each patient. In addition, some diseases involve recurrences that can increase the risk of death. In this case, the death time may be dependent on the recurrent event history. We propose a joint frailty model to analyze recurrences and death simultaneously. Two gamma-distributed frailties take into account both the inter-recurrences dependence and the dependence between the recurrences and the survival times. We estimate separate parameters for disease recurrent event times and survival times in the joint frailty model to distinguish treatment effects and prognostic factors on these two types of events. We show how maximum penalized likelihood estimation can be applied to semiparametric estimation of the continuous hazard functions in the proposed joint frailty model with right censoring. We also propose parametrical approach. We evaluate the model by simulation studies and illustrate through a study of patients with follicular lymphoma.

  6. 76 FR 10396 - New United Motor Manufacturing, Inc., Formerly a Joint Venture of General Motors Corporation and...

    Science.gov (United States)

    2011-02-24

    ... General Motors Corporation and Toyota Motor Corporation, Including On- Site Leased Workers From Corestaff, ABM Janitorial, Toyota Engineering and Manufacturing North America, NPA Coatings, Inc., Premier... of General Motors Corporation and Toyota Motor Corporation, including on-site leased workers...

  7. Chronic pain in a patient with Ehlers-Danlos syndrome (hypermobility type): The role of myofascial trigger point injections.

    Science.gov (United States)

    Tewari, Saipriya; Madabushi, Rajashree; Agarwal, Anil; Gautam, Sujeet K; Khuba, Sandeep

    2017-01-01

    Chronic widespread musculoskeletal pain is a cardinal symptom in hypermobility type of Ehler Danlos Syndrome (EDS type III). The management of pain in EDS, however, has not been studied in depth. A 30 year old female, known case of EDS, presented to the pain clinic with complaints of severe upper back pain for 6 months. Physical examination of the back revealed two myofascial trigger points over the left rhomboids and the left erector spinae. Local anaesthetic trigger point injections were given at these points, followed by stretching exercises under analgesic cover for the first week. After 1 week the patient reported 60-80% pain relief. This case highlights that we must keep a high index of suspicion for the more treatable causes of pain like myofascial pain syndrome in patients suffering from EDS, and should address it promptly and appropriately in order to maximise patient comfort. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, L; Duhn, Ph; Ullman, S

    2010-01-01

    The criteria for Ehlers-Danlos syndrome (EDS) and the hypermobility syndrome (HMS) should be reliable. Examination for general joint hypermobility has high reliability but there is only sparse information on the reliability of skin tests, and no information on the level of normal skin extensibility...

  9. 75 FR 28656 - New United Motor Manufacturing, Inc., Formerly a Joint Venture of General Motors Corporation, and...

    Science.gov (United States)

    2010-05-21

    ... General Motors Corporation, and Toyota Motor Corporation, Including On- Site Leased Workers From Corestaff, ABM Janitorial, and Toyota Engineering and Manufacturing North America, Fremont, CA; Amended... and Toyota Motor Corporation, including on-site leased workers from Corestaff and ABM...

  10. Elastic fiber abnormalities in hypermobility type Ehlers-Danlos syndrome patients with tenascin-X mutations.

    NARCIS (Netherlands)

    Zweers, M.C.; Dean, W.B.; Kuppevelt, A.H.M.S.M. van; Bristow, J.; Schalkwijk, J.

    2005-01-01

    Ehlers-Danlos syndrome (EDS) is a heterogeneous group of connective tissue disorders with characteristic skin and joint involvement. The concept that EDS is a disease of fibrillar collagen was challenged by the identification of a clinically distinct, recessive type of EDS caused by deficiency of th

  11. Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

    Institute of Scientific and Technical Information of China (English)

    Katarzyna; Jadwiga; Macura; Richard; Eugene; Thompson; David; Alan; Bluemke; Rene; Genadry

    2015-01-01

    AIM: To define the magnetic resonance imaging(MRI) parameters differentiating urethral hypermobility(UH) and intrinsic sphincter deficiency(ISD) in women with stress urinary incontinence(SUI).METHODS: The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic(UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the highresolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI. For the functional imaging of the urethral support, we performed dynamic MRI with the pelvic phased array coil. We assessed the following MRI parameters in both the patient and thevolunteer groups:(1) urethral angle;(2) bladder neck descent;(3) status of the periurethral ligaments,(4) vaginal shape;(5) urethral sphincter integrity, length and muscle thickness at mid urethra;(6) bladder neck funneling;(7) status of the puborectalis muscle;(8) pubo-vaginal distance. UDs parameters were assessed in the patient study group as follows:(1) urethral mobility angle on Q-tip test;(2) Valsalva leak point pressure(VLPP) measured at 250 cc bladder volume; and(3) maximum urethral closure pressure(MUCP). The UH type of SUI was defined with the Q-tip test angle over 30 degrees, and VLPP pressure over 60 cm H2 O. The ISD incontinence was defined with MUCP pressure below 20 cm H2 O, and VLPP pressure less or equal to 60 cm H2 O. We considered the associations between the MRI and clinical data and UDs using a variety of statistical tools to include linear regression, multivariate logistic regression and receiver operating characteristic(ROC) analysis. All statistical analyses were performed using STATA version 9.0(Stata Corp LP, College Station, TX).RESULTS: In the incontinent group, 52% have history of vaginal delivery trauma as compared to none in control group(P < 0.001). There was no difference between the continent volunteers and incontinent

  12. Application of a generalized likelihood function for parameter inference of a carbon balance model using multiple, joint constraints

    Science.gov (United States)

    Hammerle, Albin; Wohlfahrt, Georg; Schoups, Gerrit

    2014-05-01

    Advances in automated data collection systems enabled ecologists to collect enormous amounts of varied data. Data assimilation (or data model synthesis) is one way to make sense of this mass of data. Given a process model designed to learn about ecological processes these data can be integrated within a statistical framework for data interpretation and extrapolation. Results of such a data assimilation framework clearly depend on the information content of the observed data, on the associated uncertainties (data uncertainties, model structural uncertainties and parameter uncertainties) and underlying assumptions. Parameter estimation is usually done by minimizing a simple least squares objective function with respect to the model parameters - presuming Gaussian, independent and homoscedastic errors (formal approach). Recent contributions to the (ecological) literature, however, have questioned the validity of this approach when confronted with significant errors and uncertainty in the model forcing (inputs) and model structure. Very often residual errors are non-Gaussian, correlated and heteroscedastic. Thus these error sources have to be considered and residual-errors have to be described in a statistically correct fashion order to draw statistically sound conclusions about parameter- and model predictive-uncertainties. We examined the effects of a generalized likelihood (GL) function on the parameter estimation of a carbon balance model. Compared with the formal approach, the GL function allows for correlation, non-stationarity and non-normality of model residuals. Carbon model parameters have been constrained using three different datasets, each of them modelled by its own GL function. As shown in literature the use of different datasets for parameter estimation reduces the uncertainty in model parameters and model predictions and does allow for a better quantification and for more insights into model processes.

  13. Paralyse af nervus peroneus hos patient med Ehlers-Danlos syndrom

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid; Skov, Ole

    2011-01-01

    Ehlers-Danlos syndrome (EDS) is a hereditary generalized connective tissue disorder characterized by skin hyperextensibility, joint hypermobility and tissue fragility. Peripheral neuropathy is described sporadically. Although the exact mechanism of the neuropathy is not well-known, excessive...

  14. Joint inversion of GPS, InSAR and teleseismic data sets for the rupture process of the 2015 Gorkha, Nepal, earthquake using a generalized ABIC method

    Science.gov (United States)

    Yi, Lei; Xu, Caijun; Zhang, Xu; Wen, Yangmao; Jiang, Guoyan; Li, Mengkui; Wang, Yuebin

    2017-10-01

    Various observations are made to invert for the source model of the 2015 Gorkha earthquake. Previously published slip models involve different slip distributions and slip amplitudes. To obtain a robust model, we jointly invert for the rupture process of the Gorkha earthquake using three types of observations: Global Positioning System (GPS), Interferometric Synthetic Aperture Radar (InSAR), and teleseismic P wave data. Three constraints (i.e., spatial and temporal smoothness and minimum moment constraints) are applied to regulate the rupture process. The weight ratios between data sets and prior constraints are determined from a new developed generalized Akaike's Bayesian Information Criterion (gABIC) weight determination method. This gABIC method can simultaneously and objectively weigh various kinds of observations and prior constraints, rather than being limited to the two types in the traditional ABIC method. The inverted slip model reveals the seismic moment of the earthquake is 9.40 × 1020 N m released primarily in the first 60 s, equivalent to Mw 7.92. The rupture front propagates unilaterally along the strike direction and spreads in both the strike and dip directions. The slip distribution shows one large slip patch with two peaks along the strike direction with a maximum slip amplitude of approximately 7.6 m and identifies large slips (> 2 m) that occur in the updip section of the Main Himalayan Thrust (MHT) fault plane. Our results indicate that the released slip amplitude is larger than the accumulated slip amplitude since 1833, so the 2015 earthquake likely does not overlap with the 1833 earthquake.

  15. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  16. Joint swelling

    Science.gov (United States)

    ... chap 275. Raftery AT, Lim E, Ostor AJK. Joint disorders. In: Raftery AT, Lim E, Ostor AJK, eds. ... A.M. Editorial team. Related MedlinePlus Health Topics Joint Disorders Browse the Encyclopedia A.D.A.M., Inc. ...

  17. A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

    Directory of Open Access Journals (Sweden)

    Chiang Lu-May

    2006-04-01

    Full Text Available Abstract Background Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs and general practitioners (GPs in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. Methods Data are from the Joint Canada/U.S. Survey of Health (JCUSH, 2002–03, a random sample of adults in Canada (N = 3505 and the U.S. (N = 5183. Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios weighted to reflect the complex survey design were produced. Results Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. Conclusion Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and

  18. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)

    2009-01-01

    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  19. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)

    2009-01-01

    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  20. Hypermobility in Adolescent Athletes: Pain, Functional Ability, Quality of Life, and Musculoskeletal Injuries

    DEFF Research Database (Denmark)

    Schmidt, Heidi; Pedersen, Trine Lykke; Junge, Tina

    2017-01-01

    athletes, and to study the association of GJH with pain, function, HRQoL, and musculoskeletal injuries. Methods A total of 132 elite-level adolescent athletes (36 adolescent boys, 96 adolescent girls; mean ± SD age, 14.0 ± 0.9 years), including ballet dancers (n = 22), TeamGym gymnasts (n = 57), and team......-reported questionnaires, and part of physical performance was assessed by 4 postural-sway tests and 2 single-legged hop-for-distance tests. Results Overall prevalence rates for GJH4, GJH5, and GJH6 were 27.3%, 15.9%, and 6.8%, respectively, with a higher prevalence of GJH4 in ballet dancers (68.2%) and TeamGym gymnasts...... significantly larger center-of-pressure path length across sway tests. Conclusion For ballet dancers and TeamGym gymnasts, the prevalence of GJH4 was higher than that of team handball players. For ballet dancers, the prevalence of GJH5 and GJH6 was higher than that of team handball players and the general...

  1. Ceramic joints

    Science.gov (United States)

    Miller, Bradley J.; Patten, Jr., Donald O.

    1991-01-01

    Butt joints between materials having different coefficients of thermal expansion are prepared having a reduced probability of failure of stress facture. This is accomplished by narrowing/tapering the material having the lower coefficient of thermal expansion in a direction away from the joint interface and not joining the narrow-tapered surface to the material having the higher coefficient of thermal expansion.

  2. Utilities/industries joint study on seismic isolation systems for LWRs. Pt. 2; Observed behaviors of base-isolated general buildings under real earthquakes

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Takao; Sato, Shoji; Kato, Muneaki (Kansai Electric Power Co., Inc., Osaka (Japan))

    1991-06-01

    This paper describes the observed behavior of base-isolated buildings under real earthquake conditions. These buildings were constructed by five construction companies participating in the Joint Study on Seismic Isolation Systems for light-water reactors (LWRs). All the buildings are medium- or low-height buildings or reinforced-concrete structures with combinations of laminated rubber bearings or sliding bearings and various damping devices. (orig.).

  3. Temporomandibular Joint, Closed

    Science.gov (United States)

    ... Gallery > Oral Health > The Temporomandibular Joint, Closed The Temporomandibular Joint, Closed Main Content Title: The Temporomandibular Joint, Closed Description: The temporomandibular joint connects the lower ...

  4. Hypermobility in reproduction

    African Journals Online (AJOL)

    2006-02-17

    Feb 17, 2006 ... by a typical waddling gait. Symptoms usually ... All the sensations tend to worsen during .... has been shown that the average muscle power of the adductors amounts to 222 (±60) Newton (N), whereas most women with PPPP score below 150 N. The ... HM is common in young people, with an incidence of.

  5. Franchising, holding, joint venture, pool. Anglicismos en diccionarios generales españoles e italianos. Contraste con el diccionario especializado inglés

    OpenAIRE

    Gilarranz, Mar

    2012-01-01

    El presente trabajo tiene como objetivo estudiar el grado de permeabilidad que tienen nuestras lenguas, español e italiano, ante la entrada de anglicismos. Para esto observamos cómo queda reflejada la situación en los registros lexicográficos de ambas lenguas. Centramos nuestra atención en el análisis de las definiciones de cuatro entradas: franchising / franquicia, holding, joint venture y pool. Los lemas elegidos se refieren a formas de asociación empresarial que han adquirido gran d...

  6. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  7. Sacroiliac joint dysfunction in athletes.

    Science.gov (United States)

    Brolinson, P Gunnar; Kozar, Albert J; Cibor, Greg

    2003-02-01

    The sacroiliac (SI) joint is a common source of low back pain in the general population. Because it is the link between the lower extremities and the spine, it sustains even higher loads during athletic activity, predisposing athletes to a greater probability of joint dysfunction and pain. The diagnosis and treatment of SI joint dysfunction remains controversial, due to complex anatomy and biomechanics, and a lack of universally accepted nomenclature and terminology, consistently reliable clinical tests and imaging studies, and consistently effective treatments. This article clarifies these issues by presenting a model of SI joint anatomy and function, a systematic approach to the diagnosis of dysfunction, and a comprehensive treatment plan.

  8. Computational stability of human knee joint at early stance in Gait: Effects of muscle coactivity and anterior cruciate ligament deficiency.

    Science.gov (United States)

    Sharifi, M; Shirazi-Adl, A; Marouane, H

    2017-08-20

    As one of the most complex and vulnerable structures of body, the human knee joint should maintain dynamic equilibrium and stability in occupational and recreational activities. The evaluation of its stability and factors affecting it is vital in performance evaluation/enhancement, injury prevention and treatment managements. Knee stability often manifests itself by pain, hypermobility and giving-way sensations and is usually assessed by the passive joint laxity tests. Mechanical stability of both the human knee joint and the lower extremity at early stance periods of gait (0% and 5%) were quantified here for the first time using a hybrid musculoskeletal model of the lower extremity. The roles of muscle coactivity, simulated by setting minimum muscle activation at 0-10% levels and ACL deficiency, simulated by reducing ACL resistance by up to 85%, on the stability margin as well as joint biomechanics (contact/muscle/ligament forces) were investigated. Dynamic stability was analyzed using both linear buckling and perturbation approaches at the final deformed configurations in gait. The knee joint was much more stable at 0% stance than at 5% due to smaller ground reaction and contact forces. Muscle coactivity, when at lower intensities (knee joint at the heel strike. It also markedly diminishes forces in lateral hamstrings (by up to 39%) and contact forces on the lateral plateau (by up to 17%). Current work emphasizes the need for quantification of the lower extremity stability margin in gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. 46 CFR 385.38 - Joint funding.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Joint funding. 385.38 Section 385.38 Shipping MARITIME... AGREEMENTS REGULATIONS General Policies § 385.38 Joint funding. (a) Pursuant to section 10(c) of the Act, MarAd is authorized to participate in joint funded projects with other Federal agencies in any...

  10. 11 CFR 9034.8 - Joint fundraising.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Joint fundraising. 9034.8 Section 9034.8... MATCHING FUND ENTITLEMENTS § 9034.8 Joint fundraising. (a) General. Nothing in this section shall supersede... engage in joint fundraising with other candidates, political committees or unregistered committees...

  11. 14 CFR 399.37 - Joint fares.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Joint fares. 399.37 Section 399.37 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs § 399.37 Joint fares. There should be joint fares in all markets over...

  12. 关节型机器人通用仿真平台设计%Design of General Joint-Robot Simulator

    Institute of Scientific and Technical Information of China (English)

    苏豪; 薛方正

    2012-01-01

    In order to joint-robot conveni model is mixed by ent, D-H make structure verification, action planning and analysis work space about a hybrid model based design solution of joint-robot is presented. The hybrid model, graph model and ODE(Open Dynamic Engine) model. D-H parame- ters about links are used to be human-computer interfaces, to avoid ambiguity when D-H parameters are used for tree structure and closed-chains robots. D-H model is transformed to graph model to de- scribe the robot by the characteristic of arbitrariness of the connections between vertices, and finally traverse the graph and complete the simulation with ODE. A robot simulation platform based on pro- posed method is designed and realized with VS, and two simulation experiments about different robots are given. The experiment results prove the effectiveness of the presented methods.%为了方便地对关节型机器人进行结构验证、动作规划以及工作空间分析,提出了一种基于机器人混合模型的通用仿真平台设计方案。混合模型结合了机器人的D-H模型、图结构模型和ODE模型,以杆件的D-H参数作为平台人机交互接口。为克服D-H参数在描述树形或含闭链结构机器人上的歧义性问题,D-H模型被转化为图结构模型,利用图结构中顶点之间关系的任意性对机器人进行描述,最后遍历图结构模型并通过ODE引擎来完成仿真。在VS平台下实现了一个基于本方案的仿真平台,对2种不同类型的机器人进行了动作规划实验,验证了所提方案的有效性。

  13. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    Starting from Crenshaw´s point that antiracism often fails to interrogate patriarchy and that feminism often reproduces racist practices (1991: 1252), this paper asks: What are the theoretical reasons for believing that feminism and anti-racism can be regarded as fighting for the joint purpose of...

  14. Oxidative stress-induced DNA damage in the synovial cells of the temporomandibular joint in the rat.

    Science.gov (United States)

    Yamaza, T; Masuda, K F; Atsuta, I; Nishijima, K; Kido, M A; Tanaka, T

    2004-08-01

    Synovial hyperplasia is a feature of degenerative temporomandibular joint (TMJ) disease. However, the mechanism by which hyperplasia progresses in the TMJ is unknown. Based on the hypothesis that the oxidative stress generated by mechanical loading causes degenerative changes in the TMJ synovium, we investigated the generation of the highly reactive species, peroxynitrite, and the occurrence of DNA damage in the synovium. After condylar hypermobility of rat TMJs, a marker of peroxynitrite, nitrotyrosine, was localized to the nuclei and cytoplasm of the synovial lining cells and fibroblasts in synovitis-induced TMJ. DNA single-strand breaks were found in the nuclei of the synovial cells only after enzyme treatment, whereas DNA double-strand breaks were not detected. These findings indicate that condylar hypermovement induces the proliferation of synovial cells, and suggest that oxidative stress leads to the progression of synovial hyperplasia via DNA damage of the synovial cells in TMJs after mechanical loading.

  15. Doing the right thing without being told: joint effects of initiative climate and general self-efficacy on employee proactive customer service performance.

    Science.gov (United States)

    Raub, Steffen; Liao, Hui

    2012-05-01

    We developed and tested a cross-level model of the antecedents and outcomes of proactive customer service performance. Results from a field study of 900 frontline service employees and their supervisors in 74 establishments of a multinational hotel chain located in Europe, the Middle East, Africa, and Asia demonstrated measurement equivalence and suggested that, after controlling for service climate, initiative climate at the establishment level and general self-efficacy at the individual level predicted employee proactive customer service performance and interacted in a synergistic way. Results also showed that at the establishment level, controlling for service climate and collective general service performance, initiative climate was positively and indirectly associated with customer service satisfaction through the mediation of aggregated proactive customer service performance. We discuss important theoretical and practical implications of these findings. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  16. Proceedings of the AIAA/FAA Joint Symposium on General Aviation Systems Held in Ocean City, New Jersey on 11-12 April 1990

    Science.gov (United States)

    1990-05-01

    ALUMINUM COVER-•DE \\ A-357 AGED CAST ALUMINUM DE HOUSING A356 CAST ALUMINUM ROTOR A-357 AGED INVESTMENT CAST INVESTMENT CAST MODULAR IRON OR 174PH ASTM...the Fatigue Behavior 34 of Aluminum Lithium Alloys Ali Eftekhari / Jorge E. Talia Wichita State University * ETBE in General Aviation Aircraft...University ABSTRACT The principal objective of this research was to investigate paint removal by mechanical means, i.e., blasting, from aluminum structural

  17. Etiopathogenesis of disk displacement of the temporomandibular joint: a review of the mechanisms.

    Science.gov (United States)

    Manfredini, Daniele

    2009-01-01

    Disk displacement of the temporomandibular joint (TMJ) is a clinically important condition, showing a high prevalence in both patient and non-patient populations. Despite its clinical importance, there is incomplete understanding of the etiopathogenic mechanisms leading to disk displacement. A number of possible risk factors have been identified. This article analyzes the etiopathogenesis from both the clinical and the biomechanical viewpoints and also reviews the literature on the association between disk displacement and the main risk factors (i.e., trauma, altered disk shape and/or dynamic properties, occlusal abnormalities, steepness of the articular eminence, hyperactivity of the lateral pterygoid muscle, joint hypermobility, etc.). According to our interpretation of available data, an impairment of joint lubrication may be a common finding in cases of disk displacement, thus suggesting the need for future studies addressing both local and systemic neuroendocrine aspects influencing the friction coefficient of the TMJ. A full comprehension of the etiopathogenesis of disk displacement is far from being achieved, and clinicians must take into account this consideration when treating patients with temporomandibular disorders.

  18. Etiopathogenesis of disk displacement of the temporomandibular joint: A review of the mechanisms

    Directory of Open Access Journals (Sweden)

    Manfredini Daniele

    2009-01-01

    Full Text Available Disk displacement of the temporomandibular joint (TMJ is a clinically important condition, showing a high prevalence in both patient and non-patient populations. Despite its clinical importance, there is incomplete understanding of the etiopathogenic mechanisms leading to disk displacement. A number of possible risk factors have been identified. This article analyzes the etiopathogenesis from both the clinical and the biomechanical viewpoints and also reviews the literature on the association between disk displacement and the main risk factors (i.e., trauma, altered disk shape and/or dynamic properties, occlusal abnormalities, steepness of the articular eminence, hyperactivity of the lateral pterygoid muscle, joint hypermobility, etc.. According to our interpretation of available data, an impairment of joint lubrication may be a common finding in cases of disk displacement, thus suggesting the need for future studies addressing both local and systemic neuroendocrine aspects influencing the friction coefficient of the TMJ. A full comprehension of the etiopathogenesis of disk displacement is far from being achieved, and clinicians must take into account this consideration when treating patients with temporomandibular disorders.

  19. Bearing fault diagnosis under variable rotational speed via the joint application of windowed fractal dimension transform and generalized demodulation: A method free from prefiltering and resampling

    Science.gov (United States)

    Shi, Juanjuan; Liang, Ming; Guan, Yunpeng

    2016-02-01

    The conventional way for bearing fault diagnosis under variable rotational speed generally includes prefiltering, resampling based on shaft rotating frequency and order spectrum analysis. However, its application is confined by three major obstacles: a) knowledge-demanding parameter determination required by prefiltering, b) unavailable shaft rotating frequency for resampling as it is coupled with instantaneous fault characteristic frequency (IFCF) by a fault characteristic coefficient (FCC) which cannot be decided without knowing what fault actually exists, and c) complicated and error-prone resampling process. As such, we propose a new method to address these problems. The proposed method free from prefiltering and resampling mainly contains the following steps: a) extracting envelope by windowed fractal dimension (FD) transform, requiring no prefiltering, b) with the envelope signal, performing short time Fourier transform (STFT) to get a clear time frequency representation (TFR), from which the IFCF and the basic demodulator for generalized demodulation (GD) can be obtained, c) applying the generalized demodulation to the envelope signal with the current demodulator, converting the trajectory of the current time-frequency component into a linear path parallel to the time axis, d) frequency analyzing the demodulated signal, followed by searching the amplitude of the constant frequency where the linear path is situated. Updating demodulator via multiplying the basic demodulator by different real numbers (i.e., coefficient λ) and repeating the steps (c)-(d), the resampling-free order spectrum is then obtained. Based on the resulting spectrum, the final diagnosis decision can be made. The proposed method for its implementation on the example of simulated data is presented. Finally, experimental data are employed to validate the effectiveness of the proposed technique.

  20. Joint Control for Dummies*: An Elaboration of Lowenkron's Model of Joint (Stimulus) Control.

    Science.gov (United States)

    Sidener, David W

    2006-01-01

    The following paper describes Lowenkron's model of joint (stimulus) control. Joint control is described as a means of accounting for performances, especially generalized performances, for which a history of contingency control does not provide an adequate account. Examples are provided to illustrate instances in which joint control may facilitate performance of a task.

  1. Joint Control for Dummies: An Elaboration of Lowenkron's Model of Joint (Stimulus) Control

    Science.gov (United States)

    Sidener, David W.

    2006-01-01

    The following paper describes Lowenkron's model of joint (stimulus) control. Joint control is described as a means of accounting for performances, especially generalized performances, for which a history of contingency control does not provide an adequate account. Examples are provided to illustrate instances in which joint control may facilitate…

  2. 15 CFR 296.8 - Joint venture agreement.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Joint venture agreement. 296.8 Section... PROGRAM General § 296.8 Joint venture agreement. NIST shall not issue a TIP award to a joint venture and no costs shall be incurred under a TIP project by the joint venture members until such time as...

  3. "Fraud alert": joint venture arrangements.

    Science.gov (United States)

    Vipperman, R M

    1989-01-01

    The Office of Inspector General of the Department of Health and Human Services recently issued a special "Fraud Alert" identifying those characteristics of joint venture arrangements that it views as indicators of potentially unlawful activity. As discussed in this article, participants in joint ventures should examine their arrangements to see if one or more of the questionable features are present, and, if so, should take steps to eliminate them, to the extent possible.

  4. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    of anti-discrimination in Europe today? And what empirical evidence may be found for such a joint approach? The paper discusses how the contemporary EU context differs from the American context which prompted Crenshaw to raise the point about intersectionality, and it analyses documents and interviews...... from each of the two European umbrella organisations the European Women´s Lobby and the European Network against Racism, as well as a number of their national member organisations from across Europe, both within EU and non-EU member states....

  5. Temporomandibular joint reconstruction with total alloplastic joint replacement.

    Science.gov (United States)

    Jones, R H B

    2011-03-01

    This paper is a preliminary paper which presents the early findings of an ongoing prospective trial on the use of the TMJ Concepts and Biomet Lorenz total joint replacement systems for the reconstruction of the temporomandibular joint (TMJ). Total alloplastic replacement of the TMJ has become a viable option for many people who suffer from TMJ disease where surgical reconstruction is indicated. Degenerative joint diseases such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, TMJ ankylosis, malunited condylar fractures and tumours can be successfully treated using this technique. There are a number of TMJ prostheses available. Two of the joint replacement products, which have been found to be most reliable and have FDA approval in the United States, are the TMJ Concepts system and the Biomet Lorenz system, and for this reason they are being investigated in this study. This study presents the findings of seven patients with a total of 12 joint replacements using either the TMJ Concepts system or the Biomet Lorenz joint system. Two patients (3 joints) had the TMJ Concepts system and five patients (9 joints) had the Biomet Lorenz system. Although still early, the results were generally pleasing, with the longest replacement having been in position for three years and the most recent six months. The average postoperative mouth opening was 29.7 mm (range 25-35 mm) with an average pain score of 1.7 (range 0-3, minimum score of 0 and maximum 10). Complications were minimal and related to sensory disturbance to the lip in one patient and joint dislocation in two patients.

  6. Síndrome da hipermobilidade articular em jovem

    Directory of Open Access Journals (Sweden)

    Joana Neves

    2016-03-01

    We report the case of a 14 year old male patient, with chronic low back pain and generalized joint hypermobility. He also presented a marfanoid habitus, hand joint alterations and striae in the right dorsal region. He fulfilled the Brighton Criteria therefore, after excluding other connective tissue diseases, the diagnosis of JHS was established. JHS is an underestimated and underdiagnosed disease, and must be contemplated in front of musculoskeletal pain associated with generalized hypermobility. The authors describe this case highlighting the importance of looking for signs and symptoms which allow the earlier diagnosis and management.

  7. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to award him a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (Bldg. 500) from 17 March to 30 March 2008. Human Resources Department Tel. 73911

  8. Joint Advisory Appeals Board

    CERN Document Server

    2013-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a former member of the personnel, a beneficiary of the CERN Pension Fund, against the calculation of his pension in the framework of the Progressive Retirement Programme.   The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be available from 26 July to 11 August 2013 at the following link. HR Department Head Office

  9. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  10. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 26 May to 6 June 2008. Human Resources Department (73911)

  11. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2007-01-01

    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. The relevant documents will therefore be posted on the notice board of the Main building (Bldg. 60) from 24 September to 7 October 2007. Human Resources Department

  12. Joint Advisory Appeals Board

    CERN Document Server

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. These documents will therefore be posted on the notice board of the Main Building (Bldg. 60) from 21 January to 3 February 2008. Human Resources Department (73911)

  13. Joint Advisory Appeals Board

    CERN Document Server

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  14. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2006-01-01

    The Joint Advisory Appeals Board was convened to examine an appeal lodged by a member of the personnel with regard to advancement. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (No. 60) from 24 March to 10 April 2006. Human Resources Department Tel. 74128

  15. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Serge Peraire with regard to exceptional advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 17 to 31 May 2002. Human Resources Division Tel. 74128

  16. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Judith Igo-Kemenes concerning the application of procedures foreseen by Administrative Circular N§ 26 (Rev. 3). As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 6 to 20 June 2003. Human Resources Division Tel. 74128

  17. Joint Advisory Appeals Board

    CERN Multimedia

    2004-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Maria DIMOU with regard to a periodic one-step increase. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 30 April to 14 May 2004. Human Resources Department Tel. 74128

  18. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Aloïs Girardoz with regard to classification and advancement. As the appellant has not objected, the Board's report and the Director-General's decision will be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 15 to 29 August 2003. Human Resources Division Tel. 74128

  19. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Bertrand Nicquevert with regard to the non-resident allowance. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 29 November to 13 December 2002. Human Resources Division Tel. 74128

  20. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Jack Blanchard with regard to 'non recognition of specific functions'. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 12th to 26th April 2002. Human Resources Division Tel. 74128

  1. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Antonio Millich with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 27 September to 11 October 2002. Human Resources Division Tel. 74128

  2. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Poul Frandsen concerning his assimilation into the new career structure. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 13 to 24 January 2003. Human Resources Division Tel. 74128

  3. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Luc Vos with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 14 to 28 June 2002. Human Resources Division Tel. 74128

  4. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Personnel Division

    1999-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Joào Bento with regard to residential category. As the appellant has not objected, the recommendations of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article RÊVIÊ1.20 of the Staff Regulations.The relevant documents will therefore be posted on the notice boards of the Administration Building (N¡ 60) from 29 October to 12 November 1999.Personnel DivisionTel. 74128

  5. Joint Replacement (Finger and Wrist Joints)

    Science.gov (United States)

    ... artificial joint Damage to vessels, nerves or other structures in the region of the surgery Alternatives Some alternate procedures for treating arthritis include: Joint injections Oral medications such as aspirin or anti-inflammatory medicines Hand therapy exercises and ...

  6. 17th September 2010 - Signature of a joint declaration by CERN represented by Director-General R. Heuer and the Brazilian Centre for Physics Research (CBPF) represented by R. Shellard, witnessed by the Ambassador to the United Nations Office M. N. Farani Azevêdo, signing the guest book.

    CERN Multimedia

    Maximilien Brice

    2010-01-01

    17th September 2010 - Signature of a joint declaration by CERN represented by Director-General R. Heuer and the Brazilian Centre for Physics Research (CBPF) represented by R. Shellard, witnessed by the Ambassador to the United Nations Office M. N. Farani Azevêdo, signing the guest book.

  7. Professor Bakytzhan Abdiraiym Rector of the L. Gumilov Eurasian National University, Astana, Kazakhstan accompanied by Prof. Kairat Kuterbekov, Dr Bekzat Prmantayeva, Dr Kuralay Maksut with the Director-General, Dr Tadeusz Kurtyka, Adviser for Non-Member States, Mrs Julia Andreeva, Department of Information Technologies and Dr Nikolai Zimine, ATLAS Collaboration, Joint Institute for Nuclear Research, Dubna

    CERN Multimedia

    Maximilien Brice

    2011-01-01

    Professor Bakytzhan Abdiraiym Rector of the L. Gumilov Eurasian National University, Astana, Kazakhstan accompanied by Prof. Kairat Kuterbekov, Dr Bekzat Prmantayeva, Dr Kuralay Maksut with the Director-General, Dr Tadeusz Kurtyka, Adviser for Non-Member States, Mrs Julia Andreeva, Department of Information Technologies and Dr Nikolai Zimine, ATLAS Collaboration, Joint Institute for Nuclear Research, Dubna

  8. 23rd June 2010 - Australian Nuclear Science and Technology Organization Chief Executive Officer A. Paterson signing a Joint Statement of Intent and the guest book with CERN Director-General R. Heuer; in the ATLAS visitor centre and control room with Former Collaboration Spokesperson P. Jenni.

    CERN Document Server

    Maximilien Brice

    2010-01-01

    23rd June 2010 - Australian Nuclear Science and Technology Organization Chief Executive Officer A. Paterson signing a Joint Statement of Intent and the guest book with CERN Director-General R. Heuer; in the ATLAS visitor centre and control room with Former Collaboration Spokesperson P. Jenni.

  9. Spacesuit mobility knee joints

    Science.gov (United States)

    Vykukal, H. C. (Inventor)

    1979-01-01

    Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  10. Recreational facilities: a guide to recreational facilities in the East Coast Area Health Board

    LENUS (Irish Health Repository)

    2012-02-01

    OBJECTIVE: To determine whether persons with generalized joint hypermobility have an increased risk of lower limb joint injury during sport. DATA SOURCES: PubMed, CINAHL, EMBASE, and SportDiscus were searched through February 2009, without language restrictions, using terms related to risk; hip, ankle, and knee injuries; and joint instability. Reference lists of included studies and relevant reviews were searched by hand. STUDY SELECTION: Selection criteria were peer-reviewed studies with a prospective design that used an objective scale to measure generalized joint hypermobility; the participants were engaged in sport activity, and the injury data were quantitative and based on diagnosis by a health professional, were self-reported, or resulted in time lost to athletic participation. The studies were screened by 1 researcher and checked by a second. Study methods were independently assessed by 2 investigators using the 6-point scale for prognostic studies developed by Pengel. Disagreements were resolved through discussion. Of 4841 studies identified, 18 met inclusion criteria. Of these, 8 were included in random-effects meta-analyses. DATA EXTRACTION: The data extracted by 2 reviewers included participant and sport characteristics and details of joint hypermobility and injury measurements. More detailed data for 4 investigations were obtained from the study authors. Where possible, hypermobility was defined as >\\/=4 of 9 points on the British Society of Rheumatology Scale (BSRS). MAIN RESULTS: Lower limb joint injuries (3 studies, 1047 participants) occurred in 14% of participants. Using the BSRS of joint hypermobility, any lower limb injury was not associated with hypermobility [odds ratio (OR), 1.43; 95% confidence interval (CI), 0.56-3.67]. Using the original authors\\' definitions, hypermobility was associated with risk of knee joint injuries (OR, 2.62; 95% CI, 1.04-6.58) in 5 studies. In 4 studies in which the BSRS could be used (1167 participants; incidence

  11. International joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    2001-01-01

    The article analysis problems connected with corporate joint ventures. Among others the possible conflicts between the joint venture agreement and the statutes of the companies is examined, as well as certain problems connected to the fact that the joint venture partners have created commen control...... over their joint company....

  12. Joint Detect and Avoid Flight Testing

    Science.gov (United States)

    Maliska, Heather; Estrada, Ramon; Euteneuer, Eric; Gong, Chester; Arthur, Keith

    2015-01-01

    This presentation gives insight into a joint flight testing effort that included participation from NASA, Honeywell, and General Atomics. The presentation includes roles and responsibilities, test flow, and encounter requirements and summary.

  13. Deterministic joint remote state preparation

    Energy Technology Data Exchange (ETDEWEB)

    An, Nguyen Ba, E-mail: nban@iop.vast.ac.vn [Center for Theoretical Physics, Institute of Physics, 10 Dao Tan, Ba Dinh, Hanoi (Viet Nam); Bich, Cao Thi [Center for Theoretical Physics, Institute of Physics, 10 Dao Tan, Ba Dinh, Hanoi (Viet Nam); Physics Department, University of Education No. 1, 136 Xuan Thuy, Cau Giay, Hanoi (Viet Nam); Don, Nung Van [Center for Theoretical Physics, Institute of Physics, 10 Dao Tan, Ba Dinh, Hanoi (Viet Nam); Physics Department, Hanoi National University, 334 Nguyen Trai, Thanh Xuan, Hanoi (Viet Nam)

    2011-09-26

    We put forward a new nontrivial three-step strategy to execute joint remote state preparation via Einstein-Podolsky-Rosen pairs deterministically. At variance with all existing protocols, in ours the receiver contributes actively in both preparation and reconstruction steps, although he knows nothing about the quantum state to be prepared. -- Highlights: → Deterministic joint remote state preparation via EPR pairs is proposed. → Both general single- and two-qubit states are studied. → Differently from all existing protocols, in ours the receiver participates actively. → This is for the first time such a strategy is adopted.

  14. The Planar Shape of Rock Joints

    Science.gov (United States)

    Zhang, Lianyang; Einstein, Herbert H.

    2010-02-01

    Knowing the planar shape of discontinuities is important when characterizing discontinuities in a rock mass. However, the real discontinuity shape is rarely known, since the rock mass is usually inaccessible in three dimensions. Information on discontinuity shape is limited and often open to more than one interpretation. This paper discusses the planar shape of rock joints, the most common discontinuities in rock. First, a brief literature review about the shape of joints is presented, including some information on joint-surface morphology, inferences from observed trace lengths on different sampling planes, information based on experimental studies, and joint shapes assumed by different researchers. This review shows that joints not affected by adjacent geological structures such as bedding boundaries or pre-existing fractures tend to be elliptical (or approximately circular but rarely). Joints affected by or intersecting such geological structures tend to be rectangular. Then, using the general stereological relationship between trace length distributions and joint size distributions developed by Zhang et al. (Geotechnique 52(6):419-433, 2002) for elliptical joints, the effect of sampling plane orientation on trace lengths is investigated. This study explains why the average trace lengths of non-equidimensional (elliptical or similar polygonal) joints on two sampling planes can be about equal and thus the conclusion that rock joints are equidimensional (circular) drawn from the fact that the average trace lengths on two sampling planes are approximately equal can be wrong. Finally, methods for characterizing the shape and size of joints (elliptical or rectangular) from trace length data are recommended, and the appropriateness of using elliptical joint shapes to represent polygonal, especially rectangular, joints is discussed.

  15. 15 CFR 296.7 - Joint venture registration.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Joint venture registration. 296.7 Section 296.7 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL... PROGRAM General § 296.7 Joint venture registration. Joint ventures selected for assistance under...

  16. 26 CFR 1.6013-1 - Joint returns.

    Science.gov (United States)

    2010-04-01

    ...) INCOME TAXES Tax Returns Or Statements § 1.6013-1 Joint returns. (a) In general. (1) A husband and wife... income or deductions. For rules for determining whether individuals occupy the status of husband and wife... disaffirm a timely joint return made by the surviving spouse. (2) A joint return of a husband and wife...

  17. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Neil Calder, Mrs Sudeshna Datta Cockerill, Mrs Andrée Fontbonne, Mrs Moniek Laurent and Mr Ulrich Liptow with regard to membership in the Pension Fund under the period with a Paid Associate contract, appeals dealt with on a collective basis. As the appellants have not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 10 to 31 August 2001.

  18. Modeling of Human Joint Structures.

    Science.gov (United States)

    1982-09-01

    Radial Lateral " epicondyle Olecranon Radius Ulna Figure 3. Lateral aspect of the right elbow joint. -17- Annular Ligament This strong band encircles... elbow joint, knee joint, human joints, shoulder joint, ankle joint, joint models, hip joint, ligaments. 20. ABSTRACT (Continue on reverse side If...ligaments. -A rather extended discussion of the articulations and anatomical descriptions of the elbow , shoulder, hip, knee and ankle joints are

  19. Temporomandibular joint pain assessment.

    Science.gov (United States)

    Stegenga, B; de Bont, L G; Boering, G

    1993-01-01

    The aim of this study was to evaluate pain characteristics of patients with temporomandibular joint-related pain and propose a rationale for the assessment of pain and its impact on patients with temporomandibular disorders. Based on anamnestic information, the 88 patients in the sample were classified according to pain grade: (1) acute/subacute nonrecurrent or recurrent pain, n = 41 (46.6%); (2) persistently recurring pain in relatively high frequency, or nonsevere persistent pain, n = 32 (36.4%); (3) persistent and impairing pain, n = 8 (9.1%); (4) persistent and disabling pain, n = 7 (7.9%); and (5) persistent and handicapping pain, n = 0. Regarding TMJ pain provoked during the clinical examination, there was a significant difference among diagnostic subgroups, subgroups with different pain intensity levels, and pain grade subgroups, but no significant differences could be found based on the duration of the pain symptoms. Subgroups also did not significantly differ in scores on the Multi-dimensional Pain Inventory and the General Health Questionnaire. Based on the results of the study, the assessment of nonchronic TMJ pain may generally be limited to an accurate description of the pain complaint and thorough clinical assessment. Multidimensional assessment may be useful when the TMJ pain persists or is persistently recurring. Depending on individual circumstances, additional assessment procedures may prove to be useful. A general strategy for pain assessment in temporomandibular disorders is proposed.

  20. MP Joint Arthritis

    Science.gov (United States)

    ... Find a Hand Surgeon Home Anatomy MP Joint Arthritis Email to a friend * required fields From * To * ... important for both pinching and gripping. MP joint arthritis is most common in the thumb and index ...

  1. Culture - joint fluid

    Science.gov (United States)

    Joint fluid culture ... fungi, or viruses grow. This is called a culture. If these germs are detected, other tests may ... is no special preparation needed for the lab culture. How to prepare for the removal of joint ...

  2. Sacroiliac joint pain - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000610.htm Sacroiliac joint pain - aftercare To use the sharing features on this page, please enable JavaScript. The sacroiliac joint (SIJ) is a term used to describe the ...

  3. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  4. 论普通高校排球项目踝关节力量训练的重要性%On the Importance of Ankle Joint Strength Training in General Colleges and Universities' Volleyball Courses

    Institute of Scientific and Technical Information of China (English)

    杨枝创

    2012-01-01

    This paper illustrates the importance of strength training in ankle joints by analyzing the technical characteristics of volleyball with the help of analyzing the physiological structure and the motion features of ankle joint, and the reason for ankle jonits athletic injury.%分析了排球运动的技术特征,借助踝关节生理结构、运动特征及踝关节运动损伤的机制及原因分析,论述踝关节力量训练的重要性。

  5. [The Ehlers-Danlos syndrome: hystory of a clinical hendiadys].

    Science.gov (United States)

    Brazzaventre, Cristina; Celletti, Claudia; Gobattoni, Paolo; Santilli, Valter; Camerota, Filippo

    2013-01-01

    Ehlers-Danlos syndrome (EDS) is a clinically and genetically heterogeneous group of inherited connective tissue disorders characterized by joint hypermobility, skin hyperextensibility and tissue fragility, which results in easy bruising and abnormal scarring. The condition shows a phenotypic variance from milder to serious presentations. Complaints related to activity (hypermobility, dislocations, impaired balance), to pain (general pain, headache, jaw and tooth pain) and to skin (bruises, fragility, impaired wound healing) are frequent. It was first noted by Hippocrates in 400 BC in his writing 'Airs Water and Places' that the nomads Scythians had lax joints and multiple scars. Whereas the additional flexibility can give benefits in term of mobility and agility, adverse effects of tissue laxity and fragility can give rise to clinical consequences. We recognize that it is important that, in those hypermobility patients, who develop potentially debilitating symptoms of chronicfatigue or widespread pain, there should be prompt an appropriate intervention.

  6. Managing Joint Production Motivation

    DEFF Research Database (Denmark)

    Lindenberg, Siegwart; Foss, Nicolai Juul

    2011-01-01

    We contribute to the microfoundations of organizational performance by proffering the construct of joint production motivation. Under such motivational conditions individuals see themselves as part of a joint endeavor, each with his or her own roles and responsibilities; generate shared represent...... representations of actions and tasks; cognitively coordinate cooperation; and choose their own behaviors in terms of joint goals. Using goal-framing theory, we explain how motivation for joint production can be managed by cognitive/symbolic management and organizational design....

  7. Reliability of Tubular Joints

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    of the test is partly to obtain empirical data for the ultimate load-carrying capacity of tubular T-joints and partly to obtain some experience in performing tests with tubular joints. It is well known that tubular joints are usually designed in offshore engineering on the basis of empirical formulas obtained...

  8. Fractai Estimation of Joint Roughness Coefficients

    Institute of Scientific and Technical Information of China (English)

    谢和平; Willian G.Pariseau

    1994-01-01

    Based on the triadic Koch curve,a generalized fractal model of joint profiles is establishedto simulate joint roughness.The fractal dimension of a joint profile can be directly obtained from the two pa-rameters,L~* and h~*, the average base length and average height of asperities of the joint,respectively,i,e D=log4/log[2(1+cos tan~1(2h’/L’))]This fractal dimension is strongly correlated with the value of the joint roughness coefficient (JRC). An empirical relationship is found in the form,JRC=85.2671·(D-1)~0.5679 Thus, the fractal analysis proposed provides a new method of estimating JRC values

  9. Spinal sagittal mobility and joint laxity in young ballet dancers. A comparative study between first-year students at the Swedish Ballet School and a control group.

    Science.gov (United States)

    Nilsson, C; Wykman, A; Leanderson, J

    1993-01-01

    The present study compares spinal configuration, spinal range of motion and joint mobility in first-year students of the Swedish Ballet School and in nondancing students of corresponding age and sex in a state school. The study comprises all the first-year (fourth grade) students (n = 23) at the Swedish Ballet School: 11 boys and 12 girls. Their dance practice time was 10 h per week. Thirty-six children in the fourth grade at a state school comprised the control group. None of the controls took ballet classes or participated in organised gymnastics out of school. The neutral spine configuration in standing and the sagittal spine mobility were measured using Debrunner's kyphometer and Myrin's inclinometer. Joint laxity was measured by employing a modified form of the Contompasis method. Compared with the controls, the dancers showed a higher incidence of joint hypermobility, greater mobility of the thoracic spine, a less prominent lordosis of the lumbar spine and a less prominent kyphosis in the thoracic spine in the neutral standing position. The dancers had done little or no ballet training before entering the ballet school at the age of ten. The results agree with those of earlier studies and suggest that increased flexibility is an asset for those being selected as future ballet dancers.

  10. Clevis joint for deployable space structures

    Science.gov (United States)

    Rhodes, Marvin D. (Inventor)

    1990-01-01

    This invention relates generally to pin clevis joints, and more particularly, to zero play pin clevis joints for connecting structural members of a deployable space structure. A joint includes a pin, a tang, and a shackle. The pin is tapered at the same angle as the bores extending through the projections of the shackle and the tang. A spring washer biases the tang onto the tapered sidewall of the pin. The invention solves the free play problem associated with deployable space structures by using a tapered pin which is held in tapered holes by the spring washers.

  11. Sacroiliac joint involvement in psoriasis.

    Science.gov (United States)

    Kaçar, Cahit; Sezer, Ilhan; Kocabaş, Hilal; Cay, Hasan Fatih; Cevikol, Can; Alpsoy, Erkan; Melikoğlu, Meltem Alkan; Akman, Ayşe

    2010-07-01

    Psoriasis is a skin disorder that is associated with arthritis. Sacroiliac joint involvement is considered to be less frequent than the other types of psoriatic arthritis. Additionally, the psoriatic sacroiliitis is considered to be asymmetric in general. We aimed to define the frequency and type of sacroiliac involvement in patients with psoriasis. Patients with psoriasis were included the study. Characteristics of skin, nail and articular involvement were noted. Psoriasis area and severity index was calculated. Antero-posterior pelvic X-rays were obtained and graded by two rheumatologists and a radiologist independently. One hundred and thirty-three patients were included. Thirty-seven of patients (27%) have articular involvement symptomatically. The sacroiliac joint involvement was observed in 34 (26%) of patients. More than one-half of sacroiliac involvement was bilateral while less than one-half was in symptomatic patients regarding sacroiliitis. Fifty-seven percentages of all patients have psoriatic nail involvement. Sacroiliac joint involvement did not show any significant association with psoriatic nail involvement or the severity of skin disease. We found higher frequency of sacroiliac joint involvement and bilateral sacroiliitis in patients with psoriasis. This is in contrast to present information about the association of psoriasis and sacroiliitis. These findings need confirmation by further studies and with more sophisticated techniques such as magnetic resonance imaging.

  12. Joint Program Management Handbook

    Science.gov (United States)

    1994-12-01

    the Engieermg and Manufacuring Devopment Phase. Nfilestoae HI- Develommen Annros Devopment approval marks a significant step for any program, but it is...to review concept formulaton. Systems Engilneertn As with service programs, systems engineering in joint program management is an essential tool . I...MANAGEMENT HANDBOOK On=e wd Umawtaiutt As discussed in Chapter 7, systems analysis of relationships is a usef tool for joint program managers. The joint

  13. Jointly Poisson processes

    CERN Document Server

    Johnson, D H

    2009-01-01

    What constitutes jointly Poisson processes remains an unresolved issue. This report reviews the current state of the theory and indicates how the accepted but unproven model equals that resulting from the small time-interval limit of jointly Bernoulli processes. One intriguing consequence of these models is that jointly Poisson processes can only be positively correlated as measured by the correlation coefficient defined by cumulants of the probability generating functional.

  14. [Total temporomandibular joint prostheses].

    Science.gov (United States)

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Subtalar joint arthrodesis.

    Science.gov (United States)

    Lopez, Ramon; Singh, Tarika; Banga, Samantha; Hasan, Nafisa

    2012-01-01

    Isolated subtalar joint arthrodesis has gained popularity more recently. Research has shown that it preserves rearfoot motion, does not increase the risk of arthritis in adjacent joints, and is not an especially complex operative procedure. It decreases the chance of midtarsal joint nonunion and malunion postoperatively. This article takes an in-depth approach to isolated talocalcaneal fusions. Anatomy and biomechanics of the subtalar joint are reviewed. Clinical presentation and radiologic evaluation are discussed. Conservative treatment, operative technique, and postoperative management are included. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Sealed joint structure for electrochemical device

    Science.gov (United States)

    Tucker, Michael C; Jacobson, Craig P; De Jonghe, Lutgard C; Visco, Steven J

    2013-05-21

    Several members make up a joint in a high-temperature electrochemical device, wherein the various members perform different functions. The joint is useful for joining multiple cells (generally tubular modules) of an electrochemical device to produce a multi-cell segment-in-series stack for a solid oxide fuel cell, for instance. The joint includes sections that bond the joining members to each other; one or more seal sections that provide gas-tightness, and sections providing electrical connection and/or electrical insulation between the various joining members. A suitable joint configuration for an electrochemical device has a metal joint housing, a first porous electrode, a second porous electrode, separated from the first porous electrode by a solid electrolyte, and an insulating member disposed between the metal joint housing and the electrolyte and second electrode. One or more brazes structurally and electrically connects the first electrode to the metal joint housing and forms a gas tight seal between the first electrode and the second electrode.

  17. Mechanics of Sheeting Joints

    Science.gov (United States)

    Martel, S. J.

    2015-12-01

    Physical breakdown of rock across a broad scale spectrum involves fracturing. In many areas large fractures develop near the topographic surface, with sheeting joints being among the most impressive. Sheeting joints share many geometric, textural, and kinematic features with other joints (opening-mode fractures) but differ in that they are (a) discernibly curved, (b) open near the topographic surface, and (c) form subparallel to the topographic surface. Where sheeting joints are geologically young, the surface-parallel compressive stresses are typically several MPa or greater. Sheeting joints are best developed beneath domes, ridges, and saddles; they also are reported, albeit rarely, beneath valleys or bowls. A mechanism that accounts for all these associations has been sought for more than a century: neither erosion of overburden nor high lateral compressive stresses alone suffices. Sheeting joints are not accounted for by Mohr-Coulomb shear failure criteria. Principles of linear elastic fracture mechanics, together with the mechanical effect of a curved topographic surface, do provide a basis for understanding sheeting joint growth and the pattern sheeting joints form. Compressive stresses parallel to a singly or doubly convex topographic surface induce a tensile stress perpendicular to the surface at shallow depths; in some cases this alone could overcome the weight of overburden to open sheeting joints. If regional horizontal compressive stresses, augmented by thermal stresses, are an order of magnitude or so greater than a characteristic vertical stress that scales with topographic amplitude, then topographic stress perturbations can cause sheeting joints to open near the top of a ridge. This topographic effect can be augmented by pressure within sheeting joints arising from water, ice, or salt. Water pressure could be particularly important in helping drive sheeting joints downslope beneath valleys. Once sheeting joints have formed, the rock sheets between

  18. MR diagnosis of temporomandibular joint. A study of joint effusion

    Energy Technology Data Exchange (ETDEWEB)

    Kaneda, Takashi; Yamashiro, Mitsuaki; Ozawa, Kaoru; Suzuki, Hiromi; Okada, Hiroyuki; Yamamoto, Hirotsugu [Nihon Univ., Matsudo, Chiba (Japan). School of Dentistry

    1998-03-01

    The purposes of this study were to evaluate the relationship between correlation of MR joint effusion of the temporomandibular joint and disk position, to evaluate the relationship between joint effusion and aging, and to assess the frequency of MR joint effusion of bilateral temporomandibular joints. The temporomandibular joints of 192 patients with clinical symptoms of temporomandibular joint disorders were imaged bilaterally using high field, surface-coil MR imaging. Oblique sagittal and coronal proton density-weighted and T2-weighted images were obtained. Imaging findings of joint effusion were correlated with disk position, aging, and bilateral temporomandibular joints. MR showed effusion in 4% of the joints with normal superior disk position, 36% of the joints with disk displacement with reduction, and 45% of the joints with disk displacement without reduction. There were significant differences in the incidence of joint effusion between normal disk position and anterior disk displacement with or without reduction. Younger patients less than 40 years were significant higher the incidence of joint effusion than those of older patients. A significant association was seen between joint effusion and aging. MR showed effusion in 17% of the unilateral temporomandibular joint, 24% of the bilateral temporomandibular joints. There was no significant difference between unilateral and bilateral case. These results indicated that joint effusion using MR imaging was associated with varied temporomandibular joint pathologic states. (author)

  19. Creep of timber joints

    NARCIS (Netherlands)

    Van de Kuilen, J.W.G.

    2008-01-01

    A creep analysis has been performed on nailed, toothed-plates and split-ring joints in a varying uncontrolled climate. The load levels varied between 30% and 50% of the average ultimate short term strength of these joints, tested in accordance with ISO 6891. The climate in which the tests were

  20. Acromioclavicular Joint Separations

    Science.gov (United States)

    2013-01-01

    Published online: 16 December 2012 # Springer Science+Business Media New York 2012 Abstract Acromioclavicular (AC) joint separations are common...injuries. The sports most likely to cause AC joint dislocations are football, soccer , hockey, rugby, and skiing, among others [9, 28, 29]. The major cause

  1. Strategies for joint appointments.

    Science.gov (United States)

    Royle, J; Crooks, D L

    1985-01-01

    The structure and policies governing joint appointments discussed above, are developed primarily through cooperation and collaboration between nursing service and education institutions. The joint appointee participates in the process of negotiation of salary, benefits and role responsibilities and exploration of the implications of the appointment for personal career development. Implementation and maintenance of the appointment requires the collaborative efforts of the joint appointee with both contracting agencies. Factors influencing the functioning of joint appointees have been identified and strategies to facilitate functioning presented. The joint appointee must be independent in thought and action yet adaptable to work within the boundaries of two social systems with differing values and expectations. Nursing management, peers and students can provide the support needed to overcome the frustrations and to achieve the rewards inherent in successful implementation of an exciting and innovative role.

  2. CLASSIFICATION OF TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT .2. SPECIFIC DIAGNOSTIC-CRITERIA

    NARCIS (Netherlands)

    STEGENGA, B; DEBONT, LGM; BOERING, G

    1992-01-01

    Separate entities of temporomandibular joint osteoarthrosis and internal derangement are operationally defined. Criteria are based on an analysis of the diagnostic significance of symptoms and signs, principles of synovial joint pathology in general, and on therapeutic considerations. The primary go

  3. Guideline for bolted joint design and analysis : version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Kevin H.; Morrow, Charles W.; Durbin, Samuel; Baca, Allen

    2008-01-01

    This document provides general guidance for the design and analysis of bolted joint connections. An overview of the current methods used to analyze bolted joint connections is given. Several methods for the design and analysis of bolted joint connections are presented. Guidance is provided for general bolted joint design, computation of preload uncertainty and preload loss, and the calculation of the bolted joint factor of safety. Axial loads, shear loads, thermal loads, and thread tear out are used in factor of safety calculations. Additionally, limited guidance is provided for fatigue considerations. An overview of an associated Mathcad{copyright} Worksheet containing all bolted joint design formulae presented is also provided.

  4. Joint Robotics Program

    Science.gov (United States)

    2008-04-23

    Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= JOINT ROBOTICS PROGRAM Published: 23 April 2008 by Joel Brown and Paul Varian 5th Annual Acquisition Research...3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Joint Robotics Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...ëóåÉêÖó=Ñçê=áåÑçêãÉÇ=ÅÜ~åÖÉ=======- 464 - = = Joint Robotics Program Presenter: Joel Brown, Defense Acquisition University Author: Paul Varian

  5. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  6. Joints in steel buildings

    Directory of Open Access Journals (Sweden)

    Gabriel F. Valencia Clement

    2010-04-01

    Full Text Available Masonry and steel components used in constructing buildings are in a constant state of motion. Volumetric changes are produced by temperature variation and deformation resulting from static or dynamic loading and in some materials, such as masonry, due to moisture content. This article addresses means of determining when expansion and seismic joints are required and how to proportion and design appropriate joints, specifically in steel buildings. It does not cover the study of expansion joints in concrete structures, in masonry construction or in non-structural (architectural elements.

  7. A joint venture in providing home care and community service.

    Science.gov (United States)

    Reifsteck, S

    1987-01-01

    General discussion of a joint venture providing home care and community service including future possibilities, business and financial aspects and demand is presented. The author then provides a group practice joint venture model including descriptions of operating structure, contract arrangements and management.

  8. Nonlinear transient analysis of joint dominated structures

    Science.gov (United States)

    Chapman, J. M.; Shaw, F. H.; Russell, W. C.

    1987-01-01

    A residual force technique is presented that can perform the transient analyses of large, flexible, and joint dominated structures. The technique permits substantial size reduction in the number of degrees of freedom describing the nonlinear structural models and can account for such nonlinear joint phenomena as free-play and hysteresis. In general, joints can have arbitrary force-state map representations but these are used in the form of residual force maps. One essential feature of the technique is to replace the arbitrary force-state maps describing the nonlinear joints with residual force maps describing the truss links. The main advantage of this replacement is that the incrementally small relative displacements and velocities across a joint are not monitored directly thereby avoiding numerical difficulties. Instead, very small and 'soft' residual forces are defined giving a numerically attractive form for the equations of motion and thereby permitting numerically stable integration algorithms. The technique was successfully applied to the transient analyses of a large 58 bay, 60 meter truss having nonlinear joints. A method to perform link testing is also presented.

  9. 29 CFR 570.115 - Joint applicability.

    Science.gov (United States)

    2010-07-01

    ... Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS CHILD LABOR REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General Statements of Interpretation of the Child Labor... 12(a) and 12(c) § 570.115 Joint applicability. The child labor coverage provisions contained in...

  10. Improved orthopedic arm joint

    Science.gov (United States)

    Dane, D. H.

    1971-01-01

    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  11. Healthy Joints Matter

    Science.gov (United States)

    ... my joints more healthy? Definitions What can go wrong? Although you might think arthritis affects only older ... Discovery Into Health ® Home | Health Information | Research | Funding | News & Events | About Us | Portal en español | Asian-Language ...

  12. Joint Quantum Institute

    Data.gov (United States)

    Federal Laboratory Consortium — The Joint Quantum Institute (JQI) is pursuing that goal through the work of leading quantum scientists from the Department of Physics of the University of Maryland...

  13. Concrete Pavement Joint Deterioration

    OpenAIRE

    2016-01-01

    Concrete pavements are an important part of our national infrastructure. In recent years the relatively small number of reported joints deteriorating prematurely in concrete pavements around Indiana has increased. Changes over the past 45 years in INDOT specification, pavement materials, designs and construction practices, and current de-icing materials were examined and related to the durability of concrete at the joints of existing pavements. A survey of concrete pavements across the state ...

  14. Joint involvement in Ochronosis

    OpenAIRE

    Biehl, Christoph; Thormann, U.; Madera, N.; Heiß, C

    2016-01-01

    Introduction: Ochronosis is a metabolic disorder that is usually associated with the typical brown-black colored urine and retention of phenol complexes in sclera and skin. Kidney and heart are also checked, the disease can also cause damage in these organs. The disease is less associated with degenerative changes in the joints of the limbs and the spine. Methods: We report on the progress of a patient with documented family history on alcaptonuria and joint involvement. In the age of 69 ...

  15. Joint evolution of black holes and galaxies

    CERN Document Server

    Colpi, M; Haardt, F

    2006-01-01

    OBSERVATIONAL EVIDENCE FOR SUPERMASSIVE BLACK HOLES Introduction Some Useful Formalism General Considerations Resolved Stellar Dynamics Gas as a Tracer of the Gravitational Potential Tackling the Unresolvable: Reverberation Mapping Scaling Relations for SMBHs Black Hole Demographics The Future JOINT EVOLUTION OF BLACK HOLES AND GALAXIES: OBSERVATIONAL ISSUES Galaxy Activity: Generalities Local Evidence on the Interplay Between the Stellar and Gravitational Origin of AGN Activity The Cosmic History of Galaxy Activity Constraints on the Cosmic Energy Budget Current Observational Programs and Fut

  16. High pressure ceramic joint

    Science.gov (United States)

    Ward, Michael E.; Harkins, Bruce D.

    1993-01-01

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  17. [Pathogenesis of temporomandibular joint dysfunction. III. Analysis of results].

    Science.gov (United States)

    Vágó, P

    1989-09-01

    Those factors were built in in the aetiological picture (model) of the mandible joint disfunction which showed direct connection with the clinical and anamnestic data of the disfunction. Factors used for establishing the model: social situation, joint lesions, psychic factors, the general health condition, position anomalies of the teeth and tooth groups, tooth contact troubles, oral parafunctions. In forming the mandible joint disfunction hereditary joint factors and a tendency to oppression may also have a role. However, the most important aetiological factor is the parafunction caused by the effect thereof and of local anomalies, occlusional deviations and a cachectic health condition.

  18. Comparison of Joint Modeling Approaches Including Eulerian Sliding Interfaces

    Energy Technology Data Exchange (ETDEWEB)

    Lomov, I; Antoun, T; Vorobiev, O

    2009-12-16

    Accurate representation of discontinuities such as joints and faults is a key ingredient for high fidelity modeling of shock propagation in geologic media. The following study was done to improve treatment of discontinuities (joints) in the Eulerian hydrocode GEODYN (Lomov and Liu 2005). Lagrangian methods with conforming meshes and explicit inclusion of joints in the geologic model are well suited for such an analysis. Unfortunately, current meshing tools are unable to automatically generate adequate hexahedral meshes for large numbers of irregular polyhedra. Another concern is that joint stiffness in such explicit computations requires significantly reduced time steps, with negative implications for both the efficiency and quality of the numerical solution. An alternative approach is to use non-conforming meshes and embed joint information into regular computational elements. However, once slip displacement on the joints become comparable to the zone size, Lagrangian (even non-conforming) meshes could suffer from tangling and decreased time step problems. The use of non-conforming meshes in an Eulerian solver may alleviate these difficulties and provide a viable numerical approach for modeling the effects of faults on the dynamic response of geologic materials. We studied shock propagation in jointed/faulted media using a Lagrangian and two Eulerian approaches. To investigate the accuracy of this joint treatment the GEODYN calculations have been compared with results from the Lagrangian code GEODYN-L which uses an explicit treatment of joints via common plane contact. We explore two approaches to joint treatment in the code, one for joints with finite thickness and the other for tight joints. In all cases the sliding interfaces are tracked explicitly without homogenization or blending the joint and block response into an average response. In general, rock joints will introduce an increase in normal compliance in addition to a reduction in shear strength. In the

  19. Patterns of risk of cancer in patients with metal-on-metal hip replacements versus other bearing surface types: a record linkage study between a prospective joint registry and general practice electronic health records in England.

    Directory of Open Access Journals (Sweden)

    Arief Lalmohamed

    Full Text Available BACKGROUND: There are concerns that metal-on-metal hip implants may cause cancer. The objective of this study was to evaluate patterns and timing of risk of cancer in patients with metal-on-metal total hip replacements (THR. METHODS: In a linkage study between the English National Joint Registry (NJR and the Clinical Practice Research Datalink (CPRD, we selected all THR surgeries (NJR between 2003 and 2010 (n = 11,540. THR patients were stratified by type of bearing surface. Patients were followed up for cancer and Poisson regression was used to derive adjusted relative rates (RR. RESULTS: The risk of cancer was similar in patients with hip resurfacing (RR 0.69; 95% Confidence Interval [CI] 0.39-1.22 or other types of bearing surfaces (RR 0.96; 95% CI 0.64-1.43 compared to individuals with stemmed metal-on-metal THR. The pattern of cancer risk over time did not support a detrimental effect of metal hip implants. There was substantial confounding: patients with metal-on-metal THRs used fewer drugs and had less comorbidity. CONCLUSIONS: Metal-on-metal THRs were not associated with an increased risk of cancer. There were substantial baseline differences between the different hip implants, indicating possibility of confounding in the comparisons between different types of THR implants.

  20. Proximal Tibiofibular Joint: An overview

    Directory of Open Access Journals (Sweden)

    Tze Wang Chan

    2016-06-01

    Full Text Available Proximal tibiofibular joint is a frequently neglected joint which can be a source of lateral knee pain. Open surgery is the current mainstay of surgical management of proximal tibiofibular joint disorders. The proximal tibiofibular arthroscopy allows access to the joint and adjacent important ligamentous structures. This forms the basis of further development of arthroscopic procedures for a variety of pathologies.

  1. Joint ventures in medical services.

    Science.gov (United States)

    Rublee, D A

    1987-01-01

    This paper is an overview of joint-venture activity in healthcare, describing trends in joint ventures and raising issues for physicians. The purposes are to discuss the major current facets of joint-venture alliances in healthcare and to identify policy issues that arise from the trend to use joint ventures as an organizational tool. Speculation is made about the future role of joint ventures in the organization of healthcare.

  2. Temporomandibular joint disorders.

    Science.gov (United States)

    Buescher, Jennifer J

    2007-11-15

    Temporomandibular joint disorders are common in adults; as many as one third of adults report having one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint. Most symptoms improve without treatment, but various noninvasive therapies may reduce pain for patients who have not experienced relief from self-care therapies. Physical therapy modalities (e.g., iontophoresis, phonophoresis), psychological therapies (e.g., cognitive behavior therapy), relaxation techniques, and complementary therapies (e.g., acupuncture, hypnosis) are all used for the treatment of temporomandibular joint disorders; however, no therapies have been shown to be uniformly superior for the treatment of pain or oral dysfunction. Noninvasive therapies should be attempted before pursuing invasive, permanent, or semi-permanent treatments that have the potential to cause irreparable harm. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy.

  3. Temporomandibular joint examination reviewed

    Directory of Open Access Journals (Sweden)

    L. Guarda Nardini

    2011-09-01

    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  4. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

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

  5. Implicit Generalized Predictive Control of Hip-joint Rehabilitation Training Device Driven by Pneumatic Muscle Actuator%气动肌肉驱动的髋关节康复训练装置隐式广义预测控制

    Institute of Scientific and Technical Information of China (English)

    何凡; 李笑; 夏虹; 关婷

    2011-01-01

    To slove the problem of the delay, nonlinear and time-variable characteristics of hip-joint rehabilitation training device driven by pneumatic muscle actuator, a implicit generalized predictive controller was designed based on parameter model. It was applied to the isokinetic continuous passive motion control of the hip-joint rehabilitation training device. The experimental results prove that the controller has the property of high control accuracy, anti-disturbance capability and excellent adaptive abilities for the changes of system model parameters. This control method provides reference for improving the control performance of such system.%针对气动肌肉驱动的髋关节康复训练装置存在时延、非线性和时变特性,设计基于参数模型的隐式广义预测控制器,并将其应用于髋关节康复训练装置的等速持续被动运动控制中.实验研究表明:在负载干扰变化下,隐式广义预测控制器具有控制精度高、抗干扰能力强等特点,同时对系统模型参数的变化有较好的适应能力,对提高类似医疗器械的控制性能有借鉴意义.

  6. Constructing quantum games from symmetric non-factorizable joint probabilities

    CERN Document Server

    Chappell, James M; Abbott, Derek

    2010-01-01

    We construct quantum games from a table of non-factorizable joint probabilities, coupled with a symmetry constraint, requiring symmetrical payoffs between the players. We give the general result for a Nash equilibrium and payoff relations for a game based on non-factorizable joint probabilities, which embeds the classical game. We study a quantum version of Prisoners' Dilemma, Stag Hunt, and the Chicken game constructed from a given table of non-factorizable joint probabilities to find new outcomes in these games. We show that this approach provides a general framework for both classical and quantum games without recourse to the formalism of quantum mechanics.

  7. ON ONE MODEL OF ADMINISTRATION OF THE JOINT POTENTIAL OF AIRCRAFT ENTERPRISE

    Directory of Open Access Journals (Sweden)

    S. D. Lobanov

    2014-01-01

    Full Text Available The problem of control of the joint potential of airline is examined, the procedure of its estimation taking into account a change in the parameters of external and internal medium is proposed, the comparison of the concepts of joint potential and general objective control function, interrelation of their components is conducted, the model of control of joint potential is proposed.

  8. 15 CFR 296.9 - Activities not permitted for joint ventures.

    Science.gov (United States)

    2010-01-01

    ... INNOVATION PROGRAM General § 296.9 Activities not permitted for joint ventures. The following activities are not permissible for TIP-funded joint ventures: (a) Exchanging information among competitors relating... joint venture of any product, process, or service, other than the distribution among the parties to...

  9. 26 CFR 1.172-7 - Joint return by husband and wife.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Joint return by husband and wife. 1.172-7...-7 Joint return by husband and wife. (a) In general. This section prescribes additional rules for computing the net operating loss carrybacks and carryovers of a husband and wife making a joint return...

  10. 26 CFR 1.401(a)-11 - Qualified joint and survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Qualified joint and survivor annuities. 1.401(a...)-11 Qualified joint and survivor annuities. (a) General rule—(1) Required provisions. A trust, to... a qualified joint and survivor annuity (as defined in paragraph (b)(2) of this section) with...

  11. Biomechanical analysis of the influence of friction in jaw joint disorders

    NARCIS (Netherlands)

    Koolstra, J.H.

    2012-01-01

    Objective Increased friction due to impaired lubrication in the jaw joint has been considered as one of the possible causes for internal joint disorders. A very common internal disorder in the jaw joint is an anteriorly dislocated articular disc. This is generally considered to contribute to the ons

  12. Joint disease in children of Asiatic origin

    Energy Technology Data Exchange (ETDEWEB)

    Tan, T.H.; Ong, K.L

    2000-02-01

    Joint disorders in Asian children are varied due to the diversity of the Asian population and show some ethnic trends. The ethnic diversity, socio-economic and geographic factors in Asia have limited the availability of data from some of the ethnic groups, many of whom live in remote and relatively underdeveloped areas, are not subjected to epidemiological surveillance and have little awareness of these diseases and their consequences. Geographic and socio-economic factors also play a significant role in some of the joint diseases peculiar to Asian children. In general, the current available data suggests that there are no large differences in the epidemiology and clinical features between the Western and Asian children. This article reviews the available literature on joint diseases in Asian children.

  13. An exploratory examination of the association between altered lumbar motor control, joint mobility and low back pain in athletes.

    Science.gov (United States)

    Corkery, Marie B; O'Rourke, Brittany; Viola, Samantha; Yen, Sheng-Che; Rigby, Joseph; Singer, Kevin; Thomas, Adam

    2014-12-01

    Low back pain (LBP) is a common cause of lost playing time and can be a challenging clinical condition in competitive athletes. LBP in athletes may be associated with joint and ligamentous hypermobility and impairments in activation and coordination of the trunk musculature, however there is limited research in this area. To determine if there is an association between altered lumbar motor control, joint mobility and low back pain (LBP) in a sample of athletes. Fifteen athletes with LBP were matched by age, gender and body mass index (BMI) with controls without LBP. Athletes completed a questionnaire with questions pertaining to demographics, activity level, medical history, need to self-manipulate their spine, pain intensity and location. Flexibility and lumbar motor control were assessed using: active and passive straight leg raise, lumbar range of motion (ROM), hip internal rotation ROM (HIR), Beighton ligamentous laxity scale, prone instability test (PIT), observation of lumbar aberrant movements, double leg lowering and Trendelenburg tests. Descriptive statistics were compiled and the chi square test was used to analyze results. Descriptive statistics showed that 40% of athletes with LBP exhibited aberrant movements (AM), compared to 6% without LBP. 66% of athletes with LBP reported frequently self-manipulating their spine compared to 40% without LBP. No significant differences in motor control tests were found between groups. Athletes with LBP tended to have less lumbar flexion (63 ± 11°) compared to those without LBP (66 ± 13°). Chi-Square tests revealed that the AM were more likely to be present in athletes with LBP than those without (X2 = 4.66, P = 0.03). The presence of aberrant movement patterns is a significant clinical finding and associated with LBP in athletes.

  14. Studies of welded joints

    Directory of Open Access Journals (Sweden)

    J. M. Krupa

    2010-07-01

    Full Text Available Studies of a welded joint were described. The joint was made as a result of the reconstruction of a truss and one of the possible means to make a repair. The studies were of a simulation character and were targeted at the detection of welding defects and imperfections thatshould be eliminated in a real structure. A model was designed and on this model the tests and examinations were carried out. The modelwas made under the same conditions as the conditions adopted for repair. It corresponded to the real object in shape and dimensions, and in the proposed technique of welding and welding parameters. The model was composed of five plates joined together with twelve beads.The destructive and non-destructive tests were carried out; the whole structure and the respective welds were also examined visually. Thedefects and imperfections in welds were detected by surface methods of inspection, penetration tests and magnetic particle flaw detection.The model of the welded joint was prepared by destructive methods, a technique that would never be permitted in the case of a realstructure. For the investigations it was necessary to cut out the specimens from the welded joint in direction transverse to the weld run. The specimens were subjected to metallographic examinations and hardness measurements. Additionally, the joint cross-section was examined by destructive testing methods to enable precise determination of the internal defects and imperfections. The surface methods were applied again, this time to determine the severity of welding defects. The analysis has proved that, fabricated under proper conditions and with parameters of the welding process duly observed, the welded joint has good properties and repairs of this type are possible in practice.

  15. 28 November 2013 - N. N. Kudryavtsev, Russian Rector of the Moscow Institute of Physics and Technology signing an Agreement and the Guest Book with CERN Director-General R. Heuer; visiting the ATLAS cavern with ATLAS Deputy Spokesperson B. Heinemann and visiting the LHC tunnel at Point 1 with AGH University of Science and Technology A. Erokhin. M. Savino, Physics Department, Joint Institute for Nuclear Research also present.

    CERN Multimedia

    Jean-Claude Gadmer

    2013-01-01

    28 November 2013 - N. N. Kudryavtsev, Russian Rector of the Moscow Institute of Physics and Technology signing an Agreement and the Guest Book with CERN Director-General R. Heuer; visiting the ATLAS cavern with ATLAS Deputy Spokesperson B. Heinemann and visiting the LHC tunnel at Point 1 with AGH University of Science and Technology A. Erokhin. M. Savino, Physics Department, Joint Institute for Nuclear Research also present.

  16. Joint for deployable structures

    Science.gov (United States)

    Craighead, N. D., II; Preliasco, R. J.; Hult, T. D. (Inventor)

    1985-01-01

    A joint is described for connecting a pair of beams to pivot them between positions in alignment or beside one another, which is of light weight and which operates in a controlled manner. The joint includes a pair of fittings and at least one center link having opposite ends pivotally connected to opposite fittings and having axes that pass through centerplates of the fittings. A control link having opposite ends pivotally connected to the different fittings controls their relative orientations, and a toggle assemly holds the fittings in the deployed configuration wherein they are aligned. The fittings have stops that lie on one side of the centerplane opposite the toggle assembly.

  17. Transversely Compressed Bonded Joints

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Schmidt, Jacob Wittrup; Stang, Henrik

    2012-01-01

    The load capacity of bonded joints can be increased if transverse pressure is applied at the interface. The transverse pressure is assumed to introduce a Coulomb-friction contribution to the cohesive law for the interface. Response and load capacity for a bonded single-lap joint was derived using...... non-linear fracture mechanics. The results indicated a good correlation between theory and tests. Furthermore, the model is suggested as theoretical base for determining load capacity of bonded anchorages with transverse pressure, in externally reinforced concrete structures....

  18. Septic arthritis in the temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Hassan Mahdi Al-Khalisy

    2015-01-01

    Full Text Available Septic arthritis of the temporomandibular joint (TMJ is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male. Case Report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia′s and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash and had to discontinue the antibiotic. On physical exam the patient had a large swelling and tenderness in his left periauricular area, with erythema and deviation of the right mandible which limited his ability to open the mouth. A computed tomography showed mild asymmetric soft tissue swelling in the left pharyngeal region but did not show joint effusion. Subsequent magnetic resonance imaging did show effusion of the joint space. The effusion was drained, and the synovial fluid was submitted for gram stain, culture, and sensitivity. The cultures grew menthicillin sensitive Staphyloccocus Aureus. The patient was discharged to complete a two week course of intravenous (IV Ceftriaxone and IV Vancomycin via home infusion. Conclusion: Septic Arthritis of the TMJ is a rare event with very specific clinical symptoms. Due to the low sensitivity of the computed tomography scan, magnetic resonance imaging should be considered when computed tomography scan is negative for TMJ effusion.

  19. Guidelines for evaluating potential joint ventures.

    Science.gov (United States)

    Himmelsbach, W A

    1987-04-01

    Holy Cross Health System (HCHS), South Bend, IN, participates in 25 joint ventures; 9 of these involve partnerships with for-profit structures and 18 relate to activities with medical staffs. To ensure that such arrangements respect the sponsoring religious institute's requirements, HCHS follows a 16-point policy to guide the development of joint ventures. The policy requires joint ventures to: Have a specific purpose relevant to community health care needs; Strive to respond to need regardless of a person's race, creed, color, or ability to pay; Include in legal documents a statement of the intent to uphold Church teachings; Base their activities on an "arm's length" relationship; Undertake reasonable efforts to establish the entity as a not-for-profit, tax-exempt corporation; Confine operations to the subsidiary's service area unless collaboration with other Catholic-sponsored organizations is involved; Include a "dispute resolution" clause in organizational documents; Establish as the partner on adequately capitalized, wholly owned not-for-profit corporation to minimize liability exposure, if the HCHS is to be a general partner in the joint venture; Retain professional consultants approved by the corporate office; Maintain reserved powers for majority-owned or majority-controlled joint ventures that are ecclesiastical entities.

  20. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, Lars; Duhn, Ph; Ullman, S

    2010-01-01

    Objective: The criteria for Ehlers-Danlos syndrome (EDS) and the hypermobility syndrome (HMS) should be reliable. Examination for general joint hypermobility has high reliability but there is only sparse information on the reliability of skin tests, and no information on the level of normal skin ...... measurements. We suggest that skin consistency is withdrawn as a diagnostic criterion. The upper level for normal skin extensibility should be 3 cm. SC and STSM are promising para-clinical methods, but their diagnostic sensitivity and specificity need to be determined.......Objective: The criteria for Ehlers-Danlos syndrome (EDS) and the hypermobility syndrome (HMS) should be reliable. Examination for general joint hypermobility has high reliability but there is only sparse information on the reliability of skin tests, and no information on the level of normal skin...... extensibility. The present study aimed to assess skin signs by means of clinical and para-clinical methods. Methods: A total of 31 EDS patients and 28 healthy controls were examined blinded and in random order. Inter-examiner analysis of clinical tests for skin extensibility, consistency, scarring, and bruising...

  1. Joint Custody and Coparenting.

    Science.gov (United States)

    Sell, Kenneth D.

    Results are presented of an intensive search of U.S. newspapers and periodicals on the joint custody of children after divorce, where both parents have continued responsibility for parenting and where the children spend part of each week, month, or year with both of the parents. Areas of concern addressed by these materials include the following:…

  2. Keyed shear joints

    DEFF Research Database (Denmark)

    Hansen, Klaus

    This report gives a summary of the present information on the behaviour of vertical keyed shear joints in large panel structures. An attemp is made to outline the implications which this information might have on the analysis and design of a complete wall. The publications also gives a short...

  3. Jointness, A Selected Bibliography.

    Science.gov (United States)

    1997-02-01

    The Services’ Judge Advocates and Lawyers Move Toward the Next Century. Study Project. Car- lisle Barracks: US Army War College, 5 April 1993. 57pp...Shaping America’s Future Mili- tary." Parameters 24 (Winter 1994-1995): 19-29. Barlow, Jason B. "Interservice Rivalry in the Pacific." Joint Force

  4. Joint Rescue Drill

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Ships gather for a joint rescue drill at the Waigaoqiao Dock in Shanghai on August 24.A large-scale rescue drill, combining maritime and air forces,was held as part of the ongoing World Maritime Rescue Conference 2011 in the city.During the drill,

  5. Jointness: A Selected Bibliography

    Science.gov (United States)

    2010-12-01

    Leavenworth: U.S. Army Combined Arms Center, Combat Studies Institute, 2008. 428pp. (UA25 .C55 2008) http://www.cgsc.edu/ carl /download/csipubs...SMARTbook: Guide to Joint, Multinational & Interagency Operations. 2nd ed., rev. Lakeland, FL: Lightning Press, 2009. 302pp. (U260 .W33 2009) Whittaker

  6. [Temporomandibular joint, occlusion and bruxism].

    Science.gov (United States)

    Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

    2016-09-01

    Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner.

  7. Objective Assessment of Joint Stiffness: A Clinically Oriented Hardware and Software Device with an Application to the Shoulder Joint.

    Science.gov (United States)

    McQuade, Kevin; Price, Robert; Liu, Nelson; Ciol, Marcia A

    2012-08-30

    Examination of articular joints is largely based on subjective assessment of the "end-feel" of the joint in response to manually applied forces at different joint orientations. This technical report aims to describe the development of an objective method to examine joints in general, with specific application to the shoulder, and suitable for clinical use. We adapted existing hardware and developed laptop-based software to objectively record the force/displacement behavior of the glenohumeral joint during three common manual joint examination tests with the arm in six positions. An electromagnetic tracking system recorded three-dimensional positions of sensors attached to a clinician examiner and a patient. A hand-held force transducer recorded manually applied translational forces. The force and joint displacement were time-synchronized and the joint stiffness was calculated as a quantitative representation of the joint "end-feel." A methodology and specific system checks were developed to enhance clinical testing reproducibility and precision. The device and testing protocol were tested on 31 subjects (15 with healthy shoulders, and 16 with a variety of shoulder impairments). Results describe the stiffness responses, and demonstrate the feasibility of using the device and methods in clinical settings.

  8. Steroid injections - tendon, bursa, joint

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007678.htm Steroid injections - tendon, bursa, joint To use the sharing features on ... painful. It can be injected into a joint, tendon, or bursa. Description Your health care provider inserts ...

  9. Deficiencies in Indian Joint Operations

    Science.gov (United States)

    2016-05-26

    compartmentalization, and bureaucratic inefficiencies. Indian regional hegemony in South Asia faces significant risks without critically needed reforms to enable...illustrates India’s limited capability to conduct joint operations. Specifically, India demonstrated critical planning deficiencies in joint...society, and this has influenced its understanding of theory and concepts, and its application of those ideas in the development of its own joint

  10. Joint Force Quarterly. Number 8, Summer 1995

    Science.gov (United States)

    1995-06-01

    College of the Armed Forces COL Peter F. Herrly, USA National War College Col Douglas N. Hime, USAF Naval War College William T. Hodson Information...airmen who fought as a team to lay the foundations of joint and combined warfare. JFQ N O T E S 1 See, for example, statements by Ernest J. King and...on invading North Africa in 1942, a move vehemently opposed by his main mili- tary advisors, General George C. Marshall and Admiral Ernest J. King

  11. Joint Hacking and Latent Hazard Rate Estimation

    OpenAIRE

    Liu, Ziqi; Smola, Alexander J.; Soska, Kyle; Wang, Yu-Xiang; Zheng, Qinghua

    2016-01-01

    In this paper we describe an algorithm for predicting the websites at risk in a long range hacking activity, while jointly inferring the provenance and evolution of vulnerabilities on websites over continuous time. Specifically, we use hazard regression with a time-varying additive hazard function parameterized in a generalized linear form. The activation coefficients on each feature are continuous-time functions constrained with total variation penalty inspired by hacking campaigns. We show ...

  12. Achieving joint benefits from joint implementation

    Energy Technology Data Exchange (ETDEWEB)

    Moomaw, W.R. [Tufts Univ., Medford, MA (United States)

    1995-11-01

    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  13. Achieving joint benefits from joint implementation

    Energy Technology Data Exchange (ETDEWEB)

    Moomaw, W.R. [Tufts Univ., Medford, MA (United States)

    1995-11-01

    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  14. Colloidal joints with designed motion range and tunable joint flexibility.

    Science.gov (United States)

    Chakraborty, Indrani; Meester, Vera; van der Wel, Casper; Kraft, Daniela J

    2017-06-14

    The miniaturization of machines towards the micron and nanoscale requires the development of joint-like elements that enable and constrain motion. We present a facile method to create colloidal joints, that is, anisotropic colloidal particles functionalized with surface mobile DNA linkers that control the motion range of bonded particles. We demonstrate quantitatively that we can control the flexibility of these colloidal joints by tuning the DNA linker concentration in the bond area. We show that the shape of the colloidal joint controls the range of motion of bonded particles through a maximisation of the bond area. Using spheres, cubes, and dumbbells, we experimentally realize spherical joints, planar sliders, and hinges, respectively. Finally we demonstrate the potential of the colloidal joints for programmable bottom-up self-assembly by creating flexible colloidal molecules and colloidal polymers. The reconfigurability and motion constraint offered by our colloidal joints make them promising building blocks for the development of switchable materials and nanorobots.

  15. Laundry joint venture.

    Science.gov (United States)

    Giancola, D; Voyvodich, M

    1984-12-01

    Many hospitals are concerned about the loss of control which is associated with contracting for linen service. On the the hand, many laundries do not have the resources or experience to serve hospitals in a comprehensive and trouble-free manner. In many communities a joint venture, such as the one described here, can successfully combine the interests of the hospital and laundry communities without causing the hospitals to lose control of the service and without requiring the laundry operator to have detailed knowledge of hospital operations. As more hospitals opt for contract service, and if this service is to be provided at the lowest total cost, the hospitals and the laundries must come to grips with the problems surrounding the laundry-hospital interface. A joint venture, such as that described here, is one way to accomplish this.

  16. Peripheral degenerative joint diseases

    Directory of Open Access Journals (Sweden)

    Nilzio Antonio da Silva

    2008-03-01

    Full Text Available Osteoarthritis, a degenerative joint disease, is the most commonrheumatic disorder mainly in a geriatric population. Manifestationsare pain, stiffness and functional loss in the affected joint.According to etiology it is classifi ed as primary (or idiopathicand secondary. Some risk factors for disease development aregenetics, race, age, sex, obesity, occupational activities andarticular biomechanics. Pathogenesis is the same for any cause orlocalization, being catabolic alterations, with synthesis, inhibitionand reparing intent of the cartilage matrix. Metalloproteinases andcytokines (IL-1,IL-6,TNF-α actions promote infl ammatory reactionand cartilage degradation. Pain, the most important symptom,does not correlate with radiologic fi ndings. Peripheral osteoarthritisoccurs predominantly in the knee, hip and hand. Diagnosis is basedon clinical features, laboratorial tests and radiological changes.Rheumatological associations’ guidelines for treatment includenon-pharmacologic (education, physiotherapy, assistive devices,and pharmacologic (analgesics, anti-infl ammatory drugs therapyand surgery. Arthroplasty seems to work better than medicines, butshould be used if other treatments have failed.

  17. Joint International Accelerator School

    CERN Multimedia

    CERN Accelerator School

    2014-01-01

    The CERN and US Particle Accelerator Schools recently organised a Joint International Accelerator School on Beam Loss and Accelerator Protection, held at the Hyatt Regency Hotel, Newport Beach, California, USA from 5-14 November 2014. This Joint School was the 13th in a series of such schools, which started in 1985 and also involves the accelerator communities in Japan and Russia.   Photo courtesy of Alfonse Pham, Michigan State University.   The school attracted 58 participants representing 22 different nationalities, with around half from Europe and the other half from Asia and the Americas. The programme comprised 26 lectures, each of 90 minutes, and 13 hours of case study. The students were given homework each day and had an opportunity to sit a final exam, which counted towards university credit. Feedback from the participants was extremely positive, praising the expertise and enthusiasm of the lecturers, as well as the high standard and quality of their lectures. Initial dis...

  18. Variabilidade da frequência cardíaca em mulheres com hipermobilidade articular Heart rate variability in women with joint hipermobility

    Directory of Open Access Journals (Sweden)

    Mariane de Oliveira Nunes

    2011-09-01

    Full Text Available A hipermobilidade é a capacidade de desempenhar movimentos articulares com amplitude maior que o normal. A prevalência possui variações determinadas pela etnia, sexo, idade, atividade física e variações nos critérios de caracterização. Aproximadamente 30% dos adultos são portadores e apresentam feedback proprioceptivo, sensorial diminuído e espacial alterado da articulação levando a maior frequência de ativação e deformação dos mecanorreceptores nos músculos esqueléticos e na pele. O aumento dos impulsos aferentes dos mecanorreceptores sobre a área cardiovascular no bulbo altera o controle autonômico sobre o coração. O objetivo do estudo foi avaliar o balanço simpatovagal durante manobra de ortostatismo em mulheres com hipermobilidade. Participaram do estudo 27 voluntárias, com 19,97±1,79 anos, índice de massa corpórea abaixo de 25 kg/m², sedentárias e sem uso de medicação. Após diagnóstico da hipermobilidade articular, segundo o escore de Beighton, foram divididas em 2 grupos: 12 hipermóveis (GH e 15 não hipermóveis (GC. O eletrocardiograma foi realizado durante 10 minutos em supino e em pé para análise da variabilidade da frequência cardíaca. A banda de alta frequência (un apresentou diminuição da atividade vagal no GH, pJoint hypermobility is the ability to make joint movements greater than normal. The prevalence has large variations determined by race, sex, age, physical activity and variations in characterization criteria. Approximately 30% of adults are considered carriers and present proprioceptive feedback and sensory decreased and joint space positioning altered leading to greater frequency of activation and deformation on the mechanoreceptors in the skeletal muscles and skin. The increase of afferent impulses of the receptors on the bulb cardiovascular area alters the autonomic control on the heart. The objective of the study was to evaluate sympathovagal balance during orthosthatic

  19. Joint Urban Operations

    Science.gov (United States)

    2009-11-08

    in Kosovo , the Red Cross provided the most accurate figures on the number of Kosovo refugees, helping US and other coalition services to estimate the...Port-au-Prince, Ramadi, Fallujah, and cities in Bosnia, Serbia, and Kosovo ). This clearly indicates an increase in the frequency of US joint...areas perhaps including shantytowns, and military areas. Buildings may range from single-story wooden or mud dwellings to high-rise apartments and

  20. The international joint commission

    OpenAIRE

    Clamens, Murray

    2005-01-01

    For over 92 years the International Joint Commission (IJC), United States and Canada, has effectively served the two nations in approving and providing continuous oversight of water resource projects along the 5000-mile common border, in assisting the governments in preventing and resolving issues and disagreements regarding the use of these waters, and in addressing other environmental issues affecting or potentially affecting one or both of the countries. During the first years of the 20th...

  1. Joint Forces Capabilities

    Science.gov (United States)

    2007-11-02

    for countering the proliferation of weapons of mass destruction (WMD) in space. The Space Operations Center ( SPOC ), USSPACECOM is the single point...of contact for assessing space capabilities. Combatant commanders, subordinate JFCs, and Services can access this information from the SPOC via the...special operations forces SPOC Space Operations Center SSBN fleet ballistic missile submarine SST space support team UJTL Universal Joint Task List UN

  2. Successfully Developing Joint Leaders

    Science.gov (United States)

    2010-07-26

    officer’s pyramid representing his career, there is merely the word “joint”. Therefore, unless the officer adamantly pursues a joint assignment it...had the chance to participate in Bosnia stability operations. It is how we were taught to work with locals and the experiences I took with me that...Drug Ops, OAF, OEF, OIF, Bosnia , Unconventional) - When you participated in an operation was there any “joint” involvement? If “yes”, did you feel

  3. Nonarthritic hip joint pain.

    Science.gov (United States)

    Enseki, Keelan; Harris-Hayes, Marcie; White, Douglas M; Cibulka, Michael T; Woehrle, Judith; Fagerson, Timothy L; Clohisy, John C

    2014-06-01

    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these clinical practice guidelines is to describe the peer-reviewed literature and make recommendations related to nonarthritic hip joint pain.

  4. [Temporomandibular joint: MRI diagnostics].

    Science.gov (United States)

    Kress, B; Schmitter, M

    2005-09-01

    MRI of the temporomandibular joint (TMJ) requires 1.5 T. The radiologist must be familiar with the anatomy and pathology of the TMJ. This review gives a description of MRI protocols for the TMJ, and MRI anatomy and pathology of the TMJ (open and closed mouth) by means of MR images and drawings. Diagnosing of the TMJ related diseases depends on standardized clinical and MR examinations. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary.

  5. Realignment Subtalar Joint Arthrodesis.

    Science.gov (United States)

    Hentges, Matthew J; Gesheff, Martin G; Lamm, Bradley M

    2016-01-01

    Subtalar joint arthrodesis is a commonly performed procedure for the correction of hindfoot deformity and/or the relief of pain related to osteoarthritis. The purpose of the present study was to provide preoperative and intraoperative objective radiographic parameters to improve the accuracy and long-term success of realignment arthrodesis of the subtalar joint. We retrospectively reviewed the data from 16 patients, 11 male (57.9%) and 8 female (42.1%) feet, who had undergone realignment subtalar joint arthrodesis. A total of 19 fusions were performed in 9 (47.4%) right and 10 (52.6%) left feet, with a mean follow-up period of 2 (range 1 to 4.8) years. The mean age at surgery was 54.5 (range 14 to 77) years. Statistically significant improvement in radiographic alignment was found in the anteroposterior talo-first metatarsal angle (p = .002), lateral talo-first metatarsal angle (p < .001), tibial-calcaneal angle (p < .001), and tibial-calcaneal distance (p < .001). A positive correlation was observed between the tibial-calcaneal angle and tibial-calcaneal distance (r = 0.825, p < .001). The statistically significant improvement in tibial-calcaneal alignment, in both angulation and distance, support our conclusions that proper realignment of the calcaneus to vertical and central under the tibia will lead to short-term success and, likely, long-term success of subtalar joint arthrodesis. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Australias Joint Approach

    Science.gov (United States)

    2015-09-01

    offensive support (including NGS) in Exercise Tasman Link at Shoalwater Bay in 1986. A similar joint and combined exercise was held as part of Talisman ...in 2003, the exercise series was again re-named Talisman Sabre (TS) and these exercises have been conducted every two years since 2005. The exercise...work/News-and-media/News-and-media-2013/News-and-media-July-2013/Exercise- Talisman -Saber-2013-begins, as sighted on 1 December 2014. UNCLASSIFIED DST

  7. Laboratory characterization of rock joints

    Energy Technology Data Exchange (ETDEWEB)

    Hsiung, S.M.; Kana, D.D.; Ahola, M.P.; Chowdhury, A.H.; Ghosh, A. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses

    1994-05-01

    A laboratory characterization of the Apache Leap tuff joints under cyclic pseudostatic and dynamic loads has been undertaken to obtain a better understanding of dynamic joint shear behavior and to generate a complete data set that can be used for validation of existing rock-joint models. Study has indicated that available methods for determining joint roughness coefficient (JRC) significantly underestimate the roughness coefficient of the Apache Leap tuff joints, that will lead to an underestimation of the joint shear strength. The results of the direct shear tests have indicated that both under cyclic pseudostatic and dynamic loadings the joint resistance upon reverse shearing is smaller than that of forward shearing and the joint dilation resulting from forward shearing recovers during reverse shearing. Within the range of variation of shearing velocity used in these tests, the shearing velocity effect on rock-joint behavior seems to be minor, and no noticeable effect on the peak joint shear strength and the joint shear strength for the reverse shearing is observed.

  8. Laboratory characterization of rock joints

    Energy Technology Data Exchange (ETDEWEB)

    Hsiung, S.M.; Kana, D.D.; Ahola, M.P.; Chowdhury, A.H.; Ghosh, A. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses

    1994-05-01

    A laboratory characterization of the Apache Leap tuff joints under cyclic pseudostatic and dynamic loads has been undertaken to obtain a better understanding of dynamic joint shear behavior and to generate a complete data set that can be used for validation of existing rock-joint models. Study has indicated that available methods for determining joint roughness coefficient (JRC) significantly underestimate the roughness coefficient of the Apache Leap tuff joints, that will lead to an underestimation of the joint shear strength. The results of the direct shear tests have indicated that both under cyclic pseudostatic and dynamic loadings the joint resistance upon reverse shearing is smaller than that of forward shearing and the joint dilation resulting from forward shearing recovers during reverse shearing. Within the range of variation of shearing velocity used in these tests, the shearing velocity effect on rock-joint behavior seems to be minor, and no noticeable effect on the peak joint shear strength and the joint shear strength for the reverse shearing is observed.

  9. Fatigue of hollow section T-joints of circular braces and square chords

    Energy Technology Data Exchange (ETDEWEB)

    Berge, S. [Norwegian Inst. of Technology, Trondheim (Norway); Gandhi, P. [Structural Engineering Research Centre, Madras (India); Lereim, J. [Saga Petroleum A.S., Forus (Norway)

    1995-12-31

    Hollow sections are generally either circular-to-circular (CCHS) or rectangular-to-rectangular (RRHS). Structures with circular braces and rectangular chords (CRHS) may have advantages in certain applications, combining a simple joint geometry for fabrication and relatively small stress concentration factors. Seven different CRHS joints were fatigue tested in constant amplitude axial loading. Stress concentration factors (SCF) were measured experimentally and compared with various parametric formulae. The SCF values for CRHS joints were found to be between those of CCHS and RRHS joints. On the basis of measured SCF values for CRHS joints, the fatigue strength was in good correspondence with current fatigue design codes. Parametric formulae for RRHS joints were in all the cases found to give conservative predictions of SCF. In lack of more rational prediction methods, these formulae in combination with the T curve for tubular joints may be used in fatigue design of CRHS joints.

  10. Thoracic costotransverse joint pain patterns: a study in normal volunteers

    Directory of Open Access Journals (Sweden)

    Wainner Robert S

    2008-10-01

    Full Text Available Abstract Background Pain referral patterns of asymptomatic costotransverse joints have not been established. The objective of this study was to determine the pain referral patterns of asymptomatic costotransverse joints via provocative intra-articular injection. Methods Eight asymptomatic male volunteers received a combined total of 21 intra-articular costotransverse joint injections. Fluoroscopic imaging was used to identify and isolate each costotransverse joint and guide placement of a 25 gauge, 2.5 inch spinal needle into the costotransverse joint. Following contrast medium injection, the quality, intensity, and distribution of the resultant pain produced were recorded. Results Of the 21 costotransverse joint injections, 16 (76% were classified as being intra-articular via arthrograms taken at the time of injection, and 14 of these injections produced a pain sensation distinctly different from that of needle placement. Average pain produced was 3.3/10 on a 0–10 verbal pain scale. Pain was described generally as a deep, dull ache, and pressure sensation. Pain patterns were located superficial to the injected joint, with only the right T2 injections showing referred pain 2 segments cranially and caudally. No chest wall, upper extremity or pseudovisceral pains were reported. Conclusion This study provides preliminary data of the pain referral patterns of costotransverse joints. Further research is needed to compare these findings with those elicited from symptomatic subjects.

  11. China Says No to New Tobacco Joint Ventures

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    China will not launch any more tobacco joint ventures with foreign investors,according to Zhang Benfu,general manager of the China Tobacco lmport and Export(Group)Corp.Zhang states that China will not build any more joint venture cigarette manufacturing,tobacco processing or filter making facilities because the Chinese tobacco market is saturated and its cigarette production capacity is far in excess of demand.

  12. FATIGUE WELDING JOINT RESISTANCE OF MINING DUMP TRUCK BEARING CONSTRUCTIONS

    Directory of Open Access Journals (Sweden)

    A. A. Rakitsky

    2010-01-01

    Full Text Available The paper investigates a possibility to apply European norms on designing of welded constructions for frames of heavy-load mining dump trucks. Comparison of results concerning tests of welding joint specimen made of local steel with recommended standards of fatigue curves is executed in the paper. The paper reveals that while forecasting resource of automotive constructions with the accepted practical accuracy it is possible to use generalized fatigue resistance characteristics of standard welding joints

  13. Cotton-Type and Joint Invariants for Linear Elliptic Systems

    Directory of Open Access Journals (Sweden)

    A. Aslam

    2013-01-01

    that Cotton-type invariants derived from these two approaches are identical. Furthermore, Cotton-type and joint invariants for a general system of two linear elliptic equations are also obtained from the Laplace-type and joint invariants for a system of two linear hyperbolic equations equivalent to the system of linear elliptic equations by complex changes of the independent variables. Examples are presented to illustrate the results.

  14. Lisfranc Joint Injuries

    Institute of Scientific and Technical Information of China (English)

    Lisa Chinn

    2009-01-01

    @@ The ankle and foot are the most common sites for athletic injuries.[1]Midfoot,or Lisfranc,injuries are the second most common foot injury and have a high in cidence in particular sports.They account for 4% of all football injuries per year,occurring frequently in linemen.[2]They are also common in equestrians,surfers,and windsurfers.[2]Lisfranc injuries are often misdiagnosed and if not treated properly can have lingering symptoms.It is estimated that Lisfranc joint injuries occur in 1 in every 55,000 persons every year.[3,4

  15. [Temporomandibular joint disc surgery].

    Science.gov (United States)

    Potier, J; Maes, J-M; Nicot, R; Dumousseau, T; Cotelle, M; Ferri, J

    2016-09-01

    Temporomandibular joint (TMJ) disorders are a common disease and may be responsible for major functional and painful repercussions. Treatment is not consensual. The literature highlights the role of conservative treatments (physiotherapy, analgesics, splints) in a first attempt. Minimally invasive surgical techniques (arthroscopy, arthrocentesis) have developed rapidly in recent decades. They have proven effective and reliable, especially in patients suffering from irreducible or reducible anterior disc dislocation or presenting with arthopathies. The goal of our work was to make an update about disk surgery. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Bones and joints

    Energy Technology Data Exchange (ETDEWEB)

    Runge, M.

    1987-01-01

    This exercise book guides the student and the radiologist wishing to review his knowledge to rapid and correct analysis and interpretation of radiologic findings in bone and joint disorders. The first part of the volume demonstrates the radiologic findings without going into the clinical and pathological aspects. In the second part, the reader then learns to analyse and diagnose systematically the case examples by means of a complete description of the X-ray images. Contents: Introduction; iconography; commentary with corresponding schemata; references and subject index.

  17. 'Inverse' temporomandibular joint dislocation.

    Science.gov (United States)

    Alemán Navas, R M; Martínez Mendoza, M G

    2011-08-01

    Temporomandibular joint (TMJ) dislocation can be classified into four groups (anterior, posterior, lateral, and superior) depending on the direction of displacement and the location of the condylar head. All the groups are rare except for anterior dislocation. 'Inverse' TMJ dislocation is a bilateral anterior and superior dislocation with impaction of the mandible over the maxilla; to the authors' knowledge only two cases have previously been reported in the literature. Inverse TMJ dislocation has unique clinical and radiographic findings, which are described for this case. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Surgery center joint ventures.

    Science.gov (United States)

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  19. General Dentist

    Science.gov (United States)

    ... Some general dentists work in government health services, research programs, higher education, corporations and even the military. ?xml:namespace> What kind of procedures do general dentists provide? ?xml:namespace> Many general dentists are ...

  20. Stabilization of the sacroiliac joint.

    Science.gov (United States)

    Shaffrey, Christopher I; Smith, Justin S

    2013-07-01

    Lower back pain and pain involving the area of the posterior iliac spine are extremely common. Degeneration of the sacroiliac joint (SIJ) is one potential cause for lower back pain and pain radiating into the groin or buttocks. Degenerative changes to the lumbar spine and sacroiliac joints are common. A recent study evaluating SIJ abnormalities in a primary low back pain population demonstrated 31.7% of patients demonstrated SI joint abnormalities. (4) As is the case for the evaluation and management of isolated lower back pain, the evaluation, management, and role for surgical intervention in SIJ pain is very controversial. Many patients have degenerative changes of the disc, facet joints, and SIJs. A recent systematic review performed to determine the diagnostic accuracy of tests available to clinicians to identify the disc, facet joint, or SIJ as the source of low back pain concluded that tests do exist that change the probability of the disc or SIJ (but not the facet joint) as the source of low back pain. (3) It was also concluded that the usefulness of these tests in clinical practice, particularly for guiding treatment selection, remains unclear. (3) Although there is general agreement that SIJ pathological changes are a potential cause of pain, there is far less agreement about the optimal management of these conditions. A variety of conditions can cause SIJ dysfunction including degenerative and inflammatory arthritis, trauma, prior lumbosacral fusion, hip arthritis, limb length inequality, infections, and neoplasia. (8) There is increasing evidence that image intensifier-guided single periarticular injection can correctly localize pain to the SIJ but the optimal management strategy remains controversial. Recent publications have compared surgical versus injection treatments and fusion versus denervation procedures. (1 , 8) A systematic review found improvement regardless of the treatment, with most studies reporting over 40% improvement in pain as measured

  1. Joint imaging in childhood and adolescence

    Energy Technology Data Exchange (ETDEWEB)

    Lopes Viana, Sergio [Hospital da Crianca de Brasilia - Jose Alencar Clinica Vila Rica (Brazil); Machado, Ribeiro, Maria Custodia [Hospital da Crianca de Brasilia - Jose Alencar Hospital de Base do Distrito Federal (Brazil); Beber Machado, Bruno [Clinica Radiologica Med Imagem, Unimed Sul Caprixaba, Santa Casa de Misericordia de Cachoeiro de Itapemirim (Brazil)

    2013-11-01

    First book to be devoted to the imaging of skeletally immature joints since the advent of cross-sectional methods. Covers a wide range of pathologic conditions. Identifies the advantages and weak points of each imaging method. Highlights anatomic and developmental peculiarities of the growing skeleton. Richly illustrated, with up-to-date references and summaries of key points. Since the advent of cross-sectional imaging methods, few works have been devoted to pediatric musculoskeletal imaging, and information is especially limited on the skeletally immature joint. Furthermore, reduced emphasis on pediatric training means that general radiologists are increasingly unfamiliar with normal and abnormal imaging findings in children and adolescents. Knowledge of the imaging appearances of the immature joint is, however, crucial for correct image interpretation. This book covers key selected topics in the imaging evaluation of the skeletally immature joint. The opening chapters consider the current role, advantages, and limitations of each modality in pediatric assessment and present the imaging appearances of anatomic and developmental peculiarities of the growing skeleton. Findings in a wide range of important conditions are then described in a series of richly illustrated chapters that document appearances on diverse imaging studies, from conventional radiography through to modern high-tech modalities. By presenting the essential information on imaging of the immature joint, the authors hope to provide radiologists (musculoskeletal specialists and generalists alike) with a new tool that will assist greatly in overcoming the daily challenges posed by interpretation of pediatric examinations in the twenty-first century. The book will also be of interest to all other specialists involved in the diagnosis and treatment of children and adolescents with articular complaints.

  2. [Fractures of the elbow joint].

    Science.gov (United States)

    Nowak, T E; Dietz, S O; Burkhart, K J; Müller, L P; Rommens, P M

    2012-02-01

    Fractures around the elbow joint comprise fractures of the distal humerus, the radial head, the olecranon and the coronoid process. Combined lesions are particularly demanding for the surgeon. Accurate knowledge of the anatomy and of the biomechanics is an essential requirement for a specific diagnosis and therapy. A stable and painless movable elbow joint is essential for most of the activities of daily living. Risk factors for the development of posttraumatic elbow joint arthrosis are non-anatomically reconstructed joint surfaces, axial malalignment of the joint axis and untreated concomitant injuries. Modern angular stable and anatomically preshaped implants facilitate a biomechanically adequate osteosynthesis and avoid or decrease functional impairment. In consideration of an increasing number of osteoporotic elbow joint fractures, endoprosthetic replacement has gained significance.

  3. Jointly Sponsored Research Program

    Energy Technology Data Exchange (ETDEWEB)

    Everett A. Sondreal; John G. Hendrikson; Thomas A. Erickson

    2009-03-31

    U.S. Department of Energy (DOE) Cooperative Agreement DE-FC26-98FT40321 funded through the Office of Fossil Energy and administered at the National Energy Technology Laboratory (NETL) supported the performance of a Jointly Sponsored Research Program (JSRP) at the Energy & Environmental Research Center (EERC) with a minimum 50% nonfederal cost share to assist industry in commercializing and effectively applying highly efficient, nonpolluting energy systems that meet the nation's requirements for clean fuels, chemicals, and electricity in the 21st century. The EERC in partnership with its nonfederal partners jointly performed 131 JSRP projects for which the total DOE cost share was $22,716,634 (38%) and the nonfederal share was $36,776,573 (62%). Summaries of these projects are presented in this report for six program areas: (1) resource characterization and waste management, (2) air quality assessment and control, (3) advanced power systems, (4) advanced fuel forms, (5) value-added coproducts, and (6) advanced materials. The work performed under this agreement addressed DOE goals for reductions in CO{sub 2} emissions through efficiency, capture, and sequestration; near-zero emissions from highly efficient coal-fired power plants; environmental control capabilities for SO{sub 2}, NO{sub x}, fine respirable particulate (PM{sub 2.5}), and mercury; alternative transportation fuels including liquid synfuels and hydrogen; and synergistic integration of fossil and renewable resources.

  4. Phytomedicine in Joint Disorders

    Science.gov (United States)

    Dragos, Dorin; Gilca, Marilena; Gaman, Laura; Vlad, Adelina; Iosif, Liviu; Stoian, Irina; Lupescu, Olivera

    2017-01-01

    Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents) is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

  5. Joint collaborative technology experiment

    Science.gov (United States)

    Wills, Michael; Ciccimaro, Donny; Yee, See; Denewiler, Thomas; Stroumtsos, Nicholas; Messamore, John; Brown, Rodney; Skibba, Brian; Clapp, Daniel; Wit, Jeff; Shirts, Randy J.; Dion, Gary N.; Anselmo, Gary S.

    2009-05-01

    Use of unmanned systems is rapidly growing within the military and civilian sectors in a variety of roles including reconnaissance, surveillance, explosive ordinance disposal (EOD), and force-protection and perimeter security. As utilization of these systems grows at an ever increasing rate, the need for unmanned systems teaming and inter-system collaboration becomes apparent. Collaboration provides a means of enhancing individual system capabilities through relevant data exchange that contributes to cooperative behaviors between systems and enables new capabilities not possible if the systems operate independently. A collaborative networked approach to development holds the promise of adding mission capability while simultaneously reducing the workload of system operators. The Joint Collaborative Technology Experiment (JCTE) joins individual technology development efforts within the Air Force, Navy, and Army to demonstrate the potential benefits of interoperable multiple system collaboration in a force-protection application. JCTE participants are the Air Force Research Laboratory, Materials and Manufacturing Directorate, Airbase Technologies Division, Force Protection Branch (AFRL/RXQF); the Army Aviation and Missile Research, Development, and Engineering Center Software Engineering Directorate (AMRDEC SED); and the Space and Naval Warfare Systems Center - Pacific (SSC Pacific) Unmanned Systems Branch operating with funding provided by the Joint Ground Robotics Enterprise (JGRE). This paper will describe the efforts to date in system development by the three partner organizations, development of collaborative behaviors and experimentation in the force-protection application, results and lessons learned at a technical demonstration, simulation results, and a path forward for future work.

  6. Phytomedicine in Joint Disorders

    Directory of Open Access Journals (Sweden)

    Dorin Dragos

    2017-01-01

    Full Text Available Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

  7. Recent Advances in Computational Mechanics of the Human Knee Joint

    Directory of Open Access Journals (Sweden)

    M. Kazemi

    2013-01-01

    Full Text Available Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.

  8. Recent advances in computational mechanics of the human knee joint.

    Science.gov (United States)

    Kazemi, M; Dabiri, Y; Li, L P

    2013-01-01

    Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.

  9. A Joint General Staff: How Viable an Option?

    Science.gov (United States)

    1985-05-21

    were aumented by complex mobilization systeAs gearei to caximi:e all of a nation𔃽 regourcea for war. Nations today are capable of fielding aillions of...from attacking any targets, inland or otherwise, which ar 2 necessary for the accomplishment of its mission. In reality the conference accomplished...issues of importance in interservice parochialism. .4 34 Yz* -F W S I O Further, the realities of congressional-service budgeting and resource management

  10. Arthrography of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Keyl, W.; Jaeger, M.

    1981-10-01

    The standardized examination technique and the clinical problems of the arthrographic mehtod applied on the knee joint is explained by the results obtained in 3000 examinations. Whereas the accuracy of the knee-joint arthrography provides a high degree in cases of meniscus lesions, computer tomography presents in chondral and capsular ligament lesions, and sonography in popliteal cysts better diagnostic information; but in any case arthroscopy gains more and more importance in knee-joint diagnostics.

  11. OIG targets contractual joint ventures.

    Science.gov (United States)

    O'Hare, Patrick K

    2003-09-01

    A recent OIG Special Advisory Bulletin raises questions for providers involved in joint ventures. The Bulletin describes several characteristics that the OIG views as potentially suspect, including a referral stream controlled by the provider initiating the joint venture and the use of a wholly owned subsidiary of the provider to bill and collect for services. According to the OIG, profits paid by the subsidiary to the provider owner in such "suspect contractual joint ventures" could constitute illegal remuneration for referrals.

  12. Adhesive joint and composites modeling in SIERRA.

    Energy Technology Data Exchange (ETDEWEB)

    Ohashi, Yuki; Brown, Arthur A.; Hammerand, Daniel Carl; Adolf, Douglas Brian; Chambers, Robert S.; Foulk, James W., III (.,; )

    2005-11-01

    Polymers and fiber-reinforced polymer matrix composites play an important role in many Defense Program applications. Recently an advanced nonlinear viscoelastic model for polymers has been developed and incorporated into ADAGIO, Sandia's SIERRA-based quasi-static analysis code. Standard linear elastic shell and continuum models for fiber-reinforced polymer-matrix composites have also been added to ADAGIO. This report details the use of these models for advanced adhesive joint and composites simulations carried out as part of an Advanced Simulation and Computing Advanced Deployment (ASC AD) project. More specifically, the thermo-mechanical response of an adhesive joint when loaded during repeated thermal cycling is simulated, the response of some composite rings under internal pressurization is calculated, and the performance of a composite container subjected to internal pressurization, thermal loading, and distributed mechanical loading is determined. Finally, general comparisons between the continuum and shell element approaches for modeling composites using ADAGIO are given.

  13. Composite SAR imaging using sequential joint sparsity

    Science.gov (United States)

    Sanders, Toby; Gelb, Anne; Platte, Rodrigo B.

    2017-06-01

    This paper investigates accurate and efficient ℓ1 regularization methods for generating synthetic aperture radar (SAR) images. Although ℓ1 regularization algorithms are already employed in SAR imaging, practical and efficient implementation in terms of real time imaging remain a challenge. Here we demonstrate that fast numerical operators can be used to robustly implement ℓ1 regularization methods that are as or more efficient than traditional approaches such as back projection, while providing superior image quality. In particular, we develop a sequential joint sparsity model for composite SAR imaging which naturally combines the joint sparsity methodology with composite SAR. Our technique, which can be implemented using standard, fractional, or higher order total variation regularization, is able to reduce the effects of speckle and other noisy artifacts with little additional computational cost. Finally we show that generalizing total variation regularization to non-integer and higher orders provides improved flexibility and robustness for SAR imaging.

  14. Exploring the Nature of Joint Attention Impairments in Young Children with Autism Spectrum Disorder: Associated Social and Cognitive Skills

    Science.gov (United States)

    Schietecatte, Inge; Roeyers, Herbert; Warreyn, Petra

    2012-01-01

    It is generally accepted that joint attention skills are impaired in children with autism spectrum disorder (ASD). In this study, social preference, attention disengagement and intention understanding, assumed to be associated with the development of joint attention, are explored in relation to joint attention skills in children with ASD at the…

  15. Arthritis of the first metatarsophalangeal joint is not always gout: a prospective cohort study in primary care patients

    NARCIS (Netherlands)

    Kienhorst, L.B.E.; Janssens, H.J.E.M.; Fransen, J.; Lisdonk, E.H. van de; Janssen, M.

    2014-01-01

    OBJECTIVES: Arthritis of the first metatarsophalangeal joint has been considered pathognomonic for gout, but it is unknown how frequently other forms of arthritis occur in this joint. The aims were to determine the validity of the general practitioner's clinical diagnosis using joint fluid analysis

  16. Induction brazing of complex joints

    DEFF Research Database (Denmark)

    Henningsen, Poul; Zhang, Wenqi; Bay, Niels

    2003-01-01

    , or if the hottest area is located outside the joint interface, a number of defects may appear: the braze metal may flow away from the joint, the flux may burn off, poor binding of the braze metal may appear or the braze metal may be overheated. Joint geometry as well as electro-magnetic properties of the work piece......Induction brazing is a fast and appropriate method for industrial joining of complex geometries and metal combinations. In all types of brazing processes it is important to heat the joint interface of the two materials to the same, high temperature. If one of the specimens is warmer than the other...

  17. Induction brazing of complex joints

    DEFF Research Database (Denmark)

    Henningsen, Poul; Zhang, Wenqi; Bay, Niels

    2003-01-01

    Induction brazing is a fast and appropriate method for industrial joining of complex geometries and metal combinations. In all types of brazing processes it is important to heat the joint interface of the two materials to the same, high temperature. If one of the specimens is warmer than the other......, or if the hottest area is located outside the joint interface, a number of defects may appear: the braze metal may flow away from the joint, the flux may burn off, poor binding of the braze metal may appear or the braze metal may be overheated. Joint geometry as well as electro-magnetic properties of the work piece...

  18. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...

  19. Variable Joint Elasticities in Running

    Science.gov (United States)

    Peter, Stephan; Grimmer, Sten; Lipfert, Susanne W.; Seyfarth, Andre

    In this paper we investigate how spring-like leg behavior in human running is represented at joint level. We assume linear torsion springs in the joints and between the knee and the ankle joint. Using experimental data of the leg dynamics we compute how the spring parameters (stiffness and rest angles) change during gait cycle. We found that during contact the joints reveal elasticity with strongly changing parameters and compare the changes of different parameters for different spring arrangements. The results may help to design and improve biologically inspired spring mechanisms with adjustable parameters.

  20. Viola Playing May Be a Strong Aggravating Factor for Temporomandibular Disorder

    OpenAIRE

    Mahmut Alpayci

    2014-01-01

    Temporomandibular disorder (TMD) is the general term used to describe the symptoms originated from temporomandibular joint region. The most common symptom of the disorder is pain during mandibular movement. Etiology of TMD is multifactorial. Several factors such as trauma, occlusal discrepancies, stress, parafunctions, hypermobility, and heredity can make one more vulnerable to this disorder. It has been reported that viola playing might be a predisposing factor for TMD. In this article, we p...

  1. Jointness for the Rest of Us: Reforming Joint Professional Development

    Science.gov (United States)

    2016-06-10

    34Joint Force Development Vision: Adapting to New and Future Realities." JFQ: Joint Force Quarterly, no. 64 (2012): 150 (emphasis added). 7...create opportunities for professional improvement and career progression.7 The Corps concept envisioned education, training, and rotation...opportunities for entry level through senior executives. The report concluded that in order to achieve this goal, DOD career civilians, like their military

  2. Jointness for the Rest of Us: Reforming Joint Professional Development

    Science.gov (United States)

    2016-06-10

    where service capabilities are combined to maximize effectiveness while minimizing vulnerabilities. However, despite the passage of thirty years...34Joint Force Development Vision: Adapting to New and Future Realities." JFQ: Joint Force Quarterly, no. 64 (2012): 150 (emphasis added). 7...create opportunities for professional improvement and career progression.7 The Corps concept envisioned education, training, and rotation

  3. Index of Joint Condition for PVC push-fit joints

    NARCIS (Netherlands)

    Arsenio, A.M.; Vreeburg, J.H.G.; Rietveld, L.

    2014-01-01

    The Index of Joint Condition (IJC) for polyvinyl chloride (PVC) push-fit joints, discussed in this article, was derived from installation guidelines and from destructive laboratory tests. The IJC is presented in a graphical framework and is a powerful tool to employ in order to visualize and compare

  4. Mode i testing of adhesive joints: Experimental part

    Energy Technology Data Exchange (ETDEWEB)

    Noekkentved, A. [Risoe National Lab., Materials Research Dept., Roskilde (Denmark)

    2006-07-01

    The J integral approach for adhesive bonded joints is particularly attractive for modelling failure process zones. The J integral can be established by a general approach and experimental measurements. By this method, the cohesive law of the adhesive in question can be obtained. Polymer joints with different mechanical properties and geometries are considered in order to study the effect of plasticity within the bond of ductile adhesives, since this can enhance their fracture toughness. The cohesive laws established will be implemented in numerical models - more in part 2. The objective of the project is to establish and demonstrate methods for modelling the mechanical behaviour of adhesively bonded joints in polymer matrix composite materials. Fracture mechanics will assist to establish the relevant framework for their mechanical performance. The main results from this study are expected to be part in a set of recommendations regarding production parameters, design, inspection and control of adhesively bonded joints. (au)

  5. 37 CFR 1.45 - Joint inventors.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... patent for an invention invented by them jointly, except as provided in § 1.47. (b) Inventors may...

  6. 38 CFR 4.45 - The joints.

    Science.gov (United States)

    2010-07-01

    ..., ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the...

  7. Child adjustment in joint-custody versus sole-custody arrangements: a meta-analytic review.

    Science.gov (United States)

    Bauserman, Robert

    2002-03-01

    The author meta-analyzed studies comparing child adjustment in joint physical or joint legal custody with sole-custody settings, including comparisons with paternal custody and intact families where possible. Children in joint physical or legal custody were better adjusted than children in sole-custody settings, but no different from those in intact families. More positive adjustment of joint-custody children held for separate comparisons of general adjustment, family relationships, self-esteem, emotional and behavioral adjustment, and divorce-specific adjustment. Joint-custody parents reported less current and past conflict than did sole-custody parents, but this did not explain the better adjustment of joint-custody children. The results are consistent with the hypothesis that joint custody can be advantageous for children in some cases, possibly by facilitating ongoing positive involvement with both parents.

  8. Structuring managed care joint ventures.

    Science.gov (United States)

    Williams, L

    1995-08-01

    Providers that undertake joint ventures to secure managed care contracts must understand the important governance, operational, legal, and political issues involved. Careful planning in all these areas can help ensure that the joint venture will meet its goals and avoid problems such as inappropriately negotiated contracts and legal violations.

  9. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...... audits to be a net burden. Furthermore, based on DeAngelo's (1981) initial audit pricing model and legislators' claim that joint audits are an unnecessary economic burden to the companies we predict and find discounts (of around 25%) in audit fees in companies that change to single audits. The primary...

  10. Space Station alpha joint bearing

    Science.gov (United States)

    Everman, Michael R.; Jones, P. Alan; Spencer, Porter A.

    1987-01-01

    Perhaps the most critical structural system aboard the Space Station is the Solar Alpha Rotary Joint which helps align the power generation system with the sun. The joint must provide structural support and controlled rotation to the outboard transverse booms as well as power and data transfer across the joint. The Solar Alpha Rotary Joint is composed of two transition sections and an integral, large diameter bearing. Alpha joint bearing design presents a particularly interesting problem because of its large size and need for high reliability, stiffness, and on orbit maintability. The discrete roller bearing developed is a novel refinement to cam follower technology. It offers thermal compensation and ease of on-orbit maintenance that are not found in conventional rolling element bearings. How the bearing design evolved is summarized. Driving requirements are reviewed, alternative concepts assessed, and the selected design is described.

  11. Ehlers-Danlos Syndrome Hypermobility Type

    Science.gov (United States)

    ... standing, being in a warm environment, immediately after exercise, after a large meal, or in stressful situations which is caused by low blood pressure (neurally mediated hypotension) or an excessive heart rate upon standing up (postural orthostatic tachycardia). • High, narrow ...

  12. Osteoarthritis of the Wrist STT Joint and Radiocarpal Joint

    Directory of Open Access Journals (Sweden)

    Ronit Wollstein

    2012-01-01

    Full Text Available Our understanding of wrist osteoarthritis (OA lags behind that of other joints, possibly due to the complexity of wrist biomechanics and the importance of ligamentous forces in the function of the wrist. Scaphotrapeziotrapezoidal (STT OA is common, but its role in wrist clinical pathology and biomechanics is unclear. We identified the prevalence of radiographic STT joint OA in our hand clinic population and defined the relationship between STT and radiocarpal OA in wrist radiographs. One hundred consecutive wrist clinical and radiographic exams were retrospectively reviewed. Radiographs were evaluated for the presence and stage of OA. The mean age was 61.3 (±14.5 years. The radiographic occurrence of STT joint OA was 59% and of radiocarpal (RC OA was 29%. Radiographic STT and RC joint OA were inversely related. Tenderness over the STT joint in physical exam was not associated with OA in the STT or other joints. STT OA in our series was not related to wrist pain. These findings support the discrepancy between radiographic and cadaver findings and clinically significant OA in this joint. The inverse relationship between STT and RC OA, as seen in scapholunate advanced collapse (SLAC wrist, requires further biomechanical study.

  13. Osteoarthritis of the Wrist STT Joint and Radiocarpal Joint.

    Science.gov (United States)

    Wollstein, Ronit; Clavijo, Julio; Gilula, Louis A

    2012-01-01

    Our understanding of wrist osteoarthritis (OA) lags behind that of other joints, possibly due to the complexity of wrist biomechanics and the importance of ligamentous forces in the function of the wrist. Scaphotrapeziotrapezoidal (STT) OA is common, but its role in wrist clinical pathology and biomechanics is unclear. We identified the prevalence of radiographic STT joint OA in our hand clinic population and defined the relationship between STT and radiocarpal OA in wrist radiographs. One hundred consecutive wrist clinical and radiographic exams were retrospectively reviewed. Radiographs were evaluated for the presence and stage of OA. The mean age was 61.3 (±14.5) years. The radiographic occurrence of STT joint OA was 59% and of radiocarpal (RC) OA was 29%. Radiographic STT and RC joint OA were inversely related. Tenderness over the STT joint in physical exam was not associated with OA in the STT or other joints. STT OA in our series was not related to wrist pain. These findings support the discrepancy between radiographic and cadaver findings and clinically significant OA in this joint. The inverse relationship between STT and RC OA, as seen in scapholunate advanced collapse (SLAC) wrist, requires further biomechanical study.

  14. Ehlers-Danlos syndrome

    Directory of Open Access Journals (Sweden)

    Wakhloo Tulika

    2015-01-01

    Full Text Available Ehlers-Danlos syndrome is a group of clinically and genetically heterogeneous inherited connective tissue disorders with widespread manifestations. The prevalence of this syndrome is 1:5000 worldwide without gender, racial or ethnic associations. This syndrome is characterized by joint hypermobility, dermal hyperelasticity and tissue fragility caused by mutations in genes encoding collagen type I, III, V and enzymes involved in the posttranslational modifications of collagen. The oral manifestations include increased mucosal fragility, delayed wound healing, early onset generalized periodontitis and temporomandibular joint hypermobility. Children presenting with this syndrome are often misdiagnosed for hematological problem as they present with bruising, malignancy and/or child abuse. A thorough assessment of the patient is, therefore, essential for early diagnosis and patient referral. This paper reviews current literature, oral manifestations, diagnostic investigations and effective dental management.

  15. Prevalence of Signs of Temporomandibular Joint Dysfunction in Asymptomatic Edentulous Subjects: A Cross-Sectional Study

    OpenAIRE

    Shetty, Rajesh

    2010-01-01

    Patients having complete dentures with reduced vertical dimension generally do not manifest Temporomandibular Joint problems. It is not understood as to why the closure of jaws in dentulous individuals can predispose to Temporomandibular Joint problems, while the same etiology in edentulous subjects does not cause any concern. This study was planned to find out the prevalence of various Temporomandibular Joint dysfunction signs in subjects who were edentulous for a period of 6 months to 2 yea...

  16. Torsion testing of bed joints

    DEFF Research Database (Denmark)

    Hansen, Klavs Feilberg; Pedersen, Carsten Mørk

    2008-01-01

    be carried out directly in a normal testing machine. The torsion strength is believed to be the most important parameter in out-of-plane resistance of masonry walls subjected to bending about an axis perpendicular to the bed joints. The paper also contains a few test results from bending of small walls about...... an axis perpendicular to the bed joints, which indicate the close connection between these results and results from torsion tests. These characteristics make the torsion strength well suited to act as substitute parameter for the bending strength of masonry about an axis perpendicular to the bed joints....

  17. Joint ventures in health care.

    Science.gov (United States)

    Pelfrey, S; Theisen, B A

    1989-04-01

    To remain competitive, many not-for-profit hospitals have turned to joint ventures with for-profit and other not-for-profit entities. The authors examine the organizational structures that are used most often to form joint ventures (contractual agreements, subsidiary corporations, partnerships, and not-for-profit title-holding corporations), as well as the advantages and disadvantages associated with each form. Nurse executives must be aware of the opportunities that joint ventures provide their institutions. These arrangements can help improve and expand services and profitability.

  18. Creating Joint Leaders Today for a Successful Air Force Tomorrow (1REV)

    Science.gov (United States)

    2016-04-01

    promotion of joint duty officers. Obviously, Title IV was unpopular among senior military leaders. Admiral William Crowe , Chairman of the Joint Chiefs of...Command Screening Board (CSB) The most sweeping change to the CSB since former CSAF General Merrill McPeak created it occurred at CORONA Fall 2008 when

  19. Are Standing Joint Task Force Headquarters the First Step in Transforming Cold War Formations?

    Science.gov (United States)

    2002-05-01

    and General Staff College, 1995. Connaughton , Richard M. "Organizing British Joint Rapid Reaction Forces." Joint Force Quarterly. Autumn 2000, pp. 87...Margaret Roth, and Caleb Baker. Operation Just Cause: The Storming of Panama. New York: Lexington Books, 1991. Dunn, Brian J. "Rethinking Army-Marine

  20. 17 CFR 248.13 - Exception to opt out requirements for service providers and joint marketing.

    Science.gov (United States)

    2010-04-01

    ... requirements for service providers and joint marketing. 248.13 Section 248.13 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) REGULATIONS S-P AND S-AM Regulation S-P: Privacy of... out requirements for service providers and joint marketing. (a) General rule. (1) The opt...

  1. A mixture model for the joint analysis of latent developmental trajectories and survival

    NARCIS (Netherlands)

    Klein Entink, R.H.; Fox, J.P.; Hout, A. van den

    2011-01-01

    A general joint modeling framework is proposed that includes a parametric stratified survival component for continuous time survival data, and a mixture multilevel item response component to model latent developmental trajectories given mixed discrete response data. The joint model is illustrated in

  2. [Systematization of the articular surfaces of the carpometacarpal joints (author's transl)].

    Science.gov (United States)

    el Bacha, A; Maillot, C

    1977-01-01

    A study, done on 100 hands, of the systematization of the articular surfaces of the carpometacarpal joints, clearly delineates the variability of circumference, dimesions, and relief of the articular facets. An attempt to draw general conclusions from this morphological study, in terms of arthrokinetics, leads to an understanding of the nature of the joints and the movements that are performed at this site.

  3. A mixture model for the joint analysis of latent developmental trajectories and survival

    NARCIS (Netherlands)

    Klein Entink, R.H.; Fox, J.P.; Hout, A. van den

    2011-01-01

    A general joint modeling framework is proposed that includes a parametric stratified survival component for continuous time survival data, and a mixture multilevel item response component to model latent developmental trajectories given mixed discrete response data. The joint model is illustrated in

  4. Does Hypoxia-Reperfusion Injury Occur in Osteoarthritis of the Temporomandibular Joint?

    NARCIS (Netherlands)

    Vos, Lukas M.; Slater, James J. R. Huddleston; Leijsma, Martha K.; Stegenga, Boudewijn

    2012-01-01

    Aims: To determine the available evidence in the literature for whether hypoxia-reperfusion injury plays a role in the pathogenesis of joint diseases in general and of osteoarthritis (OA) of the temporomandibular joint (TMJ) in particular. Methods: The electronic databases CENTRAL, PubMed, and EMBAS

  5. Generalized product

    OpenAIRE

    Greco,Salvatore; Mesiar, Radko; Rindone, Fabio

    2014-01-01

    Aggregation functions on [0,1] with annihilator 0 can be seen as a generalized product on [0,1]. We study the generalized product on the bipolar scale [–1,1], stressing the axiomatic point of view. Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas and bipolar copulas.

  6. Generalized product

    OpenAIRE

    Greco, Salvatore; Mesiar, Radko; Rindone, Fabio

    2014-01-01

    Aggregation functions on [0,1] with annihilator 0 can be seen as a generalized product on [0,1]. We study the generalized product on the bipolar scale [–1,1], stressing the axiomatic point of view. Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas and bipolar copulas.

  7. Road network safety evaluation using Bayesian hierarchical joint model.

    Science.gov (United States)

    Wang, Jie; Huang, Helai

    2016-05-01

    Safety and efficiency are commonly regarded as two significant performance indicators of transportation systems. In practice, road network planning has focused on road capacity and transport efficiency whereas the safety level of a road network has received little attention in the planning stage. This study develops a Bayesian hierarchical joint model for road network safety evaluation to help planners take traffic safety into account when planning a road network. The proposed model establishes relationships between road network risk and micro-level variables related to road entities and traffic volume, as well as socioeconomic, trip generation and network density variables at macro level which are generally used for long term transportation plans. In addition, network spatial correlation between intersections and their connected road segments is also considered in the model. A road network is elaborately selected in order to compare the proposed hierarchical joint model with a previous joint model and a negative binomial model. According to the results of the model comparison, the hierarchical joint model outperforms the joint model and negative binomial model in terms of the goodness-of-fit and predictive performance, which indicates the reasonableness of considering the hierarchical data structure in crash prediction and analysis. Moreover, both random effects at the TAZ level and the spatial correlation between intersections and their adjacent segments are found to be significant, supporting the employment of the hierarchical joint model as an alternative in road-network-level safety modeling as well.

  8. Embedded Optimal Control of Robot Manipulators with Passive Joints

    Directory of Open Access Journals (Sweden)

    Alberto Olivares

    2015-01-01

    Full Text Available This paper studies the optimal control problem for planar underactuated robot manipulators with two revolute joints and brakes at the unactuated joints in the presence of gravity. The presence of a brake at an unactuated joint gives rise to two operating modes for that joint: free and braked. As a consequence, there exist two operating modes for a robot manipulator with one unactuated joint and four operating modes for a manipulator with two unactuated joints. Since these systems can change dynamics, they can be regarded as switched dynamical systems. The optimal control problem for these systems is solved using the so-called embedding approach. The main advantages of this technique are that assumptions about the number of switches are not necessary, integer or binary variables do not have to be introduced to model switching decisions between modes, and the optimal switching times between modes are not unknowns of the optimal control problem. As a consequence, the resulting problem is a classical continuous optimal control problem. In this way, a general method for the solution of optimal control problems for switched dynamical systems is obtained. It is shown in this paper that it can deal with nonintegrable differential constraints.

  9. Joint Force Quarterly. Issue 38, 3rd Quarter, July 2005

    Science.gov (United States)

    2005-07-01

    anthropologists such as Gregory Bateson served the war effort directly, first conduct- ing intelligence opera- tions in Burma for the Office of...leaders such as General James L. Jones, Jr., USMC, Supreme Allied Commander, Europe, and Admi- ral Gregory G. Johnson, USN, combatant com- mander, Joint

  10. Subtalar joint arthrodesis: open and arthroscopic indications and surgical techniques.

    Science.gov (United States)

    Roster, Brent; Kreulen, Christopher; Giza, Eric

    2015-06-01

    Arthrodesis of the subtalar joint can be performed via both open and arthroscopic techniques. Both groups of procedures have their own relative indications and contraindications, as well as complications. Good results have been reported for both general procedures, although some studies suggest superiority with arthroscopic subtalar arthrodesis. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Sonography for hip joint effusion in adults with hip pain

    NARCIS (Netherlands)

    S.M. Bierma-Zeinstra (Sita); A.M. Bohnen (Arthur); J.A.N. Verhaar (Jan); A. Prins (Ad); J.S. Lameris; A.Z. Ginai (Abida)

    2000-01-01

    textabstractOBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general

  12. Campus/Industry Joint Ventures.

    Science.gov (United States)

    McDonald, Eugene J.

    1985-01-01

    Opportunities for joint economic ventures of colleges and industry are discussed, and a variety of ventures undertaken by Duke University are outlined, including a health club, hotel, and office building. Tax and financing considerations are noted. (MSE)

  13. Joint Performance and Planning System

    Data.gov (United States)

    US Agency for International Development — A joint State/USAID system hosted by State that integrates resource and performance information at the program level and enables more flexible and frequent entry of...

  14. US Joint Ventures 2014 revision

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A joint venture is a self-directed partnership of agencies, organizations, corporations, tribes, or individuals that has formally accepted the responsibility of...

  15. Campus/Industry Joint Ventures.

    Science.gov (United States)

    McDonald, Eugene J.

    1985-01-01

    Opportunities for joint economic ventures of colleges and industry are discussed, and a variety of ventures undertaken by Duke University are outlined, including a health club, hotel, and office building. Tax and financing considerations are noted. (MSE)

  16. Entanglement swapping without joint Measurement

    CERN Document Server

    Yang, M; Cao, Z L; Yang, Ming; Song, Wei; Cao, Zhuo-Liang

    2004-01-01

    We propose an entanglement swapping scheme in cavity QED. In the scheme, the previously used joint measurement is not needed. Only single measurement on cavity can realize the swapping process, which avoids the difficulty of measurement on atomic state.

  17. Finishing touch to joint venture

    CERN Multimedia

    2003-01-01

    "A new process for polishing titanium and its alloys has been announced following an agreement between Bripol (an Anopol/Delmet joint venture) of Birmingham and the European Organisation for Nuclear Reseach (CERN) in Geneva" (1 paragraph).

  18. US Joint Ventures 2014 revision

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A joint venture is a self-directed partnership of agencies, organizations, corporations, tribes, or individuals that has formally accepted the responsibility of...

  19. Torsion testing of bed joints

    DEFF Research Database (Denmark)

    Hansen, Klavs Feilberg; Pedersen, Carsten Mørk

    2008-01-01

    This paper describes a simple test method for determining the torsion strength of a single bed joint between two bricks and presents results from testing using this test method. The setup for the torsion test is well defined, require minimal preparation of the test specimen and the test can...... be carried out directly in a normal testing machine. The torsion strength is believed to be the most important parameter in out-of-plane resistance of masonry walls subjected to bending about an axis perpendicular to the bed joints. The paper also contains a few test results from bending of small walls about...... an axis perpendicular to the bed joints, which indicate the close connection between these results and results from torsion tests. These characteristics make the torsion strength well suited to act as substitute parameter for the bending strength of masonry about an axis perpendicular to the bed joints....

  20. Joint Center for Robotics (JCR)

    Science.gov (United States)

    2008-04-15

    Unclassified 1 Joint Center for Robotics (JCR) Dr. Jim Overholt 15 April 2008 DISTRIBUTION STATEMENT A. Approved for public release; distribution is...REPORT DATE APR 2008 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Joint Center for Robotics (JCR) 5a. CONTRACT NUMBER 5b. GRANT...ANSI Std Z39-18 Unclassified 2 TARDEC JCR Robotics CAST Projects & Cells “White Hat” Organization - Understand the needs of the user and create

  1. Joint probabilities and quantum cognition

    CERN Document Server

    de Barros, J Acacio

    2012-01-01

    In this paper we discuss the existence of joint probability distributions for quantum-like response computations in the brain. We do so by focusing on a contextual neural-oscillator model shown to reproduce the main features of behavioral stimulus-response theory. We then exhibit a simple example of contextual random variables not having a joint probability distribution, and describe how such variables can be obtained from neural oscillators, but not from a quantum observable algebra.

  2. IRS memorandum limits joint ventures.

    Science.gov (United States)

    Herman, A W

    1992-08-01

    Based on a new memorandum, the Internal Revenue Service (IRS) will be looking at joint hospital/physician activities with greater attention to the nuances of public versus private benefit. As a result, hospitals face greater risk of losing their tax-exempt status in the maze of joint ventures, physician recruitment, and practice acquisition. To be successful, ventures will have to be backed by sound reasoning and thorough documentation.

  3. The Joint Master Operational Planner

    Science.gov (United States)

    2016-04-04

    Staff College , College of Naval Command and Staff, or Marine Corps Command and Staff College . Next, students must apply, and the services competitively...ELEMENT NUMBER 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8...Daniel H. Hibner, United States Army Joint Forces Staff College Joint Advanced Warfighting School 7800 Hampton Blvd. Norfolk, VA 23511-1702 Approved

  4. COMPLEX FUNCTIONAL ASSESSMENT OF THE HIP JOINT.

    Directory of Open Access Journals (Sweden)

    Maya S. Krastanova

    2015-09-01

    Full Text Available Introduction: In relation to the study reporting the effects of applying phased complex rehabilitation in patients with total hip arthroplasty, it has been concluded that the everyday clinical practice in Bulgaria does not apply complex examination, giving an objective picture about the extent of functional status of patients with trauma and diseases of the hip. Aim: The main goal of this report is to present a test which incorporates all known and routine research and in which the total number of points determines the functional status of patients with trauma and diseases of the hip. Material and Methods: Based on the Hip dysfunction and Osteoarthritis Outcome Score, the Harris Hip Score modified test, scale D’Aubigne and Postel and Iowa’s test for complex functional evaluation of the hip joint, we have developed a test including information about the degree of pain; goniometry and manual muscle testing of the hip; locomotor test – type of gait and adjuvants; test for Daily Activities of Life. The test has been developed on the basis of expert assessment by doctors and physiotherapists of the proposed indicators for evaluation and determination of the weighting factors’ contribution to the general condition of the patient. Conclusion: The developed and tested method of complex functional assessment of the hip joint enables our colleagues, dealing with trauma and diseases of the hip, to use it in various research and scientific projects, as well as in general medical practice.

  5. A new peak shear strength criterion for rock joints which includes spectral parameters as roughness measures

    Energy Technology Data Exchange (ETDEWEB)

    Kulatilake, P.H.S.W.; Shou, G. [Univ. of Arizona, Tucson, AZ (United States); Huang, T.H. [National Taiwan Univ., Taipei (Taiwan, Province of China)

    1996-04-01

    Most of the natural rock joint surface profiles do not belong to the self similar fractal category. In general, roughness profiles of rock joints consist of non-stationary and stationary components. At the simplest level, only one parameter is sufficient to quantify non-stationary joint roughness. The average inclination angle I, along with the direction considered for the joint surface, is suggested to capture the non-stationary roughness. It is shown that even though the fractal dimension D is a useful parameter, it alone is insufficient to quantify the stationary roughness of non-self similar profiles.

  6. Joint Services Electronics Program.

    Science.gov (United States)

    1986-09-30

    Generalized Impulse Response," Proceedings of Midwest Symposium on Circuits and Systems, Puebla , Mexico, pp. 198-202 (August 15-16, 1983). 10. S.H. Park...properties include basic studies of ambient /InP interactions and studies of the properties of various interfaces between lnP and deposited dielectrics...Investigations of InP surfaces include studies of the interaction of InP with chemical etching solutions, gas ambients , and vacuum environments. Studies

  7. General Geocryology

    Science.gov (United States)

    Yershov, Edward D.; Williams, Peter J.

    2004-08-01

    In the cold regions, freezing of the ground presents major geotechnical and environmental challenges. In Russia, oil and gas gives these regions special economic and geopolitical significance. After glasnost, it became evident that research there was more comprehensive but the problems far greater than elsewhere. This translation of a wide-ranging account of the effects of freezing and their importance for geotechnical undertakings, has been prepared by an international team of specialists. It makes available a uniquely readable and technically accurate review, especially valuable to international organisations and those involved in joint ventures. The English edition of the 16-sheet geocryological map of Russian has been prepared by the same international team. For more details please see: www.freezingground.org/map or contact Scott Polar Research Institute, (Attn. Prof. P. J. Williams), Lensfield Rd., Cambridge, CB2 1ER, UK. - or e-mail: pjw1005@cus.cam.ac.uk.

  8. Generalized multidirectional fuzzy map model of the logistics system networks

    Science.gov (United States)

    Ji, Chun-Rong; Liu, Ming-Yuan; Li, Yan; He, Yue M.

    1997-07-01

    By conducting [0, 1] treatment to time consuming of logistics system network key links, and regarding the time consumed by manufacture, inspection, storage, assembling, packing and market as a kind of existent extent of the joint and the time consumed by materials handling, transportation and logistics information as the connection strength between joints in a generalized multi-directional fuzzy map, a generalized multi-directional fuzzy map model of logistics system networks is built. The mutual flow among network joints and the special form of generalized fuzzy matrix is analyzed. Finally, an example of model building is given.

  9. 12 CFR 347.107 - Joint ventures.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or...

  10. [Great Salt Lake Ecosystem Wetlands and Wildlife: A prospectus for a mini-joint venture

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document is a general approach towards a mini-joint venture between Near River Migratory Bird Refuge and Utah State University. It is focused on the Great Salt...

  11. 26 CFR 11.401(a)-11 - Qualified joint and survivor annuities.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) TEMPORARY INCOME TAX REGULATIONS UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 § 11.401(a)-11 Qualified joint and survivor annuities. (a) In general—(1) General rule...

  12. Influence of joint models on lower-limb musculo-tendon forces and three-dimensional joint reaction forces during gait.

    Science.gov (United States)

    Dumas, Raphaël; Moissenet, Florent; Gasparutto, Xavier; Cheze, Laurence

    2012-02-01

    Several three-dimensional (3D) lower-limb musculo-skeletal models have been developed for gait analysis and different hip, knee and ankle joint models have been considered in the literature. Conversely to the influence of the musculo-tendon geometry, the influence of the joint models--i.e. number of degrees of freedom and passive joint moments--on the estimated musculo-tendon forces and 3D joint reaction forces has not been extensively examined. In this paper musculo-tendon forces and 3D joint reaction forces have been estimated for one subject and one gait cycle with nine variations of a musculoskeletal model and outputs have been compared to measured electromyographic signals and knee joint contact forces. The model outputs are generally in line with the measured signals. However, the 3D joint reaction forces were higher than published values and the contact forces measured for the subject. The results of this study show that, with more degrees of freedom in the model, the musculo-tendon forces and the 3D joint reaction forces tend to increase but with some redistribution between the muscles. In addition, when taking into account passive joint moments, the 3D joint reaction forces tend to decrease during the stance phase and increase during the swing phase. Although further investigations are needed, a five-degree-of-freedom lower-limb musculo-skeletal model with some angle-dependent joint coupling and stiffness seems to provide satisfactory musculo-tendon forces and 3D joint reaction forces.

  13. R&D returns, market structure and research joint ventures

    DEFF Research Database (Denmark)

    Amir, Rabah

    2000-01-01

    A two-period symmetric Cournot duopoly with linear demand and costs is analyzed under linear (or more general) returns to scale in process R&D. Subgame-perfect equilibrium may call for one firm to fully innovate while the other firm remains just as before. The outcome is a polar duopoly or monopoly...... (one firm endogenously exiting). Two research joint venture schemes and the noncooperative solution are compared. Due to built-in symmetry, a joint lab does not always lead to the best performance. Overall, our findings differ quite substantially from those based on strongly decreasing R&D returns...

  14. Preceding trauma in childhood hematogenous bone and joint infections.

    Science.gov (United States)

    Pääkkönen, Markus; Kallio, Markku J T; Lankinen, Petteri; Peltola, Heikki; Kallio, Pentti E

    2014-03-01

    Preceding trauma may play a role in the etiology and pathogenesis of hematogenous bone and joint infections. Among 345 children with an acute hematogenous bone and/or joint infection, 20% reported trauma during a 2-week period leading to infection. Blunt impact, bruises, or excoriations were commonly reported. The rate was similar to that in the general pediatric population obtained from the literature. In the study group, patients with and without trauma were similar in age, serum C-reactive protein and erythrocyte sedimentation rate, length of hospitalization, and late sequelae. Preceding minor trauma did not prove to be significant as an etiological or as a prognostic factor.

  15. A musculoskeletal model of the elbow joint complex

    Science.gov (United States)

    Gonzalez, Roger V.; Barr, Ronald E.; Abraham, Lawrence D.

    1993-01-01

    This paper describes a musculoskeletal model that represents human elbow flexion-extension and forearm pronation-supination. Musculotendon parameters and the skeletal geometry were determined for the musculoskeletal model in the analysis of ballistic elbow joint complex movements. The key objective was to develop a computational model, guided by optimal control, to investigate the relationship among patterns of muscle excitation, individual muscle forces, and movement kinematics. The model was verified using experimental kinematic, torque, and electromyographic data from volunteer subjects performing both isometric and ballistic elbow joint complex movements. In general, the model predicted kinematic and muscle excitation patterns similar to what was experimentally measured.

  16. Fracture analysis of adhesive joints in wind turbine blades

    DEFF Research Database (Denmark)

    Eder, Martin Alexander; Bitsche, Robert

    2015-01-01

    the air-flow rejoins and leaves the blade. Maintenance inspections of wind turbine rotor blades show that among other forms of damage, local debonding of the shells along the trailing edge is a frequent failure type. The cause of trailing edge failure in wind turbine blades is complex, and detailed...... information is scarce. This paper is concerned with the fracture analysis of adhesive joints in general, with a particular focus on trailing edges. For that, the energy release rates in prescribed cracks present in the bond line of a generic trailing edge joint are investigated. In connection...

  17. Prevalence of signs of temporomandibular joint dysfunction in asymptomatic edentulous subjects: a cross-sectional study.

    Science.gov (United States)

    Shetty, Rajesh

    2010-06-01

    Patients having complete dentures with reduced vertical dimension generally do not manifest Temporomandibular Joint problems. It is not understood as to why the closure of jaws in dentulous individuals can predispose to Temporomandibular Joint problems, while the same etiology in edentulous subjects does not cause any concern. This study was planned to find out the prevalence of various Temporomandibular Joint dysfunction signs in subjects who were edentulous for a period of 6 months to 2 year. The various signs were obtained from a population of 100 healthy asymptomatic edentulous subjects by a questionnaire and then were clinically examined for the presence or absence of signs of Temporomandibular Joint dysfunction. 59% of the subjects exhibited one or more signs of Temporomandibular Joint dysfunction, 41% of the subjects did not show any signs of Temporomandibular Joint dysfunction. 56.6% of males reported signs of Temporomandibular Joint dysfunction when compared with females which was 62.5%. 43.3% of males did not show any signs of Temporomandibular Joint dysfunction when compared with those of the females which was 37.5%. The number of subjects who showed two signs was 29%, subjects who had only one sign was 25%. It was found that dysfunction was prevalent among both men and women in more than half of the asymptomatic subjects examined. 59% had one or as many as three signs of Temporomandibular dysfunction. The most commonly seen Joint dysfunction was the joint sounds which was 47%

  18. Management of acromioclavicular joint injuries.

    Science.gov (United States)

    Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

    2014-01-01

    Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

  19. General Conformity

    Science.gov (United States)

    The General Conformity requirements ensure that the actions taken by federal agencies in nonattainment and maintenance areas do not interfere with a state’s plans to meet national standards for air quality.

  20. General Anesthesia

    Science.gov (United States)

    ... unconscious and unable to feel pain during medical procedures. General anesthesia usually uses a combination of intravenous drugs ... 1998-2017 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

  1. Joint venture instability: a life cycle approach

    OpenAIRE

    Roy Chowdhury, Prabal; Roy Chowdhury, Indrani

    2001-01-01

    Joint ventures represent one of the most fascinating developments in international business. In the last few decades, the rate of joint venture formation has accelerated dramatically. Nowadays joint ventures are much more widespread and occur in industries like telecommunications, biotechnology etc. At the same time, however, it must be noted that joint ventures are very unstable. In this paper we survey the phenomenon of joint venture instability. We draw on the relative recent theoretical l...

  2. Joint venture instability: a life cycle approach

    OpenAIRE

    Roy Chowdhury, Prabal; Roy Chowdhury, Indrani

    2001-01-01

    Joint ventures represent one of the most fascinating developments in international business. In the last few decades, the rate of joint venture formation has accelerated dramatically. Nowadays joint ventures are much more widespread and occur in industries like telecommunications, biotechnology etc. At the same time, however, it must be noted that joint ventures are very unstable. In this paper we survey the phenomenon of joint venture instability. We draw on the relative recent theoretical l...

  3. [Anterior joints of the thoracic cage].

    Science.gov (United States)

    Taddei, A; Sick, H

    1983-01-01

    The chondro-sternal, interchondral, costo-chondral joints and the upper and lower sternal joints were studied in the thorax of 60 children and human adults. Chondro-sternal joints occur as frequent symphyses in the 5th, 6th and 7th joints or ellipsoid joints which are mainly found in the 2nd, 3rd and 4th joints. Diarthrosis frequency increases with age in every joint. An articular space appears particularly in the lower part of the 2nd, 3rd and 4th joints; in fewer cases a space is found in the upper part of the 5th, 6th and 7th joints. These partial spaces disappear with age and are replaced by spaces occupying the whole articulation. The first joint is a synchondrosis which does not vary with age. Interchondral joints are diarthrodial or trochoid joints from earliest childhood and their frequency increases with age. No direct articular contact was observed between the 9th and 10th costal cartilages. Costo-chondral joints are synarthrosis. The upper sternal joint, which is a synchondrosis in the child, may develop into a non-synovial cavity with age, or even turn into synostosis. The lower sternal joint is a synchondrosis which develops partially towards synostosis.

  4. The movement kinematics of manipulator with elastic joints in the curvilinear coordinate system

    Directory of Open Access Journals (Sweden)

    A.A. Ghukasyan

    2007-09-01

    Full Text Available Movement kinematics of the multi-link manipulator with elastic joints in the curvilinear coordinate system is studied. Within the bounds of the linear theory of elasticity by generalized Lame matrix general expressions for speed and acceleration of the characteristic points of the links and manipulator handle are received. The received formulas allow to easily determine the kinematics of different constructions of the manipulators with elastic joints in the curvilinear coordinates. As an example movement velocity of a two-link manipulator with one elastic joint is determined in the cylindrical coordinate system.

  5. Ambulatory surgery center joint ventures involving tax-exempt entities.

    Science.gov (United States)

    Becker, S; Pristave, R J; McConnell, W

    1999-01-01

    This article provides an overview of the tax-exempt related issues for ambulatory surgery center joint ventures involving tax-exempt entities. The article analyzes the key points of analysis of the guidance released by the IRS, in particular General Counsel Memorandum 39862, Revenue Ruling 98-15, and Redlands Surgical Services v. Commissioner of the Internal Revenue Service. These key points include whether the venture results in private inurement to insiders and whether the venture furthers the charitable purposes of the tax-exempt entity. The article also provides practical guidance to analyze the documents and structure of the joint venture to ensure compliance with the IRS guidance. These practical considerations include, among other things, whether the charitable purposes of the tax-exempt entity are clearly expressed in the documents and whether the tax-exempt entity has sufficient control over the joint venture to ensure the charitable purposes are being adhered to.

  6. Joint estimation of phase and phase diffusion for quantum metrology

    CERN Document Server

    Vidrighin, Mihai D; Genoni, Marco G; Jin, Xian-Min; Kolthammer, W Steven; Kim, M S; Datta, Animesh; Barbieri, Marco; Walmsley, Ian A

    2014-01-01

    Phase estimation, at the heart of many quantum metrology and communication schemes, can be strongly affected by noise, whose amplitude may not be known, or might be subject to drift. Here, we investigate the joint estimation of a phase shift and the amplitude of phase diffusion, at the quantum limit. For several relevant instances, this multiparameter estimation problem can be effectively reshaped as a two-dimensional Hilbert space model, encompassing the description of an interferometer phase probed with relevant quantum states -- split single-photons, coherent states or N00N states. For these cases, we obtain a trade-off bound on the statistical variances for the joint estimation of phase and phase diffusion, as well as optimum measurement schemes. We use this bound to quantify the effectiveness of an actual experimental setup for joint parameter estimation for polarimetry. We conclude by discussing the form of the trade-off relations for more general states and measurements.

  7. Automatic finger joint synovitis localization in ultrasound images

    Science.gov (United States)

    Nurzynska, Karolina; Smolka, Bogdan

    2016-04-01

    A long-lasting inflammation of joints results between others in many arthritis diseases. When not cured, it may influence other organs and general patients' health. Therefore, early detection and running proper medical treatment are of big value. The patients' organs are scanned with high frequency acoustic waves, which enable visualization of interior body structures through an ultrasound sonography (USG) image. However, the procedure is standardized, different projections result in a variety of possible data, which should be analyzed in short period of time by a physician, who is using medical atlases as a guidance. This work introduces an efficient framework based on statistical approach to the finger joint USG image, which enables automatic localization of skin and bone regions, which are then used for localization of the finger joint synovitis area. The processing pipeline realizes the task in real-time and proves high accuracy when compared to annotation prepared by the expert.

  8. Uncertainty of knee joint muscle activity during knee joint torque exertion: the significance of controlling adjacent joint torque.

    Science.gov (United States)

    Nozaki, Daichi; Nakazawa, Kimitaka; Akai, Masami

    2005-09-01

    In the single-joint torque exertion task, which has been widely used to control muscle activity, only the relevant joint torque is specified. However, the neglect of the neighboring joint could make the procedure unreliable, considering our previous result that even monoarticular muscle activity level is indefinite without specifying the adjacent joint torque. Here we examined the amount of hip joint torque generated with knee joint torque and its influence on the activity of the knee joint muscles. Twelve healthy subjects were requested to exert various levels of isometric knee joint torque. The knee and hip joint torques were obtained by using a custom-made device. Because no information about hip joint torque was provided to the subjects, the hip joint torque measured here was a secondary one associated with the task. The amount of hip joint torque varied among subjects, indicating that they adopted various strategies to achieve the task. In some subjects, there was a considerable internal variability in the hip joint torque. Such variability was not negligible, because the knee joint muscle activity level with respect to the knee joint torque, as quantified by surface electromyography (EMG), changed significantly when the subjects were requested to change the strategy. This change occurred in a very systematic manner: in the case of the knee extension, as the hip flexion torque was larger, the activity of mono- and biarticular knee extensors decreased and increased, respectively. These results indicate that the conventional single knee joint torque exertion has the drawback that the intersubject and/or intertrial variability is inevitable in the relative contribution among mono- and biarticular muscles because of the uncertainty of the hip joint torque. We discuss that the viewpoint that both joint torques need to be considered will bring insights into various controversial problems such as the shape of the EMG-force relationship, neural factors that help

  9. Generalized polygons

    CERN Document Server

    Van Maldeghem, Hendrik

    1998-01-01

    Generalized Polygons is the first book to cover, in a coherent manner, the theory of polygons from scratch. In particular, it fills elementary gaps in the literature and gives an up-to-date account of current research in this area, including most proofs, which are often unified and streamlined in comparison to the versions generally known. Generalized Polygons will be welcomed both by the student seeking an introduction to the subject as well as the researcher who will value the work as a reference. In particular, it will be of great value for specialists working in the field of generalized polygons (which are, incidentally, the rank 2 Tits-buildings) or in fields directly related to Tits-buildings, incidence geometry and finite geometry. The approach taken in the book is of geometric nature, but algebraic results are included and proven (in a geometric way!). A noteworthy feature is that the book unifies and generalizes notions, definitions and results that exist for quadrangles, hexagons, octagons - in the ...

  10. Rheumatoid arthritis affecting temporomandibular joint.

    Science.gov (United States)

    Sodhi, Amandeep; Naik, Shobha; Pai, Anuradha; Anuradha, Ardra

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

  11. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  12. Joint US/German Conference

    CERN Document Server

    Gulledge, Thomas; Jones, Albert

    1993-01-01

    This proceedings volume contains selected and refereed contributions that were presented at the conference on "Recent Developments and New Perspectives of Operations Research in the Area of Production Planning and Control" in Hagen/Germany, 25. - 26. June 1992. This conference was organized with the cooperation of the FernuniversiHit Hagen and was jointly hosted by the "Deutsche Gesellschaft fur Operations Research (DGOR)" and the "Manufacturing Special Interest Group of the Operations Research Society of America (ORSA-SIGMA)". For the organization of the conference we received generous financial support from the sponsors listed at the end of this volume. We wish to express our appreciation to all supporters for their contributions. This conference was the successor of the JOInt ORSA/DGOR-conference in Gaithersburg/Maryland, USA, on the 30. and 31. July 1991. Both OR-societies committed themselves in 1989 to host joint conferences on special topics of interest from the field of operations research. This goal ...

  13. [Generalized periarthritis calcarea (generalized hydroxyapatite disease)].

    Science.gov (United States)

    Müller, W; Bahous, I

    1979-09-01

    The condition of generalized periarthritis calcarea (hydroxyapatite deposition disease) is characterised by multiple periarticular calcification which can be localised around practically any joint and also in proximity to the spine. This calcification consists of hydroxyapatite crystals which are responsible for the episodes of acute, subacute or chronic periarticular or articular inflammation so typical of the condition. Because of this one can classify periarthritis calcarea along with gout and chondrocalcinosis in the group of crystal deposition diseases. The actual cause of the calcification remains unknown but it is probable that, along with hereditary factors, disturbances in metabolism play an important role. The diagnosis of generalised periarthritis is made from the characteristic X-ray picture in conjunction with the clinical findings and, on occasion, the demonstration of hydroxyapatite crystals in the affected tissues. In the differential diagnosis gout, chondrocalcinosis, various inflammatory rheumatic conditions and septic arthritis must be excluded and various calcification processes, particularly interstitial calcinosis and lipocal cinogranulomatosis, must also be considered. Since the etiology of the calcification remains unknown to specific treatment is available. Symptomatic treatment with colchicine is mostly inadequate which is why one often has recourse to the use of non-steroid anti-inflammatory drugs and corticosteroids.

  14. The leading joint hypothesis for spatial reaching arm motions.

    Science.gov (United States)

    Ambike, Satyajit; Schmiedeler, James P

    2013-02-01

    The leading joint hypothesis (LJH), developed for planar arm reaching, proposes that the interaction torques experienced by the proximal joint are low compared to the corresponding muscle torques. The human central nervous system could potentially ignore these interaction torques at the proximal (leading) joint with little effect on the wrist trajectory, simplifying joint-level control. This paper investigates the extension of the LJH to spatial reaching. In spatial motion, a number of terms in the governing equation (Euler's angular momentum balance) that vanish for planar movements are non-trivial, so their contributions to the joint torque must be classified as net, interaction or muscle torque. This paper applies definitions from the literature to these torque components to establish a general classification for all terms in Euler's equation. This classification is equally applicable to planar and spatial motion. Additionally, a rationale for excluding gravity torques from the torque analysis is provided. Subjects performed point-to-point reaching movements between targets whose locations ensured that the wrist paths lay in various portions of the arm's spatial workspace. Movement kinematics were recorded using electromagnetic sensors located on the subject's arm segments and thorax. The arm was modeled as a three-link kinematic chain with idealized spherical and revolute joints at the shoulder and elbow. Joint torque components were computed using inverse dynamics. Most movements were 'shoulder-led' in that the interaction torque impulse was significantly lower than the muscle torque impulse for the shoulder, but not the elbow. For the few elbow-led movements, the interaction impulse at the elbow was low, while that at the shoulder was high, and these typically involved large elbow and small shoulder displacements. These results support the LJH and extend it to spatial reaching motion.

  15. Generalized derivations and general relativity

    CERN Document Server

    Heller, M; Pysiak, L; Sasin, W

    2013-01-01

    We construct differential geometry (connection, curvature, etc.) based on generalized derivations of an algebra A. Such a derivation, introduced by Bresar in 1991, is given by a linear mapping u: A -> A such that there exists a usual derivation d of A satisfying the generalized Leibniz rule u(a b) = u(a) b + a d(b) for all a,b in A. The generalized geometry "is tested" in the case of the algebra of smooth functions on a manifold. We then apply this machinery to study the generalized general relativity. We define the Einstein-Hilbert action and deduce from it Einstein's field equations. We show that for a special class of metrics containing, besides the usual metric components, only one non-zero term, the action reduces to O'Hanlon action that is a Brans-Dicke action with potential and with the parameter \\omega equal to zero. We also show that the generalized Einstein equations (with zero energy-stress tensor) are equivalent to those of the Kaluza-Klein theory satisfying a "modified cylinder condition" and hav...

  16. GENERAL EQUILIBRIUM

    Directory of Open Access Journals (Sweden)

    Monique Florenzano

    2008-09-01

    Full Text Available General equilibrium is a central concept of economic theory. Unlike partial equilibrium analysis which study the equilibrium of a particular market under the clause “ceteris paribus” that revenues and prices on the other markets stay approximately unaffected, the ambition of a general equilibrium model is to analyze the simultaneous equilibrium in all markets of a competitive economy. Definition of the abstract model, some of its basic results and insights are presented. The important issues of uniqueness and local uniqueness of equilibrium are sketched; they are the condition for a predictive power of the theory and its ability to allow for statics comparisons. Finally, we review the main extensions of the general equilibrium model. Besides the natural extensions to infinitely many commodities and to a continuum of agents, some examples show how economic theory can accommodate the main ideas in order to study some contexts which were not thought of by the initial model

  17. Joint Measurability and Temporal Steering

    OpenAIRE

    Karthik, H. S.; Tej, J Prabhu; Devi, A. R. Usha; Rajagopal, A. K.

    2014-01-01

    Quintino et. al. (Phys. Rev. Lett. 113, 160402 (2014)) and Uola et. al. (Phys. Rev. Lett. 113, 160403 (2014)) have recently established an intrinsic relation between non-joint measurability and Einstein-Podolsky- Rosen steering. They showed that a set of measurements is incompatible (i.e., not jointly measurable) if and only if it can be used for the demonstration of steering. In this paper, we prove the temporal analog of this result viz., a set of measurements are incompatible if and only i...

  18. Solder Joint Health Monitoring Testbed

    Science.gov (United States)

    Delaney, Michael M.; Flynn, James G.; Browder, Mark E.

    2009-01-01

    A method of monitoring the health of selected solder joints, called SJ-BIST, has been developed by Ridgetop Group Inc. under a Small Business Innovative Research (SBIR) contract. The primary goal of this research program is to test and validate this method in a flight environment using realistically seeded faults in selected solder joints. An additional objective is to gather environmental data for future development of physics-based and data-driven prognostics algorithms. A test board is being designed using a Xilinx FPGA. These boards will be tested both in flight and on the ground using a shaker table and an altitude chamber.

  19. Temporomandibular joint disorders in children.

    Science.gov (United States)

    Howard, James A

    2013-01-01

    A child's difficulty in verbalizing the precise location and nature of facial pain and jaw dysfunction often results in a nondefinitive history, increasing the importance of the dentist's awareness of the early signs and symptoms of temporomandibular joint disorders (TMD). A focused examination of the masticatory musculature, the temporomandibular joints, and associated capsular and ligamentous structures can reveal if a patient's symptoms are TMD in origin. An accurate differential diagnosis enables timely referral to appropriate health care providers and minimizes the use of diagnostic imaging.

  20. [Divorce and joint physical custody].

    Science.gov (United States)

    Golse, B

    2014-04-01

    This work first recalls the definition of joint physical custody, as well as the current legal procedure for obtaining it, its practical implementation, the financial implications for parents, and finally some statistics. Some psychological and psychopathological reflections on the impact of divorce on children are then presented before considering the question of joint physically custody with regard to attachment theory and depending on the age of the child (a great caution seems to be required before three years). The article concludes with a brief discussion of parental alienation syndrome.

  1. General Relativity

    CERN Document Server

    Canuto, V

    2015-01-01

    This is an English translation of the Italian version of an encyclopedia chapter that appeared in the Italian Encyclopedia of the Physical Sciences, edited by Bruno Bertotti (1994). Following requests from colleagues we have decided to make it available to a more general readership. We present the motivation for constructing General Relativity, provide a short discussion of tensor algebra, and follow the set up of Einstein equations. We discuss briefly the initial value problem, the linear approximation and how should non gravitational physics be described in curved spacetime.

  2. Dual joint space arthrography in temporomandibular joint disorders: Comparison with single inferior joint space arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyung Sik; Chang, Duk Soo; Lee, Kyung Soo; Kim, Woo Sun; Sung, Jung Ho; Jun, Young Hwan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1989-02-15

    The temporomandibular joint(TMJ) is really a complex of two synovial space separated by fibrocartilaginous disc. Single inferior joint space arthrography is commonly performed for evaluation of TMJ disorders, which is known to be superior in demonstrating joint dynamics. But it reveals only the inferior surface of the disc. Therefore, dual space arthrography is superior to demonstrate the soft tissue anatomic feature of the joint such as disc position and shape. Authors performed 83 TMJ arthrograms in TMJ problems. Initially, the inferior joint space was done and then the superior space was sequentially contrasted. The follow results were noted: 1. In all cases, dual space arthrography revealed accurate disc shape and positions. 2. Concordant findings between the two techniques: 68 cases (82%). Discordance between the two techniques: 15 cases (18%) 3. Possible causes of discordance between inferior and dual space arthrography. a) Normal varians of anterior recess: 3 cases b) Posterior disc displacement: 4 cases c) Influence of the patient's head position change :4 cases d) False perforation: 2 cases e) Reduction change: 2 cases 4. In 5 cases with anterior displacement, dual space arthrography gave additional findings such as adhesion within the superior space, which could not be evaluated by single inferior space.

  3. Defending the Joint Force: Lessons Learned from Joint Base Balad

    Science.gov (United States)

    2011-01-01

    the enemy’s aerial power by destroying his nests and eggs on the ground than to hunt his flying birds in the air.”1 This concept is reflected in Air...in defending its own assets and those of the joint force.  1. Giulio Douhet, The Command of the Air, trans. Dino Ferrari (1942; new imprint

  4. Focused Logistics, Joint Vision 2010: A Joint Logistics Roadmap

    Science.gov (United States)

    2010-01-01

    such best commercial business practices as Activity Based Costing ( ABC ), Activity Based Man- agement ( ABM ), and other total quality initiatives, will...Joint Warfighting Center, Fort Monroe, Virginia C-1 APPENDIX C Acronyms ABC Activity Based Costing ABM Activity Based Management ACSA Acquisition and

  5. Modeling, design, and optimization of Mindwalker series elastic joint.

    Science.gov (United States)

    Wang, Shiqian; Meijneke, Cor; van der Kooij, Herman

    2013-06-01

    Weight and power autonomy are limiting the daily use of wearable exoskeleton. Lightweight, efficient and powerful actuation system are not easy to achieve. Choosing the right combinations of existing technologies, such as battery, gear and motor is not a trivial task. In this paper, we propose an optimization framework by setting up a power-based quasi-static model of the exoskeleton joint drivetrain. The goal is to find the most efficient and lightweight combinations. This framework can be generalized for other similar applications by extending or accommodating the model to their own needs. We also present the Mindwalker exoskeleton joint, for which a novel series elastic actuator, consisting of a ballscrew-driven linear actuator and a double spiral spring, was developed and tested. This linear actuator is capable of outputting 960 W power and the exoskeleton joint can output 100 Nm peak torque continuously. The double spiral spring can sense torque between 0.08Nm and 100 Nm and it exhibits linearity of 99.99%, with no backlash or hysteresis. The series elastic joint can track a chirp torque profile with amplitude of 100 Nm over 6 Hz (large torque bandwidth) and for small torque (2 Nm peak-to-peak), it has a bandwidth over 38 Hz. The integrated exoskeleton joint, including the ballscrew-driven linear actuator, the series spring, electronics and the metal housing which hosts these components, weighs 2.9 kg.

  6. Composite failure prediction of π-joint structures under bending

    Institute of Scientific and Technical Information of China (English)

    HUANG Hong-me; YUAN Shen-fang

    2012-01-01

    In this article,the composite π-joint is investigated under bending loads.The "L" preform is the critical component regarding composite π-joint failure.The study is presented in the failure detection of a carbon fiber composite π-joint structure under bending loads using fiber Bragg grating (FBG) sensor.Firstly,based on the general finite element method (FEM)software,the 3-D finite element (FE) model of composite π-joint is established,and the failure process and every lamina failure load of composite π-joint are investigated by maximum stress criteria.Then,strain distributions along the length of FBG are extracted,and the reflection spectra of FBG are calculated according to the strain distribution.Finally,to verify the numerical results,a test scheme is performed and the experimental spectra of FBG are recorded.The experimental results indicate that the failure sequence and the corresponding critical loads of failure are consistent with the numerical predictions,and the computational error of failure load is less than 6.4%.Furthermore,it also verifies the feasibility of the damage detection system.

  7. Joint tests for quantitative trait loci in experimental crosses

    Science.gov (United States)

    Beasley, T Mark; Yang, Dongyan; Yi, Nengjun; Bullard, Daniel C; Travis, Elizabeth L; Amos, Christopher I; Xu, Shizhong; Allison, David B

    2004-01-01

    Selective genotyping is common because it can increase the expected correlation between QTL genotype and phenotype and thus increase the statistical power of linkage tests (i.e., regression-based tests). Linkage can also be tested by assessing whether the marginal genotypic distribution conforms to its expectation, a marginal-based test. We developed a class of joint tests that, by constraining intercepts in regression-based analyses, capitalize on the information available in both regression-based and marginal-based tests. We simulated data corresponding to the null hypothesis of no QTL effect and the alternative of some QTL effect at the locus for a backcross and an F2 intercross between inbred strains. Regression-based and marginal-based tests were compared to corresponding joint tests. We studied the effects of random sampling, selective sampling from a single tail of the phenotypic distribution, and selective sampling from both tails of the phenotypic distribution. Joint tests were nearly as powerful as all competing alternatives for random sampling and two-tailed selection under both backcross and F2 intercross situations. Joint tests were generally more powerful for one-tailed selection under both backcross and F2 intercross situations. However, joint tests cannot be recommended for one-tailed selective genotyping if segregation distortion is suspected. PMID:15496283

  8. Creep properties of Pb-free solder joints

    Energy Technology Data Exchange (ETDEWEB)

    Song, H.G.; Morris Jr., J.W.; Hua, F.

    2002-04-01

    Describes the creep behavior of three Sn-rich solders that have become candidates for use in Pb-free solder joints: Sn-3.5Ag, Sn-3Ag-0.5Cu and Sn-0.7Cu. The three solders show the same general behavior when tested in thin joints between Cu and Ni/Au metallized pads at temperatures between 60 and 130 C. Their steady-state creep rates are separated into two regimes with different stress exponents(n). The low-stress exponents range from {approx}3-6, while the high-stress exponents are anomalously high (7-12). Strikingly, the high-stress exponent has a strong temperature dependence near room temperature, increasing significantly as the temperature drops from 95 to 60 C. The anomalous creep behavior of the solders appears to be due to the dominant Sn constituent. Joints of pure Sn have stress exponents, n, that change with stress and temperature almost exactly like those of the Sn-rich solder joints. Research on creep in bulk samples of pure Sn suggests that the anomalous temperature dependence of the stress exponent may show a change in the dominant mechanism of creep. Whatever its source, it has the consequence that conventional constitutive relations for steady-state creep must be used with caution in treating Sn-rich solder joints, and qualification tests that are intended to verify performance should be carefully designed.

  9. Negotiating between individual and joint goals in ensemble musical performance.

    Science.gov (United States)

    MacRitchie, Jennifer; Herff, Steffen A; Procopio, Andrea; Keller, Peter E

    2017-06-06

    Successful joint action requires negotiation, especially in the event of goal incongruence. This paper addresses goal incongruence in joint musical performance by manipulating the congruence of score instructions (congruent/incongruent) regarding tempo (speed) and dynamics (sound intensity) given to piano duos. The aim is to investigate how co-performers negotiate incongruent instructions for tempo and dynamics by balancing the prioritisation of individual goals versus the joint outcome, and how this negotiation is modulated by musical expertise and personality (locus of control). Fourteen pairs of pianists, who were not informed of the congruence manipulation, were placed back-to-back and were directed to achieve a successful performance over four repeated performances without verbal communication. Interpersonal coordination generally improved from the first to final performance in the congruent and incongruent conditions for both the tempo and dynamics tasks. Furthermore, in incongruent conditions, results suggest that performers prioritise the joint performance in the tempo task, but prioritise their own performance in the dynamics task. Although individual performance appears to be modulated by musical expertise, the balance of individual/joint performance across the duo is not influenced by musical part (melody vs. accompaniment), expressive instruction, musical expertise or locus of control.

  10. Joint Service Aircrew Mask (JSAM) - Joint Strike Fighter (JSF): Speech Intelligibility Performance

    Science.gov (United States)

    2015-05-18

    AFRL-RH-WP-TP-2015-0028 Joint Service Aircrew Mask (JSAM) – Joint Strike Fighter (JSF): Speech Intelligibility Performance...COVERED (From - To) June 2014 – April 2015 4. TITLE AND SUBTITLE Joint Service Aircrew Mask (JSAM) – Joint Strike Fighter (JSF): Speech Intelligibility...Method for Measuring the Intelligibility of Speech over Communication Systems on the Joint Service Aircrew Mask (JSAM) – Joint Strike Fighter (JSF) with

  11. Experimental Investigation of the Influence of Joint Geometric Configurations on the Mechanical Properties of Intermittent Jointed Rock Models Under Cyclic Uniaxial Compression

    Science.gov (United States)

    Liu, Yi; Dai, Feng; Fan, Pengxian; Xu, Nuwen; Dong, Lu

    2017-06-01

    Intermittent joints in rock mass are quite sensitive to cyclic loading conditions. Understanding the fatigue mechanical properties of jointed rocks is beneficial for rational design and stability analysis of rock engineering projects. This study experimentally investigated the influences of joint geometry (i.e., dip angle, persistency, density and spacing) on the fatigue mechanism of synthetic jointed rock models. Our results revealed that the stress-strain curve of jointed rock under cyclic loadings is dominated by its curve under monotonic uniaxial loadings; the terminal strain in fatigue curve is equal to the post-peak strain corresponding to the maximum cyclic stress in the monotonic stress-strain curve. The four joint geometrical parameters studied significantly affect the fatigue properties of jointed rocks, including the irreversible strains, the fatigue deformation modulus, the energy evolution, the damage variable and the crack coalescence patterns. The higher the values of the geometrical parameters, the lower the elastic energy stores in this jointed rock, the higher the fatigue damage accumulates in the first few cycles, and the lower the fatigue life. The elastic energy has certain storage limitation, at which the fatigue failure occurs. Two basic micro-cracks, i.e., tensile wing crack and shear crack, are observed in cyclic loading and unloading tests, which are controlled principally by joint dip angle and persistency. In general, shear cracks only occur in the jointed rock with higher dip angle or higher persistency, and the jointed rock is characterized by lower fatigue strength, larger damage variable and lower fatigue life.

  12. General Assembly

    CERN Multimedia

    Staff Association

    2016-01-01

    5th April, 2016 – Ordinary General Assembly of the Staff Association! In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Tuesday, April 5th 2016 from 11:00 to 12:00 in BE Auditorium, Meyrin (6-2-024). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its financial management, and an opportunity to express one’s opinion, including taking part in the votes. Other points are listed on the agenda, as proposed by the Staff Council. Who can vote? Only “ordinary” members (MPE) of the SA can vote. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give his/her opinion? The Ordinary General Asse...

  13. Generalized Parabolas

    Science.gov (United States)

    Joseph, Dan; Hartman, Gregory; Gibson, Caleb

    2011-01-01

    In this article we explore the consequences of modifying the common definition of a parabola by considering the locus of all points equidistant from a focus and (not necessarily linear) directrix. The resulting derived curves, which we call "generalized parabolas," are often quite beautiful and possess many interesting properties. We show that…

  14. General discussion

    NARCIS (Netherlands)

    Jagers op Akkerhuis, Gerard A.J.M.

    2016-01-01

    The general discussion focuses on some aspects that are of overarching relevance for all the preceding chapters. The fi rst subject that is discussed is the relationship between systems theory and the philosophy of science. After a short summary of the principles of system science and the

  15. Generale preventie

    NARCIS (Netherlands)

    1949-01-01

    In part I of this study a survey has veen given of what Dutch authors have written since 1870, when capital punishment was abolished, on subjects concerning the general preventive effect of punishment. This historical survey ends where, during the years 1940-1945, under the stress of the occupation

  16. Second carpal bone slab fracture and subluxation of the middle carpal joint in a horse subsequent to arthrodesis of the carpometacarpal joint.

    Science.gov (United States)

    MacKay, Angela V; Panizzi, Luca; Sparks, Holly D; Barber, Spencer M

    2015-02-01

    To report complications of arthrodesis of the carpometacarpal (CMC) joint using a drilling technique in an adult horse. Case report. Horse (n = 1). A 12-year-old Quarter Horse mare with CMC osteoarthritis (CMC-OA) had arthrodesis under general anesthesia in right lateral recumbency. Under fluoroscopic guidance, a 4.5 mm drill bit was inserted at 3 drilling sites 5-6 cm into the CMC joint and was fanned 30-45° in the plane of the joint and 5-10° in the long axis of the limb to destroy articular cartilage and expose the subchondral bone. The horse presented 2 weeks after surgery for severe lameness of the operated limb. A slab fracture of the 2nd carpal bone (C2) and subluxation of the middle carpal (MC) joint was diagnosed. The horse was humanely euthanatized due to poor prognosis. The fanning technique of arthrodesis of the CMC joint may lead to fracture of carpal bones, joint instability, and MC joint subluxation. A balance between articular surface destruction and maintenance of joint stability should be achieved when using this technique. © Copyright 2014 by The American College of Veterinary Surgeons.

  17. Prosthesis of the wrist-joint

    Energy Technology Data Exchange (ETDEWEB)

    Feldmeier, C.

    1983-02-25

    Function of the hand-joint and the well-being of patients can be severely affected by arthrosis of the wrist-joint. Therapeutically, arthrodesis usually results in a painfree status of stiffness. A painless and well functioning joint can be achieved by alloplastic joint replacement or resurfacing. The possibilities and clinical results in cases of arthrosis of the carpo-metacarpal joint of the thumb, pseudarthrosis of the scaphoid, aseptic necrosis of the Lunate and severe arthrosis of the radio-carpal joint are demonstrated.

  18. Effects of statistical distribution of joint trace length on the stability of tunnel excavated in jointed rock mass

    Directory of Open Access Journals (Sweden)

    Kayvan Ghorbani

    2015-12-01

    Full Text Available The rock masses in a construction site of underground cavern are generally not continuous, due to the presence of discontinuities, such as bedding, joints, faults, and fractures. The performance of an underground cavern is principally ruled by the mechanical behaviors of the discontinuities in the vicinity of the cavern. During underground excavation, many surrounding rock failures have close relationship with joints. The stability study on tunnel in jointed rock mass is of importance to rock engineering, especially tunneling and underground space development. In this study, using the probability density distribution functions of negative exponential, log-normal and normal, we investigated the effect of joint trace length on the stability parameters such as stress and displacement of tunnel constructed in rock mass using UDEC (Universal Distinct Element Code. It was obtained that normal distribution function of joint trace length is more critical on the stability of tunnel, and exponential distribution function has less effect on the tunnel stability compared to the two other distribution functions.

  19. Leaving a joint audit system

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2014-01-01

    Purpose: The authors aim to exploit a natural experment in which voluntary replace mandatory joint audits for Danish listed companies and analyse audit fee implications of using one or two audit firms. Design/methodology/approach: Regression analysis is used. The authors apply both a core audit f...

  20. Diagnosis of Sacroiliac Joint Syndrome

    Directory of Open Access Journals (Sweden)

    Ya.V. Fishchenko

    2017-03-01

    Full Text Available Background. Sacroiliac joints are the cause of pain syndromes in 15–30 % of patients, who complained of pain in lumbosacral spine. In this connection, the relevant issue is the differential diagnosis of pain syndromes in the sacroiliac joint with discogenic, arthrogenic and myofascial pain syndromes. The aim of the study was to assess the informativeness of different diagnostic tests during the diagnosis of sacroiliac pain syndromes, either alone or in combination, using as a verifying procedure the diagnostic block with local anesthetic performed under X-ray control. Materials and methods. We have observed 90 patients aged from 30 to 78 years with one- or two-sided pain syndrome in the lumbosacral spine, with or without irradiation in the lower limb, its duration was more than 2 months. Results. The highest sensitivity was observed in Gaenslen’s test (83 % as compared to other tests with lower overdiagnosis (73 %. The positive predictive value of this test was equal to 79 %. Conclusions. Tests in combination with diagnostic block can effectively diagnose the pathology of sacroiliac joint and differentiate it from discogenic or arthrogenic pathology of the lumbar spine and degenerative diseases of the hip joints.

  1. Fellows Celebrated at Joint Assembly

    Science.gov (United States)

    2007-06-01

    The 2007 AGU Fellows were presented at the recent Joint Assembly in Acapulco, Mexico. A formal ceremony was held on 25 May 2007, where President Tim Killeen introduced each Fellow and read a brief statement of the achievements for which each had been selected. The presentations were followed by an honors fiesta at which family members and close colleagues further feted the honorees.

  2. What Determines Joint Venture Termination?

    DEFF Research Database (Denmark)

    Nielsen, Bo Bernhard

    2012-01-01

    Joint venture (JV) research continues to flourish as researchers seek to advance our understanding of why so many JVs fail. Cui and Kumar (this issue) take a contingency approach to explain how and why business relatedness may provide new insights as to what determines JV termination...

  3. Joint Electromagnetic Spectrum Management Operations

    Science.gov (United States)

    2012-03-20

    migrant interdiction, port waterways and coastal security); maritime stewardship (marine resources, environmental protection, aids to navigation, ice...Maritime safety (marine safety and search and rescue); (b) Maritime security (drug and migrant interdiction, port waterways and coastal security); (c...HNC to SM and frequency assignment. Joint reception , staging, onward movement, and integration, along with maintaining unit integrity, are

  4. Joint energy program makes progress

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ "Clean Energies Facing the Future," a cooperative research program jointly organized by CAS and the BP Group, has made encouraging progress, say experts at an annual sum-up workshop held on 31 July and I August at Tsinghua University in Beijing. The CAS Dalian Institute of Chemical Physics(DICP) has been entrusted as coordinator of the cooperative program between the two sides.

  5. Evading the joint decision trap

    DEFF Research Database (Denmark)

    Stenbæk, Jørgen; Jensen, Mads Christian Dagnis

    2016-01-01

    is applied, including the concept of the joint-decision trap. The paper finds that the outcome was made possible by compensating the member states that were worst affected by the policy changes. A coalition of net contributors, centered on Germany and the United Kingdom, was influential regarding the overall...

  6. Multilevel joint competing risk models

    Science.gov (United States)

    Karunarathna, G. H. S.; Sooriyarachchi, M. R.

    2017-09-01

    Joint modeling approaches are often encountered for different outcomes of competing risk time to event and count in many biomedical and epidemiology studies in the presence of cluster effect. Hospital length of stay (LOS) has been the widely used outcome measure in hospital utilization due to the benchmark measurement for measuring multiple terminations such as discharge, transferred, dead and patients who have not completed the event of interest at the follow up period (censored) during hospitalizations. Competing risk models provide a method of addressing such multiple destinations since classical time to event models yield biased results when there are multiple events. In this study, the concept of joint modeling has been applied to the dengue epidemiology in Sri Lanka, 2006-2008 to assess the relationship between different outcomes of LOS and platelet count of dengue patients with the district cluster effect. Two key approaches have been applied to build up the joint scenario. In the first approach, modeling each competing risk separately using the binary logistic model, treating all other events as censored under the multilevel discrete time to event model, while the platelet counts are assumed to follow a lognormal regression model. The second approach is based on the endogeneity effect in the multilevel competing risks and count model. Model parameters were estimated using maximum likelihood based on the Laplace approximation. Moreover, the study reveals that joint modeling approach yield more precise results compared to fitting two separate univariate models, in terms of AIC (Akaike Information Criterion).

  7. Joint IGCP 499/SDS Meeting

    Institute of Scientific and Technical Information of China (English)

    Peter K(o)nigshof; Eberhard Schindler; Volker Wildez; Jurga Lazauskiene; M. Namik Yal(c)in

    2006-01-01

    @@ A major event of IGCP 499 in 2005 took place in Southern Siberia. In the tradition of successful joint meetings and field trips of Devonian IGCP projects and the international Subcommission on Devonian Stratigraphy (SDS), a very successful meeting was held at the Institute of Petroleum Geology,United Institute of Geology and Mineralogy of the Russian Academy of Sciences, Siberian Branch in Novosibirsk.

  8. Lower limb joint forces during walking on the level and slopes at different inclinations.

    Science.gov (United States)

    Alexander, Nathalie; Schwameder, Hermann

    2016-03-01

    Sloped walking is associated with an increase of lower extremity joint loading compared to level walking. Therefore, the aim of this study was to analyse lower limb joint compression forces as well as tibiofemoral joint shear forces during sloped walking at different inclinations. Eighteen healthy male participants (age: 27.0 ± 4.7 years, height: 1.80 ± 0.05 m, mass: 74.5 ± 8.2 kg) were asked to walk at a pre-set speed of 1.1m/s on a ramp (6 m × 1.5 m) at the slopes of -18°, -12°, -6°, 0°, 6°, 12° and 18°. Kinematic data were captured with a twelve-camera motion capture system (Vicon). Kinetic data were recorded with two force plates (AMTI) imbedded into a ramp. A musculoskeletal model (AnyBody) was used to compute lower limb joint forces. Results showed that downhill walking led to significantly increased hip, tibiofemoral and patellofemoral joint compression forces (pjoint compression forces (pjoint compression forces with increasing inclination (pligament could not be supported in the current study, since anterior tibiofemoral joint shear forces did not increase with the gradient. Due to diverse tibiofemoral joint shear force patterns in the literature, results should be treated with caution in general. Finally, lower limb joint force analyses provided more insight in the structure loading conditions during sloped walking than joint moment analyses.

  9. Double dislocation of finger interphalangeal joints.

    Science.gov (United States)

    Jahangiri, Saqib Aziz; Mestha, Prabhakar; McNally, Scarlett

    2012-10-22

    A 62-year-old, right-hand-dominant man who had dementia and lived in an Elderly Mentally Infirm (EMI) nursing home was admitted through Accident & Emergency (A&E) department following unwitnessed injury to the left little finger. His examination revealed a swollen and deformed left little finger with a laceration along the middle crease on the volar aspect and head of proximal phalanx visible through this. Distally sensations and capillary refill was normal. X-rays showed a double dislocation of both proximal and distal interphalangeal joints. The finger was reduced under ring block and the laceration was washed with saline in A&E. The patient was taken to the operation theatre next morning for wound exploration and wash-out±stabilistion of the finger under general anaesthesia. The wound was thoroughly washed out and closed with 4/0 interrupted nylon. The finger was immobilised with neighbour strapping and bandaged in flexion.

  10. Modeling strategy for clinched joints in assemblies

    Science.gov (United States)

    Breda, A.; Coppieters, S.; Debruyne, D.

    2016-08-01

    Clinching is a mechanical joining technique which involves severe local plastic deformation of two or more metal sheet parts resulting in a permanent mechanical interlock. Today, it is a reliable joining technique used in automotive, HVAC and general steel constructions whilst still gaining interest. As it is not computationally feasible to include detailed sub models of these type of joints in FE simulations of real-life clinched assemblies, this paper proposes a methodology to represent these connections with simplified elements. In order to calibrate the parameters governing the equivalent model, a simple shear lap and pullout test is used. This methodology is applied to clinched configurations and validated using a modified Arcan test in which both shear and pull-out loads are considered.

  11. [General psychotherapy].

    Science.gov (United States)

    Vymetal, J

    2003-01-01

    Nowadays a theoretical psychotherapeutical thinking develops from the eclectic practice and uses particularly the research of the effective factors of the therapy. Best they can be characterized as differentiate, synthetic, integrative and exceeding other approaches. The development in question goes on with attempts of creating a general model of the psychotherapy that could be a basis for models of special psychotherapies. The aim of such a model is to describe all that is present as important factor for inducing a desirable change of a human in all psychotherapeutical approaches. Among general models we can mention the generic model of D. E. Orlinski and K. I. Howard, Grawe's cube (the author is K. Grawe) and the equation of the psychotherapy.

  12. Generalized polygons

    CERN Document Server

    Maldeghem, Hendrik

    1998-01-01

    This book is intended to be an introduction to the fascinating theory ofgeneralized polygons for both the graduate student and the specialized researcher in the field. It gathers together a lot of basic properties (some of which are usually referred to in research papers as belonging to folklore) and very recent and sometimes deep results. I have chosen a fairly strict geometrical approach, which requires some knowledge of basic projective geometry. Yet, it enables one to prove some typically group-theoretical results such as the determination of the automorphism groups of certain Moufang polygons. As such, some basic group-theoretical knowledge is required of the reader. The notion of a generalized polygon is a relatively recent one. But it is one of the most important concepts in incidence geometry. Generalized polygons are the building bricks of Tits buildings. They are the prototypes and precursors of more general geometries such as partial geometries, partial quadrangles, semi-partial ge­ ometries, near...

  13. Hypothyroidism: Does It Cause Joint Pain?

    Science.gov (United States)

    Hypothyroidism: Does it cause joint pain? Can hypothyroidism cause joint pain? I have hypothyroidism and have been experiencing severe arthritis-like pain in my shoulders and hips. Answers from Todd B. ...

  14. Joint Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Joint Disorders URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Joint Disorders - Multiple Languages To use the sharing features on ...

  15. Organizational aspects of physician joint ventures.

    Science.gov (United States)

    Rublee, D A; Rosenfield, R H

    1987-03-01

    This article describes organizational forms of physician joint ventures. Four models are described that typify physician involvement in health care joint ventures: limited partnership syndication, venture capital company, provider network, and alternative delivery system. Important practical issues are discussed.

  16. The Joint Narrative: Describing the Future Environment and Joint Operations

    Science.gov (United States)

    2009-01-01

    existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding...forces. Military procurement programs that take decades may be obso - lesced in an afternoon by new technological innovations. Meanwhile, faraway...problem that has been set out. It is the Big How, the “concept of the concept.” In the case of the CCJO, it is a single concept for how joint forces

  17. Implementing Joint Operational Access: From Concept to Joint Force Development

    Science.gov (United States)

    2014-01-01

    global commons.2 Potential enemies are developing antiaccess/area-denial (A2/AD) capabilities3 that could threaten access and jeopardize missions...efforts in U.S. 5th Fleet area of responsibility (U.S. Navy/Travis K. Mendoza ) Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting...Military Sealift Command fleet replenishment oiler USNS Guadalupe conduct replenishment at sea (U.S. Navy/Travis K. Mendoza ) 142 Joint Doctrine

  18. Joint laxity in the performing arts.

    Science.gov (United States)

    Bird, H

    2016-05-25

    Traditional scoring systems for the assessment of joint flexibility are reviewed and reasons for variation in joint laxity are defined. The value of controlled joint laxity in the hands and arms of musicians is then discussed as well as the desirability of adjusting laxity at the various joints used in the different styles of dance, some of them ethnic, that depend on the specific articular characteristics of each different dancer.

  19. Flexible joints in structural and multibody dynamics

    OpenAIRE

    O. A. Bauchau; Han, S.

    2013-01-01

    Flexible joints, sometimes called bushing elements or force elements, are found in all structural and multibody dynamics codes. In their simplest form, flexible joints simply consist of sets of three linear and three torsional springs placed between two nodes of the model. For infinitesimal deformations, the selection of the lumped spring constants is an easy task, which can be based on a numerical simulation of the joint or on experimental measurements. If the joint undergoes finite deformat...

  20. Revamped, joint ventures make a comeback.

    Science.gov (United States)

    Peters, G R

    1991-08-01

    After a period of declining popularity, joint ventures are beginning to re-emerge as viable solution to challenges facing health care. Future joint ventures likely will be different, however, in response to problems and resulting legislation. Healthcare providers interested in starting a joint venture should consider five basic formats and some guidelines for developing them. Joint ventures ultimately may become a focal point for renewed efforts at regional healthcare planning.

  1. Seismic response of rock joints and jointed rock mass

    Energy Technology Data Exchange (ETDEWEB)

    Ghosh, A.; Hsiung, S.M.; Chowdhury, A.H. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses

    1996-06-01

    Long-term stability of emplacement drifts and potential near-field fluid flow resulting from coupled effects are among the concerns for safe disposal of high-level nuclear waste (HLW). A number of factors can induce drift instability or change the near-field flow patterns. Repetitive seismic loads from earthquakes and thermal loads generated by the decay of emplaced waste are two significant factors. One of two key technical uncertainties (KTU) that can potentially pose a high risk of noncompliance with the performance objectives of 10 CFR Part 60 is the prediction of thermal-mechanical (including repetitive seismic load) effects on stability of emplacement drifts and the engineered barrier system. The second KTU of concern is the prediction of thermal-mechanical-hydrological (including repetitive seismic load) effects on the host rock surrounding the engineered barrier system. The Rock Mechanics research project being conducted at the Center for Nuclear Waste Regulatory Analyses (CNWRA) is intended to address certain specific technical issues associated with these two KTUs. This research project has two major components: (i) seismic response of rock joints and a jointed rock mass and (ii) coupled thermal-mechanical-hydrological (TMH) response of a jointed rock mass surrounding the engineered barrier system (EBS). This final report summarizes the research activities concerned with the repetitive seismic load aspect of both these KTUs.

  2. Acupuncture Therapy on Temporomandibular Joint Syndrome

    Institute of Scientific and Technical Information of China (English)

    XIA Nai-nian; HUANG Ming-juan

    2005-01-01

    @@ Temporomandibular Joint (TMJ) syndrome, an commonly and frequently encountered disease, is characterized by motor dysfunction of mandibular joint and snapping articular surface as major complaints, and then tinnitus, facial pain and occasional headache, most patients got limited mouth open and pain inside the joints or masseter muscle. The authors of this article have treated 68cases of TMJ syndrome since 2001.

  3. Joints in deployable space truss structures

    Science.gov (United States)

    Rhodes, M.

    1988-01-01

    Since the response of deployable structural concepts being considered for the Large Deployable Reflector (LDR) backup structure will be dominated by the response of joints, the joint characteristics are significant. An overview is given of the research activities at LaRC on the static behavior of joints for deployable space truss structures. Since a pin-clevis-type joint will be utilized in deployable structures, an experimental research program to characterize the joint parameters which affect stiffness was conducted. An experimental research program was conducted on a second type of joint, referred to as a near-center latch joint. It was used in the center of members on the deployable truss structure for the Control of Flexible Structures (COFS) flight experiment. The test results of the near-center latch joint and the member with the joints indicated that the stiffness of the near-center joint is linear and stiffer than the stiffness of the total member, and that non-linearities in the stiffness characteristics of the total member were due to bending introduced at the ends of the member. The resulting data indicates that stiff linear folding joints can be designed and that bending load paths should be avoided whenever possible. In summary, for deployable structures, special attention to the joint and the structure design is required to minimize the undesirable structural non-linearities.

  4. 22 CFR 228.34 - Joint ventures.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Joint ventures. 228.34 Section 228.34 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON SOURCE, ORIGIN AND NATIONALITY FOR COMMODITIES AND... Financing § 228.34 Joint ventures. A joint venture or unincorporated association is eligible only if each...

  5. Molecular monitoring of equine joint homeostasis

    NARCIS (Netherlands)

    de Grauw, J.C.

    2010-01-01

    Chronic joint disorders are a major cause of impaired mobility and loss of quality of life in both humans and horses. Regardless of the primary insult, any joint disorder is characterized by an upset in normal joint homeostasis, the balance between tissue anabolism and catabolism that is normally ma

  6. Joint prosthesis and method of bone fixation

    NARCIS (Netherlands)

    Oosterom, R.; Van der Pijl, A.J; Bersee, H.E.N.; Van der Helm, F.C.; Herder, J.L

    2006-01-01

    The invention relates to a joint prosthesis (10), for example, a knee joint or shoulder joint prosthesis comprising a first, socket-holding prosthesis part (11) for attachment to a first bone (12) and a second, ball-holding prosthesis part (13) for attachment to a second bone (14) that intermates wi

  7. 47 CFR 76.912 - Joint certification.

    Science.gov (United States)

    2010-10-01

    ... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.912 Joint certification. (a) Franchising authorities..., joint hearings, data collection, and ratemaking. Franchising authorities jointly certified to regulate their cable system(s) may make independent rate decisions. (b) Franchising authorities may apply...

  8. 30 CFR 36.24 - Engine joints.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Engine joints. 36.24 Section 36.24 Mineral... Construction and Design Requirements § 36.24 Engine joints. (a) Cylinder head. The joint between the cylinder head and block of the engine shall be fitted with a metal or metal-clad gasket satisfactory to...

  9. 18 CFR 154.307 - Joint facilities.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Joint facilities. 154... Changes § 154.307 Joint facilities. The Statements required by § 154.312 must show all costs (investment... in the subject rate change and are associated with joint facilities. The methods used in making such...

  10. Management of osteoarthrosis of the thumb joints.

    Science.gov (United States)

    Berger, Aaron J; Meals, Roy A

    2015-04-01

    We present current concepts and evidence to optimize diagnosis and management of osteoarthritis in the thumb joints. Numerous options and controversies exist for surgical treatment of carpometacarpal joint arthritis. Fewer options exist for metacarpophalangeal joint arthritis. Surgical treatment for interphalangeal arthritis is mainly arthrodesis.

  11. Space shuttle SRM field joint: Review paper

    Directory of Open Access Journals (Sweden)

    S. Mohammad Gharouni

    2014-09-01

    Full Text Available Due to Challenger space shuttle accident in 1986, significant research has been done concerning structural behavior of field joints in solid rocket boosters (SRB. The structural deformations between the clevis inner leg and the tang (male-to-female parts of joint, the sealing of the O-ring to prevent the hot gas in joints, has been neglected causing the failure of the vehicle. Redesigning the field joint in SRB engine by accurate analysis of dynamic and thermal loads and by design of insulator and good O-ring, the leakiness of combustion hot gases was eliminated. Some parts of field joint such as capture feature (CF and its third O-ring, J-leg insulator and shim were added to redesigned field joint. Also, some adjustments in sealing system and pins were done to promote the efficiency of the field joint. Due to different experimental analysis on assembled field joints with default imperfections, redesigned joints operated well. These redesigned field joints are commonly used in aerospace and mechanical structures. This paper investigates the original and the redesigned field joints with additional explanations of different parts of the redesigned joints.

  12. Applications of Joint Tactical Simulation Modeling

    Science.gov (United States)

    1997-12-01

    NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS APPLICATIONS OF JOINT TACTICAL SIMULATION MODELING by Steve VanLandingham December 1997...SUBTITLE APPLICATIONS OF JOINT TACTICAL SIMULATION MODELING 5. FUNDING NUMBERS 6. AUTHOR(S) VanLandingham, Steve 7. PERFORMING ORGANIZATION NAME(S...release; distribution is unlimited. APPLICATIONS OF JOINT TACTICAL SIMULATION MODELING Steve VanLandingham Lieutenant, United States Navy B.S

  13. Molecular monitoring of equine joint homeostasis

    NARCIS (Netherlands)

    de Grauw, J.C.

    2010-01-01

    Chronic joint disorders are a major cause of impaired mobility and loss of quality of life in both humans and horses. Regardless of the primary insult, any joint disorder is characterized by an upset in normal joint homeostasis, the balance between tissue anabolism and catabolism that is normally ma

  14. Paying for Joint or Single Audits? The Importance of Auditor Pairings and Differences in Technology Efficiency

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2016-01-01

    In the first theoretical paper on joint audits, Deng et al. predict that the audit fees for joint audits will be lower than those from single audits. However, the prediction depends on the combination of audit firms involved in the joint audit and on their technology efficiency as well...... as on the liability involved. This paper is the first to empirically test the predictions. Our findings from Denmark do not indicate any general difference in audit fees when two audit firms – regardless of combination and technology efficiency – conduct the statutory audit compared to a single Big audit firm....... The results indicate the existence of fixed coordination costs in joint audits. We do, however, find higher audit fees in Big-Small joint audits when the Small audit firm has a share of less than 25 per cent. This may reflect free-riding concerns....

  15. Manual therapy of the mandibular accessory ligaments for the management of temporomandibular joint disorders.

    Science.gov (United States)

    Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico

    2011-02-01

    Temporomandibular joint disorders are characterized by chronic or acute musculoskeletal or myofascial pain with dysfunction of the masticatory system. Treatment modalities include occlusal splints, patient education, activity modification, muscle and joint exercises, myofascial therapy, acupuncture, and manipulative therapy. In the physiology of the temporomandibular joint, accessory ligaments limit the movement of the mandible. A thorough knowledge of the anatomy of accessory ligaments is necessary for good clinical management of temporomandibular joint disorders. Although general principles regarding the anatomy of the ligaments are relatively clear, very little substantiated information on the dimension, orientation, and function of the ligaments has been published, to the authors' knowledge. The authors review the literature concerning the accessory ligaments of the temporomandibular joint and describe treatment options, including manual techniques for mobilizing the accessory ligaments.

  16. Study of the dynamic behavior of a bolted joint under heavy loadings

    Science.gov (United States)

    Daouk, Sami; Louf, François; Cluzel, Christophe; Dorival, Olivier; Champaney, Laurent; Audebert, Sylvie

    2017-03-01

    In structural dynamics, the quantification of the quality and reliability of numerical models remains a relevant issue. While the behavior of structures such as beams and plates is generally understood, a large number of industrial structures are bolted assemblies of many components with connections that are not well understood. The main reason for this lack of understanding is that the dynamical behavior of the whole assembly depends critically upon joint conditions, especially under heavy loadings. For the purpose of improving our understanding and the development of pertinent models, a dynamic test bed, based on a bolted structure, is designed and modal testing is performed. The configuration of the bolted joint and the level of the loading are the relevant parameters, related to joint conditions, that are considered in this study. The results of the experimental campaign show the variation of the dissipation in a bolted joint and its apparent stiffness as a function of joint conditions.

  17. 77 FR 41877 - International Joint Commission; International Joint Commission To Hold Public Hearings on Lake...

    Science.gov (United States)

    2012-07-16

    ... International Joint Commission; International Joint Commission To Hold Public Hearings on Lake Osoyoos The International Joint Commission (IJC) is inviting the public to comment on recommendations for the renewal of its... of the International Joint Commission's Osoyoos Lake Order now posted on the IJC Web......

  18. Quantitative Methods for Analysing Joint Questionnaire Data: Exploring the Role of Joint in Force Design

    Science.gov (United States)

    2015-08-01

    UNCLASSIFIED UNCLASSIFIED Quantitative Methods for Analysing Joint Questionnaire Data: Exploring the Role of Joint in Force Design David...joint activities selected by respondents, and the small sample size, quantitative analysis was conducted on the collected data. This statistical...APPROVED FOR PUBLIC RELEASE UNCLASSIFIED UNCLASSIFIED Quantitative Methods for Analysing Joint Questionnaire Data: Exploring the Role of

  19. Proximal tibiofibular joint: Rendezvous with a forgotten articulation

    Directory of Open Access Journals (Sweden)

    Amitav Sarma

    2015-01-01

    Full Text Available The proximal tibiofibular joint (PTFJ is a plane type synovial joint. The primary function of the PTFJ is dissipation of torsional stresses applied at the ankle and the lateral tibial bending moments besides a very significant tensile, rather than compressive weight bearing. Though rare, early diagnosis and treatment of the PTFJ dislocation are essential to prevent chronic joint instability and extensive surgical intervention to restore normal PTFJ biomechanics, ankle and knee function, especially in athletes prone to such injuries. PTFJ dislocations often remain undiagnosed in polytrauma scenario with ipsilateral tibial fracture due to the absence of specific signs and symptoms of PTFJ injury. Standard orthopedic textbooks generally describe no specific tests or radiological signs for assessment of the integrity of this joint. The aim of this paper was to review the relevant clinical anatomy, biomechanics and traumatic pathology of PTFJ with its effect on the knee emphasizing the importance of early diagnosis through a high index of suspicion. Dislocation of the joint may have serious implications for the knee joint stability since fibular collateral ligament and posterolateral ligament complex is attached to the upper end of the fibula. Any high energy knee injury with peroneal nerve palsy should immediately raise the suspicion of PTFJ dislocation especially if the mechanism of injury involved knee twisting in flexion beyond 80° and in such cases a comparative radiograph of the contralateral side should be performed. Wider clinical awareness can avoid both embarrassingly extensive surgeries due to diagnostic delays or unnecessary overtreatment due to misinformation on the part of the treating surgeon.

  20. Cartesian stiffness matrix of manipulators with passive joints: analytical approach

    CERN Document Server

    Pashkevich, Anatoly; Caro, Stéphane; Chablat, Damien

    2011-01-01

    The paper focuses on stiffness matrix computation for manipulators with passive joints. It proposes both explicit analytical expressions and an efficient recursive procedure that are applicable in general case and allow obtaining the desired matrix either in analytical or numerical form. Advantages of the developed technique and its ability to produce both singular and non-singular stiffness matrices are illustrated by application examples that deal with stiffness modeling of two Stewart-Gough platforms.